• Journal of Chest Surgery
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• v.43 no.6
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• pp.769-773
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• 2010

Systemic hypotension has been traditionally used to facilitate deployment of thoracic stent grafts. Decreasing blood pressure with vasodilating agents further increases cardiac output and, consequently, the cardiac output-mediated windsock effect during deployment. Use of rapid ventricular pacing reduces the windsock effect during stent graft deployment and allows the graft to appose to the aortic wall under zero cardiac output, thus minimizing aortic wall shear stress. In this case we report the use of transvenous rapid ventricular pacing, a safe and reproducible technique to allow precise deployment of a Valiant Captivia stent graft in the distal thoracic arch for a saccular thoracic aneurysm.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.92-95
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• 2010

Endovascular stent grafting is regarded as a promising alternative approach to open surgical repair for treating various aortic diseases in high risk patients. We report here on a case of a 79-year-old female who underwent endovascular stent-graft insertion in the ascending aorta for treating a complicated ascending aortic rupture that occurred secondary to radiation necrosis during the treatment of recurrent breast cancer.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.427-430
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• 2003

The surgical managements for the complicated aortic disease is still one of most challenging fields for the cardiac surgeons. The endovascular stent graft procedure has been tried recently to avoid serious complications caused by traditional graft replacement technique. However, indications for the procedures or management methods for the complications have not been clearly elucidated so far. We report a case of successful management for the newly-onset aneurysmal dilation of the distal aorta after an endovascular stent graft procedure in a patient with acute aortic dissection type IIIB.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.758-763
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• 2010

In current era, thoracic endovascular aortic repair (TEVAR) has gained popularity. But, it bears the risk of serious complications such as treatment failure from endoleak, retrograde aortic dissection caused by injury of aortic wall at landing zone, or aortic rupture resulting from stent graft infection. We report two cases of surgical repair of retrograde aortic dissection after TAVAR applied to acute Stanford type B aortic dissection or traumatic aortic disruption.

• Journal of Chest Surgery
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• v.39 no.2 s.259
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• pp.157-161
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• 2006

Use of endovascular stent-graft in aortic aneurysm disease is now accepted as an alternative treatment to surgery. We successfully treated two patients with high risk of thoracic aortic aneurysm with percutaneous endovascular stent-graft. Three and ten months follow up chest CT showed obliteration of aneurysm and there was no complication after stent grafting.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.781-784
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• 2010

A 74-year-old woman presented at our hospital with hemoptysis. Three months ago, she had endovascular stent-grafting done by a general surgeon for a saccular thoracic aneurysm that was found accidentally following an episode of fever and chills. Despite a lasting fever after the procedure, she was discharged without further treatment and follow-up. She was subsequently admitted to the hospital for evaluation and several exams were performed. Chest CT scans and an esophagoscopy identified an aorto-esophageal fistula at the level of the aorta that was covered by a previous stent-graft. After extensive administration of antibiotics, surgery was done - esophagectomy, cervical esophago-gastrostomy and replacement of the thoracic aorta. She was later discharged uneventfully.

• Proceedings of the Korean Society of Rheology Conference
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• 2003.05a
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• pp.57-60
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• 2003

• Journal of Chest Surgery
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• v.43 no.6
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• pp.729-733
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• 2010

Endovascular treatment of the aortic aneurysm with a stent graft is rapidly evolving. We describe here a case of hybrid TEVAR (thoracic endovascular aortic repair) in which the stent grafts were placed in the aortic arch after debranching of the arch vessels. The patient had undergone ascending aorta replacement for acute type I aortic dissection 2.5 years earlier. The aneurysmal change of the distal dissection progressed with time. A provisional bypass surgery from the ascending aorta to the innominate artery and left carotid artery was performed and then stent grafts were inserted via an antegrade route that covered the whole aortic arch and proximal descending thoracic aorta.

• Journal of Chest Surgery
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• v.37 no.11
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• pp.911-917
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• 2004

Background: There are limited number of reports on May-Thurner syndrome (Iliac vein compression syndrome) in Korea, We analysed the clinical features, diagnostic modalities and endovascular treatment of May-Thurner syndrome. Material and Method: We reviewed 12 cases of May-Thurner syndrome between March 2001 and June 2003. Mean age was $57.6\pm2$ years. We were used in venography, color doppler and computed tomographic angiography as diagnostic modalities and in thrombolysis, thrombectomy, angioplasty and stent insertion as endovascular treatment. Result: Clinical features showed edema of lower extremities in 4 patients, pain of lower extremities in 1 patient, edema with pain in 5 patients, and all in 1 patient. In one patient, he did not have any pain and any edema of lower extremities but was diagnosed as May-Thurner syndrome using venography due to varicose veins on lower extremities. Diagnostic modalities included venography, computed tomographic angiography in all patients with clinical presentation except in one patient and color doppler was only performed only in 4 patients. Four kinds of endovascular treatment were performed for May-Thurner syndrome, angioplasty in 11 patients, stent insertion in 10 patients, thrombectomy in 9 patients and thrombolysis for 7 patients. Nine patients were followed up and we can show good blood flow in Left iliac vein for 7 of 9 patients. Conclusion: it is necessary to recognize the possibility of May-Thurner syndrome in Deep vein thrombosis patients and we should use a variety of modalities to diagnose May-Thurner syndrome. Finally, endovascular treatment is a safe and effective therapy for May-Thurner syndrome.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1216-1221
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• 2020

Neoadjuvant concurrent chemoradiotherapy has been increasingly used to obtain secondary resectability for locally advanced pancreatic cancers. Although most patients require biliary decompression, only a few studies have investigated the safety of biliary stenting with chemoradiotherapy. Herein, we report a rare case of delayed hemorrhage of the hepatic artery caused by biliary stenting after chemoradiotherapy. The serial follow-up CT demonstrated that the biliary stent was approaching the right hepatic artery and eventually caused acute angulation and indentation. Diagnostic catheter angiography revealed contrast extravasation at the right hepatic artery, and endovascular embolization was performed. This report highlights the relevance of anatomical deformation after chemoradiotherapy, which can result in fatal complications. Indentation of the hepatic artery caused by biliary stents should be recognized as a warning sign of vascular injury.