• Journal of Korean Neurosurgical Society
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• 제60권3호
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• pp.335-347
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• 2017

Intravenous recombinant tissue plasminogen activator had been the only approved treatment for acute ischemic stroke since its approval in 1995. However, the restrictive time window, numerous contraindications, and its low recanalization rate were all limitations of this modality. Under those circumstances, endovascular stroke therapy went through a great evolution during the past two decades of intravenous thrombolysis. The results of the 2013 randomized trials for endovascular stroke therapy were neutral, although they were limited by insufficient imaging screening at enrollment, early-generation devices with less efficacy, and treatment delays. Huge progress was made in 2015, as there were five randomized clinical trials which all demonstrated the safety and efficacy of endovascular stroke treatment. Despite differences in detail patient enrollment criteria, all 5 trials employed key factors for good functional recovery; (1) screening with non-invasive imaging to identify the proximal occlusion and exclude a large infarct core, (2) using highly effective modern thrombectomy devices mainly with stent retriever, and (3) establishment of a fast workflow to achieve effective reperfusion. The results of those trials indicate that modern thrombectomy devices can allow for faster and more effective reperfusion, which can lead to improved clinical outcomes compared to intravenous thrombolysis alone. These advances in mechanical thrombectomy are promising in the global fight against ischemic stroke-related disability and mortality. Two current mainstreams among such mechanical thrombectomy techniques, "stent retriever thrombectomy" and "direct clot aspiration", are the topic of this review. Stent retriever thrombectomy using Solitaire and Trevo retriever will be firstly discussed. And, the commonalities and the differences between two major clot aspiration thrombectomy techniques; a direct aspiration first pass technique (ADAPT) and forced arterial suction thrombectomy (FAST), will be additionally explained. Finally, details regarding the combination of direct clot aspiration and stent retriever thrombectomy, the switching strategy and the Solumbra technique, will be described.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.27-34
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• 2019

Objective : Stent-assisted coil embolization of intracranial wide-necked aneurysm requires long-term postoperative antiplatelet therapy to prevent in-stent thrombosis. This study aimed to demonstrate results of temporary stent placement for coiling wide necked small intracranial aneurysms, which eliminated need for antiplatelet agents, and to discuss its feasibility and safety. Methods : Data of 156 patients who underwent stent-assisted coil embolization between 2011 and 2014 were retrospectively analyzed. Thirteen cases of temporary stent-assisted coil embolization were included, and their clinical and radiological results were evaluated. Results : The aneurysms treated were all unruptured except one case. All of them had wide neck with mean dome-to-neck ratio of 0.96 and were small-sized aneurysms with mean maximal diameter of 4.2 mm. There was no technical failure in retrieval of stent after completion of embolization of the target aneurysm. Immediate angiography revealed 11 complete and two partial embolization (one residual neck and one residual aneurysm). Two cases encountered thrombosis complication, and they were managed without neurological sequelae. The mean follow-up period was 43 months, angiographic follow-up revealed two cases with minor recurrence, and clinical outcome was good with modified Rankin scale score of 0. Conclusion : Temporary stent-assisted coil embolization of small wide-necked intracranial aneurysm using fully retrievable stent appears safe and effective. Further application and evaluation of this technique in more cases with larger size aneurysm is warranted.

• 한국의상디자인학회지
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• 제8권1호
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• pp.81-96
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• 2006

This study aimed to investigate the sociocultural phenomena which affected to clothing change in 1650-1900 and to examine the features of men's necktie in the western art. For this study, information about historic neckwear is obtained from the visual evidence of painted or engraved portraits, contemporary written sources. The covered area of this study was Europe mainly England and France. For this process, research steps were as follows : 1. Investigating the sociocultural phenomena which affect to clothing change through 1650-1900 and analysis of men's clothing and appearance. 2. Finding the changing characteristics of neckties including it's different types, shapes, knots, colors and materials and analyzing similarities and differences of neckties by the times. 3. Examining necktie as one of important and representative icons of male gender identity. The results of the study was as follows: 1. In 1660-1900, men's fashion was simplified in color and detail due to the influence of practical Puritanism and matured civil culture. And British men's fashion spreaded throughout whole European countries and get popularity. 2. In 1650-1720, there were band, cravat and steinkirk. And expecially cravatier, a expert custodian of cravats, was appeared in that period. In 1720-1800, there were stock, solitaire and cravat. In 1800-1850, neckwear were popularized and got various sizes and types up to shape and size of chemise collars. Black stock, scarf cravat and shawl cravat were popular and terms of 'necktie' were used for an certain neckcloth shape. And abundant literature for necktie were published thanks to the development of printing technology in that period. In 1851-1900, the leady-made neckties were spreaded and there were changes in shape, length, knot of necktie up to V-zone formed with shirt's collars and vest types. Neckwear was gradually evolving through four distinct styles, bow tie, scarf or neckerchief, Ascot and four-in-hand. 3. After the mid-l7th Century, as civil culture matured and splendid and extravagant colorful men's wear disappeared, British men's fashion spreaded throughout whole European countries and got popularity. The necktie become an essential ornamental accessory of men's fashion and one of important and representative icons of male gender identity.