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韓國人의 動脈外科症例 檢討

Surgical Experience with 35 Cases of Arterial Disease in Korea

대한외과학회지 1963년 5권 8호 p.469 ~ 497
이용각,
소속 상세정보
이용각 (  ) - 가톨릭대학 의학부 외과학교실

Abstract


Vascular surgery is a new field in Korea. The author has treated the following patients with arterial or aortic diseases:
Occlusive diseases of the lower extremities: 20 cases
Aorto-iliac thrombosis: 3 cases
Aneurysm of abdominal aorta: 3 cases
Renovascular hypertension: 4 cases
Major peripheral arterial injuries: 5 cases
Among the occlusive diseases of the lower extremities I have treated, Buerger´s disease comprised 17 cases. From the expriences of arteriographic studies, surgical explorations and pathological studies, the author believes that the pathological changes of Buerger´s disease are not specific, but similar to those changes seen in the eary phase of arteriosclerosis although the clinical patterns are unique for Buerger´s.
In treating-thrombo-obliterative arterial-diseases of the lower extremities, direct arterial surgery is often effective, even on the arteries below the popliteal level, because the patch-graft technic enables one to handle small calibered arteries without undue narrowing of the exploration site. Although rare, arteriosclerotic disease of the major arteries is thought to be on the increase with an increase of life span of Koreans. Such is the fact that arteriosclerosis of the iliofemoral arteries and aorto-iliac region were encountered at our hospital during the past year as shown above. All of the three cases of aorto-iliac occlusive diseases were treated with excision-and-graft procedure combined with endoarterectomy of the distal aorta, because extensive degenerative changes of the distal aorta made a by-pass procedure undesirable.
The author presents the first three cases of aneurysm of the abdominal aorta treated with excision-and-graft procedure. Two cases of abdominal aortic aneourysm occurred among 28 year old males. The excised aneurysms revealed frank necrosis of the aorta wall and inflammation of vasa vasorum. This unknown etiology is under investigation at our pathology department.
Special emphasis was voiced by the author on investigating renal arterial disease among hypertensive Korean people. Four cases of renal hypertension were treated at this institute during the past year and three of them were cases of renovascular hypertension.
The author believes that arterial surgery should be made a common practice in Korean hospitals in order to treat patients with major arterial injuries and to repair the arteries for lifesaving as well as restoration of function of the peripheral tissue.

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