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1.
Annals of Surgical Treatment and Research ; : 120-128, 2021.
Article in English | WPRIM | ID: wpr-896987

ABSTRACT

Purpose@#Drug-coated balloons have shown successful results in treating peripheral arterial occlusive disease. However, using multiple balloons for long femoropopliteal lesions (>15 cm) remains challenging; their safety and efficacy need to be explored. Therefore, we aimed to evaluate the outcomes of multiple drug-coated balloons for long femoropopliteal lesions in terms of the primary patency, freedom from clinically-driven target lesion revascularization, and mortality. @*Methods@#Between April 2015 and September 2018, 96 patients (117 limbs) who underwent balloon angioplasty using at least 2 drug-coated balloons for femoropopliteal lesions were retrospectively reviewed. Lesions were classified as TransAtlantic Inter-Society Consensus (TASC) classification C or D. The outcomes were analyzed using Kaplan-Meyer analysis. @*Results@#The mean age of 96 enrolled patients was 70.8 ± 9.8 years, and 83 patients were males (86.5%). Critical limbthreatening ischemia was found in 29 cases (24.8%). The mean lesion and drug-coated balloon lengths per limb were 292.3 ± 77.8 mm and 325.0 ± 70.2 mm, respectively. The technical success rate was 99.2%. A total of 82.1% were followedup for more than 6 months. The primary patency rates at 12 and 24 months were 71.4% and 41.7%, respectively; freedom from clinically-driven target lesion revascularization rates were 96.4% and 71.0% at 12 and 24 months, respectively. The Kaplan-Meier estimate of the 2-year overall cumulative mortality rate was 20.8%. All identified mortalities appeared to be less associated with paclitaxel. @*Conclusion@#Drug-coated balloons can be effectively used without drug-related mortality, even for long lesions, such as TASC classification C or D femoropopliteal lesions.

2.
Annals of Surgical Treatment and Research ; : 120-128, 2021.
Article in English | WPRIM | ID: wpr-889283

ABSTRACT

Purpose@#Drug-coated balloons have shown successful results in treating peripheral arterial occlusive disease. However, using multiple balloons for long femoropopliteal lesions (>15 cm) remains challenging; their safety and efficacy need to be explored. Therefore, we aimed to evaluate the outcomes of multiple drug-coated balloons for long femoropopliteal lesions in terms of the primary patency, freedom from clinically-driven target lesion revascularization, and mortality. @*Methods@#Between April 2015 and September 2018, 96 patients (117 limbs) who underwent balloon angioplasty using at least 2 drug-coated balloons for femoropopliteal lesions were retrospectively reviewed. Lesions were classified as TransAtlantic Inter-Society Consensus (TASC) classification C or D. The outcomes were analyzed using Kaplan-Meyer analysis. @*Results@#The mean age of 96 enrolled patients was 70.8 ± 9.8 years, and 83 patients were males (86.5%). Critical limbthreatening ischemia was found in 29 cases (24.8%). The mean lesion and drug-coated balloon lengths per limb were 292.3 ± 77.8 mm and 325.0 ± 70.2 mm, respectively. The technical success rate was 99.2%. A total of 82.1% were followedup for more than 6 months. The primary patency rates at 12 and 24 months were 71.4% and 41.7%, respectively; freedom from clinically-driven target lesion revascularization rates were 96.4% and 71.0% at 12 and 24 months, respectively. The Kaplan-Meier estimate of the 2-year overall cumulative mortality rate was 20.8%. All identified mortalities appeared to be less associated with paclitaxel. @*Conclusion@#Drug-coated balloons can be effectively used without drug-related mortality, even for long lesions, such as TASC classification C or D femoropopliteal lesions.

3.
Vascular Specialist International ; : 180-185, 2020.
Article | WPRIM | ID: wpr-837396

ABSTRACT

Accurate diagnosis and management of a femoral vascular injury is important as it is a life-threatening injury with high morbidity and mortality. This is the case of a 75-year-old man admitted to the emergency room with trauma to the right groin due to a horse fall. Computed tomography showed active bleeding of the femoral artery without pelvic or femoral fracture. We inserted a stent-graft, but hypotension persisted. Exploration of the groin was completed, and the bleeding from the external iliac vein was identified and repaired. In conclusion, vascular injury is rare in groin trauma without associated fracture, however, arterial and venous injury should not be completely ruled out. Endovascular therapy is worth recommending as a quicker and safer management than surgery in patients with active bleeding in the femoral artery. However, the possibility of combined injury of the femoral vein should be suspected in case of ongoing hemodynamic instability.

4.
Vascular Specialist International ; : 233-240, 2020.
Article in English | WPRIM | ID: wpr-896481

ABSTRACT

Purpose@#The number of infrapopliteal runoff vessels seems to be one of the factors influencing arterial patency in patients who had undergone superficial femoral artery (SFA) angioplasty with stenting. However, the effectiveness of infrapopliteal runoff vessels in predicting patency during SFA angioplasty remains unclear. This study aimed to determine whether the number and quality of infrapopliteal runoff vessels affect the primary patency after SFA angioplasty with stenting in patients with claudication. @*Materials and Methods@#This study reviewed a retrospective database of patients with claudication who underwent SFA angioplasty with stenting between March 2011 and December 2016. The preoperative computed tomography findings of all patients were reviewed to assess infrapopliteal runoff vessels. The Trans-Atlantic Inter-Society (TASC) II classification and modified Society for Vascular Surgery (SVS) runoff score were used for subsequent analysis. Kaplan–Meier survival curves were constructed, and Fisher’s exact and chi-square tests were used for data analysis. @*Results@#A total of 153 limbs of 122 patients (88.2% male, mean age: 69.1 years) underwent SFA angioplasty with stenting. The overall primary patency rates of TASC II A/B and C/D cases were 77.1% and 31.2%, respectively, at 36 months (P<0.001). The primary patency rates at 36 months using the modified SVS runoff scoring system were 64.6% and 49.8% for the good-to-compromised (≤9 points) and poor (≥10 points) runoff groups, respectively (P=0.011). @*Conclusion@#The modified SVS runoff scoring system is effective in predicting primary patency after SFA angioplasty with stenting in patients treated for claudication.

5.
Vascular Specialist International ; : 233-240, 2020.
Article in English | WPRIM | ID: wpr-904185

ABSTRACT

Purpose@#The number of infrapopliteal runoff vessels seems to be one of the factors influencing arterial patency in patients who had undergone superficial femoral artery (SFA) angioplasty with stenting. However, the effectiveness of infrapopliteal runoff vessels in predicting patency during SFA angioplasty remains unclear. This study aimed to determine whether the number and quality of infrapopliteal runoff vessels affect the primary patency after SFA angioplasty with stenting in patients with claudication. @*Materials and Methods@#This study reviewed a retrospective database of patients with claudication who underwent SFA angioplasty with stenting between March 2011 and December 2016. The preoperative computed tomography findings of all patients were reviewed to assess infrapopliteal runoff vessels. The Trans-Atlantic Inter-Society (TASC) II classification and modified Society for Vascular Surgery (SVS) runoff score were used for subsequent analysis. Kaplan–Meier survival curves were constructed, and Fisher’s exact and chi-square tests were used for data analysis. @*Results@#A total of 153 limbs of 122 patients (88.2% male, mean age: 69.1 years) underwent SFA angioplasty with stenting. The overall primary patency rates of TASC II A/B and C/D cases were 77.1% and 31.2%, respectively, at 36 months (P<0.001). The primary patency rates at 36 months using the modified SVS runoff scoring system were 64.6% and 49.8% for the good-to-compromised (≤9 points) and poor (≥10 points) runoff groups, respectively (P=0.011). @*Conclusion@#The modified SVS runoff scoring system is effective in predicting primary patency after SFA angioplasty with stenting in patients treated for claudication.

6.
Annals of Surgical Treatment and Research ; : 131-137, 2019.
Article in English | WPRIM | ID: wpr-739573

ABSTRACT

PURPOSE: A prospective study was conducted to compare radiation exposure to different parts of an endovascular surgeon's body when using a mobile C-arm with that in a hybrid room. METHODS: Exposure during individual procedures performed on 39 patients with a mobile C-arm and 42 patients in a hybrid room, from July 2016 to December 2016, was evaluated. RESULTS: The procedures performed, fluoroscopy time, and dose-area product were not significantly different between groups. The dose-area product per second in the hybrid room group appeared greater than in the C-arm group (4.5 µGym2/sec vs. 3.1 µGym2/sec). In the C-arm group, the peak skin dose on the right neck (1.77 mSv) and shoulder (1.48 mSv) appeared higher than those on their left side (0.32 mSv, 0.53 mSv, respectively) and the counterparts of the hybrid room group (0.88 mSv, 0.20 mSv, respectively). CONCLUSION: The peak skin dose in the hybrid room appeared highest for the lower part of the protective apron. The dose-area product per second seemed to be greater in the hybrid room than when using the C-arm. Thus, attention should be focused on protecting the surgeon's upper body when using the C-arm and the lower body when using the hybrid room.


Subject(s)
Humans , Endovascular Procedures , Fluoroscopy , Neck , Operating Rooms , Prospective Studies , Radiation Exposure , Shoulder , Skin , Surgeons
7.
Vascular Specialist International ; : 28-33, 2019.
Article in English | WPRIM | ID: wpr-762004

ABSTRACT

PURPOSE: Deep vein thrombosis (DVT) is the third most common cause of cardiovascular morbidity and mortality. Anticoagulation has been the primary treatment modality for acute DVT. However, catheter-directed thrombolysis (CDT) has recently become widely accepted as an additional therapy to anticoagulation. We assessed comparative outcomes in patients with acute DVT who underwent anticoagulation therapy alone (ACA) group and those treated with CDT group. MATERIALS AND METHODS: We retrospectively reviewed medical records of 149 patients with DVT from January 2011 to December 2015. We compared patients who received ACA group (n=120) and those who received CDT plus anticoagulation (CDT group, n=29). We analyzed the prevalence of lesions, thrombus removal rate in each lesion, and recurrence-free rate between the two groups. RESULTS: We found thrombus involvement in a total of 281 lesions in the ACA group and 85 lesions in the CDT group. For the distribution of lesions in each group, those in the femoral vein accounted for 34.2% of all lesions and those in the popliteal vein accounted for 31.7%. During follow-up, the overall thrombus removal rate was 91.1% in the ACA group and 87.0% in the CDT group (P=0.273). The recurrence-free rate was higher in the CDT group in a log-rank test; however, there was no statistically significant difference between the two groups (P=0.594). CONCLUSION: According to our results, there was no significant difference in thrombus removal and recurrence-free rates between the CDT and ACA groups. ACA still has an important role in the treatment of DVT.


Subject(s)
Humans , Anticoagulants , Femoral Vein , Follow-Up Studies , Lower Extremity , Medical Records , Mortality , Popliteal Vein , Prevalence , Retrospective Studies , Thrombolytic Therapy , Thrombosis , Venous Thrombosis
8.
Journal of the Korean Society of Traumatology ; : 210-219, 2019.
Article in English | WPRIM | ID: wpr-916943

ABSTRACT

PURPOSE@#Traumatic diaphragmatic injury (TDI) is no longer considered to be a rare condition in Korea. This study investigated differences in the prevalence of accompanying injuries and the prognosis in patients with traumatic diaphragmatic damage according to the mechanism of injury.@*METHODS@#We retrospectively reviewed the medical records of patients with TDI who were seen at a regional emergency medical center from January 2000 to December 2018. Among severe trauma patients with traumatic diaphragmatic damage, adults older than 18 years of age with a known mechanism of injury were included in this study. Surgery performed within 6 hours after the injury was sustained was defined as emergency surgery. We assessed the survival rate and likelihood of respiratory compromise according to the mechanism of injury.@*RESULTS@#In total, 103 patients were analyzed. The patients were categorized according to whether they had experienced a penetrating injury or a blunt injury. Thirty-five patients had sustained a penetrating injury, and traffic accidents were the most common cause of blunt injuries. The location of the injury did not show a statistically significant difference between these groups. Severity of TDI was more common in the blunt injury group than in the penetrating injury group, and was also more likely in patients with respiratory compromise. However, sex, the extent of damage, and the initial Glasgow coma scale score had no significant relationship with severity.@*CONCLUSIONS@#Based on the findings of this study, TDI should be recognized and managed proactively in patients with blunt injury and/or respiratory compromise. Early recognition and implementation of an appropriate management strategy would improve patients' prognosis. Multi-center, prospective studies are needed in the future.

9.
Annals of Surgical Treatment and Research ; : 74-82, 2019.
Article in English | WPRIM | ID: wpr-762688

ABSTRACT

PURPOSE: Colon perfusion status is one of the most important factors for the determination of postoperative anastomotic complications. Colonic hypoperfusion can be induced by inferior mesenteric artery (IMA) ligation in some patients. This study aimed to evaluate atherosclerotic risk assessment and vascular parameters of CT angiography as predictors of colonic hypoperfusion. METHODS: This prospective study was conducted at a tertiary referral hospital and included 46 rectosigmoid colon cancer patients undergoing laparoscopic anterior resection between August 2013 to July 2014. Atherosclerotic risk scores were assessed using the Framingham cardiovascular risk score system. The IMA length, branching pattern, atherosclerotic calcification, and intermesenteric artery and mesenteric vascular diameters were evaluated using CT angiography. Mesenteric marginal artery pressures were measured before and after IMA clamping. The mean arterial pressure (MAP) index was calculated by dividing the mesenteric marginal MAP into the systemic MAP to determine the mesenteric hypoperfusion status after IMA clamping. A critically low MAP index was defined as <0.4. RESULTS: Critically low MAP index (<0.4) was observed in 6 cases (13.0%) after IMA clamping. Atherosclerotic calcification of the IMA and superior mesenteric artery occurred in 11 (23.9%) and 5 patients (10.9%), respectively. Low MAP index was associated with high atherosclerotic risk score and short IMA length, rather than atherosclerotic calcification and other vascular parameters of the major mesenteric arteries. Multivariate analysis indicated that high atherosclerotic risk and short IMA length were independent predictors of critically low MAP index. CONCLUSION: Atherosclerotic risk assessment and IMA length were useful predictors of the mesenteric hypoperfusion status following IMA ligation during laparoscopic rectosigmoid colon surgery.


Subject(s)
Humans , Angiography , Arterial Pressure , Arteries , Atherosclerosis , Colon , Colonic Neoplasms , Constriction , Ligation , Mesenteric Arteries , Mesenteric Artery, Inferior , Mesenteric Artery, Superior , Multivariate Analysis , Perfusion , Prospective Studies , Risk Assessment , Tertiary Care Centers
10.
Vascular Specialist International ; : 48-50, 2018.
Article in English | WPRIM | ID: wpr-742467

ABSTRACT

Mycotic aneurysms of the common carotid artery (CCA) are very rare and warrant surgical treatment to prevent rupture and death. A 89-year-old man who complained of a sore throat and swelling of the right side of neck. He had no history of trauma or neck infection. Physical examination revealed hard and pulsatile mass. Computed tomography showed initially pseudoaneurysm rupture on the right CCA with surrounding inflammation. The emergency operation revealed mycotic aneurysm rupture with CCA necrosis and was successfully done by wide debridement and carotid artery resection with interposition bypass. The resected tissue and blood culture grew growth of Staphylococcus aureus group. We report a rare case of mycotic aneurysm of right CCA that treated by bypass interposition.


Subject(s)
Aged, 80 and over , Humans , Aneurysm, False , Aneurysm, Infected , Carotid Arteries , Carotid Artery, Common , Debridement , Emergencies , Inflammation , Neck , Necrosis , Pharyngitis , Physical Examination , Rupture , Staphylococcus aureus
11.
Clinical and Molecular Hepatology ; : 184-187, 2017.
Article in English | WPRIM | ID: wpr-10605

ABSTRACT

We present a case of a 65-year-old man with psoriasis who developed autoimmune hepatitis (AIH) without receiving immunosuppressive therapy with either anti-tumor necrosis factor-α or methotrexate. The AIH had completely resolved at 2 months after prednisolone and azathioprine therapy. This case confirms the need to consider AIH in psoriasis patients who experience new elevations in liver enzymes. To our knowledge, this is first description of the development of AIH in an immunosuppressant-naïve patient with psoriasis.


Subject(s)
Aged , Humans , Azathioprine , Hepatitis, Autoimmune , Liver , Methotrexate , Necrosis , Prednisolone , Psoriasis
12.
Vascular Specialist International ; : 170-173, 2017.
Article in English | WPRIM | ID: wpr-742455

ABSTRACT

The aim of this paper is to report a salvage treatment for malpositioned stent graft due to mislabeled product during thoracic endovascular aortic repair (TEVAR) in descending thoracic aneurysm (DTA). A 78-year-old male presented with 6.7×4.1 cm sized saccular DTA and 7.1×7.3 cm sized abdominal aortic aneurysm (AAA). DTA was initially treated by TEVAR and 2 months later AAA was treated by open aortic repair. Unfortunately, although the stent graft was correctly labeled for DTA, the actual size of product wrapped in a box was different contrary to our expectations. On completion angiography, proximal sealing zone showed no endoleak, however, celiac trunk and superior mesenteric artery (SMA) was found to be accidentally occluded. Through an emergent thoracotomy, distal part of stent graft was removed by cutting distal segment of stent graft and pulling out maneuver to restore blood flow. The completion angiography presented no endoleak, and celiac trunk and SMA were secured. Cutting distal segment of stent graft and pulling out maneuver is one of feasible rescue technique to maintain blood flow of occluded celiac trunk during TEVAR.


Subject(s)
Aged , Humans , Male , Aneurysm , Angiography , Aortic Aneurysm, Abdominal , Blood Vessel Prosthesis , Endoleak , Mesenteric Artery, Superior , Salvage Therapy , Stents , Thoracotomy
13.
Annals of Coloproctology ; : 234-238, 2016.
Article in English | WPRIM | ID: wpr-225104

ABSTRACT

An endoscopic mucosal resection (EMR) is an effective and safe therapeutic technique for treating a patient with a laterally-spreading tumor (LST). Colonoscopic-procedure-related complications are noted to be about 2.8% worldwide, and a perforation is the most common. Most colon perforations cause pneumoperitoneum. However, a perforation within the retroperitoneal portion of the colon (rectum and some of sigmoid colon) may cause an extraperitoneal perforation, and the leaking free air may induce pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema, depending on the amount of discharged air. Herein, we present the case of a patient with an extraperitoneal colon microperforation which manifested as pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema after an EMR for a sigmoid LST, which was successfully treated with medical treatment and endoscopic clipping.


Subject(s)
Humans , Colon , Colon, Sigmoid , Colonoscopy , Mediastinal Emphysema , Pneumoperitoneum , Retropneumoperitoneum , Subcutaneous Emphysema
14.
Korean Journal of Family Medicine ; : 31-36, 2016.
Article in English | WPRIM | ID: wpr-30640

ABSTRACT

BACKGROUND: Menstrual irregularity is a common major complaint in women of reproductive age. It is also a known marker for underlying insulin resistance. We investigated the association between menstrual irregularity and metabolic syndrome in the general population of middle-aged women in Korea. METHODS: This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey 2010-2012. A total of 2,742 subjects were included in the analysis. Participants were divided into two categories based on their menstrual cycle regularity and the relationship between metabolic syndrome and its variables was investigated by multiple logistic regression analysis. RESULTS: Adjusted analyses revealed significantly higher odds ratios for metabolic syndrome, high waist circumference, high triglyceride levels, and low high density lipoprotein cholesterol levels with the presence of menstrual irregularity. CONCLUSION: Metabolic syndrome and its components (high waist circumference, high triglyceride levels, and low high density lipoprotein cholesterol levels) were significantly associated with menstrual irregularity in women of reproductive age.


Subject(s)
Female , Humans , Cholesterol, HDL , Cross-Sectional Studies , Insulin Resistance , Korea , Logistic Models , Menstrual Cycle , Nutrition Surveys , Obesity , Odds Ratio , Polycystic Ovary Syndrome , Triglycerides , Waist Circumference
15.
Vascular Specialist International ; : 11-16, 2016.
Article in English | WPRIM | ID: wpr-165370

ABSTRACT

PURPOSE: The purpose of this study was to review the natural history, clinical outcome and safety in patients undergoing sartorius muscle flap (SMF) for groin infection, including lymphocele. MATERIALS AND METHODS: We retrospectively reviewed the records of patients who underwent SMF in a single center between 2000 and 2009. RESULTS: Thirty patients (17 male, 13 female) underwent SMF for groin infection, which included infections of 22 artificial femoral bypass grafts (including 2 cryoveins) and 5 common femoral patch grafts, and 3 lymphocele infections (2 cardiac catheterizations and 1 penile cancer lymph node dissection). Wound isolates were most commonly Gram-positive organisms (n=22) with Gram-negative isolates and mixed infections accounting for 4 and 3 cases, respectively. In 9 patients there was no growth of organisms. Adjunctive wound vacuum-asssisted wound closure therapy was performed in 18 patients. Follow-up duration ranged from 8 days to 56 months (mean 14.1 months) after SMF. Reoperation was performed in 3 patients due to wound bleeding (n=1) and reinfection (n=1). One patient underwent graft excision with external bypass operation. There was 1 mortality case due to sepsis during the study period. CONCLUSION: We found that muscle flap surgery provides successful single-intervention therapy for groin infections including lymphocele. Graft ligation or aggressive excision with bypass surgery should be reserved for patients requiring rapid control of sepsis for lifesaving.


Subject(s)
Humans , Male , Cardiac Catheterization , Cardiac Catheters , Coinfection , Follow-Up Studies , Groin , Hemorrhage , Ligation , Lymph Nodes , Lymphocele , Mortality , Natural History , Penile Neoplasms , Reoperation , Retrospective Studies , Sepsis , Transplants , Wounds and Injuries
16.
Vascular Specialist International ; : 68-71, 2014.
Article in English | WPRIM | ID: wpr-30777

ABSTRACT

Renal artery aneurysm (RAA) is uncommon, and the coexistence of an abdominal aortic aneurysm (AAA) is an extremely rare condition with potentially high life-threatening mortality in case of rupture. Aneurysms can be treated by endovascular intervention or open surgery. Although most of aneurysms are treated by endovascular intervention, open surgery is often necessary for RAAs associated with the proximal renal bifurcation or the branches in the distal renal arteries. We report a rare case of coexisting RAA with AAA treated by hybrid method, consisting of endovascular aneurysm repair for AAA and open surgery for RAA located adjacent to the distal branches of the renal artery.


Subject(s)
Humans , Aneurysm , Aortic Aneurysm, Abdominal , Gallbladder Neoplasms , Mortality , Renal Artery , Rupture
17.
Vascular Specialist International ; : 155-158, 2014.
Article in English | WPRIM | ID: wpr-159758

ABSTRACT

Portal vein (PV) thrombosis (PVT) is a rare condition with development of thrombosis in the PV and its branches. Further extension to the splenic and superior mesenteric vein (SMV) causes intestinal infarction, with a reported mortality of up to 50%. A variety of treatments for PVT exist including anticoagulation, thrombolysis, surgical thrombectomy, insertion of shunts, bypass surgery, and liver transplantation. We experienced a case of successfully treated by surgical thrombectomy with direct thrombolysis into the thrombosed-PV and SMV. A 31-year-old male presented worsening abdominal pain for one week. Preoperative contrast enhanced computed tomography scan revealed complete PVT extending to splenic vein and SMV. The PV was accessed surgically and opened by thrombectomy; visual inspection confirmed proximal and distal flow. Urokinase was administered directly into the inferior mesenteric vein with successful decrease in thrombus burden. The complete angiography showed complete dissolution of thrombosis in PV and SMV.


Subject(s)
Adult , Humans , Male , Abdomen, Acute , Abdominal Pain , Angiography , Infarction , Liver Transplantation , Mesenteric Veins , Mortality , Portal Vein , Splenic Vein , Thrombectomy , Thrombosis , Urokinase-Type Plasminogen Activator , Venous Thrombosis
18.
Journal of the Korean Society for Vascular Surgery ; : 46-51, 2013.
Article in English | WPRIM | ID: wpr-726642

ABSTRACT

The final goal of vascular surgery is to prevent amputation and maintain walking ability. Many surgical techniques for peripheral arterial disease (PAD) have been reported. The combined use of endovascular and open techniques (hybrid) in the same surgical setting has been reported since the mid-1990s, and has gained popularity over time as vascular surgeons have acquired increasing experience with endovascular interventions. The hybrid operation offers adequate access for the treatment of both inflow and outflow lesions, while dealing with the common femoral artery lesion in the most appropriate way. The main advantage of hybrid procedures is the ability to treat more complex anatomy by less invasive procedures in patients who are considered as high medical risk. Extensive revascularizations can be accomplished without significant hemodynamic changes, minimal blood loss, and limited risk of preoperative complications. Therefore, the hybrid procedure was thought to be an acceptable strategy in PAD patients with severe lower extremity arterial disease and may provide less invasive therapeutic options tailored to the needs of high risk patients with multiple lesions.


Subject(s)
Humans , Amputation, Surgical , Chimera , Femoral Artery , Hemodynamics , Imidazoles , Lower Extremity , Nitro Compounds , Peripheral Arterial Disease , Stents , Walking
19.
Journal of the Korean Society for Vascular Surgery ; : 138-141, 2013.
Article in English | WPRIM | ID: wpr-726628

ABSTRACT

PURPOSE: This study suggests that venous calcification (VC) may occur within the arterialized vein (AV) of patients with chronic renal failure. VC may be the cause of arteriovenous fistula (AVF) failure. METHODS: Specimens of AV were obtained during the removal of AVF to study morphological changes in the AV wall. We retrospectively analyzed 27 patients with AV specimens prepared and stained with hematoxylin and eosin, Masson's trichrome and Verhoeff van Gieson stains. RESULTS: Of the 27 patients, only 7 (4 males and 3 females, mean age 49.4 years) had evidence of VC in the AV (5 patients media only, 2 patients intima and media involved). AVF removal was done due to aneurym (3 cases), stenosis (2 cases), and kidney transplantation (2 cases). The mean duration from AVF construction to the repair of AVF was 88 months (range, 50 to 144 months). There were two cases of diabetes mellitus and hypertension in patients with VC. CONCLUSION: VC may occur within the arterialized vein in chronic kidney disease patients after AVF construction.


Subject(s)
Female , Humans , Male , Arteriovenous Fistula , Constriction, Pathologic , Diabetes Mellitus , Eosine Yellowish-(YS) , Fistula , Hematoxylin , Hypertension , Kidney Failure, Chronic , Kidney Transplantation , Renal Dialysis , Renal Insufficiency, Chronic , Retrospective Studies , Veins
20.
Journal of the Korean Society of Pediatric Nephrology ; : 49-56, 2013.
Article in Korean | WPRIM | ID: wpr-75961

ABSTRACT

PURPOSE: IgA nephropathy (IgAN) is one of the major causes of end-stage renal disease. Mass school urine screening (SUS) has been performed to enable early detection of chronic renal diseases, including IgAN. We wanted to evaluate the patients with IgAN, including those diagnosed through SUS. METHODS: Between 1998 and 2010, 64 children were diagnosed with IgAN based on renal biopsy results obtained at the Pediatric Nephrology Department, OO University Hospital. We divided these patients into the SUS group (37 cases), diagnosed through SUS, and the symptomatic (Sx) group (27 cases), diagnosed clinically. The medical records of both groups were analyzed retrospectively. RESULTS: The mean age of the SUS and Sx groups was 10.8+/-2.7 and 9.5+/-3.4 years (P>0.05), respectively. Both groups had a higher proportion of male patients. The time from the notification of an abnormal urinary finding to a hospital visit or renal biopsy was shorter in the Sx group than in the SUS group. Regarding clinical manifestations, there were fewer cases with gross hematuria (P<0.001) and edema (P=0.008) in the SUS group, but there were no differences in terms of the therapeutic regimen and treatment duration. Regarding laboratory parameters, the Sx group had a higher white blood cell count (P=0.007) and lower hemoglobin (P=0.007) and albumin (P=0.000) levels. There were no differences in the renal biopsy findings in both groups, based on the history of gross hematuria or the severity of proteinuria. However, in all 64 patients with IgAN, the light microscopy findings (Hass classification) were related to a history of gross hematuria or the severity of proteinuria. CONCLUSION: There were no significant clinical and histological differences between the groups, as both had early stage IgAN. Although SUS facilitates the early detection of IgAN, long-term, large-scale prospective controlled studies are needed to assess the benefits of early diagnosis and treatment in chronic renal disease progression.


Subject(s)
Child , Humans , Male , Biopsy , Early Diagnosis , Edema , Glomerulonephritis, IGA , Hematuria , Immunoglobulin A , Kidney Failure, Chronic , Leukocyte Count , Mass Screening , Medical Records , Microscopy , Nephrology , Proteinuria , Renal Insufficiency, Chronic
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