• 제목/요약/키워드: Endovascular stent graft

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자가팽창성 Stent-graft의 경관적 설치술을 이용한 대동맥류의 치료 -2 예 보고- (Endovascular Placement of Self-Expandable Stent-Graft for the Treatment of Aortic Aneurysms -2 cases-)

  • 신현우;이재성
    • Journal of Chest Surgery
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    • 제33권1호
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    • pp.99-102
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    • 2000
  • The usual treatment for aortic aneurysms is surgical replacement with a prosthetic graft; however the associated morbidity and mortality rates must be considered. Endovascular placement of self-expandable stent-graft is a safe noninvasive treatment that can be an alternative to the surgical repair, the postoperative course of the 2 cases of thoracoabdominal aortic aneurysms was uneventful and no complication has been associated with the stent-graft during the 17 months and 5 months follow-up studies,.

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Endovascular Repair in Acute Complicated Type B Aortic Dissection: 3-Year Results from the Valiant US Investigational Device Exemption Study

  • Lim, Chang Young
    • Journal of Chest Surgery
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    • 제50권3호
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    • pp.137-143
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    • 2017
  • Acute complicated type B aortic dissection (TBAD) is a potentially catastrophic, life-threatening condition. If left untreated, there is a high risk of aortic rupture, irreversible organ or limb damage, or death. Several risk factors have been associated with acute complicated TBAD, including age and refractory hypertension. In the acute phase, even uncomplicated patients are more prone to develop complications if hypertension and pain are left medically untreated. Innovations in stent graft technologies have incrementally improved outcomes since their first use for this condition in 1999, though improvement is needed in mitigating periprocedural complications, adverse events, and mortality. In the past decade, endovascular repair has become the preferred treatment because of its superior outcomes to open repair and medical therapy. The Valiant Captivia Thoracic Stent Graft System is a third-generation endovascular stent graft with advancements in minimally invasive delivery, conformability to the anatomy, and the minimization of adverse sequelae. Herein, this stent graft is briefly reviewed and its 3-year outcomes are presented. Freedom from all-cause and dissection-related mortality was 79.1% and 90.0%, respectiv ely. The Valiant Captiv ia Stent Graft represents a safe, effective intervention for acute complicated TBAD. Continued surveillance is needed to verify its longer-term durability.

총간동맥 가성동맥류의 치료로 삽입한 스텐트 그라프트의 공장으로의 위치 이동 (Jejunal Migration of the Stent-Graft Used for Common Hepatic Artery Pseudoaneurysm)

  • 김지원;이병희
    • 대한영상의학회지
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    • 제83권1호
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    • pp.189-193
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    • 2022
  • 췌장-담도계 수술 후에 발생하는 합병증 중에 출혈은 드물지만 사망률이 높은 합병증이다. 출혈의 주요 원인은 가성동맥류의 파열이며, 코일색전술 혹은 혈관 내 스텐트 그라프트 삽입술이 효과적인 치료 방법으로 알려져 있다. 저자들은 유문부 보존 췌두부십이지장절제술 이후 발생한 총간동맥의 가성동맥류의 치료를 위해 삽입한 스텐트 그라프트가 공장으로 이동한 후 몸 밖으로 빠져나간 사례를 보고하고자 한다.

Endovascular Graft-Stent Placement for Treatment of Traumatic Carotid Cavernous Fistulas

  • Choi, Beom-Jin;Lee, Tae-Hong;Kim, Chang-Won;Choi, Chang-Hwa
    • Journal of Korean Neurosurgical Society
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    • 제46권6호
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    • pp.572-576
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    • 2009
  • Detachable balloon-based endovascular fistula occlusion is a widely accepted treatment for traumatic carotid cavernous fistulas (CCF). However, more recently coils have been used to obliterate the lesion, especially in case detachable balloon is not available. We failed balloon-assisted coil embolization for CCF because of large fistulas and herniation of coil loops into the parent artery. The authors describe our experiences of balloon-expandable graft-stents to treat CCF, and place emphasis on arterial wall reconstruction. Three traumatic CCF patients were treated using a graft-stent with/without coils, and underwent angiographic follow-up to evaluate the patency of the internal carotid artery (ICA). In all cases, symptoms related to CCF regressed after stent deployment and did not recur during follow-up. Follow-up angiography revealed good patency of the ICA in all patients. Graft-stents should be considered as an alternative means of treating CCF and preserving the parent artery by arterial wall reconstruction especially in patients with a fistula that cannot be successfully occluded with detachable balloons or coils.

Non-Anastomotic Rupture of a Woven Dacron Graft in the Descending Thoracic Aorta Treated with Endovascular Stent Grafting

  • Lee, Youngok;Kim, Gun-Jik;Kim, Young Eun;Hong, Seong Wook;Lee, Jong Tae
    • Journal of Chest Surgery
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    • 제49권6호
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    • pp.465-467
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    • 2016
  • The intrinsic structural failure of a Dacron graft resulting from the loss of structural integrity of the graft fabric can cause late graft complications. Late non-anastomotic rupture has traditionally been treated surgically via open thoracotomy. We report a case of the successful use of thoracic endovascular repair to treat a Dacron graft rupture in the descending aorta. The rupture occurred 20 years after the graft had been placed. Two stent grafts were placed at the proximal portion of the surgical graft, covering almost its entire length.

Stent Graft Repair of Penetrated Injury of the Common Carotid Artery

  • Kim, Soon Jin;Ryu, Sang Woo;Chekar, Jaykey;Kim, Yong Tae;Seo, Bo Ra
    • Journal of Trauma and Injury
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    • 제29권4호
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    • pp.172-175
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    • 2016
  • Penetrated injury of common carotid artery (CCA) is rare and extremely lethal. Carotid artery injury tends to bleed actively and potentially occlude the trachea. It can cause fatal neurological complications. An accurate diagnosis and adequate treatment are very needed to the successful outcome of the penetrating vascular injury in zone 1, 2, and 3 of the neck. Open surgical treatment is more invasive and complicated than endovascular treatment. We experienced a case with penetrating injury in neck zone 2. Here, we report the case successfully treated with endovascular stent graft technique.

급성 하행대동맥 박리증에서 스텐트-그라프트 삽입 후 새로이 발생한 원위부 대동맥류에 대한 인조혈관 대치술 치험 1예 (Management for the Newly-Onset Aneurysmal Dilation of the Distal Aorta after an Endovascular Stent Graft Procedure for the Patient with Acute Aortic Dissection Type IIIb)

  • 이길수;방정희;조광조;성시찬;우종수
    • Journal of Chest Surgery
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    • 제36권6호
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    • pp.427-430
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    • 2003
  • 합병증이 있거나 수술의 적응증이 되는 대동맥 질환 사망률과 이환율이 높지만 수술기법이 난해하고 적지 않은 수술부작용이 발생하는 바, 최근 들어 이들 질환을 혈관내 스텐트 삽입술로 치료하려는 시도가 늘어가고 있는 추세인 반면에 적합한 적응증 및 시술 후 발생하는 합병증에 대한 논의는 아직 초기 단계에 있다. 저자들은 하행 대동맥 박리증으로 혈관내 스텐트 삽입술을 시행한 후, 원위부 흉복부 대동맥류가 커져 관류부전의 징후를 보인 환자를 수술적인 방법으로 교정하여 성공하였기에 이를 문헌 고찰과 더불어 보고하는 바이다.

Bilateral Vertebral Artery Dissecting Aneurysms Presenting with Subarachnoid Hemorrhage Treated by Staged Coil Trapping and Covered Stents Graft

  • Yoon, Seok-Mann;Shim, Jai-Joon;Kim, Sung-Ho;Chang, Jae-Chil
    • Journal of Korean Neurosurgical Society
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    • 제51권3호
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    • pp.155-159
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    • 2012
  • The treatment of bilateral vertebral artery dissecting aneurysms (VADAs) presenting with subarachnoid hemorrhage (SAH) is still challenging. The authors report a rare case of bilateral VADA treated with coil trapping of ruptured VADA and covered stents implantation after multiple unsuccessful stent assisted coiling of the contralateral unruptured VADA. A 44-year-old woman was admitted to our hospital because of severe headache and sudden stuporous consciousness. Brain CT showed thick SAH and intraventricular hemorrhage. Cerebral angiography demonstrated bilateral VADA. Based on the SAH pattern and aneurysm configurations, the right VADA was considered ruptured. This was trapped with endovascular coils without difficulty. One month later, the contralateral unruptured VADA was protected using a stent-within-a-stent technique, but marked enlargement of the left VADA was detected by 8-months follow-up angiography. Subsequently two times coil packing for pseudosacs resulted in near complete occlusion of left VADA. However, it continued to grow. Covered stents graft below the posterior inferior cerebellar artery (PICA) origin and a coronary stent implantation across the origin of the PICA resulted in near complete obliteration of the VADA. Covered stent graft can be used as a last therapeutic option for the management of VADA, which requires absolute preservation of VA flow.

Successful Endovascular Management of Intraoperative Graft Limb Occlusion and Iliac Artery Rupture Occurred during Endovascular Abdominal Aortic Aneurysm Repair

  • Lim, Jae Hong;Sung, Yong Won;Oh, Se Jin;Moon, Hyeon Jong;Lee, Jeong Sang;Choi, Jae-Sung
    • Journal of Chest Surgery
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    • 제47권1호
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    • pp.71-74
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    • 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.

흉부대동맥류 환자에서 경피적 인조혈관 스텐트의 사용 (Use of Percutaneous Endovascular Stent Graft in Patients with Thoracic Aortic Aneurysm)

  • 전용선;백완기;윤용한;김영삼;김광호;김정택
    • Journal of Chest Surgery
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    • 제39권2호
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    • pp.157-161
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    • 2006
  • 최근 대동맥류 질환에서 혈관내스텐트 치료는 외과 수술의 대체적 치료로 알려져 있다. 저자들은 두명의 고위험군 흉부대동맥류 환자에서 혈관내스텐트를 이용하여 치료하였다. 시술 후에 특별한 합병증은 없었으며 각각 3개월과 10개월 후의 추적 전산화 단층촬영에서 대동맥류는 소실되는 양상을 보였다.