• Title/Summary/Keyword: Y-Stent

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Stent implantation to relieve secondary pulmonary venous stenosis in total anomalous pulmonary venous connection: case report (총 폐정맥 환류 이상 완전교정술 후 이차적으로 발생한 폐정맥 협착에서 스텐트 삽입술 2례)

  • Shin, Youn Ho;Kim, Ki Eun;Kwon, Hae Sik;Yoo, Byung Won;Choi, Jae Young
    • Clinical and Experimental Pediatrics
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    • v.50 no.9
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    • pp.919-924
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    • 2007
  • Pulmonary venous stenosis may be congenital or acquired. Regardless of its origin, the prognosis for patients affected with PVS remains poor. There have been many attempts to palliate PVS with little success. This report describes two patients with PVS which became evident after repair of total anomalous pulmonary venous connection. Intravascular stents were successfully implanted, but progressive restenoses in the stents occurred and eventually both of the patients died. The pertinent literature is reviewed.

Treatment for Giant Fusiform Aneurysm Located in the Cavernous Segment of the Internal Carotid Artery Using the Pipeline Embolization Device

  • Oh, Se-Yang;Kim, Myeong Jin;Kim, Bum-Soo;Shin, Yong Sam
    • Journal of Korean Neurosurgical Society
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    • v.55 no.1
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    • pp.32-35
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    • 2014
  • The pipeline embolization device (PED) is a new endovascular device for treatment of complex, fusiform and wide-neck intracranial aneurysms. The main mechanism of this stent is to divert the flow in the parent artery with reduction of inflow in the aneurysm leading to thrombosis. We treated a 40-year-old woman who had left facial pain and orbit discomfort. Angiography showed a giant fusiform aneurysm located in the cavernous segment of the left internal carotid artery. A PED was successfully deployed across the aneurysm. The procedure and post-procedural course were uneventful. After 3 months, angiography showed complete obliteration of the aneurysm with good patency of the branching vessels originating from the deployed segment. The patient's symptoms improved completely without complications.

Posterior Cricoid Split with Costal Cartilage Grafting and T-tube Stenting for Treatment of Subglottic Stenosis (성문하협착증에서 윤상연골절개 및 윤상연골 후벽 늑연골 이식술과 T-tube stenting)

  • Sohn, Jin-Ho
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.182-190
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    • 1999
  • OBJECTIVES : To determine the results of posterior cricoid split with costal cartilage graft in the treatment of moderate and severe subglottic stenosis in adults, and to assess the effect of T-tube as a stent in this surgery. PATIENTS AND METHODS : Four adults with moderate and severe subglottic stenosis who underwent posterior cricoid split with costal cartilage graft from 1994 to 1995. Three patients were male and one was female. All of the patients had acquired subglottic stenosis, 2 of whom had a bilateral vocal folds paralysis. The surgical procedure we used included a cricoid lamina split with costal cartilage grafting and T-tube stenting. Arytenoidectomy was a added in 2 patients with bilateral vocal folds paralysis. RESULTS : Three of the 4 patients underwent decannulation, and 1 is still undergoing treatment. 3 patients who underwent decannulation demonstrated marked improvement in their symptoms of airway obstruction and good postoperative voice quality. CONCLUSIONS : The posterior cricoidotomy lumen augmentation with costal cartilage grafting is a safe and effective technique for the treatment of moderate and severe subglottic stenosis in adults and T-tube is a good alternative stenting material for this procedure.

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Traumatic Aortic Injury: Single-center Comparison of Open versus Endovascular Repair

  • Cho, Jun Woo;Kwon, Oh Choon;Lee, Sub;Jang, Jae Seok
    • Journal of Chest Surgery
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    • v.45 no.6
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    • pp.390-395
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    • 2012
  • Background: Conventional open repair is a suboptimal therapy for blunt traumatic aortic injury (BTAI) due to the high postoperative mortality and morbidity rates. Recent advances in the thoracic endovascular repair technique may improve outcomes so that it becomes an attractive therapeutic option. Materials and Methods: From August 2003 to March 2012, 21 patients (mean age, 45.81 years) with BTAI were admitted to our institution. Of these, 18 cases (open repair in 11 patients and endovascular repair in 7 patients) were retrospectively reviewed and the early perioperative results of the two groups were compared. Results: Although not statistically significant, there was a trend toward the reduction of mortality in the endovascular repair group (18.2% vs. 0%). There were no cases of paraplegia or endoleak. Statistically significant reductions in heparin dosage, blood loss, and transfusion amounts during the operations and in procedure duration were observed. Conclusion: Compared with open repair, endovascular repair can be performed with favorable mortality and morbidity rates. However, relatively younger patients who have acute aortic arch angulation and a small aortic diameter may be a therapeutic challenge. Improvements in graft design, delivery sheaths, and graft durability are the cornerstone of successful endovascular repair.

Surgical Removal of a IVUS Catheter that was Fractured During PCI (경피적 관상동맥 중재술 시 골절된 혈관 내 IVUS 카테터의 외과적 제거)

  • Kim, Young-Hak;Kim, Hyuck;Song, Young-Joo;Chung, Won-Sang;Kang, Jeong-Ho
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.768-771
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    • 2008
  • The use of IVUS provides information about the lumen and arterial wall, the location and extent of atherosclerotic plaque and the state of the arterial wall after PCi. The use of IVUS after insertion of an intracoronary stent has currently increased, while conflicting evidence exists concerning the long-term benefits of IVUS. We report here on a case of surgical removal of an entrapped and fractured IVUS catheter during insertion of intracoronary stents, and we include a review of the relevant literature.

Refractory Vascular Spasm Associated with Coronary Bypass Grafting

  • Kim, Young Sam;Yoon, Yong Han;Kim, Jeoung Taek;Shinn, Helen Ki;Woo, Seong Ill;Baek, Wan Ki
    • Journal of Chest Surgery
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    • v.47 no.5
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    • pp.468-472
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    • 2014
  • Diffuse refractory vascular spasms associated with coronary bypass artery grafting (CABG) are rare but devastating. A 42-year-old male patient with a past history of stent insertion was referred for the surgical treatment of a recurrent left main coronary artery disease. A hemodynamic derangement developed during graft harvesting, necessitating a hurried initiation of cardiopulmonary bypass (CPB). Although CABG was carried out as planned, the patient could not be weaned from the bypass. An emergency coronary angiography demonstrated a diffuse spasm of both native coronary arteries and grafts. CPB was switched to the femorofemoral extracorporeal membrane oxygenator (ECMO). Although he managed to recover from heart failure, his discharge was delayed due to the ischemic injury of the lower limb secondary to cannulation for ECMO. We reviewed the case and literature, placing emphasis on the predisposing factors and appropriate management.

Anti-sclerotic Effect of Cinnamomi Ramulus Via Suppression of MMP-9 Activity and Migration of TNF-$\alpha$-induced HASMC (인간대동맥평활근의 유주능 및 기질금속단백분해효소의 억제를 통한 계지의 항동맥경화능)

  • Kim, Jai-Eun;Lee, Chang-Sup;Choi, Sung-Kyu;Choi, Dall-Yeong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.5
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    • pp.974-979
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    • 2009
  • Proliferation of vascular smooth muscle cell(VSMC) is one of the key features in onset of atherosclerosis and restenosis after vascular surgery such as stent implant. Atherosclerotic plaques are usually composed of collagen, elatsin and smooth muscle cells. Release of matrix metalloproteinases(MMPs) is considered to have correlation with development of atherosclerotic plaques. Based on the hypothesis that MMP inhibition would be helpful in the treatment of atherosclerosis, we investigated inhibition of MMP activity and migration of TNF-$\alpha$-induced human aortic smooth muscle cell(HASMC) by Cinnamomi Ramulus(CC). The result from gelatin zymography showed that CC inhibited MMP-9 activity in a dose-dependent manner. In addition, CC considerably inhibited the migration of HASMC induced by TNF-$\alpha$, while it showed little cytotoxic effect on HASMC. These results suggest that CC can be a potential anti-atherosclerotic agent through inhibition of MMP-9 activity and SMC migration.

Surgical Management of Tracheal and Bronchial Stenosis (기관및 기관지 협착증 환자의 외과적 치료)

  • 유정훈
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1299-1304
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    • 1992
  • We experienced 5 cases of tracheal stenosis and 7 cases bronchial stenosis treated surgically at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Hanyang University during 5 years. The causes of tracheal stenosis were prolonged endotracheal intubation 1 case, tracheostomy 1 case, the sequela of endobronchial tuberculosis 2 cases and tracheomalacia 1 case. The causes of bronchial stenosis were all endobronchial tuberculosis. The managements of tracheal stenosis were tracheal resection and end to end anastomosis. The resected lengths of trachea were 1.5cm, 3cm and 7.5cm. One case of suglottic stenosis was underwent the resection of trachea, 8cm in length, and the laryngotracheal anastomosis was done, but the re-stenosis of trachea was developed after 4 weeks post-operatively. One case of tracheomalacia was done permanent tracheostomy only, because the entire trachea was adhered to the surrounding tissue. The managements of bronchial stenosis were resection of involved lobe or one lung, in the 5 case. One case with Lt. main bronchial stenosis and atelectasis of Lt. upper lobe was done the lobectomy of Lt. upper lobe only and then, the Lt. pneumonectomy was done re-operatively because the atelectasis of Lt. lower lobe had continued. The other one case with stenosis of Rt. main bronchus, failed the insertion of metalic stent, was underwent the Rt. upper lobe lobectomy, sleeve resection and side to end anastomosis

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Hybrid Procedure for Aortic Arch Aneurysm: Arch Vessels Debranching andThoracic Endovascular Aortic Repair? -2 case Reports- (대동맥궁 대동맥류에서 Hybrid 술식의 적용 - 2예 보고 -)

  • Kim, Seok;Kwon, Oh-Choon;Lee, Sub;Cho, Jun-Woo;Bae, Chi-Hoon;Park, Ki-Sung
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.529-533
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    • 2010
  • Conventional surgery for aortic arch aneurysms have many postoperative complications and a high mortality rate due to prolonged cardiopulmonary bypass time, especially in high risk patients. In this report, we present two cases of a hybrid procedure that involves open brachiocephalic bypass with concomitant endovascular arch stent grafting in high risk patients with distal aortic arch aneurysm.

Primary Aortoesophageal Fistula - A case report - (원발성 대동맥-식도 누공 - 1예 보고 -)

  • Kim, Dae-Hyun;Kim, Bum-Shik
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.520-522
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    • 2008
  • Aortoesophageal fistula that causes massive bleeding from the esophagus is a rare and fatal disease. The most common cause of aortoesophageal fistula is an aortic aneurysm, and the other causes are inflammatory disease and neoplasm. The treatment of choice for aortoesophageal fistula is surgery, and this surgery carries a high rate of mortality and morbidity. Stent-graft treatment is now being applied for this malady. Herein we report on a case of primary aortoesophageal fistula that was treated with primary repair of the fistula openings, and we include a review of the relevant literature.