• Clinical Endoscopy
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• 제56권6호
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• pp.741-743
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• 2023

• Journal of Korean Neurosurgical Society
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• 제61권2호
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• pp.219-223
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• 2018

Objective : To investigate nationwide statistics on flow-diverting stent usage for cerebral aneurysm treatment and related mortality data. Methods : We requested data extraction from the National Health Insurance Service claims database using electronic data interchange codes (J3207064, J3207073). Patient and hospital information as well as death statistics were collected from the database. Results : A total of 169 procedures were performed using flow-diverting stents for cerebral aneurysm treatment from November 2014 to December 2016 in Korea. The majority of primary diagnosis was unruptured intracranial aneurysm. During the study period, nine subjects died, including one patient initially diagnosed with subarachnoid hemorrhage. The crude mortality rate was 5.3%. Five patients died within one month after the procedure; therefore, the estimated periprocedural mortality rate was $3.0{\pm}1.3%$. The mortality rate as of the last day of 2016 was $6.3{\pm}2.1%$. Conclusion : In a 171 person-year follow-up in a Korean series, nine deaths occurred after flow-diverting stent treatment. The crude mortality rate in Korea (5.3%) was higher than that reported in a previous meta-analysis (3.8%).

• Journal of Korean Neurosurgical Society
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• 제52권3호
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• pp.187-192
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• 2012

Objective : Stent-assisted coiling on intracranial aneurysm has been considered as an effective technique and has made the complex aneurysms amenable to coiling. To achieve reconstruction of intracranial vessels with preservation of parent artery the use of stents has the greatest potential for assisted coiling. We report the results of our experiences in ruptured wide-necked intracranial aneurysms using Y-stent coiling. Methods : From October 2003 to October 2011, 12 patients (3 men, 9 women; mean age, 62.6) harboring 12 complex ruptured aneurysms (3 middle cerebral artery, 9 basilar tip) were treated by Y-stent coiling by using self-expandable intracranial stents. Procedural complications, clinical outcome, and initial and midterm angiographic results were evaluated. The definition of broad-necked aneurysm is neck diameter over than 4 mm or an aneurysm with a neck diameter smaller than 4 mm in which the dome/neck ratio was less than 2. Results : In all patients, the aneurysm was successfully occluded with no apparent procedure-related complication. There was no evidence of thromboembolic complication, arterial dissection and spasm during procedure. Follow-up studies showed stable and complete occlusion of the aneurysm in all patients with no neurologic deficits. Conclusion : The present study did show that the Y-stent coiling seemed to facilitate endovascular treatment of ruptured wide-necked intracranial aneurysms. More clinical data with longer follow-up are needed to establish the role of Y-stent coiling in ruptured aneurysms.

• Journal of Korean Neurosurgical Society
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• 제46권6호
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• pp.572-576
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• 2009

Detachable balloon-based endovascular fistula occlusion is a widely accepted treatment for traumatic carotid cavernous fistulas (CCF). However, more recently coils have been used to obliterate the lesion, especially in case detachable balloon is not available. We failed balloon-assisted coil embolization for CCF because of large fistulas and herniation of coil loops into the parent artery. The authors describe our experiences of balloon-expandable graft-stents to treat CCF, and place emphasis on arterial wall reconstruction. Three traumatic CCF patients were treated using a graft-stent with/without coils, and underwent angiographic follow-up to evaluate the patency of the internal carotid artery (ICA). In all cases, symptoms related to CCF regressed after stent deployment and did not recur during follow-up. Follow-up angiography revealed good patency of the ICA in all patients. Graft-stents should be considered as an alternative means of treating CCF and preserving the parent artery by arterial wall reconstruction especially in patients with a fistula that cannot be successfully occluded with detachable balloons or coils.

• 대한기계학회논문집B
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• 제31권1호
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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.

• Tuberculosis and Respiratory Diseases
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• 제76권6호
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• pp.292-294
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• 2014

Primary tracheal amyloidosis (PTA) can lead to airway obstructions, and patients with severe PTA should undergo bronchoscopic interventions in order to maintain airway patency. Focal airway involvements with amyloidosis can only be treated with mechanical dilatation. However, the PTA with diffused airway involvements and concomitant cartilage destructions requires stent placement. Limited information regarding the usefulness of silicone stents in patients with PTA has been released. Therefore, we report a case of diffused PTA with tracheomalacia causing severe cartilage destruction, which is being successfully managed with bronchoscopic interventions and silicone stent placements.

• 한국기계가공학회지
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• 제16권1호
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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.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 추계학술대회
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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.

• Journal of Hospice and Palliative Care
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• 제12권2호
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• pp.49-55
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• 2009

상부 위장관 스텐트 삽입술은 근치적 수술이 불가능한 상부 악성 종양에 의한 상부 위장관 협착 환자의 폐쇄 증상 완화를 위한 보존적 치료로서 확립되었으며 내시경 개발 기술이 발달하고 임상 경험이 축적됨에 따라서 여러 상부 위장관 질환에서 스텐트 삽입술을 보다 편리하고 안전하게 시행할 수 있게 되었다. 그러나 스텐트 삽입술 이후에는 동통, 출혈, 천공과 같은 조기 합병증이나 스텐트 일탈, 스텐트 폐쇄 등의 후기 합병증이 발생할 수 있으므로 사후 관리 또한 중요하다.

• Tuberculosis and Respiratory Diseases
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• 제71권1호
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• pp.59-61
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• 2011

Obstructive Fibrinous Tracheal Pseudomenbrane (OFTP) is a rarely known but potentially fatal complication of endotracheal intubation. Sudden respiratory failure shortly after extubation is not infrequent in the ICU. However, these cases are commonly diagnosed as laryngospasm, retention of secretion or laryngeal edema. A 68-year-old woman presented with a 6-day history of progressive dyspnea. She had undergone invasive ventilator care for 24 hours. The patient was discharged from the hospital with improvement after having an extubation. However, after 3 days she revisited the emergency department with progressive dyspnea. The patient was diagnosed with OFTP from the results of chest CT and bronchoscopy. This is the first case studied in detail using CT images, pulmonary function test, and bronchoscopy.