• Journal of Korean Neurosurgical Society
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• 제49권3호
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• pp.153-156
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• 2011

Objective : This prospective, non-randomized study compared the safety and efficacy of the Angio-$Seal^{TM}$ $Evolution^{TM}$ to that of manual compression for common femoral artery punctures in neurovascular diagnostic angiography. Methods : From June 2009 to September 2009, we performed 169 diagnostic trans-femoral cerebral angiographies, using either the Angio-$Seal^{TM}$ $Evolution^{TM}$ or manual compression to achieve hemostasis. We included 60 patients in this study, 30 in each group. We defined minor complications as those requiring no further treatment such as hematoma size less than 6 cm and bruise size less than 25 cm. Major complications were those requiring surgery of the femoral artery pseudoaneurysm and/or the second line increase of hospital stay even without further treatment. Results : Mean time to hemostasis was $0.42{\pm}0.04$ minutes for the angioseal and $15.83{\pm}1.63$ minutes for manual compression (p<0.001). Overall complication rate did not differ between the 2 groups. After the patients were fully mobile, at 24 hours, the rate of onset of new complication differed significantly between the 2 groups (p=0.032). In the angioseal group, 5 (16.7%) of the 30 patients experienced the onset of a new complication after 24 hours, including 3 (60.0%) of the 5 who experienced major complications. Conclusion : The Angio-$Seal^{TM}$ $Evolution^{TM}$ is effective at decreasing mean time to hemostasis, like other closing devices. However, it may not be effective at producing early ambulation and discharge, compared to manual compression, because delayed complications may occur significantly after 24 hours.

• Archives of Reconstructive Microsurgery
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• 제2권1호
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• pp.82-92
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• 1993

A comparative study was undertaken to evaluate the contact Neo-dymium : yttrium aluminum garnet(Nd:YAG) laser system for vascular anastomosis of small caliber blood vessels(diameter 0.5-1.2 mm) in the animal model. In this study 40 femoral arteries and 40 femoral veins of Sprague-Dawley rats were anastomosed by contact laser assisted microvascular anastomosis(LAMA) utilizing 3 stay sutures which were placed 120 degrees apart and the intervals welded with contact Nd:YAG laser unit, conventionally sutured anastomosis(CSA) served as controls. The time needed for vascular anastomosis, patency rate(immediate postoperative, postoperative 2nd day, postoperative 1 week, postoperative 4 weeks), gross and microscopic evaluations were compared to conventional microsurgical suture technique. The results are as follows: 1. Postoperative patency rate was 82.5% for femoral artery and 75% for femoral vein by contact LAMA technique compared to 90% and 75% by CSA technique at postoperative 4 weeks. 2. Less time-consumed for arterial anastomosis by 6 minutes 23 seconds and venous anastomosis by 8 minutes 55 seconds with contact LAMA technique compared to CSA technique. 3. Grossly almost complete healing had taken place by postoperative 1 week by contact LAMA technique. 4. Aneurysm formation was 5% for femoral artery and 15% for femoral vein by contact LAMA technique compared to 5% and 10% respectively by CSA technique. 5. Microscopically, re-endothelization was complete by postoperative 7th day by contact LAMA technique. There was less medial hypertrophy and hyperplasia and also less inflammatory response compared to CSA.

• Journal of Chest Surgery
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• 제23권4호
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• pp.791-798
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• 1990

Takayasu’s disease produces the occlusive and aneurysmal lesions of major branches of the aorta. Angiography is the most important diagnostic procedure in Takayasu’s disease. Surgical treatment is often justified to avoid the possible lethal consequences of hypertension on the heart, kidney, and brain, as well as in the case of aneurysm because of its risk of rupture. We experienced one case of the Takayasu’s disease associated with abdominal coarctation and renovascular hypertension. The patient was 17 years old female and had suffered from hypertension for 14 months. On physical examination, BP was 150/100 mmHg in the right arm and 120/80 mmHg in the left arm. The pulses of the left brachial and femoral arteries were weakly palpable. Aortogram showed the stenosis of the left common and subclavian arteries, coarctation of the abdominal aorta, and stenosis of the right renal artery and complete occlusion of the left renal artery. The stenosis of the right renal artery and the occlusion of the left renal artery produced the renovascular hypertension. She underwent aorta-aortic bypass for the coarctation of the abdominal aorta and aorta-renal bypass for treatment of renovascular hypertension Postoperatively, both femoral pulses were equally palpable. On discharge, antihypertensive drugs were discontinued. She has remained normotensive for last one year.

• Journal of Chest Surgery
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• 제26권11호
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• pp.833-837
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• 1993

In an effort to reduce the stroke rate of patients after coronary artery bypass, many authors have studied the prevalence of the extracranial carotid disease and its role in determining neurologic morbidity and mortality rates. From April 1992 to August 1993, Seventy-five patients undergoing coronary artery bypass were preoperatively evaluated for presence of carotid and femoral stenosis by Duplex sono. Among them, fourteen patients was positive by Duplex sono and overall prevalence of carotid or femoral stenosis was 18.7%. And significant carotid stenosis [ > 60% ] had proved to be in 3 patients [ 4.0% ].Prophylatic bilateral carotid endarterectomy was performed in one patient, at 5 months prior to and , 1 week prior to coronary artery bypass respectively. Their mean age was 57.6 years [ ranged from 40 to 70 years] and were composed of 10 males and 4 females. There was no postoperative morbidiry and mortality related to neurologic complications. Our data, although small, suggest that preoperative carotid screening is helpful to determine patients at high risk of stroke, and significant simultaneous carotid and coronary atherosclerosis should be corrected in selected patients by staged operations when feasible.

• 동아시아식생활학회지
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• 제15권5
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• pp.606-612
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• 2005

This study was performed to provide basic data that predict the application of Saengmaegsan(SMS) as medicinal food. SMS has been used in oriental medicine for many years as a therapeutic agent for cerebral disease. We examined the effects of SMS on physiological function in isolated abdominal aorta and femoral artery from rabbit and measured the changes of regional cerebral hood flow(rCBF), which was continually monitored by laser-doppler flowmeter and pressure transducer in anesthetized adult Spargue-Dawley rats through the data acquisition system composed of MacLab and Macintosh computer. The contraction forces by injection of norephinephrine in isolated abdominal aorta and femoral artery were significantly decreased in each concentration of SMS treatment compared with control. rCBF was increased by SMS in a dose-dependent manner. These results suggest that SMS causes a diverse response of rCBF and arterial diameter. These mechanism in rCBF increase may be mediated by prostaglandis, cyclic GMP and adrenergic $\beta-receptor$. Also mechanism in artery contraction decrease is also mediated by prostaglandis and cyclic GMP. These results indicate that SMS can be nsed as a safe and clinically applicable as a supplementation of diet therapy for cerebral cardiovascular disease patients.

• Archives of Plastic Surgery
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• 제34권2호
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• pp.274-277
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• 2007

Purpose: Microsuturing is a difficult job for beginners of microsurgery. It is because they are not familiar with microscopic environment and, it needs much time for them to get used to microanastomosis. Before the real microsurgery, sometimes a surgeon wants rehearsal. But, microsurgical exercise has been performed with surgical glove, silastic drain or rat femoral artery. Rat femoral artery is a very good training material. But, it needs animal laboratory, anesthesia and its keeping facilities. And the surgeon should appoint the time to exercise with the laboratory. Methods: We used chicken wing brachial artery for education material of microsuturing. The artery is 5 cm long and the diameter is about 1 mm. Monofilament 10-0 was used for suture material. Results: Six persons of Seoul National University medical school students and one resident attended in this program. Each of them performed arterial anastomosis ten times. They were satisfied with chicken wing brachial artery for anastomosis training under the magnification environment. Conclusion: We think that chicken wing brachial artery is a very cheap and an effective training material for the beginners of microsurgery.

• 대한한방내과학회지
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• 제31권3호
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• pp.467-476
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• 2010

Object : The purpose of this study was to investigate the correlation of atherosclerosis risk factors and pulse wave velocity (PWV) of carotid-femoral artery with Sasang constitution. This study also aimed to investigate the relationship between PWV and risk factors of atherosclerosis, including serum cholesterol and homosisteine, hs-CRP. Methods : We enrolled 160 patients without experience strokes who visited our hospital for a medical examination from January 1, 2008 to April 30, 2010 except patients whose body constitutions were undetermined according to QSCCII. We investigated the correlation between serum cholesterol values, blood pressure, body mass index(BMI), homosistein, hs-CRP and PWV. Pearson's correlation and partial correlation analysis were applied to examine the relationship between PWV and risk factors of atherosclerosis. Result : Among the 160 subjects, 54 were Taeumin, 54 were Soyangin, and 52 were Soeumin. The prevalences of high BMI (P-value <0.01), high hs-CRP(P-value <0.05), and high PWV(P-value <0.05) of Taeumin were higher than those of the other constitutions. PWV of carotid-femoral artery was significantly different among the three constitutional groups(Taeumin: $8.12{\pm}1.64m/sec$, Soyangin: $7.48{\pm}1.16m/sec$, Soeumin: $7.49{\pm}1.12m/sec$)(P-value <0.05). This research has show a statistical significance between the average amount of carotid-femoral artery PWV that is higher in Taeumin. Age factor of Taeumin was the effective determinant of the increase of mean PWV of carotid-femoral arteries. Conclusions : There were significant differences in the prevalence of atherosclerosis according to Sasang constitution. This study showed that atherosclerosis was more prevalent in Taeumin. Therefore, according to our results, risk of atherosclerosis was higher in Taeumin than among other constitutions.

• Journal of Chest Surgery
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• 제46권5호
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• pp.369-372
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• 2013

While popliteal artery aneurysm is the most common form of peripheral artery aneurysm, it is a rare condition in the general population. Furthermore, a giant popliteal artery aneurysm has not previously been reported in Korea. A 67-year-old male presented with left thigh pain that had begun 4 months earlier and was aggravated when in a sitting position. We found a giant aneurysm on the left popliteal artery and performed a bypass from the common femoral artery to the distal popliteal artery below the knee, using the autologous greater saphenous vein, and excluded the aneurysm at the sites of anastomoses.

• Journal of Chest Surgery
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• 제30권7호
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• pp.724-728
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• 1997

68세된 남자로 좌측과 후측 흉부에 통증을 주소로 내원하였다. 술전 시행한 흉복부 W scan에서 대동맥류는 좌측 쇄골하동맥에서 횡격막까지 연결되었고 긴박성 파열의 소견도 보였다. 또한 술전 관동맥조영술에서는 좌회선동맥에 95%, 좌전하행지에 50%의 협착소견을 보였다. 수술은 고동맥-고정맥 우회술을 하면서 좌측 제 4늑간을 통하여 측후방 개흉절개를 하여 수술시야를 확보하였고 대동맥을 차단한뒤 대동맥류를 절개하고 인조혈관으로 대치하였다. 그리고 심박동하에서 대복제정 맥을 이용하여 좌회선동맥의 두번째 둔각변연동맥과 좌측 쇄골하동맥 기시부에 관상동맥 우회술을 하였다. 술후 환자는 술중 저혈압성 쇼크와 저산소증으로 다발성 뇌경색의 합병증을 보였다.

• 대한골관절종양학회지
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• 제3권1호
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• pp.39-46
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• 1997

The pasteurization of bone tumor shows necrosis of tumor tissue and it is used widely as one of the options of limb salvage operation. However malignant tumors of the extremities commonly involve major neurovascular structures and pasteurization of this structure will make limb salvage operation much easier and safer than autogenous vein graft or artificial vessel graft. So the purpose of this study is to evaluate that the pasteurization can be applied in the limb salvage surgery of malignant tumor involving major vessels by means of studying the patency of pasteurized femoral vessels of the dogs. The right femoral arteries of 5 to 7 mm in diameters and veins of 7 to 10 mm in diameters of five dogs were pasteurized with sterile $60^{\circ}C$ saline for 30 minutes. Contralateral femoral vessels were evaluated for the control study. After one month, the changes in the pasteurized femoral vessels were evaluated by physical examinations, femoral angiography, gross findings, and pathologic findings on the each side. One month after pasteurization, the pulse of the femoral and popliteal arteries was palpated with normal tone on the each side of the all five experimental animals, and there was no gross swelling or necrotic changes in the legs. Femoral angiography showed a good patency of femoral and popliteal arteries. On the gross examinations at time of sampling of the specimen for the pathologic examinations, there was a good patency of femoral artery and vein, and mild fibrous adhesion was noted around the pasteurized femoral vessels. On the pathologic examinations, the more fibrotic adhesion and neocapillarization were noted in the outer layer of adventitia of the pasteurized femoral arteries and veins than the control sides. The vascular lumina were also patent in all cases. With these results, we suggest that the malignant tumor of the extremity involving major vessels is possibly treated by the limb salvage operation using the pasteurization of the involved vessels.