• Tuberculosis and Respiratory Diseases
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• 제74권6호
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• pp.286-290
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• 2013

Pigtail catheter drainage is a common procedure for the treatment of pleural effusion and pneumothorax. The most common complications of pigtail catheter insertion are pneumothorax, hemorrhage and chest pains. Cerebral air embolism is rare, but often fatal. In this paper, we report a case of cerebral air embolism in association with the insertion of a pigtail catheter for the drainage of a pleural effusion. A 67-year-old man is being presented with dyspnea, cough and right-side chest pains and was administered antibiotics for the treatment of pneumonia. The pneumonia failed to resolve and a loculated parapneumonic pleural effusion developed. A pigtail catheter was inserted in order to drain the pleural effusion, which resulted in cerebral air embolism. The patient was administered high-flow oxygen therapy and recovered without any neurologic complications.

• Advances in pediatric surgery
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• 제12권2호
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• pp.238-243
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• 2006

Chemoport is widely used in pediatric surgery field. But various complications can occur during the process of insertion or removal of chemoport. Surgeons must be familiar with the treatment of these complications. We had one catheter cuts off during chemoport removal, become a catheter embolism. Interventional radiologic removal was successful. Verifying the length of removed catheter and careful observation of the catheter tip during removal procedure is important to prevent the possibility of catheter embolus. Radiologic intervention was accessible to remove the retained catheter.

• Journal of Chest Surgery
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• 제28권3호
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• pp.316-319
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• 1995

Systemic emboli occur in approximately one-third of patients with cardiac myxoma. Embolization is common because of the friability of the tumor and intracardiac location. Embolic episodes in young patients with normal sinus rhythm should arouse suspicions of cardiac myxoma in the absence of active endocarditis. We present one case of 17 years old girl having saddle embolism combined with left atrial myxoma. We planned staged operation. First, the emergency thromboembolectomy of aortic bifurcation was performed through bilateral transfemoral approach with use of Forgaty catheter. One week later, the extirpation of myxoma was successfully done with ECC.

• Tuberculosis and Respiratory Diseases
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• 제77권3호
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• pp.105-110
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• 2014

Venous thromboembolism (VTE), which includes pulmonary embolism and deep vein thrombosis, is an important cause of morbidity and mortality. The aim of this review is to summarize the findings from clinically important publications over the last year in the area of VTE. In this review, we discuss 11 randomized controlled trials published from March 2013 to April 2014. The COAG and the EU-PACT trials indicate that pharmacogenetic testing has either no usefulness in the initial dosing of vitamin K antagonists or marginal usefulness in the Caucasian population. Recent clinical trials with novel oral anticoagulants (NOACs) have demonstrated that the efficacy and safety of rivaroxaban, apixaban, edoxaban, and dabigatran are not inferior to those of conventional anticoagulants for the treatment of VTE. The PEITHO and ULTIMA trials suggested that rescue thrombolysis or catheter-directed thrombolysis may maximize the clinical benefits and minimize the bleeding risk. Lastly, riociguat has a proven efficacy in treating chronic thromboembolic pulmonary hypertension. In the future, NOACs, riociguat, and catheter-directed thrombolysis have the potential to revolutionize the management of patients with VTE.

• Investigative Magnetic Resonance Imaging
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• 제23권1호
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• pp.70-74
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• 2019

Cerebral air embolism (CAE) is a rare complication of various medical procedures. It manifests with symptoms similar to those of typical acute cerebral infarction, however the treatment is quite different. We present a case of arterial CAE that was associated with a disconnected central venous catheter and appeared as punctate dark signal intensities with aliasing artifacts on the susceptibility-weighted filtered phase magnetic resonance image. The susceptibility-weighted filtered phase image can be helpful for diagnosing CAE and the magnetic resonance imaging reflects the pathophysiology of CAE.

• 한국의학물리학회지:의학물리
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• 제17권3호
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• pp.167-172
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• 2006

전산화단층촬영에서 조영 증강을 위한 조영제 주입은 정맥내에 삽입한 카테터를 통해 자동주입기로 주입하고 있다. 정맥내에 위치한 카테터를 제거하는 도중에 IV 카테터가 부러져 정맥내에 남아 있는 카테터의 조각은 환자에게 순환기 질환의 위험을 초래할 수 있다. CT 검사 중에 정맥내에 카테터 조각이 남아있는 2명의 환자를 대상으로 카테터의 크기 및 위치를 정확히 확인하기 위해 MDCT를 이용하여 정맥내 주사부위를 스캔하였다. 3D 재구성은 MPR, MIP, 볼륨렌더링, SSD 등으로 구성하였다. 정맥내에 위치한 카테터 조각을 MDCT로 스캔한 데이터를 3D 재구성으로 정맥내의 위치 및 크기를 확인하였고, 카테터 조각을 제거하는데 일조하였다.

• Journal of Chest Surgery
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• 제23권4호
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• pp.811-815
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• 1990

Successful emergency pulmonary embolectomy with the cardiopulmonary bypass was performed in a 41 \ulcorneryear old male who suffered massive pulmonary embolism after longterm bed rest due to the injury of left knee. Temporary cardiopulmonary bypass provided 120 minutes of circulatory support while complete removal of bilateral pulmonary emboli accomplished using Forgarty catheter and Gall stone forceps. Also, manual compression of the lungs was necessary to remove distal branching emboli. The patient had smooth and uneventful hospital course without complications and discharged from hospital taking coumadine on the 13th day after the operation.

• Journal of Chest Surgery
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• 제32권3호
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• pp.315-317
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• 1999

폐동맥도관과 연관된 합병증으로는 부정맥, 심전도 장애, 폐동맥 파열, 폐경색, 심내막 손상, 풍선 파열, 동맥 파열, 혈전색전증, 공기 색전증, 감염, 기흉, 도관의 매듭형성등이 있다. 도관의 매듭형성은 드문 합병증으로 폐동맥 도관을 정상적으로 기대되는 거리 이상으로 삽입하게되면 발생할수 있다. 한양대학교 흉부외과 교실에서는 정중절개후 체외순환하에서 매듭지어진 폐동맥 도관의 외과적 적출을 치험하였기에 보고하는바이다.

• 대한응급의학회지
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• 제29권6호
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• pp.641-648
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• 2018

Objective: This study examined the incidence and amount of air inflow during central venous catheter (CVC) insertion. Methods: This study was an experimental study aimed at designing an apparatus to implement blood vessel and blood flow in the human body. A 1.5-m long core tube with a Teflon tube, suction rubber tube, and polyvinyl chloride tube were made. This core tube was assumed to be the blood vessel of the human body. Blood was replaced with a saline solution. The saline solution was placed higher than the core tube and flowed into the inside of the tube by gravity. The CVC was injected 15-cm deep into the core tube. The air was collected through a 3-way valve into the upper tube. The experiments were carried out by differentiating the pressure in the tube, CVC insertion step, and diameter of the end of the catheter. The experiment was repeated 10 times under the same conditions. Results: The amount of air decreased with increasing pressure applied to the tube. Air was not generated when the syringe needle was injected, and the amount of air increased with increasing size of the distal end catheter. Conclusion: To minimize the possibility of air embolism, it is necessary to close the distal end catheter at the earliest point as soon as possible.

• Journal of Chest Surgery
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• 제30권2호
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• pp.172-178
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• 1997

인제대학교 서울 백병원에서 실시한 말초동맥 색전제거술을 후향적으로 분석하였다. 1987년 3월부터 1996년 2월까지 26명의 환자가 색전제거술을 시술받았고 남자는 18명 여자는 8명이였으며 평균연령은 56.8세 였다. 24명의 환자에서 휴식시 동통이 주소였고 2명의 환자에서 급성 증상의 회복후 장기간의 간헐적 파행을 호소하였으며 10명의 환자에서만 신경/근육 증상을 보였다. 대부분의 색전은 심인성으로 빈도가 높은 원인질환으로8명의 환자는 허혈성 심질환, 11명의 환자는 심장판막질환이 있었다. 동맥색전 부위는 상지동맥이 6명, 안장색전증이 2명, 하지동맥 18명이였고 대퇴동맥이 11명으로 가장 많았다. 술전 동맥조영술은13명의 환자에서 진단과 수술계획을 위해 실시하였으나 나머지 환자에서는 실시하지 않았다. 2명만이 6시간이내 색전제거술을 실시하였으나 나머지 환자는 모두 6시간 이후에 수술하였 다. 모든 환자에서 우회로 조성술 엄이 포가티 색전제거 카테터를 사용하여 색전제거술을 하였는데, 상지동맥 색전증은 상완동맥 절개로 수술하였고, 안장색전증의 경우 양측 서혜부 절개로 접근하였으며, 하지동맥 색전증은 경대퇴동맥 접근을 하 느립\ulcorner3명의 원위부 슬와-경골동맥 색전증 환자에서 재수술시 경술와 동맥 색전제거술을 시행하였다. 수술 전후로 18명의 환자가 헤파린이나 푸락시파린으로 항응 고제 요법을 받았고 17명의 환자에서 퇴원시 와파린을 투여하였으며 항응고제 투여의 적응증은 심판막 질환, 심방세동, 말초동맥 죽상경화증, 재발색전 등이었다. 색전제거술후 14명의 환자에서 좋은 결과가 있었고, 5명에서 재수술후 증상 호전되었으며, 심한 하지동맥 죽상경화증을 보인 환자 1명에서 슬관절 이하 하지절단을 시행하였다. 색전재발은 1명, 사망 환자는 2명이 였는데, 사인은 각각 급성 신부전과 뇌동맥 혈전증이였다. 색전제거술 합병증으로 재관류 손상, 가성동맥류, 내막박리 등이 각각 1례 발생하였다. 결론적으로 사지동맥 색전증치 진단이 지연되고 있고, 허혈성 심질환을가진 고령환자가 증가되고 있는 경향이었다. 술전 동맥조영술은 항상 진단과 수술을 위해 필요하지 않으며 항응고제는 적응증에 따라 선택적으로 투여하여 색전재발을 방지할 수 있다. 원위부 슬와-경골동맥 색전증의 경우, 경대퇴동 맥 접근으로 선택적인 경골동맥 색전제거에 어려움이 있었다.