• Title/Summary/Keyword: Long-term follow up

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Long Term Outcome of In-Stent Stenosis after Stent Assisted Coil Embolization for Cerebral Aneurysm

  • Kim, Sung Jin;Kim, Young-Joon;Ko, Jung Ho
    • Journal of Korean Neurosurgical Society
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    • v.62 no.5
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    • pp.536-544
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    • 2019
  • Objective : The objective of this study was to evaluatelong-term radiologic prognosis and characteristics of in-stent stenosis (ISS) after stent assisted coiling (SAC) for cerebral aneurysm and analyze its risk factors. Methods : Radiological records of 362 cases of SAC during 10 years were retrospectively reviewed. Patients were included in this study if they had follow-up angiogram using catheter selected angiography at least twice. All subjected were followed up from 12 months to over 30 months. Of 120 patients, 123 aneurysms were enrolled. Patient data including age, sex, aneurysm size, neck size, procedural complication, kinds of stent, ISS associated symptom, ruptured state, location of ISS, degree of ISS, radiologic prognosis of ISS, follow-up period of time, and medical comorbidities such as hypertension, diabetes mellitus (DM), dyslipidemia, and smoking were collected.Statistical comparisons of group clinical characteristics were conducted for the total population. Results : Among 123 casesof aneurysm, 22 cases (17.9%) of ISS were revealed on follow-up angiography. Multiple stenting was performed in three cases and intra-procedural rupture occurred in two cases. Most cases were asymptomatic and symptomatic stenosis was identified in only one case. Sixteen cases were ruptured aneurysm. Mild stenosis was observed in 11 cases. Moderate stenosis was found in eight cases and severe stenosis was identified in three cases. Mean timing of identification of ISS was 8.90 months. The most common type was proximal type. Most cases were improved or not changed on follow-up angiography. Only one case was aggravated from mild stenosis to occlusion of parent artery. Mean follow-up period was 44.3 months. We compared risk factors and characteristic between ISS group and non-ISS group using univariate analysis. Multiple stenting was performed for three cases (13.6%) of the ISS group and four cases (4.0%) of the non-ISS group, showing no statistical difference between the two groups (p=0.108). Additionally, the proportion of patients who had more than two risk factors among four medical risk factors (hypertension, DM, dyslipidemia, and smoking) was higher in the ISS group than that in the non-ISS group, the difference between the two was not statistically significant either (31.8% vs. 12.9%, p=0.05). Conclusion : Clinical course and long-term prognosis of ISS might be benign. Most cases of ISS could be improved or not aggravated. Control of medical co-morbidity might be important. To the best of our knowledge, our study had more cases with longer follow-up period of time than other reports.

Long-term complications after extrahepatic cyst excision for type IV-A choledochal cysts

  • Utpal Anand;Aaron George John;Rajeev Nayan Priyadarshi;Ramesh Kumar;Basant Narayan Singh;Kunal Parasar;Bindey Kumar
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.433-436
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    • 2023
  • Forty-five adults with type IV-A choledochal cysts (CDC) who underwent extrahepatic cyst excision from January 2013 to December 2021 were followed up for a median interval of 25 months (range, 2 to 10 years) to observe the long-term complications in the remaining intrahepatic cyst. Late complications in varying combinations were seen in 10 patients, which included cholangitis and/or intrahepatic stones in 9 patients, intrahepatic bile duct stenosis with stones in 2 patients, anastomotic stricture in 6 patients, and left lobar atrophy with intrahepatic stones in 3 patients. Out of 6 patients who required re-do hepaticojejunostomy (HJ), three patients had left lobe atrophy with patent HJ anastomosis and a recurrent attack of cholangitis on follow-up at 3, 8, and 10 years. Complications occur frequently after extrahepatic cyst excision for type IV-A CDC and require a long-term follow-up.

Long-Term Evaluation of Conservative Treatment for Craniomandibular Disorders (두개하악장애환자의 보존적 치료에 관한 장기평가)

  • June-Sang Park;Myung-Yun Ko
    • Journal of Oral Medicine and Pain
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    • v.18 no.2
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    • pp.81-96
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    • 1993
  • In order to evaluate the prognosis of conservative treatment for Craniomandibular Disorders, 127 patients were subjected at the Dept. of Oral Medicine, Pusan National University Hospital from 1983 through 1991. All the changes of patients' symptoms and related factors were analyzed before treatment, after treatment and at follow-up examination by means of subjective and objective symptom indicies (Ai, AAI, SDS, Di, CDS, MCO). 1. All the indices were reduced and MCO became increased at follow-up examination (p<0.01). 2. As the duration after treatment became longer, all the indices became reduced and MCO became increased. 3. There were no significant differences in index scores according to sex and age. 4. Long-term patients showed higher index scores and lower MCO than short-term patients(p<0.01). 5. Chronic group showed higher index scores and lower MCO than acute group (p<0.05). 6. Macrotrauma group showed higher index scores and lower MCO than microtrauma group (p<0.05) 7. While muscle group showed the lowest MCO, muscle and joint group showed the highest index scores (p<0.01). 8. The long-term success rate of conservative treatment was more than 80% (p<0.01)

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Long-term Outcome after Surgery for Biliary Atresia (Study of 10 patients surviving more than 10 years) (담도 폐쇄증으로 Kasai 수술 받은 환아들의 장기간의 추적관찰 (10년 이상 생존한 환아들을 대상으로))

  • Rhim, Si-Youn;Jung, Poong-Man
    • Advances in pediatric surgery
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    • v.13 no.1
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    • pp.1-12
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    • 2007
  • Biliary atresia (BA) is the result of fibrosing destructive inflammatory process affecting intrahepatic and extrahepatic bile ducts, which lead to cirrhosis and portal hypertension. Kasai portoenterostomy has been the standard operative procedure in biliary atresia. Recently, there has been remarkable increase in the survival rate in cases of BA. However, long-term survivors are not clearly evaluated in Korea. To define long-term prognosis factors of patients who underwent surgery for BA, a retrospective study was undertaken of 10 (37 %) patients surviving more than 10 years among 27 patients who underwent one of Kasai procedures between 1981 and 1995. Hepatomegaly was present in 4 and splenomegaly in 7 patients. Serum bilirubin was normalized at 1 year after operation. Aspartate aminotransferase (AST, GOT), Alanine aminotransferase(ALT, GPT) were normalized at 12 years and alkaline phosphatase(ALP) was normalized at 13.5 years. Cholangitis developed mainly within 5 years after operation so close follow up is needed. Life long follow-up is needed because of progressive deterioration of liver function even after 10 years.

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Long Term Follow Up of Surgical Treatment of Axillary Osmidrosis and Hyperhidrosis by Instrumental Shaving and Manual Shaving (Instrumental Shaving과 Manual Shaving을 병용한 액와부 액취증 및 다한증의 수술적 치료 후 장기 추적관찰)

  • Kim, Ki Yup;Cho, Sung Duck
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.709-715
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    • 2008
  • Purpose: Axillary osmidrosis is caused by excessive apocrine gland secretion, which causes an unpleasant odor. Axillary osmidrosis causes difficulty in social activities and personal handicap. We studied the long term follow up results of our surgical procedures and sought to find a best surgical treatment methods. Methods: From January 1991 to December 2006, a total of 1864 patients(587 men, 1277 women) had been treated with this procedure for axillary osmidrosis and hyperhidrosis. Follow up periods varied from 10 to 15 years. We used the subdermal excision technique, using two small incisions over the axilary folds and using a Kawata dissector(instrumental shaving) and additional manual subdermal excision(manual shaving). Results: Among the total patients, 782 patients were followed up. Except a pure hyperhidrosis patients, 759 osmidrosis patients was included. 588 patients(77.4%) had a good results, 148 patients(19.5%) had a moderate results and 23 patients(3.1%) had a recurrence. Complication developed in 189 patients(10.1%): hematoma or seroma in 25 patients, wound dehiscence in 86 patients, partial skin necrosis in 45 patients, and infection in 28 patients. Conclusion: We conclude that our method has several advantages such as 1) short operation time, 2) minimal scaring, 3) lower complication rates, 4) high satisfactory rates.

Covered Stenting Is an Effective Option for Traumatic Carotid Pseudoaneurysm with Promising Long-Term Outcome

  • Wang, Kai;Peng, Xiao-xin;Liu, Ao-fei;Zhang, Ying-ying;Lv, Jin;Xiang, Li;Liu, Yun-e;Jiang, Wei-jian
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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    • pp.590-597
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    • 2020
  • Objective : Covered stenting is an optional strategy for traumatic carotid pseudoaneurysm, especially in malignant conditions of potential rupture, but the long-term outcomes are not clear. Our aim was to determine if covered stenting is an effective option for traumatic carotid pseudoaneurysm with promising long-term outcomes. Methods : Self-expanding Viabahn and balloon-expandable Willis covered stents were separately implanted for extra- and intracranial traumatic carotid pseudoaneurysm. The covered stent was placed across the distal and proximal pseudoaneurysm leakage under roadmap guidance. Procedural success was defined as technical success (complete exclusion of the pseudoaneurysm and patency of the parent artery) without a primary end point (any stroke or death within 30 days after the procedure). Long-term outcomes were evaluated as ischemic stroke in the territory of the qualifying artery by clinical follow-up through outpatient or telephone consultation and as the exclusion of the pseudoaneurysm and patency of the parent artery by imaging follow-up through angiography. Results : Five patients with traumatic carotid pseudoaneurysm who underwent covered stenting were enrolled. The procedural success rate was 100%. No ischemic stroke in the territory of the qualifying artery was recorded in any of the five patients during a mean clinical follow-up of 44±16 months. Complete exclusion of the pseudoaneurysm and patency of the parent artery were maintained in all five patients during a mean imaging follow-up of 39±16 months. Conclusion : Satisfactory procedural and long-term outcomes were obtained, suggesting that covered stenting is an effective option for traumatic carotid pseudoaneurysm.

Long-Term Follow-Up Results of Anterior Cervical Inter-Body Fusion with Stand-Alone Cages

  • Kim, Woong-Beom;Hyun, Seung-Jae;Choi, Hoyong;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.385-391
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    • 2016
  • Objective : The purpose of this study was to evaluate long-term follow-up radiologic/clinical outcomes of patients who underwent anterior cervical discectomy and inter-body fusion (ACDF) with stand-alone cages (SAC) in a single academic institution. Methods : Total 99 patients who underwent ACDF with SAC between February 2004 and December 2012 were evaluated retrospectively. A total of 131 segments were enrolled in this study. Basic demographic information, radiographic [segmental subsidence rate, fusion rate, C2-7 global angle, and segmental angle changes)/clinical outcomes (by Odom's criteria and visual analog score (VAS)] and complications were evaluated to determine the long-term outcomes. Results : The majority were males (55 vs. 44) with average age of 53.2. Mean follow-up period was 62.9 months. The segmental subsidence rate was 53.4% and fusion rate was 73.3%. In the subsidence group, anterior intervertebral height (AIH) had more tendency of subsiding than middle or posterior intervertebral height (p=0.01). The segmental angle led kyphotic change related to the subsidence of the AIH. Adjacent segmental disease was occurred in 18 (18.2%) patients. Total 6 (6%) reoperations were performed at the index level. There was no statistical significance between clinical and radiological outcomes. But, overall long-term clinical outcome by Odom's criteria was unsatisfactory (64.64%). The neck and arm VAS score were increased by over time. Conclusion : Long-term outcomes of ACDF with SAC group were acceptable but not satisfactory. For optimal decision making, more additional comparative long-term outcome data is needed between ACDF with SAC and ACDF with plating.

A Follow-up Study of Clinical Characteristics of Recurrent Aphthous Stomatitis Patients Treated with Herbal Medicine (한약 치료를 시행한 재발성 아프타성 구내염 환자의 임상소견에 관한 추적 관찰 연구)

  • Ha, Na-yeon;Lee, Jae-hyung;Lee, Jung-eun;Nam, Seong-uk;Ko, Whee-hyoung;Hwang, Mi-ni;Kim, Jin-sung
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.812-819
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    • 2017
  • Objectives: The purpose of this study was to report the long-term efficacy of herbal medicine for treatment of patients with recurrent aphthous stomatitis (RAS). Methods: We reviewed the clinical records of 17 patients with RAS who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from September 1st, 2014 to August 29th, 2017. The patients were treated with herbal medicine for more than 3 consecutive weeks, followed by a telephone survey. We evaluated the clinical characteristics of RAS, and compared the short-term and long-term efficacy of herbal medicine treatment. Results: After treatment with herbal medicine, the clinical characteristics improved in the 17 patients with RAS, especially in terms of the duration and interval of recurrence. Prolonged effects were reported upon the follow-up telephone survey. Conclusion: Herbal medicine treatment may have a long-term effect in patients with RAS.

Long-term Follow-up of Metaphyseal Sclerotic Lines in Children Treated with Pamidronate (파미드로네이트 치료받은 환자에서 발생한 골간단 경화성 선에 대한 장기간 추적 연구)

  • Choi, Yu-Mi;Suh, Jin-Soon;Cho, Byoung-Soo
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.92-97
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    • 2014
  • Purpose: Bisphosphonates are widely used for the management steroid-induced osteoporosis (SIO) in children. With the increasing use of bisphosphonates, there have been reports of abnormal radiological findings in the growing skeleton. Therefore, their use in pediatric patients remains controversial. The present study was conducted to evaluate the long-term follow-up radiographic features, particularly metaphyseal sclerotic lines, in children who receive pamidronate therapy for nephropathy. Methods: Twenty-four children with nephropathy treated with oral calcium and pamidronate (mean duration, 9 months; dose, 100 mg daily), were evaluated retrospectively. All patients had SIO secondary to chronic glucocorticoid therapy for treating nephropathy. Long bone radiographic imaging was performed before treatment with pamidronate, and at follow-up, several years later. Physeal growth rates were estimated by measuring the distance that the sclerotic lines moved on the radiographs during the corresponding time intervals. Results: The mean follow-up period was 138 months. Long bone radiographs showed well-defined sclerotic lines at the metaphyseal ends, progressively moving from the physeal plate to the diaphysis, in all patients. The mean rate of movement of the sclerotic line was 6.21 mm per year. In 12 patients, the lines disappeared. The mean rate of growth in height was 7.33 cm per year. Conclusions: Results of long-term follow-up suggest that the metaphyseal sclerotic lines associated with pamidronate treatment tend to disappear without affecting overall skeletal growth. Bisphosphonate treatment for SIO in children with nephropathy seems to be safe, although further studies in larger number of patients are needed.