• Title/Summary/Keyword: Surgical Stent

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A Case of Complication of Expandible Metallic Stent with Endobronchial Stenosis (결핵성 기관지 협착시 팽창성 금속 스텐트 시행후 발생한 육아종 형성 1예)

  • Lim, Seong-Hee;You, Kwan-Hee;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.1
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    • pp.47-50
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    • 1994
  • To maintain an adequate airway in a patient with tracheobronchial narrowing coming from various causes, prosthetic tracheobronchial stents provide palliative treatment for narrowed airways where surgical resection is inadvisable. After insertion, previous reported complications were granuloma formation, dysphagia, suction catheter entrapment and fatal massive hemoptysis. We report, a case of complication associated with expandible metallic stent with endobronchial stenosis due to tuberculosis.

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Endovascular Treatment for Common Iliac Artery Injury Complicating Lumbar Disc Surgery : Limited Usefulness of Temporary Balloon Occlusion

  • Nam, Taek-Kyun;Park, Seung-Won;Shim, Hyung-Jin;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.261-264
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    • 2009
  • Vascular injury during lumbar disc surgery is a rare but potentially life-threatening complication. It has been managed by open vascular surgical repair. With recent technologic advance, endovascular treatment became one of effective treatment modalities. We present a case of a 32-year-old woman who suffered with common iliac artery injury during lumbar disc surgery that was treated successfully by endovascular repair with temporary balloon occlusion and subsequent insertion of a covered stent. Temporary balloon occlusion for 1.5 hours could stop bleeding, but growing pseudoaneurysm was identified at the injury site during the following 13 days. It seems that the temporary balloon occlusion can stall bleeding from arterial injury for considerable time duration, but cannot be a single treatment modality and requires subsequent insertion of a covered stent.

Hybrid Right Ventricular Outflow Stent Insertion in a Small Neonate with Muscular Pulmonary Atresia with Intact Ventricular Septum: A Case Report

  • Byeong A Yoo;Jae Suk Baek;Chun Soo Park
    • Journal of Chest Surgery
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    • v.56 no.4
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    • pp.290-293
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    • 2023
  • Pulmonary atresia with intact ventricular septum (PAIVS) is a rare congenital heart disease that often needs a critical decision on whether to open the right ventricular outflow tract (RVOT). Significant morbidity and considerable mortality might preclude the safe use of percutaneous or surgical right ventricular decompression in patients with muscular PAIVS. We report the case of a 21-day-old neonate weighing less than 3 kg who underwent hybrid RVOT stent insertion as initial palliation for muscular PAIVS and subsequent anatomical correction at 5 months of age, with 6 years of follow-up.

Management for the Newly-Onset Aneurysmal Dilation of the Distal Aorta after an Endovascular Stent Graft Procedure for the Patient with Acute Aortic Dissection Type IIIb (급성 하행대동맥 박리증에서 스텐트-그라프트 삽입 후 새로이 발생한 원위부 대동맥류에 대한 인조혈관 대치술 치험 1예)

  • 이길수;방정희;조광조;성시찬;우종수
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.427-430
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    • 2003
  • The surgical managements for the complicated aortic disease is still one of most challenging fields for the cardiac surgeons. The endovascular stent graft procedure has been tried recently to avoid serious complications caused by traditional graft replacement technique. However, indications for the procedures or management methods for the complications have not been clearly elucidated so far. We report a case of successful management for the newly-onset aneurysmal dilation of the distal aorta after an endovascular stent graft procedure in a patient with acute aortic dissection type IIIB.

Pyloric Obstruction with Advanced Gastric Cancer: Stent vs. Bypass (악성 위출구 폐쇄 치료의 선택: 스텐트 삽입술 혹은 수술적 우회술?)

  • Lee, Beom-Jae;Park, Jong-Jae
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.1-5
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    • 2009
  • In the past, conservative bypass surgery was usually performed for palliation of malignant obstruction of the gastrointestinal tract. However, endoscopic stenting was developed recently, and technical advances and clinical experience have made it possible to establish stent implantation as one of the main treatment options. There are several advantages in stent implantation over bypass surgery, such as high feasibility and technical success rate, non-invasiveness, rapid symptomatic response, short hospitalization, and cost-effect benefits. Complications, such as stent ingrowth, stent injury by bile or acid, and migration, may occur and early re-insertion is frequently needed. Recently, diverse novel stents which are powered to predict stent migration or ingrowth have been developed and are being used in the clinical setting. In general, stent implantation is known to be beneficial in patients who are expected to survive <6 months, and surgical bypass may be more effective in patients who can survive >6 months. In this review, we have compared the technical feasibility, clinical outcomes, complications, and cost-benefit between stent implantation and bypass surgery, and determined the optimal treatment strategy in malignant upper gastrointestinal obstruction.

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Preservation of keratinized mucosa around implants using a prefabricated implant-retained stent: a case-control study

  • Kim, Chang-Soon;Duong, Hieu Pham;Park, Jung-Chul;Shin, Hyun-Seung
    • Journal of Periodontal and Implant Science
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    • v.46 no.5
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    • pp.329-336
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    • 2016
  • Purpose: The aim of this study was to clinically assess the impact of a prefabricated implant-retained stent clipped over healing abutments on the preservation of keratinized mucosa around implants after implant surgery, and to compare it with horizontal external mattress sutures. Methods: A total of 50 patients were enrolled in this study. In the test group, a prefabricated implant-retained stent was clipped on the healing abutment after implant surgery to replace the keratinized tissue bucco-apically. In the control group, horizontal external mattress sutures were applied instead of using a stent. After the surgical procedure, the width of the buccal keratinized mucosa was measured at the mesial, middle, and distal aspects of the healing abutment. The change in the width of the buccal keratinized mucosa was assessed at 1 and 3 months. Results: Healing was uneventful in both groups. The difference of width between baseline and 1 month was $-0.26{\pm}0.85mm$ in the test group, without any statistical significance (P=0.137). Meanwhile, the corresponding difference in the control group was $-0.74{\pm}0.73mm$ and it showed statistical significance (P<0.001). The difference of width between baseline and 3 months was $-0.57{\pm}0.97mm$ in the test group and $-0.86{\pm}0.71mm$ in the control group. These reductions were statistically significant (P<0.05); however, there was no difference between the 2 groups. Conclusions: Using a prefabricated implant-retained stent was shown to be effective in the preservation of the keratinized mucosa around implants and it was simple and straightforward in comparison to the horizontal external mattress suture technique.

Bronchoscopic Intervention for Airway Disease (기도질환 환자의 치료기관지경술)

  • Kim, Ho-Joong
    • Korean Journal of Bronchoesophagology
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    • v.14 no.2
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    • pp.10-16
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    • 2008
  • Surgical resection and reanastomosis has been the treatment of choice in patients with tracheobronchial stenosis. Recent development of bronchoscopic intervention has been replacing the role of surgery in these patients. After summarizing the upto date data of bronchoscopic intervention, the proper management of tracheobronchial stenosis will be presented. Bronchoscopic intervention would be much effective when performed under rigid bron- choscopy, due to the stable patients' condition and endoscopic view. The usual method of intervention includes ballooning, Nd-YAG laser resection, bougienation, mechanical airway dilatation, stenting and photodynamic therapy. Silicone stents are very effective in patients with tracheobronchial stenosis to maintain airway patency. Bronchoscopic intervention provided immediate symptomatic relief and improved lung function in most of patients. After airway stabilization, stents were removed successfully in 2/3 of the patients at a 12-18 months post-insertion. Less than 5% of patients eventually needs surgical management. Acute complications, including excessive bleeding, pneumothorax, and pneumomediastinum develops in less than 5% of patients but managed without mortality. Stent-related late complications, such as, migration, granuloma formation, mucostasis, and restenosis are relatively high but usually controlled by follow-up bronchoscopy. In conclusion, bronchoscopic intervention, including silicone stenting could be a useful and safe method for treating tracheobronchial stenosis.

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Intervention with Balloon Valvuloplasty followed by Patent Ductus Arteriosus Stent in a Patient with Pulmonary Atresia with Intact Ventricular Septum (풍선판막성형술과 동맥관 스텐트를 이용하여 치료한 심실중격결손을 동반하지 않은 폐동맥 폐쇄 1례)

  • Lim, Han Hyuk;Kim, Young Deuk;Lee, Jae Hwan;Chang, Mea Young;Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1256-1256
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    • 2005
  • Pulmonary atresia with intact ventricular septum (PAIVS) is rare, less than 1% of congenital heart disease. It needs a therapeutic approach according to its individual morphologic feature. Surgical treatment of valvotomy and modified Blalock-Taussig shunt or non-surgical interventional catheter balloon valvuloplasty can be used for mild to moderate hypoplasia of right ventricle. Fontan operation can be considered for less optimum morphological substrate of two ventricular repair. A 3-day-old male neonate was admitted with cyanosis and cardiac murmur. On echocardiogram, he had membranous pulmonary atresia with intact ventricular septum, normal sized tripartite right ventricle, large atrial septal defect with right-to-left shunt, small sized patent ductus arteriosus, and moderate tricuspid regurgitation. He was treated with intravenous continuous infusion of prostaglandin $E_1$ ($PGE_1$) at once. On the third day of hospitalization, Balloon valvuloplasty was performed. After insertion of patent ductus arteriosus stent on the tenth day, $PGE_1$ infusion was discontinued. On the fifteenth day, he was discharged. Now, he is 9 months old and has nearly normal cardiac structure and function with 97% of percutaneous oxygen saturation.

Endoscopic Intervention for Anastomotic Leakage After Gastrectomy

  • Ji Yoon Kim;Hyunsoo Chung
    • Journal of Gastric Cancer
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    • v.24 no.1
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    • pp.108-121
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    • 2024
  • Anastomotic leaks and fistulas are significant complications of gastric surgery that potentially lead to increased postoperative morbidity and mortality. Surgical intervention is reserved for cases with severe symptoms or hemodynamic instability; however, surgery carries a higher risk of complications. With advancements in endoscopic treatment options, endoscopic approaches have emerged as the primary choice for managing these complications. Endoscopic clipping is a traditional method comprising 2 main categories: through-the-scope clips and over-the-scope clips. Through-the-scope clips are user friendly and adaptable to various clinical scenarios, whereas over-the-scope clips can close larger defects. Another promising approach is endoscopic stent insertion, which has shown a high success rate for leak closure, although vigilant monitoring is required to monitor stent migration. Infection control is essential in post-surgical leakage cases, and endoscopic internal drainage provides a relatively safe and noninvasive means to manage fluids, contributing to infection control and wound healing promotion. Endoscopic suturing offers full-thickness wound closure, but requires additional training and endoscopic versatility. As a promising tool, endoscopic vacuum therapy potentially surpasses stent therapy by draining inflammatory materials and closing defects. Furthermore, the use of tissue sealants, such as fibrin glue and cyanoacrylate, has been reported to be effective in selected situations. The choice of endoscopic device should be tailored to individual cases and specific patient conditions, with careful consideration of the nature of the defect. Further extensive studies involving larger patient populations are required to provide more robust evidence on the efficacy of endoscopic approach in managing post-gastric anastomotic leaks.

Covered Self-expandable Metallic Stent Insertion as a Rescue Procedure for Postoperative Leakage after Primary Repair of Perforated Duodenal Ulcer (십이지장 궤양 천공 단순 봉합수술 후 완전 피막형 자가확장 금속 스텐트 삽입술로 치료된 봉합 부위 누출)

  • Yoo, Young Jin;Lee, Yong Kang;Lee, Joong Ho;Lee, Hyung Soon
    • The Korean Journal of Gastroenterology
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    • v.72 no.5
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    • pp.262-266
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    • 2018
  • Surgery has been the standard treatment for perforated duodenal ulcers, with mostly good results. However, the resolution of postoperative leakage after primary repair of perforated duodenal ulcer remains challenging. There are several choices for re-operation required in persistent leakage from perforated duodenal ulcers. However, many of these choices are complicated surgical procedures requiring prolonged general anesthesia that may increase the chances of morbidity and mortality. Several recent reports have demonstrated postoperative leakage after primary repair of a perforated duodenal ulcer treated with endoscopic insertion using a covered self-expandable metallic stent, with good clinical results. We report a case with postoperative leakage after primary repair of a perforated duodenal ulcer treated using a covered self-expandable metallic stent.