• 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.

• Korean Circulation Journal
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• 제54권8호
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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.

• 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.

• 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.

• Journal of Chest Surgery
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• 제43권6호
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• pp.769-773
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• 2010

전신저혈압은 흉부대동맥질환의 스텐트 그라프트 치료에 전통적으로 많이 이용되어 왔으나, 혈관확장제를 이용한 혈압강하는 심박출량을 증가시킬 수 있으며 이로 인해 스텐트 그라프트의 전개 시 바람자루효과가 발생할 수 있다. 빠른 심실유도는 자동제어방식으로 일시적인 심박출량의 정지를 유도하여 심정지 지속시간이 제어 가능하고, 스텐트 그라프트 전개 시 대동맥 손상을 최소한으로 줄일 수 있다는 장점이 있다. 본원에서는 흉부대동맥궁 하방에 발생한 주머니동백자루 환자에게 빠른 심실유도하에 Valiant Captivia 스텐트 그라프트를 이용하여 효과적으로 혈관내 스텐트 그라프트 시술을 하였기에 문헌 고찰과 함께 보고하는 바이다.

• 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.

• Tuberculosis and Respiratory Diseases
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• 제56권4호
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• pp.405-410
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• 2004

저자들은 1년전 하행흉부대동맥 가성동맥류로 진단 받고 혈관내 스텐트 삽입술을 시행 받은 53세 남자 환자가 내원 1달여 전부터 간헐적인 혈담을 호소하다가 대량 객혈을 주소로 내원하여 대동맥류와 좌측 주기관지와의 누공을 확인한 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• International Journal of Vascular Biomedical Engineering
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• 제2권2호
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• pp.10-15
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• 2004

Purpose: In the treatment of aortic aneurysm, endovascular stent-graft application has become an established method of treatment. To observe the outcomes of the procedure as the size change of aneurysm in relation with endoleak, a retrospective analysis was done for the consecutive cases who undertook the procedure. Materials & Method: Stent-graft was applied to the aortic aneurysm in 33 patients. The location of the aneurysm was thoracic in 11 patients and abdominal in 22 patients. CT angiographic was done for the follow-up evaluation to analyze the aneurysm size and the presence of endoleak. Results: Technical success rate was 97% (32/33). The primary success rate without endoleak was 84% (28/33). The secondary success was 90% (30/33). During the follow-up period of 3 months to 7years and 6months in 26 patients, a secondary endoleak developed in 5 cases. Post-implantation syndrome developed in 17 cases (51%). Among the 14 cases with follow-up imaging data for size, endoleak was negative in 10 cases. The aneurysm decreased in 5 cases, stable in size in 4 cases and enlarged in one case (10%).Among the 4 cases with endoleak positive, the aneurysm enlarged in two cases (50%). Conclusion: In the stent-graft application for aortic aneurysm, there is high chance of decrease of aneurysm size in those cases with endoleak negative. However, the aneurysm may increase and eventually rupture in the cases with en do leak positive. Close observation with CT angiography is necessary for the evaluation for the presence of endoleak and size change.

• Journal of Chest Surgery
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• 제42권4호
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• pp.524-527
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• 2009

Stent graft는 점차 대동맥질환에 대해 수술적 치료를 대체하거나 수술 범위를 줄여줄 수 있을 것으로 기대된다. 저자들은 상행대동맥과 하행대동맥에 각각 독립된 대동맥류를 가진 80세 남자환자에서 수술적 치료와 스텐트 삽입을 동시에 시행하였기에 문헌 고찰과 함께 증례보고를 하는 바이다.

• 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.