• Journal of the Korean Society of Radiology
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• v.84 no.6
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• pp.1408-1413
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• 2023

Adrenal gland trauma is uncommon and is diagnosed at an increasing frequency using CT scans. However, owing to the rarity of this injury and its diverse clinical presentations and prognoses, there is no consensus on its management. In this case report, a 73-year-old male patient experienced recurrent bleeding in the right adrenal gland due to an in-car traffic accident, which was treated with repeated transcatheter arterial embolization.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.4
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• pp.454-457
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• 2000

The posterior nasal bleeding sometimes develope a life threatening situation because of its limited access and the profuse vascular network of the bleeding area. There are various methods of hemostasis including packing, cautery, and arterial ligation those vary in effectiveness. But sometimes patients cannot tolerate these methods or show rebleeding sign. So, if all of these methods are not successful, we should consider the further treatment. The selective angiographic embolization has various advantages such as rapidness, repetition, good visualization, and being performed under local anesthesia, therefore it can provide useful way in patients with massive, intractable posterior nasal bleeding. We report a case of angiographic embolization for intractable posterior nasal bleeding patient and review the effectiveness of the this treatment.

• Korean Journal of Radiology
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• v.1 no.4
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• pp.208-211
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• 2000

We present a case in which an arterial rupture occurring during embolization of an arteriovenous malformation of the left occipital lobe with a flow-directed microcatheter, was successfully sealed with a small amount of glue. We navigated a 1.8-Fr Magic catheter through the posterior cerebral artery, and during superselective test injection, extravasation was observed at the parieto-occipital branch. The catheter was not removed and the perforation site was successfully sealed with a small amount of glue injected through the same catheter. Prompt recognition and closure of the perforation site is essential for good prognosis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.6
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• pp.592-596
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• 2010

The common local causes of active gingival bleeding are the vessel engorgement and erosion by severe inflammation and injury to hypervascularity lesion. Abnormal gingival bleeding is also associated with systemic bleeding disorders (liver disease, leukemia etc.). There are many conventional methods for gingival bleeding control, such as, direct pressure, packing, electrocoagulation, tight suture and application of hemostatic agents. If the continuous gingival bleeding is not stopped in spite of the all local application methods, the medical consultation should be obtained for systemic condition care and the major feeding arterial embolization. This is a case report of severe gingival bleeding and periodontitis control in a patient with liver cirrhosis and oral metastatic lesion of hepatocellular carcinoma. The bleeding lesion was placed in left buccal mucosa and gingiva of the left mandibular molars. The control methods were dental crown removal, primary endodontic drainage, gingival sulcus drainage and maxillary arterial embolization with medical consultation.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.435-440
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• 2023

Mesenteric injury occurs rarely in cases associated with blunt abdominal trauma. Despite its low incidence, mesenteric injury can lead to fatal outcomes such as hypovolemic shock due to hemoperitoneum or sepsis due to intestinal ischemia, or perforation-related peritonitis. For mesenteric injuries, especially those involving massive bleeding, intestinal ischemia, and perforation, the standard treatment is surgery. However, in the case of operative management, it should be borne in mind that there is a possibility of complications and mortality during and after surgery. The usefulness of transcatheter arterial embolization (TAE) is well known in solid organs but is controversial for mesenteric injury. We present a 75-year-old man with mesenteric injury due to blunt abdominal trauma. Initial abdominal computed tomography showed no hemoperitoneum, but a mesenteric contusion and pseudoaneurysm with a diameter of 17 mm were observed near the origin of the superior mesenteric artery. Since there were no findings requiring emergency surgery such as free air or intestinal ischemia, it was decided to perform nonoperative management with TAE using microcoils in hybrid emergency room system. TAE was performed successfully, and there were no complications such as bleeding, bowel ischemia, or delayed bowel perforation. He was discharged on the 23rd day after admission with percutaneous catheter drainage for drainage of mesenteric hematoma. The authors believe that treatment with TAE for highly selected elderly patients with mesenteric injuries has the positive aspect of minimally invasive management, considering the burden of general anesthesia and the various avoidable intraoperative and postoperative complications.

• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.223-227
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• 2005

Systemic multiple aneurysms are rare, and an association between intracranial and visceral arterial or abdominal aortic aneurysm in the same patient is a very rare occurrence. We report herein three such cases. In one case, aneurysms of the right internal carotid artery(ICA) and the right middle cerebral arterial bifurcation(MCAB) coexisted with the inferior pancreaticoduodenal arterial pseudoaneurysm and two ileal arterial aneurysms. In another case, the patient had the A-com arterial aneurysm and the right renal arterial aneurysm. And in the other patient, he had the right vertebral artery dissecting aneurysm with the abdominal aortic aneurym. Initially, all patients were referred to our hospital with subarachnoid hemorrhage(SAH), and thereafter first two patients developed visceral arterial aneurysm rupture in the course of hospital stay and in the last patient, the abdominal aortic aneurysm was detected incidentally during carotid angiogram for Guglielmi detachable coil(GDC) embolization of vertebral dissecting aneurym. After thorough review of our cases together with pertinent literatures, we emphasize the possibility of underlying extracranial aneurysms in ruptured intracranial arterial aneurysm patient and it's uncommon but fatal complication.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.199-205
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• 2009

Purpose: This study compared the characteristics of and the prognosis for intraperitoneal and retroperitoneal/pelvic contrast extravasation, which had been confirmed by enhanced abdominal CT scan, after blunt trauma in patients who had undergone angiographic embolization. Methods: From January 2001 to March 2009, data were retrospectively collected regarding patients who had undergone contrast extravasation (CE) on CT scanning and arterial embolization after blunt trauma. The study patient group was divided into the intraperitoneal and the retroperitoneal/pelvic groups according to the area of contrast extravasation. We reviewed the initial demographic data, the location of injury, the solid organ injury, the embolized vessel, and the clinical outcome. Results: The mean age of the study subjects was $40.2{\pm}2.6$ years old, and there were 24 male patients. The intraperitoneal group included 10 patients, and retroperitoneal/pelvic group was comprised of 17 patients. The amount of transfusion from presentation to intervention and during the first 24 hours was greater in the retroperitoneal/pelvic group than in the intraperitoneal group. The intraperitoneal group showed a higher frequency and severity of liver injury than the retroperitoneal/pelvic group. Angiography revealed that the hepatic artery (n=4) was the most frequently embolized vessel in the intraperitoneal group, while the internal iliac artery (n=6), followed by the renal artery (n=4), internal pudendal artery (n=3), and the gluteal artery (n=2), were the most frequently injured vessels in the retroperitoneal/pelvic group. Conclusion: In patients with intra-abdominal contrast extravasation found on CT scanning and arterial embolization after blunt trauma, the need for transfusion was less in the intra-abdominal group than in the retroperitoneal/pelvic group. Liver injury was also more frequent and severe in the intraperitoneal group than in the retroperitoneal/pelvic group.

• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.606-614
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• 2023

Purpose This study aimed to evaluate the efficacy and safety of transcatheter arterial embolization (TAE) for bleeding due to uterine body cancer. Materials and Methods In this retrospective study, six patients with varying types of uterine body cancer who underwent TAE for bleeding control were investigated. Angiographic findings, cross-sectional images, TAE details, and clinical outcomes were studied. Technical and clinical success rates were calculated. Results The identified patients had endometrioid adenocarcinoma, sarcoma, and gestational trophoblastic neoplasia, and most were patients with advanced-stage cancer. In four patients, tumor bleeding presented as vaginal bleeding. Technical success was achieved in all seven TAE procedures in six patients. Two patients with recurrent masses who had undergone hysterectomy presented with hematochezia, and TAE was able to provide technical success in these patients as well. The clinical success rate was 50%, indicating bleeding control for > 1 week. Rebleeding was directly associated with death in one patient. On the following day, mild fever was observed in one patient. Conclusion TAE can be considered an effective and safe method of bleeding control for uterine body cancer, especially during critical periods throughout the disease course of patients with inoperable, advanced-stage cancer.

• Journal of Trauma and Injury
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• v.34 no.3
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• pp.191-197
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• 2021

Renal injuries occur in more than 10% of patients who sustain blunt abdominal injuries. Non-operative management (NOM) is the established treatment strategy for lowgrade (I-III) renal injuries. However, despite some evidence that NOM can be successfully applied to high-grade (IV, V) renal injuries, it remains unclear whether NOM is appropriate in such cases. The authors report two cases of high-grade renal injuries that underwent NOM after embolization in a hybrid emergency room (ER) system with a 24/7 in-house interventional radiology (IR) team. A 29-year-old male visited Wonkwang University Hospital Regional Trauma Center complaining of right abdominal pain after being hit by a rope. Computed tomography (CT) was performed 16 minutes after arrival, and the CT scan indicated a grade V right renal injury. Arterial embolization was initiated within 31 minutes of presentation. A 56-year-old male was transferred to Wonkwang University Hospital Regional Trauma Center with a complaint of right flank pain. He had initially presented to a nearby hospital after falling from a 3-m height. Thanks to the key CT images sent from the previous hospital prior to the patient's arrival, angiography was performed within 8 minutes of the patient's arrival and arterial embolization was completed within 25 minutes. Both patients were treated successfully through NOM with angioembolization and preserved kidneys. Hematoma in the first patient and urinoma in the second patient resolved with percutaneous catheter drainage. The authors believe that the hybrid ER system with an in-house IR team could contribute to NOM and kidney preservation even in high-grade renal injuries.

• Journal of Chest Surgery
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• v.14 no.1
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• pp.63-66
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• 1981

True aneurysm of the carotid artery is relatively rare in comparison with the total number of aneurysms of the arterial system. The threat of rupture and embolization from mural thrombi are indications for treatment even though no symptoms may be present. Resection of the aneurysm and restoration of arterial continuity is the treatment of choice. A case of aneurysm of the Lt. common carotid artery of a 21 year-old male patient is presented. The confirmatory diagnosis was made by left carotid angiogram, and the aneurysmectomy & reconstruction with woven dacron vascular prosthesis was done, while cerebral circulation was maintained by internal shunt.