• Archives of Plastic Surgery
• /
• v.49 no.6
• /
• pp.755-759
• /
• 2022

Brachial artery aneurysms are rare diseases that may be caused by infection or trauma. We report a case of a 71-year-old man who presented with a mass in his right antecubital fossa that increased in size slowly over time. Three years ago, the patient underwent ascending and total-arch replacement with artificial vessel graft to treat aortic root and ascending aorta aneurysm. Preoperative physical examination of right upper extremity showed a nonpulsatile mass with normal pulse of axillary, brachial, and radial arteries. The mass was removed and brachial artery reconstruction was done initially using saphenous vein graft. Two months later, the patient revisited with recurrent pseudoaneurysm, involving the bifurcation point of brachial artery. Aneurysm was totally resected and the brachial artery was reconstructed by interposition graft using a bifurcated GORE-TEX artificial vessel graft. The patient healed without complication and no recurrence was observed. Artificial vessel graft is an available option for reconstruction, and revascularization of vessel defect after excision of brachial artery aneurysm may involve bifurcation point.

• Journal of Chest Surgery
• /
• v.37 no.3
• /
• pp.220-227
• /
• 2004

The number of patients with coronary artery disease and peripheral vascular disease are increasing, and the need of small diameter vessel is also increasing. We developed small diameter artificial vessel and experimented in vivo. We got allogenic valve from mongrel dogs, and removed all cells from the allogenic valve. Then, we seeded autologous bone marrow cells onto the decellularized scaffold. After implantation of artificial vessel into the canine carotid artery, we performed angiography regularly. In case of vessel occlusion or at 8 weeks after operation, we euthanized dogs, and retrieved the implanted artificial vessels. Control vessels were all occluded except one (which developed aneurysmal dilatation). But autologous cell seeded vascular graft were patent by 4 weeks in one, by 6 in one and by 8 weeks in two. Histologic examination of patent vessel revealed similar structure to native artery. Tissue-engineered vascular graft manufactured with decellularized allogenic matrix and autologous bone marrow cells showed that tissue engineered graft had similar structure to native artery.

• Journal of Chest Surgery
• /
• v.27 no.11
• /
• pp.948-952
• /
• 1994

Superior mesenteric artery aneurysm is the third most common lesion and comprises approximately 5.5 % of all visceral artery aneurysms. The first successful repair was performed by DeBakey and Cooley in 1949. Since then, more than 100 cases have been reported. Fifty to sixty percent of these aneurysms are mycotic in origin. Other less frequent causes include arteriosclerosis, trauma, and medial degeneration. The operations are bypass with autologous tissue or with artificial vascular graft and aneurysmorrhaphy. We have experienced a case of superior mesenteric artery aneurysm which had undergone aneurysmectomy and artificial graft interposition. This is the first domestic case which was successful surgical repaired.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.29 no.3
• /
• pp.227-232
• /
• 2007

The radial forearm fasciocutaneous flap(RFFF) is a well-known flap for the reconstruction of oral and maxillofacial defects. It was first described by Yang et al. in 1981 and Soutar et al. developed it for the reconstruction of intraoral defect. RFFF provides a reliable, thin, and pliable soft tissue/skin paddle that is amenable to sensate reconstruction. It also has a long vascular pedicle that can be anastomosed to any vessel in either the ipsilateral or contralateral neck. However, split thickness skin graft(STSG) is most commonly used to cover the donor site, and a variety of donor site complications have been reported, including delayed healing, swelling of the hand, persistent wrist stiffness, reduced hand strength, and partial loss of the graft with exposure of the forearm flexor tendon. Various methods for donor site repair in addition to STSG have been developed and practiced to minimize both functional and esthetic morbidity, such as direct closure, V-Y closure, full thickness skin graft, tissue expansion, acellular dermal graft. We got a good result of using artificial dermis($Terudermis^{(R)}$) and secondary STSG for the repair of RFFF donor site defect esthetically and report with a review of literature.

• Journal of Korean Foot and Ankle Society
• /
• v.9 no.2
• /
• pp.224-226
• /
• 2005

In diabetic foot with arterial occlusive disease, skin defect on heel was tried to treat with free flap or local flap, but couldn't be treated well. Therefore below knee amputation was perfomed mostly. But we treated a patient of large heel defect with using of artificial bypass graft and antero-lateral thigh perforator flap.

• Journal of Chest Surgery
• /
• v.41 no.2
• /
• pp.160-169
• /
• 2008

Bakcground: To treat anastomosis site stenosis and occlusion of the artificial vessels used in vascular surgery, tissue-engineered artificial vessels using autologous cells have been constructed. We developed artificial vessels using a polymer scaffold and autologous bone marrow cells and performed an in vivo evaluation. Material and Method: We manufactured a vascular scaffold using biodegradable PLCL (poly lactide-co-${\varepsilon}$-caprolactone) and PGA (poly glycolic acid) fibers. Then we seeded autologous bone marrow cells onto the scaffold. After implantation of the artificial vessel into the abdominal aorta, we performed an angiography 3 weeks after surgery. After the dogs were euthanized we retrieved the artificial vessels and performed histological analysis. Result: Among the six dogs, 2 dogs died of massive bleeding due to a crack in the vascular scaffold 10 days after the operation. The remaining four dogs lived for 3 weeks after the operation. In these dogs. the angiography revealed no stenosis or occlusion at 3 weeks after the operation. Gross examination revealed small thrombi on the inner surface of the vessels and the histological analysis showed three layers of vessel structure similar to the native vessel. Immunohistochemical analysis demonstrated regeneration of the endothelial and smooth muscle cell layers. Conclusion: A tissue engineered vascular graft was manufactured using a polymer scaffold and autologous bone marrow cells that had a structure similar to that of the native artery. Further research is needed to determine how to accommodate the aortic pressure.

• Journal of Chest Surgery
• /
• v.35 no.5
• /
• pp.369-374
• /
• 2002

Background: Proper construction of vascular access and adequate maintenance are essential for the prognosis of the hemodialysis patients. Though arteriovenous fistula using autogenous vessel is the first of choice, the incidence of arteriovenous fistula using artificial graft is gradually increasing. The aim of this study was to analyse the patency rates between autogenous and artificial fistula, among artificial graft types, according to the accompanied disease. Material and Method: A retrospective study was conducted on 186 patients who underwent 292 arteriovenous fistula operations for hemodialysis at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 54.37 $\pm$ 12.79years, and the male: female ratio 99:87. Result: Among 292 operations, there were 156 autogenous fistula and 116 graft fistula. The other 20 operations were thrombectomy, takedown of graft, revision, and balloon dilatation. Patency rates of autogenous fistula were 92.78 $\pm$ 2.35% at 1 year and 39.03$\pm$9.08% at 5 years, and those of graft fistula were 96.09 $\pm$ 2.22% at 1 year and 16.45 $\pm$ 10.15% at 5 scars. However, there was no statistical significance between the two operations. The patients who had hypertension, diabetes or both had no statistical significance in the patency rate compared to that of patients without underlying disease. In addition, the type of graft used did not affect the patency rate. Second operation was needed in 62 patients and third operation in 31 patients, but their patency rate again had no statistical significance compared to that of the first operation. Conclusion: The patency of the artificial graft fistula was comparable to the autogenous fistula, but the patency according to types of graft need to be studied further. Furthermore, the underlying diseases did not affect the fistula patency.

• The Journal of the Korean bone and joint tumor society
• /
• v.3 no.1
• /
• pp.39-46
• /
• 1997

The pasteurization of bone tumor shows necrosis of tumor tissue and it is used widely as one of the options of limb salvage operation. However malignant tumors of the extremities commonly involve major neurovascular structures and pasteurization of this structure will make limb salvage operation much easier and safer than autogenous vein graft or artificial vessel graft. So the purpose of this study is to evaluate that the pasteurization can be applied in the limb salvage surgery of malignant tumor involving major vessels by means of studying the patency of pasteurized femoral vessels of the dogs. The right femoral arteries of 5 to 7 mm in diameters and veins of 7 to 10 mm in diameters of five dogs were pasteurized with sterile $60^{\circ}C$ saline for 30 minutes. Contralateral femoral vessels were evaluated for the control study. After one month, the changes in the pasteurized femoral vessels were evaluated by physical examinations, femoral angiography, gross findings, and pathologic findings on the each side. One month after pasteurization, the pulse of the femoral and popliteal arteries was palpated with normal tone on the each side of the all five experimental animals, and there was no gross swelling or necrotic changes in the legs. Femoral angiography showed a good patency of femoral and popliteal arteries. On the gross examinations at time of sampling of the specimen for the pathologic examinations, there was a good patency of femoral artery and vein, and mild fibrous adhesion was noted around the pasteurized femoral vessels. On the pathologic examinations, the more fibrotic adhesion and neocapillarization were noted in the outer layer of adventitia of the pasteurized femoral arteries and veins than the control sides. The vascular lumina were also patent in all cases. With these results, we suggest that the malignant tumor of the extremity involving major vessels is possibly treated by the limb salvage operation using the pasteurization of the involved vessels.

• Journal of Chest Surgery
• /
• v.29 no.4
• /
• pp.373-380
• /
• 1996

Prevention of thromboembolism is the most important task in the development of bioconpatible small caliber artificial vascular graft. In normal vessels, vascular endothelial cells maintain homeosatsis by secreting numerous factors. The aim of this study is to develope a method which Improves biocompatibility of small caliver polyurethane graft using endothelial cell culture technique, and ev luate the efTectiveness of extracelluar matrix for endothelization which was produced by cultured fibroblast. Methods ; Multiporous polyurethane tube of 3 mm diameter, 0.3 mm thickness was manufactured for vascular graft. Three mongrel dogs were intubated and internal jugular veins removed. Extracelluar matrix produced by cultured flbrobast which was obtained from dog's internal jugular vein were coated to the polyurethane graft. Then, endothelial cells extracted from Jugular vein were cultured and fixed on the extracelluar matrix layer of vascular graft. Endothelial cell coated vascular grafts were implanted to the carotid arteries of experimental dogs as interposed autograft. Implanted grafts were removed after 3 and 6 weeks. As a control, PTFE graft was interposed on carotid artery. These experiments demonstrated that extracelluar matrix produced by fibroblast can afford a base for endothelial cell linings of polyurethane graft. Although thrombosis were developed on autografted en othelial cell coated graft, 33% opening was noticed, and showed less adhesion to adjacent tissue layer. These findings suggest that fiboblast produced extracelluar matrix which can be used for edothelial cell lining vascular graft, and by improving the cultured endothelial cell function, there will be a new modality for reducing thrombosis on small vascular graft.

• The Journal of the Korean bone and joint tumor society
• /
• v.1 no.1
• /
• pp.105-112
• /
• 1995

Soft tissue sarcomas are malignant tumors that arise in the extraskeletal connective tissues of the body. And the clinical behavior of soft tissue sarcomas is characterized by a tendency to extensively invade surrounding soft tissues as well as early metastatic dissemination. Difficulties were encounted when soft tissue sarcomas invade the major vessels. There are a few reprots about the reconstruction of the major vessels after resection of soft tissue sarcomas. We have treated 3 cases of the soft tissue sarcomas involving the major artery. After marginal excision of the tumor mass, the involved major artery was reconstructed with Gortex artificial vessel graft and we could salvage the patient's extremity.