• Title/Summary/Keyword: 말초동맥질환

Search Result 62, Processing Time 0.023 seconds

Embolectomy of Arteries of Extremities -Clinical analysis of 26 cases (사지동맥의 색전제거술 -26례의 분석-)

  • 강종렬;구본일
    • Journal of Chest Surgery
    • /
    • v.30 no.2
    • /
    • pp.172-178
    • /
    • 1997
  • We present a etrospective analysis of arterial embolectomies performed at the Inje University Seoul Paik Hospital. During the period of March 1987 Feburary 1996 twenty-six patients underwent embolectomies, eighteen patients were male and eight patients were female, mean age of patients was 56.8 years. Rest pain was the chief complaint in 24 patients, the remaining two patients complained of long term history of claudication after recovery of acute symtoms. But only 10 patients had sensBrylmotor symtoms. Heart was the most common source of embolization and frequent predisposing factor of embolism was ischemic heart disease in 8 cases and valvular heart disease in 11 cases. The sites of embolization were upper extremities artery in 6 cases, saddle embolism in 2 cases, lower extremities artery in 18 cases and the most common site of embolism was femoral artery in 1 1 cases. Preoperative angiography was taken in the diagnosis and planning of the embolectomy in 1) patients while in the other patient p eoperative angiography was not taken. Only two cases were operated within the golden period of 6 hours and other cases were operated in more than 6 hours after embolization. In all patients, the Fogarty embolectomy catheter was used without bypass surgery via bachial ateriotomy in the embolism of upper extremities artery, bilateral groin approaches in the saddle embolism and transfemoral approach in the embolism of lower extremities artery. However 3 patients were re-operated via transpopliteal approach in the distal poplitiotibial embolism. Eighteen patients received perioperative anticoagulation therapy by heparin or fraxiparine and wafarin was used in 17 patients at the time of discharge and the indication of anticogulation was patients of valvular heat disease andfor atrial fibrillation, peripheral artery atherosclerosis and recurrent embolism. Postoperative results of the embolectomy were as follows: fouteen pateints had excellent results, five cases had symtom improvement after re-operation, B. K. amputation in 1 case who had severe atherosclerosis of lower extremities, recurrent embolism in 1 case and death in 2 cases the cause of death were acute renal failure and cerebral artery embolism, respectively. The complications of the embolectomy were reperfusion syndrome, pseudoaneurysm and intimal dissection in one case each. Conclusively the problems of embolism is delayed diagnosis and increasing number of old aged patient who had suffered from ischemic heart diease. Preoperative angiography was not always needed for embol ectomy. Selective anticoagulation therapy can decrease incidence of re-embolism. In the distal poplitiotibial embolism, embolectomy of tibial artery was difficult.

  • PDF

Effects of Uncertainty, Social Support, and Sick Role Behavior on Health-Related Quality of Life in Patients with Peripheral Arterial Disease (말초동맥질환자의 불확실성, 사회적 지지, 환자역할행위 이행이 건강 관련 삶의 질에 미치는 영향)

  • Lee, Hye Ju;Kim, Youn Kyoung
    • Journal of Korean Clinical Nursing Research
    • /
    • v.26 no.3
    • /
    • pp.314-326
    • /
    • 2020
  • Purpose: This study was conducted to examine the effects of uncertainty, social support, and sick role behavior on health-related quality of life in patients with peripheral arterial disease. Methods: This study is a descriptive research using self-reporting questionnaire. Data were collected from 167 patients with peripheral arterial disease. Measurement tools were Multidimensional Scale of Perceived Social Support(MSPSS), Mishel's Uncertainty in Illness Scale (MUIS), Sick role behavior measurement tools and SF-36 Version I. The data were analyzed using descriptive statistics, correlation, and regression analysis by using SPSS/WIN 24.0. Results: Factors that significantly influenced physical health-related quality of life were age (β=-.19, p=.010), monthly income (β=.17, p=.027), uncertainty (β=-.29, p<.001), and exercise and rest (β=.28, p<.001) that all together accounted for 32.6% of the variance. Factors that significantly influenced mental health-related quality of life were monthly income (β=.20, p=.015), drinking (β=.17, p=.040), uncertainty (β=-.24, p=.001), and exercise and rest in sick role behavior (β=.26, p=.003) that all together accounted for 18.2% of the variance. Social support was an insignificant factor on physical and mental health-related quality of life. Conclusion: To improve the health-related quality of life of people with peripheral arterial disease, it is necessary to develop a systematic nursing intervention program including a strong support system, education, strategies for alcohol abstinence, and exercise and rest therapy.

Popliteal Artery Entrapment Syndrome -One case report - (슬와동맥 포착증후군 - 1예 보고 -)

  • Oh Jae-Yun;Lee Seock-Yeol;Lee Chol-Sae;Lee Seung-Jin
    • Journal of Chest Surgery
    • /
    • v.39 no.10 s.267
    • /
    • pp.791-794
    • /
    • 2006
  • Popliteal artery entrapment syndrome is a rare disorder and lead to claudication and disturbance of blood flow from the results of an abnormal relationship of the popliteal artery to the gastrocnemius muscle, a fibrous band or the popliteus muscle in a young male population. The specific diagnosis is difficult, In most cases, surgical treatment provides a definitive diagnosis of the lesion and is necessary for the patient's recovery. A 34-years-old male was admitted complaining of claudication and pain on left leg. Ankle-brachial index, vascular sonography, CT-angiogram and MRI revealed an occlusion of proximal popliteal artery of left leg. The patient was confirmed as a popliteal artery entrapment syndrome (type IV) that the popliteal artery was entrapped by a fibrous band around the popliteus muscle in the operative fold. Completely occluded fibrotic popliteal artery was removed, and interposition with ipsilateral greater saphenous vein graft was done. After surgery, symptoms of the patient have improved.

Bilateral Popliteal Artery Entrapment Syndrome (양측성 슬와동맥 포착증후군)

  • Yoo, Dong-Gon;Kim, Chong-Wook;Park, Chong-Bin
    • Journal of Chest Surgery
    • /
    • v.40 no.2 s.271
    • /
    • pp.136-139
    • /
    • 2007
  • Bilateral popliteal artery entrapment syndrome is a rare vascular disease, which leads to ischemic claudication as a result of disturbance to the blood flow from the abnormal relationship of the popliteal artery to the gastrocnemius muscle, a fibrous band or the popliteus muscle in the young male population. A 58-years-old male patient, complaining of ischemic claudication, coldness and 3rd toe gangrene of left leg of 1 month's duration was admitted to our institution. His left ankle-brachial index was decreased; therefore, a femoral artery angiography was peformed, which revealed a total occlusion below the distal superficial femoral artery of the left leg. An EKG revealed atrial fibrillation, suggestive of a thromboembolism of the popliteal artery due to atrial fibrillation; therefore, Urokinase thrombolysis was attempted. After the Urokinase thrombolysis, popliteal artery entrapment syndrome was diagnosed, with MRI then performed for an anatomical diagnosis. The popliteal artery entrapment was type 1, where the popliteal artery was displaced medial to the Gastrocnemius head. After complete removal of the popliteal artery aneurysm, interposition was performed with a contra lateral greater saphenous vein graft. A mild right popliteal artery aneurysm still remained, but surgery was not performed. Currently, the patent is surviving, without complications. Herein, the good results obtained for the surgical treatment of a severely affected leg, and the conservative treatment of a mildly affected leg, are reported.

The Relationship between Human Neutrophil Elastase and Coronary Arterial Dilatation in Kawasaki Disease (가와사끼병 환아에서의 혈장 및 호중구의 Elastase 활성도와 관상동맥 증대와의 관계)

  • Shim, Jun Yong;Choi, Hee Won;Hong, Ja Hyun;Lee, Jong Kyun;Lee, Hae Yong
    • Clinical and Experimental Pediatrics
    • /
    • v.46 no.9
    • /
    • pp.903-908
    • /
    • 2003
  • Purpose : Kawasaki disease is notorious for coronary arterial complication which is usually developed as a febrile disease in early childhood. Increased polymorphonucleus(PMN) cell levels in acute phases may be associated with the pathophysiology of Kawasaki disease. We studied the relationship between coronary arterial dilatation and elastase activity which was excreted from PMN cell and roles as an important factor for vasculitis. Methods : Ten patients diagnosed with Kawasaki disease in Yonsei University Medical Center were examined between November, 2001 and January, 2002. In addition, 15 patients with other febrile diseases were also examined. Echocardiography was done in patients with Kawasaki disease on the first day of admission and four weeks after the onset of the disease. At each time, venous samples were drawn and separated into plasma and leukocytes. In patients with other febrile disease, samples were drawn on admission. Elastase activities in plasma and neutrophil extracts were measured. Results : The significant increased plasma elastase activity, $6.19{\pm}0.74U/mL$, found in Kawasaki disease patients compared with the other febrile disease patients, $4.86{\pm}1.17U/mL$(P<0.05). And there was no significance between the above two diseases in terms of the elastase activity in neutrophil extracts. The relationship between initial elastase activity and the coronary arterial complication which was shown in subacute phase wasn't significant. Conclusion : Plasma elastase activity was increased in Kawasaki disease significantly, but the initial plasma elastase activity in the acute phase could not reflect the range of coronary arterial complication.

Current Strategy in Endovascular Management for Below-the-Knee Arterial Lesions (무릎 밑 동맥의 혈관 내 치료의 최신 지견)

  • Kyosoo Hwang;Sang Woo Park
    • Journal of the Korean Society of Radiology
    • /
    • v.82 no.3
    • /
    • pp.541-550
    • /
    • 2021
  • The below-the-knee arterial tree is the thinnest of all the leg vessels and is an important path for blood flow to the foot. Hence, lesions including stenosis, especially obstruction, may lead to critical limb ischemia which represents the most severe clinical manifestation of peripheral arterial disease. It is characterized by the presence of ischemic rest pain, ischemic lesions, or gangrene attributable to the objectively proven arterial occlusive disease. Typically, the atherosclerotic disease process involving the below-the-knee arterial tree is diffuse in the majority of patients. The cornerstone of therapy is vascular reconstruction and limb salvage. Revascularization should be attempted whenever technically possible, without delay, in patients presenting critical limb ischemia and when the clinical status is not hopelessly non-ambulatory. Therefore, endovascular treatment can become the gold standard for the full range of patients including below-the-knee, limiting the clinical role of the classically trained surgeons.

당뇨병에서 고혈압의 치료 - 첫번째 이야기

  • 이형우
    • The Monthly Diabetes
    • /
    • s.134
    • /
    • pp.72-73
    • /
    • 2001
  • 당뇨병 환자에서 고혈압의 빈도는 일반인에 비해 2배 이상 높고, 대개 환자의 약 40$\~$60$\%$에서 고혈압을 동반한다. 고혈압이 당뇨병과 같이 있는 경우는 대혈관 및 미세혈관 질환의 위험인자로서 작용하여 심장사, 관상동맥 질환, 울혈성 심부전, 뇌혈관질환, 그리고 말초혈관 질환의 발생 위험을 높여 당뇨병 환자 사망원인의 대부분을 차지하며, 고혈압이 동반되어 있지 않을 경우에는 장기생존률이 높다. 또한 당뇨병에서 확장기 및 수축기 혈압은 당뇨병성 신증과 망막증의 발생 및 경과 악화에도 영향을 미친다. 당뇨병에서 고혈압이 예후에 중대한 영향을 미치는 만큼, 고혈압을 동반한 당뇨병 환자에서, 혈당의 조절뿐 아니라 죽상경화증의 예방 및 고혈압의 치료가 당뇨병에 의한 혈관 합병증의 발생과 진행을 지연시키고 사망률을 감소시키는데 결정적이라 할 수 있다.

  • PDF

특집 : 미세혈관 합병증 - 당뇨병은 혈관병 - 당뇨병은 혈관에 어떤 영향을 미칠까?

  • 사단법인 한국당뇨협회
    • The Monthly Diabetes
    • /
    • s.259
    • /
    • pp.14-16
    • /
    • 2011
  • 당뇨병을 장기간 앓게 되면 혈관이 분포한 모드 조직 또는 기관을 침범하는 임상 증후군이 발생하는데 이를 당뇨병의 만성 합병증이라고 부른다. 당뇨병 만성 합병증의 기본적인 병리생리는 혈관 질환이며 침범하는 장기와 혈관의 크기에 따라 다음과 같이 분류된다. 눈에 생기는 망막증, 신장에 생기는 신장병증, 신경 특히 말초신경에 발생하는 신경병증들은 미세혈관의 손상에 따라 발생하므로 미세혈관 합병증이라고 부르며 심장에 생기는 협심증, 뇌혈관 경색으로 대표되는 뇌졸중, 하지 동맥폐색증은 대혈관 합병증이라고 부른다.

  • PDF

Implementation of the Wireless Pulse Transit Time Monitoring System for Ubiquitous Healthcare (유비쿼터스 헬스케어를 위한 무선 맥파전달시간 측정시스템 구현)

  • Jung, Hwan;Jo, Kyung-Min;Jeong, Do-Un
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
    • /
    • 2008.05a
    • /
    • pp.624-627
    • /
    • 2008
  • 본 연구에서는 유비쿼터스 헬스케어를 위하여 비침습적으로 측정기 가능하고, 많은 건강정보를 포함하고 있는 심전도(electrocardiogram, ECG)와 광전용적맥파(photo plethysmograph, PPG)를 측정하고자 하였다. 이를 위하여 배터리로 구동 가능한 초소형의 심전도 및 맥파측정 시스템의 구현을 위하여 각각의 신호를 검출 및 신호처리하기 위한 회로를 구현하였다. 그리고 계측된 심전도 및 맥파신호의 무선전송을 위하여 초저전력 무선센서네트워크 기술을 적용한 무선 생체신호 전송시스템을 구현하였다. 계측된 심전도의 R파 정점과 인체의 말초부위에서 측정한 맥파의 기준점 사이의 시간인 맥파전달시간(pulse transit time, PTT)을 분석하여 심장에서 말초부위까지 혈관의 물리적 특성을 평가함으로써 동맥경화와 같은 혈관질환의 사전모니터 링이 가능한 시스템을 구현하고자 하였다.

  • PDF

Association between physical activity measured using an accelerometer and arterial stiffness based on pulse wave velocity and ankle-brachial index in healthy adults (건강한 성인에서 가속도계로 측정한 신체활동과 맥파전달속도 및 상완-발목 간 혈압비에 기반한 동맥경화지표와의 관계)

  • Lee, Hyunju;Park, Kye Wol;Jun, Ha Yeon;Gwak, Ji Yeon;Kim, Eun Kyung
    • Journal of Nutrition and Health
    • /
    • v.55 no.4
    • /
    • pp.506-520
    • /
    • 2022
  • Purpose: Physical activity (PA) has a beneficial effect on the prevention of arteriosclerosis in healthy adults. The purpose of this study was to analyze the relationship between PA measured using an accelerometer and arterial stiffness in healthy Korean adults. Methods: This study involved 87 subjects (36.8% women) aged 20-64 years. PA was evaluated using an accelerometer (wGT3X-BT, ActiGraph, Florida, USA) for 7 days. Based on the results of the accelerometer measurement, subjects were classified into active and inactive groups according to the World Health Organization (WHO) PA guidelines. The brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) to assess arterial stiffness were measured by a non-invasive vascular screening device (VP-1000 Plus, Omron). Results: The average age of the study subjects was 47.7 ± 11.3 years and the WHO PA guideline achievement rate was 29.9%. There was no significant difference in arterial stiffness (baPWV and ABI) between the active and inactive groups. In females, the time spent in light PA were positively correlated with ABI (r = 0.396; p < 0.05) and the number of sedentary bouts over 50 minutes was inversely correlated with ABI (r = -0.402; p < 0.05). However, there was no significant correlation between PA and arterial stiffness in males. Conclusions: The results of this study suggest that light PA and sedentary behavior have a positive correlation with arterial stiffness in females.