• Title/Summary/Keyword: graft occlusion

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Hemodynamic Interpretation of Various Extraanatomical Bypasses: Clinical & Engineering Views

  • Lee, Byung-Boong;Kim, Young-Wook;Suh, Sang-Ho;Roh, Hyung-Woon;Kim, Dong-Ik;Yoo, Sang-Sin;Cho, Min-Tae;Huh, Sung
    • International Journal of Vascular Biomedical Engineering
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    • v.1 no.1
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    • pp.32-40
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    • 2003
  • Axillo-bifemoral (Ax-Fem) bypass are now well accepted for bilateral iliac artery occlusion as the second best option. This extra-anatomical (unnatural) bypasses, however, have various hemodynamic liabilities affecting the patency. Hemodynamic conditions of each different type of Ax-Fem bypass were assessed with computer simulation model to determine the hemodynamically more sound type. Simulation models of five different types of Ax-Fem bypass were constructed. Our investigation based on the computer simulation models have shown distinct differences between two most popular Lazy-S type and Inverted-C type on the distribution of flow volume, shear stress and recirculation zone, etc., though both types have shown similar clinical results. Lazy-S type has shown better hemodyanmic status than inverted-C type. The theoretical advantage of "Lazy-S" type has never been adequately proved for its superiority clinically over the inverted-C type. Inverted-C type is now in more favor with clinically better results in spite of many hemodynamic liabilities including retrograde flow to the branching graft. The improvement of over-all long-term patency rate of various extra-anatomical bypasses is still warranted through proper correction of the hemodynamic liability. Even though clinical outcome of the extra-anatomical bypass has been equal regardless of the type of crossover femoral graft configuration, there are distinct differences on the hemodynamic characteristics among various types of configuration. Further hemodynamic study in the pulsatile flow status is warranted to correct hemodynamic defects with proper modification of various hemodynamic factors of each model.

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Guided Bone Regeneration using Fibrin Glue in Dehiscence or Fenestration Defects Occurred by Maxillary Anterior Implants: Case Report (상악 전치부 임플란트 식립에 의한 열개 및 천공형 골결손 발생 시 조직 접착제를 이용한 골유도 재생술: 증례보고)

  • Chee, Young-Deok;Seon, Hwa-Gyeong
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.3
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    • pp.277-290
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    • 2012
  • Dental implants are universal restorative method on edentulous site in oral cavity and generally recognized by patients as well as clinicians. Rapid bone resorption of labial portion of maxillary anterior area is performed due to dental trauma, chronic periodontitis, and so on. Accordingly, Implants on maxillary anterior alveolar ridge with narrow labiopalatal width would lead to bony defects of dehiscence or fenestration. In this case, guided bone regeneration procedure is used to augment maxillary anterior alveolar ridge. It can have mechanical and biological advantages to mix tissue adhesive with bone graft materials in guided bone regeneration procedure. In these cases, when the dehiscence or fenestration defects was occurred by dental implants on maxillary anterior alveolar ridge with narrow labiopalatal width, guided bone regeneration procedures were performed with various combination of particle bone graft materials(allograft, xenograft, and alloplast) mixed with fibrin glue, excepting autogerous bone. We reported that all of 4 cases showed favorable alveolar ridge augmentations.

Treatment of retrograde peri-implantitis: seven-year follow-up study (역행성 임플란트 근단병소 주위염(Retrograde Peri-implantitis) 치료의 7년 관찰)

  • Lee, Ju-Youn
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.3
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    • pp.259-264
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    • 2014
  • Retrograde peri-implantitis (RPI) is defined as a clinically symptomatic periapical lesion. RPI is generally accompanied by symptoms of pain, tenderness, swelling and fistula. Several etiologic factors of RPI were possible, residual bacteria would be the main cause of RPI. Various treatment modalities have been introduced: debridement only or a combination of debridement with the grafting material accompanied by a detoxification of the infected implant surfaces, apicoectomy and so on. Although the definitive management methods remain undefined, many favorable clinical results of a treatment of RPI have been published. This case report introduces the 7-year long-term clinical result of the application the principle: implant surface detoxification using saline and chlorhexidine and guided bone regeneration with bone graft material and barrier membrane. If the implant was not mobile, it would be possible to treat RPI according to surgical approach and good results will be maintained over long term.

Surgical Treatment of Peripheral Arterial Disease -Clinical Analysis Of 55 Cases- (말초동맥질환의 외과적치료 -55예의 임상분석-)

  • 김한용
    • Journal of Chest Surgery
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    • v.24 no.12
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    • pp.1173-1184
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    • 1991
  • This report is a review of 55 cases of peripheral arterial disease, who were treated at the department of thoracic and cardiovascular surgery, Masan Koryo General Hospital from January, 1986 to December, 1990. The result are summerized as follows ; 1. The incidence of peripheral arterial disease were as follows that : Arterial injury was in 21 cases(38.2%), arteriosclerosis oblitrans 18cases(32.7%), thromboembolism 9cases(16.4%), Buerger's disease was in 7cases(12.7%). 2. Overall male to female ratio was 6.8 : 1, the prevalent age was 3rd and 4th decade in arterial injury, 7th and 8th decade in atherosclerosis and thromboembolism and 5th and 6th decade in Buerger's disease. 3. The farmer was the first ranked occupation of these patients with chronic occlusive arterial disease, which was composed of 17 cases (68%). 4. 23 cases of patients with chronic occlusive disease has been smoking and most of them have been smoking over 10 years. 5. The clinical symptoms in acute and chronic arterial obstruction were pain, claudication, gangrene and coldness in order. 6. The duration of symptom of chronic arterial occlusive disease was less 1 years in 15 cases(60%). 7. The lower extremity were more affected than upper extremity in peripheral arterial disease. 8. The cause of arterial injury was traffic accident 9 cases(42.9%) stab wound 8 cases (38.1%), postangiography 2 cases(9.5%) and belt injury 1 case. 9. The etiologic factors of acute arterial occlusion was arterial fibrillation myocardial ischemia and postangiography in order. 10. Lumber sympathectomy in Buerger's disease, artificial bypass graft in atherosclerosis and thromboembolctomy in thromboembolism, end to end with vein graft in arterial injury were performed frequently. 11. Conclusively overall result was satis factory but 3 cases was below knee amputated after operation of chronic arterial occlusive disease.

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Massive Edema of the Lower Extremity after Surgery for Abdominal Aortic Aneurysm, A case report (복부 대동맥류 수술후 발생한 하지의 심한 부종)

  • Kim, Tae-Gyun;Kang, Jung-Ho;Chung, Won-Sang;Kim, Hyuck;Lee, Chul-Bum;Kim, Young-Hak
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.483-486
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    • 2002
  • 71 years old man was operated on due to abdominal aortic aneurysm associated with complete occlusion of left common iliac artery. The coexisting chronic deep vein thrombosis of the left femoral and iliac vein was not diagnosed preoperatively. Resection of aneurysm and Y-graft interposition was performed. Recurrent edema and pain occured to the left lower extremity immediately postoperatively, which aggrevated with the lapse of time, resulting in fatal extensive venous thrombosis. This report regards the surgical treatment and complication of the aortoiliac occlusive disease associated with chronic deep vein thrombosis.

Surgical Treatment for Renovascular Hypertension and Iliac Artery Occlusion (신혈관성 고혈압 및 장골동맥 폐쇄에 대한 수술)

  • Ryu, Kyoung-Min;Ryu, Jae-Wook;Park, Seong-Sik;Kang, Tae-Soo;Kim, Seok-Kon;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.582-586
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    • 2007
  • A 48-year old male patient visited our hospital with uncontrolled hypertension and pair of the left leg. CT angiography shows atherosclerotic occlusion of both renal artery orifices and the left common iliac artery. Despite of medical treatment for 2 months, the clinical condition of the patient worsened. We performed the surgical revascularization with both renal arteries and aorto-left femoral artery bypass with using an 8 mm artificial vascular graft. He lived well without hypertension with using only angiotensin receptor blocker and an anticoagulant for 10 postoperative months. Using surgical revascularization for renovascular hypertension has decreased due to the development of intervention technology and medication, but this surgery is indicated in cases of renovascular hypertension with extensive atherosclerotic lesions. We report here on a case of surgical revacularization for medically Intractable atherosclerotic renovascular hypertension together with left common iliac artery occlusion.

Histological Study of Extraction Socket Grafted with Calcium Phosphate Materials: An Animal Study (Calcium Phosphate Graft Material이 적용된 발치와의 치유 양상에 대한 조직학적 연구)

  • Yang, Seung-Min;Yoon, Hyun-Min;Shin, Seung-Yoon;Kye, Seung-Beom
    • Journal of Dental Rehabilitation and Applied Science
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    • v.25 no.3
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    • pp.279-285
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    • 2009
  • The purpose of this study was to evaluate histologic result of bone substituting materials on extraction sockets. We compare the histologic findings of control, $MBCP^{(R)}$, $Polybone^{(R)}$. Mandibular premolar teeth of Beagle dogs were extracted available for bone filling. All alveolar extraction sockets were thoroughly debrided with surgical curet to remove the periodontal ligament. The graft materials were filled into the extraction sockets. The animals were sacrified 90 days after implantation. Both treated and control mandibular sites were histologically evaluated with light microscopy. Histological observation at 90 days revealed that control and experimental sites were healed uneventfully without any adverse tissue reaction. Regenerated new bone formation ratio is 34.5% for control, 28.4% for $MBCP^{(R)}$, 23.8% for $Polybone^{(R)}$. From this results, it was suggested that $MBCP^{(R)}$, $Polybone^{(R)}$ are promising bone substituting materials to promote normal tissue healing and new bone formation.

Ulnar Artery Obstruction in Guyon Canal Compression Syndrome (기욘씨관 압박 증후군에서의 척골 동맥의 폐색)

  • Ahn, Hee-Chang;Kim, Jong-Do;Lee, Jang-Hyeon;Choi, Seung-Suk
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.783-787
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    • 2010
  • Purpose: There are many articles describing about Guyon canal compression syndrome. Until recently, most of these articles have been presented about the symptoms of ulnar nerve compression, but there have been no reports about ulnar artery compression. In this article, besides the nerve compression symptoms in the Guyon's canal, we represented the symptoms and treatments based on the ulnar artery obstruction. Methods: Guyon canal is composed of the hamate and pisiform, and the ligaments which connect them. The course of the ulnar nerve and artery, which passes through this narrow canal, is affected by the anatomical structure of the base of the canal. Out of 14 patients (21 cases) were retrospectively reviewed in this study from 2006 to 2009. Of 14 patients, there were 5 men and 9 women with ages between 21 to 61 years old. The symptoms had volar sensory loss of ulnar sided digits, with muscular atrophy of hypothenar muscles. Prior to surgery, most of these patients had vascular disorders which was diagnosed definitively by angiography and electromyogram. Results: The release of Guyon canal and interposition graft of the obstructed arteries was carried out to 11 patients (15 cases) who had artery (vascular) occlusive disorder, and. 12 cases had sympathectomy and interposition graft after resection of obstructed ulnar artery. Six cases had release of carpal tunnel performed simultaneously. There were no major complications after surgery. The circulation of the ulnar artery was improved along with the patients' symptoms. Conclusion: The pre-existing articles about Guyon canal compression syndrome were mainly focused on ulnar nerve compression. This study, which was carried out by our department, showed that most of these patients had ulnar artery obstruction or stenosis simultaneously with ulnar nerve compression. The vascular disorder was corrected by interposition graft after the resection of the site of ulnar artery occlusion. And to conclude, When we resolve the ulnar nerve compression, the proper diagnosis & treatment of impaired ulnar artery circulation should be carried out concomitantly.

Ergotamine-induced Vasospasm (에르고타민으로 인한 혈관경축)

  • Lim Chang Young;Lee Hyeon Jae;Lee Gun
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.245-248
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    • 2005
  • Drugs containing ergotamine are widely used in the treatment of migraine. Spastic vasoconstriction is one of the most serious side effects even with recommended dosage. We report a case of 63-year-old male with severe arterial occlusion of the upper limbs which might be related with vasospasm caused by ergotamine-containing medication because of migraine for f5 years. He was treated with bypass graft, sympathicotomy and heparin and prostaglandin E1 infusion. But dramatic clinical reversal of the vasospasm was obtained after withdrawal of ergotamine.

Left Carotid-to-Subclavian Artery Bypass Grafting for Recurrent Angina Caused by Coronary-Subclavian Steal Syndrome

  • Kim, Min-Seok;Paeng, Jin Chul;Kim, Ki-Bong;Hwang, Ho Young
    • Journal of Chest Surgery
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    • v.46 no.1
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    • pp.84-87
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    • 2013
  • A 60-year-old man visited the outpatient clinic due to one month of recurrent exertional chest pain. Eleven years earlier he had undergone off-pump coronary artery bypass grafting using bilateral internal thoracic artery (ITA) Y-composite grafts based on the left ITA. Preoperative coronary angiography showed patent distal graft anastomoses and visualized the left ITA retrogradely. The arch aortography revealed near-total occlusion of the left subclavian artery at the level of the ostium. The patient underwent left carotid-to-subclavian artery bypass grafting using a 6 mm vascular conduit. Postoperative computed tomographic angiography revealed a patent bypass conduit between the left common carotid artery and left subclavian artery. The patient was discharged on postoperative day 4 with no symptoms or signs of myocardial ischemia.