• Title/Summary/Keyword: Balloon test occlusion

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Mechanical Behavior of Porcine Abdominal Organ Tissue with Resuscitative Endovascular Balloon Occlusion of the Aorta (혈관내 풍선 확장에 의한 대동맥 차단소생술이 적용된 돼지 복부 장기 조직의 기계적 거동 평가)

  • Wang, Il Jae;You, Ji-Hun;Huh, Up;Song, Seunghwan;Ahn, Hyo Young;Song, Chan-Hee;Lee, Chi-Seung;Ryu, Dong-Man
    • Korean Journal of Materials Research
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    • v.30 no.4
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    • pp.197-203
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    • 2020
  • Abdominal organs are the most vulnerable body parts under vehicle trauma, and there is high mortality from acute injuries in accidents. There are various ways to reduce this high mortality; one method is Resuscitative Endovascular Balloon Occlusion of the Aorta, which has recently become very popular as a minimally invasive alternative in the emergent management of patients with non-compressible hemorrhages below the diaphragm. However, high safety factor for patients is applied in actual clinical practice because there is no exact standard for the operating time. Therefore, in this study, the effects of the mechanical behavior of organ tissues for the duodenum, kidney, and liver on the operating time of Resuscitative Endovascular Balloon Occlusion of the Aorta is investigated in order to obtain data needed to establish standards of operating time. In characteristic analysis of organ tissues, uniaxial tensile test and compression test are conducted according to the operating time.

A Case of Carotid Artery Resection and Replacement (경동맥 절제술 및 치환술 1례)

  • Kim, Dea-Sik;Oh, Cheon-Hwan
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.202-206
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    • 1999
  • A carotid artery resection and replacement including neck dissection are used as a method of treatment for head and neck cancer with infiltration into the carotid artery. The recent development of imaging technique makes it easy to estimate the detailed anatomical relationship between the tumor infiltration into the carotid artery, it's resection and replacement are indicated at radical neck dissection. To detect any possibility of cerebral ischemia at the time of ligation of carotid artery, a temporary occlusion test of internal carotid artery with a ballon catheter (balloon occlusion test) is performed. Recently, we performed a carotid artery resection and replacement using an artificial vessel Gore-Tex) in a case of neck cancer with infiltration into the carotid artery.

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Fusiform Aneurysm on the Basilar Artery Trunk Treated with Intra-Aneurysmal Embolization with Parent Vessel Occlusion after Complete Preoperative Occlusion Test

  • Jung, Young-Jin;Kim, Min-Soo;Choi, Byung-Yon;Chang, Chul-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.53 no.4
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    • pp.235-240
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    • 2013
  • Fusiform aneurysms on the basilar artery (BA) trunk are rare. The microsurgical management of these aneurysms is difficult because of their deep location, dense collection of vital cranial nerves, and perforating arteries to the brain stem. Endovascular treatment is relatively easier and safer compared with microsurgical treatment. Selective occlusion of the aneurysmal sac with preservation of the parent artery is the endovascular treatment of choice. But, some cases, particularly giant or fusiform aneurysms, are unsuitable for selective sac occlusion. Therefore, endovascular coiling of the aneurysm with parent vessel occlusion is an alternative treatment option. In this situation, it is important to determine whether a patient can tolerate parent vessel occlusion without developing neurological deficits. We report a rare case of fusiform aneurysms in the BA trunk. An 18-year-old female suffered a headache for 2 weeks. Computed tomography and magnetic resonance image revealed a fusiform aneurysm of the lower basilar artery trunk. Digital subtraction angiography revealed a $7.1{\times}11.0$ mm-sized fusiform aneurysm located between vertebrovasilar junction and the anterior inferior cerebellar arteries. We had good clinical result using endovascular coiling of unruptured fusiform aneurysm on the lower BA trunk with parent vessel occlusion after confirming the tolerance of the patient by balloon test occlusion with induced hypotension and accompanied by neurophysiologic monitoring, transcranial Doppler and single photon emission computed tomography. In this study, we discuss the importance of preoperative meticulous studies for avoidance of delayed neurological deficit in the patient with fusiform aneurysm on lower basilar trunk.

Stent-Assisted Coil Trapping in a Manual Internal Carotid Artery Compression Test for the Treatment of a Fusiform Dissecting Aneurysm

  • Seung, Won-Bae;Kim, Jin-Wook;Park, Yong-Seok
    • Journal of Korean Neurosurgical Society
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    • v.51 no.5
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    • pp.296-300
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    • 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.

The Preoperative Evaluation of the Carotid Artery in Head and Neck Surgery (두경부수술에서 경동맥 희생과 사전검사)

  • Kwon Tack-Kyun;Sung Myung-Whun;Kim Kwang-Hyun;Kim Jeong-Jun;Lee Chul-Hee;Min Yang-Gi
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.175-181
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    • 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.

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Serial Vascular Responses of Balloon-Expandable Stent With Biodegradable Film-Type Graft in a Rabbit Iliac Artery Dissection Model (BioGard Study)

  • Sang Min Park;Kyung-Chan Choi;Byeong Han Lee;Sang Yol Yoo;Christopher Y. Kim
    • Korean Circulation Journal
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    • v.54 no.8
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    • pp.499-512
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    • 2024
  • Background and Objectives: Arterial dissection during endovascular therapy rarely occurs but can be lethal. A fabric-based covered graft stents yield poor clinical outcomes. A novel balloon-expandable stent with biodegradable film graft for overcoming these issues was evaluated in a rabbit iliac artery model. Method: Eighteen rabbits with iliac artery dissections were induced by balloon over-inflation on angiography (Ellis type 2 or 3) and treated using the test device (3.0×24 mm). Subsequently, survived twelve animals underwent histologic examinations and micro-computed tomography (CT) at 0, 2, 4, and 8 weeks and 3, 6, 9, and 12 months and angiography at one-year. Results: There were no adverse cardiovascular events during the one-year. Early-stage histologic examination revealed complete sealing of disrupted vessels by the device, exhibiting mural hematoma, peri-stent red thrombi, and dense infiltration of inflammatory cells. Mid- and long-term histologic examination showed patent stents with neointimal hyperplasia over the stents (% area stenosis: 11.8 at 2 weeks, 26.1 at 1 month, 29.7 at 3 months, 49.2 at 9 months, and 51.0 at 1 year), along with mild peri-strut inflammatory response (Grade: 1-2 at mid-term and 0-1 at long-term). The graft film became scarcely visible after six months. Both CT and angiography revealed no instances of thrombotic occlusion or in-stent restenosis (% diameter stenosis: 5.7 at 2 weeks, 12.3 at 1 month, 14.2 at 3 months, 25.1 at 9 months, and 26.6 at 1 year). Conclusions: The novel balloon-expandable stent with a biodegradable film graft demonstrates feasibility in managing severe artery dissection and preventing lethal vascular events in animal model.

Preoperative Evaluation and Significance of Carotid Resection in Advanced Cervical Metastatic Cancer (진행된 경부 전이암에서 경동맥 절제를 위한 술전검사와 절제술의 의의)

  • Cho Jung-Il;Kim Young-Mo;Choi Won-Suk;Choi Sang-Hak;Han Chang-Joon
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.1
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    • pp.13-18
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    • 2001
  • Objectives: We studied what is the role of elective carotid artery resection in the management of advanced cervical metastatic cancer. Materials and Methods: 5 patients with elective carotid artery resection in advanced metastatic cervical cancer were reviewed retrospectively. The patients underwent complete neuroradiologic evaluation, including CT/MRI. angiography, duplex doppler, balloon occlusion test with EEG, and brain SPECT for determination of compatible collateral circulation after carotid artery resection. Results: Perioperative complication were appeared in 2 patients those were middle cerebral arterial infarction and mediastinal bleeding. Postoperative mortality rate was 20%. 4 patients recurred within 1 year. Conclusion: Preoperative collateral study rarely provide whether resection carotid artery or not. Elective carotid artery resection cannot provide locoregional control of tumor and don't promote survival.

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Treatment of Traumatic Carotid-Cavernous Fistulas using Debrun's Detachable Balloons (Debrun분리 풍선 카데타법에 의한 경동맥 해면동루의 치료)

  • Lee, Sang-Jin;Kim, Sun-Yong;Hwang, Mi-Soo;Chang, Jae-Chun;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
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    • v.6 no.2
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    • pp.91-101
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    • 1989
  • The goal of therapy in patients with traumatic carotid-cavernous fistulas is to occlude the fistula, preferably while maintaining the carotid blood flow. Since the introduction of the concepts of detachable balloon technique to occlude arteriovenous fistulas, the technique has become the treatment of choice in the management of traumatic carotid-cavernous fistulas. The major symptoms of traumatic CCFs are (1)pulsating exophthalmos, (2)orbital and cephalic bruit and murmur, (3) headache, (4) chemosis. (5) extraocular palsies, and (6) visual failure. Traumatic CCFs are combined with multiple associated lesions. We tried the occlusion of fistulas using Goldvalve balloons in 8 consecutive cases of traumatic CCF and the result of our experience is reported. Transarterial approach with manually-tied latex balloons is tried in all cases and the fistulas was successfully occluded in all cases. In 5 cases. the internal carotid artery was preserved and the arterial lumen was occluded along with fistula opening in :3 cases. In one case, surgical ligation was done because of symptoms recurred and incomplete occlusion of fistula. We experienced hemiparesis as a major complication in one case during occlusion tolerance test, which was remitted spontaneously. The results of Debrun balloon treatment were relatively excellent. We consider that the first choice of treatment of traumatic CCF is occlusion of the fistula by a detachable balloons.

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Assessment of Cerebral Collateral Circulation Using $^{99m}Tc$-Hexamethyleneamine Oxime (HMPAO) SPECT During Internal Carotid Artery Balloon Test Occlusion (내경동맥 풍선 시험 결찰술(BTO)시 $^{99m}Tc$-HMPAO 뇌 SPECT를 이용한 대뇌 측부 순환의 평가)

  • Ryu, Young-Hoon;Yun, Mi-Jin;Chung, Tae-Sub;Lee, Jong-Doo;Park, Chang-Yun
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.22-30
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    • 1995
  • To predict preoperatively the safety of permanent occlusion of an internal carotid artery with $^{99m}Tc$-HMPAO brain single photon emission computed tomography(SPECT) from an objective point of view, Twenty-four patients underwent balloon test occlusion (BTO) of the internal carotid arteries because of neck and skull base tumors. The authors assessed the uptake of both middle cerebral artery territories before and during BTO with $^{99m}Tc$-HMPAO brain SPECT using semiquantitative analysis method and compared the results with other factors(neurologic examination, arterial stump pressure and electroenceph-alogram). Nineteen patients had not experienced neurological deteriorating or any problem during BTO. Their comparative uptakes of the middle cerebral artery territories were 95 to 101% of the pre-BTO state. The remaining five patients showed severe neurologic symptoms such as transient hemiplegia and unconsciousness. Their comparative uptake of the middle cerebral artery territories were 77 to 85% of the pre-BTO state, and were well matched with other factors. $^{99m}Tc$-HMPAO brain SPECT before and during BTO seems to be a simple and objective method for prediction of permanent neurologic deficits when the comparative uptake of middle cerebral artery territories during BTO is lower than 85% of that before BTO.

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