• Title/Summary/Keyword: stent

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Endovascular Repair in Acute Complicated Type B Aortic Dissection: 3-Year Results from the Valiant US Investigational Device Exemption Study

  • Lim, Chang Young
    • Journal of Chest Surgery
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    • v.50 no.3
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    • pp.137-143
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    • 2017
  • Acute complicated type B aortic dissection (TBAD) is a potentially catastrophic, life-threatening condition. If left untreated, there is a high risk of aortic rupture, irreversible organ or limb damage, or death. Several risk factors have been associated with acute complicated TBAD, including age and refractory hypertension. In the acute phase, even uncomplicated patients are more prone to develop complications if hypertension and pain are left medically untreated. Innovations in stent graft technologies have incrementally improved outcomes since their first use for this condition in 1999, though improvement is needed in mitigating periprocedural complications, adverse events, and mortality. In the past decade, endovascular repair has become the preferred treatment because of its superior outcomes to open repair and medical therapy. The Valiant Captivia Thoracic Stent Graft System is a third-generation endovascular stent graft with advancements in minimally invasive delivery, conformability to the anatomy, and the minimization of adverse sequelae. Herein, this stent graft is briefly reviewed and its 3-year outcomes are presented. Freedom from all-cause and dissection-related mortality was 79.1% and 90.0%, respectiv ely. The Valiant Captiv ia Stent Graft represents a safe, effective intervention for acute complicated TBAD. Continued surveillance is needed to verify its longer-term durability.

Retrievable Nitinol Stent for Treatment of Tuberculous Tracheobronchial Stenosis -A case report- (결핵성 기관-기관지 협착에서 제거형 니티놀 스텐트 삽입요법 -1례-)

  • Chung, Bong-Kyu;Kim, Kwang-Taik;Park, Sung-Min;Sun, Kyung;Kim, Hyoung-Mook;Lee, In-Sung
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.107-111
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    • 2000
  • Although a tracheal stent can be an option for inoperable tracheal stenoses there still are some troublesome side effects including overgranulation from foreign body irritation restenosis and patient's discomfort associated with the procedure. We report a successful case of a retrievable stent made of self-expandable 'shape memory' metal and polyurethane in a 24 year old female patient with respiratory distress and tight stenosis in the trachea and left main bronchus, The stent was inserted following a balloon dilatation and was successfully removed on the 7th days after the procedure. She regained a normal active life without any repiratory symptoms and a follow-up of 8 months showed satisfactory results.

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Stent-graft Insertion in High Risk Patients with Aortic Dissection Including Intimal Tear of the Aortic Isthmus (대동맥 협부의 내막파열을 가진 고위험군 대동맥박리환자에서 시행한 스텐트 그라프트 삽입)

  • Do, Young-Woo;Kim, Gun-Jik;Cho, Joon-Young;Lee, Jong-Tae
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.424-427
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    • 2010
  • Recently, stent-graft insertion has been widely used along with surgery for treatment of thoracic and abdominal aortic aneurysm. However, use of stent-graft insertion is controversial in descending aortic dissection. We report here on our experience of a patient who received a stent-graft for descending aortic dissection that nearly ruptured. Based on CT findings at three months follow up, results were satisfactory.

Curcumin-Loaded PLGA Nanoparticles Coating onto Metal Stent by Electrophoretic Deposition Techniques

  • Nam, So-Hee;Nam, Hye-Yeong;Joo, Jae-Ryang;Baek, In-Su;Park, Jong-Sang
    • Bulletin of the Korean Chemical Society
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    • v.28 no.3
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    • pp.397-402
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    • 2007
  • Restenosis after percutaneous coronary intervention (PCI) continues to be a serious problem in clinical cardiology. To solve this problem, drug eluting stents (DES) with antiproliferative agents have been developed. Variable local drug delivery systems in the context of stenting require the development of stent manufacture, drug pharmacology and coating technology. We have worked on a system that integrates electrophoretic deposition (EPD) technology with the polymeric nanoparticles in DES for local drug delivery and a controlled release system. The surface morphology and drug loading amount of DES by EPD have been investigated under different operational conditions, such as operation time, voltage and the composition of media. We prepared poly-D,L-lactide-co-glycolic acid (PLGA) nanoparticles embedded with curcumin, which was done by a modified spontaneous emulsification method and used polyacrylic acid (PAA) as a surfactant because its carboxylic group contribute negative charge to the surface of CPNPs (?53.5 ± 5.8 mV). In the process of ‘trial and error' endeavors, we found that it is easy to control the drug loading amount deposited onto the stent while keeping uniform surface morphology. Accordingly, stent coating by EPD has a wide application to the modification of DES using various kinds of nanoparticles and drugs.

CFD Analysis on Stent Shape to Reduce Blood Flowing into Cerebral Aneurysm (뇌동맥류 혈액유입 저감을 위한 스텐트 형상에 관한 전산유체해석)

  • Yeo, Dong-Hyeon;Park, Dong-Gyu;Byon, Sang-Min
    • Journal of the Korean Society of Manufacturing Process Engineers
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    • v.16 no.1
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    • pp.42-50
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    • 2017
  • A cerebral aneurysm is a ballooning arising from a weakened area in the wall of a blood vessel in the brain. In this study, the flow analysis of the blood vessel, including the cerebral aneurysm and the stent, was conducted to investigate the effect of the stent shape on reduction of blood flowing into the cerebral aneurysm. We used the Carreau model to describe Non-Newtonian behaviors of blood flow. Two kinds of stents, which had different cross angles were modelled by the commercial CAD program and the geometries of those stents were reflected in the analysis domain of the blood vessel. From the results of the flow analysis, we found that the blood flowing into the cerebral aneurysm was decreased as the cross angle of the stent was decreased.

Solitaire AB Stent-Assisted Coiling of Wide-Neck Micro Aneurysms

  • Li, Xue-dong;Qin, Jun;Xiao, Zhen-yong;Feng, Yi;Chen, Jia-kang
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.341-345
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    • 2016
  • Objective : Solitaire AB stent-assisted coiling facilitates the endovascular treatment of wide-necked intracranial aneurysms. We present our experience of coiling the micro-aneurysms of wide-neck with Solitaire AB stent assisting in a single center. Methods : Thirty-one Solitaire AB stents were used to treat via endovascular approach patients with 31 wide-neck micro aneurysms in a single center in China. Technical and clinical complications were recorded. Modified Rankin Scale was used to evaluate the patients' conditions via clinic and telephone follow-up. Results : The mean width of aneurysm sac was $2.30{\pm}0.42mm$, and the mean diameter of aneurysm neck was $2.83{\pm}.48mm$. Complete occlusion was achieved in 28 aneurysms (90.32%); neck remnant was seen in 3 aneurysms (9.68%). Technical and clinical complications related to the procedure were encountered in four patients (12.5%). Two patients died (6.25%). No patient had a permanent deficit. Conclusion : Solitaire AB stent was a safe and efficiency tool in assisting coiling of micro aneurysms with wide neck, but may be not suitable for a blaster-like one. Mid- and long-term follow-up will be required to elucidate the impact of the Solitaire AB stent on recanalization rate.

Esophageal Stent Insertion at the Esophagogastrostomy Site Stenosis - Report of 3 cases - (식도 재건술후 발생한 식도-위 문합부 협착의 식도스텐트를 이용한 치험 -3례 -)

  • 정성철;배윤숙;유환국;정승혁;이정호;김병열;이명준
    • Journal of Chest Surgery
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    • v.36 no.1
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    • pp.55-58
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    • 2003
  • Although postanastomosis of esophageal reconstruction is rare but it is a very unwelcome complication. Previously, the problem was solved by balloon dilatation, reoperation, and feeding jejunostomy. However, balloon dilatation is not effective because of high recurrence rate, reoperation is difficult due to its operative approachableness and also jejunostomy is inconvenient for patients. Therefore, we inserted esophageal stent as a method of relieving postanastomosis stenosis, From Jan, 2001 to Dec, 2001, there were three patients with postanastomosis stenosis, who received esophageal stent insertion, one had case is benign esophageal stenosis, two had esophageal carcinoma. We followed up them over 12 months after inserting the stent, Dysphagia was improved, so we report that the clinical performance was satisfactory

Indication and Post-Procedural Management of Upper GI Stent Implantation (상부 위장관 스텐트 삽입술의 이해 -적응증 및 추적 관리-)

  • Joo, Moon-Kyung;Park, Jong-Jae
    • Journal of Hospice and Palliative Care
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    • v.12 no.2
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    • pp.49-55
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    • 2009
  • Self expandable metal stent (stent) implantation of upper gastrointestinal (UGI) tract is now widely accepted for the palliation of obstructive symptoms caused by inoperable malignant UGI obstruction. With the technical progress and accumulation of clinical experiences, it became possible to perform the procedure easily, safely and effectively. However, clinicians should pay attention to the post-procedural care, because early or late complications such as ulceration, pain, bleeding, food impaction, perforation, migration or in-stent tumor growth could occur. In this review, several topics about stent placement in the UGI tract are discussed, such as major indications for stenting, kinds of stents, and post-procedural management.

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Biodegradable sheath-core biphasic monofilament braided stent for bio-functional treatment of esophageal strictures

  • Han, Cheol-Min;Lih, Eugene;Choi, Seul-Ki;Bedair, Tarek M.;Lee, Young-Jae;Park, Wooram;Han, Dong Keun;Son, Jun Sik;Joung, Yoon Ki
    • Journal of Industrial and Engineering Chemistry
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    • v.67
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    • pp.396-406
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    • 2018
  • In this study, a polydioxanone (PDO) and poly(L-lactic acid) (PLLA) sheath-core biphasic monofilament was designed to develop an esophageal stent with improved mechanical properties and controlled biodegradability. The radial force of PDO/PLLA sheath-core stent was 10.24 N, while that of PDO stent was 5.64 N. Deteriorations of tensile strength, elastic modulus and elongation during degradation test were also delayed on PDO/PLLA group. Hyaluronic acid-dopamine conjugate and $BaSO_4/PDO$ conjugate coating layers provided improved tissue adhesion strength and reasonable X-ray contrast, respectively. Taken all together, the sheath-core filaments with tissue adhesive and radiopaque properties will be useful in designing esophageal stents.

A Case of Bronchoesophageal Fistula Treated by Bronchial Stent Insertion and Endoscopic Histoacryl Injection (기관 스텐트 삽입과 히스토아크릴 주입법으로 치료한 식도 누공 1례)

  • Dong Joon Oh;Joo Young Cho
    • Journal of Digestive Cancer Research
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    • v.2 no.1
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    • pp.21-23
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    • 2014
  • We report a bronchoesophageal fistula that treat with bronchial stent insertion and histoacryl injection. A 52-year-old man with esophagel cancer was transferred for dysphagia management. At the CT scan that underwent on admission, esophageal cancer with multiple lymph node metastasis was observed. At the gastroduodenoscopy and contrast study, bronchoesophageal fistula was observed. Recurrent stent insertion treatment was failed, and then, By the broncoscopy, covered stent was inserted to right bronchus, and By the endoscopy, fibrin glue and histoacryl was injected in the fistula opening. At the contrast study, contrast leakage was not observed, and the patient was discharged. But, at the 14 days after discharge, the patient was admitted to the emerency room because of cough symptom whenever he eat food. The patient was diagnosed with aspiration pneumonia, we were determined that it is unable to oral intake. The patient received a jejunostomy and antibiotic treatment for aspiration pneumonia. He was discharged after symptomatic improvement.

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