• Title/Summary/Keyword: peripheral artery

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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.

Bilateral Popliteal Artery Entrapment Syndrome (양측성 슬와동맥 포착증후군)

  • Yoo, Dong-Gon;Kim, Chong-Wook;Park, Chong-Bin
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.136-139
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    • 2007
  • Bilateral popliteal artery entrapment syndrome is a rare vascular disease, which leads to ischemic claudication as a result of disturbance to the blood flow from the abnormal relationship of the popliteal artery to the gastrocnemius muscle, a fibrous band or the popliteus muscle in the young male population. A 58-years-old male patient, complaining of ischemic claudication, coldness and 3rd toe gangrene of left leg of 1 month's duration was admitted to our institution. His left ankle-brachial index was decreased; therefore, a femoral artery angiography was peformed, which revealed a total occlusion below the distal superficial femoral artery of the left leg. An EKG revealed atrial fibrillation, suggestive of a thromboembolism of the popliteal artery due to atrial fibrillation; therefore, Urokinase thrombolysis was attempted. After the Urokinase thrombolysis, popliteal artery entrapment syndrome was diagnosed, with MRI then performed for an anatomical diagnosis. The popliteal artery entrapment was type 1, where the popliteal artery was displaced medial to the Gastrocnemius head. After complete removal of the popliteal artery aneurysm, interposition was performed with a contra lateral greater saphenous vein graft. A mild right popliteal artery aneurysm still remained, but surgery was not performed. Currently, the patent is surviving, without complications. Herein, the good results obtained for the surgical treatment of a severely affected leg, and the conservative treatment of a mildly affected leg, are reported.

Effect of Bee Venom Therapy in a Rat Femoral Artery Model induced Vasospasm (봉독약침(蜂毒藥鍼)이 백서(白鼠) 대퇴동맥(大腿動脈)의 혈관연축(血管攣縮)에 미치는 영향(影響))

  • Kim, Jae-soo;Kim, Hyung-hwan;Choi, Ho-young;Kim, Chang-hwan
    • Journal of Acupuncture Research
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    • v.20 no.1
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    • pp.35-50
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    • 2003
  • In order to study the effect of Bee venom(BV) on the subarachnoid hemorrhage animal model, the autologous whole blood was applied to the vicinity of the sprague dawley rat right femoral artery. Following periarterial application of autologous whole blood(PAB) and intraperitoneal injection of BV(1:5,000 nd 1:500), the vasomotor responses to BV(from 1:500,000 to 1:500) were identified and the histological changes, neovascularized blood vessel were observed. We have shown that alterations in vasomotor and histological findings are elicited following application of periarterial blood and i.p. injection of BV(1:5,000 and 1:500) induced heavy vasospasm and neovascularization on the subarachnoid hemorrhage like model form peripheral artery.

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Left External Iliac and Common Femoral Artery Occlusion Following Blunt Abdominal Trauma without Associated Bone Injury

  • Byun, Chun Sung;Park, Il Hwan;Do, Hye-Jin;Bae, Keum Seok;Oh, Joong Hwan
    • 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.

Aorticopulmonary Window: one case report (대동맥중격결손증[수술치험 1예])

  • 최영호
    • Journal of Chest Surgery
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    • v.14 no.3
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    • pp.302-306
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    • 1981
  • Aorticopulmonary window is a rare anomaly among congenital heart disease. Various terms have been suggested including A-P window, A-P fenestration, fistula, aorticseptal defect etc. The defect lies usually between the left side of the ascending aorta and right wall of the pulmonary artery just anterior to the origin of the right main pulmonary artery. We have experienced one case of aorticopulmonary septal defect which was diagnosed as V5D with pulmonary hypertension in 1 4/12 year old, 7.2 Kg, male patient. Operation was done under the hypothermic cardiopulmonary bypass using 5t. Thomas cardioplegic solution. Vertical right ventriculotomy over the anterior wall of RVOT revealed no defect in the ventricular septum, and incision was extended up to the main pulmonary artery to find the source of massive regurgitation of blood through MPA. Finger tip compression of the aorticopulmanary window was replaced with Foley bag catheter balloon, and the $7{\times}10$ mm aorticoseptal defect located 15mm above the pulmonic valve was sutured continuously wih 3-0 nylon suture during azygos flow of cardiopulmonary cannula which was located distal to the window resulted massive air pumping systemically, and temporary reversal of pumping was tried to minimize cerebral air embolism. Remained procedure was done as usual, and pump off was smooth and uneventful. Postoperatively, patient was attacked frequent opistotonic seizure with no recovery sign mentally and p.hysically. Vital signs were gradually worsen with peripheral cyanosis and oliguria, and cardiac activity was arrested 1485 minutes after operation. Autopsy was performed to find the sutured window and massive edema of the brain.

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Comparison of Radiographic and Echocardiographic Features between Small and Large dogs with Heartworm Disease

  • Kim, So-Young;Park, Hyun-Young;Lee, Jung-Yang;Lee, Young-Won;Choi, Ho-Jung
    • Journal of Veterinary Clinics
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    • v.36 no.4
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    • pp.207-211
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    • 2019
  • This study was performed to compare the radiographic and echocardiographic features of cardiovascular changes between small and large dogs with heartworm diseases. Total of 49 dogs from two institutions were included in this study. The dogs were diagnosed with heartworm infestation and underwent thoracic and echocardiography. On thoracic radiographs, vertebral heart scale, reverse D shape, main pulmonary artery dilation, peripheral pulmonary artery dilation, and evidence of right heart failure were evaluated. On echocardiographs, visibility of worms, main pulmonary artery to aortic root (MPA/Ao) ratio, right to left ventricular basal diameter (RVD/LVD) ratio, and pulmonary hypertension were evaluated and analyzed between small and large dogs. The proportion of reverse D shape of the heart and accuracy for right ventricular hypertrophy in small dogs were lower than those of the large dogs. For echocardiographic parameter, the MPA/Ao and RVD/LVD ratio in the small dogs were significantly lower than those of the large dogs. As the results, thoracic radiography have a tendency to underestimate the severity of HWD in small dogs and should be used with echocardiography.

A Case of Moyamoya Disease in a Child with Alagille Syndrome (Alagille 증후군 환아에서 발생한 Moyamoya병 1례)

  • Lim, Mi Rang;Lee, So Yaun;Kim, Deok Soo;Kim, Kyung Mo;Ko, Tae Sung
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.86-90
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    • 2003
  • Alagille syndrome is a autosomal dominant disorder characterized by intrahepatic bile duct paucity and resultant chronic cholestasis in combination with cardiac(mainly peripheral pulmonary stenosis), skeletal, ocular, and facial abnormalities. In addition to the pulmonary stenosis, in large series, anecdotal reports of vascular lesions have concerned the renal artery, aorta, hepatic artery, carotid artery, celiac artery or subclavian artery. Theses diffuse vascular abnormalities, which appear to be a feature of Alagille syndrome, suggest Notch signaling pathway defects affect angiogenesis. The associations of Alagille syndrome with moyamoya disease, the chronic cerebrovascular occlusive disease, were reported and suggested as additional evidence of vasculopathy of Alagille syndrome. We report another 25 month-old Alagille syndrome girl who presented with acute left hemiparesis and was diagnosed with moyamoya disease through the cerebral angiographic study.

박막니티놀 생체재료의 혈액적합성 및 소형혈관계 스텐트 연구

  • Cheon, Yeong-Jae
    • Journal of the KSME
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    • v.52 no.12
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    • pp.41-48
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    • 2012
  • 생명을 위협하는 주요한 소형혈관 치료를 위한 의료기기의 생체재료로서 박막니티놀이 최근 소개되었고, 다양한 실험실 실험(in vitro)과 생체실험(in vivo)을 통하여 혈액적합성과 소형혈관치료 디바이스로서의 가능성에 대한 연구가 이루어졌다. 이 글에서는 박막니티놀의 특성, 제조방법 그리고 이 재료를 이용한 디바이스인 뇌동맥류 유량 조절 스텐트(cerebral aneurysm flow-diverting stent)와 말초동맥질환 스텐트 그라프트(peripheral artery disease stent graft)에 대하여 설명을 하였다.

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Off-Pump Coronary Artery Bypass Grafting (심폐바이패스없이 시행하는 관상동맥우회술)

  • Kim, Ki-Bong;Lim, Hong-Gook;Huh, Jae-Hak;Ahn, Hyuk;Ham, Byung-Moon
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.38-44
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    • 2000
  • Background: We analyzed the result of the "Off-Pump" Coronary Artery Bypass grafting (OPCAB) performed to minimize inflammatory responses to cardiopulmonary bypass and myocardial ischemia during the aortic cross-clamp period. Material and Method : The preoperative diagnosis operative procedure mortality complication and postoperative course of the 50 patients who underwent OPCAB between January 1998 and September 1998 were analyzed. There were 34 males and 16 females with mean age of 60$\pm$9 years. Preoperative clinical diagnoses were unstable angina in 31(62%) stable angina in 16(32%) and clinical diagnoses were unstable angina in 31(62%) stable angina in 16(32%) and postinfarction angina in 3(6%) patients. Preoperative angiographic diagnoses were three-vessel disease in 25(50%) two-vessel disease in 5(10%) one-vessel disease in 7(14%) and left main disease in 13(26%) patients. There were elective operation in 37 cases and urgent operation in 13 cases. Result: The mean number of grafts was 3.2$\pm$1.2 per patient. Grafts used were unilateral internal thoracic artery in 43 greater saphenous vein in 37 radial artery in 7 bilateral internal thoracic arteries in 4 and right gastroepiploic artery in 2 cases Forty sequential anastomoses were performed in 18 cases. Vessels accessed were left anterior descending artery in 48 diagonal branch in 41 obtuse marginal branch in 30 right coronary artery in 24 posterior descending artery in 9 ramus intermedius in 5 and posterolateral branch in 5 anastomoses. Predischarge coronary angiography performed in 44 patients demonstrated the patency rate of 89.5%(128/143) Operative mortality was 2%(1/150) Postoperative complications were arrhythmia in 5 graft occlusion that needed reoperation in 4. perioperative myocardial infarction in 2 femoral artery thromboembolism developed after the application of IABP in 1 postoperative transient delirium in 1 peripheral compression neuropathy in 1 case. Sixteen patients(32%) were extubated at the operating room and the other patients were extubated at the mean 13$\pm$20 hours after the operation. Mean duration of stay in intensive care unit was 49$\pm$46 hours. Thirteen patients(26%) required blood transfusions perioperatively and the amount of perioperative blood transfusion was mean 0.70$\pm$1.36 pack/patient. Conclusion: OPCAB is suggested to be the ideal technique with less postoperative complication less hospitalization time and less cost.less cost.

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