Since introduction of venous flap in 1980, many experimental studies and clinical applications of various kinds of venous flaps were reported. Venous flap has the following advantages : (1) nonbulky and goo-quality of flap (2) long & large vascular pedicle (3) easy & rapid elevation of flap (4) no sacrifice of major arteries (5) a single operative field. But, we also have some disadvantages of difficult handling of the pliable veins and the tmcertainty of flap survival. For the better result we had to design the size of the flap larger than that of defect and increase the number of draining vein to reduce the postoperative edema of the flap. We have treated the defects of soft tissue of the hand using free arterialized venous flap from the flexor aspect of the forearm & had an excellent results.
Arteries ; Edema ; Forearm ; Hand* ; Veins ; Wounds and Injuries*

Because of extensive vascular injury, reconstruction of ring avulsion injury is classically believed to be challenging for a hand surgeon. We report a case of ring avulsion injury treated by debridement of the damaged artery and interpositioning vessel graft with a healthy proper palmar digital artery, which lead to successful functional recovery.
Arteries ; Debridement ; Glycosaminoglycans ; Hand ; Transplants ; Vascular System Injuries

Arteries ; Fractures, Bone ; Humans ; Pubic Bone ; Vascular System Injuries

PURPOSE: Fingertip injuries are the most common type of hand injuries. The most effective method of reconstruction is controversial functionally and aesthetically. We reports the clinical results of reverse digital artery island sensory flap by bilateral neurorrhaphy for finger tip reconstruction. MATERIALS AND METHODS: From April 1998 to November 2000, 11 fingers in 10 patients with soft tissue defect of the distal phalanx were reconstructed using a reverse digital artery island sensory flap. In all cases bilateral neurorrhaphy was performed. RESULTS: The survival of flaps was successful in all cases. All of the patients were followed up for more than 6 months. The mean value of moving two-point discrimination was 4.0 mm. Our patients were usually satisfied with the end result of these flaps both aesthetically and functionally. CONCLUSION: We consider that reverse digital artery sensory flap is a safe and reliable procedure with a high survival rate, and that this modaleity is an excellent choice functionally and aesthetically for the coverage of defects of the distal phalanx.
Arteries* ; Discrimination (Psychology) ; Fingers ; Hand Injuries ; Humans ; Survival Rate

BACKGROUND AND OBJECTIVES: ovastatin, a HMG-CoA reductase inhibitor, is known to show antiproliferative effects on VSMC after vessel injury, but a large amount of the drug is needed orally for this purpose. This study investigated the effects of lovastatin given locally to injured carotid arteries of rats on reducing neointimal hyperplasia. MATERIALS AND METHOD: Lovastatin was given perivascularly to balloon-injured carotid arteries of 21 rats in 1 microM to the low-dose group, and 30 microM to the high-dose group. The control group was treated with pluronic gel only. Two weeks later, the lumen area, neointimal areas and the number of actively proliferating cells were obtained and compared. RESULTS: eointimal area was 0.113+/-0.032 mm2, 0.065+/-0.017 mm2, 0.072+/-0.017 mm2 in the control, low-dose and high-dose groups respectively. The area was significantly smaller in the treatment groups (p<0.05), but no significant difference was observed between the treatment groups. The number of actively proliferating cells per mm2 of neointimal area were 714.5+/-227.4, 688.4+/-333.7, and 1526.3+/-744.0 in the groups respectively, and the number was significantly high in the high-dose group (p<0.05). CONCLUSION: Local administration of lovastatin is effective in reducing neointimal hyperplasia after vascular injury, but extremely high doses are not needed locally for this purpose.
Animals ; Carotid Arteries* ; Carotid Artery Injuries* ; Hyperplasia* ; Lovastatin* ; Oxidoreductases ; Rats* ; Vascular System Injuries

BACKGROUND AND OBJECTIVES: ovastatin, a HMG-CoA reductase inhibitor, is known to show antiproliferative effects on VSMC after vessel injury, but a large amount of the drug is needed orally for this purpose. This study investigated the effects of lovastatin given locally to injured carotid arteries of rats on reducing neointimal hyperplasia. MATERIALS AND METHOD: Lovastatin was given perivascularly to balloon-injured carotid arteries of 21 rats in 1 microM to the low-dose group, and 30 microM to the high-dose group. The control group was treated with pluronic gel only. Two weeks later, the lumen area, neointimal areas and the number of actively proliferating cells were obtained and compared. RESULTS: eointimal area was 0.113+/-0.032 mm2, 0.065+/-0.017 mm2, 0.072+/-0.017 mm2 in the control, low-dose and high-dose groups respectively. The area was significantly smaller in the treatment groups (p<0.05), but no significant difference was observed between the treatment groups. The number of actively proliferating cells per mm2 of neointimal area were 714.5+/-227.4, 688.4+/-333.7, and 1526.3+/-744.0 in the groups respectively, and the number was significantly high in the high-dose group (p<0.05). CONCLUSION: Local administration of lovastatin is effective in reducing neointimal hyperplasia after vascular injury, but extremely high doses are not needed locally for this purpose.
Animals ; Carotid Arteries* ; Carotid Artery Injuries* ; Hyperplasia* ; Lovastatin* ; Oxidoreductases ; Rats* ; Vascular System Injuries

Blunt carotid artery injury is uncommon, yet not rare. However, it is often underdiagnosed because of inconsistent early symptoms or masking by the presence of coexisting brain and spinal injuries. The delay between the accident and the onset of cerebral ischemic symptoms is variable and has been reported to range from minutes to ten years. However, to our knowledge, there has been no report on a case presented with delayed intracerebral hemorrhage 25months after blunt carotid artery injury. We report on a case with discussion of supporting evidence and possible mechanisms.
Brain ; Carotid Arteries* ; Carotid Artery Injuries* ; Cerebral Hemorrhage ; Masks ; Spinal Injuries

Surgical resection is the only option for the treatment of carotid body tumor. The tumor is characterized by its hypervascularity and adherence to the carotid artery. Neurovascular injuries have been a well known surgical complication during the procedure. We experienced a case of carotid artery injury during the resection of carotid body tumor and which was reconstructed with interposition graft using autogenous vein. Vascular injury as a complication during the resection of carotid body tumor was reviewed.
Carotid Arteries ; Carotid Artery Injuries ; Carotid Body Tumor ; Carotid Body ; Transplants ; Vascular System Injuries ; Veins

The superficial palmar arch of the hand is formed by the anastomosis of the palmar branch of the radial artery and the distal part of the ulnar artery. The variation of the superficial palmar arch and its branches have been known to occur frequently. There are many reports about the formation of the arch and the branches of it and the incidence of the median artery. These variations of the arch are considerablly valuable in the surgical management of the hand injuries, especially in vascular injury. This study deals with the Korean hands. The author observed the pattern of the superficial palmar arch, the presence of the median artery and the pattern of the common palmar digital arteries and the results are as followings; 1. The superficial palmar arch was complete type in 97.2% and incomplete type in 2.8%, The majority of the complete arch was type 1 and type 2. 2. The median artery was present in 2.8%. 3. The common palmar digital artery was present as type 1 in 65.3% type 2 in 13.9% type 3 in 4.2%, type 4 in 5.5%, type 5 in 6.9% and type 7 in 1.4%.
Arteries ; Hand ; Hand Injuries ; Incidence ; Radial Artery ; Ulnar Artery ; Vascular System Injuries

In acute hand injury, there are sometimes hattened neglected or overlooked vascular injury by primary operators. The authors evaluated the final results and prognosis after secondary revascularization. In eight cases, the authors performed secondary revascularization after prolonged warm ischemia. Five fingers in five cases among them were successfully survived and three cases finally necrosed. The mean warm ischemic time was 56.1 hours. In revascularization procedures, end-toend artery anastomosis was possible in six cases. In two cases, vein graft was needed to anastomose digital artery, which resulted in complete survival of the fingers. In all three cases, revision amputation of the fingers was done. In acute complex hand injury, the importance of evaluation of the vascular injury can not be overemphasized. The necessity of the early secondary revascularization as well as serious consequence caused by misdiagnosis of vascular injury should be aware.
Amputation ; Arteries ; Diagnostic Errors ; Fingers ; Hand Injuries* ; Hand* ; Prognosis ; Transplants ; Vascular System Injuries* ; Veins ; Warm Ischemia