• Title/Summary/Keyword: 경피적 혈관성형술

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Prevalence and Management of Venous Rupture Following Percutaneous Transluminal Angioplasty in Dysfunctional Arteriovenous Access: A Comparative Study of Primary Patency Rates with Non-Ruptured Access Circuits (동정맥루 기능 부전에서 경피적 혈관성형술 후 발생한 정맥 파열의 유병률 및 관리: 파열되지 않은 혈관과의 일차 개통 비교 연구)

  • Yoon Soo Park;Seung Boo Yang;Chae Hoon Kang;Dong Erk Goo
    • Journal of the Korean Society of Radiology
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    • v.85 no.4
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    • pp.746-753
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    • 2024
  • Purpose This study aims to evaluate the incidence and management of venous ruptures after percutaneous transluminal angioplasty (PTA) for dysfunctional arteriovenous (AV) access. Materials and Methods From January 1998 to December 2015, 13506 PTA, mechanical thrombectomy, and thrombolysis procedures were performed in 6732 patients. The venous rupture rate following PTA was obtained, and access circuit primary patency (ACPP) was compared according to the etiology (PTA, thrombotic occlusion, and treatment type) of the venous rupture present. Results Venous rupture developed in 604 of the 13506 procedures. Venous ruptures were more frequent in female, AV graft cases, and in cases accompanied by thrombosis. Balloon tamponade was performed in 604 rupture cases, and stents were deployed in 119 cases where contrast extravasation and flow stasis persisted. ACPP was significantly better in the non-ruptured AV access circuits than in the ruptured group. However, AV access type and thrombosis was not associated with primary patency. In ruptured cases, ACPP is 8.4 months for prolonged balloon tamponade and 11.2 months for bare-metal stent insertion, showing statistically significant difference. Conclusion Balloon tamponade and bare-metal stent placement are effective treatment for PTA-induced venous ruptures. In particular, stent placement showed a similar ACPP to that of non-ruptured AV access circuits.

A Case of Renovascular Hypertension Controlled by Percutaneous Transluminal Renal Angioplasty with Balloon Dilatation (경피적 신동맥 혈관 성형술로 치료한 신혈관 고혈압증 1례)

  • Park, Sung-Woo;Jeong, Su-Ho;Jeong, Young-Sun;Jun, Yong-Hoon;Hong, Young-Jin;Lee, Ji-Eun
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.105-110
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    • 2008
  • Renovascular hypertension results from a lesion that impairs blood flow to a part of or all, of one or both kidneys. Renal artery stenosis is the major cause of renovascular hypertension and the most common cause of treatable secondary hypertension. Recently, percutaneous transluminal renal angioplasty(PTRA) with or without stent placement, has become the preferred choice for correcting symptomatic renal artery stenosis since it is less invasive than surgical reconstruction. PTRA with balloons designed for the dilatation for the dilatation of the coronary artery can be tried in small sized renal artery stenosis. We report a case of renovascular hypertension in a 13-year-old male who had small sized renal artery stenosis. Hypertension was controlled by PTRA with balloon dilatation.

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Femoral Endarteritis as a Complication of Percutaneous Suture Closure Device -A case report- (경피적 혈관봉합술 후 발생한 대퇴동맥 내막염 -1예 보고-)

  • Hong, Joon-Hwa;Choi, Jin-Wook;Moon, Jong-Hwan;Soh, Dong-Moon
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.864-867
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    • 2006
  • Percutaneous suture closure device is known as relatively safe and convenient tool, which can decrease not only bed rest period of patient but also time consuming effort of manual compression of doctor after femoral artery puncture. However[C1], there are also some reports on complication of its use. We report a 62-year-old male patient who had femoral artery endarteritis[0] with pseudoaneurysm as a complication of percutaneous suture closure device after percutaneous coronary angiography[C2]. He was treated successfully by appropriate antibiotics and vessel reconstruction using autologous saphenous vein patch.

A Case of Renovascular Hypertension Controlled by Renal Artery Embolization (신동맥 색전술로 치료한 신혈관 고혈압증 1례)

  • Yew, Jung Hun;Kim, Young Deuk;Shin, Byung Seok;Gil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.212-215
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    • 2005
  • Renal artery stenosis is a major cause of renovascular hypertension and the most common cause of treatable secondary hypertension. There are several methods to treat renal artery stenosis, including surgery, percutaneous transluminal renal angioplasty(PTRA), and renal artery stenting(RAS). But, renal artery embolization can be tried in atherosclerotic stenosis, multiple stenosis, microaneurysm, and stenosis difficult to try PTRA or RAS. We report a case of renovascular hypertension in a 14-year-old female who had multiple segmental renal artery stenosis. Hypertension was controlled by renal ablation therapy with renal artery embolization.

Comparative Analysis of Surgical Thrombectomy with Revision and Percutaneous Thrombectomy with Angioplasty for Treating Obstruction of a Dialysis Graft (인조혈관 동정맥루 폐쇄의 치료에서 수술적 혈전제거술 및 재건술과 경피적 혈전제거술 및 혈관성형술의 비교연구)

  • Lim, Jae-Woong;Won, Yong-Soon;Kim, Dong-Hyun;Shin, Hwa-Kyun
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.487-491
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    • 2009
  • Background: Salvaging prosthetic arteriovenous grafts can be performed using surgical or endovascular techniques. We conducted a retrospective analysis to compare the efficacy of these two methods for restoring dialysis graft function. Material and Method: We studied 41 patients who had received surgical thrombectomy with revision (Group A) or percutaneous thrombectomy with angioplasty (Group B) from January 2006 to December 2007. We compared them according to the patient characteristics and the location of stenotic lesions, and we analyzed the post-intervention primary patency rates. Result: 21 patients underwent surgery and 20 patients underwent percutaneous balloon angioplasty. There were no significant differences of the patients' characteristics between the two groups. Venous anastomotic stenosis was the most common cause of graft thrombosis in both groups. In Group A, 90.5% of the grafts remained functional at 6 months and 38.1% remained functional at 12 months. In Group B, 55.0% of the grafts were functional at 6 months and 20.0% of the grafts were functional at 12 months. The post-intervention primary patency rate was significantly better in Group A (p=0.034). Conclusion: Surgical treatment resulted in significantly longer post-intervention primary patency in this study, and this supports its use as the primary method of management for most patients in whom dialysis graft obstruction develops.

Numerous Bilateral Radiographically Dense Branching Opacities after Vertebroplasty with Polymethylmethacrylate (Polymethylmethacrylate를 이용한 경피적 척추성형술 후 흉부 X선에서 관찰된 다수의 양측성, 분지상 선상 음영)

  • Cho, Jun Hyun;Jung, Jong Pil;Eum, Jun-Bum;Seo, Kwang Won;Jegal, Yang Jin;Choi, Seong Hoon;Ahn, Jong Joon
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.2
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    • pp.184-188
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    • 2006
  • Percutaneous vertebroplasty consists of the percutaneous injection of polymethylmethacrylate (PMMA) cement into a collapsed vertebral body in order to obtain pain relief and mechanically strengthen the vertebral body. This procedure is now extensively used in treating osteoporotic vertebral compression fracture. It is an efficient treatment, but it is not free of complications. Most complications after vertebroplasty are associated with PMMA leakage. Pulmonary embolism of PMMA is rare, but this can occur when there is a failure to recognize venous migration of cement early during the procedure. We encountered a case of a patient with asymptomatic pulmonary embolism because of PMMA after percutaneous vertebroplasty. Chest X-ray and CT scanning revealed numerous tubular branching opacities that corresponded to the pulmonary vessels at the segmental and subsegmental levels.

Determinants of Successful Percutaneous Transluminal Coronary Angioplasty (경피적 관상동맥 성형술의 성공율에 영향을 미치는 인자에 대한 고찰)

  • Choi, Kyo-Won;Kweon, Jun-Young;Kim, Young-Jin;Lee, Tae-Il;Shin, Dong-Gu;Kim, Young-Jo;Shim, Bong-Seup;Lee, Hyun-Woo;Lee, Sam-Beom
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.230-239
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    • 1994
  • In Order to evaluate determinants of successful percutaneous transluminal coronary angioplasty (PTCA), PTCA was performed for 172 coronary arterial lesions in 120 patients (89 male, 31 female) at Yeungnam university hospital from Sep. 1992 to Aug. 1993. The corinary artery luminal diameter at the site of the original stenosis was eveluated from end-diastolic frames of identical projections of the preangioplasty and immediate post angioplasty. The coronary luminal and balloon diameters were measured with using of computer measuring system. Overall success rate of 172 attempted lesions was 87.2%. Success rate of female patients was 93.5% and higher than those of male patients. According to the clinical diagnosis, success rate in stable angina was 93.7% and higher than those of post myocardial infarction angina, unstable angina and acute myocardial infarcrion. Success rate of American Heart Association type C lesion was 65.5% and lower those of type A (95.7%), type B (89.5%). There was signfifcantly difference in preangioplasty luminal stenosis, elastic recoil and length of lesion between successful PTCA group and failed PTCA group. Success rate of lesion location at a bend > $45^{\circ}$ and presence of intracoronary thrombus were lower than than those of other angiographic findings. In coclusion, primary angioplasty success was affected by specific angiographic factors. Stenosis severity, thrombus, lesion location at a bend > $45^{\circ}$, elastic recoil, and length of lesion were the principle of determinants of coronary angioplasty success rate.

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Safety and Efficacy of the Percutaneous Manual Aspiration Thrombectomy Technique to Treat Thrombotic Occlusion of Native Arteriovenous Fistulas for Hemodialysis (혈액투석용 자가혈관 동정맥루의 혈전을 동반한 폐색에서 경피적 수동 흡인 혈전제거술의 안정성과 유용성)

  • Sang Eun Yoon;Sun Young Choi;Soo Buem Cho
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.409-417
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    • 2020
  • Purpose To evaluate the safety and efficacy of the percutaneous manual aspiration thrombectomy technique to treat thrombotic occlusion of native arteriovenous fistulas. Materials and Methods A retrospective review of 20 patients who underwent percutaneous manual aspiration thrombectomy for native thrombotic arteriovenous fistula occlusion from March 2012 to December 2017 was performed. We evaluated technical and clinical success rates and complications. The primary and secondary patency rates were calculated using the Kaplan-Meier analysis. Results Percutaneous manual aspiration thrombectomy was performed in 20 patients (n = 20) with concomitant balloon angioplasty. The overall technical and clinical success rates were both 85% (n = 17). The native arteriovenous fistulas, based on their site, were the left radiocephalic (n = 13), left brachiocephalic (n = 4), and right radiocephalic (n = 3) fistulas. An underlying stenosis was detected in the juxta-anastomotic venous site (n = 16), outflow draining vein (n = 12), and central vein (n = 4). The primary and secondary patency rates at 1, 3, 6, and 12 months were 100%, 70.6%, 70.6%, and 56.5% and 100%, 94.1%, 94.1%, and 86.9%, respectively. There were no complications associated with procedure. Conclusion Percutaneous manual aspiration thrombectomy is a safe and effective method to treat thrombotic native arteriovenous fistula occlusion.

Surgical Treatment for Rupture of the Right Common Iliac Artery Caused by Transcatheter Balloon Aortic Valvuloplasty in a Baby with Congenital Aortic Stenosis - A case report - (선천성 대동맥 판막 협착증에서 풍선 판막 성형술 중 발생한 총장골 동맥 파열의 외과적 치료 -1예 보고 -)

  • Han, Jong-Hee;Kim, Yong-Ho;Yu, Jeong-Hwan;Kim, Si-Wook;Kil, Hong-Ryang;Yu, Jae-Hyeon
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.116-119
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    • 2008
  • Transcatheter interventions are widely used for diagnosis and treatment of congenital heart disease. Complications associated with transcatheter interventions are uncommon. However, when they occur they are most often self-limited. Rarely, however, serious catheter related complications occur that may require emergent surgical intervention. In this case, the right common iliac artery was disrupted during transcatheter balloon valvuloplasty during the treatment of congenital aortic stenosis in a 2-week-old baby. After immediate surgical intervention with bleeding control using two balloon catheters the baby did well. Here we report this case and review the medical literature.

Outcome of Patch Angioplasty for Left Main Coronary Ostial Stenosis (좌주관상동맥 개구부 협착에서의 혈관성형술의 결과)

  • Kang, Chang-Hyun;Na, Chan-Young;Seo, Hong-Joo;Kim, Jae-Hyun;Lee, Cheul;Chang, Yoon-Hee;Hwang, Seong-Wook;Baek, Man-Jong;Oh, Sam-Se;Kim, Woong-Han;Lee, Young-Tak;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.56-63
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    • 2004
  • Background: Patch angioplasty is an alternative surgical procedure to coronary artery bypass grafting (CABG) for left main coronary ostial stenosis. The purpose of this study is to evaluate the outcome of patch angioplasty by analyzing the short-term and long-term results. Material and Method: Twenty nine patients who had undergone patch angioplasty due to left main coronary ostial stenosis between July 1991 and May 2003 were enrolled in the study. The mean age of the patients was 53.1 $\pm$12.5 years. There were 8 males and 21 females, and there were 12 female patients who had no risk factor for atherosclerosis. Twenty six (89.7%) patients showed isolated coronary ostial stenosis without any distal coronary lesion. Result: Anterior approach was used in 28 patients and superior approach was used in one patient. Transsection of the main pulmonary artery was used in one patient. Concomitant CABG was performed in 4 patients because of left anterior descending artery lesions in 3 patients and unstable postoperative hemodynamic status in one patient. Hospital mortality had occurred in one patient (3.4%) and late mortality also in one patient, therefore the overall 5 year survival rate was 91.2$\pm$6.1%. Seventeen coronary angiographies were done in 13 patients (44.8%) postoperatively. Two distal patch stenoses, 1 proximal patch stenosis, and 1 new right coronary ostial lesion were identified and 3 percutaneous interventions and 1 CABG were performed during the follow-up period. The overall 5 year freedom from reintervention rate was 82.4 $\pm$ 8.5%. Aortic regurgitation less than grade 1 had developed postoperatively in 4 patients and one patient showed progression of preexisting aortic regurgitation from grade II to III. Conclusion: Patch angioplasty in left main coronary ostial lesion showed acceptable short-term and long-term results in this study. However, restenosis at the patch anastomosis site and aortic regurgitation should be carefully investigated during the follow-up period.