• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.7
• /
• pp.4651-4655
• /
• 2015

The subclavian artery pseudoaneurysm in blunt trauma is uncommon and rarely occurs secondary to penetrating injury. Subclavian artery injuries represent an uncommon complication of blunt chest trauma, this structure being protected by subclavius muscle, the clavicle, the first rib, and the deep cervical fascia as well as the costo-coracoid ligament, a clavi-coraco-axillary fascia portion. Subclavian artery injury appears early after trauma, and arterial rupture may cause life-threatening hemorrhages, pseudoaneurysm formation and compression of brachial plexus. Most injuries were related to clavicle fracture, gunshot, other penetrating trauma, and complication of central line insertion. The presence of large hematomas and pulsatile palpable mass in supraclavicular region should raise the suspicion of serious vascular injury and these clinical evidences must be carefully worked out by physical examination of the upper limb. Since the first reports of endovascular treatment for traumatic vascular injuries in the 1993, an increasing number of vascular lesions have been treated this way. We report a case of subclavian artery pseudoaneurysm 10 days after blunt chest trauma due to traffic accident, treated by endovascular stent grafting.

• Journal of radiological science and technology
• /
• v.34 no.3
• /
• pp.209-214
• /
• 2011

Goal of this study was to measure effective radiation dose of highly exposed patients who were treated by TACE, interventional radiology from June to September 2010. The effective radiation dose was approximately measured by weighted DAP (dose area product) with the ionization chamber which is inserted in angiography equiment (Philips Allura Xper FD 20). Radiation dose was measured by TLD which was attached to patients' thyroid and genital gland. The average of ED (effective dose) was 18.43${\pm}$6.63 mSv per person and the average of radiation dose of thyroid and genital gland was 0.37 mSv, 0.77 mSv, respectively. The mean radiation dose of operators who wear the protector was 0.07 mSv for thyroid, and 0.01 mSv for genital gland, respectively. All staffs involved in TACE treatment, have to keep them aware and use the appropriate protectors to reduce the radiation dose of patient.

• Proceedings of the KIEE Conference
• /
• 2003.11c
• /
• pp.460-463
• /
• 2003

의료영상에서의 혈관의 분할은 심혈관계질환의 진단 및 시술을 위한 3차원 가시화 및 가상내시경을 하기위한 필수 선행 단계로 이에 대한 연구가 많이 이루어 지고 있다. 조영제를 투여한 환자의 CT데이터에서 혈관분할의 가장 큰 문제점은 혈관의 밝기값이 뼈의 밝기값과 비슷하기 때문에 기존의 3차원 SRG방법으로 분할하는 경우 새나감의 문제를 가지고 있었다. 본 논문에서는 Cubic SRG라는 방법을 통해 기존의 3차원 SRG가 가지는 깔끔한 분할결과와 적응적인 특성등의 여러 장점을 그대로 취하며 Cubic이라는 구조적 특징을 이용하여 혈관을 빠르고 강인하게 분할하는 방법을 제안한다. Cubic SRG는 SRG가 픽셀단위의 성장을 통해 동질 영역을 분할하는 방법을 사용함에 반해 Cubic이라는 부피 단위를 지정하여 이를 SRG의 픽셀과 같이 퍼트리는 방식으로 기존의 3차원 SRG에 비해 2$\sim$5배 정도의 빠른 수행속도를 보이며 3차원 SRG의 장점인 적응적인 특성을 그대로 가질수 있도륵 구현되었다. 또한 복셀들을 Cubic이라는 단위로 묶음으로서 혈관의 구조적인 분석을 수행하여 혈관을 트리형태의 구조로 그룹화가 가능하기 때문에 혈관을 가지별로 분할하기에 용이한 특징을 가지도록 하였으며, 이를 통해 새나감이 시작된 가지를 찾아서 잘라내는 방법을 통하여 SRG의 가장 큰 문제인 새나감 방법을 효과적으로 해결하는 방법을 제시한다. 최종적으로 위의 방법을 기본으로 하여 적응형 임계값 기반의 분할 방법을 혼합하여 사용자가 지정한 두 지점사이의 혈관을 강인하게 분할할수 있도록 구현하였고, 제안한 방법으로 여러 환자의 CT데이터에 실험하여 좋은 결과를 얻을 수 있었다.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.7 no.1
• /
• pp.49-66
• /
• 2014

Traditionally, cervical interventions have been performed under fluoroscopy. But radiation exposure is the major concern when obtaining fluoroscopic images and even under real-time fluoroscopy with contrast media or CT guidance, some cases of serious spinal cord injuries, cerebellar and brain stem infarction have been reported by unintentional intra-arterial injections especially during the transforaminal root blocks. Recently, the use of ultrasound-guided cervical interventions have increased. Ultrasound offers visualization of soft tissues including major neurovascular structures and also allows to observe the spread of injectant materials around the target structure. Ultrasound is radiation free, easy to use and the image can be performed continuously while the injectant is visualized in real-time, increasing the precision of injection. Importantly, ultrasound allows visualization of major nerves and vessels and thus leads to improve safety of cervical interventions by decreasing the incidence of injury or injection into nearby vasculature. We therefore reviewed to investigate the feasibility of performing cervical interventions under real-time ultrasound guidance.

• Journal of Chest Surgery
• /
• v.43 no.6
• /
• pp.758-763
• /
• 2010

In current era, thoracic endovascular aortic repair (TEVAR) has gained popularity. But, it bears the risk of serious complications such as treatment failure from endoleak, retrograde aortic dissection caused by injury of aortic wall at landing zone, or aortic rupture resulting from stent graft infection. We report two cases of surgical repair of retrograde aortic dissection after TAVAR applied to acute Stanford type B aortic dissection or traumatic aortic disruption.

• Journal of the Korean Society of Radiology
• /
• v.81 no.3
• /
• pp.549-561
• /
• 2020

Since the endosaccular coil embolization technique was introduced as an alternative for treating selected patients with aneurysms, it has become a mainstay of treatment for cerebral aneurysms. In lesions with a neck larger than the aneurysmal body, an irregular shape, or arterial branches incorporated within the sac, endovascular treatment using detachable coils are traditionally contraindicated because of technical difficulties. Coil embolization has evolved as a result of both the development of related devices and the introduction of technical improvements using various devices. Use of various technical and device options can make endovascular treatment of cerebral aneurysms safer and can widen the treatment indications. Various technical options, including the technical modification of device-assisted techniques, will be presented, and the related practical points will be discussed in this issue.

• Journal of Chest Surgery
• /
• v.39 no.2 s.259
• /
• pp.157-161
• /
• 2006

Use of endovascular stent-graft in aortic aneurysm disease is now accepted as an alternative treatment to surgery. We successfully treated two patients with high risk of thoracic aortic aneurysm with percutaneous endovascular stent-graft. Three and ten months follow up chest CT showed obliteration of aneurysm and there was no complication after stent grafting.

• Journal of the Korean Society of Radiology
• /
• v.82 no.3
• /
• pp.527-540
• /
• 2021

Peripheral arterial occlusive disease (PAOD) of the femoropopliteal artery is commonly caused by atherosclerosis. It can present with varying clinical symptoms depending on the degree of disease, ranging from intermittent claudication to critical limb ischemia and tissue loss. Therefore, appropriate and timely treatment is required to improve symptoms and salvage the affected limbs. Interventional approaches for femoropopliteal arterial disease commonly include percutaneous transluminal angioplasty, atherectomy, and stent placement. Over the years, endovascular recanalization has been widely performed for treating PAOD due to continuous developments in its techniques and availability of dedicated devices with the inherent advantage of being minimal invasive. In this review, we introduce various types of endovascular treatment methods, discuss the results of clinical research from existing literature, and illustrate the treatment procedures using representative images.

• Journal of Chest Surgery
• /
• v.43 no.6
• /
• pp.769-773
• /
• 2010

Systemic hypotension has been traditionally used to facilitate deployment of thoracic stent grafts. Decreasing blood pressure with vasodilating agents further increases cardiac output and, consequently, the cardiac output-mediated windsock effect during deployment. Use of rapid ventricular pacing reduces the windsock effect during stent graft deployment and allows the graft to appose to the aortic wall under zero cardiac output, thus minimizing aortic wall shear stress. In this case we report the use of transvenous rapid ventricular pacing, a safe and reproducible technique to allow precise deployment of a Valiant Captivia stent graft in the distal thoracic arch for a saccular thoracic aneurysm.

• Journal of Chest Surgery
• /
• v.36 no.11
• /
• pp.834-838
• /
• 2003

Background: Deairing from the heart after open heart surgery(cardiopulmonary bypass) is a very important procedure. Artificial arteriovenous fistula was used to remove air, and the efficiency was evaluated by transesophageal echocardiography. Material and Method: Just before termination of cardiopulmonary bypass, a standard pressure transducer line is connected between the stopcocks of the connections in the arterial and venous circuits, creating a small controlled arteriovenous fistula between the arterial and venous cannulas. The degree of intracardiac air and air removal time were evaluated either by transesophageal echocardiography or direct vision of pressure transducer line. Result: By simple procedure, cardiopulmonary time was shortened and air clearing can be confirmed using echocardiography in a few minutes. Conclusion: Creation of arteriovenous fistula using small connecting line between aortic and venous cannula is a very simple and effective method of deairing and preventing of air embolism after open heart surgery.