• Anatomy and Cell Biology
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• 제55권2호
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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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• 제2권3호
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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.

• 대한의용생체공학회:의공학회지
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• 제25권6호
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• pp.497-503
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• 2004

건강한 정상인의 복부대동맥과 장골동맥 분기관의 다이콤 의료 영상으로부터 구성된 혈관 모델을 대상으로 전산혈류해석을 수행하였다. 본 연구에서는 CT로 촬영한 혈관영상으로부터 단면영상을 읽고 각 단면의 경계 좌표를 매끄럽게 추출하는 프로그램을 개발하여 적응하였다. 해석용 3차원 메쉬 생성과 혈류해석은 상용프로그램을 사용하였다. 해석을 통해 얻어진 압력, 속도 및 유량 분포는 정상인의 생리학적 범위 내에 있었다. 초음파로 측정된 장골동맥 중심부의 심장 수축기 속도는 해석에 비해 20% 정도 작은 값을 보였으며 한 주기 동안 속도 변화의 경향은 유사하였다. 본 연구의 접근방법은 환자 개인의 실제 혈관 형상에 기반한 혈류해석으로서 좁아진 동맥 또는 시술 될 동맥에서의 압력, 속도값, 속도분포에 대한 정보를 제공한다. 이 결과는 의사로 하여금 환자의 혈류역학적 변수의 변화를 파악하게 하여 환자의 상태를 더 잘 이해하고 수술의 필요성을 판단하도록 도움을 줄 수 있으며 나아가 혈관 수술의 기초자료로 사용될 수 있을 것이다. 이 연구는 향후 동맥경화와 밀접히 연관된 혈류역학적 변수의 분포를 혈관 내에 보여줌으로서 동맥경화를 조기 진단하는 프로그램으로 발전할 것으로 기대된다.

• Journal of Chest Surgery
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• 제48권3호
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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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• 제3권1호
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• pp.24-31
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• 1994

저자들은 1980년 1월부터 1993년 5월까지 종골부위의 피부결손이나 또는 골결손을 동반한 연부조직 손상이 있었던 총 22례 환자에 대하여 유리피판술 또는 생골및 생피부편 이식술을 시행하고 최저 1년 이상 추시하여 다음과 다음과 같은 결과를 얻었다. 1. 유리 피부편의 크기는 최저 $7cm{\times}6cm$에서 최대 $28cm{\times}10cm$로 평균 $12.1cm{\times}9.2cm$였고, 유리 골편의 크기는 각각 $4cm{\times}3cm$, $5cm{\times}4cm$였다. 2. 재건술에 이용된 방법으로 유리 피부피판술은 족배 비판 11례, 서혜부 피판 2례, 전완부 피판 2례였고, 유리 피부근피판술은 활배근 피부근피판 3례, 대퇴근막장근 피부근피판 2례였으며, 골결손을 동반한 연부조직 손상인 경우 2례에서 생장골 피부편을 이식하였다. 3. 총 22례중 19례에서 유리편이 생존하여 86.4%의 성공율을 보였으며, 수술후 혈전증 2례와 감염이 발생하였던 1례에서 실패하였다. 이상의 결과로 볼 때, 고식적인 방법으로 치료하기 어려운 발뒤꿈치의 연부조직 또는 골결손의 치료로서 미세수술을 이용한 유리편 재건술이 유용한 방법으로 사료되며, 발뒤꿈치의 감각신경 회복에 대하여는 향후 지속적인 연구가 필요한 것으로 사료된다.

• Journal of Chest Surgery
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• 제47권1호
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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.

• 고신대학교 의과대학 학술지
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• 제33권3호
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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.

• 대한영상의학회지
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• 제81권6호
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• pp.1511-1516
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• 2020

허리근뒤 이상 온엉덩동맥은 엉덩허리 혈관 이상 중에서도 굉장히 희귀한 선천적 이상이다. 51세 여성이 응급실에 점점 심해지는 오른쪽 하지 통증과 쇠약으로 내원하였다. 하지 CT 혈관조영술에서 하지 동맥들에 협착 소견 없었으며 이 검사 중에 오른쪽 허리근뒤 온엉덩동맥을 우연히 발견하였다. 우리는 희귀한 허리근뒤 이상 온엉덩동맥 증례를 보고하자고 한다. 외과의사와 임상의는 이 선천적 이상을 알고 있어야 골반 쪽이나 기타 정형외과적 수술 시 발생할 수 있는 심각한 합병증을 예방할 수 있다.

• Journal of Chest Surgery
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• 제22권2호
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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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• 제59권5호
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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.