• Journal of the Korean Society of Radiology
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• v.82 no.2
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• pp.447-454
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• 2021

The authors report a successful thrombectomy using the AngioJet Rheolytic Thrombectomy System (AngioJet) and an embolic protection device in a patient with femorofemoral bypass graft occlusion. Lower extremity CT angiograms showed occlusion in the left-to-right femorofemoral bypass graft. A rheolytic thrombectomy using the AngioJet and balloon angioplasty restored blood flow to the right lower extremity, and distal embolization may be effectively prevented by placing an embolic protection device within the right superficial femoral artery during the procedure.

• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.228-233
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• 2008

Objective : The standard treatment strategy of intracranial aneurysms includes either endovascular coiling or microsurgical clipping. In certain situations such as in giant or dissecting aneurysms, bypass surgery followed by proximal occlusion or trapping of parent artery is required. Methods : The authors assessed the result of extracranial-intracranial (EC-IC) bypass surgery in the treatment of complex intracranial aneurysms in one institute between 2003 and 2007 retrospectively to propose its role as treatment modality. The outcomes of 15 patients with complex aneurysms treated during the last 5 years were reviewed. Six male and 9 female patients, aged 14 to 76 years, presented with symptoms related to hemorrhage in 6 cases, transient ischemic attack (TIA) in 2 un ruptured cases, and permanent infarction in one, and compressive symptoms in 3 cases. Aneurysms were mainly in the internal carotid artery (ICA) in 11 cases, middle cerebral artery (MCA) in 2, posterior cerebral artery (PCA) in one and posterior inferior cerebellar artery (PICA) in one case. Results : The types of aneurysms were 8 cases of large to giant size aneurysms, 5 cases of ICA blood blister-like aneurysms, one dissecting aneurysm, and one pseudoaneurysm related to trauma. High-flow bypass surgery was done in 6 cases with radial artery graft (RAG) in five and saphenous vein graft (SVG) in one. Low-flow bypass was done in nine cases using superficial temporal artery (STA) in eight and occipital artery (OA) in one case. Parent artery occlusion was performed with clipping in 9 patients, with coiling in 4, and with balloon plus coil in 1. Direct aneurysm clip was done in one case. The follow up period ranged from 2 to 48 months (mean 15.0 months). There was no mortality case. The long-term clinical outcome measured by Glasgow outcome scale (GOS) showed good or excellent outcome in 13/15. The overall surgery related morbidity was 20% (3/15) including 2 emergency bypass surgeries due to unexpected parent artery occlusion during direct clipping procedure. The short-term postoperative bypass graft patency rates were 100% but the long-term bypass patency rates were 86.7% (13/15). Nonetheless, there was no bypass surgery related morbidity due to occlusion of the graft. Conclusion : Revascularization technique is a pivotal armament in managing complex aneurysms and scrupulous prior planning is essential to successful outcomes.

• Journal of Chest Surgery
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• v.28 no.10
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• pp.900-905
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• 1995

Between Jan.1990 and Mar.1994, twenty-three patients[Male:20, Female:3 with aortoilac occlusive disease had underwent reconstruction [bypass garft . Two main causes of occlusion were atherosclerosis [21 patients and chronic thromboembolism[2 patients . Indications for operation were disabling claudication in 20 patients and critical limb ischemia in 12 patients. The procedures of operation included femorofemoral[8 , axillobifemoral[6 , aorto-bifemoral[6 , axillounifemoral[2 , aortoiliac[1 bypass graft. Postoperatively one patient died for sepsis and the operative mortality was 4.3%. Various anticoagulant therapy were maintained for at least six months. The 1year, 2year, 3year and 4year patency rates of bypass graft after operation were 91.3%, 80.8%, 71.4% and 58.4% respectively.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.600-612
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• 2021

Purpose To evaluate the long-term radiologic and clinical outcomes of stent-graft placement for the treatment of post-pancreaticoduodenectomy arterial hemorrhage (PPAH) based on the imaging findings of stent-graft patency and results of liver function tests. Materials and Methods We retrospectively reviewed the medical records of nine consecutive patients who underwent stent-graft placement for PPAH between June 2012 and May 2017. We analyzed the immediate technical and clinical outcomes and liver function test results. Stent-graft patency was evaluated using serial CT angiography images. Results All stent-grafts were deployed in the intended position for the immediate cessation of arterial hemorrhage and preservation of hepatic arterial blood flow. Technical success was achieved in all nine patients. Eight patients survived after discharge, and one patient died on postoperative day 28. The median follow-up duration was 781 days (range: 28-1766 days). Follow-up CT angiography revealed stent-graft occlusion in all patients. However, serum aspartate aminotransferase or alanine aminotransferase levels in all patients were well below those observed in hepatic infarction cases. Conclusion Stent-graft placement is a safe and effective treatment method for acute life-threatening PPAH. Liver function and distal hepatic arterial blood flow were maintained postoperatively despite the high incidence of stent-graft occlusion observed on follow-up CT.

• Journal of Korean Neurosurgical Society
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• v.46 no.6
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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.

• Journal of Chest Surgery
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• v.2 no.1
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• pp.65-72
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• 1969

Superior Vena Cava Syndrome: Dacron and Nylon graft between the left innominate vein and the right atrial appendage. Two cases with typical superior vena cave syndrome treated by by-pass graft between the left innominate vein and the right atrial apepndage were presented. One of them was a 58 year old farmer who suffered from marked swelling of the neck and upper half of body, the other was a 50 years old government employee who had acutely progressive symptoms of superior vena cave obstruction. Both of cases revealed that [1] cubitel venous pressure was markedly increased. [2] tumors were noted in the posterior mediastinum by laminography. [3] preoperative cavogram showed the occlusion of superior vena cava and marked collaterals. Dacron and Nylon graft were inserted between the left innominate vein and the right atrial appendage. Postoperatively, the symptoms were relieved markedly, showing edema free face and decreased cubital venous pressure. Postoperative cavogram showed patent graft. Histologically the first case was diagnosed as squamous cell carcinoma and the second as undifferentiated carcinoma, originated probably from bronchus. Total doses of 3150 r X-ray irradiation and 5000 mg of 5-FU were administered in each cases. The first case expired 11 months postoperatively without recurrence of superior vena cave obstruction symptom and the second case is living now without obstruction signs, 4 months after by-pass operation.

• Journal of Chest Surgery
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• v.53 no.6
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• pp.403-407
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• 2020

To validate the technique of the single Heartstring aortotomy for multiple off-pump venous bypass grafts (described in 2015), the results of a 38-month follow-up study of 18 patients, including high-risk patients, are presented. No early deaths or cardiac or cerebral complications occurred. During the follow-up period, 2 patients died of non-cardiac causes, and 3 developed coronary ischemia. Ischemia occurred due to late graft occlusion in 2 patients, both of whom had normal postoperative courses and correct graft flow. The presence of acute symptoms 24 months after surgery in these patients indicated that technical graft failure was unlikely. This safe technique combines the advantages of simple and reproducible revascularization, the off-pump approach, and minimal aortic manipulation.

• Journal of Chest Surgery
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• v.51 no.6
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• pp.423-426
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• 2018

This study determined the feasibility of the cuff technique for small-caliber vascular grafts in a rat model. A graft was implanted with the cuff technique or suture technique in a 1-cm segment of the abdominal aorta in 12 rats. The mean aortic clamp time was 29 minutes with the cuff technique and 44 minutes with the suture technique; the cuff technique was significantly shorter. Abdominal angiography at 1 week after implantation showed no significant stenosis in 9 rats, focal stenosis of the mid-portion of the graft in 1 rat with each technique, and total occlusion of the graft in 1 rat with the suture technique. We have successfully used the cuff technique for anastomosis for small-caliber vascular grafts in an animal model.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.1
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• pp.109-115
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• 2011

Implants were placed after performing ridge expansion by inserting screws of gradually increasing thickness. Favorable clinical outcome was obtained. During surgery, buccal cortical plate fracture did not occur. Autogenous tooth bone graft material was grafted around the implant dehiscence defects and over the buccal cortical plate. The method involving the insertion of screws for ridge expansion is a successful and predictable technique for implant placement in narrow alveolar bone. Autogenous tooth bone graft material can be used for ridge augmentation and GBR.

• Journal of Korean Neurosurgical Society
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• v.51 no.3
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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.