• 제목/요약/키워드: stenting

검색결과 164건 처리시간 0.025초

경동맥스텐트삽입술 직후 악화된 혈관신생녹내장 사례 (Acute Exacerbation of Neovascular Glaucoma after Carotid Artery Stenting)

  • 고명아;이채원;조성양;강동화;전상범
    • 대한신경과학회지
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    • 제36권4호
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    • pp.325-328
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    • 2018
  • Neovascular glaucoma is a subtype of secondary glaucoma that is characterized by proliferation of fibrovascular tissue in the anterior chamber angle. This condition may be acutely aggravated by carotid revascularization therapies. There have been few previous reports of acute aggravation of neovascular glaucoma following carotid artery stenting. We report the case history of a patient who had acute exacerbation of neovascular glaucoma following carotid artery stenting and required surgical management.

Contemporary Interventional Approach to Calcified Coronary Artery Disease

  • Jonathan Gabriel Sung;Sidney TH Lo;Ho Lam
    • Korean Circulation Journal
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    • 제53권2호
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    • pp.55-68
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    • 2023
  • Calcific coronary artery disease is an increasingly prevalent entity in the catheterization laboratory which has implications for stenting and expected outcomes. With new interventional techniques and equipment, strategies to favorably modify coronary calcium prior to stenting continue to evolve. This paper sought to review the latest advances in the management of severe coronary artery calcification in the catheterization laboratory and discuss contemporary percutaneous interventional approaches.

관동맥혈관 내 방사선 근접 치료 (Intracoronary Radiation Therapy)

  • 문대혁;박성욱;홍명기;오승준;범희승;이희경
    • 대한핵의학회:학술대회논문집
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    • 대한핵의학회 2001년도 제40차 춘계학술대회 및 연수교육
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    • pp.24-34
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    • 2001
  • Restenosis remains a major limitation of percutaneous coronary interventions. Numerous studios including pharmacological approaches and new devices failed to reduce the restenosis rate except coronary stenting. Since the results of $BENESTENT^{1)}\;and\;STRESS^{2)}$ studies came out, coronary stenting has been the most popular interventional strategy in the various kinds of coronary stenotic lesions, although the efficacy of stenting was shown only in the discrete lesion of the large coronary artery. The widespread use of coronary stenting has improved the early and late outcomes after coronary intervention, but it has also led to a new and serious problem, e.g., in-stent restenosis. Intravascular radiation for prevention of restenosis is a new technology in the field of percutaneous coronary intervention. Recent animal experiments and human trials have demonstrated that local irradiation, in conjunction with coronary interventions, substantially diminished the rate of restenosis. This paper reviews basic radiation biology of intracoronary radiation and its role in the inhibition of restenosis. The current status of intracoronary radiation therapy using Re-188 liquid balloon is also discussed.

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Use of Drug-eluting Stents Versus Bare-metal Stents in Korea: A Cost-minimization Analysis Using Population Data

  • Suh, Hae Sun;Song, Hyun Jin;Jang, Eun Jin;Kim, Jung-Sun;Choi, Donghoon;Lee, Sang Moo
    • Journal of Preventive Medicine and Public Health
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    • 제46권4호
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    • pp.201-209
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    • 2013
  • Objectives: The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data. Methods: We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses. Results: Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to-BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7%, 0.6%, 4.3%, and 35.3%, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization. Conclusions: Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.

기관-기관지 협착에서 내시경적 확장술 및 실리콘 스텐트의 유용성 : 예비보고 (Effectiveness of Endoscopic Dilatation & Silicone Stent Insertion for Tracheobronchial stenoses : Preliminary study)

  • 이경수;박동욱;김규훈;김재욱;고윤우;김도진;이승원
    • 대한기관식도과학회지
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    • 제15권1호
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    • pp.50-55
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    • 2009
  • Objectives: Endoscopic airway dilatation and stenting has been developed to treat the airway stenosis without potential morbidities of open surgery. We report the clinical results of endoscopic airway dilatation with silicone stenting in patients with posttuberculous bronchial stenosis(PTBS) and with severe main tracheal stenosis who have poor general conditions Methods : A prospective observation study of five patients, who have undergone endoscopic airway dilatation and silicone stenting between Feb 2007 and Feb 2009. A total of twelve patients were treated with endoscopic airway dilatation, among them 5 patients were included in this study. three patients were treated with newly designed silicone stent (Natural stent: TNO Co., Seoul, South Korea) because of poor surgical conditions and longer stenotic segment Results: 3 patients were grade III PTBS, and the other 2 patients were grade IV post tracheotomy main tracheal stenosis. One patient of PTBS were treated with silicone stent following endoscopic dilatation because of longer stenotic segment. Two patients of main tracheal stenosis patients were treated with silicone stent because of tracheal lumen collapse. There was no severe postoperative complications except mild granulation tissue formations Conclusions : Endoscopic dilatation including silicone stenting could be a useful method for treating patients with PTBS, and for main tracheal stenosis patients with poor general surgical conditions

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Preliminary Experience of Neuroform Atlas Stenting as a Rescue Treatment after Failure of Mechanical Thrombectomy Caused by Residual Intracranial Atherosclerotic Stenosis

  • Yi, Ho Jun;Sung, Jae Hoon;Lee, Dong Hoon
    • Journal of Korean Neurosurgical Society
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    • 제64권2호
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    • pp.198-206
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    • 2021
  • Objective : The low-profile Neuroform Atlas stent can be deployed directly without an exchange maneuver by navigating into the Gateway balloon. This retrospective study assessed the safety and efficacy of Neuroform Atlas stenting as a rescue treatment after failure of mechanical thrombetomy (MT) for large artery occlusion. Methods : Between June 2018 and December 2019, a total of 31 patients underwent Neuroform Atlas stenting with prior Gateway balloon angioplasty after failure of conventional MT caused by residual intracranial atherosclerotic stenosis (ICAS). Primary outcomes were successful recanalization and patency of the vessel 24 hours after intervention. Secondary outcomes were vessel patency after 14 days and 3-month modified Rankin Scale. Peri-procedural complications, intracerebral hemorrhage (ICH), and 3-month mortality were reviewed. Results : With a 100% of successful recanalization, median value of stenosis was reduced from 79.0% to 23.5%. Twenty-eight patients (90.3%) showed tolerable vessel patency after 14 days. New infarctions occurred in three patients (9.7%) over a period of 14 days; two patient (6.5%) underwent stent occlusion at 24 hours, and the other patient (3.2%) with delayed stent occlusion had a non-symptomatic dot infarct. There were no peri-procedural complications. Two patients (6.5%) developed an ICH immediately after the procedure with one of them is symptomatic. Conclusion : Neuroform Atlas stenting seems to be an effective and safe rescue treatment modality for failed MT with residual ICAS, by its high successful recanalization rate with tolerable patency, and low peri-procedural complication rate. Further multicenter and randomized controlled trials are needed to confirm our findings.

External Carotid Artery Angioplasty and Stenting Followed by Superficial Temporal Artery to Middle Cerebral Artery Anastomosis

  • Ko, Jun-Kyeung;Lee, Sang-Weon;Lee, Tae-Hong;Choi, Chang-Hwa
    • Journal of Korean Neurosurgical Society
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    • 제46권5호
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    • pp.488-491
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    • 2009
  • A 31-year-old man presented with right hemiparesis, and magnetic resonance imaging revealed a small infarct at left basal ganglia. Digital subtraction angiography showed left cervical internal carotid artery (ICA) occlusion and severe stenosis of the ipsilateral external carotid artery (ECA) with collateral cerebral circulation fed by ECAs. Based on the results of a functional evaluation of cerebral blood flow, we performed preventive ECA angioplasty and stenting for advanced ECA stenosis to ensure sufficient blood flow to the superficial temporal artery. Eight weeks later, superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis was performed. His postoperative course was uneventful and no additional transient ischemic attacks have occurred. To our knowledge, this is the first report of preventive angioplasty and stenting for advanced narrowing of an ECA before STA-MCA anastomosis for ipsilateral ICA occlusion.

Intracranial Atherosclerotic Disease; Current Options for Surgical or Medical Treatment

  • Huh, Pil-Woo;Yoo, Do-Sung
    • Journal of Korean Neurosurgical Society
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    • 제42권6호
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    • pp.427-435
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    • 2007
  • Recently, intracranial atherosclerosis has become a major cause of ischemic stroke, appearing more frequently in Koreans than Caucasians. Symptomatic or asymptomatic intracranial atherosclerosis is a disease that could recur readily even during the treatment with anti-platelet agents. When the symptoms develop, ischemic stroke can not be recovered readily. Therefore, aggressive treatments such as endovascular therapy and bypass surgery are required in addition to medical treatment for the intracranial artery stenosis. Recent intracranial stenting and drug eluting stenting have shown as very advanced effective therapeutic modalities. Nevertheless, until now, a randomized controlled study has not been conducted. Regarding bypass surgery, since the failed EC-IC bypass surgery study performed 20 years ago, extensive studies on its efficacy has not been conducted yet, and thus it has to be performed strictly only in hemodynamically compromised patients. Unless breakthrough drugs that suppress the progression of intracranial atherosclerosis and the formation of thrombi, and facilitate the regression of the arterial stenosis, the treatment concept of the recovery of the blood flow of stenotic arterial territory by mechanical recanalization or bypass surgery would be remained for the prevention as well as treatment of ischemic stroke caused by intracranial atherosclerosis.

내경동맥에 발생한 외상성 가성동맥류에 대한 혈관내 스텐트 치료 (Endovascular Stenting of a Traumatic Pseudoaneurysm on C5 Portion of the Internal Carotic Artery - A Case Report -)

  • 정현호;김헌주;이명섭;황금;조성민;허철;변진수;홍순기
    • Journal of Korean Neurosurgical Society
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    • 제30권sup2호
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    • pp.332-336
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    • 2001
  • This 18-year-old male patient had a massive epistaxis after motorcycle traffic accident on 1st day of admission. There were no other significant brain parenchymal lesion on initial brain CT exam, except multiple pneumocephalus and basal skull fracture lines. We treated epistaxis conservatively till vital signs were corrected, and then conventional cerebral angiogram was followed. On angiogram, there was traumatic pseudoaneurysm on C5 portion(by Fischer) of ICA, so we treated it only by endovascular stenting. For the purpose of sparing parent arterial patency, endovascular stenting on pseudoaneurysm may play a role with safety and good results.

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Gastric cancer presenting with ramucirumab-related gastrocolic fistula successfully managed by colonic stenting: a case report

  • Hiroki Fukuya;Yoichiro Iboshi;Masafumi Wada;Yorinobu Sumida;Naohiko Harada;Makoto Nakamuta;Hiroyuki Fujii;Eikichi Ihara
    • Clinical Endoscopy
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    • 제56권6호
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    • pp.812-816
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    • 2023
  • We report a rare case of gastric cancer presenting with a gastrocolic fistula during ramucirumab and paclitaxel combination therapy that was successfully managed with colonic stenting. A 75-year-old man was admitted to our hospital with the chief complaint of melena. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower stomach, judged by laparoscopy as unresectable (sT4bN1M0). After four cycles of first-line chemotherapy with S-1 plus oxaliplatin, the patient showed disease progression, and second-line therapy with ramucirumab and paclitaxel was started. At the end of the third cycle, the patient had gastric antral stenosis, which necessitated the placement of a gastroduodenal stent. When the patient complained of diarrhea 10 days later, esophagogastroduodenoscopy revealed a fistula between the greater curvature of the stomach and the transverse colon. The fistula was covered by double colonic stenting, with a covered metal stent placed within an uncovered metal stent, after which leakage from the stomach to the colon stopped.