• Journal of Chest Surgery
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• 제3권1호
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• pp.31-38
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• 1970

This is a report of three cases of successful embolectomy in peripheral arteries. First case was the patient who received a mitral commissurotomy 8 months ago. In that time, there was no evidence of left atrial thrombosis. He showed an embolism in the middle portion of left brachial artery without complaining of any ischemic pain. Embolectomy was performed 15 days after disappearance of radial pulse and resulted in no return of radial pulse postoperatively. Second case was a case of an embolism in lower portion of right brachial artery. She complained severe ischemic pain and cyanosis in the right forearm and fingers. She was also in the beginning state of cardiac failure, which was suspected from her hypertension associated with cardiomegaly and arrythmia Embolectomy was performed 17 hours after onset of acute pain. Immediate full pulsation of radial artery was obtained after embolectomy and the acute ischemic symptoms subsided gradually. Third case was an embolism in superior mesenteric artery which occured 24 hours after pneumonectomy for right bronchogenic carcinoma and the patient suddenly complained diffuse abdominal colicky pain. 7 hours after attack of abdominal pain. embolectomy with extensive reset ion of the small intestine was performed with uneventful recovery and without complication, such as short bowel syndrome, postoperatively. Histopathologically, the embolus was consisted of a tissue of anaplastic cell carcinoma, which was identical to the tumor of the resected right lung. Histological findings of other emboli of first and second case were old thrombus.

• Journal of Korean Neurosurgical Society
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• 제47권5호
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• pp.332-337
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• 2010

Objective : Although a transradial angiography is accepted as the gold standard for cardiovascular procedures, cerebral angiography has been performed via transfemoral approach in most institutions. The purpose of this study is to present our experience concerning the feasibility, efficacy, and safety of a transradial approach to cerebral angiography as an alternative to a transfemoral approach. Methods : Between February 2007 and October 2009, a total of 1,240 cerebral angiographies were performed via a transradial approach in a single center. The right radial approach was used as an initial access route. The procedure continued only after the ulnar artery was proven to provide satisfactory collateral perfusion according to two tests (a modified Allen's test and forearm angiography). Results : The procedural success rate was 94.8% with a mean duration of 28 minutes. All supra-aortic vessels were successfully catheterized with a success rate of 100%. The success rates of selective catheterization to the right vertebral artery, right internal carotid artery, left internal carotid artery, and left vertebral artery were 96.1%, 98.6%, 82.6% and 52.2%, respectively. The procedure was performed more than twice in 73 patients (5.9%), including up to 4 times in 2 patients. The radial artery occlusion was found in 4 patients (5.4%) on follow-up cerebral angiography, but no ischemic symptoms were observed in any of the cases. Conclusion : This study suggests that cerebral angiography using a transradial approach can be performed with minimal risk of morbidity. In particular, this procedure might be useful for follow-up angiographies and place less stress on patients.

• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.185-190
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• 2011

Objective : To investigate the efficacy of extracranial-intracranial (EC-IC) bypass surgery using a radial artery interposition graft (RAIG) for surgical management of cerebrovascular diseases. Methods : The study involved a retrospective analysis of 13 patients who underwent EC-IC bypass surgery using RAIG at a single neurosurgical institute between 2003 and 2009. The diseases comprised intracranial aneurysm (n=10), carotid artery occlusive disease (n=2), and delayed stenosis in the donor superficial temporal artery (STA) following previous STA-middle cerebral artery bypass surgery (n=1). Patients were followed clinically and radiographically. Results : Bypass surgery was successful in all patients. At a mean follow-up of 53.4 months, the short-term patency rate was 100%, and the long-term rate was 92.3%. Twelve patients had an excellent clinical outcome of Glasgow Outcome Scale (GOS) 5, and one case had GOS 3. Procedure-related complications were a temporary dysthesia on the graft harvest hand (n=1) and a hematoma at the graft harvest site (n=1), and these were treated successfully with no permanent sequelae. In one case, spasm occurred which was relieved with the introduction of mechanical dilators. Conclusion : EC-IC bypass using a RAIG appears to be an effective treatment for a variety of cerebrovascular diseases requiring proximal occlusion or trapping of the parent artery.

• Journal of Chest Surgery
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• 제37권11호
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• pp.897-902
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• 2004

배경: 관상동맥조영술 또는 중재술에 사용된 요골동맥을 관상동맥우회술시 우회도관으로 사용하는 경우가 늘고 있으나 이로 인한 요골동맥도관의 개존성 및 환자의 임상성적에 미치는 영향에 대해 체계적인 연구는 보고되고 있지 않다. 이에 본 저자들은 관상동맥조영술에 사용된 요골동맥을 우회도 관으로 사용한 환자들의 임상성적과 술 후 개존도를 그렇지 않은 환자들과 비교 분석하고자 하였다. 대상 및 방법: 2000년 1월 부터 2004년 2월까지 관상동맥조영술에 사용된 요골동맥을 동맥도관으로 사용한 49예를 I군으로, 관상동맥조영술에 산이지 않은 요골동맥을 동맥도관으로 사용한 44예를 II군으로 정하여 두 군간에 성비, 나이, 술 전 위험인자, 과거력, 임상진단, 수술방법, 수술성적, 우회도관의 개존도 등을 후향적으로 비교 분석하였다. 결과: 두 군 간 남녀비, 연령, 진단명, 수술 위험인자, 심박출률 등의 유의한 차이는 없었다. 술 전 관상동맥조영술은 I군에서는 전예에서 좌측 요골동맥을 이용하였고 II군에서는 대퇴동맥 혹은 우측 요골동맥을 이용하였다. 수술은 전예에서 인공심폐기를 이용한 관상동맥우회술을 시행하였으며 수술사망은 양군에서 모두 없었고 주요합병증은 I군은 5예(10%), II군은 3예(7%) 있었다. 수술에 이용된 우회도관으로는 양군에서 내흉동맥, 요골동맥, 대복재 정맥을 주로 이용하였고 I군은 환자당 평균 3.7$\pm$1.1원위부문합, II군은 3.7$\pm$0.9원위부문합을 시행하였고 요골동맥절편은 I군에서 환자당 평균 1.2$\pm$0.4원위부문합, II군에서 1.3$\pm$0.5원위부문합을 시행하였다. 요골동맥의 원위부문합은 양 군에서 회선지 부위가 가장 많았고 근위부문합은 두군에서 모두 상행대동맥, 내흉동맥, 대복재정맥 후드 순이었다. 수술 후 관상동맥조영술상 양군에서 내흉동맥과 요골동맥은 모두 100%의 개존도를 보였으며 대복재정맥은 I군 85%, II군 86%의 개존도를 보였다. 요골동맥절편에서 완전개존이 I군에서 93%로 II군의 81%보다 오히려 높게 나왔으나 유의하지는 않았다. 결론: 술 후 시행한 관상동맥조영술에서 양군에 개존율에 큰 차이는 없었으며 수술 전 관상동맥 조영술에 사용된 요골동맥도 비교적 안전하게 관상동맥우회술의 우회도관으로 사용할 수 있다고 판단된다.

• Journal of Chest Surgery
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• 제18권3호
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• pp.466-469
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• 1985

The patient was 17 years old female who complained of coldness of right arm and occasional dizziness, since 4 months prior to admission. On physical examination, the right radial, brachial and common carotid arterial pulses were not palpable. Aortography revealed narrowing of innominate and right common carotid arteries, and complete obstruction of right subclavian artery. The right axillary artery was faintly visualized on the delayed film. Axillo-axillar bypass was done using Gore-Tex graft of 8 mm I.D.. By bilateral subclavicular incision, both side axillary arteries was exposed. End to side anastomosis was made between graft and right axillary artery and the graft was brought out to the left side, subcutaneously, over the sternum, and the anastomosis was made between graft and left axillary artery. Postoperatively, both radial pulses were equally palpable. On follow-up visiting, there were no subjective symptoms and blood pressure in both arms was equal.

• 한국자기학회지
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• 제24권5호
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• pp.146-151
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• 2014

영구자석과 홀소자로 구비된 집게형 맥진기를 이용하여 목 부위의 경추동맥의 맥진파형과 손목 부위의 요골동맥 맥진파형을 각각 측정하였다. 두 개의 맥진파형을 비교하여 얻은 맥파전달시간과 맥파전달속도를 분석하였다. 맥파전달속도는 기존의 방식으로 측정한 값과 유사한 약 8.5 m/s으로 나타났다. 재현성과 신뢰성이 있는 한방의료기기인 집게형 맥진기로 얻은 맥파전달속도를 기준하여 동맥경화도를 예측할 수 있음을 제시하였다.

• Journal of Chest Surgery
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• 제54권2호
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• pp.117-126
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• 2021

Background: Several factors, such as the degree of target vessel stenosis, are known to be associated with radial artery (RA) graft patency in coronary artery bypass grafting (CABG). There is a lack of data regarding the effect of the RA proximal configuration (aortic anastomosis versus T-anastomosis). This study evaluated the effects of the RA proximal configuration on the patency rate and clinical outcomes after CABG. Methods: We conducted a retrospective study, analyzing 328 patients who had undergone CABG with an RA graft. We divided the patients into 2 groups. The primary endpoint was RA patency and the secondary endpoints were overall mortality and major adverse cardiac and cerebrovascular events (MACCE). We performed a propensity score-matched comparison. Results: Aorta-RA anastomosis was performed in 275 patients, whereas the rest of the 53 patients received T-RA anastomosis. The mean age was 67.3±8.7 years in the T-RA anastomosis group and 63.8±9.5 years in the aorta-RA anastomosis group (p=0.02). The mean follow-up duration was 5.13±3.07 years. Target vessel stenosis ≥70% (hazard ratio [HR], 0.42; 95% confidence interval [CI], 0.20-0.91; p=0.03) and T-RA anastomosis configuration (HR, 2.34; 95% CI, 1.01-5.19; p=0.04) were significantly associated with RA occlusion in the multivariable analysis. However, T-RA anastomosis was not associated with higher risks of overall mortality and MACCE following CABG (p=0.30 and p=0.07 in the matched group, respectively). Conclusion: Aorta-RA anastomosis showed a superior patency rate compared to T-RA anastomosis. However, the RA proximal anastomosis configuration was not associated with mortality or MACCE.

• Archives of Plastic Surgery
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• 제44권1호
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• pp.12-18
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• 2017

Background Nonliving chickens are commonly used as a microvascular anastomosis training model. However, previous studies have investigated only a few types of vessel, and no study has compared the characteristics of the various vessels. The present study evaluated the anatomic characteristics of various chicken vessels as a training model. Methods Eight vessels-the brachial artery, basilic vein, radial artery, ulnar artery, ischiatic artery and vein, cranial tibial artery, and common dorsal metatarsal artery-were evaluated in 26 fresh chickens and 30 chicken feet for external diameter (ED) and thicknesses of the tunica adventitia and media. The dissection time from skin incision to application of vessel clamps was also measured. Results The EDs of the vessels varied. The ischiatic vein had the largest ED of $2.69{\pm}0.33mm$, followed by the basilic vein ($1.88{\pm}0.36mm$), ischiatic artery ($1.68{\pm}0.24mm$), common dorsal metatarsal artery ($1.23{\pm}0.23mm$), cranial tibial artery ($1.18{\pm}0.19mm$), brachial artery ($1.08{\pm}0.15mm$), ulnar artery ($0.82{\pm}0.13mm$), and radial artery ($0.56{\pm}0.12mm$), and the order of size was consistent across all subjects. Thicknesses of the tunica adventitia and media were also diverse, ranging from $74.09{\pm}19.91{\mu}m$ to $158.66{\pm}40.25{\mu}m$ (adventitia) and from $31.2{\pm}7.13{\mu}m$ to $154.15{\pm}46.48{\mu}m$ (media), respectively. Mean dissection time was <3 minutes for all vessels. Conclusions Our results suggest that nonliving chickens can provide various vessels with different anatomic characteristics, which can allow trainees the choice of an appropriate microvascular anastomosis training model depending on their purpose and skillfulness.

• Journal of Chest Surgery
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• 제37권10호
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• pp.839-844
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• 2004

배경 및 목적: 속가슴동맥 편과 유리 노동맥 편의 Y-복합이식편은 관상동맥우회 술에 많이 이용된다. 이 연구의 목적은 속가슴동맥 편의 혈류를 증가시킬 수 있는 방법을 찾고 Y-복합이식편의 혈류역학을 알고자 함이다. 대상 및 방법: 관상동맥우회 술을 받은 15예에서 속가슴동맥 편을 두 가지 방법으로 처치하여 속가슴동맥 혈류량을 측정하였다. 7예에서는 혈관 외부에만 파파베린 액을 처치하였고 8예에서는 혈관 내로 파파베린 액을 주입하였다. 다른 18예에서는 속가슴동맥 편과 유리 노동맥 편으로 Y-복합이식편을 만들어 사용하였고 그 자유 혈류량과 두 분지의 혈류 변화를 조사하였다. 결과: 속가슴동맥 편의 혈관 내로 파파베린을 주사한 경우는 혈관외부에 파파베린을 처치한 경우보다 약 2배의 자유혈류량을 얻을 수 있었다(47.7$\pm$9.6 mL/min와 100.8$\pm$26.3 mL/min, p<0.001). Y-복합이식편의 양측을 다 연 상태에서 총 자유혈류량은 속가슴동맥 측만을 열었을 때나 노동맥 측만을 열었을 경우보다 훨씬 많았다(173.3$\pm$45.3 mL/min와 121.1$\pm$34.3 mL/min 혹은 117.5$\pm$42.8 mL/min, 각각 p<0.001). Y-복합이식편의 양 분지를 다 연 경우 양측의 혈류량은 차이가 없었다(85.4$\pm$27.8 mL/min와 87.9$\pm$42.4 mL/min, p=0.772). Y-복합이식편에서 한 측의 혈류량은 다른 측을 열 때보다 막을 때 훨씬 많았다. 결론: 속가슴동맥 편의 혈관 내에 파파베린 액을 주입하는 방법은 자유혈류량을 올릴 수 있는 매우 효과적인 방법이다. 속가슴동맥 편과 유리 노동맥 편의 Y-복합이식편은 속가슴동맥의 단독이식편보다 더 많은 자유혈류량을 보이며, Y-복합이식편의 한 측의 혈류량은 다른 측의 혈류량의 변화에 따라 변할 수 있다.

• Journal of Yeungnam Medical Science
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• 제4권1호
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• pp.145-149
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• 1987

경피요골동맥삽관후 수지괴사가 발생되어 손목을 절단한 1례를 보고하며, 동맥삽관후 수지괴사가 유발될 수 있는 요인으로는 사용된 카테터의 크기, 종류, 천자횟수, 삽관거치기간 및 카테터삽관후 유지방법외에도 환자의 혈액구성성분변화, 혈액응고장애, 심박출량감소상태, 성별 등을 들 수 있으며, 본원에서 발생된 예에서는 수술후 환자가 심히 움직여 끈으로 동맥삽관된 손목을 침대에 묶어 놓음으로써 카테터에 의한 혈관손상이 심했음이 가장 큰 원인일 것으로 추측되며 그 외에도 혈액성분변화 및 응고장애에 의해 심한 혈전형성이나 heparin용액의 간헐적 관류시 발생될 수 있는 혈전의 전색도 가능성이 있을 것으로 사료된다.