• Title/Summary/Keyword: Y-Stent

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Development and Clinical Application of a New Nitinol Stent (새로운 나이티놀 스텐트의 개발과 임상적용)

  • Park, S.S.;Kim, T.H.;Huh, S.J.;Song, H.Y.;Choi, S.P.;Kim, C.S.
    • Proceedings of the KOSOMBE Conference
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    • v.1997 no.11
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    • pp.343-346
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    • 1997
  • A new type of stent was invented using a Nitinol wire. The hoop strength of the new stent was found to be 2 times larger than that of the Cragg or Memotherm stents. However, the longitudinal flexibility of the new stent was inferior to both the Cragg and Memotherm stents. This new stent seems to be useful or the treatment of stenosis with straight configuration, but need to be improved or use in tortuous stenotic region. The stent was applied to the patients with esophargeal stenosis and showed a good result.

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Numerical Evaluation and Shape Design of Coronary Artery Stent (관상동맥혈관용 스텐트의 수치해석 및 형상 설계)

  • Kim, Dae-Young;Lee, Seung-Yeol;Kim, Heon-Young
    • Journal of the Korean Society for Precision Engineering
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    • v.29 no.1
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    • pp.103-108
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    • 2012
  • Restenosis symptom, which is well known as a problem of stents, is due to the recoil and expansion pressure depending on shapes of stent. In order to reduce the effect of recoil problem, study on pattern and shape for the stent is required and the expansion pressure and recoil should be evaluated. This paper aims at evaluating mechanical characteristics of stent used in surgery for vessel stenosis. The expansion process of coronary artery stent in vessel for two models including the Cypher$^{(R)}$ from Johnson & Johnson$^{TM}$ and a suggested model were simulated using the Finite Element Analysis. Comparison of the directional recoil simulation results was made. The issues in the deformed shape of vessel and recoil of Cypher$^{(R)}$ were partially resolved in the suggested model. Therefore, the shape design suggested in this paper was able to reduce the restenosis symptom.

Subarachnoid Hemorrhage from a Dissecting Aneurysm of the Posterior Cerebral Artery in a Child : Rebleeding after Stent-Assisted Coiling Followed by Stent-Within-Stent Technique

  • Lee, Ji-Yeoun;Kwon, Bae-Ju;Kang, Hyun-Seung;Wang, Kyu-Chang
    • Journal of Korean Neurosurgical Society
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    • v.49 no.2
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    • pp.134-138
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    • 2011
  • Pediatric patients with dissecting aneurysms usually present with ischemia rather than bleeding. We report a case of a 15-year-old boy with a dissecting aneurysm of the posterior cerebral artery (PCA) presenting with hemorrhage. He was first treated with stent-assisted coil embolization, in an attempt to avoid trapping of the PCA and preserve the perforators. After the procedure, he recovered well from general anesthesia, but rebleeding occurred from the same lesion 6 hours after the procedure, therefore endovascular segmental occlusion of the parent artery was performed secondarily. Apparently, a reconstructive method of stent-assisted coiling is worth trying to preserve the parent vessel and perforators, but it is not always efficient and durable for dissecting aneurysms.

Numerical Analysis on the Effect of Wall Shear Stress Around the Ring Drug-Eluting Stent (고리형 약물분출 스텐트 주위 벽전단응력의 영향에 대한 수치해석)

  • Seo, Tae-Won;Barakat, Abdul
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.31 no.1 s.256
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    • pp.21-28
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    • 2007
  • The use of drug-eluting stents has dramatically reduced the incidence of restenosis however, much remains to be teamed about the performance of these stouts. In the present study, we tested the hypothesis that the design of drug-eluting stents influences the efficacy of local drug delivery to the arterial wall and that this effect depends on both arterial geometry and the prevailing flow conditions. We performed computational simulations in which the coupled Navier-Stokes and advection-diffusion equations were solved to determine the flow field and drug concentration in the vicinity of model drug-eluting stouts It is found that the characteristics of flow phenomena can be influenced greatly by the ratio of stent diameter to vessel diameter. The presence of drug-eluting stent may have profound effect on wall shear stresses, recirculation sizes and drug distributions. The results show that recirculation zone is influenced by the imposed flow conditions and stent diameter. In pulsatile flow, the low wall shear stress and high drug concentration occur along the arterial wall during the decelerating flow conditions. These results could provide the guideline for future drug-eluting stent designs toward reducing restenosis by affecting local wall shear stress distributions associated with neointimal hyperplasia.

Simple Coiling versus Stent-Assisted Coiling of Paraclinoid Aneurysms : Radiological Outcome in a Single Center Study

  • Kim, Soo Yeon;Park, Dong Sun;Park, Hye Yin;Chun, Young Il;Moon, Chang Taek;Roh, Hong Gee
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.644-653
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    • 2017
  • Objective : Paraclinoid aneurysms are a group of aneurysms arising at the distal internal carotid artery. Due to a high incidence of small, wide-necked aneurysms in this zone, it is often challenging to achieve complete occlusion when solely using detachable coils, thus stent placement is often required. In the present study, we aimed to investigate the effect of stent placement in endovascular treatment of paraclinoid aneurysms. Methods : Data of 98 paraclinoid aneurysms treated by endovascular approach in our center from August 2005 to June 2016 were retrospectively reviewed. They were divided into two groups : simple coiling and stent-assisted coiling. Differences in the recurrence and progressive occlusion between the two groups were mainly analyzed. The recurrence was defined as more than one grade worsening according to Raymond-Roy Classification or major recanalization that is large enough to permit retreatment in the follow-up study compared to the immediate post-operative results. Results : Complete occlusion was achieved immediately after endovascular treatment in eight out of 37 patients (21.6%) in the stent-assisted group and 18 out of 61 (29.5%) in the simple coiling group. In the follow-up imaging studies, the recurrence rate was lower in the stent-assisted group (one out of 37, 2.7%) compared to the simple coiling group (13 out of 61, 21.3%) (p=0.011). Multivariate logistic regression model showed lower recurrence rate in the stent-assisted group than the simple coiling group (odds ratio [OR] 0.051, 95% confidence interval [CI] 0.005-0.527). Furthermore there was also a significant difference in the rate of progressive occlusion between the stent-assisted group (16 out of 29 patients, 55.2%) and the simple coiling group (10 out of 43 patients, 23.3%) (p=0.006). The stent-assisted group also exhibited a higher rate of progressive occlusion than the simple coiling group in the multivariate logistic regression model (OR 3.208, 95% CI 1.106-9.302). Conclusion : Use of stents results in good prognosis not only by reducing the recurrence rate but also by increasing the rate of progressive occlusion in wide-necked paraclinoid aneurysms. Stent-assisted coil embolization can be an important treatment strategy for paraclinoid aneurysms when considering the superiority of long term outcome.

Surgical Treatment of Bronchial Restenosis Occuring After Insertion of Self-Expandable Metalic Stent in Patients with Bronchial Stenosis -2 Cases Reports- (기관지협착환자에서 기관지내 팽창성 급속 스텐트 삽입후 재발한 기관지협착 치험 2례)

  • Kim, Woo-Chan;Jin, Ung;Rha, Suk-Joo;Jo, Keon-Hyon;Lee, Sun-Hee;Kwack, Moon-Sub;Kim, Se-Wha
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.499-503
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    • 1995
  • Since the insertion of self expandable metalic stent[SEMS has became popular method for hollow organ stenosis, many attempts for further apply the stent to airway stenosis as an simple procedure has been made, but intrabronchial migration of stent or occurrence of inflammatory granuloma around stent develop occasionally and sometimes it worsen bronchial stenosis further more. This report describes 2 case of surgically treated bronchial restenosis in whom intrabronchial stent were applied for release of bronchial stenosis. Our surgical option was pneumonectomy and bronchoplasty with sleeve right middle and upper lobectomy respectively. During the operation we found the SEMSs were tightly impacted in restenotic bronchial lumen with overgrowth of granulation tissues. The bronchial obstructions occupied more than 90% of lumens in both cases, and needed much complicated procedure to be relieved. Therefore, even though the insertion of SEMS remains as a prcedure determined by the physician`s preference, it has to be considered prudently that the use of SEMS can cause severe restenosis and the surgeon has more difficulties in performing segmental resection of restenotic bronchus in patient with SEMS previously inserted. Throughout these experiences we can conclude that the insertion of SEMS must be performed only in very selected cases of bronchial stenosis.

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Covered Stents for the Endovascular Treatment of a Direct Carotid Cavernous Fistula : Single Center Experiences with 10 Cases

  • Li, Ke;Cho, Young Dae;Kim, Kang Min;Kang, Hyun-Seung;Kim, Jeong Eun;Han, Moon Hee
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.12-18
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    • 2015
  • Objective : Covered stent has been recently reported as an effective alternative treatment for direct carotid cavernous fistulas (DCCFs). The purpose of this study is to describe our experiences with the treatment of DCCF with covered stents and to evaluate whether a covered stent has a potential to be used as the first choice in selected cases. Methods : From February 2009 through July 2013, 10 patients underwent covered stent placement for a DCCF occlusion. Clinical and angiographic data were retrospectively reviewed. Results : Covered stent placement was performed for five patients primarily as the first choice and in the other five as an alternative option. Access and deployment of a covered stent was successful in all patients (100%) and total occlusion of the fistula was achieved in nine (90%). Complete occlusion immediately after the procedure was obtained in five patients (50%). Endoleak persisted in five patients and the fistulae were found to be completely occluded by one month control angiography in four. The other patient underwent additional coil embolization by a transvenous approach. Balloon inflation-related arterial dissection during the procedure was noted in two cases; healing was noted at follow-up angiography. One patient suffered an asymptomatic internal carotid artery occlusion noted seven months post-treatment. Conclusion : Although endoleak is currently a common roadblock, our experience demonstrates that a covered stent has the potential to be used as the first choice in DCCF; this potential is likely to increase as experience with this device accumulates and the materials continue to improve.

Transcatheter Intravascular Stent Placement in a Shih Tzu Dog with Refractory Pulmonic Stenosis (카테터를 통한 혈관스텐트 장착을 통한 심한 폐동맥협착증 치료 1례)

  • Kim, Hyun-Wook;Kim, Sung-Soo;Lee, Joon-Soek;Nam, So-Jeong;Choi, Ran;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.48-53
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    • 2009
  • A 4-year-old intact male Shih Tzu dog (5.4 kg of body weight) was referred with primary complaints of heart murmur and exercise intolerance. Diagnostic studies found severe valvular pulmonic stenosis (peak velocity of 6.4 m/s, pressure gradient 165 mmHg). The dog was treated with 3 cm (length) ${\times}$ 1.5 cm (diameter) of Palmaz biliary stent. The outcome of stent placement was favorable and remarkably reduced the severity of PS (6.4 m/s to 3.0 m/s of peak velocity). Clinical condition was remarkably improved with the absence of cardiac murmur, although mild pulmonic regurgitation existed from the day of stent placement. To our best knowledge, this case is the first clinical trial for treating PS with intravascular stent in Korea.