• Title/Summary/Keyword: Y-Stent

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Endovascular Stent Placement in a Patient with a Posttraumatic Isolated Superior Mesenteric Artery Dissection with Focally Progressing Dissecting Aneurysms and a Severely Compressed True Lumen (외상 후 단독 상장간막동맥박리 후에 국소적으로 진행된 박리성 동맥류와 심한 진강의 압박이 있는 환자에서 혈관내 스텐트설치술 1례)

  • Kim, Young-Kyu;Her, Kyu Hee;Kim, Seung Hyoung;Kim, Kwangsik
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.266-271
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    • 2015
  • Reports on a posttraumatic isolated superior mesenteric artery (SMA) dissection are rare. Recently, endovascular stent placement via percutaneous access, instead of vascular surgery, has been widely accepted as the initial treatment for a patient with an isolated SMA dissection or its complications. A 60-year-old female patient was transferred to our hospital due to an isolated SMA dissection after a car accident. The SMA dissection was 8.5 cm in length, and it involved the true lumen, which was severely compressed by the thrombosed false lumen. The patient was closely observed because she did not complain of any specific visceral pain. On the seventh hospital day, she underwent computed tomography (CT) to decide on a further treatment plan, irrespective of the presence of the abdominal symptom. The findings of the follow-up CT showed no difference compared to those of the previous CT. She was discharged with anti-coagulants. One month later, the follow-up CT revealed focally progressing dissecting aneurysms in the false lumen of the dissected SMA and a more severely compressed true lumen. Two self-expandable metallic stents were successfully placed in the true lumen of the dissected SMA, covering two aneurysmal lesions. Herein, we report a successful endovascular treatment with stent placement for treating focally progressing dissecting aneurysms and a severely compressed true lumen in a patient with a posttraumatic isolated SMA dissection.

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Urgent Recanalization with Stenting for Severe Intracranial Atherosclerosis after Transient Ischemic Attack or Minor Stroke

  • Park, Tae-Sik;Choi, Beom-Jin;Lee, Tae-Hong;Song, Joon-Suk;Lee, Dong-Youl;Sung, Sang-Min
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.322-326
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    • 2011
  • Objective : Stenting of symptomatic intracranial stenosis has recently become an alternative treatment modality. However, urgent intracranial stenting in patients with intracranial stenosis following a transient ischemic attack (TIA) or minor stroke is open to dispute. We sought to assess the feasibility, safety, and effectiveness of urgent intracranial stenting for severe stenosis (>70%) in TIA or minor stroke patients. Methods : Between June 2009 and October 2010, stent-assisted angioplasty by using a balloon-expandable coronary stent for intracranial severe stenosis (>70%) was performed in 7 patients after TIA and 5 patients after minor stroke (14 stenotic lesions). Technical success rates, complications, angiographic findings, and clinical outcomes were retrospectively analyzed. Results : Stenting was successful in all 12 patients. The mean time from symptom onset to stenting was 2.1 days (1-8 days). Post-procedural angiography showed restoration to a normal luminal diameter in all patients. In-stent thrombosis occurred in one patient (n=1, 8.3%), and was lysed with abciximab. No device-related complications, such as perforations or dissections at the target arteries or intracranial hemorrhaging, occurred in any patient. The mortality rate was 0%. No patient had an ischemic event over the mean follow-up period of 12.5 months (range, 7-21 months), and follow-up angiography (n=7) revealed no significant in-stent restenosis (>50%). Conclusion : Urgent recanalization with stenting is feasible, safe, and effective in patients with TIA or acute minor stroke with intracranial stenosis of ${\geq}$ 70%.

A Case of Idiopathic Tracheal Stenosis Treated with Tracheal Resection After a Retrievable Stent Insertion (스텐트 삽입술 후 수술적 절제술로 치료한 특발성 기관 협착증 1예)

  • Lee, Hyoung-No;Cho, Hye-Jin;Lee, Jong-Woo;Shin, Seung-Soo;Oh, Yoon-Jung;Park, Kwang-Joo;Hwang, Sung-Chul;Choi, Ho;Lee, Ki-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.450-456
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    • 2002
  • Idiopathic tracheal stenosis is a type of benign stenosis that possesses specific characteristics but is of unknown origin. It is a rare disease characterized by extensive fibrosis of a portion of trachea, and predominantly found in women. The lesion presents as circumferential fibrotic stenosis that usually occurs at upper trachea and the subglottic larynx, but lower trachea may also be involved. Diagnosis is made from the clinical characteristics accompanide by compatible pathologic features and by exclusion of other etiologies. Conservative management such as laser resection, dilatation and stent insertion can be tried initially, but surgical resection is recommended for definitive treatment due to frequent restenosis and maintenance problems of conservative approach. We report a case of idiopathic tracheal stenosis treated with tracheal resection and anastomosis followed by insertion of a retrievable stent for immediate relief of airway obstruction.

Dual Stent Application on Congenital Tracheobronchial Stenosis - 1 case - (선천성 기관기관지 협착에서의 이중 스텐트의 적용 - 1례 보고 -)

  • 강문철;황성욱;김용진;김희수;김종성;성명훈
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.149-152
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    • 2002
  • We report successful application of dual trachcobronchial stcnt to the diffuse tracheal stenosis. An one-month-old boy was transferred to the emergency room due to tachypnea and respiratory difficulty with COB retention. Preoperative computed tomography revealed pulmonary artery sling with diffuse tracheal stenosis. We found that the diameter of the both main bronchus was less than 3mm and the trachea was a complete ring. We divided the left pulmonary artery and implanted it to the main pulmonary artery under cardiopulmonary bypass. After that, tracheoplasty was performed with autologous pericardium. However, after the initial measures, CO2 retention and respiratory difficulty persisted due to the granulation tissue and dynamic obstruction of the airway ensued by the overlying pericardial flap. Therefore, we decided to apply a single tracheal stunt. After the insertion of tracheal stent, residual stenosis of the both main bronchus opening continued to cause respiratory difficulty Finally we applied dual tracheobronchial stent and resolved the airway obstruction.

A Case of Tracheal Stent Insertion in Airway Compromise Resulting from Anaplastic Thyroid Cancer (호흡 곤란을 유발한 미분화 갑상선암에서 기관 스텐트 삽입 1예)

  • Nam, Woo joo;Kim, So Yean;Kim, Tae Hwan;Lee, Sang Hyuk
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.1
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    • pp.47-52
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    • 2017
  • Anaplastic thyroid cancer is a rare disease entity consist 2% of whole thyroid cancer but once diagnosed, it is too fatal to survive. Airway obstruction is a leading cause of death in anaplastic thyroid cancer, which may be caused by both vocal cord palsy, mass effect of the cancer or direct invasion of the cancer itself to the tracheal lumen. Tracheal stent insertion can be a solution for airway compromised cases where surgical excision cannot be performed. The advantage is that the airway problem can be solved without invasive procedure. In this case, we tried expandable tracheal stent insertion for 66 years-old man with anaplastic cancer who visited ER for small amount of hemoptysis and dyspnea. There was severe tracheal narrowing and deviation due to the anaplastic thyroid cancer, ECMO (Extra Corporal Membrane Oxygenation) was used instead of a tracheal intubation for general anesthesia.

Design of Ultrasonic Vibration Device using PZT Actuator for Precision Laser Machining (압전구동기를 이용한 정밀 가공용 초음파 진동장치 설계)

  • Kim, W.J.;Fei, L.;Cho, S.H.;Park, J.K.;Lee, M.G.
    • Laser Solutions
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    • v.14 no.2
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    • pp.8-12
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    • 2011
  • As the aged population grows around the world, many medical instruments and devices have been developed recently. Among the devices, a drug delivery stent is a medical device which requires precision machining. Conventional drug delivery stent has problems of residual polymer and decoating because the drug is coated on the surface of stent with the polymer. If the drug is impregnated in micro hole array on the surface of the stent, the problem can be solved. Micro sized holes are generally fabricated by laser machining; however, the fabricated holes do not have an enough aspect ratio to contain the drug or a good surface finish to deliver it to blood vessel tissue. To overcome these problems, we propose a vibration-assisted machining mechanism with PZT (Piezoelectric Transducers) for the fabrication of micro sized holes. If the mechanism vibrates the eyepiece of the laser machining head, the laser spot on the workpiece will vibrate vertically because objective lens in the eyepiece shakes by the mechanism's vibration. According to the former researches, the vibrating frequency over 20kHz and amplitude over 500nm are preferable. The vibration mechanism has cylindrical guide, hollowed PZT and supports. In the cylinder, the eyepiece is mounted. The cylindrical guide has upper and low plates and side wall. The shape of plates and side wall are designed to have high resonating frequency and large amplitude of motion. The PZT also is selected to have high actuating force and high speed of motion. The support has symmetrical and rigid characteristics.

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Comparison between Basic and Inverse Dual Drug and Peptide-coated Stents in a Porcine Restenosis Model

  • Jang, Eun-Jae;Lee, So-Youn;Bae, In-Ho;Park, Dae Sung;Jeong, Myung Ho;Park, Jun-Kyu
    • Applied Chemistry for Engineering
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    • v.31 no.5
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    • pp.502-508
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    • 2020
  • Dual drug-eluting stents (DES) is a primary treatment method for coronary arterial diseases in current interventional cardiology practice. However, their pathological results according to the sequence of coating of drugs have not been reported yet. The peptide-dopamine dissolved in acetonitrile was coated onto the Chonnam National University Hospital (CNUH) stent using an electrospinning coating machine. For secondary coating (e.g., sirolimus coating, designated as SPS), sirolimus (SRL) and poly lactic-glycolic acid (PLGA) were mixed in tetrahydrofuran (THF), and the solution was then coated on the CNUH stent that had underwent the primary peptide coating using an electrospinning and spray technique. Next, the peptide-dopamine was coated on the SRL-PLGA coated stent (PSS). In this study, it was confirmed that endothelialization was promoted without being significantly affected by the coating order (SPS or PSS). The sequence of drug and peptide coating may affect the development of restenosis and PSS was effective in the prevention of restenosis compared to that of using SPS.

A Case of Postpneumonectomy Syndrome Treated with Endobronchial Stent (기관지 스텐트 삽입으로 치료한 전폐절제술후 증후군 1예)

  • Jeong, Seong-Hyun;Cho, Hye-Jin;Lee, Hyoung-No;Lee, Hyung-Sook;Sheen, Seung-Soo;Oh, Yoon-Jung;Park, Kwang-Joo;Hwang, Sung-Chul;Won, Jae-Hwan;Park, Kyung-Joo
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.325-331
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    • 2002
  • Postpneumonectomy syndrome is a rare complication that usually occurs in younger patients within the first year after a right total lung resection. Its clinical presentations are stridor, dyspnea, and recurrent pulmonary infections. An airway obstruction secondary to the extreme mediastinal shift and ratation after a pneumonectomy is the main mechanism. It is commonly complicated with tracheobronchomalacia due to longstanding airway compression. The management modalities involve a repositioning of the mediastinum with volume expansion of the pneumonectomy site by a expandable prosthesis. however, other methods including an endobronchial stent insertion should be considered in the presence of a tracheobronchomalacia or in poor surgical candidates. Here we describe a case of postpneumonectomy syndrome complicated by a bronchomalacia, which was successfully treated with a self-expandable endobronchal stent.

A Case of Aortobronchial Fistula with Massive Hemoptysis after Aortic Stent Graft (대량객혈로 내원한 대동맥기관지루 1예)

  • Hwang, Sang Yon;Chung, Jae Ho;Park, Moo Suk;Kim, Hong Jeong;Hahn, Chang Hoon;Moon, Jin Wook;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Won, Jong Yoon;Kim, Young Sam
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.4
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    • pp.405-410
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    • 2004
  • Aortobronchial fistula may cause a massive fatal hemoptysis. Recently prosthetic aortic graft insertion or endovascular stent graft is a cause of aortobronchial fistula. We report a rare case of hemoptysis from a fistula between an aortic arch aneurysm and the left main bronchus in a patient who had undergone an endovascular stent graft in pseudoaneurysm of descending thoracic aorta one year before.

Serious Complications after Self-expandable Metallic Stent Insertion in a Patient with Malignant Lymphoma

  • Cho, Sung Bae;Cha, Seon Ah;Choi, Joon Young;Lee, Jong Min;Kang, Hyeon Hui;Moon, Hwa Sik;Kim, Sei Won;Yeo, Chang Dong;Lee, Sang Haak
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.1
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    • pp.31-35
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    • 2015
  • An 18-year-old woman was evaluated for a chronic productive cough and dyspnea. She was subsequently diagnosed with mediastinal non-Hodgkin lymphoma (NHL). A covered self-expandable metallic stent (SEMS) was implanted to relieve narrowing in for both main bronchi. The NHL went into complete remission after six chemotherapy cycles, but atelectasis developed in the left lower lobe 18 months after SEMS insertion. The left main bronchus was completely occluded by granulation tissue. However, the right main bronchus and intermedius bronchus were patent. Granulation tissue was observed adjacent to the SEMS. The granulation tissue and the SEMS were excised, and a silicone stent was successfully implanted using a rigid bronchoscope. SEMS is advantageous owing to its easy implantation, but there are considerable potential complications such as severe reactive granulation, stent rupture, and ventilation failure in serious cases. Therefore, SEMS should be avoided whenever possible in patients with benign airway disease. This case highlights that SEMS implantation should be avoided even in malignant airway obstruction cases if the underlying malignancy is curable.