Hung Chang Hsieh

Introduction Balloon angioplasty maturation (BAM) is a salvage method for autologous arteriovenous fistula (AVF) maturation failure. AVF creation using small‐diameter veins is considered to have poor outcomes. Therefore, this study aimed to explore the long‐term patency of small‐diameter veins (≤3 mm) using BAM. Methods BAM was performed if the fi...

Background The arteriovenous fistula is the preferred access route for hemodialysis, although its high primary failure rate remains a clinical challenge. Multiple studies have attempted to determine the risk factors for primary arteriovenous fistula failure; however, none have identified pulse pressure as a potential predictive marker. High pulse p...

Objective: To compare the tunnel transposition and elevation transposition methods used for superficialization of the basilic vein in terms of complication and patency rates. Methods: This retrospective study included patients who underwent two-stage basilic vein transposition between August 2016 and December 2019. Patients were categorized into...

Objective Cephalic arch stenosis (CAS) causes repeated dysfunction and failure of arteriovenous access. Percutaneous transluminal angioplasty is the standard initial treatment for CAS, but its outcome is unsatisfactory. This study aimed to evaluate the outcome of stent graft placement for CAS in patients on hemodialysis. Methods A retrospective ch...

Background: Hemodialysis graft outflow stenosis is a significant complication occurring in hemodialysis patients with prosthetic grafts for vascular access. Balloon angioplasty remains the first-line endovascular treatment of this complication, although covered stent graft implantation after balloon angioplasty also appears to be an effective and...

The optimal tip position for an intravenous port and the angle between the locking nut and the catheter are still debatable. This study evaluates the use of chest X-ray plain films for screening patients with potential intravenous port complications. We reviewed, retrospectively, 1505 patients who had an intravenous port implanted between January 1...

An 18-month retrospective study was done on consecutive patients who were diagnosed with lower extremity peripheral artery disease (PAD) with a Rutherford classification 4~6 and received conventional angiography at a single institution. Duplex spectral waveforms of both inflow and outflow of superficial femoral artery (SFA), anterior tibial artery...

We reviewed the outcomes of patients treated for nontyphoidal Salmonella-infected abdominal aortic aneurysm (AAA) treatment at a single center. This was a retrospective chart review of 26 patients with nontyphoidal Salmonella-infected AAA. Four patients underwent medical therapy alone, while 22 patients underwent surgical therapy. Revascularization...

Purpose: This study evaluated the use of intravenous ports and provides a guide related to clinical decision making. Methods: This study retrospectively reviewed 1505 patients who had received intravenous ports at Chang Gung Memorial Hospital in 2006. The relationships between the complications and entry routes were assessed. The intervention-fr...

We sought to determine the safety and efficacy of two different treatment strategies for patients with primary infected aortic aneurysms, including antibiotic treatment alone and endovascular aneurysm repair (EVAR) with aggressive antibiotic treatment, as alternatives to the established treatment of open surgical repair. We conducted a retrospectiv...

To identify the risk factors for catheter migration and demonstrate possible mechanisms of this migration. Retrospective study. Chang Gung Memorial Hospital, a tertiary medical centre in Taiwan. Patients who underwent implantation of intravenous ports via the superior vena cava (SVC). Procedures involving catheter placement and re-intervention for...

Intravenous ports are widely used for oncology patients. However, catheter fractures may lead to the need for re-intervention. We aimed to identify the risk factors associated with catheter fractures. Between January 1 and December 31, 2006, we retrospectively reviewed the clinical data and plain chest films of 1,505 patients implanted with an intr...

To determine predictors associated with early hospital death, 30-day mortality, and long-term survival after open surgical treatment of ruptured abdominal aortic aneurysms (RAAAs). A retrospective chart review of 127 consecutive patients who received open surgical treatment of a RAAA at Chang Gung Memorial Hospital, Taiwan, from February 1994 to Ma...

The present study was designed to review surgical outcomes for mycotic aneurysm of the aortic or iliac arteries at a single center. The study was based on retrospective chart review of patients undergoing operation for mycotic aneurysm. From January 1998 to December 2007, 56 patients received surgical treatment for mycotic aneurysm of the aortic or...

There is no standard procedure for revascularization after infected infrarenal abdominal aortic aneurysm resection. This study examines the outcomes of two contemporary methods. We retrospectively reviewed medical records for patients who underwent repair of infected infrarenal abdominal aortic aneurysms from January 1998 to December 2007 at a sing...

It is important to correct underlying graft outlet stenosis after thrombectomy of dialysis grafts. This study retrospectively reviewed patients who received dialysis graft thrombectomy at this institution to compare the effectiveness of 2 different methods. A total of 289 dialysis graft thrombectomy procedures performed during 2001-2003 were retros...

Although autogenous arteriovenous fistulae are the optimal route for dialysis access, extended polytetrafluoroethylene (ePTFE) grafts continue to be the preferred access for patients without suitable superficial veins. Among the common complications related to dialysis grafts, thrombosis due to graft outlet stenosis is the most frequently encounter...

Vascular surgeons often encounter dialysis graft failure in hemodialysis patients during their daily practice. Despite advances in percutaneous treatment, there remains a role for surgical thrombectomy of thrombosed dialysis grafts. This study was designed to investigate the long-term outcome of dialysis graft thrombectomy and to examine the indica...

To identify independent risk factors for visceral artery aneurysms. Retrospective medical record review over 10 years. There were 26 men and 15 women, median age of 54 (range 22 to 85), and median follow-up was 20.6 months (range 0 to 94 months). There were 11 splenic, 17 hepatic, 8 gastroduodenal, 6 pancreatoduodenal, 5 superior mesenteric, and tw...

The objective of this study was to determine prospectively the difference between the graft outlet strictures of a polytetrafluoroethylene (ePTFE) graft with a cuff at the graft-vein anastomosis (Venaflo; Bard industries, Tempe, Ariz.) and that of the regular ePTFE graft (Stretch Gore-Tex; Gore, Flagstaff, Ariz.) placed for hemodialysis access. Bet...

Aortic dissection is rare in the pediatric and young adult population. We hereby present a case of a 17-year- old male patient, without any predisposing factors, who developed an aortic dissection. The initial presentation was acute abdominal pain with massive retroperitoneal hematoma. His clinical condition deteriorated rapidly, did not respond to...

Mycotic aneurysms are an important cause of morbidity and mortality in endocarditis despite advanced antibiotic therapy. Visceral artery aneurysms are uncommon and usually remain clinically silent until rupture. We now report a case of successful surgical treatment of a superior mesenteric mycotic aneurysm of the superior mesenteric artery, followe...

In order to extend the availability of each extremity as an access site for long-term dialysis, we created a brachiobasilic fistula by superficialization of the basilic vein, which had previously been arterialized. In this work, we present the preliminary results of this procedure. Patients with prior forearm arteriovenous fistula dysfunction witho...

This preliminary investigation evaluated the procedures for intraoperative angiography-assisted peripheral vascular revascularization in a teaching hospital. Between August 2000 and July 2001, intraoperative angiography with or without intervention was applied during surgery for peripheral arterial occlusive disease (PAOD) in 11 patients. Intraoper...

Abdominal aortic surgery is a form of major vascular surgery, which traditionally involves long hospital stays and significant postoperative morbidity. Experiences with transit ileus are often encountered after the aortic surgery. Thus traditional postoperative care involves delayed oral feeding until the patients regain their normal bowel activiti...

Superior vena cava (SVC) syndrome caused by malignant tumors in the upper mediastinum is not uncommon. Radiation therapy or endovascular treatment with stenting is the first choice of treatment to relieve symptoms. However, surgical treatment may be considered when the less invasive treatment modalities failed. In this report, we present two cases...

Polytetrafluoroethylene (PTFE) has long been used for hemodialysis access when there is no suitable superficial vein. We conducted a prospective randomized study to compare two PTFE grafts; the stretch Gore-tex graft and the Exxcel graft. Between May 2000 and February 2001, PTFE grafts were implanted for hemodialysis access in the upper extremities...

Traditionally, extensive prosthetic arteriovenous (AV) graft infection is treated with graft removal and the arteriotomy or the graft stumps were simply sutured following the removal of the graft. However, postoperative bleeding may occur which requires emergent intervention. We report the results achieved at our clinic after arteriotomy repair wit...

Access failure in hemodialysis patients is commonly encountered by vascular surgeons. Researchers have reported various solutions for dealing with clotted grafts, including thrombectomy, thrombolysis, interposition grafting, angioplasty, or a combination of these methods. Surgical thrombectomy has been the standard procedure for dealing with thromb...

To evaluate the feasibility of sonographically guided antegrade common femoral artery puncture and superficial femoral artery access. Fifty antegrade common femoral artery punctures and superficial femoral artery access procedures were performed under sonographic guidance alone in 30 consecutive patients (24 male and 6 female; mean age, 55.1 +/- 25...

Secondary aortoenteric fistula (SAF) is now recognized as an uncommon but exceedingly important complication of abdominal aortic reconstruction. The complication often occurs months to years after the original surgery. The main clinical manifestation of the disease is always upper gastrointestinal bleeding. Treatment of the disease is early surgica...

Recurrent vulvar cancer involving the femoral artery after groin radiation is usually considered inoperable. A patient with such recurrent vulvar cancer successfully treated by femoral vascular graft and rectus abdominis myocutaneous flap reconstruction with limb salvage is described. A 51-year-old woman had recurrent vulvar cancer involving the ri...

We report a case of first rib hemangioma that caused thoracic outlet syndrome. A 50-year-ole woman who was admitted to our hospital with a clinical diagnosis of thoracic outlet syndrome presented with fullness and easy fatigue of her right arm. Her right arm discomfort was associated with intermittent engorgement of superficial veins over the shoul...

Minimally invasive cardiac surgery has recently been applied to the correction of intracardiac lesions. This report reviews our experience of minimally invasive cardiac surgery in 119 patients with intracardiac congenital lesions. From October 1995 to April 1997, 119 patients (48 male and 71 female, aged 0.9-65 years old, 18.5+/-17.8) received elec...

To present our experience in surgical excision of intracardiac tumors in three patients using video-assisted cardiac surgical techniques. Three patients received emergency video-assisted cardiac surgery for excision of right atrial or left atrial tumors. These surgeries were performed through right anterior submammary minithoracotomies and guided b...

Objective: To present our experience in surgical excision of intracardiac tumors in three patients using video-assisted cardiac surgical techniques. Methods: Three patients received emergency video-assisted cardiac surgery for excision of right atrial or left atrial tumors. These surgeries were performed through right anterior submammary minithorac...

Fistular communication between an internal iliac artery aneurysm and rectum presenting as massive lower gastrointestinal tract bleeding is a rare entity in clinical practice. Prompt diagnosis and experienced therapeutic application determine the outcome. Herein we report the successful management of such a complication. A 68-year-old male had multi...

Experiments were designed to evaluate the effect of warm blood cardioplegia on endothelium-dependent contraction of the coronary endothelium after cardiac global ischemia and reperfusion. Dogs (n = 12 in each group) were exposed to extracorporeal circulation with the body temperature at 37 degrees C (group 1) or 28 degrees C (groups 2 and 3). The a...

Traumatic isolated common iliac artery occlusion is unusual. Only rare cases of common iliac arterial injuries resulting from blunt abdominal trauma have been reported, and most of them were attributed to the seat-belt syndrome and associated with visceral organ perforation or pelvic fracture. We reported an unusual isolated common iliac artery occ...

Traumatic isolated common iliac artery occlusion is unusual, Only rare cases of common iliac arterial injuries resulting from blunt abdominal trauma have been reported, and most of them were attributed to the seat-belt syndrome and associated with visceral organ perforation or pelvic fracture. We reported an unusual isolated common iliac artery occ...

Experiments were designed to determine whether hyperkalemic crystalloid cardioplegic solution enhances endothelium-dependent contraction of coronary arteries. Segments of canine coronary arteries (n = 8 in each group) were preserved in cold (4 degrees C) crystalloid cardioplegic solution (group 1) and physiologic solution (group 2) for 60 minutes....

Video-assisted thoracoscopic technique was evaluated in 28 patients who underwent operation for massive pericardial effusion. Excellent results were obtained using this newly developed approach for inspection of all pericardial surfaces as well as pleural and pulmonary disorders. No perioperative or postoperative complications ensued. Videothoracos...

Intrathoracic lesions are usually removed through conventional thoracotomy. The long incision and the spreading of the rib usually results in much pain and interference of chest wall mechanics. Today, with the development of imaged thoracic surgery (combination of thoracoscope and video optics), major procedures can be performed through small incis...

University of Wisconsin (UW) solution has been used almost routinely in the preservation of the hepatic, pancreatic, renal, and cardiac allografts. However, its effect on vascular endothelium is unknown. Experiments were designed to evaluate its effect on canine coronary endothelium. Canine coronary arteries (n = 8 in each group) were preserved in...

Thoracoscopy has assumed a major role in the management of a variety of surgical diseases of the chest. This technique, which was primarily devised for diagnostic purposes, has subsequently come to be used for therapeutic applications in most centers today. In this report we review 300 cases of therapeutic thoracic procedures in which a video-assis...

Thoracoscopy has assumed a major role in the management of a variety of surgical diseases of the chest. This technique, which was primarily devised for diagnostic purposes, has subsequently come to be used for therapeutic applications in most centers today. In this report we review 300 cases of therapeutic thoracic procedures in which a video-assis...

Epstein-Barr virus (EBV) DNA has been detected in peripheral T-cell lymphomas. In this study, analysis of the EBV termini indicated that the infection was clonal and nonpermissive. Analysis of viral expression detected the processed, spliced mRNAs representing EBNA1, LMP1, LMP2, and BamHI A transcripts in all EBV-positive peripheral T-cell lymphoma...

A 30-year-old male presented with left side empyema due to gastro-pleural fistula following repair of penetrating stab injuries of left lower chest and abdomen. Exploratory thoracotomy was done due to persistent moderate amount of purulent discharge. However, fistula tract was not detected through this approach. The small fistula tract was repaired...

Utilization of Kirschner wires for bone and joint fixation is potentially complicated by migration of the wire from the fixation site over time. However, a review of the literature disclosed few reports of this complication. We describe such a case in order to emphasize the potential danger of the migration of such metallic devices used near thorac...

Utilization of Kirschner wires for bone and joint fixation is potentially complicated by migration of the wire from the fixation site over time. However, a review of the literature disclosed few reports of this complication. We describe such a case in order to emphasize the potential danger of the migration of such metallic devices used near thorac...

A 39-year-old woman was admitted with abdominal pain and dyspnea, and a diagnosis of systemic lupus erythematosus with renal involvement was established. Laboratory tests revealed highly elevated anticardiolipin antibody, thrombocytopenia and false positive VDRL. Generalized thrombus formation and Libman-Sacks endocarditis were found at postmortem...

It has been recently demonstrated that the Epstein-Barr virus (EBV) can infect human thymocytes and may be involved in the T cell neoplasms, in addition to African Burkitt's lymphoma, nasopharyngeal carcinoma and Hodgkin's disease. Four distinct clinicopathologic categories of EBV-associated T cell malignancies have been recognized. The angiocentri...

Hodgkin's disease (HD) is uncommon in Taiwan. In reviewing the clinicopathologic features of 50 cases, the authors found that the diagnosis of HD was complicated with non-Hodgkin's lymphoma (NHL). Fourteen cases were reclassified as NHL containing Reed-Sternberg (RS) giant cells, mostly peripheral T-cell lymphoma (PTL), and 34 cases as classic HD,...

The use of Kirschner wires (K-wires) for bone and joint fixation carries the risk of migration of the wire from the fixation site over time. However, review of the literatures disclosed rather few reports on this issue. We describe such a case in order to emphasize the potential complication and serious hazard that migration of such metallic device...

Two unusual cases of cutaneous angiocentric T-cell lymphoma were found to be associated with Epstein-Barr virus infection. The objective was to study the clinical course and the response of the disease to conventional chemotherapy. Histologic specimens from both patients were studied. Clonal proliferation was assessed by Southern blot hybridization...

The internal mammary artery (IMA) has become the conduit of choice in coronary artery bypass surgery because of superior long-term patency. It had been shown that IMA graft could release prostacyclin. Prostacyclin is a potent vasodilator and also can inhibit platelet aggregation. To determine the role of human IMA endothelium in production of prost...

The Epstein-Barr virus (EBV) has been shown to be associated with posttransplant lymphoma, Hodgkin's disease, and T-cell lymphoma, in addition to African Burkitt's lymphoma. In a retrospective study of 56 consecutive cases of T-cell lymphoma, EBV DNA was found by Southern blot and in situ DNA hybridization in 10 (20%) of 50 peripheral T-cell lympho...

The Epstein-Barr virus (EBV) has been shown to be associated with posttransplant lymphoma, Hodgkin's disease, and T-cell lymphoma, in addition to African Burkitt's lymphoma. In a retrospective study of 56 consecutive cases of T-cell lymphoma, EBV DNA was found by Southern blot and in situ DNA hybridization in 10 (20%) of 50 peripheral T-cell lympho...

Two childhood cases are reported of peripheral T-cell lymphoma; the neoplastic cells expressed activated CD8 (T8) phenotype and contained Epstein-Barr viral (EBV) DNA. Both patients had an aggressive and rapid clinical course despite chemotherapy. Elevated titers of antibodies to EBV-viral capsid antigen (greater than 640) and early antigen (greate...

This study was undertaken to identify the cutaneous manifestations among different prognostic subgroups of postthymic T cell malignancies. Cutaneous involvement was demonstrated in 43 of 88 cases. We recognized five clinicopathologic subtypes: type I, classical cutaneous T cell lymphoma (CTCL) or mycosis fungoides, six cases; type II, primary large...

From 1982 to 1985, four cases of primary myelofibrosis were diagnosed in our department. Three were boys and one was a girl. Their ages ranged from 7 months to 15 years. The diagnosis was made based on anemia, leukoerythroblastic change and presence of giant platelets in the peripheral blood, and a bone marrow biopsy showing myelofibrosis. Most of...

We reported 3 fatal cases of primary Epstein-Barr virus (EBV) infection resembling histiocytic medullary reticulosis (HMR) in young children in Taiwan, where an HMR-like illness has been previously found to be prevalent. The disease ran a fulminant course, manifesting as fever, anemia, jaundice, skin rash, pulmonary infiltration, and/or hepatosplen...

Peripheral T-cell lymphoma (PTCL) forms a morphologically heterogeneous group of non-Hodgkin's lymphomas (NHL) with distinct immunophenotypes of mature T cells. Progress has been slow in defining specific clinicopathological entities to this particular group of NHL. In order to elucidate the specific characteristics of PTCL, a direct comparison of...

To elucidate the clinicopathologic features of non-Hodgkin's lymphoma (NHL) in Taiwan, 123 adult patients with proven NHL were studied. They were classified according to the international working formulation as: low grade (LG), 12.2%; intermediate grade (IG), 42.3%; and high grade (HG) lymphoma, 45.5%. The most common subtypes were diffuse large ce...

The frequency, pattern, extent and clinical features of bone marrow involvement in 94 cases of non-Hodgkin's lymphoma, classified according to the International Working Formulation, were reviewed. In 30% of cases there was bone marrow involvement by lymphoma at the time of diagnosis. Marrow involvement was most frequently found in the follicular sm...

To elucidate the biologic significance of hepatocyte HBsAg, its expression patterns were correlated with virus replication and liver pathology in 578 liver biopsies taken from chronic HBsAg carriers aged 1 to 80 years. Five major patterns of hepatocyte HBsAg were identified: homogeneous [intense and discrete, (Pattern A), faint and discrete, (Patte...

Postthymic T-cell malignancy shows marked geographic, clinicopathologic, and prognostic diversity. The frequency and spectrum of T-cell malignancies in Taiwan were investigated. Fifty-two patients (35 male and 17 female) with a median age of 49 years, were consecutively encountered between October 1983 and April 1987; these accounted for 39% of non...

A total of 11 cases of Waldenstróm's Macroglobulinemia (WM) have been investigated to study the association of the disease with neuropathy. A 53-year-old female patient (Wu) had a pronounced peripheral neuropathy, in which the role of IgM M-protein could be observed. Sections of Wu's biopsied sural nerve were subjected to light and electron microsc...