• Title, Summary, Keyword: Peripheral vascular disease

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A clinical study of peripheral vascular surgery using prosthetic or autogenous vein grafts -34 cases- (인조혈관 및 자가혈관을 이용한 말초혈관 수술 34예에 대한 임상적 고찰)

  • 이정렬
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.412-420
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    • 1986
  • From 1968 through September 1986, the authors have experienced 34 cases of peripheral arterial surgery using various vascular grafts. Almost all patients [32] were men, and age distribution was variable according to the disease entities. There were twenty eight cases of chronic occlusive peripheral vascular disease including ASO [21], Buerger`s disease [6], Aortoenteric fistula complicating infrarenal abdominal aortic aneurysm [1], four cases of vascular trauma, one case of acute arterial embolism [1] and one case of unknown etiology. The indications of operations for chronic vascular disease was intermittent claudication in 48%, rest pain in 45%, ischemic pregangrene or gangrene in 28%, and sensory change in 10% of patients. Types of operation used were arterial bypass in 28 cases [Aortobifemoral in 5, Aortoiliac in 3, Aortofemoral in 4, Aortoiliac with Aortofemoral in 1, Femorofemoral in 1, Femoropopliteal in 8, Femoroperoneal in 2, Axillofemoral in 3 cases of patients], graft interposition in four and patch angioplasty in three cases. Thirty four prosthetic vascular grafts including Dacron, Gore-Tex, Nylon and two autogenous saphenous vein graft and patch were used for vascular reconstruction in thirty four patients. Unfortunately recently performed one vein bypass was failed immediate postoperatively due to severity of disease and poor case selection. The authors experienced five post operative complications: wound infection [1], graft infection [1], bleeding [1], great saphenous neuralgia [1], pseudoaneurysm [1]. Twenty two of thirty four patients were followed up for more than one month and their cumulative patency rate was 81% [17/22] at 1 month and, 31% [7/22] at 5 month.

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Simultaneous Revascularization for Coronary Artery Stenosis and Peripheral Vascular Disease. (관상동맥 우회술과 말초 혈관 협착의 동맥 우회술의 동시 수술)

  • Song, Hyun; Lee, Eun-Sang;Yoo, Dong-Gon
    • Journal of Chest Surgery
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    • v.32 no.10
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    • pp.943-946
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    • 1999
  • There was no significant difference in morbidity and mortality between those that received simultaneous operation for coronary artery disease and peripheral vascular disease versus those that received coronary artery bypass graft alone. Simultaneous operation is also cost effective. A 46 year-old patient with resting chest pain and intermittent claudication was diagnosed as unstable angina and Leriche's syndrome. We performed simultaneous revascularization for coronary artery stenosis with internal mammary artery and right gastroepiploic artery and a bifurcated vascular graft interposition between in the aorta, left common iliac and right femoral arteries for Leriche's syndrome. The postoperative coronary angiogram and aortogram revealed a good patency of the arterial conduits and vascular graft. He has been followed for 12 months without any problem.

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Circulating Vascular Progenitor Cells in Moyamoya Disease

  • Kang, Hyun-Seung;Wang, Kyu-Chang;Kim, Seung-Ki
    • Journal of Korean Neurosurgical Society
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    • v.57 no.6
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    • pp.428-431
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    • 2015
  • Various approaches have been attempted in translational moyamoya disease research. One promising material for modeling and treating this disease is vascular progenitor cells, which can be acquired and expanded from patient peripheral blood. These cells may provide a novel experimental model and enable us to obtain insights regarding moyamoya disease pathogenesis. We briefly present the recent accomplishments in regard to the studies of vascular progenitor cells in moyamoya disease.

Surgical management of vascular disease : Clinical experience of 127 vascular surgery (혈관질환의 수술요법)

  • Ahn, Hyuk;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.261-269
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    • 1987
  • From 1976 through 1986, authors have experienced 127 cases of peripheral vascular surgery which had been done in this department. There were 29 cases of atherosclerosis obliterances including 7 Leriche syndrome, 32 Buerger`s diseases, 25 arterial thromboembolisms, 21 vascular injuries, 2 peripheral arterial aneurysms, 2 renovascular hypertensions, 1 congenital A-V malformation, 13 varicose vein of lower extremities, and 2 Jugular venous ectasia. Cases with vena caval disease and aortic disease were excluded. The mean age of ASO and Buerger`s disease was 56.1 yrs, 33.8 yrs respectively. The male to female ratio showed marked male preponderance [27:2, and 30:2], and almost every male patient was smoker. The indication of operation was similar in both disease entities. The method of operation for ASO were bypass procedure [17], thromboendarterectomy [6], and lumbar sympathectomy [5], and for Buerger`s disease were mainly sympathectomy and few bypass procedures and amputations. Seventeen patients with ASO were followed from 3 to 75 month and overall patency rate for bypass or endarterectomy in one and two months and 2 1/2 yr were 93%, 87%, and 31% respectively. Post operatively patient`s symptoms was relieved or alleviated in almost ASO patients, and about 60% of Buerger`s disease. We concluded that in patient with ischemic limb, we must revascularized aggressively for symptomatic relief. And choice of graft for bypass procedure was to be evaluated further.

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Crossed Renal Ectopia and Aorto-Occlusive Disease: A Management Strategy

  • Ng, Eugene;Campbell, Ian;Choong, Andrew MTL;Dunglison, Nigel;Aziz, Maged
    • Journal of Chest Surgery
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    • v.48 no.5
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    • pp.371-374
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    • 2015
  • We present a rare case of a patient with aortoiliac occlusive disease on the background of type A crossed renal ectopia, for whom open surgical intervention was required. Aortic exposure in patients with concomitant crossed renal ectopia can present technical challenges to the vascular surgeon. The knowledge of variations in the ectopic renal blood supply is of paramount importance when performing surgery to treat this condition and affects the choice of surgical exposure. We present and discuss the operative details of our patient and outline an approach to this subset of patients.

Reevaluation of Clinical Efficacy of Peripheral Vasodilator: Ethaverine HCl (말초혈관(襪梢血管) 확장제(擴張劑) Ethaverine HCl의 임상효과(臨床效果)의 재평가(再評價))

  • Kim, Yoon-Young;Cho, Young-W.
    • The Korean Journal of Pharmacology
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    • v.11 no.1
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    • pp.33-38
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    • 1975
  • The clinical efficacy of Ethaverine, a peripheral vasodilator, was studied according to a double-blind, non-cross over method in 29 diabetic patients with peripheral arterial diseases. The clinical improvement was assessed from the history of patients including the incidence and frequency of intermitten claudication. Ethaverine, after 4 weeks of therapy, was not effective in improving clinical symptoms compared to placebo. Ethaverine, however, was an efective vasodilator than placebo. The quality of vasodilation induced by Ethaverine, was similar to that of alcohol. A new clinical method of studying peripheral vasodilator was presented. The clinical symptoms of peripheral vascular arterial disease in the lower extrimities include reduced intensity of palpable pulses, coldness, and discoloration of the skin. Intermittent claudication may be present. Pathologic changes in vessel architecture precede the symptoms, and recognition of impending vascular insufficiency is a determining factor in selecting vasodilating therapy or surgical management. Also, post-operative patients who have chronic peripheral vascular arterial disease may be candidates for subsequent vasodilating therapy. Peripheral vasodilators, according to the series of reports, may be indicated in vasospastic peripheral vascular condition rather than an occlusive vascular disease and the vessel responds best when a relatively large vascular beds are involved rather than a small, capillary beds. Recently, the clinical efficacy of peripheral vasodilators have been challanged by many clinical investigators and clinicians. In this study, we have re-evaluated the efficacy of Ethaverine HCl as peripheral vasodilator in patients with vasospastic peripheral arterial disease. Ethaverine is claimed to be two to four times as potent a spasmolytic agent as papaverine in a variety of laboratory and clinical work.

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Vascular health late after Kawasaki disease: implications for accelerated atherosclerosis

  • Cheung, Yiu-Fai
    • Clinical and Experimental Pediatrics
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    • v.57 no.11
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    • pp.472-478
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    • 2014
  • Kawasaki disease (KD), an acute vasculitis that primarily affects young children, is the most common acquired paediatric cardiovascular disease in developed countries. While sequelae of arterial inflammation in the acute phase of KD are well documented, its late effects on vascular health are increasingly unveiled. Late vascular dysfunction is characterized by structural alterations and functional impairment in term of arterial stiffening and endothelial dysfunction and shown to involve both coronary and systemic arteries. Further evidence suggests that continuous low grade inflammation and ongoing active remodeling of coronary arterial lesions occur late after acute illness and may play a role in structural and functional alterations of the arteries. Potential importance of genetic modulation on vascular health late after KD is implicated by associations between mannose binding lectin and inflammatory gene polymorphisms with severity of peripheral arterial stiffening and carotid intima-media thickening. The changes in cholesterol and lipoproteins levels late after KD further appear similar to those proposed to be atherogenic. While data on adverse vascular health are less controversial in patients with persistent or regressed coronary arterial aneurysms, data appear conflicting in individuals with no coronary arterial involvements or only transient coronary ectasia. Notwithstanding, concerns have been raised with regard to predisposition of KD in childhood to accelerated atherosclerosis in adulthood. Until further evidence-based data are available, however, it remains important to assess and monitor cardiovascular risk factors and to promote cardiovascular health in children with a history of KD in the long term.

A study on the development of oxygen measurement device for diagnosis of peripheral vascular disease in lower extremity (하지 (下脂) 조직내의 말초 혈관계 질환 진단을 위한 산소 측정장치의 개발에 관한 연구)

  • 임현수;이준규;박동철
    • Progress in Medical Physics
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    • v.10 no.1
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    • pp.9-15
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    • 1999
  • The oxygen saturation of blood can be measured by the difference absorption in optical spectra of Hb and Hb0$_2$, as the well known previous study. In this study we developed the non-invasive oxygen measurement device for diagnosis of peripheral vascular disease in lower extremity using infrared and red LED which produce a peak spectral emission at a wavelength of 660 nm, and 940 nm. To evaluate the clinical application of the oxygen measurement device, we performed lower extremity study to measure the oxygen changes in response to physiological changes within biological tissue. The results showed that oxygen saturation of blood in biological tissue can be monitored from the separation arrangement light source and detector.

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Diagnosis of Coronary Artery Disease using Myocardial Perfusion SPECT in Patients with Diabetes Mellitus: Analysis of Risk Factors (당뇨병 환자에서 심근관류 SPECT을 이용한 관동맥질환의 진단: 위험인자 분석)

  • Seo, Ji-Hyoung;Kang, Seong-Min;Bae, Jin-Ho;Jeong, Shin-Young;Lee, Sang-Woo;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Lee, Jae-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.3
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    • pp.155-162
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    • 2006
  • Purpose: Diabetes mellitus (DM) is a critical disease with higher rates of cardiovascular morbidity and mortality due to myocardial ischemia and infarction. There is glowing interest in how to determine high-risk patients who are candidates for screening testing. This study was performed to evaluate the incidence of coronary artery disease (CAD) in diabetic patients detected by Tc-99m MIBI myocardial perfusion SPECT (MPS) and to assess risk factors of CAD and cardiac hard events. Subjects and Methods: 203 diabetic patients (64 male, mean age $64.1{\pm}9.0$ years) who underwent MPS were included between Jan 2000 and July 2004. Cardiac death and nonfatal myocardial infarction (MI) were considered as hard events, and coronary angioplasty and bypass surgery >60 days after testing were considered as soft events. The mean follow-up period was $36{\pm}18$ months. Patients underwent exercise (n=6) or adenosine stress (n=197) myocardial perfusion SPECT. Results: Perfusion defects on MPS were detected in 28.6% (58/203) of the patients. There was no cardiac death but 11 hard events were observed. The annual cardiac hard event rate was 1.1%. In univariate analysis of clinical factors, typical anginal pain, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were significantly associated with the ocurrence of hard events. Anginal pain, peripheral vascular disease, and resting ECG abnormality remained independent predictors of nonfatal MIs with multivariate analysis. Abnormal SPECT results were significantly associated with high prevalence of hard events but not independent predictors on uni- and multivariate analyses. Conclusion: Patients who were male, had longer diabetes duration (especially over 20 years), peripheral vascular disease, peripheral polyneuropathy, or resting ECG abnormality had higher incidence of CAD. Among clinical factors in diabetic patients, typical angina, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were strong predictors of hard events.

Color Doppler Ultrasonogram for the Peripheral Vascular disease in Diabetes Patients (당뇨병 환자의 하지 혈관 질환 검사에서 색도플러 초음파의 이용)

  • Lee, Kyung-Tai;Choi, Yun-Sun;Young, Ki-Won;Bae, Sang-Won;Lee, Seung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.80-85
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    • 2002
  • Purpose: This study is to assess the involvement of vessels in lower extremity in diabetics, using color doppler ultrasonogram. Materials and Methods: Arteries of both lower extremities were divided into 3 groups-large vessel (above-knee arteries), popliteal vessel, and small vessel(below-knee arteries) -, and evaluated using color doppler ultrasonogram in 60 diabetics. In color doppler ultrasonogram, the wave forms of all vessels were divided into 5 grades; grade I was triphasic wave form, grade II was spectral broadening form, grade III was monophasic wave form, grade IV was pulsus tardus et parvus form, grade V was absence of wave. Grade III, IV, V were grouped into vessel obstruction. We reviewed the correlationships among the degree of the peripheral vascular involvement, duration of dibetes, existence of bilaterality, types of dibetes. Results: Bilateral involvement was high in both lower extremity. Luminal stenosis, vascular calcification and vessel obstruction were high incidence in the patients over ten years of diabetic duration. Prevalence of vascular calcification and vessel obstruction were high in the small vessel of ankle level. But, insulin injection was not related to the incidence of vascular abnormality. Conclusion: Color doppler ultrasonogram seems to be useful for evaluation of peripheral vascular status, decision making for necessity of additional test, periodic follow -up tool in diabetes patients.

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