• Title/Summary/Keyword: Interventional Procedures

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Therapeutic potential of stellate ganglion block in orofacial pain: a mini review

  • Jeon, Younghoon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.3
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    • pp.159-163
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    • 2016
  • Orofacial pain is a common complaint of patients that causes distress and compromises the quality of life. It has many etiologies including trauma, interventional procedures, nerve injury, varicella-zoster (shingles), tumor, and vascular and idiopathic factors. It has been demonstrated that the sympathetic nervous system is usually involved in various orofacial pain disorders such as postherpetic neuralgia, complex regional pain syndromes, and atypical facial pain. The stellate sympathetic ganglion innervates the head, neck, and upper extremity. In this review article, the effect of stellate ganglion block and its mechanism of action in orofacial pain disorders are discussed.

Hybrid Approach for Treatment of Multiple Traumatic Injuries of the Heart, Aorta, and Abdominal Organs

  • Kim, Seon Hee;Song, Seunghwan;Cho, Ho Seong;Park, Chan Yong
    • Journal of Chest Surgery
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    • v.52 no.5
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    • pp.372-375
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    • 2019
  • A 55-year-old man was admitted to the trauma center after a car accident. Cardiac tamponade, traumatic aortic injury, and hemoperitoneum were diagnosed by ultrasonography. The trauma surgeon, cardiac surgeon, and interventional radiologist discussed the prioritization of interventions. Multi-detector computed tomography was carried out first to determine the severity and extent of the injuries, followed by exploratory sternotomy to repair a left auricle rupture. A damage control laparotomy was then performed to control mesenteric bleeding. Lastly, a descending thoracic aorta injury was treated by endovascular stenting. These procedures were performed in the hybrid-angio room. The patient was discharged on postoperative day 135, without complications.

Introduction to Knobology Focusing on B Mode and Doppler Setting in Musculoskeletal Ultrasound (근골격계 초음파의 기판 조절 입문: B Mode와 Doppler)

  • Min, Kyunghoon
    • Clinical Pain
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    • v.20 no.1
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    • pp.7-14
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    • 2021
  • Musculoskeletal ultrasound has evolved as the essential tool to diagnose and guide intervention procedures in people with neuromusculoskeletal conditions. Image optimization and understanding device operations are core components for ultrasound guided intervention procedure training. All ultrasound machines share the common operative features and there are various buttons for the features in the device control panel. Ultrasound "knobology" refers to the thorough understanding of imaging optimization. This review addressed basic information for the transducers, depth setting, gain and focus control, different modes focusing on brightness and doppler modes.

CT Imaging for Mitral Valve Surgery and Intervention (승모판막수술 및 중재술을 위한 전산화단층영상)

  • Dong Hyun Yang
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.290-301
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    • 2020
  • The surgical technique of mitral valvuloplasty or transcatheter mitral valve (MV) replacement has been developed recently. Surgeons and interventionists require detailed anatomical information on the MV for the purpose of treatment planning. In this review, we discussed the anatomic features of the MV on CT and the method of evaluating the MV for treatment planning, as well as its preservation, for interventional procedures.

Update on Transradial Access for Percutaneous Transcatheter Visceral Artery Embolization

  • Hee Ho Chu;Jong Woo Kim;Ji Hoon Shin;Soo Buem Cho
    • Korean Journal of Radiology
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    • v.22 no.1
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    • pp.72-85
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    • 2021
  • Transfemoral access (TFA) is a widely used first-line approach for most peripheral vascular interventions. Since its introduction in cardiologic and neurointerventional procedures, several advantages of transradial access (TRA) over TFA have been demonstrated, such as patient preference, lower complication rates, early ambulation, and shorter hospital stay. However, studies reporting the safety and efficacy of this approach for peripheral vascular interventions performed by interventional radiologists are relatively few. This review aimed to summarize the technique and clinical applications of TRA in percutaneous transcatheter visceral artery embolization and the management of complications.

Smart Glasses Cannula Guide System Development for Interventional Cardiology Procedures (중재적 심장 질환 시술을 위한 스마트 글래스 삽입관 가이드 시스템 개발)

  • Jang, Ik Gyu;Heo, Yeong Jun;Jeon, Geum Sang;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.41 no.5
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    • pp.173-178
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    • 2020
  • Remote control intervention surgery robotic system improves treatment effect on cardiovascular patients and reduces X-ray exposure. However, at the time of the first procedure, CT (computerized tomography) and other ultrasound diagnostic equipment should be used because the operator must insert the cannula directly into the patient's leg. Improvements to this have been un-met-needs of hospitals. In this paper, we developed a system that can insert the cannula intuitively and quickly by displaying blood vessels at a glance through the system using smart wearable glasses. The core development method is as follows. In order to project augmented reality onto the surgical image, CT scan angiography image is extracted and processed. In the process, three CT-Markers are used to create a coordinate system of blood vessel images. Additionally, a reference marker is photographed on a single camera to obtain a camera coordinate system. Since the CT marker and the reference marker are in the same position, 3D registration is performed. In the text, a detailed explanation will be given.

Renal Artery Embolization Using a New Liquid Embolic Material Obtained by Partial Hydrolysis of Polyvinyl Acetate (Embol): Initial Experience in Six Patients

  • Sung Il Park;Do Yun Lee;Jong Yoon Won;Sangsoo Park
    • Korean Journal of Radiology
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    • v.1 no.3
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    • pp.121-126
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    • 2000
  • Objective: To evaluate the therapeutic efficacy of a new liquid embolic material, Embol, in embolization of the renal artery. Materials and Methods: Embol is a new embolic material obtained by partial hydrolysis of polyvinyl acetate mixed in absolute ethanol and Iopromide 370 and manufactured by Schering Korea, Kyonggido, Korea. Six patients who underwent embolization of the renal artery using Embol were evaluated. Four were male and two were female and their ages ranged from 11 to 70 (mean, 53) years. Clinical and radiologic diagnoses referred for renal artery embolization were renal cell carcinoma (n = 3), renal angiomyolipoma (n = 2) and pseudoaneurysm of the renal artery (n = 1). After selective renal angiography, Embol was injected through various catheters, either with or without a balloon occlusion catheter. Changes in symptoms and blood chemistry which may have been related to renal artery embolization with Embol were analyzed. Results: The six patients showed immediate total occlusion of their renal vascular lesions. One of the three in whom renal cell carcinoma was embolized with Embol underwent radical nephrectomy, and the specimen thus obtained revealed 40% tumor necrosis. In the two patients with angiomyolipomas, the tumors decreased in size and abdominal pain subsided. Bleeding from pseudoaneurysm of the renal artery was successfully controlled. Four patients showed symptoms of post-embolization syndrome, and one of these also showed increased levels of blood urea nitrogen and creatinine. One patient experienced transient hypertension. Conclusion: Embol is easy to use, its radiopacity is adequate and it is a safe and effective embolic material which provides immediate and total occlusion of renal vascular lesions.

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Interventional Treatments for Femoropopliteal Arterial Disease and Recent Updates (대퇴슬와동맥의 인터벤션과 최신 지견)

  • Minuk Kim;Soo Buem Cho
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.527-540
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    • 2021
  • Peripheral arterial occlusive disease (PAOD) of the femoropopliteal artery is commonly caused by atherosclerosis. It can present with varying clinical symptoms depending on the degree of disease, ranging from intermittent claudication to critical limb ischemia and tissue loss. Therefore, appropriate and timely treatment is required to improve symptoms and salvage the affected limbs. Interventional approaches for femoropopliteal arterial disease commonly include percutaneous transluminal angioplasty, atherectomy, and stent placement. Over the years, endovascular recanalization has been widely performed for treating PAOD due to continuous developments in its techniques and availability of dedicated devices with the inherent advantage of being minimal invasive. In this review, we introduce various types of endovascular treatment methods, discuss the results of clinical research from existing literature, and illustrate the treatment procedures using representative images.

MR Imaging-Histopathologic Correlation of Radiofrequency Thermal Ablation Lesion in a Rabbit Liver Model: Observation during Acute and Chronic Stages

  • Jong Deok Lee;Jeong Min Lee;Sang Won Kim;Chong Soo Kim;Woo Sung Mun
    • Korean Journal of Radiology
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    • v.2 no.3
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    • pp.151-158
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    • 2001
  • Objective: To determine the ability of MR imaging to detect the pathological changes occurring in radiofrequency (RF) thermal lesions and to assess its accuracy in revealing the extent of tissue necrosis. Materials and Methods: Using an RF electrode, thermal lesions were created in the livers of 18 rabbits. The procedure involved three phases. In the acute phase, six animals were killed the day after performing thermal ablation with RF energy, and two on day 3. In the subacute and chronic phases, eight rabbits underwent percutaneous hepatic RF ablation. After performing MR imaging, two animals were sacrificed at 1, 2, 4, and 7 weeks after the procedure, and MRpathologic correlation was performed. Results: In the acute phase, the thermal ablation lesions appeared at gross examination as well-circumscribed, necrotic areas, representing early change in the coagulative necrosis seen at microscopic examination. They were hypointense on T2-weighted images, and hyperintense on T1-weighted images. Gadolinium-enhanced MR imaging showed that a thin hyperemic rim surrounded the central coagulative necrosis. In the subacute phase, ablated lesions also showed extensive coagulative necrosis and marked inflammation at microscopic examination. Beyond two weeks, the lesions showed gradual resorption of the necrotic area, with a peripheral fibrovascular rim. The size of lesions measured by MR imaging correlated well with the findings at gross pathologic examination. Conclusion: MR imaging effectively demonstrates the histopathological tissue change occurring after thermal ablation, and accurately determines the extent of the target area.

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Ultrasound-guided needle decompression and steroid injection for calcific tendinitis of the shoulder: risk factors for repeat procedures and outcome analysis

  • Kim, Su Cheol;Lee, Sang Min;Park, Gun Tae;Jang, Min Chang;Yoo, Jae Chul
    • Clinics in Shoulder and Elbow
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    • v.24 no.2
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    • pp.55-65
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    • 2021
  • Background: Although ultrasound-guided needle decompression (US-GND) can treat calcific tendinitis of the shoulder effectively, repeat procedures might be required for unresolved symptoms. We evaluated the overall clinical outcomes of US-GND with subacromial steroid injection and the final results and factors predisposing toward repeat procedures. Methods: Ninety-eight patients who underwent US-GND for calcific tendinitis of the supraspinatus/infraspinatus were analyzed between March 2017 and December 2018. The clinical outcomes (pain visual analog scale, functional visual analog scale [FVAS], and American Shoulder and Elbow Surgeons [ASES] score) and final subjective satisfaction were compared between groups A (single US-GND) and B (repeat US-GND). The factors predisposing toward repeated US-GNDs were analyzed. Results: We found that 59.3% (58/98) of patient ASES scores were ≥80, and 73.5% of patients (72/98) were satisfied with the outcome. Group B (n=14) demonstrated a significantly higher rate of dominant-arm involvement compared to group A (78.6% vs. 48.8%, p=0.046). However, initial calcification size, shape, number, density, subscapularis involvement, lavage, and procedure time did not differ significantly between the groups. Group B showed poorer final FVAS (7 [interquartile range, 6-8] vs. 8 [interquartile range, 7-9], p=0.036) and subjective satisfaction compared to group A (satisfied: 5 [35.7%] vs. 67 [79.8%], p<0.001]. Conclusions: US-GND with subacromial steroid injection is a viable treatment option for calcific tendinitis of the shoulder. Dominant-arm involvement was the only independent factor for repeated US-GND. Final outcome of repeated US-GND for unimproved patients was promising; however, these outcomes were poor compared to those of the patients who improved after the first procedure.