• Title/Summary/Keyword: Stenting

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Sole Stenting Technique for Treatment of Complex Aneurysms

  • Kim, Young-Joon
    • 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.

Posterior Cricoid Split with Costal Cartilage Grafting and T-tube Stenting for Treatment of Subglottic Stenosis (성문하협착증에서 윤상연골절개 및 윤상연골 후벽 늑연골 이식술과 T-tube stenting)

  • Sohn, Jin-Ho
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.182-190
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    • 1999
  • OBJECTIVES : To determine the results of posterior cricoid split with costal cartilage graft in the treatment of moderate and severe subglottic stenosis in adults, and to assess the effect of T-tube as a stent in this surgery. PATIENTS AND METHODS : Four adults with moderate and severe subglottic stenosis who underwent posterior cricoid split with costal cartilage graft from 1994 to 1995. Three patients were male and one was female. All of the patients had acquired subglottic stenosis, 2 of whom had a bilateral vocal folds paralysis. The surgical procedure we used included a cricoid lamina split with costal cartilage grafting and T-tube stenting. Arytenoidectomy was a added in 2 patients with bilateral vocal folds paralysis. RESULTS : Three of the 4 patients underwent decannulation, and 1 is still undergoing treatment. 3 patients who underwent decannulation demonstrated marked improvement in their symptoms of airway obstruction and good postoperative voice quality. CONCLUSIONS : The posterior cricoidotomy lumen augmentation with costal cartilage grafting is a safe and effective technique for the treatment of moderate and severe subglottic stenosis in adults and T-tube is a good alternative stenting material for this procedure.

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Treatment of Esophagojejunostomy Leakage with Expanding Stent (식도-공장 문합루에 대한 Stent 삽관치료)

  • 박재길;이선희;이성호;곽문섭;김세화
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.77-81
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    • 1998
  • It would be possible to manage the intestinal anastomotic failure with intraluminal stenting, but its reports are very rare. We experienced a effective and dramatic improvement of esophago-jejunal anastomotic leak in a esophageal and gastric double cancer patient with intraluminal stenting. The intraluminal stenting was tried at the 28th postoperative day and the anastomotic leak and inflammatory signs were disappeared about 3 weeks later. Postoperative 11th months now, the stent was moved about 1 cm downward but not changed further, and he enjoys regular diet without any problems. And we think the stenting would be helful with some limitations in the intestinal anastomotic leak patient.

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Multimodal Therapy for Patients with Acute Ischemic Stroke : Outcomes and Related Prognostic Factors

  • Jeong, Seung-Young;Park, Seung-Soo;Koh, Eun-Jeong;Eun, Jong-Pil;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.360-368
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    • 2009
  • Objective : The objectives of this study were to analyze the recanalization rates and outcomes of multimodal therapy that consisted of sequential intravenous (IV)/intra-arterial (IA) thrombolysis, mechanical thrombolysis including mechanical clot disruption using microcatheters and microwires, balloon angioplasty, and stenting for acute ischemic stroke, and to evaluate the prognostic factors related to the outcome. Methods : Fifty patients who were admitted to the hospital within 8 hours from ischemic symptom onset were retrospectively analyzed. Initial IV thrombolysis and subsequent cerebral angiography were performed in all patients. If successful recanalization was not achieved by IV thrombolysis, additional IA thrombolysis with mechanical thrombolysis, including balloon angioplasty and stenting, were performed. The outcomes were assessed by the National Institute of Health Stroke Scale (NIHSS) change and modified Rankin scale (mRS) and prognostic factors were analyzed. Results : Successful recanalization was achieved in 42 (84%) of 50 patients, which consisted of 8 patients after IV thrombolysis, 19 patients after IA thrombolysis with mechanical clot disruption, and 15 patients after balloon angioplasty or stenting. Symptomatic hemorrhage occurred in 4 (8%) patients. Good outcomes were achieved in 76% and 70% of patients upon discharge, and 93% and 84% of patients after 3 months according to the NIHSS change and mRS. The initial clinical status, recanalization achievement, and presence of symptomatic hemorrhage were statistically related to the outcomes. Conclusion : Multimodal therapy may be an effective and safe treatment modality for acute ischemic stroke. Balloon angioplasty and stenting is effective for acute thrombolysis, and produce higher recanalization rates with better outcomes.

Routine double-J stenting for live related donor kidney transplant recipients: It doesn't serve the purpose, but does it serve a better purpose?

  • Kumar, Vikash;Punatar, Chirag B;Jadhav, Kunal K;Kothari, Jatin;Joshi, Vinod S;Sagade, Sharad N;Kamat, Madhav H
    • Investigative and Clinical Urology
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    • v.59 no.6
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    • pp.410-415
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    • 2018
  • Purpose: Despite meticulous techniques, surgical complications continue to be problematic in kidney transplant recipients. Role of routine stenting to reduce complications is controversial. In this study, we compare incidence of early urological complications, lymphoceles, urinary tract infections (UTI) and graft function; with or without double-J stenting. Materials and Methods: All patients who underwent live related donor renal transplantation from February 2014 to February 2016 were included. Transplants prior to February 2015 were without routine stenting; subsequent transplants were with routine stenting. Patients with neurogenic bladder, previously operated bladder and delayed or low urinary output were excluded. Followup was for at least three months. Descriptive statistics was performed for all parameters. Chi square test and Fisher's Exact test were used for qualitative variables. For quantitative variables, Mann-Whitney test was used to test median difference and independent samples t-test for mean difference. The p-value ${\leq}0.05$ was considered significant. Results: We analysed 74 patients (34 stented and 40 non-stented). There was no difference in the incidence of urinary leak, anastomotic obstruction, lymphoceles or UTI (p>0.4 for all comparisons). However, mean estimated glomerular filtration rate at sixth day, 14th day, one month and two months were 76.1 vs. 61.5 (p=0.025), 72.1 vs. 56.6 (p=0.005), 79.4 vs. 63.1 (p=0.002) and 82.0 vs. 63.3 (p=0.001) in the stented versus non-stented groups. Conclusions: Placement of ureteral stent in renal transplant does not significantly affect the incidence of early urinary complications or UTI. However, graft function is significantly better in stented recipients, at least in the short term.

Delayed Carotid Wallstent Shortening Resulting in Restenosis Following Successful Carotid Artery Angioplasty and Stenting

  • Yoon, Seok-Mann;Jo, Kwang-Wook;Baik, Min-Woo;Kim, Young-Woo
    • Journal of Korean Neurosurgical Society
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    • v.46 no.5
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    • pp.495-497
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    • 2009
  • Carotid angioplasty and stenting (CAS) for carotid stenosis has been increasingly used as an alternative treatment in patients not eligible for surgery. Even though CAS can be performed relatively simply in many cases, various complications can occur. We report four cases of CAS using the Carotid Wallstent, which were complicated by delayed shortening of the stent, resulting in restenosis after successful CAS.

Delayed Cerebral Hyperperfusion Syndrome Three Weeks after Carotid Artery Stenting Presenting as Status Epilepticus

  • Oh, Seong-Il;Lee, Seok-Joon;Lee, Young Jun;Kim, Hee-Jin
    • Journal of Korean Neurosurgical Society
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    • v.56 no.5
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    • pp.441-443
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    • 2014
  • Cerebral hyperperfusion syndrome (CHS) is increasingly recognized as an uncommon, but serious, complication subsequent to carotid artery stenting (CAS) and carotid endarterectomy (CEA). The onset of CHS generally occurs within two weeks of CEA and CAS, and a delay in the onset of CHS of over one week after CAS is quite rare. We describe a patient who developed CHS three weeks after CAS with status epilepticus.

Tracheal Agenesis Reconstruction with External Esophageal Stenting: Postoperative Results and Complications

  • Park, Byung-Jo;Kim, Min Soo;Yang, Ji-Hyuk;Jun, Tae-Gook
    • Journal of Chest Surgery
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    • v.48 no.6
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    • pp.439-442
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    • 2015
  • Tracheal agenesis is an extremely rare and typically lethal congenital disorder. Approximately 150 cases have been described since 1900, and very few cases of survival have been reported. We describe tracheal reconstruction with external esophageal stenting in a patient with Floyd's type II tracheal agenesis. Neither long-term survival nor survival without mechanical ventilation for even a single day has previously been reported in patients with Floyd's type II tracheal agenesis. The infant in the present case survived for almost a year and breathed without a ventilator for approximately 50 days after airway reconstruction using external supportive stents.

Superficial Temporal Artery-Middle Cerebral Artery Anastomosis for Internal Carotid Artery Occlusion by Subacute In-Stent Thrombosis after Carotid Artery Stenting

  • Choi, Hoi Jung;Kim, Sung Tae;Jeong, Yeong Gyun;Jeong, Hae Woong
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.551-554
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    • 2012
  • Alternative to carotid endarterectomy, carotid artery stenting (CAS) can be performed for symptomatic severe stenosis of internal carotid artery, especially for high-risk patients. Among several complications after CAS, subacute in-stent thrombosis is rare but important, because patient's condition can deteriorate rapidly. Subacute in-stent thrombosis with carotid artery occlusion can be managed by superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. We report two cases of STA-MCA anastomosis for internal carotid artery occlusion by subacute in-stent thrombosis after CAS.

Acute Exacerbation of Neovascular Glaucoma after Carotid Artery Stenting (경동맥스텐트삽입술 직후 악화된 혈관신생녹내장 사례)

  • Ko, Myung-Ah;Lee, Chae-Won;Jo, Sungyang;Kang, Dong-Wha;Jeon, Sang-Beom
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.325-328
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    • 2018
  • Neovascular glaucoma is a subtype of secondary glaucoma that is characterized by proliferation of fibrovascular tissue in the anterior chamber angle. This condition may be acutely aggravated by carotid revascularization therapies. There have been few previous reports of acute aggravation of neovascular glaucoma following carotid artery stenting. We report the case history of a patient who had acute exacerbation of neovascular glaucoma following carotid artery stenting and required surgical management.