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위팔 자쪽피부정맥 전위를 이용한 동정맥루의 임상적 효과: 하완 인조혈관 투석접근(Forearm Arterivenous Graft)과의 비교
정인목,민상일,김서민,정중기 대한혈관외과학회 2013 Vascular Specialist International Vol.29 No.1
Purpose: The purposes of this study were to evaluate upper arm basilic vein transposition (BVT) arteriovenous fistula in terms of graft patency and surgical complications and to compare BVT with the forearm loop arteriovenous graft (AVG). Methods: Between March 2003 and December 2008, 23 patients underwent BVT and 30 patients underwent AVG. The patency rates and complications were analyzed. Results: Patients who underwent BVT had more previous history of operations for arteriovenous access (2.5±1.2 in BVT vs. 1.8±1.4 in AVG; P=0.038). A total of 10 cases of complications occurred in patients with BVT and 22 cases in patients with AVG (P=0.047). One-year and 2-year primary patency rates were 55.2%, and 36.3%, respectively, for BVT and 31.3% and 17.9%, respectively, for AVG (P=0.031). One-year and 2-year primary assisted patency rates were 85.2% and 66.7% for BVT, respectively and 67.2% and 43.8 for AVG, respectively (P=0.112). During follow-ups, less rescue procedures were performed in BVT than in AVG patients (P=0.055). One case of thrombolysis, 4 balloon angioplasty, and 1 stent insertion were performed in BVT, whereas 5 cases of thrombectomy, 3 thrombolysis, 4 balloon angioplasty, and 2 interposition grafting were performed in AVG. Conclusion: BVT had higher 1-year and 2-year patency rates and fewer complications compared to AVG. Lower numbers of intervention were required to maintain patency in BVT compared to AVG. BVT is a feasible procedure and can be considered before planning forearm loop AVG, particularly in a rescue vascular access.
정인목(In Mok Jung),한소리(So Rhee Han),최금희(Keum Hee Choi),권유진(Yujin Kwon),이태승(Taeseung Lee),민승기(Seung-Kee Min),박양진(Yang Jin Park),정중기(Jung Kee Chung),하종원(Jongwon Ha),김상준(Sang Joon Kim) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.6
Purpose: Although progenitor cells may contribute to intimal hyperplasia (IH) after arterial injury, positive contribution of IH is variable with type of injury or cells. This study was designed to examine whether differentiated muscle derived stem cells (MDSC) attenuate IH in rat. Methods: MDSCs were retrieved using preplate techniques from rat calf muscle and MDSCs (preplate 6th culture fraction, pp6) were exposed to VEGF (50 ng/㎖) for endothelial differentiation prior to injection. Male rats were divided into two groups (cell treated vs. control) and underwent carotid balloon injury with 2-Fr catheter. The virus containing Green fluorescent protein (GFP) gene was transfected into cells for monitoring. Cells (5×10?) were indwelled into carotid artery for 30 minutes after injury and then blood flow was restored. Arteries were harvested at various intervals (1, 2 and 4 weeks) after injury. The intima to media thickness ratio (IMTR) was calculated with morphometric analysis. Results: Endothelial surface markers such as VE-CADHERIN were strongly expressed on differentiated MDSCs. At 4 weeks after injury, IH was predominantly observed in control group compared to cell treated group. The intensity of GFP was strongly observed at 1 week and declined at 4 weeks in carotid artery wall at MDSC group. CD31(+) endothelial cells were observed at MDSC group compared to control. The mean IMTR in cell treated groups were significantly lower than control at 2 weeks (P=0.005) and 4 weeks (P≤0.001). Conclusion: Our study demonstrates that MDSCs therapy promotes re-endothelialization and leads to attenuation of IH after balloon injury in rat.