• Title/Summary/Keyword: 혈관침습

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Successful Treatment of Lower Extremity Malperfusion Caused by Acute Aortic Dissection (급성 대동맥 박리증에 의한 하지 관류부전의 치료)

  • Lee, Jae-Hoon;Kim, Hyong-Tae;Kim, Young-Hwan;Choi, Sae-Young;Keum, Dong-Yoon;Park, Nam-Hee
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.934-938
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    • 2006
  • Organ malperfusion may mask the presence of aortic dissection and is one of major cause of death in patient with aortic dissection. Several key mechanism appear to contribute to the development of malperfusion, therefore optimal choosing of treatment is necessary to obtain better result. In cases of extremity malperfusion, open bypass procedures have been used for primary treatment, but noninvasive interventional procedures are also recommended as good alternatives in some cases. Here in, we report a case of successful aortic replacement followed by stent insertion in patient with extremity malperfusion caused by acute aortic dissection.

Atherectomy in Peripheral Artery Disease: Current and Future (말초동맥질환에서의 죽종절제술: 현재와 미래)

  • Yohan Kwon;Jinoo Kim;Je-Hwan Won;Seong Ho Kim;Jeong-Eun Kim;Sung-Joon Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.551-561
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    • 2021
  • Atherectomy has become a promising treatment option for peripheral artery disease caused by diabetes mellitus or end-stage renal disease. Atherectomy refers to the removal of atheromatous tissue by mechanical method, resulting in an enlarged lumen of the treated blood vessel. Based on this method, the term is limited to the percutaneous minimally invasive approach, and there are currently two types of atherectomy devices available in Korea. The increased prevalence of atherectomy has led to the concept of "vascular preparation" and a new treatment concept of "leave nothing behind." Various studies have proven the safety and effectiveness of atherectomy; however, there are some limitations. We need to remain focused on patient selection and subsequent large-scale research.

Transarterial Coil Embolization in Two Maltese Dogs with Patent Ductus Arteriosus Using a Mini Cobra-tip Angiocatheter (말티스 견에서 시술된 미니코브라 카테터와 코일을 이용한 동맥관 개존증의 치료 2 증례)

  • Han, Dong-Hyun;An, Hyo-Jin;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.740-745
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    • 2010
  • Patent ductus arteiosus (PDA) is the persistent opening of ductus arterious located between pulmonary artery and descending aorta after birth. Although PDA can be occluded by surgical ligation, interventional closure of PDA using various devices is being rapidly replaced to surgical ligation, because of its non-invasive nature of treatment and minimal post-care after treatment. Main problem encountering in interventional treatment in toy breed dogs is vascular inaccessibility due to small size of artery. Although transvenous approach using jugular veins has been developed, this technique requires experienced skill to locate occlude devices into PDA and has high risk of accidental dislodgement of occluding devices (i.e. embolization coils or vascular plugs). Therefore, in this study, we developed a modified technique for coil embolization using mini-angiocatheter with trans-femoral approach in toy breed dogs (< 3.0 kg of body weight). With this modified method, we were successfully treated two toy breed (Maltese) dogs with the left to right shunted PDA.

A Study on the Efficiency Evaluation of Ultrasound Therapy Using Varicose Vein Simulated Tissue Phantom and Tissue Equivalent Phantom (하지정맥류 모사 생체조직 팬텀과 조직등가 팬텀을 이용한 초음파 치료효과 평가에 관한 연구)

  • Kim, Ju-Young;Jung, Tae-Woong;Shin, Kyoung-Won;Noh, Si-Cheol;Choi, Heung-Ho
    • Journal of the Korean Society of Radiology
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    • v.12 no.3
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    • pp.427-433
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    • 2018
  • Because of the expectation of the non-invasive treatment effect, Various studies on the treatment of varicose veins using focused ultrasound are reported. In this study, the bio-tissue phantom and tissue equivalent phantom that can be applied to estimation of ultrasonic varicose veins treatment effect. Each phantom was evaluated for its usefulness by evaluating the acoustic characteristics and the shrinkage rate according to the ultrasonic irradiation. A multi-layer structure phantom with three layers of skin, fat, and muscle was constructed considering the structure of the tissue where the varicose veins occurred. The materials constituting each layer were made to have characteristics similar to human body. In addition, the multi-layered phantoms with blood vessel mimic tube, with bovine blood vessel, and with animal tissue were fabricated. The degree of shrinkage of blood vessel mimic material and vascular tissue according to ultrasonic irradiation was evaluated using B-mode image. As the results of this study, it was thought that the proposed phantom could be used effectively in the evaluation of ultrasonic varicose veins treatment. In addition, it is thought that these phantoms could be applied to the development of varicose vein treatment device using the focused ultrasound and the verification of the therapeutic effect.

Hybrid Off-pump Coronary Artery Bypass Combined with Percutaneous Coronary Intervention: Indications and Early Results (심폐바이패스 없이 시행하는 관상동맥우회술과 경피적 관상동맥중재술의 병합요법 : 적응증 및 조기성적)

  • Hwang Ho Young;Kim Jin Hyun;Cho Kwang Ree;Kim Ki-Bong
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.733-738
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    • 2005
  • Background: The possibility of incomplete revascularization and development of flow competition after revascularization of the borderline lesion made the hybrid strategy as an option for complete revascularization. Material and Method: From January f998 to July 2004, 25 $(3.2\%)$ patients underwent hybrid revascularization among 782 total OPCAB procedures. Clinical results and angiographic patencies were evalulated. Percutaneous coronary intervention (PCI) was peformed before CABG in 8 patients and after CABG in 47 patients. Result: The causes of PCIs before CABG were to achieve complete revascularization with minimally invasive surgery (n=7) and emergent PCI for culprit lesion (n=1). The indications of PCIs after CABG were high possibility of flow competition in the borderline lesion of right coronary artery territory (n=8), diffuse atheromatous lesion preventing anastomosis of graft (n=5), severe calcified ascending aorta with no more arterial grafi available (n=3), and intramyocardial coronary lesion (n=1). Mean number of distal anastomoses was $2.3\pm1.0$. Mean number of lesions treated by PCI was $1.2\pm0.4$. There was no operative or procedure-related mortality. PCI-related complication was periprocedural myocardial infarction in one patient, and complications related to CABG were transient atrial fibrillation (n=5), perioperative myocardial infarction (n=1), and transient renal dysfunction (n=1). Early postoperative coronary angiography $(1.8{pm}1.6days)$ revealed $100\%$ patency rate of grafts (57/57). The stenosis occurred in one patient performed PCI before CABG, which was successfully treated with re-ballooning. During midterm follow-up (mean; $25{\pm}26$ months), 1 patient died of congestive heart failure. All survivors (n=24) accomplished follow-up coronary angiographics, which showed .all grafts (56/57) were patent except one string sign. In-stent restenosis was developed in 2 patients who received bare metal stents. Conclusion: In selected patients, complete revascularization was achieved with low risk by taking the hybrid strategy.

Stented Aortic Graft Insertion in an Infrarenal Abdominal Aortic Aneurysm as Performed by Cardiovascular Surgeons - Report of 3 cases- (흉부외과 의사에 의해 시행된 복부 대동맥류의 스텐트 그라프트 삽입술 -3예 보고 -)

  • Chung, Eui-Suk;Lim, Cheong;Seong, Yong-Won;Choi, Jin-Ho;Park, Kay-Hyun;Chung, Woo-Young
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.377-380
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    • 2008
  • Abdominal aortic aneurysm has traditionally been treated by open repair. Aortic endovascular stent grafting has recently been introduced as a new modality. We report here on three cases of endovascular stent grafting that were performed by cardiovascular surgeons for the treatment of abdominal aortic aneurysm in the high risk patients with multiple comorbidities such as old age, hypertension, renal failure, cerebrovascular accident and immobility.

Primary Pul monary Carcinosarcorna -A case of report- (폐의 원발성 암육종 -1례 보고-)

  • 안상구;김재영
    • Journal of Chest Surgery
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    • v.29 no.9
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    • pp.1036-1039
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    • 1996
  • Pulmonary carcinosarcon!as are rare malignant tumors consisting of an admixture of epithelial and mas- enchymal elements of the type ordinarily seen in malignancies of adults. Compared with all pulmonary neoplasms it occurs with a frequency of 0.3% and has a strong association with smoking. Carcinosarcomas be divided into two clinicopathologic groups based on the locution of the lung: a solid parenchymal type and a central or endobronchial lesion Noninvasive diagnostic tests have a rather low yield in detecting carcinosarcoma. The most frequent metastatic sites are hilar and mediastinal Lymph nodes. Surgical resection is both diagnostic and the initial treatment. The prognosis is poor and average postoperative survival is 9 months. We report one case of pulmonary carcinosarcoma demonstrated by immunohlstochemical staining in a 61 year old male patient with a review of literatures.

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Endoscopic Removal of Benign Endotracheal/Endobronchial Tumor (기도 내 양성 종양의 굴곡형 내시경하 절제술)

  • 문석환;왕영필;서종희;조건현;곽문섭;이선희
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.699-702
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    • 2003
  • Endoscopic removal is acceptable for the treatment of endotracheal/endobronchial mass, because it is less invasive in high-risk patients and a conservative procedure for benign tumors. Two benign tumors in the lumen of the trachea (pure lipoma) and in the intermediate bronchus (hamartoma) were completely eradicated by our procedures, which involved diathermic snaring and residual mass removal with biopsy forceps under the guidance of fiberoptic bronchoscopy. No tumor recurrence was evident after extended follow-up (6 years for endotracheal lipoma and 2.5 years for endobroncheal hamartoma). Our method is safe and less invasive for the patient and provides the surgeon with better view during procedure.

Laparoscopic Heller Myotomy with Dor Fundoplication in Achalasia -One case report - (식도이완불능증에시 복강경을 이용한 식도근절개술 및 전방위저주름술 - 1예 보고 -)

  • Kim Yeon Soo;Ryoo Ji Yoon
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.258-262
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    • 2005
  • An 18-year old woman had dysphagia and frequent vomiting after meals for 6 years. She lost 15 kg in 6 months recently. After esophageal manometry, she was diagnosed with achalasia. We decided to use laparoscopic surgery because there was no symptomatic improvement after medication. We made small 5 incisions on her abdomen. We performed Heller myotomy and Dor fundoplication. We performed esophagogram one day after the operation. There was no leakage of the contrast media, and it passed well. She started to eat at the 2nd day after the operation and was discharged on the 9th day without other specific problem.

Robotic Assisted Surgery in Adult Patient with Congenital Ventricular Septal Defect (내시경 수술 보조 로봇을 이용한 성인 심실중격결손 교정술)

  • Park, Il;Lee, Jong-Tae;Kim, Gun-Jik;Cho, Joon-Yong
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.931-933
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    • 2006
  • Robotic assisted surgery in adult patient with congenital ventricular septal defect Since December in 2005, we have done minimally invasive surgeries in selected cases of mitral valve diseases, tricuspid valve diseases, atrial septal defects and atrial fibrillations with the $AESOP^{TM}$ robotic arm. We have had a better surgical view and skill, according to accumulation of the experience of this procedure. Recently, we performed robotic assisted surgery in a 47-year-old female with congenital perimembranous ventricular septal defect.