• 대한수의학회지
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• 제48권4호
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• pp.493-500
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• 2008

A 2-year-old female Pekingese dog was presented with primary complaints including exercise intolerance and neurological sign associated with hepatic encephalopathy. The major findings in clinical examination included an intermittent seizure, a slow heart rate with pulse deficit, leukocytosis and anemia in hemogram, elevated pre- and post-prandial serum bile acid and hepatic enzymes, hypoproteinemia, coagulopathy, ammonium urate crystaluria and bilirubinuria. Diagnostic tests revealed an intrahepatic portosystemic shunt complicated with a second degree atrioventricular block and QT prolongation. The case was successfully treated with a transvenous coil embolization. Clinical signs were gradually improved and cardiac bradyarrhythmia disappeared. This case is a rare case of intrahepatic portosystemic shunts complicated with a cardiac bradyarrhythmia in a small breed dog fixed by a transvenous coil embolization.

• 한국임상수의학회지
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• 제24권3호
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• pp.426-431
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• 2007

5개월령 암컷 샤모에드종 개가 운동 불내성과 간성뇌증과 관련된 신경증상으로 내원하였다. 임상검사상 간헐적 발작, 빈혈, 식전/식후 담즙산 농도 상승, 저단백혈증 및 빌리루빈뇨증이 관찰되었다. 진단영상검사에서 간내 문정맥 문합이 확인되었다. 문합이 일어난 문맥혈관을 경정맥을 통한 embolization coil을 이용하여 성공적으로 폐색시켰다. 환자의 임상증상은 점진적으로 개선되었다. 본 증례는 대형품종 개에서 발생한 간내 문정맥 문합을 embolization coil을 이용하여 성공적으로 치료한 증례이다.

• Journal of Korean Neurosurgical Society
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• 제55권2호
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• pp.92-95
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• 2014

Ehlers-Danlos syndrome (EDS) is a rare inherited connective disease. Among several subgroups, type IV EDS is frequently associated with spontaneous catastrophic bleeding from a vascular fragility. We report on a case of carotid-cavernous fistula (CCF) in a patient with type IV EDS. A 46-year-old female presented with an ophthalmoplegia and chemosis in the right eye. Subsequently, seizure and cerebral infarction with micro-bleeds occurred. CCF was completely occluded with transvenous coil embolization without complications. Thereafter, the patient was completely recovered. Transvenous coil embolization can be a good treatment of choice for spontaneous CCF with type IV EDS. However, every caution should be kept during invasive procedure.

• 대한두개안면성형외과학회지
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• 제11권2호
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• pp.116-119
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• 2010

Purpose: Arteriovenous fistulas that involve the cavernous sinus often produce ophthalmologic symptoms and signs. Transvenous endovascular access is the method of choice for a carotid-cavernous sinus fistula. The superior ophthalmic vein is a safe and reasonable alternative route for the transvenous embolization of carotid-cavernous sinus fistula. We report a case of the embolization of a carotid-cavernous sinus fistula using the superior ophthalmic vein approach. Methods: A 58 year old female had conjunctival congestion, periocular pain and diplopia with a 2 month duration. Diagnostic orbital CT, brain MRI and cerebral angiography revealed a carotid-cavernous sinus fistula. The fistula occlusion was treated by coil embolization using the superior ophthalmic vein approach. Results: The initial presenting symptoms, conjunctival congestion, periocular pain and diplopia, decreased after surgery. Coil embolization via the superior ophthalmic vein approach was difficult because of the venous tortuosity and friability. During the follow up period, the patient was in a good condition without complications. Conclusion: Surgical exposure of the superior ophthalmic vein provides direct venous access to the cavernous sinus as well as an effective and safe treatment approach. The cooperation of the plastic surgeon and interventionist is a factor in successful treatment.

• 대한수의학회지
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• 제47권4호
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• pp.461-467
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• 2007

A 6-year-old female Maltese dog (body weight 2.0 kg) was referred to the Veterinary Teaching Hospital, Kangwon National University with primary complaints including exercise intolerance and heart murmur. Based on clinical and diagnostic findings including grade V/VI left basal continuous murmur, bounding femoral pulsation, left ventricular enlargement pattern in electrocardiogram, cardiomegaly with aortic bulging on the thoracic radiography, and shunt flow between aorta and pulmonary artery on the echocardiography, the dog was diagnosed as the left-to-right patent ductus arteriosus. The patent ductus arteriosus was successfully treated by lodging a single embolization coil with transjugular approach.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2007년도 추계국제학술대회 및 컨퍼런스
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• pp.574-574
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• 2007

• Journal of Korean Neurosurgical Society
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• 제65권5호
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• pp.688-696
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• 2022

Objective : Transvenous embolization (TVE) via an occluded inferior petrosal sinus (IPS) in a cavernous sinus dural arteriovenous fistula (CSDAVF) is challenging, often requiring navigation of a microcatheter through resistive obstacles between the occluded IPS and shunted pouch (SP), although the reopening technique was successfully performed. We report five cases of successful access to the cavernous sinus (CS) or SP using the rigid-tipped microguidewire such as chronic total occlusion (CTO) wire aiming to share our initial experience with this wire. Methods : In this retrospective study, four patients with CSDAVF underwent five procedures using the CTO wire puncture during transfemoral transvenous coil embolization. Puncture success, shunt occlusion, and complications including any hemorrhage and cranial nerve palsy were evaluated. Results : Despite successful access through the occluded IPS, further entry into the target area using neurointerventional devices was impossible due to a short-segment stricture before the CS (three cases) and a membranous barrier within the CS (two cases). However, puncturing these structures using the rigid-tipped microguidewire was successful in all cases. We could advance the microcatheter over the rigid-tipped microguidewire for the navigation to the SP and achieved complete occlusion of the SP without complications. Conclusion : The use of the rigid-tipped microguidewire in the TVE via the occluded IPS of the CSDAVF would be feasible and safe.

• 대한영상의학회지
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• 제81권1호
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• pp.231-236
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• 2020

십이지장 정맥류는 간경화증에 의한 문맥압 고혈압 환자에서 발생할 수 있으며, 치명적인 심한 상부 위장관 출혈을 일으킬 수 있으나 아직까지 명확한 치료 지침이 정립되어 있지는 않다. 일차적으로 내시경으로 치료를 시도하고 지혈 실패 시 목정맥경유간속문맥전신순환연결술, 풍선 혹은 혈관 마개를 이용한 역행성 경정맥 폐색술, 피부간경유 폐색술 등과 같은 중재적 치료를 고려할 수 있다. 저자들은 내시경적 치료에 실패한 십이지장 정맥류 출혈 환자에게 저하된 간 기능과 해부학적인 구조의 제한으로 인해 코일을 이용한 역행성 경정맥 폐색술을 시행하여 성공적으로 치료한 1예를 경험하였기에 이를 보고하고자 한다.

• Journal of Korean Neurosurgical Society
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• 제50권2호
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• pp.126-129
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• 2011

Bilateral traumatic carotid-cavernous fistulae (TCCFs) is rarely encountered neurovascular disease. For treatment of TCCF, detachable balloons have been widely used. Nowadays, transarterial and/or transvenous coil embolization with placement of covered stents is adopted as another treatment method. We experienced a patient with a bilateral TCCFs who was successfully treated with covered stents. However, cerebral hemorrhage occurred in the bed of previous infarction one day after treatment. Hyperperfusion syndrome was considered as a possible cause of the hemorrhage, so that barbiturate coma therapy was started and progression of hemorrhage was stopped. We emphasize that cerebral hyperperfusion hemorrhage can occur even after successful endovascular treatment of TCCF.

• 한국임상수의학회지
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• 제27권6호
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• pp.740-745
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• 2010

동맥관개존증은 출생 후에도 폐동맥과 하행대동맥 사이에 동맥관이 지속적으로 열려 있는 선천성 심장질환이다. 동맥관개존증은 외과적인 결찰술로 폐쇄할 수 있지만, 다양한 도구를 이용한 동맥관개존증의 중재적 치료술은 비침습적인 치료과정과 시술 후 관리의 최소화의 이유로 빠르게 대체되고 있다. 소형품종에서의 중재적인 치료술은 동맥의 크기가 작기 때문에 혈관으로의 접근성이 주요한 문제점이 된다. 비록 경정맥을 이용한 정맥 접근법이 개발되었으나 이 기술은 동맥관에 폐색장치를 장착시키기 위해서 숙달된 기술이 필요하며, 폐색 장치 (색전 코일이나 혈관폐색장치)가 예기치 않게 잘못 장착될 위험성을 가지고 있다. 따라서, 우리는 이번 연구에서 소형품종 (체중3 kg미만)에서 대퇴동맥 접근을 통한 미니 혈관카테타를 이용한 변형된 코일 색전법을 개발하였다. 이러한 변형된 방법을 통하여 우리는 좌우 단락된 동맥관개존증을 가진 두마리의 소형품종 (말티즈)을 성공적으로 치료하였다.