Trends and Recommendations in the Resource-based Relative Value System.
Journal of the Korean Society for Vascular Surgery.2004;20(2):276-281.
No abstract available.
Journal of the Korean Society for Vascular Surgery
to Present ISSN: 1229-991X
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Treatment of Angioaccess Induced Ischemia with Distal Revascularization Interval Ligation: 1 Case.
Journal of the Korean Society for Vascular Surgery.2004;20(2):272-275.
Ischemic steal syndrome is an infrequent but potentially serious complication that can be difficult to manage while maintaing vascular access surgery. Traditional procedures directed toward increasing the resistance in the fistula have yielded unreliable results. The technique of distal revascularization interval ligation provides a more physiologic approach. We report that 79-year-old man with ischemic hand after angioaccess surgery was successfully treated after DRIL procedure.
Aged ; Fistula ; Hand ; Humans ; Ischemia* ; Ligation*
Aged ; Fistula ; Hand ; Humans ; Ischemia* ; Ligation*
Acute Embolic Attack on Persistent Sciatic Artery: 1 case.
Journal of the Korean Society for Vascular Surgery.2004;20(2):268-271.
Persistent sciatic artery (PSA) is a continuation of the internal iliac artery into the popliteal-tibial vessels and this structure provides the major blood supply to the lower limb bud during early embyrologic development, Its remnants participate in the formation of the inferior gluteal, deep femoral, popliteal, peroneal and pedal vessels. When the femoral artery develops, the PSA then involutes. In rare circumstances it persists and so provides the only major blood supply to the lower limb. The PSA was first reported by Green in 1832 and until now, only about 100 cases have been reported in the world literatures. This rare vascular anomaly is associated with aneurysmal formation in 15% to 46% of cases and it has a bilateral location in 22% of PSA cases. In more than 40% of cases, PSA is asymptomatic. When present, such non-specific symptoms as gluteal pain and painful buttock mass are presented. However, the most frequent clinical finding is lower limb ischemia because in 25% of such cases, the presented symptoms are limb threatening. We describe here the case of a 54 year-old female affected with PSA occlusion, and she was treated with a combination of thrombolysis and thromboembolectomy.
Aneurysm ; Arteries* ; Buttocks ; Extremities ; Female ; Femoral Artery ; Humans ; Iliac Artery ; Ischemia ; Lower Extremity ; Middle Aged
Aneurysm ; Arteries* ; Buttocks ; Extremities ; Female ; Femoral Artery ; Humans ; Iliac Artery ; Ischemia ; Lower Extremity ; Middle Aged
Acute Lower Limb Ischemia in a Patient with Persistent Sciatic Artery: A Case Report.
Journal of the Korean Society for Vascular Surgery.2004;20(2):264-267.
The persistent sciatic artery (PSA) is a rare congenital vascular anomaly. It may predispose to thrombosis, atherosclerotic or aneurismal degeneration. We report a patient having PSA presenting with acute lower limb ischemia due to popliteal artery embolism. The patient was successfully treated with surgical exclusion of the PSA and arterial reconstruction of the lower extremity.
Arteries* ; Embolism ; Humans ; Ischemia* ; Lower Extremity* ; Popliteal Artery ; Thrombosis
Arteries* ; Embolism ; Humans ; Ischemia* ; Lower Extremity* ; Popliteal Artery ; Thrombosis
Tuberculous Pseudoaneurysm of the Descending Thoracic Aorta.
Journal of the Korean Society for Vascular Surgery.2004;20(2):259-263.
The tuberculous aortic aneurysm is exceedingly rare. Kamen L. first described tuberculous aortic aneurysm in 1899. Since then, only about 40 cases have been reported in the literature 1945 to 2001, and among them only 19 cases have affected the thoracic aorta. The incidence and prevalence of tuberculosis is still reported to be far too high, and the demographic and geographic disease distribution has changed rapidly because of immigration and traveling from endemic areas, and also this is due to the increasing use of immunosuppression or because of HIV cases. Multi-resistant strains and comorbidities impair the effects of medical therapy and so this might result in surgical complications. The tuberculous aortic aneurysm generally occurs in the setting of disseminated tuberculosis, and it has a high mortality rate. This report describes a 35-year-old woman who had miliary pulmonary tuberculosis, and she underwent a surgical operation for tuberculous pseudoaneurysm of the thoracic aorta. Early detection and the proper surgical and medical combination therapy are essential for the optimal treatment of thoracic aortic pseudoaneurysm, as was done in this successful case.
Adult ; Aneurysm ; Aneurysm, False* ; Aorta, Thoracic* ; Aortic Aneurysm ; Comorbidity ; Emigration and Immigration ; Female ; HIV ; Humans ; Immunosuppression ; Incidence ; Mortality ; Prevalence ; Tuberculosis ; Tuberculosis, Pulmonary
Adult ; Aneurysm ; Aneurysm, False* ; Aorta, Thoracic* ; Aortic Aneurysm ; Comorbidity ; Emigration and Immigration ; Female ; HIV ; Humans ; Immunosuppression ; Incidence ; Mortality ; Prevalence ; Tuberculosis ; Tuberculosis, Pulmonary
Laparoscopic-assisted Aortic Surgery.
Journal of the Korean Society for Vascular Surgery.2004;20(2):255-258.
Since the initial success and widespread acceptance of laparoscopic cholecystectomy (1), the application of this laparoscopic technique to vascular surgery has been somewhat limited. However, after laparoscopic techniques were first applied to vascular surgery in 1993 (2), many technological developments for this procedure have been accepted. Laparoscopy confers three major benefits: better visualization of the aorta, less bowel manipulation, and avoidance of hypothermia. However, advanced total laparoscopic surgery can be difficult and time-consuming, and its benefits are not yet readily apparent. Laparoscopic-assisted aortic surgery enables the surgeon to use a smaller incision and this reduces surgical trauma when compared with the conventional surgical techniques (3). The use of the HandPort device enables the surgeon to use their hands while maintaining the pneumoperitoneum; this allows the vascular surgeon to maintain the sense of touch, and to perform the aortoprosthetic anastomosis safely with use of a MultiTool instrument. Our two case reports illustrate the feasibility of laparoscopic-assisted aortic surgery via minilaparotomy.
Aorta ; Cholecystectomy, Laparoscopic ; Hand ; Hypothermia ; Laparoscopy ; Laparotomy ; Pneumoperitoneum
Aorta ; Cholecystectomy, Laparoscopic ; Hand ; Hypothermia ; Laparoscopy ; Laparotomy ; Pneumoperitoneum
Clinical Study of Endovenous Laser Treatment in Short Saphenous Vein Varicosity.
Journal of the Korean Society for Vascular Surgery.2004;20(2):250-254.
PURPOSE: With regard to the selection of varicose treatment, conventional therapy such as stripping and ligation has became unpopular but the selection of endovenous radiofrequency coagulations (RF) or endovenous laser treatment (EVLT) of the greater saphenous varicose vein have increased as they are more convenient for patient. Mipiphlebectomy (MP) and sclerotherapy (SC) have also been welcome due to the advantages of less scaring and a rapid return to work. Therefore, varicose vein of the greater saphenous vein (GSV) and its tributaries are well controlled by new modalities, such as RF, EVLT, MP and SC, but those of the short saphenous vein (SSV) are difficult to control because of the many tributaries and perforating veins. A new modality with a simultaneous EVLT +/-MP combination for the treatment of SSV varicosities has been used. METHOD: 27 cases of SSV varicosities in 24 patients, between Feb 2002 and May 2004, were included in this study. The series of patients were followed up for recurrence of varisose vein, SSV recanalization and complications. RESULT: The patients were grossly examined postoperatively, and doppler were checked, and the varicose recurrence rates at 1, 3 and 6 months were found to be 0, 7.4 (2/27) 25.9% (7/27), espectively, the Doppler SSV recanalization rates at 1, 3 and 6 months were 0, 0 and 11.1% (3/27) and tributaries recurrence rates were 0, 7.4 (2/27) and 14.8% (4/27) with recurrence controlled by MP or SC, or observed for progression only. Most patients (93.6%) were satisfied with our treatment modality, and complications, such as pain, hematoma and swelling were controlled within 1 month, with 3 cases of tingling sensation of calf that subsided spontaneously. CONCLUSION: The control of SSV varicosities wes a little hard due to the many recurrences after surgery or EVLT alone. In our study, the cases of SSV varicosity alone were collected, and combination therapy, such as EVLT with miniphlebectomy, wes effective, as indicated by the relatively few recurrences, and even in these recurrence cases, additional postoperative MP or SC was enough for patient's satisfaction.
Hematoma ; Humans ; Ligation ; Recurrence ; Return to Work ; Saphenous Vein* ; Sclerotherapy ; Sensation ; Varicose Veins ; Veins
Hematoma ; Humans ; Ligation ; Recurrence ; Return to Work ; Saphenous Vein* ; Sclerotherapy ; Sensation ; Varicose Veins ; Veins
The Clinical Value of Venography Prior to Arteriovenous Fistula Creation.
Journal of the Korean Society for Vascular Surgery.2004;20(2):242-249.
PURPOSE: Maturation failure after arteriovenous fistula (AVF) creation is a major problem that determines the early success of a fistula for hemodialysis. Therefore the pre-operative evaluation of venous status is widely recommended for obtaining a favorable AVF result. To assess the effectiveness and significance of venography as a pre-operative vein evaluation mode, we compared the short-term and long-term results of AVF according to the performance of pre-operative venography. METHOD: Two hundred forty patients who underwent AVF from March 2002 to May 2004 were enrolled in this study. We performed pre-operative venography on selected patients with equivocal physical findings such as small vein, interrupted venous drainage and arm edema. The clinical manifestations and AVF results such as the early failure rate and patency rate by performance of venography were reviewed retrospectively. RESULT: Pre-operative venography was performed in 86 patients (35.8%). The mean age, proportion of female gender and prevalence of diabetes was significantly higher in the venography group compared to the non-venography group. Among the 86 cases of venography, 53 cases (61.6%) contained one or more abnormal venous findings. Small or turbulent veins at the planned operation site were found in 36 cases (41.9%), thrombosis or sclerotic change of veins were found in 8 cases, disappearance of veins were found in 8 cases and stenosis of the central vein was found in one case. We changed the planned AVFs according to the venography findings in 43 cases (50.0%). For this reason, the proportion of upper fistulas and graft fistula was significantly increased in the venography group. The fistula maturation failure rate in the venography group was 5.8% (5/86), which was significantly lower than that of the non-venography group. The one-year and two-year patency rate of the venography group were 86.8% and 83.5% respectively, which was also significantly higher than those rates of the non-venography group (74.9% and 73.4%, for one-year and two-year patency rate, respectively)(P=0.03). CONCLUSION: The selective application of venography for pre-operative venous mapping is valuable for the selection of the type of AVF, and it produces good results with a superior maturation rate and patency rate.
Arm ; Arteriovenous Fistula* ; Constriction, Pathologic ; Drainage ; Edema ; Female ; Fistula ; Humans ; Phlebography* ; Prevalence ; Renal Dialysis ; Retrospective Studies ; Thrombosis ; Transplants ; Veins
Arm ; Arteriovenous Fistula* ; Constriction, Pathologic ; Drainage ; Edema ; Female ; Fistula ; Humans ; Phlebography* ; Prevalence ; Renal Dialysis ; Retrospective Studies ; Thrombosis ; Transplants ; Veins
Journal of the Korean Society for Vascular Surgery.2004;20(2):237-241.
PURPOSE: Deep vein thrombosis (DVT) is recognized as a common complication in surgical patients in western countries, and especially for high risk patients. However there is little informations on the incidence and risk factors of DVT after gastrointestinal cancer surgery in Korea. The aim of this study is to evaluate the incidence and risk factors of DVT after gastrointestinal cancer surgery that is performed without antithrombotic prophylaxis. METHOD: From August 2003 to February 2004, 107 patients who underwent gastrointestinal cancer surgery were evaluated prospectively. Hypercoagulability studies were done before the operation or before any blood transfusion, and the other clinical risk factors were also examined. All the patients were examined between the 5th and 10th postoperative day with duplex ultrasonographic assessment of both lower extremities. RESULT: DVT was found in 8 patients (7.5%) and two patients had symptomatic DVT. Five patients showed thrombi in there calf veins, two patients in the popliteal vein, and one patient in the iliac vein. The DVT group showed a significantly higher incidence of hyperhomocysteinemia than non-DVT group. There was no statistically significant difference between the DVT and non-DVT group according to other risk factors. CONCLUSION: The incidence of DVT after intra-abdominal cancer surgery in Koreans is significantly lower than for the patients in western countries. Considering the lower rate of proximal DVT, routine prophylaxis for DVT appears to be unwarranted in Koreans before and after intra-abdominal cancer surgery. Finally we did not identify a correlation between DVT and the so-call risk factors except for hyperhomocysteinemia. It would be interesting to perform further studies to clarify the association between hyperhomocysteinemia and DVT in cancer patients.
Blood Transfusion ; Gastrointestinal Neoplasms* ; Humans ; Hyperhomocysteinemia ; Iliac Vein ; Incidence* ; Korea ; Lower Extremity ; Popliteal Vein ; Prospective Studies ; Risk Factors* ; Thrombophilia ; Veins ; Venous Thrombosis*
Blood Transfusion ; Gastrointestinal Neoplasms* ; Humans ; Hyperhomocysteinemia ; Iliac Vein ; Incidence* ; Korea ; Lower Extremity ; Popliteal Vein ; Prospective Studies ; Risk Factors* ; Thrombophilia ; Veins ; Venous Thrombosis*
Clinical Results of Lower Extremity Trauma Accompanied with Popliteal Artery Injury.
Journal of the Korean Society for Vascular Surgery.2004;20(2):232-236.
PURPOSE: Although popliteal artery injuries are uncommon, the consequent lack of management protocols may contribute to the high level of outcome morbidity. METHOD: We retrospectively reviewed the records of popliteal artery trauma treated at our institution in the past 5 years. RESULT: In 15 patients [male 13, female 2, median age 45.9 (15-73)] there were 13 cases of blunt trauma, mainly motorcycle accident. Most patients presented with severe signs of ischemia when they arrived at the emergency unit. Most commonly skeletal injury was accompanied (fracture 13, nerve injury 7). Some delays occurred between injury and treatment in every cases. Bypass using the contralateral long saphenous vein was the predominant procedure for arterial injury. Our limb salvage rate was 66.7% (10/15), but all patients needed more than two additive operations, and finally had persistent neurologic disability. CONCLUSION: Popliteal artery injury, especially in Korean urban society, was mainly caused by blunt trauma from traffic accidents and the results remain challenging.
Accidents, Traffic ; Emergency Service, Hospital ; Female ; Humans ; Ischemia ; Limb Salvage ; Lower Extremity* ; Motorcycles ; Popliteal Artery* ; Retrospective Studies ; Saphenous Vein
Accidents, Traffic ; Emergency Service, Hospital ; Female ; Humans ; Ischemia ; Limb Salvage ; Lower Extremity* ; Motorcycles ; Popliteal Artery* ; Retrospective Studies ; Saphenous Vein
Country
Republic of Korea
Publisher
ElectronicLinks
Editor-in-chief
Abbreviation
Journal of the Korean Society for Vascular Surgery
Vernacular Journal Title
ISSN
1229-991X
EISSN
Year Approved
2007
Current Indexing Status
Currently Indexed
Start Year
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