• Title/Summary/Keyword: 하지 동맥

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Endovascular Revascularization for Aortoiliac Occlusive Disease (대동맥-장골동맥 폐쇄성 질환의 혈관 내 재개통술)

  • Myungsu Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.512-526
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    • 2021
  • Peripheral arterial disease is an occlusive condition commonly involving the lower extremity vessels. When the aortoiliac region is affected by this disease, conventional management involves surgical bypass and endovascular treatment has been mainly recommended for patients with focal and simple lesions. It has been common strategy to perform endovascular treatment for selected patients with high surgical risk due to its minimally invasive nature. However, recent advances in the devices and techniques for endovascular treatment have resulted in its utilization for treating patients with various disease status and its clinical outcomes are comparable to those of conventional surgery. This review discusses the current diagnostic strategies for peripheral artery disease in the aortoiliac region, followed by the introduction of techniques and devices, and the role of endovascular treatment.

Successful Embolization in the Patient with Hemoptysis Due to Right Inferior Phrenic Artery-pulmonary Artery Anastomosis and Pseudoaneurysm (우하횡경막동맥-폐동맥 문합부위의 가성동맥류로 인한 객혈로 색전술 후 성공한 예)

  • Park, Hyun Woong;Lee, Go Eun;Park, Yong Sung;Son, Ji Woong;Choi, Eu Gene;Na, Moon Jun;Kwon, Sun Jung
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.319-323
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    • 2009
  • The primary cause of hemoptysis is the bronchial artery. However, it should be noted that pulmonary artery and other vessels can cause hemoptysis. If the source of the bleeding is not determined after embolization, other evaluations are needed. Systemic-pulmonary anastomosis and pulmonary artery pseudo-aneurysm are rare vascular abnormalities with varying etiologies. An accurate and rapid diagnosis is needed in hemoptysis, since the cause may be life-threatening. We report a case of a 77-years-old man with persistent hemoptysis due to the right inferior phrenic artery - pulmonary artery anastomosis and pseudoaneurysm. After the embolization of the inferior phrenic artery, the hemoptysis was successfully treated.

Carotid Web in Duplex Sonography: 4 Cases (이중초음파에서 관찰된 경동맥갈퀴막: 4례)

  • Han, Minho;Seo, Kangsik;Choi, Junghye
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.1
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    • pp.78-82
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    • 2020
  • Carotid web is a disease that is rarely found in patients with ischemic stroke, whereas it is more frequently observed in cryptogenic stroke patients. Fibromuscular dysplasia is known as the cause of carotid web, and it has been reported that carotid web causes blood flow disturbance, resulting in both thrombus and embolic stroke. Carotid web is confused with carotid dissection because fibromuscular dysplasia causes relatively rigid fibrous structures to grow into the lumen of the carotid artery and this creates a double lumen that is seen on duplex sonography. In addition, carotid web is web-shaped and may be confused with other carotid artery diseases such as ulcerative plaque. However, carotid web tends to be thicker at the beginning and thinner at the end, and it also has no flutter. Therefore, this study reports on four cases of carotid web with the overall description of the carotid web and the characteristic findings of duplex sonography in patients with carotid web.

Surgical Treatment for Common Iliac Arteriovenous Fistula after Lumbar Laminectomy (요추궁절제술 후에 발생한 총장골동맥의 동정맥루에 대한 수술)

  • Ryu, Kyoung-Min;Ryu, Jae-Wook;Park, Seong-Sik;Kim, Seok-Kon;Seo, Pil-Won
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.455-458
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    • 2007
  • A 40 year-old male patient admitted for dyspnea and edema of the lower extremities. A pulsatile abdominal mass with a bruit was palpable in the right lower quadrant. Four months previously, he had underwent left partial lam-inectomy ($L4{\sim}5$) and discectomy at the L4 level due to disc protrusion, Computed tomography showed an ilio-iliac AV fistula with pseudoaneurysm at the L5 level. Because massive bleeding occurred when the aneurysm was entered, we closed the aneurysm and performed resection and suture of the aorta and both iliac arteries very near the aneurysm. After exclusion of the arterial side, we performed reduction angioplasty at the aneurysm and aorto-biiliac reconstruction with an artifcial graft. Twenty-four months after operation, he is doing well and hasn't had any complications on the follow-up.

Total Arterial 011-Pump Coronary Revascularization with Multiple Y Arterial Composite Grafts (다중 복합 Y 동맥 이식편(Multiple Y Composite Craft)을 이용한 완저너 동맥 무인공 심폐바이패스 관상동맥우회술)

  • Kim Do-kyun;Lee Kyo Jgon;Joo Hyun Chul;Li Gyjong;Ahn Jiyoung;shim Yungee;Yoo Kyung Jong
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.551-556
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    • 2005
  • Background: Complete arterial off-pump coronary artery bypass grafting (OPCAB) by sequential anastomoses with one or two arterial grafts provides favorable outcomes. However, problems of insufficient graft length, hypopefusion, kinking of graft, and unfavorable course of graft may be encountered. To solve these problems, we have used different technique with multiple arterial Y composite graft to allow end-to-side rather than sequential anastomoses and evaluated the results of this method. Material and Method: Between February 2003 and October 2004, If patients underwent total arterial OPCAB using multiple arterial V composite grafts with left internal mammary artery (LIMA), radial artery (RA), and right internal mammary artery (RIMA). We divided RA into multiple segments by number of distal target site after measuring of individual proper length and constructed arterial composite graft. One of segments was sutured end-to-side to LIMA and other segment was sutured end-to-side to the previously constructed radial graft. Postoperative graft patency was evaluated in 6f patients by multi-slice computed tomegraphy. Result: An average of $2.5\pm0.6$ arteries and $3.7pm0.7$ distal anastomoses per patient were done. There was no perioperative myocardial infarction, clinical hypoperfusion syndromes, and operative mortality. Postoperative mean CK-MB level was $17.4pm29.7\;IU/L.$Overall graft patency was $99.1\%\;(214/216)(LIMA:\;100\%,\;RA:\;98.4\%,\;RIMA:\;100\%).$ Conclusion: This technique allows total arterial OPCAB without technical problems and provides excellent early clinical results and graft patency. We believe that this technique is more convenient in the obtuse marginal area compared to sequential technique, and helpful in patients who require complex arterial grafting.

Depression and Coronary Artery Disease(I) : Pathophysiologic Mechanisms (우울증과 관상동맥 질환(I) : 병태생리적 기전)

  • Bae, Kyung-Yeol;Kim, Jae-Min;Yoon, Jin-Sang
    • Korean Journal of Biological Psychiatry
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    • v.15 no.4
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    • pp.275-287
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    • 2008
  • Depression and coronary artery disease are both highly prevalent diseases. Many previous studies suggest that depression is a common comorbid condition in patients with coronary artery disease and has a significant negative impact on the onset, course, and prognosis of coronary artery disease. However, the exact mechanisms that underlie the association between these two diseases remain unclear. Pathophysiologic mechanisms that may explain the effect of depression on coronary artery disease include hypercoagulability, hypothalamus-pituitary-adrenal axis and autonomic nervous system dysregulation, altered inflammatory response. On the contrary, pathophysiologic mechanisms in coronary artery disease that affect depression are less well known. It is also suggested that both diseases may share a common genetic vulnerability. The authors reviewed the literature on the pathophysiologic relationships of depression and coronary heart disease.

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Arterial Switch Operation: The Technical Modification of Coronary Reimplantation and Risk Factors for Operative Death (동맥전환술: 판상돔맥이식 수기변형과 수술사망의 위험인자)

  • 성시찬;이형두;김시호;조광조;우종수;이영석
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.235-244
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    • 2004
  • Anatomic correction of the transposition of the great arteries (TGA) or Taussig-Bing anomaly by means of the arterial switch operation is now accepted as the therapeutic method of choice. This retrospective study was conducted to evaluate the risk factors for operative deaths and the efficacy of technical modification of the coronary transfer. 85 arterial switch operations for TGA or Taussig-Bing anomaly which were performed by one surgeon from 1994 to July 2002 at Dong-A university hospital were included in this retrospective study Multivariate analysis of perioperative variables for operative mortality including technical modification of the coronary transfer was peformed. Overall postoperative hospital mortality was 20.0% (17/85). The mortality before 1998 was 31.0% (13/42), but reduced to 9.3% (4/43) from 1998. The mortality in the patients with arch anomaly was 61.5% (8/13), but 12.5% (9/72) in those without arch anomaly. In patients who underwent an open coronary reimplantation technique, the operative mortality was 28.1% (18/64), but 4.8% (1/21) in patients undergoing a technique of reimplantation coronary buttons after neoarotic reconstruction. Risk factors for operative death from multivariated analysis were cardiopulmonary bypass time ($\geq$ 250 minutes), aortic cross-clamping time ($\geq$ 150 minutes), aortic arch anomaly, preoperative event, and open coronary reimplantation technique. Operative mortality has been reduced with time. Aortic arch anomaly and preoperative events were important risk factors for postoperative mortality. However atypical coronary artery patterns did not work as risk factors. We think that the technical modification of coronary artery transfer played an important role in reducing the postoperative mortality of arterial switch operation.