• Anatomy and Cell Biology
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• v.55 no.2
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• pp.118-123
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• 2022

This study aimed to clarify the anatomy of middle rectal artery and pelvic vasculature patterns, and to provide schematic information in a manner applicable to the total mesorectal excision. Forty sides of pelvis from 20 formalinembalmed cadavers (10 male, 10 female) were dissected, and all the pelvic vasculatures from the internal iliac artery were investigated, focusing on the middle rectal artery. Middle rectal arteries were classified into major types depending on their vascular origins. Each type was subdivided into minor types according to variability of the pelvic vasculature. A middle rectal artery was identified in 18 out of 20 cadavers, and in 25 out of 40 pelvic sides. In most cases, the middle rectal artery originated from the internal pudendal artery or inferior gluteal artery. These two arteries arose directly from the anterior trunk of the internal iliac artery or were bifurcated from the gluteal-pudendal trunk. In rare cases, these arteries arose from the posterior trunk of the internal iliac artery. The other origins of the middle rectal artery included the gluteal pudendal trunk, inferior vesical artery, internal iliac artery, obturator artery, and the prostatic artery, and the pelvic vasculatures in these cases also presented variability. The detailed anatomical findings related to the middle rectal artery and pelvic vasculatures are noteworthy for their improved clinical applicability.

• Korean Journal of Radiology
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• v.2 no.3
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• pp.145-150
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• 2001

Objective: To investigate the effectiveness of the newly designed Niti-S stent in the management of iliac arterial stenoses and occlusions. Materials and Methods: Stenoses (n=25) or occlusions (n=5) in the iliac arteries of 25 patients (30 limbs) were treated. The site of the lesions was the common (n=15) or external (n=11) iliac artery, or both (n=4). Eight limbs were treated for diffuse disease, six for highly eccentric lesion, five for occlusive lesion, and 11 for failed angioplasty. Results: In all patients, technical success was achieved without major complications. One death, not procedure-related, occurred within 30 days. Ankle-brachial indexes improved from 0.63 0.30 to 0.99 0.21, and ischemic symptoms showed improvement in 22 patients (88%). Fontaine classifications before stenting, namely IIa(n=3), IIb(n=16), III(n=2), and IV(n=4) improved to I(n=17), IIa(n=5), and IV(n=3). Follow-up over a 27 (mean, 19.8 8)-month period showed that cumulative patency rates were 95.8% at 1 year and 86.2% at 2 and 3 years. No significant decrease in the mean ankle-brachial index was observed. Conclusion: The Niti-S stent appears to be a safe and effective device for the treatment of iliac stenoses and occlusions. These preliminary results require confirmation with a larger series.

• Journal of Biomedical Engineering Research
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• v.25 no.6
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• pp.497-503
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• 2004

Numerical simulation of blood flow has been conducted based on real vessel geometries generated front DICOM medical images of abdominal and iliac bifurcated arteries of a healthy man. A program was developed to read cross sectional images of the three dimensional arteries and smoothly extract boundary coordinates of vessels. Commercial programs were employed for mesh generation and flow simulation. Pressures, velocities, and flow distributions were found to lie within normal physiological ranges. Peak velocity measured in the iliac artery by ultrasound was 20% smaller than that obtained by simulation. The trend of velocity variation in a cardiac cycle was fairly similar between the simulation and the ultrasonic measurements. Simulation based on real vessel geometry of individual patient provides information on pressure, velocity, and its distribution in the diseased arteries or arteries to be surgically treated. The results of simulation may help surgeons to better understand hemodynamic status and surgical need of the patient by revealing variation of the hemodynamic parameters. Futhermore, they may serve as basic data for surgical treatment of arteries. This research is expected to develop to a program in the future that early diagnose atherosclerosis by showing distribution of a hemodynamic index closely related to atherosclerosis in arteries.

• Journal of Chest Surgery
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• v.48 no.3
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• pp.214-216
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• 2015

Blunt abdominal trauma may cause peripheral vascular injuries. However, blunt abdominal trauma rarely results in injuries to the external iliac and common femoral arteries, which often stem from regional bone fractures. Here, we present the case of a patient who had experienced trauma in the lower abdominal and groin area three months before presenting to the hospital, but these injuries did not involve bone fractures and had been managed conservatively. The patient came to the hospital because of left lower leg claudication that gradually became severe. Computed tomography angiography confirmed total occlusion of the external iliac and common femoral arteries. The patient underwent femorofemoral bypass grafting and was discharged uneventfully.

• Archives of Reconstructive Microsurgery
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• v.3 no.1
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• pp.24-31
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• 1994

The heel, with its specialized fat for shock absorption at heel strike and large surface area for balance and weight bearing, is a important component of normal ambulation. Despite of distinguished improvement in the field of microsurgical free flaps, the choice of reconstruction of the heel has been remained controversial. We reviewed 22 cases of the heel reconstruction using vascularized free flaps from January, 1980 through May, 1993 at the Department of Orthopedic Surgery of Korea University Hospital. The results were as follows: 1. The etiology was traumatic in 21 cases, and chronic ulceration due to burn in 1. 2. The arteries used in free flaps were 11 dorsalis pedis arteries, 2 deep circumflex iliac arteries, 2 supeficial iliac arteries, 2 branches of lateral femoral circumflex iliac arteries, 2 radial arteries, and 3 thorcodorsal arteries. 3. The mean size of the vascularized bone was $4.5cm{\times}3.5cm$, and that of skin flap was $12.1cm{\times}9.2cm$. 4. Of the 22 cases, 19 had a successful outcome and 3 in failure, the causes of failure were thrombosis and infection.

• Journal of Chest Surgery
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• v.47 no.1
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• pp.71-74
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• 2014

For high-risk patients, endovascular aortic aneurysm repair (EVAR) is a good option but may lead to serious complications, which should be addressed immediately. A 75-year-old man with a history of abdominal surgery underwent EVAR for an aneurysm of the abdominal aorta and iliac arteries. During EVAR, iliac artery rupture and graft limb occlusion occurred, and they were successfully managed by the additional deployment of an iliac stent graft and balloon thrombectomy, respectively. We, herein, report a rare case of the simultaneous development of the two fatal complications treated by the endovascular technique.

• Kosin Medical Journal
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• v.33 no.3
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• pp.431-437
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• 2018

Spontaneous and isolated dissection of the limb arteries without involvement of the aorta is extremely rare, and has been reported previously in pregnant patients in association with collagen vascular disease, and in cases of high-energy trauma or intensive activity in athletes. There is no consensus yet on indications for medical or surgical therapeutic modality. Due to the rarity of spontaneous dissection of external iliac artery, its natural history has been poorly described. A healthy 50-year-old male with normotension was admitted with an acute onset of left flank pain. Left external iliac artery dissection was diagnosed by abdominal computed tomography.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1511-1516
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• 2020

The anomalous retro-psoas iliac artery is an extremely rare congenital iliolumbar vascular anomaly. A 51-year-old woman presented to our emergency department with worsening right lower extremity pain and weakness for 3 months. CT angiography of the right lower extremity showed no evidence of stenosis in the lower extremity arteries and the incidental finding of an anomalous right retro-psoas iliac artery. Herein, we report a rare case of anomalous retro-psoas iliac artery. Surgeons and clinicians need to be aware of this rare congenital anomaly to avoid severe complications during pelvic or orthopedic surgery.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.330-336
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• 1989

The patient was 47-year-old male who had suffered from aphasia and hemiplegia of the right side, but mental state was alert. On physical examination, BP was 130/80 mmHg in the right arm, but not checked in the left arm. The pulses of the left common carotid, brachial, and radial arteries were not palpable. The pulses of the right femoral, popliteal, and dorsalis pedis arteries were weakly palpable. Brain CT Scan revealed cerebral infarction of the left hemisphere. Aortogram showed occlusion of the left common carotid, and the right internal carotid and common iliac arteries. Subclavian steal phenomena were observed in the delayed aortogram. Double extra-anatomic bypasses; Axillo-Axillar bypass and Femora-Femoral bypass, were performed in the local anesthesia at two stages, because of risk of major operation under general anesthesia. Postoperatively, all pulses except for pulse of the left common carotid artery were equally palpable. On discharge, the hemiplegia of the right side was improved and able to walk with assistance.

• Clinical and Experimental Pediatrics
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• v.59 no.5
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• pp.242-245
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• 2016

Thromboembolic complications (TECs) are clinically important sequelae of nephrotic syndrome (NS). The incidence of TECs in children is approximately 2%-5%. The veins are the most commonly affected sites, particularly the deep veins in the legs, the inferior vena cava, the superior vena cava, and the renal veins. Arterial thrombosis, which is less common, typically occurs in the cerebral, pulmonary, and femoral arteries, and is associated with the use of steroids and diuretics. Popliteal artery thrombosis in children has been described in cases of traumatic dissection, osteochondroma, Mycoplasma pneumoniae infection, and fibromuscular dysplasia. We report of a 33-month-old girl with bilateral iliac and popliteal arterial thrombosis associated with steroid-resistant NS due to focal segmental glomerulosclerosis. Her treatment involved thrombectomy and intravenous heparinization, followed by oral warfarin for 8 months. Herein, we report a rare case of spontaneous iliac and popliteal arterial thrombosis in a young child with NS.