Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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The Use of Greater Saphenous Vein In Situ Graft in Arterial Occlusive Disease of Lower Extremity

하지동맥 폐쇄성 질환에서 자가 대복재정맥 정위 이식편의 이용

  • Shin Yong-Chul (Department of Thoracic & Cardiovascular Surgery, National Medical Center) ;
  • Kim Mi-Jung (Department of Thoracic & Cardiovascular Surgery, National Medical Center) ;
  • Song Chang-Min (Department of Thoracic & Cardiovascular Surgery, National Medical Center) ;
  • Ahn Jae-Bum (Department of Thoracic & Cardiovascular Surgery, National Medical Center) ;
  • Kim In-Sub (Department of Thoracic & Cardiovascular Surgery, National Medical Center) ;
  • Kim Woo-Sik (Department of Thoracic & Cardiovascular Surgery, National Medical Center) ;
  • Kim Byung-Yul (Department of Thoracic & Cardiovascular Surgery, National Medical Center)
  • Published : 2006.06.01
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Abstract

Background: Distal anastomosis using artificial vascular graft is difficult when luminal size mismatch occurred owing to severe occlusion of popliteal artery and its branches. So we reconstructed blood flow to ischemic lower limb by using autologous greater saphenous vein in situ graft (GSVISG) as vascular graft material. Material and Method: From July 2000 to July 2005, 26 patients treated using GSVISG. We analyzed clinical results retrospectively by chart review. Result: There was no in hospital or early postoperative death and 6 late deaths occurred during follow up period. Postoperative complications were 5 cases of early graft obstruction, 2 cases of wound dehiscence, 1 case of graft aneurysmal change, 1 case of seroma formation at inguinal wound and 1 case of graft injury during valvulotomy. Overall patency rate during follow up period was 69.3%. Conclusion: Greater saphenous vein in situ graft is acceptable vascular graft for arterial occlusive disease of lower extremity.

배경: 하지동맥의 협착성 질환에서 슬와동맥 및 그 이하 분지들의 협착이 있을 경우 인조혈관과 슬와 동맥 사이의 크기 불일치가 발생하여 원위부 문합이 곤란하게 된다. 본원에서는 자가 대복재정맥 정위 이식편을 이용하여 하지동맥의 혈류를 복원하고자 하였다. 대상 및 방법: 2000년 7월부터 2005년 7월까지 총 26명의 환자에서 대복재정맥 정위 이식편을 이용한 수술을 시행하였으며, 임상 결과들을 환자의 차트 기록에 근거하여 후향적으로 분석하였다. 결과: 술 후 원내 사망이나 조기 사망은 없었으며, 추적기간 동안 총 6명의 만기 사망이 발생하였다. 수술 도중 및 술 후 합병증으로는 5예의 조기 이식편 폐쇄, 2예의 창상 열개, 1예의 이식편 내 동맥류 형성, 1예의 서혜부 창상 장액종 형성, 1예의 이식편 손상이 발생하였으며, 추적기간 동안 이식편 개통률은 69.3%였다. 결론: 대복재정맥 정위 이식편은 슬와동맥 및 그 이하 분지의 협착을 동반한 하지동맥 폐쇄성 질환에서 유용한 혈관 이식편으로 생각된다.

Keywords

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