• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.7
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• pp.4651-4655
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• 2015

The subclavian artery pseudoaneurysm in blunt trauma is uncommon and rarely occurs secondary to penetrating injury. Subclavian artery injuries represent an uncommon complication of blunt chest trauma, this structure being protected by subclavius muscle, the clavicle, the first rib, and the deep cervical fascia as well as the costo-coracoid ligament, a clavi-coraco-axillary fascia portion. Subclavian artery injury appears early after trauma, and arterial rupture may cause life-threatening hemorrhages, pseudoaneurysm formation and compression of brachial plexus. Most injuries were related to clavicle fracture, gunshot, other penetrating trauma, and complication of central line insertion. The presence of large hematomas and pulsatile palpable mass in supraclavicular region should raise the suspicion of serious vascular injury and these clinical evidences must be carefully worked out by physical examination of the upper limb. Since the first reports of endovascular treatment for traumatic vascular injuries in the 1993, an increasing number of vascular lesions have been treated this way. We report a case of subclavian artery pseudoaneurysm 10 days after blunt chest trauma due to traffic accident, treated by endovascular stent grafting.

• Journal of Korean Neurosurgical Society
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• v.65 no.6
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• pp.765-771
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• 2022

Objective : Stent-assisted coil embolization (SAC) has been increasingly used to treat various types of intracranial aneurysms. Delayed thromboembolic complications are major concerns regarding this procedure, so dual antiplatelet therapy with aspirin and clopidogrel is needed. However, clinicians vary the duration of dual antiplatelet therapy after SAC, and no randomized study has been performed. This study aims to compare the safety and efficacy of long-term (12 months) dual antiplatelet therapy and short-term dual antiplatelet therapy (6 months) after SAC for patients with unruptured intracranial aneurysms (UIAs). Methods : This is a prospective, randomized and multicenter trial to investigate the optimal duration of dual antiplatelet therapy after SAC in patients with UIAs. Subjects will receive dual antiplatelet therapy for 6 months (short-term group) or 12 months (long-term group) after SAC. The primary endpoint is the assessment of thromboembolic complications between 1 and 18 months after SAC. We will enroll 528 subjects (264 subjects in each group) and perform 1 : 1 randomization. This study will involve 14 top-performing, high-volume Korean institutions specializing in coil embolization. Results : The trial will begin enrollment in 2022, and clinical data will be available after enrollment and follow-up. Conclusion : This article describes that the aim of this prospective randomized multicenter trial is to compare the effect of short-term (6 months) and long-term (12 months) dual antiplatelet therapy on UIAs in patients undergoing SAC, and to find the optimal duration.

• Journal of Korean Neurosurgical Society
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• v.46 no.6
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• pp.545-551
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• 2009

Objective : Complex aneurysms such as fusiform and very small aneurysms (< 3 mm) are challenging in neurovascular and endovascular surgery. Author reports follow-up results of 9 cases treated by sole stent technique with pertinent literature review. Methods : A retrospective study was made of 9 patients who were treated by sole stenting technique for cerebral aneurysm between January 2003 and January 2009. Two of them had fusiform aneurysm, 5 had very small aneurysm, and 2 had small saccular aneurysm. Five patients had ruptured aneurysms and four had unruptured aneurysms. Seven aneurysms were located in the internal carotid artery (ICA), 1 in the middle cerebral artery (MCA) and 1 in the basilar artery. Follow-up cerebral angiography was performed at post-procedure 3 months, 6 months, and 12 months. Mean follow-up period is 30 months (ranged from 3 days to 30 months). Results : Aneurysm size was decreased in 6 of 9 cases on follow-up images and was not changed in 3 cases. Although total occlusion was not seen, patients had stable neurological condition and angiographic result. The procedural complication occurred in 2 cases. One was coil migration and the other was suboptimal deployment of stent, and both were asymptomatic. Re-bleeding and thromboembolic complication had not been occurred. Conclusion : Sole stenting technique is relatively effective and safe as an alternative treatment for fusiform and very small aneurysms.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.520-523
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• 2009

Aortic arch aneurysm generally requires an urgent treatment due to the risk of catastrophic aortic rupture. However conventional surgery for aortic arch repair still carries significant risks of postoperative morbidity and mortality, especially in patients with old age. In an effort to correct the aortic pathology while minimizing the risks of complication, we performed a hybrid technique which comprises the off pump arch aortic stent grafting in an 86-old male patient with an aortic arch aneurysm.

• Journal of the Korean Society of Radiology
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• v.83 no.5
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• pp.1128-1133
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• 2022

Common carotid artery (CCA) rupture during parathyroid cancer surgery is extremely rare and is generally life-threatening. We present a case of successful management of a ruptured CCA following the emergency placement of stent-graft in a 59-year-old male diagnosed with recurrent parathyroid cancer. During recurrent parathyroid cancer surgery, his right CCA ruptured unexpectedly, and his vital signs deteriorated rapidly despite surgical management. After stent replacement, his unstable vital signs improved and, thereafter, he was discharged without any complications.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.26 no.3
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• pp.311-317
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• 2024

While mechanical thrombectomy is known to be effective for distal medium vessel occlusion (DMVO) as well as large vessel occlusion, tortuous DMVO are predisposed to vessel injury during stent retriever thrombectomy. Furthermore, getting access to the thrombus may be difficult during suction thrombectomy using a dedicated suction catheter. Most studies describe DMVO treatment using stent retrievers and dedicated suction catheters, but there are limited studies reporting DMVO treated with suction thrombectomy using a microcatheter. Herein, we describe three cases of DMVO treated with suction thrombectomy that was performed using a microcatheter and subsequently showed good results. Therefore, suction thrombectomy using a microcatheter is a viable alternative treatment for tortuous DMVO.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.100-103
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• 2010

We report her on a rare case of a renal stent that migrated into the right ventricle in a patient with nutcracker syndrome. A 29-year-old woman was admitted to the hospital and she was suffering from flank pain. The computed tomography of the abdomen demonstrated that the left renal vein was compressed between the abdominal aorta and the superior mesenteric artery (nutcracker syndrome). A self expandable stent was placed across the left renal vein for treating her nutcracker syndrome. The next day after the procedure, the follow up chest radiograph showed that the displaced stent had migrated into the right ventricle. After percutanous endovascular stent removal had failed, the stent was ultimately removed by performing cardiac surgery. At the $6^{th}$ postoperative month, there have been no abdominal or cardiac symptoms.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.785-789
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• 2010

The acute technical failure of endovascular treatment of chronic total occlusions is most often due to the inability to re-enter the true lumen after occlusion is crossed in a subintimal plane. True lumen re-entry catheters are very effective at gaining wire passage back to the true lumen and facilitating successful endovascular treatment of chronic total occlusions that would otherwise require open bypass. These case reports describe our initial experiences with a new catheter system (the $Outback^{(R)}$ $LTD^{TM}$ catheter) that is designed to allow fluoroscopically controlled re-entry of the true arterial lumen after subintimal guidewire passage during recanalization procedures of arterial occlusions.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.425-428
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• 2021

Aortobronchial fistula (ABF) induced by an infected pseudoaneurysm of the thoracic aorta is a life-threatening condition. As surgical treatment is associated with significant mortality and morbidity, thoracic endovascular aneurysm repair (TEVAR) may be an alternative for the treatment of ABF. However, the long-term durability of this intervention is largely unknown and the recurrence of ABF is a potential complication. We experienced a case of recurrent ABF after stent grafting as an early procedure for an infected pseudoaneurysm of the thoracic aorta. Remnant ABF, bronchial and/or aortic wall erosion, vasa vasorum connected with ABF, and recurrent local inflammation of the thin aortic wall around ABF might cause recurrent hemoptysis. As a result, we suggest that TEVAR should be considered as a bridge therapy for the initial treatment of ABF resulting from an infected pseudoaneurysm, and that several options, such as second-stage surgery, should be considered to prevent the recurrence of ABF.

• Korean Journal of Radiology
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• v.22 no.4
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• pp.577-583
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• 2021

Objective: To report the authors' experience in performing thoracic endovascular aortic repair (TEVAR) for zone 2 lesions after traumatic aortic injury (TAI). Materials and Methods: This retrospective review included 10 patients who underwent zone 2 TEVAR after identification of aortic isthmus injury by CT angiography (CTA) upon arrival at the emergency room of a regional trauma center from 2016 to 2019. Patients were classified into two groups: those who underwent left subclavian artery (LSA) embolization concurrently with the main TEVAR procedure, and those in whom LSA embolization was not performed during the main procedure, but was planned as a bailout treatment if type II endoleak was noted on follow-up CTA images. Pre-procedural and procedure-related factors and post-procedure prognosis were compared between the groups. Results: There were no differences in pre-procedural factors, occurrence of endoleaks, and post-procedure prognosis (including mortality) between patients in the two groups. The duration of the procedure was shorter in the non-LSA embolization group (61 minutes vs. 27 minutes, p = 0.012). During follow-up, type II endoleak did not occur in either group. Conclusion: Delaying preventative LSA embolization until stabilization of the patient would be desirable when performing zone 2 TEVAR for TAI, in the absence of endoleak on the completion aortography image taken after complete deployment of the stent graft.