• 제목/요약/키워드: Endovascular surgery

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슬와 동맥 손상을 동반한 슬관절 탈구에서 혈관내 중재술 후 시행한 수술적 치료 - 증례 보고 - (Surgical treatment for knee dislocation with popliteal artery injury after endovascular intervention for arterial injury - A case report -)

  • 안지현;김상길
    • 대한정형외과스포츠의학회지
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    • 제10권2호
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    • pp.113-116
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    • 2011
  • 발생 빈도가 높진 않지만, 슬관절 탈구 시 슬와 동맥 손상이 종종 동반된다. 발견된 모든 동맥 손상에 대한 치료의 필요성이 보고되어 왔으며 관혈적 수술이 보편적인 방법으로 알려져 왔다. 슬관절 탈구에 동반된 슬와 동맥 손상에 대하여 혈관내 중재술로 혈류를 회복하고 이후 손상된 인대에 대한 수술적 치료를 시행한 1례를 보고하고자 한다.

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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.

Endovascular Repair in Acute Complicated Type B Aortic Dissection: 3-Year Results from the Valiant US Investigational Device Exemption Study

  • Lim, Chang Young
    • Journal of Chest Surgery
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    • 제50권3호
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    • pp.137-143
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    • 2017
  • Acute complicated type B aortic dissection (TBAD) is a potentially catastrophic, life-threatening condition. If left untreated, there is a high risk of aortic rupture, irreversible organ or limb damage, or death. Several risk factors have been associated with acute complicated TBAD, including age and refractory hypertension. In the acute phase, even uncomplicated patients are more prone to develop complications if hypertension and pain are left medically untreated. Innovations in stent graft technologies have incrementally improved outcomes since their first use for this condition in 1999, though improvement is needed in mitigating periprocedural complications, adverse events, and mortality. In the past decade, endovascular repair has become the preferred treatment because of its superior outcomes to open repair and medical therapy. The Valiant Captivia Thoracic Stent Graft System is a third-generation endovascular stent graft with advancements in minimally invasive delivery, conformability to the anatomy, and the minimization of adverse sequelae. Herein, this stent graft is briefly reviewed and its 3-year outcomes are presented. Freedom from all-cause and dissection-related mortality was 79.1% and 90.0%, respectiv ely. The Valiant Captiv ia Stent Graft represents a safe, effective intervention for acute complicated TBAD. Continued surveillance is needed to verify its longer-term durability.

하행 대동맥 내 스텐트-도관 삽입 후 발생한 역행성 대동맥 박리 - 2예 보고 - (Retrograde Aortic Dissection after Thoracic Endovascular Aortic Repair for Descending Aorta - 2 case reports-)

  • 홍순창;김정환;이희정;윤영남
    • Journal of Chest Surgery
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    • 제43권6호
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    • pp.758-763
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    • 2010
  • 흉부대동맥 질환에서 대동맥 내에 스텐트-도관(stent-graft)을 삽입하는 흉부 혈관내 대동맥 성형술(Thoracic endovascular aortic repair, TEVAR)은 최근 이의 적용이 점점 늘어나고 있는 추세이다. 하지만, 이 술식은 endoleak으로 인한 치료 실패, 시술 중 안착지점(landing zone)에서 발생하는 혈관벽의 손상으로 인한 역행성 대동맥박리 및 스텐트-도관 감염으로 인한 대동맥 파열 등의 심각한 합병증 발병의 위험성을 내재하고 있다. 저자들은 급성 하행 대동맥 박리 혹은 외상성 하행 대동맥 파열에서 적용된 TEVAR 후 발생한 2예의 역행성 대동맥 박리의 치료 경험을 문헌과 함께 보고하고자 한다.

Aorta Remodeling after Endovascular Treatment of a Chronic DeBakey IIIb Aneurysm and Simultaneous Palliation of a Renal Cell Carcinoma

  • Kim, Do Jung;Lee, Kwang-Hun;Lim, Sun-Hee;Chung, Byung Ha;Song, Suk-Won
    • Journal of Chest Surgery
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    • 제48권2호
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    • pp.142-145
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    • 2015
  • We report the case of a patient with a chronic DeBakey type IIIb aneurysm who underwent thoracic endovascular aortic repair to seal the primary entry tear and stent-graft insertion to cover the re-entry tear at the renal artery. The procedure was performed in order to achieve complete thrombosis in the entire thoracoabdominal false lumen, leading to favorable aortic remodeling. Simultaneously, ethanol ablation and renal artery embolization were performed to treat a renal tumor suspicious of renal cell carcinoma. Radical nephrectomy then confirmed clear cell carcinoma. To the best of our knowledge, no other cases of this type have been reported in the Korean literature.

Successful Repair of Type I Endoleak Using the Frozen Elephant Trunk Technique

  • Kim, Seon Hee;Song, Seunghwan;Kim, Sang-pil;Lee, Chung Won;Son, Joohyung
    • Journal of Chest Surgery
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    • 제49권4호
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    • pp.298-301
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    • 2016
  • Thoracic endovascular aortic repair (TEVAR) has emerged as an effective therapy for a variety of thoracic aortic pathologies. However, various types of endoleak remain a major concern, and its treatment is often challenging. We report a case of type I endoleak occurring 19 months after zone II hybrid TEVAR. The endoleak was successfully repaired by the frozen elephant trunk technique, without removal of a previous stent graft, combined with ascending aorta and total arch replacement.

Surgical Treatment of an Innominate Artery Aneurysm Using Near-Infrared Spectroscopy for Cerebral Monitoring: A Case Report

  • Jeon, Byeng Hun;Lee, Chul Ho;Bae, Chi Hoon;Jang, Jae Seok;Cho, Jun Woo
    • Journal of Chest Surgery
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    • 제54권6호
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    • pp.517-520
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    • 2021
  • Innominate artery aneurysms are challenging for surgeons to treat because of the requirement for brain protection during surgery. In innominate artery aneurysms, the endovascular approach does not require cardiopulmonary bypass, but patients who can be treated using this approach are limited in number, and the long-term results of endovascular treatment are unclear. Here, we report our experience of successfully treating a patient with an innominate artery aneurysm using near-infrared spectroscopy without cardiopulmonary bypass support or hypothermic circulatory arrest.

Aortic Valve Replacement Using Balloon Catheter for Thoracic Endovascular Aortic Repair to Patient with Calcified Aorta

  • Kim, In Sook;Byun, Joung Hun;Yoo, Byung Ha;Kim, Han Yong;Hwang, Sang Won;Song, Yun Gyu
    • Journal of Chest Surgery
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    • 제46권3호
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    • pp.212-215
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    • 2013
  • A 79-year-old man was admitted to Samsung Changwon Hospital due to chest pain and dyspnea. The ejection fraction was 31% and mean pressure gradient between the left ventricle and aorta was 69.4 mmHg on echocardiography. Chest computed tomography showed severe calcification of the ascending aorta. Aortic valve replacement was successfully performed using a thoracic endovascular aortic repair balloon catheter without classic aortic cross clamping. The patient was discharged on the eleventh postoperative day.

Thoracic Duct Embolization with Lipiodol for Chylothorax due to Thoracic Endovascular Aortic Repair with Debranching Procedure

  • Lee, Kwang Hyoung;Jung, Jae Seung;Cho, Sung Bum;Lee, Seung Hun;Kim, Hee Jung;Son, Ho Sung
    • Journal of Chest Surgery
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    • 제48권1호
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    • pp.74-77
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    • 2015
  • Chylothorax is a rare postoperative complication of a thoracic surgical procedure. Here, we report a case of chylothorax after thoracic endovascular aortic repair with debranching for the distal arch aneurysm of the aorta. First, the patient was treated by a medical method (nil per os, fat-free diet, and octreotide), but this method failed. The patient strongly refused surgical treatment. Therefore, we tried to occlude the thoracic duct by lymphangiography Lipiodol, and this line of treatment was successful.