• 대한핵의학회:학술대회논문집
• /
• 대한핵의학회 1991년도 제30차 춘계학술대회
• /
• pp.142-143
• /
• 1991

• Journal of Korean Neurosurgical Society
• /
• 제29권2호
• /
• pp.280-285
• /
• 2000

Posterior transarticular screw fixation for atlantoaxial instability due to trauma or rheumatoid arthritis provides immediate rigid fixation of the C1-2 vertebral segment while preserving motion between the occiput and C1. This technique provides more resistance to translational and rotational forces than wiring technique. However, the technique of transarticular screw fixation is inherently demanding because of the complex anatomy of the occipitocervical region and vertebral artery(VA) at risk for arterial damage. VA injury may lead to serious subsequent neurological deficits and possibly death from bilateral VA injury. We report a case of a vertebral artery-to-epidural venous plexus fistula after posterior transarticular screw fixation which was treated with balloon occlusion.

• Journal of Chest Surgery
• /
• 제41권1호
• /
• pp.61-67
• /
• 2008

배경: 여러 가지 원인에 의해서 일반적인 상행대동맥 차단법을 이용한 수술이 제한되는 경우가 있다. 본 연구는 대동맥 내 풍선카테터를 이용하여 대동맥 내 차단법을 이용한 수술의 효용성 및 안전성에 대해 알아보고자 하였다. 대상 및 방법: 2004년 4월부터 2007년 1월까지 총 7명의 환자에서 대동맥내 차단법을 이용한 수술을 시행하였다. 6예에서 RAP catheter를 사용하였고, 2예에서 Pruitt's balloon catheter를 사용하였다. 원인 질환으로는 흉골하 대동맥 근부의 가성대동맥류가 4예, 상행대동맥의 광범위한 석회화를 동반한 대동맥 판막 역류증이 2예, 심방중격결손이 1예이었다. 5예에서 이전에 1회 이상의 심장수술을 받은 과거력이 있었다. 결과: 전 예에서 성공적인 도관의 삽입 및 대동맥 차단이 이루어졌다. 1예에서 RAP catheter의 풍선이 파열되어, 상행대동맥 내 풍선도관을 추가적으로 삽입하여 대동맥 차단을 하였다. 수술사망은 없었으며, 대동맥 박리, 뇌졸중이나 혈관계 합병증은 없었다. 결론: 대동맥 내 풍선을 이용한 대동맥 차단법은 전통적인 수술방법으로 접근하기 어려운 질환에서 유용한 대안으로 이용될 수 있다고 생각된다.

• 대한영상의학회지
• /
• 제79권6호
• /
• pp.332-336
• /
• 2018

신장 동맥 손상은 둔상의 드문 합병증이나, 신장의 혈류 차단을 일으켜 신부전증을 일으킬 수도 있어 조기 진단과 치료가 필요하다. 신장 동맥 손상의 치료 방법은 아직 논란이 남아 있기는 하지만, 최근 연구들에서 혈관 내 스텐트를 이용한 성공적인 치료 결과가 보고 되었다. 그러나 아직 소아 환자에 대해서는 표준 치료법이 정해지지 않았다. 우리는 16세 여자 환아에서 발생한 4등급 간 열상과 동반된 우측 신장 동맥 폐색 증례를 보고하고자 한다. 환아는 풍선 혈관형성술만을 이용한 치료를 시행 받았고, 후에 신장의 실질 혈류 관류가 뚜렷하게 개선되었으며 신기능이 정상화 되었다. 따라서 소아 환자에서 신장 동맥 손상이 발생했을 경우, 풍선 혈관형성술을 이용한 시술이 치료의 한가지 방법이 될 수 있다.

• Journal of Korean Neurosurgical Society
• /
• 제64권2호
• /
• pp.198-206
• /
• 2021

Objective : The low-profile Neuroform Atlas stent can be deployed directly without an exchange maneuver by navigating into the Gateway balloon. This retrospective study assessed the safety and efficacy of Neuroform Atlas stenting as a rescue treatment after failure of mechanical thrombetomy (MT) for large artery occlusion. Methods : Between June 2018 and December 2019, a total of 31 patients underwent Neuroform Atlas stenting with prior Gateway balloon angioplasty after failure of conventional MT caused by residual intracranial atherosclerotic stenosis (ICAS). Primary outcomes were successful recanalization and patency of the vessel 24 hours after intervention. Secondary outcomes were vessel patency after 14 days and 3-month modified Rankin Scale. Peri-procedural complications, intracerebral hemorrhage (ICH), and 3-month mortality were reviewed. Results : With a 100% of successful recanalization, median value of stenosis was reduced from 79.0% to 23.5%. Twenty-eight patients (90.3%) showed tolerable vessel patency after 14 days. New infarctions occurred in three patients (9.7%) over a period of 14 days; two patient (6.5%) underwent stent occlusion at 24 hours, and the other patient (3.2%) with delayed stent occlusion had a non-symptomatic dot infarct. There were no peri-procedural complications. Two patients (6.5%) developed an ICH immediately after the procedure with one of them is symptomatic. Conclusion : Neuroform Atlas stenting seems to be an effective and safe rescue treatment modality for failed MT with residual ICAS, by its high successful recanalization rate with tolerable patency, and low peri-procedural complication rate. Further multicenter and randomized controlled trials are needed to confirm our findings.

• Clinical and Experimental Pediatrics
• /
• 제49권9호
• /
• pp.917-929
• /
• 2006

Over the last several decades there has been a remarkable change in the therapeutic strategy of congenital heart disease. Development of new tools and devices, accumulations of experience, technical refinement have positively affected the outcome of interventional treatment. Many procedures including atrial septostomy, balloon valvuloplasty, balloon dilation of stenotic vessel with or without stent implantation, transcatheter occlusion of abnormal vascular structure, transcatheter closure of patent arterial duct and atrial septal defect, are now performed as routine interventional procedures in many institutes. In diverse conditions, transcatheter techniques also provide complementary and additive role in combination with surgery. Intraoperative stent implantation on stenotic vessels, perventricular device insertion, and hybrid stage 1 palliative procedure for hypoplastic left heart syndrome have been employed in high risk patients for cardiac surgery with encouraging results. Transcatheter closure of ventricular septal defect has been performed safely showing comparable result with surgery. Investigational procedures such as percutaneous valve insertion and valve repair are expected to replace the role of surgery in certain group of patients in the near future. Continuous evolvement in this field will contribute to reduce the risk and suffering from congenital heart disease, while surgery will be still remained as a gold standard for significant portion of congenital heart disease.

• Journal of Korean Neurosurgical Society
• /
• 제51권5호
• /
• pp.296-300
• /
• 2012

Internal carotid artery (ICA) trapping can be used for the treatment of giant intracranial aneurysms, blood blister-like aneurysms, and fusiform dissecting aneurysms. Fusiform dissecting aneurysms are challenging to treat surgically and endovascularly because of no definite neck and critical perforators. Surgical or endovascular trapping of the ICA with or without an extracranial-intracranial bypass has commonly been used as an effective method to treat these lesions, but balloon test occlusion (BTO) must be performed. Here, we report a case of a ruptured fusiform dissecting aneurysm of the distal ICA, which was successfully treated using an endovascular ICA trapping with a manual ICA compression test instead of BTO.

• Journal of Chest Surgery
• /
• 제47권1호
• /
• pp.71-74
• /
• 2014

For high-risk patients, endovascular aortic aneurysm repair (EVAR) is a good option but may lead to serious complications, which should be addressed immediately. A 75-year-old man with a history of abdominal surgery underwent EVAR for an aneurysm of the abdominal aorta and iliac arteries. During EVAR, iliac artery rupture and graft limb occlusion occurred, and they were successfully managed by the additional deployment of an iliac stent graft and balloon thrombectomy, respectively. We, herein, report a rare case of the simultaneous development of the two fatal complications treated by the endovascular technique.

• Journal of Trauma and Injury
• /
• 제33권3호
• /
• pp.153-161
• /
• 2020

Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure and extremely time-dependent, and the proficiency of the physician is important. Due to a lack of REBOA education programs in Republic of Korea, few physicians have been trained in the procedure. In this study, we examined how REBOA education affects clinical outcomes in a single center. Methods: A retrospective study conducted from February 2017 to June 2020 at a regional trauma center. We collected data of patients who underwent REBOA and analyzed the factors that influenced the outcome. The patients were divided into the educated and non-educated groups (based on REBOA training received by their physicians), and the success and failure groups. Results: A total of 24 patients underwent REBOA during the study. There were eight patients in the success group and 16 patients in the failure group. There are no significant differences between the educated and non-educated groups in sex, age, ISS, shock, injury-to-REBOA time, injury mechanism, injury sites, arrest, access site, type of catheter, type of REBOA, target Zone, mortality, and the result of REBOA. The non-educated group had a higher risk for failure compared to the educated group in multivariate analysis (odds ratio [OR] 154.64, 95% confidence interval [CI] 1.11-22.60). Conclusions: Failure in REBOA is harmful to patients. The risk of failure is increased in the non-educated group. Physicians working in the trauma center or emergency department need to complete the REBOA education program.

• 대한두경부종양학회지
• /
• 제14권2호
• /
• pp.175-181
• /
• 1998

Objectives: The authors tried to analyze the results of carotid artery sacrifice with or without preoperative carotid evaluation. Materials and Methods: Thirteen patients undergone carotid sacrifice were evaluated. Carotid balloon occlusion test (BOT) and single-photon emission computed tomography (SPECT) with technetium-99m-labeled hexamethylpropyleneamineoxime ($^{99m}Tc-HMPAO$) were used for preoperative carotid evaluation. Results: The causes of carotid artery sacrifice consisted of the neck mass involving the carotid artery, spontaneous aneurysmal rupture, and traumatic pseudoaneurysm. Five patient had postoperative neurologic complications and two of them had permanent neurologic deficits. Conclusion: The authors stress that the preoperative evaluation in carotid artery sacrifice is imperable, and the BOT with SPECT can be used in selecting the method of treatment. But since these tests cannot predict the postoperative outcome perfectly, careful perioperative care of the patients should be exercised regardless of the results of the preoperative evaluation.