• Title/Summary/Keyword: Balloon technique

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Development of a Rabbit Iliac Arterial Stenosis Model Using a Controlled Cholesterol Diet and Pullover Balloon Injury (콜레스테롤 식이 및 내막 손상을 통한 토끼 장골동맥 협착 전임상 모델 개발)

  • Hooney D. Min;Chong-ho Lee;Jae Hwan Lee;Kun Yung Kim;Chang Jin Yoon;Minuk Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.372-380
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    • 2024
  • Purpose This study aimed to develop a rabbit iliac stenosis model and evaluate the effects of different mechanical injury techniques on the degree of arterial stenosis. Materials and Methods Eighteen rabbits were divided into three groups: cholesterol-fed with pullover balloon injury (group A; n = 6), cholesterol-fed with localized balloon dilatation (group B; n = 6), and chow-diet with pullover balloon injury (group C; n = 6). After baseline angiography, the left iliac arteries of all rabbits were injured with a 3 × 10 mm noncompliant balloon using either a wide pullover technique (groups A and C) or a localized balloon dilatation technique (group B). A nine-week follow-up angiography was performed, and the angiographic late lumen loss and percentage of stenosis were compared. Results Group A exhibited the most severe late lumen loss (A vs. B, 0.67 ± 0.13 vs. 0.04 ± 0.13 mm, p < 0.0001; A vs. C, 0.67 ± 0.13 vs. 0.26 ± 0.29 mm, p < 0.05; stenosis percentage 32.02% ± 6.54%). In contrast, group B showed a minimal percentage of stenosis (1.75% ± 6.55%). Conclusion Pullover-balloon injury can lead to significant iliac artery stenosis in rabbits with controlled hypercholesterolemia. This model may be useful for elucidating the pathogenesis of atherosclerosis and for evaluating the efficacy of novel therapeutic interventions.

Detection of Foreign Body in Esophageal Foreign Body Model Using Three Dimensional Reconstruction Technique (식도 이물 모델에서 이물 탐색을 위한 삼차원 재구성법의 활용)

  • Woo, Kuk Sung;Yoo, Young Sam;Kim, Dong Won
    • Korean Journal of Bronchoesophagology
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    • v.18 no.1
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    • pp.13-18
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    • 2012
  • Objective This study was conducted to gather basic information of 3D CT in detecting and gaining information of esophageal foreign body (FB) models. Materials and Methods The chest model was made using PVC bottle, rubber balloon and plaster. Fish bone, Persimmon stone were used to mimic foreign bodies of esophageal model. The foreign body models were inserted into the balloon removing air from it and the balloon was sealed. The esophageal FB model was inserted into the chest model. The remaining space in the chest model was filled with fish paste and water to simulate soft tissue around esophagus. CT of chest model was reconstructed three-dimensionally by Rapidia software to make images of foreign body models. The axial CT, MPR image and VOI image were compared with real foreign body materials as to shape, size, location and orientation. Results Esophageal FB models were easily made. CT data gave good 3D images and showed realistic foreign body materials. Conclusion The results indicate the usefulness of 3D CT technique to help in diagnosis of esophageal foreign body models.

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External Iliac Artery Transection Managed by Iliofemoral Bypass Grafting Using Temporary Balloon Occlusion

  • Choi, Young Un;Lee, Jae Gil;Kim, Kwangmin;Kim, Seongyup;Bae, Keumseok;Jang, Ji Young;Jung, Pil Young;Shim, Hongjin;Youn, Young Jin;Park, Il Hwan
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.242-246
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    • 2017
  • Traumatic abdominal vessel injury is rare, but difficult to manage. Approaching the injured vessel and controlling the bleeding is very hard. We experienced the right iliac artery transection managed by iliofemoral bypass grafting using temporary balloon occlusion. Proximal occlusion of an iliac artery with a temporary balloon cab be an option or bridge technique for a definite operation in case of iliac artery rupture. So, we present our case.

Hysteroscopic Septotomy of a Complete Septate Uterus Using a Balloon with Methylene Blue (완전 중격 자궁에서 메틸렌 블루가 들어 있는 풍선을 이용한 자궁경하 중격 제거술)

  • Jang, Ji-Hyon;Cho, Jung-Hyun;Cha, Dong-Hyun;Han, Won-Bo
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.4
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    • pp.369-375
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    • 2010
  • A complete septate uterus with cervical duplication and a longitudinal vaginal septum is a rare uterine malformation. The dissection of the septum can be difficult because it is difficult for hysteroscopists to find out initial point, direction and final point of a complete septum. This study aimed the introduction of more efficient surgical procedure using a balloon with methylene blue. We have experienced three cases with a complete septate uterus. We performed hysteroscopic dissection of a complete uterine septum using a balloon with methylene blue and obtained good reproductive outcomes. So we report three cases with a brief review of literatures.

Percutaneous Balloon Compression of Trigeminal Ganglion for the Treatment of Idiopathic Trigeminal Neuralgia : Experience in 50 Patients

  • Park, Seong-Soon;Lee, Myung-Ki;Kim, Jae-Woo;Jung, Jin-Young;Kim, Ik-Soo;Ghang, Chang-Ghu
    • Journal of Korean Neurosurgical Society
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    • v.43 no.4
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    • pp.186-189
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    • 2008
  • Objective : We assessed the surgical results of percutaneous balloon compression in 50 patients with idiopathic trigeminal neuralgia. Methods : Fifty patients with follow-up period of more than 12 months were retrospectively analyzed. The mean follow-up period was 42 months (range, 12-82). The mean age was 65.8 years (range, 27-83). Seventeen patients (34%) had other previous surgical procedures. The balloon was inflated by injecting radio-contrast media under brief general anesthesia according to Mullan’s technique. The mean inflating time was 88 seconds (range, 60-120). The whole procedure took about 20 minutes. Results : We reported excellent and good results in 70% of the cases, poor in 6% as annoying dysesthesia, recurrence in 16%, and 8% failure due to technical deficiencies. Forty-six patients (92%) were initially relieved of their pain. There were permanent motor weakness of the masseter muscle in 4% of patients and transitory diplopia in 8%. Neither anesthesia dolorosa nor keratitis occurred. Almost all patients (92%) were discharged postoperatively within two days. Conclusion : These results indicate that balloon compression would be an effective method with acceptable morbidity, technically, It can be performed rapidly and simply in the treatment of idiopathic trigeminal neuralgia.

Intra-aortic Balloon Pump Therapy for Hemodynamic Instability during Off-pump Coronary Artery Bypass Surgery (심폐바이패스를 사용하지 않는 관상동맥우회술 중 발생한 혈역학적 불안정에 대한 대동맥내 풍선펌프 치료)

  • Jeong, Dong-Seop;Kim, Ki-Bong;Choi, Eun-Seok
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.704-709
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    • 2009
  • Background: We assessed the efficacy of intraoperative intra-aortic balloon pump therapy for achieving hemodynamic instability during off-pump coronary artery bypass surgery. Material and Method: We studied seven hundred ninety-six patients who underwent off-pump coronary artery bypass between January 2000 and December 2006. The patient were divided into group I (n=39), which received intraoperative intra-aortic balloon pump therapy, and group II (n=757), which did not receive intraoperative intra-aortic balloon pump therapy. Result: There were no differences in the operative mortalities (2.6%, 1/39 vs 0.8%, 6/757; p=0.195) and morbidities such as atrial fibrillation (p=0.691), stroke (p=0.908) and mediastinitis (p=0.781) between the 2 groups, although the ventilator support time, the length of the intensive care unit stay and the length of the hospital stay were longer in group I than in group II (p<0.05). Multivariate analysis failed to prove that group I was a high risk group for operative mortality (p=0.549). There were 3 intraoperative intra-aortic balloon pump-related complications in group I (7.9%). However, no longer complications occurred after 2003, when the surgeons began using a smaller sized 8 F catheter that was inserted using a sheathless technique. Conclusion: Intraoperative intra-aortic balloon pump therapy for achieving hemodynamic instability during off-pump coronary artery bypass surgery can be performed safely and it showed comparable clinical results to that of not using intraoperative intra-aortic balloon pump therapy.

Arteriovenous Fistula after C1-2 Posterior Transarticular Screw Fixation - Case Report - (환축추체 후방 나사고정술 후 생긴 동정맥루)

  • Lee, Hyuk Gi;Cho, Jae Hoon;Lee, Sung Lak;Kang, Dong Gee;Kim, Sang Chul;Kim, Yong Sun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.280-285
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    • 2000
  • Posterior transarticular screw fixation for atlantoaxial instability due to trauma or rheumatoid arthritis provides immediate rigid fixation of the C1-2 vertebral segment while preserving motion between the occiput and C1. This technique provides more resistance to translational and rotational forces than wiring technique. However, the technique of transarticular screw fixation is inherently demanding because of the complex anatomy of the occipitocervical region and vertebral artery(VA) at risk for arterial damage. VA injury may lead to serious subsequent neurological deficits and possibly death from bilateral VA injury. We report a case of a vertebral artery-to-epidural venous plexus fistula after posterior transarticular screw fixation which was treated with balloon occlusion.

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Daily Setup Uncertainties and Organ Motion Based on the Tomoimages in Prostatic Radiotherapy (전립선암 치료 시 Tomoimage에 기초한 Setup 오차에 관한 고찰)

  • Cho, Jeong-Hee;Lee, Sang-Kyu;Kim, Sei-Joon;Na, Soo-Kyung
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.99-106
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    • 2007
  • Purpose: The patient's position and anatomy during the treatment course little bit varies to some extend due to setup uncertainties and organ motions. These factors could affected to not only the dose coverage of the gross tumor but over dosage of normal tissue. Setup uncertainties and organ motions can be minimized by precise patient positioning and rigid immobilization device but some anatomical site such as prostate, the internal organ motion due to physiological processes are challenge. In planning procedure, the clinical target volume is a little bit enlarged to create a planning target volume that accounts for setup uncertainties and organ motion as well. These uncertainties lead to differences between the calculated dose by treatment planning system and the actually delivered dose. The purpose of this study was to evaluate the differences of interfractional displacement of organ and GTV based on the tomoimages. Materials and Methods: Over the course of 3 months, 3 patients, those who has applied rectal balloon, treated for prostatic cancer patient's tomoimage were studied. During the treatment sessions 26 tomoimages per patient, Total 76 tomoimages were collected. Tomoimage had been taken everyday after initial setup with lead marker attached on the patient's skin center to comparing with C-T simulation images. Tomoimage was taken after rectal balloon inflated with 60 cc of air for prostate gland immobilization for daily treatment just before treatment and it was used routinely in each case. The intrarectal balloon was inserted to a depth of 6 cm from the anal verge. MVCT image was taken with 5 mm slice thickness after the intrarectal balloon in place and inflated. For this study, lead balls are used to guide the registration between the MVCT and CT simulation images. There are three image fusion methods in the tomotherapy, bone technique, bone/tissue technique, and full image technique. We used all this 3 methods to analysis the setup errors. Initially, image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours and then the radiation therapist registered the MVCT images with the CT simulation images based on the bone based, rectal balloon based and GTV based respectively and registered image was compared with each others. The average and standard deviation of each X, Y, Z and rotation from the initial planning center was calculated for each patient. The image fusions were based on the visual alignment of lead ball, CT anatomy and CT simulation contours. Results: There was a significant difference in the mean variations of the rectal balloon among the methods. Statistical results based on the bone fusion shows that maximum x-direction shift was 8 mm and 4.2 mm to the y-direction. It was statistically significant (P=<0.0001) in balloon based fusion, maximum X and Y shift was 6 mm, 16mm respectively. One patient's result was more than 16 mm shift and that was derived from the rectal expansions due to the bowl gas and stool. GTV based fusion results ranging from 2.7 to 6.6 mm to the x-direction and 4.3$\sim$7.8 mm to the y-direction respectively. We have checked rotational error in this study but there are no significant differences among fusion methods and the result was 0.37$\pm$0.36 in bone based fusion and 0.34$\pm$0.38 in GTV based fusion.

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Reconstruction of the Orbital Floor Fracture using the Antral Balloon Catheter with Radiopaque Dye (안저골절 정복술 후 풍선 달린 카테터와 방사선조영제의 이용)

  • Choi, Hwan-Jun;Lee, Han-Jung;Yang, Hyung-Eun;Lee, Young-Man
    • Archives of Plastic Surgery
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    • v.37 no.1
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    • pp.99-103
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    • 2010
  • Purpose: Blow-out fractures are reduced through transcutaneous or transconjunctival incisions. But the field of orbital surgery is difficult due to lack of visualization of fracture site, blind dissection of orbital floor, susceptibility of injury of orbital structures. In these situations, the former technique of using an antral balloon catheter has advantages over other methods for reconstruction because of its rapidity, simplicity, and inexpensiveness. Furthermore, the antral balloon catheter allows not only elevation of the orbital bone fragment but also expansion of the maxillary sinus in cases where there is a fracture of its walls. But postoperative follow-up method using computed tomography is expensive. Hence, we report a simple and inexpensive follow-up method using radiopaque dye inflation. Methods: We performed endoscopic transantral approach in 5 cases of blow-out fracture under general anesthesia. To accomplish this technique, a rigid 4 mm, 0 or 30 degree angled endoscopy was inserted into the maxillary sinus. Inflation of the catheter started gradually, with 10 to 15 mL of saline mixed radiopaque dye (saline: dye, 5 : 1) by syringe and while observing the elevation of the fracture site with endoscope until a proper contour was reached. For the maintain of the position of fractured site, 12 French urinary balloon foley catheter were used in fracture site for 7 - 10 days. Results: Postoperative assessment was performed by means of clinical and simple radiographic examination to secure the catheter under the inferior orbital wall and in the maxillary sinus. No specific complications occurred related to this procedure. Results of the surgery and follow-up in all cases were satisfactory. Conclusion: It may be a better alternative to the conventional follow-up method, with less cost and effectiveness of the catheter patency. The advantages of using the urinary balloon foley catheter with the radiopaque dye include the following : it is safe, efficacy, simple, and especially low cost. On drawback of this method is the discomfort to the patient caused by the catheter during the treatment.

Efficacy of Combining Proximal Balloon Guiding Catheter and Distal Access Catheter in Thrombectomy with Stent Retriever for Anterior Circulation Ischemic Stroke

  • Kim, Sang Hwa;Choi, Jae Hyung;Kang, Myung Jin;Cha, Jae Kwan;Kim, Dae Hyun;Nah, Hyun Wook;Park, Hyun Seok;Kim, Sang Hyun;Huh, Jae Taeck
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.405-413
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    • 2019
  • Objective : We evaluated efficacy of combining proximal balloon guiding catheter (antegrade flow arrest) and distal access catheter (aspiration at the site of occlusion) in thrombectomy for anterior circulation ischemic stroke. Methods : We retrospectively analyzed 116 patients who underwent mechanical thrombectomy with stent retriever. The patients were divided by the techniques adopted, the combined technique (proximal balloon guiding catheter and large bore distal access catheter) group (n=57, 49.1%) and the conventional (guiding catheter with stent retriever) technique group (n=59, 50.9%). We evaluated baseline characteristics (epidemiologic data, clinical and imaging characteristics) and procedure details (the number of retrieval attempts, procedure time), as well as angiographic (thrombolysis in cerebral infarction (TICI) score, distal thrombus migration) and clinical outcome (National Institutes of Health Stroke Scale at discharge, modified Rankin Scale [mRS] at 3 months) of them. Results : The number of retrieval attempts was lower (p=0.002) and the first-pass successful reperfusion rate was higher (56.1% vs. 28.8%; p=0.003) in the combined technique group. And the rate of final result of TICI score 3 was higher (68.4% vs. 28.8%; p<0.01) and distal thrombus migration rate was also lower (15.8% vs. 40.7%; p=0.021) in the combined technique group. Early strong neurologic improvement (improvement of National Institutes of Health Stroke Scale ${\geq}11$ or National Institutes of Health Stroke Scale ${\leq}1$ at discharge) rate (57.9% vs. 36.2%; p=0.02) and favorable clinical outcome (mRS at 3 months ${\leq}2$) rate (59.6% vs. 33.9%; p=0.005) were also better in the combined technique group. Conclusion : The combined technique needs lesser attempts, decreases distal migration, increases TICI 3 reperfusion and achieves better clinical outcomes.