• Title/Summary/Keyword: Iliac

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Resuscitative Endovascular Balloon Occlusion of the Aorta for an Iliac Artery Aneurysm: Case Report

  • Chang, Sung Wook;Chun, Sangwook;Lee, Gyeongho;Seo, Pil Won
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.429-432
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    • 2021
  • Isolated iliac artery aneurysm (IAA) is rare, but can be fatal. Emergency surgery is performed in cases of hemorrhagic shock due to a suddenly ruptured IAA, which may have a high mortality rate because of massive non-compressible torso hemorrhage (NCTH). Recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been accepted as an alternative to aortic cross-clamping via open thoracotomy to achieve hemostasis in trauma patients with profound shock due to NCTH and is considered an emerging bridging therapy for damage control. However, there is limited information on the use of REBOA in non-trauma patients with shock. Herein, we describe a patient with impending cardiac arrest due to isolated ruptured IAA, in whom perioperative bleeding was successfully controlled by REBOA.

Detection of Lymphomatous Marrow Infiltration using F-18 FDG PET at Initial Staging and after chemotherapy

  • Yun, Mi-Jin;Kim, Young-Jin;Moon, Jin-Wook;Park, Sang-Joon;Lee, Jong-Doo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.3
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    • pp.171-177
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    • 2003
  • PURPOSE: To asess the ability of FDG PET for the detection of bone marrow infiltration compared to iliac crest biopsy in patients with lymphoma. MATERIALS AND METHODS: Seventy-three patients (30 females and 43 males, mean age of 47 years old) with malignant lymphoma (4 Hodgkin's disease, HD and 69 Non-Hodgkin's lymphoma, NHL) were included. FDG PET was performed for staging in 53 patients and to assess treatment response after the completion of chemotherapy in 20 patients. Final conclusions were based on biopsy, other imaging studies, or clinical follow-up. RESULTS: There were 54 (74%) of the 73 patients in whom FDG PET and iliac crest biopsy were concordant. Forty-seven of the 54 patients showed concordant negative results while the remaining 7 patients had concordant positive results. Of 19 patients with discordant results, FDG PET accurately detected bone marrow infiltration in 6 patients with negative iliac crest biopsy. On the contrary, iliac crest biopsy identified bone marrow infiltration in 12 or the 19 patients. In remaining one of the 19 patients with discordant results, iliac crest biopsy was true negative but FDG PET was falsely positive. CONCLUSION: FDG PET seems to be an adjunct in detecting marrow infiltration that may not be revealed by iliac crest biopsy at staging. For the assessment of treatment roponse, it may be less helpful than biopsy in detecting microscopic residual disease in the bone marrow.

Effect of Bone Marrow Aspirate with Autogenous Bone graft for Alveolar Cleft in a new Rabbit Model (가토의 치조열 모델에서 골수 흡인물이 자가뼈 이식술에 미치는 효과)

  • Bae, Sung Gun;Chung, Ho Yun;Lee, Sang Yun;Cho, Byoung Chae;Yang, Jung Dug;Park, Mee Young
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.531-537
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    • 2009
  • Purpose: Alveolar bone grafting has become an essential process in the treatmemt of alveolar cleft patient for stabilization of the maxillary arch, elimination of oronasal fistula, the reconstruction of the soft tissue nasal base support, and creation of bony support for tooth eruption for implant. The use of Autologous iliac cancellous bone is preferable because of the adequate quantity and high osteoinductive potential. However, even with iliac bone, insufficient osteoregeneration and absorption occur due to several factors such as the patient's age, cleft width, functional stress, and others. In order to increase osteoregeneration where the iliac bone is placed, the present study is associated with bone marrow aspirate (BMA). The experimental study evaluated the efficacy of osteoregeneration in normal cleft rabbits when alveolar bone grafting was performed with autologous iliac corticocancellous bone. Methods: Twenty - four New Zealand White rabbits were divided randomly into 2 groups (BMA, control). All animals underwent harvesting of corticocancellous bone graft from the right posterior iliac crest via standard surgical technique. $1m{\ell}$ of BMA were obtained by scraping the needle and aspirate with $10m{\ell}$ syringe from the contralateral iliac bone wall. The muco - periosteal flap on the palate was elevated. A mixture of Equal bone's volumes with BMA and saline as its control was inserted into the cleft. Animals were sacrificed at 2, 4, and 8 weeks and maxilla was harvested for dental peri - apical X-ray, bone matrix density (BMD),and histologic analysis. Result: BMD of regenerated bone to the cleft in the rabbits was higher than that of the control rabbits. X-ray, histologic analysis showed that increased osteoregeneration and low absorption rate were observed in the BMA group. Conclusion: Our experimental study showed BMA enhanced the osteoregeneration and survival rate of alveolar bone grafting. BMA is easy to extract & cost - time effective. So it can be an effective enhancers for bone grafting mixtures.

Bleeding control of an injury to the infrarenal inferior vena cava and right external iliac vein by ipsilateral internal iliac artery and superficial femoral vein ligation after blunt abdominal trauma in Korea: a case report

  • Hoonsung Park;Maru Kim;Dae-Sang Lee;Tae Hwa Hong;Doo-Hun Kim;Hangjoo Cho
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.441-446
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    • 2023
  • Inferior vena cava (IVC) injuries, while accounting for fewer than 0.5% of blunt abdominal trauma cases, are among the most difficult to manage. Despite advancements in prehospital care, transportation, operative techniques, and perioperative management, the mortality rate for IVC injuries has remained at 20% to 66% for several decades. Furthermore, 30% to 50% of patients with IVC injuries succumb during the prehospital phase. A 65-year-old male patient, who had been struck in the back by a 500-kg excavator shovel at a construction site, was transported to a regional trauma center. Injuries to the right side of the infrarenal IVC and the right external iliac vein (EIV) were suspected, along with fractures to the right iliac bone and sacrum. The injury to the right side of the infrarenal IVC wall was repaired, and the right internal iliac artery was ligated. However, persistent bleeding around the right EIV was observed, and we were unable to achieve proximal and distal control of the right EIV. Attempts at prolonged manual compression were unsuccessful. To decrease venous return, we ligated the right superficial femoral vein. This reduced the amount of bleeding, enabling us to secure the surgical field. We ultimately controlled the bleeding, and approximately 5 L of blood products were infused intraoperatively. A second-look operation was performed 2 days later, by which time most of the bleeding sites had ceased. Orthopedic surgeons then took over the operation, performing closed reduction and external fixation. Five days later, the patient underwent definitive fixation and was transferred for rehabilitation on postoperative day 22.

The Use of an Iliac Branch Device: Single-Center Study of Endovascular Preservation of Internal Iliac Artery Flow (장골 분지 장치 사용: 내장골동맥 흐름의 혈관내 보존에 대한 단일 기관의 경험)

  • Hyeseung Lee;Jeong-min Lee;Soongu Cho;JungUi Hong
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1339-1349
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    • 2023
  • Purpose To determine the efficacy and safety of iliac branch device (IBD) implantation and to evaluate its limitations based on 7 years of experience in a single center. Materials and Methods This single-center study included patients with bilateral common iliac artery aneurysms (CIAAs). We investigated follow-up CT and reviewed the internal iliac artery (IIA) patency and complications related to IBD. A retrospective analysis was performed and the overall survival rate and freedom from reintervention rate were reported according to the Kaplan-Meier method. Results Of the 38 patients with CIAAs, only 10 (12 CIAAs) were suitable for IBD treatment. Five patients underwent unilateral IBD insertion with contralateral IIA embolization, and three (60%) showed claudication; however, symptoms resolved within 6 months. The 7-year freedom from IBD-related reintervention rate was 77.8%. No procedure-related deaths occurred. Conclusion IBD has good technical success and long-term patency rates; however, anatomical factors frequently limit its application, particularly in Asians. Additionally, unilateral IIA embolization showed relatively mild complications and a good prognosis; therefore, it can be performed safely for anatomically complex aortoiliac aneurysms.

Crossover bypass in the Obstruction of the Common Iliac Vein Using with Saphenous Vein Graft - A Report of Case - (외상성 총장골정맥폐쇄에서 Palma 씨 수술치험 1례)

  • 이종락
    • Journal of Chest Surgery
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    • v.22 no.2
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    • pp.337-341
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    • 1989
  • A 40-year-old male developed the swelling of the right leg one month after trauma on cycling. Conservative measures to relieve the swelling of the right leg for three months were failed. Venogram showed complete obstruction of the right common iliac vein. Crossover bypass [Palmas operation] with great saphenous vein graft for relief of venous stasis of the right leg was performed. Postoperatively, the swelling of the right leg was subsided and able to walk without edema of the right leg.

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May-Thurner Syndrome Treated with Endovascular Wall Stent - Report of two cases - (May-Thurner 증후군의 혈관 내 스텐트를 이용한 치료 - 치험 2예 -)

  • Yoon, You-Sang;Won, Je-Hwan;Choi, Ho;Soh, Dong-Mun;Lee, Cheol-Joo;Kim, Hyung-Tae
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.202-205
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    • 2003
  • Deep vein thrombosis (DVT) is a common disease. However, May-Thurner syndrome, which is the cause of DVT, is an uncommon processes in which there is an impaired venous return due to compression of the left iliac vein by the overlying right common artery. This condition results in a left iliofemoral deep thrombosis and severe leg edema. It is, therefore, called iliac compression syndrome. Catheter-directed thrombolytic therapy of acute extensive iliofemoral DVT and balloon angioplasty with venous stenting are recommended. Two cases with history of left leg swelling are diagnosed as May-Thurner syndrome, which was demonstrated by venography. We successfully treated the patients with thrombolysis, balloon angioplasty, and stent insertion at the site of common iliac vein compression. Therefore, we report the cases with overall review of the literature.

A Study on the Transfer of Amino Acids across the Human Placenta at Term of Pregnancy (임신말 태반을 통한 아미노산 이동에 관한 연구)

  • Ahn, Hong-Seok
    • Journal of Nutrition and Health
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    • v.18 no.3
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    • pp.209-216
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    • 1985
  • The plasma levels of 23 free amino acids in both the umbilical circulation (umbilical vein and artery) and the maternal circulation (antecubital vein, uterine vein and iliac artery ) of 34 pregnant women were measured at delivery by the cesarean section. Each amino acid with the exception of glutamate was found to be in higher concentration in the fetal blood and the cord plasma characterized by hyperaminoacidemia with a marked increase of the lysine and ornithine levels. The linear relationships found between the amino acids concentrations of iliac artery and those of umbilical vein suggest three transport groups across the placental membrane One group consists of neutral amino acids whose slopes are equal to one and the other two groups are characterized by their slopes higher and lower than unity respectivly. This division into three groups is tentatively explained by the result of a dynamic equilibrium between active transport towards the fetus and diffusion back towards the maternal circulation.

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Selective embolization of the internal iliac arteries for the treatment of intractable hemorrhage in children with malignancies

  • Bae, Sul-Hee;Han, Dong-Kyun;Baek, Hee-Jo;Park, Sun-Ju;Chang, Nam-Kyu;Kook, Hoon;Hwang, Tai-Ju
    • Clinical and Experimental Pediatrics
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    • v.54 no.4
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    • pp.169-175
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    • 2011
  • Purpose: Acute internal hemorrhage is an occasionally life-threatening complication in pediatric cancer patients. Many therapeutic approaches have been used to control bleeding with various degrees of success. In this study, we evaluated the efficacy of selective internal iliac artery embolization for controlling acute intractable bleeding in children with malignancies. Methods: We retrospectively evaluated the cases of 6 children with various malignancies (acute lymphoblastic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, T-cell prolymphocytic leukemia, Langerhans cell histiocytosis, and rhabdomyosarcoma), who had undergone selective arterial embolization (SAE) of the internal iliac artery at the Chonnam National University Hwasun Hospital between January 2004 and December 2009. SAE was performed by an interventional radiologist using Gelfoam$^{(R)}$ and/or Tornado$^{(R)}$ coils. Results: The patients were 5 boys and 1 girl with median age of 6.9 years (range, 0.7-14.8 years) at the time of SAE. SAE was performed once in 4 patients and twice in 2, and the procedure was unilateral in 2 and bilateral in 4. The causes of hemorrhage were as follows: hemorrhagic cystitis (HC) in 3 patients, procedure-related internal iliac artery injuries in 2 patients, and tumor rupture in 1 patient. Initial attempt at conservative management was unsuccessful. Of the 6 patients, 5 (83.3%) showed improvement after SAE without complications. Conclusion: SAE may be a safe and effective procedure for controlling acute intractable hemorrhage in pediatric malignancy patients. This procedure may obviate the need for surgery, which carries an attendant risk of morbidity and mortality in cancer patients with critical conditions.

Successful Angiographic Embolization of Superficial Circumflex Iliac Artery Rupture Caused by Blunt Abdominal Trauma: A Case Report (복부 둔상에 의한 얕은엉덩휘돌이동맥 파열의 혈관조영색전술을 통한 성공적인 치료: 증례보고)

  • Lee, Sang Bong;Park, Sung Jin;Yeo, Kwang Hee;Kim, Ho Hyun;Park, Chan-Yong;Kim, Jae Hun;Kim, Chang Wan;Choi, Seon Uoo;Kim, Seon Hee;Hwang, Jung Joo;Cho, Hyun Min
    • Journal of Trauma and Injury
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    • v.28 no.1
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    • pp.39-42
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    • 2015
  • Lat. abdominal wall hematoma with active bleeding is very rare but need prompt bleeding control. We report successful treatment by angiographic embolization of superficial circumflex iliac artery rupture caused by blunt trauma. A 60-year-old woman presented painful, enlarging, lat. abdominal wall mass with ecchymosis caused by blunt abdominal trauma. Contrast leakage of superficial circumflex iliac a. within the lt. ext. oblique m. hematoma was confirmed by abdominal computed tomography. Angiographic embolization was performed successfully. Patient was discharged at 4th day after trauma without complication. Angiographic embolization is important treatment option of lat. abdominal wall hematoma with active bleeding replacing emergency surgery.

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