• Title/Summary/Keyword: Transluminal angioplasty

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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.

Preventive Effect of Traditional Korean Formulations on Intimal Thickening of Rat Carotid Artery Injured by Balloon Catheter

  • Kim, Seong Bin;Paudel, Keshav Raj;Kim, Dong Wook
    • Korean Journal of Plant Resources
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    • v.26 no.6
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    • pp.678-685
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    • 2013
  • The objective of this study was to examine the effect of 7 traditional Korean formulations (7TKFs) on intimal thickening of rat carotid artery injured by balloon catheter in vivo and on the proliferation of human smooth muscle cells (HASMCs) and secretion of matrix metalloproteinase-2 (MMP-2) in vitro. 7TKFs (400 mg/kg) were administered orally for 4 weeks from the day of balloon injury in the rats. HASMC proliferation was assessed by 3-(4,5-dimethylthiazol-2)-2,5-diphenyltetrazolium bromide (MTT) assay while enzymatic action of MMP-2 was carried out by gelatin zymography. Among 7TKFs, Samhwang-sasim-tang (SST), Banha-sasim-tang (BST) and Kegi-honghwa-tang (KHT) significantly reduced the intimal thickening by suppressing HASMC proliferation and MMP-2 expression in both extracellular and intracellular levels. Thus, the results suggest that SST, BST and KHT can be considered as a therapeutic value in the prevention of atherosclerosis because restenosis after PTCA (percutaneous transluminal coronary angioplasty) is supposed to be 'accelerated atherosclerosis'.

Early Clinical Result of Coronary Artery Bypass Surgery for Ischemic Heart Diaseas (허혈성심장질환의 치료에서 관상동맥 우회술의 조기성적;53례의 임상적 결과)

  • 최종범
    • Journal of Chest Surgery
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    • v.26 no.4
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    • pp.271-275
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    • 1993
  • In this country, the number of patients with coronary artery disease is progressively increasing with the change of life style and improvement of the diagnostic procedures. In addition, the medically invasive procedure for treating ischemic heart disease was rapidly developed and the surgical patients have more complex and multiple lesions and more surgical risks. Fifty three patients with ischemic heart disease underwent coronary bypass grafting [CABG] for recent 24 months. Twenty patients had three-vessel disease, 17 patients two-vessel disease, and 2 patients single-vessel disease. The average number of distal anastomoses was 3.3 per patient with the range of I to 6 grafts. Forty-one patients [77.4 %] had preoperative left ventricular ejection fraction of 50 % or more and 14 patients[26.4%] had a significant left main coronary lesion. Saphenous vein grafts were employed in 52/53 patients [98.1%] and internal mammary grafts, which were anastomosed to left anterior descending artery, in 38/53 patients[71.7%]. Two patients, whom percutaneous transluminal coronary angioplasty failed for, underwent emergency CABG with only saphenous vein grafts and both patients survived.The hospital mortality was 1.9 % and there was no late death. Perioperative myocardial infarction occurred in 1.9%. All survivors were asymptomatic[in 83% of the patients] and/or improved over their preoperative status. Twenty-nine patients were included in blood conservation group and 21 patients [72.4 %] underwent CABG without any homologous blood transfusion. Our early result of coronary bypass grafting was comparable to that which was reported in other coronary surgery units.

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"On-Pump" CABG on the Beating Heart - Two case report - (심폐바이패스하의 심박동상태에서 시행한 관상동맥우회로술)

  • 신종목;김기봉
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.480-483
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    • 1999
  • The widely accepted method for coronary artery bypass grafting(CABG) is performing the distal coronary artery anastomoses on the flaccid and nonbeating heart with the aid of cardiopulmonary bypass(CPB) and cardioplegic arrest. However, current cardioplegic techniques are not consistent in avoiding myocardial ischemic damages especially in high risk patients undergoing CABG. In this regard, "Off-Pump" seems to be an ideal method for preventing myocardial ischemic damage and adverse effects during CPB. However, "Off-pump" CABG is not always technically feasible. We report 2 cases of "On-pump" CABG performed on the beating heart in high risk patients; The first patient had left ventricular dysfunction(Ejection Fraction=25%), and the second patient had cardiogenic shock after percutaneous transluminal coronary angioplasty.

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A Study on the Effects of Percutaneous Transluminal Coronary Angioplasty and Pediatric Heart Surgery on the Differences of Risk-Adjusted Length of Stay and In-Hospital Death for Coronary Artery Bypass Graft Patients (관상동맥우회로술(CABG)환자의 재원일수와 병원 내 사망률 변이에 대한 경피적관상동맥성형술(PTCA)과 소아심장수술(PHS)의 영향분석)

  • Kim, Da-Yang;Lee, Kwang-Soo
    • The Korean Journal of Health Service Management
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    • v.8 no.4
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    • pp.47-55
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    • 2014
  • The purpose of this study was to analyze the differences in the outcome for CABG according to whether hospitals provided heart related surgeries. The 2011 National Inpatient Sample (NIS) and inpatient quality indicator principles from the Healthcare Research and Quality (AHRQ) were used for analysis. Hospitals were divided into three groups according to the surgeries they provided. The length of stay and in-hospital deaths were adjusted for the differences in risks. ANOVA was performed to examine the differences for the risk-adjusted in-hospital mortality rate and risk-adjusted length of stay among the three groups. The analysis results showed that hospitals providing CABG, PTCA, and PHS had lower risk-adjusted in-hospital mortality rates or similar risk-adjusted lengths of stay compared to those of hospitals providing only CABG. However, the three groups did not have statistically significant differences in outcome indicators. Another study will be needed with a larger sample.

Superior Vena Cava Syndrome Without Thrombosis Found in Behcet's Disease

  • Kim, Hyun-Soo;Kim, Hyung-Jun;Hur, Ki-Hwan;Kim, Kyung-Rok;Choi, Jae-Won;Kang, Dong-Woo
    • Journal of Yeungnam Medical Science
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    • v.29 no.1
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    • pp.38-41
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    • 2012
  • Behcet's disease is a rare multisystemic disorder whose main pathological defectis vasculitis, and superior vena cava (SVC) syndrome without thrombosis is a very rare manifestation of the disease. These authors encountered a case of SVC syndrome without thrombosis caused by Behcet's disease. A 33-year-old man visited the hospital for aggravated dyspnea without any related medical and familial history. He had a threeday history of abrupt swelling of the face, neck, and right arm. He suffered from recurrent oral ulcer, and there were acneiform nodules on his face as well as redness and swelling at the site of the intravenous injection. On the multi-detected computed tomography (CT) chest angiograms (chest angio MDCT), the SVC narrowed without thrombosis. Venogram was carried out, and percutaneous transluminal balloon angioplasty of the SVC stenotic site was performed. The following day, the swelling was found to have subsided. The details of the case are reported herein.

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A Case of Renovascular Hypertension Controlled by Renal Artery Embolization (신동맥 색전술로 치료한 신혈관 고혈압증 1례)

  • Yew, Jung Hun;Kim, Young Deuk;Shin, Byung Seok;Gil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.212-215
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    • 2005
  • Renal artery stenosis is a major cause of renovascular hypertension and the most common cause of treatable secondary hypertension. There are several methods to treat renal artery stenosis, including surgery, percutaneous transluminal renal angioplasty(PTRA), and renal artery stenting(RAS). But, renal artery embolization can be tried in atherosclerotic stenosis, multiple stenosis, microaneurysm, and stenosis difficult to try PTRA or RAS. We report a case of renovascular hypertension in a 14-year-old female who had multiple segmental renal artery stenosis. Hypertension was controlled by renal ablation therapy with renal artery embolization.

Complications amd Mortality After Coronary Artery Bypass Graft Surgery; Collective Review of 61 Cases (관상동맥우회수술후 합병증과 사망율에 대한 임상적 고찰;61례 보고)

  • 조건현
    • Journal of Chest Surgery
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    • v.26 no.7
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    • pp.526-531
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    • 1993
  • Sixty-one consecutive patients with coronary artery bypass graft for myocardial revascularization were retrospectively reviewed to analyze various pattern of postoperative complication and death during hospital stay from Nov. 1988 to Oct. 1992. Fortytwo of the patients were male and nineteen female. The mean age was 56 and 51 years in male and female. Preoperative diagnosises were unstable angina in 14 of patients, stable angina in 28, postmyocardial infarction state in 15, and state of failed percutaneous transluminal coronary angioplasty in 4. 141 stenosed coronary arteries were bypassed with use of 20 pedicled internal mammary artery and 124 reversed saphenous vein grafts. Postoperative complications and perioperative death were as follows: 1. Of 61 patients undergoing operation, peri and postoperative over all complication occured in 15 patients [ 25% ]; newly developed myocardial infarction in 4, intractable cardiac arrhythmia including atrial fibrillation and frequent ventricular premature contraction in 3, bleeding from gastrointestinal tract in 2, persistent vegetative state as a sequele of brain hypoxia in 1, wound necrosis in 1, left hemidiaphragmatic palsy in 3 and poor blood flow through graft in 2. 2. Operative mortality was 8%[5 patients]. 3 out of these died in operating room; 1 patient by bleeding from rupture of calcified aortic wall, 1 by air embolism through left atrial vent catheter, 1 by low cardiac output syndrome. 2 patients died during hospital stay; 1 by acute respiratory distress syndrome with multiuple organ failure, 1 by brain death after delayed diagnosis of pericardial tamponade.

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Femoral Endarteritis as a Complication of Percutaneous Suture Closure Device -A case report- (경피적 혈관봉합술 후 발생한 대퇴동맥 내막염 -1예 보고-)

  • Hong, Joon-Hwa;Choi, Jin-Wook;Moon, Jong-Hwan;Soh, Dong-Moon
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.864-867
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    • 2006
  • Percutaneous suture closure device is known as relatively safe and convenient tool, which can decrease not only bed rest period of patient but also time consuming effort of manual compression of doctor after femoral artery puncture. However[C1], there are also some reports on complication of its use. We report a 62-year-old male patient who had femoral artery endarteritis[0] with pseudoaneurysm as a complication of percutaneous suture closure device after percutaneous coronary angiography[C2]. He was treated successfully by appropriate antibiotics and vessel reconstruction using autologous saphenous vein patch.

Factors associated with delay in reperfusion therapy in patients with acute myocardial infarction (급성심근경색 환자에서 재관류 치료 지연율과 그에 관련된 요인)

  • Kim, Yoon;Koh, Bong-Yeun
    • Health Policy and Management
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    • v.13 no.4
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    • pp.115-130
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    • 2003
  • Reperfusion delay in patients with acute myocardial infarction leads to increased morbidity and mortality. We sought to measure the rates of reperfusion delay and to identify factors associated with reperfusion delay after arrival to hospitals. We included 360 patients who had acute myocardial infarction with ST-elevation or left bundle branch block on electrocardiogram and received reperfusion therapy from the three participating academic medical centers from 1997 to 2000. Through retrospective chart review, we collected data about time to reperfusion therapy, patient and hospital factors potentially associated with reperfusion delay. Factors independently associated with reperfusion delay were determined by logistic regression analysis. Median door­to­needle time was 60.0 minutes, and median door­to­balloon time was 102.5 minutes. According to recommendation of the American College of Cardiology/American Heart Association Guidelines, 226 out of 264(85.6%) of thrombolytic patients and 43 out of 96(44.8%) percutaneous transluminal coronary angioplasty(PTCA) patients experienced reperfusion delay. The significant factors associated with delay were type of reperfusion therapy, patient factors including hypertension and delayed symptom onset to presentation(>4 hours), and hospital factors including nocturnal presentation(6pm∼8am), weekend, and an individual hospital. A significant proportion of patients experienced reperfusion delay. The identified predictors of reperfusion delay may help design a hospital system to reduce the delay in reperfusion therapy