• Title/Summary/Keyword: 중재방사선시술

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Interventional radiology of Bronchial artery embolization due to massive hemoptysis (대량객혈로 인한 기관지 동맥 색전의 중재적 방사선시술)

  • Min, Byoung-Yun;Lee, Sang-Bock
    • Journal of the Korean Society of Radiology
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    • v.4 no.4
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    • pp.17-24
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    • 2010
  • Hemoptysis which is comparatively common symptom in respiratory disease patients is a clinical symptom which has high risk of death in spite of many curative means. Bronchial tube embolization is a very useful medical procedure when hemoptysis does not stop for treatment of internal medicine or surgery and in addition to the purpose of instant hemostasis, for patients for whom surgical operation is impossible or for the purpose of gaining time to improve the state of the patient before surgical operation. In relation to this, this study is to know of the usefulness of bronchial tube artery embolization. The objects were 60 persons for whom bronchial tube artery embolizations are conducted because of large hemoptysis occurred from March 2007 to December 2009 in J hospital. They had large hemoptysis of 400ml or more per day and 200ml or more at a time or though the quantity of hemoptysis was less than 400ml they did not respond to the treatment of internal medicine for 10 days or longer. The average age was 60.5 years and cause diseases were tuberculosis, bronchiectasis, and pneumonia and lung cancer. Embolus parts were Rt bronchial artery 19 examples, Lt bronchial artery, both bronchial artery, Rt Intercostobronchial artery, and they were the case where embolization for many blood vessels were simultaneously carried out. As embolus materials, PVA (conteour) and microcoil were used. In 76.6% of 60 persons of patients hemorrhage stopped with the lapse of time after the procedure and in 4 examples (6.6) re-embolization was carried out due to re-bleeding after the procedure. Bronchial tube artery embolization has high early success rate and effectively controls hemoptysis in the treatment of hemoptysis and is an effective emergency remedy for hemorrhage due to large hemoptysis and will be a good medical procedure which reduces death rate. In addition, primarily if it is conducted together with the treatment of internal medicine it will be, as an effective curative means for hemorrhage due to large hemoptysis, a good mediate radial rays medical procedure which reduces death rate.

Usefulness of a Functional Tracheobronchial Phantom for Interventional Procedure (중재 시술용 기능성 기관-기관지 팬텀의 유용성)

  • Kim, Tae-Hyung;Lim, Cheong-Hwan;Kim, Jeong-Koo;Kim, Myeong-Soo;Choi, Won-Chan;Lim, Jin-Oh;Lee, Kwang-Jong;Park, In-Ae;Kim, Mi-Ok;Jung, Eun-Mi;Shin, Ryung-Mi;Jung, Seung-Ki;Youn, Sun-Hee
    • Journal of radiological science and technology
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    • v.26 no.4
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    • pp.27-32
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    • 2003
  • To evaluate usefulness of a functional tracheobronchial phantom for interventional procedure. The functional phantom was made as a actual size with human normal anatomy used silicone and a paper clay mold. A tracheobronchial-shape clay mold was placed inside a square box and liquid silicone was poured. After the silicone was formed, the clay was removed. We measured film density and tracheobronchial angle at the human, animal and phantom, respectively. The film density of trachea part were 0.76(${\pm}0.011$) in human, 0.97(${\pm}0.015$) in animal, 0.45(${\pm}0.016$) in phantom. The tracheobronchial bifurcation part measured 0.51(${\pm}0.006$) in human, 0.65(${\pm}0.005$) in animal, 0.65(${\pm}0.008$) in phantom. The right bronchus part measured 0.14(${\pm}0.008$) in human, 0.59(${\pm}0.014$) in animal and 0.04(${\pm}0.007$) in phantom. The left bronchus were 0.54(${\pm}0.004$) in human, 0.54(${\pm}0.008$) in animal and 0.08(${\pm}0.008$) in phantom. At the stent part were 0.54(${\pm}0.004$) in human, 0.59(${\pm}0.011$) in animal and 0.04(${\pm}0.007$) in phantom, respectively. The tracheobronchial angle of the left bronchus site were $42.6({\pm}2.07)^{\circ}$ in human, $43.4({\pm}2.40)^{\circ}$ in animal and $35({\pm}2.00)^{\circ}$ in phantom, respectively. The right bronchus site were $32.8({\pm}2.77)^{\circ}$ in human, $34.6({\pm}1.94)^{\circ}$ in animal and $50.2({\pm}1.30)^{\circ}$ in phantom, respectively. The phantom was useful for in-vitro testing of tracheobronchial interventional procedure, since it was easy to reproduce.

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Quality Control and Image Quality Comparison according to Ultrasonic Equipment (초음파 장비에 따른 정도관리와 화질 비교)

  • Dong-Hee, Hong
    • Journal of the Korean Society of Radiology
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    • v.16 no.7
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    • pp.935-942
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    • 2022
  • In doing interventional treatment under the guidance of ultrasonography, the medical team detects the legion site with ultrasonic equipment at first, and insert angio needle. In this situation, if the position of legion and the depth of inserted needle on the ultrasonographic screen are different from real position and depth, the needle is likely to damage a major blood vessel or tissue. Accordingly, we had wondered how much such differences between screen image and reality, and so decided to examine them. Using five ultrasonographic equipments manufactured from different companies in different years, this study tried to compare the lengths of the needle on the screen images and real lengths of it, and find out the factors affecting skewness of them. This study used hog meat chunk to mimic human flesh, and sausages as the target of needle. It compared penetrating depths of the needle as the images on the five equipments using single sample t test in the SPSS 22 statistical program. It was found that all the errors were statistically significant(<.05). So, this study decided that it was wrong to evaluate performances of the equipments by the makers and ages of them. It is necessary to do periodic quality controls of equipments and improve the skillfulness of sonographers to reduce error rates between real treatment areas and the images of them.

Compared the Causes of Problematic Chemo-Ports According to the Types of Chemo-Ports(Valved, vs. Non-Valved) (Valve포트와 Non-Valved포트 사용에 따른 문제점의 비교 분석)

  • You, In-Gyu;Lim, Cheong-Hwan;Han, Beom-Hee;Jung, Hong-Ryang;Joo, Yeong-Cheol
    • Journal of radiological science and technology
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    • v.34 no.1
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    • pp.35-41
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    • 2011
  • Total implanted central venous port (TIAP, Chemoport) is widely used in oncology patients because it does not require external dressing and restricts patient activity. Chemoport only requires monthly flushes of heparinized saline to keep the patency of the catheter and probably less prone to infectious complications than tunneled catheter. Despite the extensive use of permanent central venous access in oncology patients, there are only few reports about clinical experience of the Groshong catheter. The purpose of this study is to compare the complication rate between the traditional open-ended (non-valved) chemoports and valved chemoports (Groshong catheter connected to TIAP). During 5 years (Jan 2006 to May 2010), 438 patients received chemoport insertion procedure in our interventional radiology department. Among them 30 patients was referred to our department for problematic chemoports. We compared the cause of problematic chemoports between two types of chemoports (valved, vs. non-valved). Valved chemoports had higher referral rates than non-valved chemoports. When there is a need to insert valved port, different method of insertion and maintenance procedure seems to be necessary. More than 20 ml of flusing with heparinized saline after blood sampling could be a good suggestion. Adequate care of chemoport is essential for long patency. Also following the guideline from the manufacturing company is necessary.

Interventional Approaches for Treatment of Saddle Embolus in Two Cats with Hypertrophic Cardiomyopathy (고양이 심근비대증에 병발한 안장색전증의 중재치료 증례)

  • Kang, Min-Hee;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.298-302
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    • 2014
  • An 8-year-old castrated male domestic shorthair cat (Case 1) and 3-year-old castrated male Siamese cat (Case 2) was presented with acute paresis of the hindlimbs, constant open-mouth breathing, and hemoptysis. Heart murmur (Case 1) and gallop sound (Case 2) was ausculated on the left heart base. Radiographs revealed alveolar infiltration of the caudodorsal lung lobes with aerophagea in Case 1 and prominent cardiomegaly in Case 2. Marked concentric hypertrophy of the ventricular septum and free wall, and left atrial enlargement was detected through echocardiography in both cats. Based on the examinations including echocardiography, those cats were diagnosed as hypertropic cardiomyopathy. Abdominal ultrasound revealed echogenic material in the aortic trifurcation region, aortic thromboembolism (ATE). Although prognosis of those animals was guarded, interventional therapeutic approach through direct endovascular thrombolytic therapy was attempted. ATE was visualized through angiography; however dissolving the embolus using interventional thrombolytic approach was not successful due to the extensive thrombus.

Comparison of Methods using Radial and Femoral Arteries in Coronary Angiography (심장동맥 조영술 시 노동맥과 넙다리동맥을 이용한 방법 비교)

  • Ahn, Jun-Ho;Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
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    • v.16 no.2
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    • pp.87-94
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    • 2022
  • In this study, 61 patients who underwent coronary angiography from March 2018 to August 2019 were divided into Group I (Radial, n=34 patients) and Group II (Femoral, n=27 patients), and compared and analyzed methods using radial and femoral arteries when coronary angiography was performed. As a result of comparative analysis, Catheter usage was reduced in the examination using radial artery, and in the abnormal shape of blood vessels, Loops arterial abnormalities were more in the radial artery (20.6% vs, 0%, p<0.05), and it was found that the abnormal shape of the radial vessels increased with age. 60s, 70s, 80s, 90s or older (0%, 18.2%, 25.0%, 100%)

Multiple Congenital Anomalies in a Neonate of a Diabetic Mother (당뇨병 산모에서 출생한 다발성 기형 신생아 1례)

  • Kim, Hyun-A;O, Yung-Chul;Park, Hyun-Kyung;Jeon, Seok-Chol;Seol, In-Joon;Moon, Soo-Jee
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.89-93
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    • 2009
  • Maternal diabetes is known to have teratogenic effects which increase the risk for congenital anomalies, such as caudal dysplasia, cardiac defects, hydronephrosis, and small left colon syndrome. Infants of diabetic mothers have a 10-fold higher frequency of anomalies in the central nervous system and a 5-fold higher frequency of congenital heart defects. However, jejunal atresia combined with multiple anomalies of the face, ears, and hands has rarely been reported. Herein we report a neonate born to a diabetic mother, who had hemifacial microsomia, displacement of the lacrimal ducts, polydactyly of the right hand, microtia of the right ear and proximal jejunal atresia presenting as bile regurgitation on the 1st day of life.

Considerations for Fluoroscopic Guided Intervention in Lumbar Spine (방사선 투시장치를 이용한 요추 중재술 시 고려점)

  • Kim, Dong-Hyun;Song, Kwang-Sup
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.210-221
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    • 2020
  • Spinal block procedures are useful methods that reduce the need for surgical treatment. In addition to their therapeutic aspects of pain relief, in many patients, they are also used for diagnostic purposes to distinguish from symptoms originating from extra-spinal areas. Therefore, these procedures are the most basic technique for orthopedic surgeons dealing with diseases from limbs and spine. On the other hand, despite the simplicity of the instruments and drugs used, the overall understanding of them and the lack of knowledge of the possible side effects and complications can cause serious harm to the patient at the beginning of the trial. Therefore, it is necessary to understand the types of drugs used in the spinal block procedures, pharmacokinetic properties, and the side effects of each drug. In addition, efforts should be made to identify their indications, as well as advantages and disadvantages of each procedure to avoid possible complications. The purpose of this review was to provide basic knowledge and skills necessary for lumbar spinal block procedures as well as provide the reader with the ability to perform themselves.

Comparison of Efficacy of Overlapped Versus Long Eluting Stent in Acute Myocardial Infarction Patients with Diffuse Long Lesion (미만성 긴 병변이 있는 급성심근경색환자에서 긴 단일 용출 스텐트 시술과 중첩 스텐트 시술의 효과 비교)

  • Kim, Won Hyo;Kim, In Soo;Kong, Chang gi;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.14 no.3
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    • pp.319-336
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    • 2020
  • The purpose of this study was to compare the outcomes of two interventional methods, overlapping drug-eluting stents (DES) and long DES, for long-term clinical outcomes in patients with acute myocardial infarction (AMI). A total of 438 patients with AMI (65.9±11.0 years, 306 males) from June 2008 to March 2019 who had diffuse long coronary artery lesion, more than 30mm were divided into two groups; group I (overlapped DES group; n=140) and group II (long DES group; n=298). We compared the incidences of major adverse cardiac events [MACEs; cardiac death, myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST)] during 12 months between the two groups. Everolimus-eluting stent was more commonly used in group II than in group I (28.1% vs. 51.8% p<0.001). Mean lesion diameter was slightly longer in group II (3.1±0.3mm vs. 3.2±0.3mm, p=0.042), and prevalence of ACC/AHA lesion type C was higher in group I (41.7% vs. 25.4%, p<0.001). Incidences of MACEs during 12 months were higher in group I than group II (18.5% vs. 14.4%, p=0.034). The rates of cardiac death (2.1% vs. 4.4%, p=0.667), MI (5.0% vs. 2.7%, p=0.260) and stent thrombosis rate (0.7% vs. 1.7%, p=0.669) were similar between the two groups. However, TLR rate was higher in group I (10.7% vs. 5.6%, p=0.041). In multivariate logistic regression analysis, presence of diabetes mellitus [Hazard ratio (HR) 2.383, 95% confidence interval (CI) 1.332-4.260, p=0.003] and use of paclitaxel-eluting stent (HR) 2.367, 95% CI 1.371-4.086, p=0.002) were independent predictors of 12-month MACEs, without significant differences in prevalence between the two groups. In AMI patients with diffuse long lesion, TLR rate was higher in the overlapped DES group during 12-month follow-up. Presence of diabetes and use of paclitaxel-eluting stent were independent predictors of MACEs.

The evaluation for Clinical usefulness and Safety of Sirolimus-eluting stent and Paclitaxel-Eluting Stents In Patients With Acute Myocardial Infarction (급성심근경색증 환자의 일차적 관동맥 스텐트 삽입술 시 삽입된 Sirolimus-eluting stent 와 Paclitaxel-eluting stent의 임상적 안정성 및 유용성 평가)

  • Min, Gye-Sik;Han, Man-Seok
    • Journal of the Korean Society of Radiology
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    • v.6 no.1
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    • pp.5-10
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    • 2012
  • There is a still unsettled issue about the comparison of long-term clinical effects between sirolimus-(SES) and paclitaxel-eluting stents (PES) for the patients with acute myocardial infarction (AMI). Therefore, we performed a retrospective analysis to evaluate the 4-year clinical outcome of SES as compared with PES after percutaneous coronary intervention (PCI) in patients with AMI. From January 2004 to August 2006, all consecutive patients with acute ST-segment elevation myocardial infarction (STEMI) underwent primary PCI and acute NSTEMI underwent PCI by implantation either SES or PES were enrolled. The occurrence of death, cardiac death, recurrent infarction, target vessel revascularization (TVR) and stent thrombosis were analyzed. The composite of major adverse cardiac events (MACE; death, recurrent infarction and TVR) were also analyzed. During the study period, total 668 AMI patients had visited. Of them, total 522 patients (299 with SES and 223 with PES) were enrolled. During 4-year clinical follow-up, there were similar occurrences of death ($18.3{\pm}3.0%$ vs. $14.6{\pm}2.2%$, p=0.26), cardiac death ($11.2{\pm}2.6%$ vs. $6.8{\pm}1.52%$, p=0.39), re-infarction ($6.4{\pm}1.8%$ vs. $3.3{\pm}1.1%$, p=0.31), and stent thrombosis ($5.4{\pm}1.7%$ vs. $3.2{\pm}1.1%$, p=0.53) between the two groups, consecutively. The occurrences of TVR ($10.0{\pm}3.0%$ vs. $4.0{\pm}1.2%$, p=0.008) and MACE ($29.4{\pm}3.5%$ vs. $19.4{\pm}2.5%$, p=0.003) were significantly higher in patients treated with PES than SES. In AMI patients treated with either SES or PES implantation, SES had a significantly lower risk of TVR and MACE during 4-year clinical follow-up. Rates of death, cardiac death or recurrent infarction, and stent thrombosis were similar.