• 제목/요약/키워드: Embolization, therapeutic

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Endovascular embolization of persistent liver injuries not responding to conservative management: a narrative review

  • Simon Roh
    • Journal of Trauma and Injury
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    • 제36권3호
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    • pp.165-171
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    • 2023
  • Trauma remains a significant healthcare burden, causing over five million yearly fatalities. Notably, the liver is a frequently injured solid organ in abdominal trauma, especially in patients under 40 years. It becomes even more critical given that uncontrolled hemorrhage linked to liver trauma can have mortality rates ranging from 10% to 50%. Liver injuries, mainly resulting from blunt trauma such as motor vehicle accidents, are traditionally classified using the American Association for the Surgery of Trauma grading scale. However, recent developments have introduced the World Society of Emergency Surgery classification, which considers the patient's physiological status. The diagnostic approach often involves multiphase computed tomography (CT). Still, newer methods like split-bolus single-pass CT and contrast-enhanced ultrasound (CEUS) aim to reduce radiation exposure. Concerning management, nonoperative strategies have emerged as the gold standard, especially for hemodynamically stable patients. Incorporating angiography with embolization has also been beneficial, with success rates reported between 80% and 97%. However, it is essential to identify the specific source of bleeding for effective embolization. Given the severity of liver trauma and its potential complications, innovations in diagnostic and therapeutic approaches have been pivotal. While CT remains a primary diagnostic tool, methods like CEUS offer safer alternatives. Moreover, nonoperative management, especially when combined with angiography and embolization, has demonstrated notable success. Still, the healthcare community must remain vigilant to complications and continuously seek improvements in trauma care.

Endovascular Embolization of a Ruptured Distal Lenticulostriate Artery Aneurysm in Patients with Moyamoya Disease

  • Hwang, Kihwan;Hwang, Gyojun;Kwon, O-Ki
    • Journal of Korean Neurosurgical Society
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    • 제56권6호
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    • pp.492-495
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    • 2014
  • A ruptured distal lenticulostriate artery (LSA) aneurysm is detected occasionally in moyamoya disease (MMD) patients presented with intracerebral hemorrhage. If the aneurysm is detected in hemorrhage site on angiographic evaluation, its obliteration could be considered, because it rebleeds frequently, and is associated with poorer outcome and mortality in MMD related hemorrhage. In this case report, the authors present two MMD cases with ruptured distal LSA aneurysm treated by endovascular embolization.

A Case of Catamenial Hemoptysis Treated by Bronchial Artery Embolization

  • Shin, Suk Pyo;Park, Chi Young;Song, Ji Hyun;Kim, Hong Min;Min, Daniel;Lee, Sang Hwan;Kang, San Ha;Jeon, Gyeong Sik;Lee, Ji-Hyun
    • Tuberculosis and Respiratory Diseases
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    • 제76권5호
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    • pp.233-236
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    • 2014
  • Catamenial hemoptysis is a rare condition, characterized by recurrent hemoptysis associated with the presence of intrapulmonary or endobronchial endometrial tissue. Therapeutic strategies proposed for intrapulmonary endometriosis with catamenial hemoptysis consist of medical treatments and surgery. Bronchial artery embolization is a well-established modality in the management of massive or recurrent hemoptysis, but has seldom been used for the treatment of catamenial hemoptysis. We report a case of catamenial hemoptysis associated with pulmonary parenchymal endometriosis, which was successfully treated by a bronchial artery embolization.

Embolization of Multiple Systemic Artery to Pulmonary Artery Fistula with Recurrent Hemoptysis

  • Lee, Jung-Kyu;Park, Ju-Hee;Kim, Junghyun;Kim, Soo Jung;Lee, Ae-Ra;Lee, Chang Hoon;So, Young-Ho
    • Tuberculosis and Respiratory Diseases
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    • 제75권3호
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    • pp.120-124
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    • 2013
  • Herein, we report a case of multiple systemic arteries to pulmonary artery fistulas without any underlying causes, presenting recurrent hemoptysis. Transcatheter embolization was successfully performed several times on multiple systemic feeding arteries. Multiple systemic arteries to pulmonary fistulas can be a source of uncontrolled bleeding, and embolization may be a reasonable therapeutic option to control the bleeding.

Spinal Dural Arteriovenous Fistulas : Clinical Experience with Endovascular Treatment as a Primary Therapeutic Modality

  • Park, Sung-Bae;Han, Moon-Hee;Jahng, Tae-Ahn;Kwon, Bae-Ju;Chung, Chun-Kee
    • Journal of Korean Neurosurgical Society
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    • 제44권6호
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    • pp.364-369
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    • 2008
  • Objective : The aim of this study was to evaluate the efficacy of endovascular therapy as a primary treatment for spinal dural arteriovenous fistula (DAVF). Methods : The authors reviewed 18 patients with spinal DAVFs for whom endovascular therapy was considered as an initial treatment at a single institute between 1993 and 2006. NBCA embolization was considered the primary treatment of choice, with surgery reserved for patients in whom endovascular treatment failed. Results : Surgery was performed as the primary treatment in one patient because the anterior spinal artery originated from the same arterial pedicle as the artery feeding the fistula. Embolization was used as the primary treatment modality in 17 patients. with an initial success rate of 82.4%. Two patients with incomplete embolization had to undergo surgery. One patient underwent multiple embolizations, which failed to completely occlude the fistula but relieved the patient's symptoms. Spinal DAVF recurred in two patients (one collateral development and one recanalization) during the follow-up period. The collateral development was obliterated by repeated embolization, but the patient with recanalization refused further treatment. The overall clinical status improved in 15 patients (83.3%) during the follow-up period. Conclusion : Endovascular therapy can be successfully used as a primary treatment for the majority of patients with spinal DAVFs. Although it is difficult to perform in some patients, endovascular embolization should be the primary treatment of choice for spinal DAVF.

Osler-Rendu-Weber 증후군 환자에서 색전요법을 이용한 다발성 폐동정맥루 치험 1예 (Treatment of Multiple Pulmonary Arteriovenous Fistulas with Therapeutic Embolization in Osler-Rendu-Weber Syndrome)

  • 김재학;최택희;남승모;장재진;박연희;허남현;최두환;이병희;김유철;이춘택
    • Tuberculosis and Respiratory Diseases
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    • 제44권4호
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    • pp.914-921
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    • 1997
  • 저자들은 최근 가족력은 없지만 폐동정맥루와 간동맥혈관 조영술 및 위점막에서 관찰된 혈관기형을 동반한 Osler-Rendu-Weber 증후군 1예에서 폐동정맥루에 대해 금속코일을 이용한 색전요법을 시행하여 특별한 합병증 없이 증상의 개선을 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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Technical Consideration for Coiling of Ruptured Proximal Posterior Inferior Cerebellar Artery Aneurysm

  • Kim, Jong Hoon;Jeon, Ik Chan;Chang, Chul Hoon;Jung, Young Jin
    • Journal of Korean Neurosurgical Society
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    • 제61권5호
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    • pp.653-659
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    • 2018
  • Objective : Surgical obliteration of ruptured aneurysm of the proximal posterior inferior cerebellar artery (PICA) is challenging because of limited surgical accessibility. In recent years, coil embolization is the first-choice treatment for these lesions. However, coil embolization is not always easy in ruptured PICA aneurysm owing to the variable anatomical diversity of its shapes, its relationship to the parent artery, its low incidence, and accordingly, lesser neurointerventionist experience. Methods : The parent artery and microcatheter for easier navigation and the embolization technique for stable coiling were identified. Results : This study aimed to identify the more appropriate approach route, microcatheter, and strategies for an easier and safer, and more durable coil embolization in the treatment of lesions in the proximal PICA. Conclusion : Coil embolization for aneurysmal subarachnoid hemorrhage due to a ruptured proximal PICA remains a challenge, but with the appropriate coiling plan, it can be treated successfully.

코일 색전술로 치료된 다발성 폐동정맥기형 1 예 (A Case of Multiple Pulmonary Arteriovenous Malformation Treated with Coil Embolization)

  • 안혁수;이흥범;이용철;이양근
    • Tuberculosis and Respiratory Diseases
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    • 제45권4호
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    • pp.896-901
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    • 1998
  • Pulmonary arteriovenous malformation(PAVM) is an uncommon congenital anomaly. As pulmonary arteriovenous malformation is a direct communication between the branches of pulmonary artery and vein which originated from the malformation of capillary development, major disturbances in gas exchange can result. This malformation results in the several symptoms such as dyspnea, hemopyssis, cyanosis, and severe neurologic complaints. However, the most of patients are usually asymptomatic. Selective pulmonary angiography is well known the helpful diagnostic method. Recently, therapeutic embolization has been advocated as the treatment of choice for pulmonary arteriovenous malformations. We report a case of multiple pulmonary arteriovenous malformation, which was detected on the simple chest X-ray and successfully treated with coil embolization in a 19-year-old asymptomatic woman.

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Occurrence of De Novo Dural Arteriovenous Fistula after Transvenous Embolization of Dural Arteriovenous Fistula : Case Reports of Two Patients

  • Makita, Ippei;Kamio, Yoshinobu;Hiramatsu, Hisaya;Kurozumi, Kazuhiko
    • Journal of Korean Neurosurgical Society
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    • 제65권4호
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    • pp.598-602
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    • 2022
  • Development of de novo dural arteriovenous fistula (DAVF) at a different site after resolution of an initial DAVF, is rare. Here we report two cases, which we encountered in our hospital. A 68-year-old woman presented with pulsatile tinnitus on the left side. Cerebral angiography demonstrated a left anterior condylar confluence (ACC) DVAF and she underwent transvenous embolization. Four years after this treatment, she presented with tinnitus on the left side, and cerebral angiography revealed a right DAVF around the sinus of the lesser sphenoid wing. Another 69-year-old woman presented with left-sided orbital bruits, chemosis, and conjunctival hyperemia. Cerebral angiography showed left cavernous sinus (CS) DAVF, for which she underwent transvenous embolization for CS DAVF. One year later, she developed a left ACC and transverse-sigmoid sinus (TSS) DAVF.

Exercise-induced traumatic muscle injuries with active bleeding successfully treated by embolization: three case reports

  • Heo, Yoonjung;Kang, Hye Lim;Kim, Dong Hun
    • Journal of Trauma and Injury
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    • 제35권3호
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    • pp.219-222
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    • 2022
  • Muscle injuries caused by indirect trauma during exercise are common. Most of these injuries can be managed conservatively; however, further treatment is required in extreme cases. Although transcatheter arterial embolization is a possible treatment modality, its role in traumatic muscle injuries remains unclear. In this case series, we present three cases of exercise-induced muscle hemorrhage treated by transcatheter arterial embolization with successful outcomes. The damaged muscles were the rectus abdominis, adductor longus, and iliopsoas, and the vascular injuries were accessed via the femoral artery during the procedures.