• Title/Summary/Keyword: 치료 색전술

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Endovascular Treatment for Head and Neck Trauma (두경부 외상의 인터벤션)

  • Jae Won Han;Jae Il Lee;Lee Hwangbo
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.792-808
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    • 2023
  • Trauma to the head and neck region can have serious consequences for vital organs such as the brain, and injuries to blood vessels can cause permanent neurological damage or even death. Thus, prompt treatment of head and neck vessels is crucial. Although the level of evidence is moderate, an increasing amount of research indicates that endovascular treatments can be a viable alternative to traditional surgery or medical management. Embolization or reconstructive endovascular procedures can significantly improve patient outcomes. This article provides an overview of various endovascular options available for specific clinical scenarios, along with examples of cases in which they were employed.

Endovascular Treatment of Aortic Dissection due to Suture Line Dehiscence after Aortic Graft Replacement for Type A Aortic Dissection: A Report of Two Cases (A형 대동맥박리의 대동맥 이식편 치환술 후 봉합선 열개의 혈관내 치료: 2건의 증례 보고)

  • Woo Jin Shim;Young Hwan Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.3
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    • pp.668-675
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    • 2024
  • Aortic anastomotic leak is an uncommon complication after ascending aortic replacement for acute aortic dissection. Redo-surgery is the traditional standard treatment despite high mortality and morbidity. Recently, endovascular treatment has been attempted as an alternative approach in a few case reports. Here, we present two cases of aortic anastomotic leak due to suture line dehiscence after aortic graft replacement for type A aortic dissection, which were successfully treated by coil with subsequent N-butyl cyanoacrylate embolization and an AmplatzerTM vascular plug.

A Giant Bronchial Artery Aneurysm in Brochiectatic Patient -One case report- (기관지 확장증 환자에서의 거대 기관지 동맥류 -1예 보고-)

  • 최세용;안창;민선경;한재진;안재호;원태희
    • Journal of Chest Surgery
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    • v.37 no.11
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    • pp.951-954
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    • 2004
  • Bronchial artery aneurysm is a rare but life-threatening disease when it ruptures, and it requires prompt treatment to prevent from catastrophic ruptures. A 78-year-old woman was referred to our hospital to evaluate mediastinal massfound on chest computed tomography. We did a selective bronchial artery angiography and diagnosed as bronchial artery aneurysm. Aneurysmectomy with division of afferent and efferent arteries was performed through standard thoracotomy without cardiopulmonary bypass. The patient recovered uneventfully and was discharged on postoperative 8th day without any complications.

Role of Interventional Radiologists in Trauma Centers (외상센터에서의 인터벤션 영상의학 의사의 역할)

  • Jeong Ho Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.784-791
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    • 2023
  • Based on statistics available in Korea, trauma centers play a critical role in treatment of patients with trauma. Interventional radiologists in trauma centers perform various procedures, including embolization, which constitutes the basic treatment for control of hemorrhage, although interventions such as stent graft insertion may also be used. Although emergency interventional procedures have been used conventionally, rapid and effective hemorrhage control is important in patients with trauma. Therefore, it is important to accurately understand and implement the concept of damage control interventional radiology, which has gained attention in recent times, to reduce preventable trauma-induced mortality rates.

Endovascular Treatment of a Systemic-to-Pulmonary Artery Fistula: A Case Report (체-폐동맥루의 혈관 내 치료: 증례 보고)

  • Eunbyul Lee;Dong Jae Shim;Doyoung Kim;Jung Whee Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.682-687
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    • 2021
  • Systemic-to-pulmonary artery fistulas are rare. This condition may be congenital, post-traumatic, or post-inflammatory and can cause infection, hemorrhage, or pulmonary hypertension. Here, we report a case of an intercostal-to-pulmonary artery fistula, incidentally detected during the evaluation of dyspnea in a 67-year-old female. Retrograde transcatheter coil embolization in a dilated draining pulmonary artery was initially attempted. However, another draining pulmonary artery developed after 5 months. The intercostal arteries or systemic feeders were successfully embolized through a transarterial access. At the 10-month follow-up, the abnormally dilated vessels had regressed, and dyspnea had improved. Sequential or simultaneous retro- and antegrade transcatheter embolization may successfully treat pleural arterio-arterial fistulas.

Two Case of Pulmonary Arteriovenous Fistula Treatment Depending on the Presence of Pulmonary Hypertension (폐동맥고혈압 동반여부에 따른 폐동정맥루의 치료)

  • Huh, Yun Jeong;Kim, Jeong Tae;Choi, Jae Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.216-220
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    • 2005
  • Pulmonary arteriovenous fistulas(PAVFs) is a rare disorder that occurs in two to three children per 100,000 population. It is presented as absence of intervening capillary beds between the pulmonary artery and vein with resultant persistent right to left shunt. Other causes include trauma, liver cirrhosis, malignancy and schistosomiasis. It is mostly asymptomatic, but it may present with respiratory difficulty, cyanosis, clubbed fingers induced by right to left shunt or hemoptysis, polycythemia and epistaxis. Major complications, such as brain abscess, brain embolism, paradoxical embolism and subacute infective endocarditis can be devastating, so therapeutic intervention is recommended in all patients. However, removal of low-resistance fistulas can aggrevate pulmonary hypertension, so detection of increased pulmonary pressure is important. We report two patients : One a 42 year-old male with PAVFs treated with coil embolization, and a 42 year-old female who was treated with anticoagulants due to pulmonary hypertension.

Hepatitis B Virus Reactivation after Partial Hepatic Irradiation Alone: A Case Report (부분 간조사만을 시행받은 환자에서의 B형 간염바이러스의 재활성화: 증례보고)

  • Kim, Bo-Kyong
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.106-110
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    • 2010
  • Reactivation of the hepatitis B virus (HBV) is a well-recognized complication in patients with chronic HBV infection who receive cytotoxic or other immunosuppressive therapy. In cases of patients treated by radiotherapy however, only a few of such reports exist and most of these include the patients previously treated by chemotherapy or transarterial chemoembolization. The results of this study point to a case of a patient with reactivation of HBV after radiotherapy alone. This study shows the possibility of HBV reactivation by partial hepatic irradiation alone hence, special attention should be paid to patients with HBV disease.

Successful Transcatheter Arterial Embolization following Diverticular Bleeding in the Third Portion of the Duodenum: A Case Report (경동맥 색전술을 이용한 십이지장 3부 게실 출혈의 성공적인 지혈: 증례 보고)

  • Seok Jin Hong;Sang Min Lee;Ho Cheol Choi;Jung Ho Won;Jae Boem Na;Ji Eun Kim;Hye Young Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.237-243
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    • 2021
  • This is a rare case of a 73-year-old male patient who presented with hematochezia and was treated using transcatheter arterial embolization following upper gastrointestinal bleeding in the third portion of the duodenum. The cause of the bleeding was not found on gastrointestinal endoscopy and CT. On the third day of hospitalization, the hemoglobin level continued to decrease. A technetium-99m-labeled red blood cell scan revealed suspicious bleeding in the diverticulum of the third portion of the duodenum. Superior mesenteric artery angiography showed active bleeding from the posteroinferior pancreaticoduodenal artery, which was embolized with N-butyl cyanoacrylate. The patient was discharged on the seventh day after embolization without re-bleeding or complication. We report a rare case of a patient with active bleeding from a duodenal diverticulum that was difficult to diagnose using routine modalities. Herein, we report a rare case of a patient with active bleeding from a duodenal diverticulum that was difficult to diagnose using routine modalities. We also conducted a relavant literature review.

A Case of Coil Embolization in a 15-year-old Child with Pulmonary Sequestration (코일 색전술로 치료한 15세 소아의 폐 격리 1례)

  • Kim, Hyo Bin;Kim, Ja Hyung;Lee, Jong Seung;Hong, Soo-Jong;Sung, Gyou Bo
    • Clinical and Experimental Pediatrics
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    • v.46 no.4
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    • pp.385-388
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    • 2003
  • Pulmonary sequestration is a rare congenital mass of nonfunctional pulmonary tissue that lacks a normal-connection with the bronchial tree or the pulmonary arteries. It is clinically asymptomatic but when it is complicated with recurrent infection, it needs to be treated. Conventionally, surgical removal was recommended, but these days we are trying new and less invasive techniques, such as arterial embolization. There were several reports about successful cases of pulmonary sequestration treated by embolization, but mostly all of them were done to newborns or infants. We report a case of a 15-year-old boy with an asymptomatic pulmonary sequestration on whom was performed coil embolization, and in the follow-up computed tomography(CT), the size of the lesion was decreased. He did not suffer severe respiratory symptoms.

Diagnosis and Post-Therapeutic Evaluation of Arteriovenous Malformations in Extremities Using Transarterial Lung Perfusion Scintigraphy (경동맥 폐관류 신티그라피를 이용한 상하지 동정맥 혈관기형의 진단과 치료 평가)

  • Chung, Hyun-Woo;Choi, Joon-Young;Kim, Young-Wook;Kim, Dong-Ik;Do, Young-Soo;Lee, Eun-Jeong;Lee, Su-Jin;Cho, Young-Seok;Hyun, Seung-Hyup;Lee, Kyung-Han;Kim, Byung-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.6
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    • pp.316-321
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    • 2006
  • Purpose: Differential diagnosis between arteriovenous (AVMs) aud non-arteriovenous malformations (nAVMs) is important in patients with congenital vascular malformations, because AVMs can cause hemodynamic alteration and require immediate treatment. We investigated whether transarterial lung perfusion scintigraphy (TLPS) was useful for the diagnosis and post-therapeutic evaluation of AVMs in extremities. Materials and Methods: Fifty-seven patients (M:F=26:31, $21{\pm}13$ yr, 9 upper and 48 lower extremities) suspected of congenital vascular malformations in extremities underwent TLPS using $^{99m}Tc-MAA$ before embolization/sclerotherapy. Dose-corrected shunt fraction (SF) was calculated from time-activity curve of the lung. Final diagnosis of AVMs was determined by angiography. in patients with AVMs, follow-up TLPS was done for post-therapeutic evaluation. Results: Sixteen patients (8 upper and 8 lower extremities) had AVMs, while the remaining 41 had nAVMs (1 upper and 40 lower extremities). The mean SF of AVMs on TLPS was significantly higher than that of nAVMs ($66.4{\pm}25.8%\;vs.\;2.8{\pm}4.3%$), p=0.003). The sensitivity, specificity, and accuracy of TLPS (cut-off of SF = 20.0%) in diagnosis of AVMs before treatment were 93.8% (15/16), 100% (41/41) and 98.2% (56/57), respectively. The follow-up TLPS and angiography for post-therapeutic evaluation showed concordant results in 13 of 16 patients (81.3%) with AVMs. The mean SF of TLPS was significantly decreased after embolization/sclerotherapy ($69.5{\pm}24.0%\;vs.\;41.0{\pm}34.7%$, p=0.01). Conclusion: TLPS provides hemodynamic information of AVMs in extremities semiquantitatively. Furthermore, the results of TLPS showed a high concordance rate with angiographic findings. Therefore, TLPS is useful for the diagnosis and post-therapeutic evaluation of AVMs in extremities.