• Title/Summary/Keyword: Balloon technique

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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.

Inferior Blow-Out Fracture Reduction Using Two Urinary Balloon Catheters

  • Jo, Eun Jun;Kim, Jong Hwan;Yang, Ho Jik
    • Archives of Craniofacial Surgery
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    • v.16 no.3
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    • pp.114-118
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    • 2015
  • Background: The reduction of orbital blowout fracture primarily aims to normalize the extra-ocular movement by returning the herniated orbital soft tissue into the original position, and to prevent enophthalmos by normalizing the orbital cavity volume. We introduce a balloon catheter-assisted orbital floor reduction technique. Methods: A retrospective review was performed for all patients with orbital floor fracture who underwent the technique described in the main body of this text. Medical records were reviewed for demographic data, clinical presentation and course, degree of enophthalmos, intraorbital volume on computed tomography scan, and postoperative outcomes. The enophthalmos and intraorbital volume of the injured site were compared to the uninjured eye and orbit. Results: The review identified 14 patients (11 male, 3 female). The mean preoperative difference in en-exopthalmos was 2.13 mm, while the mean orbital volume was 116%. The mean postoperative difference in en-exophthalmos had improved to 0.61 mm with a mean orbital volume of 101.85%. At the time of catheter removal at 10 days, three patients experienced diplopia (n=1), extra-ocular movement disorder (1), or enophthalmos (1). All of these had resolved by the 6-month follow-up visit. Conclusion: Balloon catheter-assisted reduction of the orbital floor fractures was associated with improvements in intraorbital volume and enopthalmos in the 14 patients. Notable complications included diplopia, enophthalmos, and limited extra-ocular movement, all of which were transient in the early postoperative period and had resolved by 6-month follow up.

Balloon Kyphoplasty for the Treatment of Vertebral Compression Fractures (척추 압박골절 환자에서의 풍선 척추체 복원술의 치료 효과)

  • Han, Kyung Ream;Kim, Chan;Yang, Jong Yoon;Han, Seung Tak;Kim, Yeui Seok
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.56-62
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    • 2006
  • Background: Balloon kyphoplasty is the new technique that helps to decrease the pain and improve mobility as well as restore the vertebral body height and kyphotic curve in fractured vertebrae. We evaluated the outcome of balloon kyphoplasty in the reduction of vertebral body height, kyphotic curve and clinical improvement in the patients with painful vertebral compression fractures. Methods: From July 2002 to February 2005, 84 levels of vertebral compression fractures in 66 patients were treated with balloon kyphoplasty. The assessment criteria were the changes over time in visual analogue scale (VAS) and mobility score. We evaluated the vertebral body height and kyphotic curve at preoperative 1 day and postoperative 1 day. Results: Procedures were performed in 66 patients with a total of 84 affected vertebral bodies. The anterior wall height was restored in 74 / 84 (88%) levels with a mean increment of 2.9 mm, and the mid-vertebral body height was restored in 79 / 84 (94%) levels with a mean increment of 4.2 mm. Kyphosis correction was achieved in 60 / 84 (71.4%) from 10.1 degrees to 7.5 degrees. Pain intensity reduced by 60% in one day after operation and by 75-85% in later time. Mobility scores of all patients were improved immediately after the procedure. Cement leakage occurred in 3 levels but there was no clinical problem. Conclusions: Kyphoplasty is an efficient and safe treatment of painful vertebral compression fracture in pain relief, mobility improvement, and reduction of deformity.

Atrial Septotomy with Inflow Occlusion (우심혈류차단법에 의한 심방중격 절개술)

  • 김창수
    • Journal of Chest Surgery
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    • v.3 no.2
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    • pp.107-112
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    • 1970
  • Atrial septotomy with inflow occlusion technique is well accepted palliative treatment for infants with cogenital anomaly of transposition of the great vessels. We have recently experienced a complete transposition of the great vessels in an one month old infant. Balloon atrial septotomy was initially done with gradual recurrence of cyanosis, which necessitated surgical form of atrial septotomy in 2 weeks. Atrial septotomy was performed with success with inlfow occlusion method and discussed problems concerning its surgical technique.

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A Case of Carotid Artery Resection and Replacement (경동맥 절제술 및 치환술 1례)

  • Kim, Dea-Sik;Oh, Cheon-Hwan
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.202-206
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    • 1999
  • A carotid artery resection and replacement including neck dissection are used as a method of treatment for head and neck cancer with infiltration into the carotid artery. The recent development of imaging technique makes it easy to estimate the detailed anatomical relationship between the tumor infiltration into the carotid artery, it's resection and replacement are indicated at radical neck dissection. To detect any possibility of cerebral ischemia at the time of ligation of carotid artery, a temporary occlusion test of internal carotid artery with a ballon catheter (balloon occlusion test) is performed. Recently, we performed a carotid artery resection and replacement using an artificial vessel Gore-Tex) in a case of neck cancer with infiltration into the carotid artery.

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Merit of Zone III Resuscitative Endovascular Occlusion of the Aorta under Real-Time Fluoroscopy in Hybrid ER: A Case of REBOA in Traumatic Cardiac Arrest

  • Lee, Sung Do;Chung, Seungwoo;Ki, Young Jun;Seo, Sang Hyun;Park, Chan Yong
    • Journal of Trauma and Injury
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    • v.33 no.3
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    • pp.191-194
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    • 2020
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a novel technique to maintain proximal arterial pressure. It is important to locate the balloon catheter correctly in performing REBOA but it is inaccurate to check the catheter position by external measurement. Even if the position of the catheter is initially confirmed by X-ray, it is difficult to determine the location of the catheter that changes according to various situations. We performed REBOA under real-time fluoroscopy and could maintain the catheter in correct position under various situations.

Modified Book Binding Technique (MBBT) for Intracorporeal Gastroduodenostomy in Totally Laparoscopic Distal Gastrectomy: Initial Experience

  • Kim, Jin Sung;Park, Eun Young;Park, Dong Jin;Kim, Gyu Yeol
    • Journal of Gastric Cancer
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    • v.19 no.3
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    • pp.355-364
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    • 2019
  • Totally laparoscopic distal gastrectomy (TLDG) frequently involves the use of delta shaped gastroduodenostomy (DSG) for intracorporeal anastomosis. However, DSG has some drawbacks, and the book binding technique (BBT) was developed as a new technique to overcome these drawbacks. Subsequently, this technique was further improved with the development of modified book binding technique (MBBT). This study evaluated the safety and feasibility of MBBT in patients undergoing TLDG. Thirty-three patients who underwent TLDG with MBBT were retrospectively evaluated. The mean operation time was $277.6{\pm}37.1minutes$, including $51.9{\pm}15.7minutes$ for reconstruction. Two patients had anastomosis-related complications, one patient with stricture after leakage and 1 patient with stenosis. The former patient was treated with endoscopic balloon dilatation, and the latter was managed conservatively; neither required re-operation. MBBT is a safe and feasible technique, with acceptable surgical outcomes. It may be a good alternative option for the treatment of intracorporeal anastomosis in patients undergoing TLDG.

Role of Balloon Guide Catheter in Modern Endovascular Thrombectomy

  • Chueh, Ju-Yu;Kang, Dong-Hun;Kim, Byung Moon;Gounis, Matthew J.
    • Journal of Korean Neurosurgical Society
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    • v.63 no.1
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    • pp.14-25
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    • 2020
  • Proximal flow control achieved with a balloon guide catheter (BGC) during endovascular treatment of acute ischemic stroke is reviewed in this article. In clinical practice, BGCs offer a multi-faceted approach for clot retrieval by creating proximal flow arrest, reducing embolic burden, and shortening procedure time. Evaluation of frontline thrombectomy procedures with BGCs revealed advantages of combined use over the conventional guide catheter (CGC), notably in the significant reduction of distal emboli to both the affected and previously unaffected territories. Recently, new measures of early and complete reperfusion at first thrombectomy pass have been identified as independent predictors of improved outcomes, which were consistently demonstrated with use of BGC as a safe and effective option to minimize number of passes during intervention. Prior randomized controlled trials reported the positive correlation between BGC-treated patients and a lower risk of mortality as well as shortened procedure time. While BGC use is more common in stent retriever-mediated mechanical thrombectomy, preliminary data has shown the potential benefit of device application during contact aspiration thrombectomy to achieve successful recanalization. However, the question of which major endovascular strategy reigns superior as a frontline remains to be answered. Along with clinical case assessments, BGC performance during in-vitro simulation was analyzed to further understand mechanisms for optimization of thrombectomy technique.

Neck Clipping of Giant Aneurysm in ICA Using Intra-Operative Temporary Balloon Occlusion and Suction Decompression Technique - A Case Report - (술중 풍선 확장을 이용한 일시적 근위부 결찰과 흡입, 감압술을 실시한 내경동맥의 거대동맥류 결찰 - 증례보고 -)

  • Weon, Keun Soo;Shin, Yong Sam;Park, Han Jun;Lee, Seung Un;Yun, Su Han;Cho, Ki Hong;Cho, Kyung Gi
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.165-169
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    • 2001
  • Apatient, 51 years old woman, had suffered form headache and decrease of visual acuity. She had $3{\times}3cm$ sized giant aneurysm originated in cavernous and clinoid portion of left ICA(C4,C5) in the cerebral angiography. Before craniotomy, left CCA was exposed and 6F double lumen catheter was inserted in left ICA through the sheath. Pre-operative angiography was done. balloon catheter was positioned at the petrous portion of ICA. Eyebrow approach was done and giant aneurysm was exposed. The proximal blood flow was controlled with balloon dilatation and suction and decompression was tried, then multiple clips were applied. The loss of distal blood flow under intra-operative angiography was notified after clipping. The position of clips were repositioned to preserve blood flow & the rich flow was confirmed at distal part of clipping. In the post-operative cerebral angiography, the same finding was shown.

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