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*

For the management of small intracranial arteriovenous malformation(AVM), various methods were proposed and their clinical outcomes have been analyzed. Microsurgery, radiosurgery, and embolization can be effective for the treatment of small AVM. Small AVM is known to be at a higher risk of bleeding. Therefore, the aim of treatment should be the prevention of neurological deterioration from bleeding. Microsurgery has the advantage of prompt elimination of the risk of rebleeding by complete excision with single procedure. With the advance of microsurgical techniques, small AVM can be cured with minimal neurological deficit. Outcome of microsurgery depends on location, size, and numbers and patterns of draining veins, which mean Spetzler-Martin grades. Stereotactic device guided surgery, preoperative careful evaluation, intraoperative electrophysiological and hemodynamic monitoring, and experienced surgical skills can greatly reduce adverse brain injury and help complete and exact excision of malformations. Radiosurgery has its unique role for the deep seated AVM, but long term outcome remains to be evaluated. In the management of small AVM, surgery should be considered as the first line of treatment, and radiosurgery can be an alternative for the surgically inaccessible lesions.
Brain Injuries ; Hemodynamics ; Hemorrhage ; Microsurgery ; Radiosurgery ; Veins

Catheterization ; adverse effects ; Child ; Humans ; Jugular Veins ; injuries ; Male ; Punctures

Carotid artery-internal jugular vein arteriovenous fistula is very rare, but it should be suspected in case of vascular injury by neck trauma because the diagnosis may be missed due to anatomical complexity of neck. We report a 57-year old male who had the carotid artery-jugular vein arteriovenous fistula caused by gunshot injury in the neck 44 years ago.
Arteriovenous Fistula* ; Diagnosis ; Fistula ; Humans ; Jugular Veins ; Male ; Middle Aged ; Neck ; Vascular System Injuries ; Veins

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

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

A 46-year-old male sustained severe pe- netrating injury by a sharp instrument to his right upper sternoclavicular junction. The wound tract was from suprasternal notch to mediastinum. Exploratory operation via median sternotomy under general anesthesia found a large mediastinal septum hematoncus, as well as brachiocephalic trunk and left brachiocephalic vein injuries. The perforating vascular wounds were repaired with 5-0 prolene suture. He was recovered uneventfully and discharged 9 days after operation. There was no sequel found during 7 years follow-up.
Brachiocephalic Trunk ; injuries ; surgery ; Brachiocephalic Veins ; injuries ; surgery ; Humans ; Male ; Middle Aged ; Sternoclavicular Joint ; injuries ; surgery ; Wounds, Penetrating ; surgery

A great variety of penetrating injuries is happening due to the increasing population and violence today. An optimal surgical approach is the key factor for successful repair of a complicated penetrating injury. A 23-yearold woman fell down the stairs from the second floor and received cervico-thoracic penetration injury due to a metalic bar. The metalic bar ruptured the right jugular vein and penetrated the left upper and lower lung. Under cervico-median sternotomy, neck vessels were repaired and the left thorax was successfully entered to repair the damaged lung through the mediastinal pleura. With this approach, the patient's position did not need to be changed during operation, while reduced the operation time compared to the conventional approach (cervical incision and standard thoracotomy).
Emergencies ; Female ; Floors and Floorcoverings ; Humans ; Jugular Veins ; Lung ; Neck ; Neck Injuries ; Pleura ; Sternotomy ; Thoracic Injuries ; Thoracotomy ; Thorax ; Violence ; Wounds, Penetrating

Most sharp force fatalities are attributed to homicide or suicide, with only a few accidental cases reported to date. Broken glass accounts for most of these accidental fatalities. We herein report an unusual accidental death caused by a broken glass cup. A 21-year-old woman was found dead on the floor of her studio apartment. The studio was a duplex consisting of one room and a bathroom, with a stepped drawer leading to the second floor. She was lying face down with her legs spread apart in a large pool of blood, surrounded by many pieces of broken glass. There was an oblique cut measuring 9 cm in length in the right sternocleidomastoid region just above the right clavicle. The surface of the cut wound showed irregular edges and the internal jugular vein was severed in the depth of the wound. She appeared to have fallen down the steps onto the ground floor and been fatally injured in the neck by a piece of broken glass.
Clavicle ; Deception ; Female ; Glass ; Homicide ; Humans ; Jugular Veins ; Leg ; Neck ; Neck Injuries ; Suicide ; Wounds and Injuries ; Young Adult

Long-term venous access devices have become an important part of the stantard care for children with malignant disease requiring chemotherapy. Totally implantable venous access system(TIVAS) gained widespread use and acceptance in the management of children with cancer in whom frequent and prolonged venous access is required. We analysed our experiences of insertion and use of totally implantable venous access device in 70 pediatric patients(79 devices), between April 1991 and April 1996. Median age of patients was 6 years and 10 months old. Median duration of utilization was 320 days(range 7-1449 days). Access vein was right external jugular vein(46.8%), left external jugular vein(21.5%), right internal jugular vein(11.4%), left internal jugular vein(3.8%), right subclavian vein(1.3%), left subclavian vein (7.6%), right cephalic vein(2.5%), left cephalic vein(5.1%). Complications related to surgical factors included: wound dehiscence(3 cases), hematoma(1 case), malposition of catheter(1 case). Complications not related to surgical factors included: occlusion of catheter(12 cases), wound infection(7 cases), sepsis(6 cases), leakage(3 cases), hematoma(3 cases), thrombosis of vein (1case). Many complications resolved spontaneously or with medical threatment and 14 cases(17.7%) required removal of system. We conclude that with long-term usage of totally implantable venous access system making it a safe and viable alternative for patients requiring long-term intravenous therapy.
Child ; Drug Therapy ; Humans ; Infant ; Subclavian Vein ; Thrombosis ; Veins ; Wounds and Injuries