• Title/Summary/Keyword: 하지 동맥

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Use of an Amplatzer Vascular Plug to occlude a tubular type of patent ductus arteriosus (원통형 모양 동맥관의 경피적 폐쇄술에서의 Amplatzer Vascular Plug 의 사용)

  • Choi, Eun-Young;Jang, So-Ick;Kim, Soo-Jin
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.1035-1037
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    • 2009
  • Patent ductus arteriosus (PDA) is a common congenital heart defect. All PDAs, regardless of size or degree of symptoms, require occlusion. Transcatheter PDA occlusion features fewer complications than trans-thoracic closure. It is also more cost-effective and has an excellent occlusion rate. Therefore, transcatheter PDA occlusion is accepted as the standard treatment option for PDA. However, tubular-type PDAs are difficult to close with ordinary detachable coils or the Amplatzer Duct Occluder; thus, these lesions remain a challenge for transcatheter closure. We attempted to occlude a tubular-type PDA by using an oversized Amplatzer Vascular Plug, which allowed intraluminal packing of the ductus. By using this treatment method, PDA occlusion was achieved safely with an excellent final outcome. We suggest that this approach may be a good option for transcatheter closure of a tubular-type PDA.

Popliteal Artery Entrapment Syndrome - A case report - (슬와동맥 포착증후군 - 1예 보고 -)

  • Kim, Duk-Sil;Kim, Sung-Wan;Kim, Byung-Ki;Lee, Hyeon-Jae;Lee, Gun;Lim, Chang-Young
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.653-656
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    • 2009
  • The entrapment of the popliteal artery is a rare cause of ischemia of the lower extremities among young males. The development of local occlusive or aneurysmal changes of the popliteal artery is caused by abnormal anatomic relationships between vascular and musculo-tendinous structures in the popliteal fossa. An 18-year-old male visited our outpatient clinic with the chief complaint of claudication in his right calf. Three dimensional CT angiography showed an occlusion of the popliteal artery and less opacified arteries of the right leg. Intraoperatively, the popliteal artery was compressed by an accessory muscle band arising from the medial head of the gastrocnemius. After release of the muscle band, thrombectomy with endarterectomy was done. Three years after surgery, he is doing well without any problems.

Off-pump Coronary Artery Bypass Surgery Versus Drug Eluting Stent for Multi-vessel Coronary Artery Disease (다혈관 관상동맥질환에서의 심폐바이패스를 사용하지 않은 관상동맥우회술과 약물용출 스텐트시술)

  • Lee, Jae-Hang;Kim, Ki-Bong;Cho, Kwang-Ree;Park, Jin-Shik;Kang, Hyun-Jae;Koo, Bon-Kwon;Kim, Hyo-Soo;Sohn, Dae-Won;Oh, Byung-Hee;Park, Young-Bae
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.202-209
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    • 2008
  • Background: The introduction of Drug Eluting Stents (DES) decreased the number of patients referred for coronary artery bypass grafting (CABG). The impact of DES on CABG (Step 1) was studied and compared with the 1-year outcome after CABG with DES (Step 2). Material and Method: Surgical results for patients who underwent off-pump CABG (OPCAB) before the introduction of DES(n=298) were compared with those who underwent OPCAB after the introduction of DES (n=288) (Step 1). Postoperative 30-day and 1-year results were also compared between the patients who underwent percutaneous coronary intervention (PCI) using DES (n=220) and those who underwent OPCAB (n=255) (Step 2). Result: Since the introduction of DES, the ratio of CABG versus PCI decreased. In the CABG group, the number of high risk patients such as elderly patients (age 62 vs. 64, p=0.023), those with chronic renal failure (4% vs. 9%, p=0.021), calcification of the ascending aorta (9% vs. 15%, p=0.043), or frequency of urgent or emergent operations (12% vs. 22%, p=0.002) increased. However, there were no differences in the cardiac death and graft patency rates between the two groups (step 1). During the one-year follow up period, the rate of target vessel revascularization (12.3% vs. 2.4%, p<0.001) and major adverse cardiac events (MACE: death, myocardial infarct, TVR) were higher in the DES than the CABG group (13.6% vs 4.3%) (stage 2). Conclusion: Introduction of DES decreased the number of patients referred for surgery, and increased the comorbidity in patients who underwent CABG. DES increased the rate of target vessel revascularization, and the occurrence of MACE during the 1-year follow-up. However, there was no difference in the incidence of myocardial infarction and cardiac death between the two groups.

Visualization of Borderline Coronary Artery Lesions by CT Angiography and Coronary Artery Disease Reporting and Data System (관상동맥 질환 판독과 자료 체계와 CT 혈관조영술에서의 경계성 관상동맥 병변)

  • Hyewon Park;Yu-Whan Oh;Ki Yeol Lee;Hwan Seok Yong;Cherry Kim;Sung Ho Hwang
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.297-307
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    • 2024
  • Coronary artery disease (CAD) narrows vessel lumens at the sites of atherosclerosis, increasing the risk of myocardial ischemia or infarction. Early and accurate diagnosis of CAD is crucial to significantly improve prognosis and management. CT angiography (CTA) is a noninvasive imaging technique that enables assessment of vascular structure and stenosis with high resolution and contrast. Coronary CTA is useful in the diagnosis of CAD. Recently, the CAD-reporting and data system (CAD-RADS), a diagnostic classification system based on coronary CTA, has been developed to improve intervention efficacy in patients suspected of CAD. While the CADRAD is based on CTA, it includes borderline categories where interpreting the coronary artery status solely based on CTA findings may be challenging. This review introduces CTA findings that fall within the CAD-RADS categories that necessitate additional tests to decide to perform invasive coronary angiography and discusses appropriate management strategies.

Conversion Arterial Switch Operation for Failed Sensing Procedure in TGA with VSD -One Case Report- (심방교체수술을 시행한 대혈관 전위증환자에서의 동맥전환술-1례 보고-)

  • 조유원;서동만
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.86-89
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    • 1996
  • This is a report of successful conversion arterial switch operation for failed Sunning procedure in transposition of the great arteries(TGA) with ventricular septal defect(VSD). A 15 month-male patient was admitted due to intractable congestive heart failure after Sunning operation was done at the age of 8 months. Angiography revealed marked dysfunction of the morphologic right ventricle with tricuspid regurgitation and residual VSD. The pulmonary ventricle 1 systemic ventricle pressure ratio' of 75/85 at catheter study enabled us to do the take down of denning repair, patch closure of VSD and arterial switch without pulmonary artery banding. After the operation, the baby showed good growth with normal ventricular function.

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SE-LSTMNet Model Using Polar Conversion for Diagnosis of Atherosclerosis (죽상동맥경화증 진단을 위한 극좌표 변환과 SE-LSTMNet 모델)

  • Na, In-ye;Park, Hyunjin
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.10a
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    • pp.294-296
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    • 2022
  • Atherosclerosis is a chronic vascular inflammatory disease in which plaque builds up in the arteries and impairs blood flow. This can lead to heart disease and stroke. Since most people do not have any symptoms until the artery is severely narrowed, early detection of atherosclerosis is critical. In this paper, in order to effectively detect atherosclerotic lesions in tube-shaped blood vessels, polar conversion is applied to MRI images based on the vessel center. We then propose a SE-LSTMNet model using continuous signal information for each angle of a polar coordinate image. The trained model showed classification performance of 0.9194 accuracy, 0.9370 sensitivity, 0.8796 specificity, 0.8700 F1 score, and 0.9719 AUC on the validation data.

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Transcatheter Arterial Embolization in the Treatment of Massive Hemoptysis (대량 객혈 환자에서 동맥 색전술의 치료 효과)

  • Choi, Wan-Young;Choi, Jin-Won;Lim, Byung-Sung;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee;Seo, Heung-Suk
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.1
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    • pp.35-41
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    • 1992
  • Background: Massive hemoptysis is a major clinical and surgical problem related to high motality. Bronchial and nonbronchial systemic arteries are considered to be the main source of hemoptysis. Embolization of these arteries has become an accepted treatment in the management of massive hemoptysis. Herein we evaluate the effect of arterial embolization in immediate control of massive hemoptysis and investigate the clinical and angiographic characteristics and the course of patients with recurrent hemoptysis after initial successful embolization. Method: 21 patients (15 men & women, aged 21 to 74 years) underwent transcatheter arterial embolization for the treatment of life-threatening massive hemoptysis from Jan 1988 to July 1991. Seven patients had inactive residual pulmonary tuberculosis, 5 cases aspergilloma, 4 cases active pulmonary tuberculosis, 3 cases bronchiectasis and 2 case lung cancer. Arteriography was done by percutaneous catheterization via the femoral artery, and at the same time, arterial embolization was done with gelfoam particle. Result: Immediate control of massive hemoptysis was achieved in all 21 cases by arterial embolization. Hemoptysis recurred in nine of 21 patients. Four cases were aspergilloma, two inactive tuberculosis, two lung cancer, and one bronchiectasis. The initial angiographic findings revealed that nonbronchial systemic arterial supply, bronchial-pulmonary arterial shunt, and marked vascularity were more frequently, but statistically insignificant, in recurred patients. The following complications occured: fever, chest pain, cough, voiding difficulty, paralytic ileus, paraplegia, and splenic infarction. The course of the recurred patients was as follows: Three patients were died due to recurred massive hemoptysis. one was aspergilloma and two lung cancer. Surgical resection could be performed successfully in two patient with relatively good lung function, one aspergilloma and the other inactive tuberculosis. In 4 patients with poor lung function, repeated embolization or medical conservative treatment was continued. Conclusion: Arterial embolization as initial treatment of massive hemoptysis is most useful and relatively safe, although this is a palliative procedure and the potentiality for recurrence exists. Repeated embolization in inoperable patient with recurrent bleeding may improve the lengthening of life.

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Delayed Bilateral Common Femoral Pseudoaneurysm after Percutaneous Access with Interventional Management: A Case Report (경피적 접근을 통한 시술 후에 발생한 지연성 양측 총대퇴 가성동맥류 및 인터벤션 치료: 증례 보고)

  • Sang Hoon Lee;Doo Ri Kim;Jeong Sub Lee;In Chul Nam;Su Yeon Ko
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.705-712
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    • 2023
  • Common femoral artery pseudoaneurysm is a potentially serious complication of peripheral angiography. There have been few prior reports of simultaneous pseudoaneurysm in both common femoral arteries after percutaneous access. Here we report the case of a 58-year-old male patient who presented with phlegmon or abscess a few days after bilateral femoral access, after which newly developed bilateral femoral pseudoaneurysm with wide neck was observed on CT angiography 2 months after infection treatment. Because the patient refused surgery for pseudoaneurysm, a stent-graft was inserted in the left side, and percutaneous thrombin injection under US guidance with balloon occlusion was performed for the right side. Most pseudoaneurysms occur immediately after the causative procedure. However, there have been some cases in which pseudoaneurysms may occur several weeks or months later; it is therefore necessary to check the risk factors and to carefully observe the hemostasis site.

Massive Edema of the Lower Extremity after Surgery for Abdominal Aortic Aneurysm, A case report (복부 대동맥류 수술후 발생한 하지의 심한 부종)

  • Kim, Tae-Gyun;Kang, Jung-Ho;Chung, Won-Sang;Kim, Hyuck;Lee, Chul-Bum;Kim, Young-Hak
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.483-486
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    • 2002
  • 71 years old man was operated on due to abdominal aortic aneurysm associated with complete occlusion of left common iliac artery. The coexisting chronic deep vein thrombosis of the left femoral and iliac vein was not diagnosed preoperatively. Resection of aneurysm and Y-graft interposition was performed. Recurrent edema and pain occured to the left lower extremity immediately postoperatively, which aggrevated with the lapse of time, resulting in fatal extensive venous thrombosis. This report regards the surgical treatment and complication of the aortoiliac occlusive disease associated with chronic deep vein thrombosis.

Beyond Coronary CT Angiography: CT Fractional Flow Reserve and Perfusion (전산화단층촬영 관상동맥조영술: 분획혈류예비력과 심근관류 영상)

  • Moon Young Kim;Dong Hyun Yang;Ki Seok Choo;Whal Lee
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.3-27
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    • 2022
  • Cardiac CT has been proven to provide diagnostic and prognostic evaluation of coronary artery disease for cardiovascular risk stratification and treatment decision-making based on rapid technological development and various research evidence. Coronary CT angiography has emerged as a gateway test for coronary artery disease that can reduce invasive angiography due to its high negative predictive value, but the diagnostic specificity is relatively low. However, coronary CT angiography is likely to overcome its limitations through functional evaluation to identify the hemodynamic significance of coronary artery disease by analyzing myocardial perfusion and fractional flow reserve through cardiac CT. Recently, studies have been actively conducted to incorporate artificial intelligence to make this more objective and reproducible. In this review, functional imaging techniques of cardiac computerized tomography are explored.