• Title/Summary/Keyword: stents

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Unexpected Detachment of Solitaire Stents during Mechanical Thrombectomy

  • Kim, Sung Tae;Jin, Sung-Chul;Jeong, Hae Woong;Seo, Jung Hwa;Ha, Sam Yeol;Pyun, Hae Wook
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.463-468
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    • 2014
  • Objective : Unexpected Solitaire stent detachment can occur during mechanical Solitaire thrombectomy. The purpose of this study was to retrospectively evaluate the influencing factors causing unexpected Solitaire stent detachment and the clinical outcomes. Methods : Between October 2011 to December 2013, 232 cases of mechanical Solitaire thrombectomy for acute ischemic stroke were performed in 3 stroke centers. During this period, we encountered unexpected Solitaire stent detachments during mechanical Solitaire thrombectomies in 9 cases. Results : Solitaire stents unexpectedly detached in 9 cases (3.9%) during the retrieval of Solitaire stents. The median patient age was 76 years. The occlusion sites of the unexpected stent detachment were the proximal middle cerebral artery (MCA) in 7 cases and the internal carotid artery in 2 cases. The sizes of the stents that unexpectedly detached were $6{\times}30$ mm in 7 cases, $5{\times}30$ mm in 1 case, and $4{\times}20$ mm in 1 case. Four patients had unexpected detachment at the first retrieval, 1 patient at the second, 3 patients at the third, and 1 patient at the fifth. In all of the cases of unexpected detachment at the first retrieval, the stent deployment site was the proximal MCA. After detachment, a proximal marker of the Solitaire stent was observed in 3 patients. However, no marker was visible in the remaining 6 patients. Conclusion : Unexpected Solitaire stent detachment should be considered in the first instance of stent retrieval for a relatively large-diameter stent, especially in elderly patients with MCA occlusions.

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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    • v.46 no.4
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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.

Thermal Process for Enhancing Mechanical Strength of PLGA Nanoparticle Layers on Coronary Stents

  • Joo, Jae-Ryang;Nam, Hye-Yeong;Nam, So-Hee;Baek, In-Su;Park, Jong-Sang
    • Bulletin of the Korean Chemical Society
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    • v.30 no.9
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    • pp.1985-1988
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    • 2009
  • Poly (lactic-co-glycolic acid) (PLGA) nanoparticles loading paclitaxel have been deposited on coronary stents by self-assembling properties of colloidal particles. The layers of the nanoparticles were enhanced to a sufficient mechanical strength by a thermal process under the proper temperature and humidity conditions. In vitro release studies proved the controlled paclitaxel release of the nanoparticle layers. This technique gives rise to a new range of applications for nanoparticles and drug-eluting stents.

Cerebral Hemorrhage after Endovascular Treatment of Bilateral Traumatic Carotid Cavernous Fistulae with Covered Stents

  • Cho, Kwang-Chun;Seo, Dae-Hee;Choe, Il-Seung;Park, Sung-Choon
    • Journal of Korean Neurosurgical Society
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    • v.50 no.2
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    • pp.126-129
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    • 2011
  • Bilateral traumatic carotid-cavernous fistulae (TCCFs) is rarely encountered neurovascular disease. For treatment of TCCF, detachable balloons have been widely used. Nowadays, transarterial and/or transvenous coil embolization with placement of covered stents is adopted as another treatment method. We experienced a patient with a bilateral TCCFs who was successfully treated with covered stents. However, cerebral hemorrhage occurred in the bed of previous infarction one day after treatment. Hyperperfusion syndrome was considered as a possible cause of the hemorrhage, so that barbiturate coma therapy was started and progression of hemorrhage was stopped. We emphasize that cerebral hyperperfusion hemorrhage can occur even after successful endovascular treatment of TCCF.

Modified 'Y-Configured Stents with Waffle Cone Technique' for Broad Neck Basilar Top Aneurysm

  • Cho, Jun-Sung;Kim, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.50 no.6
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    • pp.517-519
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    • 2011
  • Stent assisted coiling on intracranial broad neck aneurysm has been considered as an effective technique and has made the complex aneurysms amenable to coiling. However, stent navigation and application themselves often have the problems especially when the parent vessel angle (entrance between afferent and efferent vessel) is over 90 degrees. We report here a case of a ruptured broad neck basilar top aneurysm that was successfully coiled using two self-expandable stents (Enterprise and Neuroform) placed in a fashion of modified Y-configured stents with waffle cone technique.

Endovascular Treatment of Blood Blister-Like Aneurysms Using Multiple Self-Expanding Stents

  • Kim, Young-Woo;Park, Ik-Seong;Baik, Min-Woo;Jo, Kwang-Wook
    • Journal of Korean Neurosurgical Society
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    • v.49 no.2
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    • pp.116-119
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    • 2011
  • The surgical as well as endovascular treatment of blood-blister-like aneursysms (BBAs) is extremely difficult because of these pathological natures, such as small and the fragile necks. The optimal treatment of BBAs has remained uncertain. Stents are known to divert blood flow and induce thrombosis of intracranial aneurysms. We report 3 cases of successful obliteration of BBAs after multiple stents placement.

Left Wedge Pneumonectomy for the Complication of the Self Expandable Metallic Stent -A Case Report- (Self expandable Metallic Stent 합병증으로 인한 좌측 전폐 설상 절제술 -치험 1례-)

  • Kim, Jin;Shin, Hyeong-Ju;Kuh, Ja-Hong;Kim, Kong-Soo
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.201-205
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    • 1995
  • Most of the patient with endobronchial tuberculosis have some degree of bronchial stenosis. however, a part of bronchial stenosis need aggressive treatment for the patency because of severe symptoms. The self-expendable metallic stents provide palliative treatment for narrowed airways where surgical resection is inadvisable. We experienced a successful left wedge pneumonectomy on a 29-year-old woman with obstruction of left main bronchus due to complication of the bronchial stent. She had inserted self-expendable metallic stents on left main bronchus of the tuberculous bronchial stenosis two times. There was no specific postoperative complication.

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Self-expandable Metal Stents for Malignant Colorectal Obstruction (악성 대장 폐색에서의 자가팽창형 스텐트 삽입술)

  • Jae Jun Park
    • Journal of Digestive Cancer Research
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    • v.12 no.1
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    • pp.15-22
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    • 2024
  • Malignant colorectal obstructions urgently require decompression therapy to prevent the severe risks of intestinal ischemia and bowel perforation. In managing malignant colonic strictures endoscopically, the use of self-expandable metal stents (SEMS) is the predominant approach. Colonic SEMs are primarily used in preoperative decompression therapy before curative surgery and palliative treatment in patients with advanced disease stages. Furthermore, the stenting process, which requires rigorous clinical supervision, can lead to complications. This review endeavors to concisely review the clinical considerations associated with the SEMS procedure, with a focus on its indications, technical aspects, and potential complications that may arise during the procedure.

Prospective Multicenter Study of the Challenges Inherent in Using Large Cell-Type Stents for Bilateral Stent-in-Stent Placement in Patients with Inoperable Malignant Hilar Biliary Obstruction

  • Yang, Min Jae;Kim, Jin Hong;Hwang, Jae Chul;Yoo, Byung Moo;Lee, Sang Hyub;Ryu, Ji Kon;Kim, Yong-Tae;Woo, Sang Myung;Lee, Woo Jin;Jeong, Seok;Lee, Don Haeng
    • Gut and Liver
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    • v.12 no.6
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    • pp.722-727
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    • 2018
  • Background/Aims: Although endoscopic bilateral stent-instent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic re-intervention. This study aimed to evaluate the technical accessibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Methods: Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Results: Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases of technical success. Stent occlusion occurred in 63.2% of the patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months postoperatively, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Conclusions: Large cell-type stents for endoscopic bilateral stent-in-stent placement had acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.

Effect of Biodegradable Polymer Coating on the Corrosion Rates and Mechanical Properties of Biliary Magnesium Alloy Stents (생분해성 고분자 코팅이 담관용 마그네슘 합금 스텐트의 분해 속도와 기계적 물성에 미치는 영향)

  • Kim, Hyun Wook;Lee, Woo-Yiel;Song, Ki Chang
    • Korean Chemical Engineering Research
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    • v.58 no.1
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    • pp.36-43
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    • 2020
  • A biliant stent was fabricated using a magnesium alloy wire, a biodegradable metal. In order to control the fast decomposition and corrosion of magnesium alloys in vivo, magnesium alloy wires were coated with biodegradable polymers such as polycaprolactone (PCL), poly(propylene carbonate) (PPC), poly (L-lactic acid) (PLLA), and poly (D, L-lactide-co-glycolide) (PLGA). In the case of PPC, which is a surface erosion polymer, there is no crack or peeling compared to other polymers (PCL, PLLA, and PLGA) that exhibit bulk erosion behavior. Also, the effect of biodegradable polymer coating on the axial force, which is the mechanical property of magnesium alloy stents, was investigated. Stents coated with most biodegradable polymers (PCL, PLLA, PLGA) increased axial forces compared to the uncoated stent, reducing the flexibility of the stent. However, the stent coated with PPC showed the axial force similar to uncoated stent, which did not reduce the flexibility. From the above results, PPC is considered to be the most efficient biodegradable polymer.