• Title/Summary/Keyword: Intimal Hyperplasia

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Pulmonary Artery Aneurysm in Behcet`s Disease - Report of a Case - (Bechet씨 병에 발생한 폐동맥류: 치험 1례)

  • 김선한
    • Journal of Chest Surgery
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    • v.25 no.4
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    • pp.412-417
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    • 1992
  • Pulmonary artery aneurysm is Behcet`s disease is rare and can be fatal due to rupture. We experienced a case of pulmonary artery aneurysm in Behcet`s disease. The patient was 21 year old woman who was adimitted with three month history of dyspnea, fever and cough. On examination, she had aphthous ulcer in the mouth and erythema nodosum on the left popletial fossa and forearm, but didn`t have any lesion at eyes and genitalia. The latex fixation test for rheumatoid factor, VDRL test for syphillis, antinuclear antibody and LE cell test were all negatives. The third and fourth components of complement in the serum, serum immunoglobulin concentrations[IgG, IgM, IgA] were within normal range. The chest radiography revealed a 5x6cm sized radiopaque mass density in the left hilar region. Two months later, the mass was enlarged to 6x7cm. The IV-DSA showed a single aneurysm at the proximal part of left lower lobe artery with lingular segment artery and no distal perfusion by thombotic obstruction. The steroid therapy was done for a month, but symptoms not improved. We performed resection of lingular segment and lower lobe including the aneurysm. The microscopic findings of the operative specimen were intimal hyperplasia and fragmentation of the internal elastic fibers. She was improved without remarkable event, except infection of the operative wound.

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Influence of the Anastomosis Angle Variation on Flow Features and Wall Shear Stress of an Artery (관상동맥 우회로 관의 문합각도의 변화가 유동과 벽 전단력에 미치는 영향)

  • Kim H. M.
    • Journal of computational fluids engineering
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    • v.9 no.4
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    • pp.34-40
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    • 2004
  • It is known that the non-planar model of bypass is more profitable to suppress the development of intimal hyperplasia that tends to occur preferentially in regions of low time averaged shear stress and rapid temporal changes in wall shear stress. In this study it was numerically simulated the blood flow in an coronary artery grafted by artificial bypass to determine the flow characteristic variations due to the anastomosis angle changing. 5 different non-planar anastomosis angle models such as 45°, 60°, 90°, 120° and 135° were considered. When the anastomosis angle is higher, the backward flow region is spatially extended near the downstream region of the anastomosis because of the development of horseshoes vortex. For the case of the nan-planar 45° and 60° of anastomosis, the area of low-OSI zone was decreased by 26% and 13% respectively and the time averaged wall shear stress was increased by more than 55% as compared with 45° of planar model. However, both of the area of the low-OSI zone and the time averaged wall shear stress of 90°, 120° model were significantly increased.

Intracoronary Radiation Therapy Using Re-188 after percutaneous Coronary Angioplasty (경피적 관동맥혈관성형술 후 Re-188을 이용한 혈관 내 방사선조사요법)

  • Chae, In-Ho;Lee, Myoung-Mook;Lee, Dong-Soo
    • 대한핵의학회:학술대회논문집
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    • 1999.05a
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    • pp.228-241
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    • 1999
  • Percutaneous coronary angioplasty is well established therapeutic modality in the management of coronary artery disease. However, the high restenosis rate of 30 to 50% limits its usefulness. The principal mechanism of restenosis, intimal hyperplasia, is the proliferative response of vessel wall to injury, which consists largely of smooth muscle cells. A large body of animal investigations and a limited number of clinical studies have established the ability of ionizing radiation to reduce neointimal proliferation and restenosis rate significantly. Human studies have been reported that intravascular radiation after first restenosis inhibits a second restenosis. Encouraged by these reports, we are also conducting a double blind, placebo-controlled, randomized trial to evaluate this new therapeutic modality in patients with coronary artery stenosis. The objective of our trial is to determine the safety and efficacy of catheter-based solutional beta emitting radioisotope system in preventing restenosis after angioplasty. This review describes the vascular brachytherapy systems and isotopes that have been utilized in the initial clinical trials performed in this area of post PTCA coronary restenosis. The results of many worldwide ongoing clinical trials will determine whether this new technology will change the future practice of vascular intervention.

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Histomorphological changes in the common carotid artery of the male rat in induced hypogonadism

  • Cheruiyot, Isaac;Olabu, Beda;Kamau, Martin;Ongeti, Kevin;Mandela, Pamela
    • Anatomy and Cell Biology
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    • v.51 no.4
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    • pp.284-291
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    • 2018
  • The role of androgens in the development of cardiovascular diseases remains controversial. The current study therefore sought to determine the changes in the histomorphology of the common carotid artery of the male rat in orchidectomy-induced hypogonadism. Twenty-two Rattus norvegicus male rats aged 2 months were used. The rats were randomly assigned into baseline (n=4), experimental (n=9), and control (n=9) groups. Hypogonadism was surgically induced in the experimental group by bilateral orchiectomy under local anesthesia. At experiment weeks 3, 6, and 9, three rats from each group (experimental and control) were euthanized, their common carotid artery harvested, and routine processing was done for paraffin embedding, sectioning, and staining. The photomicrographs were taken using a digital photomicroscope for morphometric analysis. Orchidectomy resulted in the development of vascular fibrosis, with a significant increase in collagen fiber density and decrease in smooth muscle and elastic fiber density. Moreover, there was development of intimal hyperplasia, with fragmentation of medial elastic lamellae in the common carotid artery of the castrated rats. Orchidectomy induces adverse changes in structure of the common carotid artery of the male rat. These changes may impair vascular function, therefore constituting a possible structural basis for the higher incidences of cardiovascular diseases observed in hypogonadism.

Flow diversion of a middle cerebral artery pseudoaneurysm secondary to a gunshot wound: A case report

  • Justin C. Gelman;Max Shutran;Michael Young;Philipp Taussky;Rafael A. Vega;Rocco Armonda;Christopher S. Ogilvy
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.434-439
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    • 2023
  • Pseudoaneurysms are rare but devastating complications of penetrating head traumas. They require rapid surgical or endovascular intervention due to their high risk of rupture; however, complex presentations may limit treatment options. Our objective is to report a case of severe vasospasm, flow diversion, and in-stent stenosis complicating the treatment of a middle cerebral artery pseudoaneurysm following a gunshot wound. A 33-year-old woman presented with multiple calvarial and bullet fragments within the right frontotemporal lobes and a large right frontotemporal intraparenchymal hemorrhage with significant cerebral edema. She underwent an emergent right hemicraniectomy for decompression, removal of bullet fragments, and evacuation of hemorrhage. Once stable enough for diagnostic cerebral angiography, she was found to have an M1 pseudoaneurysm with severe vasospasm that precluded endovascular treatment until the vasospasm resolved. The pseudoaneurysm was treated with flow diversion and in-stent stenosis was found at 4-month follow-up angiography that resolved by 8 months post-embolization. We report the successful flow diversion of an middle cerebral artery (MCA) pseudoaneurysm complicated by severe vasospasm and later in-stent stenosis. The presence of asymptomatic stenosis is believed to be reversible intimal hyperplasia and a normal aspect of endothelial healing. We suggest careful observation and dual-antiplatelet therapy as a justified approach.

Changes in the Luminal Surface of the PTFE Graft used in Systemic- pulmonary Shunt Operation (체폐단락술에 사용되었던 PTFE 인조혈관 내면의 변화)

  • Park, Yeong-Hwan;Jang, Byeong-Cheol;Sin, Dong-Hwan;Jo, Beom-Gu
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.836-843
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    • 1996
  • Histologic, and scanning electron microscopic observa ions were made of 12 biopsy specimens from polytetrdiluoroethylene (PTFE) grafts that had been Implanted as systemic-pulmonAry shunt for improving oxygenation of cyanotic congenital heart disease and harvested near the end of pulmonary artery side at the time of redo shunt or tonal correction between 1985 and 1992. The types of shunt operation are modified Blalock-Taussig shunt in 10 cases, Waterston-Cooley shunt in 1 And Potts shunt in 1 case. The 5 mm PTFE graft was used In 10, 4mm in 1 and 6mm in 1 case. The mean duration of implantalion was 0 $\pm$ 14.1 months(rl.on 12 months to 55 months). The plAtelets were aggregated between gaps'of Coretex surface and intimal thickening was noted about 10 to 20 months after implantation. Endothelial cells were found in the 40-months patent PTFE graft by light and scanning electron microscopy. In the specimen of poor flow or zero flow graft, severe intimal hyperplasia and thrombi which was made of platelets were noted . Based on this experience, we think that the patency will be maintained well if the connective tissue could be Hxed firmly over the Inner layer of the Goretex and the endothelial cell layer sllould form over the con- nective tissue and platelet aggregation should be prevented.

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Coronary Artery Disease Affected by Moyamoya Disease - A case report - (관상 동맥 질환을 동반한 모야모야 병 1례의 증례 보고)

  • 김학제;조원민;류세민;황재준;손영상;최영호
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.231-234
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    • 2002
  • Moyamoya disease is an unusual cerebrovascular disorder characterized by occlusive intimal dysplasia of the distal internal carotid and proximal cerebral arteries as well as other collateral arteries. However, moyamoya diseases are recently being reported as a systemic process. We experienced one case of coronary artery occlusive disease affected by moyamoya disease. The patient was a 35-year-old female, experiencing intermittent NYHA class ll dyspnea and exertional chest pain for 6 months and right paresthesia for 1 month before admission. Cerebral artery angiogram showed abnormal cerebrovascular systems and confirmed moyamoya disease with cerebral infarction of the left frontal lobe. In coronary artery angiogram, left coronary artery was not visualized due to total occlusion of the left main ostium and left coronary blood flow was supplied from normal right coronary artery. CABG was performed with OPCAB. Both internal mammary arteries were used for LAD and LCx. Intraoperative coronary artery findings showed intimal hyperplasia and no definite thrombi, and nondiseased coronary arteries were good and patent. We concluded that this patient's coronary artery disease was affected by moyamoya disease, and moyamoya disease should be evaluated in the extracerebral cardiovascular system.

Inhibition of Intimal Hyperplasia by Perivascular Delivery of Paclitaxel Using Poly(n-butylmethacrylate) or Poly(3-hydroxybutyrate-co-4-hydroxybutyrate) in Balloon-Injured Rat Carotid Arteries (쥐 경동맥 손상 모델에서 Poly(n-butylmethacrylate) 혹은 Poly(3-hydroxybutyrate-co-4-hydroxybutyrate)를 이용한 Paclitaxel 국소 전달 요법의 신생내막 형성 억제 효과)

  • Kwon, Jin-Sook;Lee, Ho-Yeon;Heo, Shin-Haeng;Park, Rho-Kwan;Shim, Tae-Jin;Kim, Yu-Kyug;Kim, Beom-Soo;Kim, Dong-Woon
    • Polymer(Korea)
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    • v.32 no.3
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    • pp.284-289
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    • 2008
  • Polymer is a critical component of local drug delivery to prevent restenosis. This study tested whether poly(n-butylmethacrylate)(PBMA) and poly(3-hydroxybutyrate-co-4-hydroxybutyrate)(PHA) was candidates for this purpose. In vitro release of paclitaxel from PBMA and PHA loaded with 10% paclitaxel exhibited a triphasic release profile, with a fast initial and intermediate second phase followed by a slow release phase. Perivascular delivery of paclitaxel using these films inhibited neointimal hyperplasia in balloon-injured rat carotid arteries. The paclitaxel-loaded PBMA or PHA groups showed significant neointimal formation reductions versus the control groups (PBMA vs control: $0.03{\pm}0.02$ vs $0.10{\pm}0.01\;mm^2$, p<0.05; PHA vs control: $0.04{\pm}0.03$ vs $0.09{\pm}0.01\;mm^2$, p<0.05). This study suggests that PBMA and PHA could be good candidate polymers of local drug delivery to prevent restenosis. Perivascular delivery using these films represents a possible approach for prevention of restenosis. These can be candidate polymers for drug eluting stents.

The Study on the Diameter Ratio of the Artery-PTFE Anastomosis for the Optimized Deformed Shape (변형후 형상의 최적화를 위한 동맥과 PTFE 문합의 직경비 연구)

  • 이성욱;심재준;한근조
    • Journal of Biomedical Engineering Research
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    • v.24 no.2
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    • pp.113-119
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    • 2003
  • In this paper we introduced optimized deformed shape to prevent the blood vessel disease caused by the discord of deformed shape in the end-to-end anastomosis. This study considered the preliminary deformed shape induced by suture in the anastomosis of artery and PTFE, artificial blood vessel, with different diameters. Then we analyzed the final deformed shape of the anastomotic part under the systolic blood pressure. 120mmHg(16.0kPa). The final deformed shape of the anstomotic part was analyzed with respect to the change of initial diameter ratio(R$_{I}$) and the PTFE thickness. Equivalent and circumferential stresses induced by the systolic blood pressure in the anastomosis were also analyzed with respect to the initial diameter ratio(R$_{I}$). The results obtained were as follows : 1. Considering the preliminary deformed shape induced by suture and the systolic pressure in the anastomosis, not intimal hyperplasia, the optimal initial diameter ratio(R$_{I}$) was 1.073. 2. As the initial diameter ratio(R$_{I}$) became larger, higher equivalent and circumferential stresses were induced. And all the maximum stresses occurred on the side of PTFE 0.4mm apart from the anastomosis.

Early Failure of the Shelhigh Pulmonary Valve Conduit in Ross Operation - Two case reports- (Ross 수술시 사용한 Shelhigh 폐동맥판 도관의 조기 실패 -2예 보고-)

  • Jang Woo Sung;Kim Dong Jung;Kim Jin Hyun;Han Kook Nam;Choi Chang Hyu;Kim Woong Han
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.382-384
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    • 2005
  • Background: It is very difficult to choose the ideal valved conduit used in right ventricle outflow reconstruction in child. We can use the cryopreserved homograft but there is a limit of application because of its difficulties in the size matching and supply capacity. The $Shelhigh^{(R)}$porcine-valved conduit is commercially available and used as an alternative choice in these days. We report two cases of early Shelhigh conduit failure in right ventricular outflow tract after Ross operation in congenital aortic stenosis.