• Title/Summary/Keyword: Thrombotic occlusion

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Emergent Recanalization with Stenting for Acute Stroke due to Athero-Thrombotic Occlusion of the Cervical Internal Carotid Artery : A Single Center Experience

  • Choi, Jae Young;Lee, Jae Il;Lee, Tae Hong;Sung, Sang Min;Cho, Han Jin;Ko, Jun Kyeung
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.313-320
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    • 2014
  • Objective : The purpose of this study is to demonstrate the technical feasibility and clinical efficacy of emergent carotid angioplasty and stenting (CAS) for acute stroke due to athero-thrombotic occlusion of the cervical internal carotid artery (ICA). Methods : Review of medical records identified 17 patients who underwent emergent CAS for treatment of athero-thrombotic occlusion of the cervical ICA with acute stroke between 2009 and 2013. Eleven patients (64.7%) presented with concomitant intracranial artery occlusion, which was treated primarily by mechanical thrombectomy after CAS. Results : Successful revascularization of the cervical ICA with emergent CAS was achieved in all patients. After CAS, intracranial recanalization with Thrombolysis in Cerebral Infarction ${\geq}2b$ flow was achieved in four of the 11 patients (36.4%). The overall recanalization rate (cervical ICA and intracranial artery) was 10 of 17 patients (58.8%). Symptomatic intracranial hemorrhage occurred in two patients (11.8%), resulting in death. Ten patients (58.8%) showed improvement (decrease in NIHSS score of ${\geq}4$ points) at seven days after recanalization. Nine patients (52.9%) showed a favorable outcome ($mRS{\leq}2$) at the last follow-up. A favorable outcome ($mRS{\leq}2$) was obtained in four of the six patients with isolated cervical ICA occlusion (4/6, 66.7%) and five of 11 patients with intracranial tandem occlusion (5/11, 45.5%). Conclusion : Emergent CAS for acute stroke due to athero-thrombotic occusion of the cervical ICA showed a good technical feasibility and favorable clinical outcome.

A Case of a Patient with Pain & Cold sensation in the Left Upper Segment due to Thrombotic Occlusion of Lt. Brachial Artery (혈전색전증으로 인한 좌상지의 통증 및 냉감을 호소하는 환자 치험 1례)

  • Yang, Jung-yun;Park, Min-jeong;Lee, Mi-rim;Mun, Sang-Kwan;Jung, Woo-sang;Kwon, Seung-won;Cho, Ki-ho
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.18 no.1
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    • pp.23-29
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    • 2017
  • A case of a 47-year-old male patient with Lt.hand pain & cold sensation due to Thrombotic occlusion of Lt. brachial a. is presented. He was treated with acupuncture, electroacupuncture and herbal medicine - 桂枝茯苓丸(Gyejibongnyeong-hwan, Keishibukuryo-gan). We used NRS of pain and Digital Infrared Thermal Image(DITI) to evaluate the progress. After 11days of treatment, there were notable improvement in pain scale, DITI. Korean medical treatment may be effective in treating thrombotic occlusion.

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Acute Thrombotic Occlusion of Left Internal Jugular Vein Compressed by Bypass Graft for Thoracic Endovascular Aortic Repair Debranching Procedure

  • Sim, Hyung Tae;Beom, Min Sun;Kim, Sung Ryong;Ryu, Sang Wan
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.552-555
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    • 2014
  • Thoracic endovascular aortic repair has become a widespread alternative treatment option for thoracic aortic aneurysm. The debranching of arch vessels may be required to provide an acceptable landing zone for an endovascular stent graft. We report a case where the bypass graft used in the thoracic endovascular aortic repair procedure compressed the left internal jugular vein, causing acute thrombotic occlusion.

Invention of the Guide Catheter Irrigation Monitoring Device for Neuroendovascular Therapy

  • Ozkul, Ayca;Park, Jong-Hyun;Shin, Dong-Seung;Yilmaz, Ali;Kim, Bum-Tae
    • Journal of Korean Neurosurgical Society
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    • v.60 no.4
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    • pp.471-474
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    • 2017
  • Objective : The thromboembolic events during neuroendovascular therapy (NET) are the major complications of concern that can be occasionally fatal. The thrombotic occlusion of the guide catheter for NET is thought to be the risk of the thromboembolic events. We have developed an idea for inventing the monitoring system of the continuous irrigation through the guide catheter. We herein present a unique invention of the guide catheter irrigation monitoring device. Methods : We have developed ideas for preventing the thrombotic occlusion of the guide catheter. In order to design a convenient device working in the practical use, we have consulted and shared the ideas with the electrical engineers about putting the invention. Results : The guide catheter irrigation monitoring device (GCIMD) consisted of three parts of optical sensor, main body and electric adapter. In brief, the basic principles of working of the GCIMD are as follows. The optical sensor is attached to the dripping chamber of the line to irrigation solution. The main body had the small light and speaker to make an alarm sounds. The sensor monitors the dripping of flush solution. If the dripping stops more than three seconds, a warning alarm has been activated. So, the operating physicians can concentrate and check the guide catheter irrigation. After the use of the GCIMD, there was no major thromboembolic complication in conjunction with the thrombotic occlusion of the guide catheter in our institute. Conclusion : We have developed a brilliant invention of the GCIMD for NET.

Safety and Efficacy of the Percutaneous Manual Aspiration Thrombectomy Technique to Treat Thrombotic Occlusion of Native Arteriovenous Fistulas for Hemodialysis (혈액투석용 자가혈관 동정맥루의 혈전을 동반한 폐색에서 경피적 수동 흡인 혈전제거술의 안정성과 유용성)

  • Sang Eun Yoon;Sun Young Choi;Soo Buem Cho
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.409-417
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    • 2020
  • Purpose To evaluate the safety and efficacy of the percutaneous manual aspiration thrombectomy technique to treat thrombotic occlusion of native arteriovenous fistulas. Materials and Methods A retrospective review of 20 patients who underwent percutaneous manual aspiration thrombectomy for native thrombotic arteriovenous fistula occlusion from March 2012 to December 2017 was performed. We evaluated technical and clinical success rates and complications. The primary and secondary patency rates were calculated using the Kaplan-Meier analysis. Results Percutaneous manual aspiration thrombectomy was performed in 20 patients (n = 20) with concomitant balloon angioplasty. The overall technical and clinical success rates were both 85% (n = 17). The native arteriovenous fistulas, based on their site, were the left radiocephalic (n = 13), left brachiocephalic (n = 4), and right radiocephalic (n = 3) fistulas. An underlying stenosis was detected in the juxta-anastomotic venous site (n = 16), outflow draining vein (n = 12), and central vein (n = 4). The primary and secondary patency rates at 1, 3, 6, and 12 months were 100%, 70.6%, 70.6%, and 56.5% and 100%, 94.1%, 94.1%, and 86.9%, respectively. There were no complications associated with procedure. Conclusion Percutaneous manual aspiration thrombectomy is a safe and effective method to treat thrombotic native arteriovenous fistula occlusion.

Lower limb ischemia after bee sting

  • Ryu, Hee Yun;Yoo, Min Seok;Park, Ji Young;Choi, Jae Woong;Ryu, Sung Kee;Kim, Seunghwan;Lee, Se Jin;Kim, Young Bin
    • Journal of Yeungnam Medical Science
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    • v.33 no.2
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    • pp.134-137
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    • 2016
  • Bee sting causes mild symptoms such as urticaria and localized pain, and severe symptoms including anaphylaxis, cardiovascular collapse, and death. We reported on a patient with arterial thrombotic occlusion and severe ischemia in the lower limb after multiple bee stings. The patient was stung 5 times and complained of pallor, pain, and coldness in the left toe, and did not have dorsalis pedis pulsation. Computed tomography angiography showed multiple thrombotic occlusion of the anterior and posterial tibial artery below the knee. Local thrombolytic therapy using urokinase was administered and the occluded arteries were successfully recanalized.

Subclavian Vein Thrombotic Occlusion Secondary to Hemodialysis Catheterization (혈액투석 카테터에 의한 쇄골하정맥 혈전성 폐쇄증의 수술치험 1례)

  • Kim, Kwan-Mien;Chee, Hyun-Keun;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.28 no.1
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    • pp.73-77
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    • 1995
  • We are reporting one case of right subclavian vein thrombotic occlusion as a result of previous hemodialysis catheter placement in a patient with a functioning right brachio-cephalic arteriovenous fistula. Its complication was painful right arm swelling, limitation of motion and cellulitis. Diagnosis was confirmed by right subclavian venography and the complication was successfully managed by right subclavian vein-superior vena cava bypass with a GoreTex vascular graft. The arteriovenous fistula had remained to protect patency of the bypass at first, but two months later after the operation, the arteriovenous fistula had to be occluded because of the heart failure resulting from shunt over flow. After ligation of arteriovenous fistula, heart failure improved, and uncomfortable arm swelling did not develop again.

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Comparison of Clinical Outcomes in Patients Undergoing a Salvage Procedure for Thrombosed Hemodialysis Arteriovenous Grafts

  • Park, You Kyeong;Lim, Jae Woong;Choi, Chang Woo;Her, Keun;Shin, Hwa Kyun;Shinn, Sung Ho
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.500-508
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    • 2021
  • Background: The major limitation of arteriovenous graft access is the high incidence of thrombotic occlusion. This study investigated the outcomes of our salvage strategy for thrombosed hemodialysis arteriovenous grafts (including surgical thrombectomy with balloon angioplasty) and evaluated the efficacy of intragraft curettage. Methods: Salvage operations were performed for 290 thrombotic occluded arteriovenous grafts with clinical stenotic lesions from 2010 to 2018. Of these, 117 grafts received surgical thrombectomy and balloon angioplasty from 2010 to 2012 (group A), and 173 grafts received surgical thrombectomy and balloon angioplasty, with an additional salvage procedure using a curette and a graft thrombectomy catheter, from 2013 to 2018 (group B). Outcomes were described in terms of post-intervention primary patency and secondary patency rates. Results: The post-intervention primary patency rates in groups A and B were 44.2% and 66.1% at 6 months and 23.0% and 38.3% at 12 months, respectively (p=0.003). The post-intervention secondary patency rates were 87.6% and 92.6% at 6 months and 79.7% and 85.0% at 12 months, respectively (p=0.623). Multivariate Cox regression analysis demonstrated that intragraft curettage was a positive predictor of post-intervention primary patency (hazard ratio, 0.700; 95% confidence interval, 0.519-0.943; p=0.019). Conclusion: Surgical thrombectomy and balloon angioplasty showed acceptable outcomes concerning post-intervention primary and secondary patency rates. Additionally, intragraft curettage may offer better patency to salvage thrombotic occluded arteriovenous grafts with intragraft stenosis.

Screening of Anti-thrombotic Activity of Herbal Extracts in Ferric Chloride-induced Thrombosis Model (경동맥 혈전 유발 동물모델을 이용한 한약재 추출물의 효능 검색)

  • Park, In Sil;Lee, Ki Mo;Lee, In Sun;Han, Jae Il;Jeon, Won Kyung
    • The Korea Journal of Herbology
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    • v.28 no.5
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    • pp.33-38
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    • 2013
  • Objectives : The aim of this study was to examine anti-thrombotic effect of traditional herbal extracts in a rat model of ferric chloride ($FeCl_3$)-induced carotid arterial thrombosis. Methods : Thirty minutes prior to a 35% $FeCl_3$ application, Sprague Dawley(SD) rats were injected with the 10 types of traditional herbal extracts (100mg/kg, intraperitoneal injection), respectively. The effect of these herbal extracts was examined for time to occlusion(TTO) using the Laser doppler flow meter and measured for thrombus weight (TW) in $FeCl_3$-induced thrombosis model. Results : In the TTO, Salvia miltiorrhiza (Sm, $2.30{\pm}0.28$ min, p<0.001) and Santalum album (Sa, $2.19{\pm}0.19$ min, p<0.001) showed significantly delayed TTO more than twice compared with Saline-treated group. Cnidium officinale (Co), Psoralea corylifolia (Pc), Scutellatia baicalensis (Sba), Panax notoginseng (Pn), Angelica tenuissima (At), Scrophularia buergeriana (Sbu), Rhus verniciflua (Rv) and Picrasma quassioides (Pq), except for Rhus verniciflua (Rv) also meaningfully impeded TTO more than one fold. In addition, Salvia miltiorrhiza, Santalum album, Cnidium officinale, Psoralea corylifolia and Scutellatia baicalensis significantly reduced TW more than 10% compared with Saline-treated group. Especially, Salvia miltiorrhiza and Santalum album showed the most excellent anti-thrombotic effect among the 10 herbal extracts tested on the restoration of altered TTO and TW. Conclusions : These results suggest that Sm and Sa extracts have outstanding anti-thrombotic effect in $FeCl_3$-induced thrombosis model and is potentially useful as herbal medicines for the treatment and prevention of thrombosis.

Bilateral Persistent Sciatic Arteries Complicated with Aneurysmal Dilatation and Thrombotic Occlusion: A Case Report (동맥류와 혈전성 폐색이 동반된 양측 잔류좌골동맥: 증례 보고)

  • Seo Jin Jang;Yoonhee Han;Jae Hyun Kwon
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1517-1522
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    • 2020
  • Persistent sciatic artery (PSA), a rare congenital vascular anomaly, increases susceptibility to aneurysms and accounts for 40-61% of the cases. Here, we describe a case of PSA in a 70-yearold man with a history of alcoholic liver cirrhosis. Bilateral complete PSAs were detected incidentally on computed tomography angiography during evaluation for spontaneous intramuscular bleeding in the thigh due to cirrhosis-related coagulopathy. Selective angiography of the left PSA revealed aneurysmal dilatation and thrombotic occlusion of the PSA, which was partially removed with aspiration thrombectomy. Intramuscular bleeding was succesfully managed with empirical embolization of the deep femoral artery.