• Title/Summary/Keyword: Atherectomy

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Atherectomy in Peripheral Artery Disease: Current and Future (말초동맥질환에서의 죽종절제술: 현재와 미래)

  • Yohan Kwon;Jinoo Kim;Je-Hwan Won;Seong Ho Kim;Jeong-Eun Kim;Sung-Joon Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.551-561
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    • 2021
  • Atherectomy has become a promising treatment option for peripheral artery disease caused by diabetes mellitus or end-stage renal disease. Atherectomy refers to the removal of atheromatous tissue by mechanical method, resulting in an enlarged lumen of the treated blood vessel. Based on this method, the term is limited to the percutaneous minimally invasive approach, and there are currently two types of atherectomy devices available in Korea. The increased prevalence of atherectomy has led to the concept of "vascular preparation" and a new treatment concept of "leave nothing behind." Various studies have proven the safety and effectiveness of atherectomy; however, there are some limitations. We need to remain focused on patient selection and subsequent large-scale research.

Interventional Treatments for Femoropopliteal Arterial Disease and Recent Updates (대퇴슬와동맥의 인터벤션과 최신 지견)

  • Minuk Kim;Soo Buem Cho
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.527-540
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    • 2021
  • Peripheral arterial occlusive disease (PAOD) of the femoropopliteal artery is commonly caused by atherosclerosis. It can present with varying clinical symptoms depending on the degree of disease, ranging from intermittent claudication to critical limb ischemia and tissue loss. Therefore, appropriate and timely treatment is required to improve symptoms and salvage the affected limbs. Interventional approaches for femoropopliteal arterial disease commonly include percutaneous transluminal angioplasty, atherectomy, and stent placement. Over the years, endovascular recanalization has been widely performed for treating PAOD due to continuous developments in its techniques and availability of dedicated devices with the inherent advantage of being minimal invasive. In this review, we introduce various types of endovascular treatment methods, discuss the results of clinical research from existing literature, and illustrate the treatment procedures using representative images.

A Morphometric Study on Cadaveric Aortic Arch and Its Major Branches in 25 Korean Adults : The Perspective of Endovascular Surgery

  • Shin, Il-Young;Chung, Yong-Gu;Shin, Won-Han;Im, Soo-Bin;Hwang, Sun-Chul;Kim, Bum-Tae
    • Journal of Korean Neurosurgical Society
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    • v.44 no.2
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    • pp.78-83
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    • 2008
  • Objective : To understand the anatomic characteristics of the aortic arch (AA) and its major branches to build a foundation toward performing endovascular surgery safely. Methods : A total of 25 formalin fixed Korean adult cadavers were used. The authors investigated : anatomical variations of the AA and its major branches; curvature of the AA; distance from the mid-vertebrae line to the origin of the major branches; distances from the origin of the major branches of AA to the origin of its distal branches; and the angle of the three major branches, the brachiocephalic trunk (BCT), the left common carotid artery (LCCA) and the left subclavian artery (LSCA) arising from AA. Results : The three major branches directly originated from AA in 21 (84%) of the cadavers. In two (8%) of remaining four cadavers. orifice of LCCA was slightly above the stem of BCT. In remaining two (8%) cadavers, the left vertebral artery (LVA) was directly originated from AA. Average angle of AA curvature to the coronal plane was 62.2 degrees. BCT originated 0.92 mm on the right of the mid-vertebrae line. LCCA and LSCA originated from 12.3 mm and 22.8 mm on the left of the mid-vertebrae line. Mean distance from the origin of the BCT to the origin of the RCCA was 32.5 mm. Mean distance from the origin of the LSCA to the origin of the LVA was 33.8 mm. Average angles at which the major branches arise from the AA were 65.3, 46.9 and 63.8 degrees. Conclusion : This study may provides a basic anatomical information to catheterize AA and its branches for safely performing endovascular surgery.

General Treatment Strategy for Intervention in Lower Extremity Arterial Disease (하지동맥 질환의 인터벤션: 전반적 치료 계획 수립)

  • Je Hwan Won
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.500-511
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    • 2021
  • The prevalence of lower extremity disease is increasing with age. With recent technological advancements, endovascular treatment is being performed more frequently. The treatment goal of intermittent claudication is to improve walking and reduce claudication. To achieve these goals, anatomical durability and patency are important. In patients with critical limb ischemia, the lesions are diffuse and particularly severe in below-the-knee arteries. The treatment goal of critical limb ischemia is to promote wound healing and to prevent major amputation, which is evaluated by the limb salvage rate. Primary stenting using covered or bare metal stents is a widely accepted endovascular treatment. While drug-eluting technologies with or without atherectomy are widely used in the treatment of femoropopliteal disease, balloon angioplasty is the mainstay treatment for below-the-knee intervention. CT angiography provides a road map for planning endovascular treatment in patients without absolute contraindications.