• 제목/요약/키워드: Stent Thrombosis

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스텐트 재협착 병변에서 약물코팅 풍선카테터과 약물용출 스텐트의 예후 분석 (Prognostic Analysis of Drug-Eluting Balloon Catheter and Drug-Eluting Stent for In-Stent Restenosis of Drug-Eluting Stent)

  • 이두환;송종남;박신의;최남길;한재복;김인수
    • 한국방사선학회논문지
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    • 제13권3호
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    • pp.381-389
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    • 2019
  • 약물용출 스텐트(drug-eluting stents, DES)는 일반 금속 스텐트에 비하여 재협착을 현저하게 줄였지만, 여전히 관상동맥 스텐트 재협착은 비율이 높다. 2012년 11월부터 2016년 12월까지의 일 대학교병원 심혈관센터에서 경피적 관상동맥 스텐트 삽입술 후 관상동맥 조영술에서 스텐트 재협착 환자 187명 그룹 I (약물코팅 풍선카테터 사용, n=127명), 그룹 II (약물용출 스텐트 사용, n=60명)로 분류하여 치료효과, 주요심장사건, 사망 발생률, 심근경색, 표적병변 재개통술 그리고 스텐트 혈전 등을 2년 동안 추적 분석하였다. 임상적 특성은 두 그룹간 차이는 없었고($21.1{\pm}5.3$ vs. $25.3{\pm}9.6 mm$, p<0.002), 혈관조영검사에서 약물코팅 풍선카테터 사용 그룹에서 스텐트 재협착 길이가 짧았다. 주요심장사건은 8.7%vs.10.0%, p=0.789, 사망발생률 0%vs. 0%,p=1.000, 심근경색 1.6%vs.6.7%, p=0.085, 표적병변 재개통술 8.7% vs. 10.0%, p=0.789 그리고 스텐트 혈전증 0% vs. 0%, p=1000에서 양군 간에 차이를 보이지 않았다. 약물코팅 풍선카테터가 약물방출 스텐트와 비교하여 2년 추적 검사 결과 주요심장사건에서 차이가 없었고, 약물코팅 풍선카테터는 스텐트 재협착 병변에서 약물방출 스텐트와 함께 선택할 수 있는 좋은 치료방법이라고 사료된다.

Acute Thrombotic Occlusion of Left Internal Jugular Vein Compressed by Bypass Graft for Thoracic Endovascular Aortic Repair Debranching Procedure

  • Sim, Hyung Tae;Beom, Min Sun;Kim, Sung Ryong;Ryu, Sang Wan
    • Journal of Chest Surgery
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    • 제47권6호
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    • pp.552-555
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    • 2014
  • Thoracic endovascular aortic repair has become a widespread alternative treatment option for thoracic aortic aneurysm. The debranching of arch vessels may be required to provide an acceptable landing zone for an endovascular stent graft. We report a case where the bypass graft used in the thoracic endovascular aortic repair procedure compressed the left internal jugular vein, causing acute thrombotic occlusion.

Endovascular Treatment of Blood Blister-Like Aneurysms Using Multiple Self-Expanding Stents

  • Kim, Young-Woo;Park, Ik-Seong;Baik, Min-Woo;Jo, Kwang-Wook
    • Journal of Korean Neurosurgical Society
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    • 제49권2호
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    • pp.116-119
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    • 2011
  • The surgical as well as endovascular treatment of blood-blister-like aneursysms (BBAs) is extremely difficult because of these pathological natures, such as small and the fragile necks. The optimal treatment of BBAs has remained uncertain. Stents are known to divert blood flow and induce thrombosis of intracranial aneurysms. We report 3 cases of successful obliteration of BBAs after multiple stents placement.

동맥경화증의 발생에 관한 혈류역학적 가설들에 대한 비교연구 (A Comparative Study of the Hemodynamic Hypotheses for the Generation of Atherosclerosis)

  • 서상호;조민태;노형운;권혁문
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2003년도 춘계학술대회
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    • pp.1915-1918
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    • 2003
  • Atherosclerosis, which is a degenerate disease, is believed to occur in the vascular system due to deposition of cholesterol and low density lipoprotein(LDL) or thrombosis on the blood vessel. Atherosclerosis narrows arterial lumen, which is known as stenosis phenomenon of blood vessel. Pathogenesis of atherosclerosis is thought to occur mainly by aging. Restenosis phenomenon is observed in the same site of insertion of a stent and balloon angioplasty after treatment of interventional theraphy. Several hypothetical theories related to the generation of atherosclerosis have been reported: high shear stress theory, low shear stress theory, high shear stress gradient theory, flow separation and turbulence theory and high pressure theory. However, no one theory clearly explains the causes of atherosclerosis. In the present study the generation of atherosclerosis in the left coronary artery is investigated. The hypotheses are verified by using the computer simulation.

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복부 둔상 환자에서 골반 골절을 동반하지 않고 발생한 총장골동맥 손상 증례 (Common Iliac Artery Injury due to Blunt Abdominal Trauma without a Pelvic Bone Fracture)

  • 정필영;변천성;오중환;배금석
    • Journal of Trauma and Injury
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    • 제27권4호
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    • pp.215-218
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    • 2014
  • Blunt abdominal trauma may often cause multiple vascular injuries. However, common iliac artery injuries without associated bony injury are very rarely seen in trauma patients. In the present case, a 77-year-old male patient who had no medical history was admitted via the emergency room with blunt abdominal trauma caused by a forklift. At admission, the patient was in shock and had abdominal distension. On abdomino-pelvic computed tomography (CT), the patient was seen to have hemoperitoneum, right common iliac artery thrombosis and left common iliac artery rupture. During surgery, an additional injury to inferior vena cava was confirmed, and a primary repair of the inferior vena cava was successfully performed. However, the bleeding from the left common iliac artery could not be controlled, even with multiple sutures, so the left common iliac artery was ligated. Through an inguinal skin incision, the right common iliac artery thrombosis was removed with a Forgaty catheter and a femoral-to-femoral bypass graft was successfully performed. After the post-operative 13th day, on a follow-up CT angiography, the femoral-to-femoral bypass graft was seen to have good patency, but a right common iliac artery dissection was diagnosed. Thus, a right common iliac artery stent was inserted. Finally, the patient was discharged without complications.

Aorta Remodeling after Endovascular Treatment of a Chronic DeBakey IIIb Aneurysm and Simultaneous Palliation of a Renal Cell Carcinoma

  • Kim, Do Jung;Lee, Kwang-Hun;Lim, Sun-Hee;Chung, Byung Ha;Song, Suk-Won
    • Journal of Chest Surgery
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    • 제48권2호
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    • pp.142-145
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    • 2015
  • We report the case of a patient with a chronic DeBakey type IIIb aneurysm who underwent thoracic endovascular aortic repair to seal the primary entry tear and stent-graft insertion to cover the re-entry tear at the renal artery. The procedure was performed in order to achieve complete thrombosis in the entire thoracoabdominal false lumen, leading to favorable aortic remodeling. Simultaneously, ethanol ablation and renal artery embolization were performed to treat a renal tumor suspicious of renal cell carcinoma. Radical nephrectomy then confirmed clear cell carcinoma. To the best of our knowledge, no other cases of this type have been reported in the Korean literature.

Treatment for Giant Fusiform Aneurysm Located in the Cavernous Segment of the Internal Carotid Artery Using the Pipeline Embolization Device

  • Oh, Se-Yang;Kim, Myeong Jin;Kim, Bum-Soo;Shin, Yong Sam
    • Journal of Korean Neurosurgical Society
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    • 제55권1호
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    • pp.32-35
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    • 2014
  • The pipeline embolization device (PED) is a new endovascular device for treatment of complex, fusiform and wide-neck intracranial aneurysms. The main mechanism of this stent is to divert the flow in the parent artery with reduction of inflow in the aneurysm leading to thrombosis. We treated a 40-year-old woman who had left facial pain and orbit discomfort. Angiography showed a giant fusiform aneurysm located in the cavernous segment of the left internal carotid artery. A PED was successfully deployed across the aneurysm. The procedure and post-procedural course were uneventful. After 3 months, angiography showed complete obliteration of the aneurysm with good patency of the branching vessels originating from the deployed segment. The patient's symptoms improved completely without complications.

Triflusal과 Ibudilast 동시처리에 의한 혈소판응집 및 혈액응고 억제효과 (Inhibitory Effects on Platelet Aggregation and Blood Coagulation by Concurrent Administration of Trifusal and Ibudilast)

  • 황인영;손윤아;황선아;구연경;김선영;윤혜숙;권순경;정춘식
    • 약학회지
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    • 제56권4호
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    • pp.248-253
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    • 2012
  • This study aims to develop a novel regimen for enhanced efficacy and reduced side effect in inhibiting platelet aggregation and blood coagulation by concurrent administration of triflusal and ibudilast as anticoaggulants. The result shows this combination of triflusal and ibudilast (300~500 ${\mu}M$, respectively) has additive effect in inhibiting platelet aggregation and blood coagulation over the administration of truflusal or ibdilast as a single treatment. This pharmaceutical composition is expected to be useful for the prevention or treatment of various diseases and symptoms, for example, ischemic heart disease, ischemic cerebral infarction, arteriosclerosis, and thrombosis caused by the insertion of a stent.

둔상성 외상 후 양측 간내 담관에서 담즙 누출의 치료 사례 1례 (Management of Bile Leaks from Bilateral Intrahepatic Ducts after Blunt Trauma)

  • 김동훈;최석호;고승제
    • Journal of Trauma and Injury
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    • 제27권3호
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    • pp.89-93
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    • 2014
  • Bile leaks are complications that are much more frequent after a high-grade liver injury than after a low-grade liver injury. In this report, we describe the management of bile leaks that were encountered after angiographic embolization in a 27-year-old man with a high-grade blunt liver injury. He had undergone an abdominal irrigation and drainage with a laparotomy on post-injury day (PID) 16 due to bile peritonitis and continuous bile leaks from percutaneous abdominal drainage. He required three percutaneous drainage procedures for a biloma and liver abscesses in hepatic segments 4, 5 and 8, as well as endoscopic retrograde cholangiopancreatography with biliary stent placement into the intrahepatic biloma via the common bile duct. We detected communication between the biloma and the bilateral intrahepatic duct by using a tubogram. Follow-up abdominal computed tomography on PID 47 showed partial thrombosis of the inferior vena cava at the suprahepatic level, and the patient received anticoagulation therapy with low molecular weight heparin and rivaroxaban. As symptomatic improvement was achieved by using conservative management, the percutaneous drains were removed and the patient was discharged on PID 82.

생분해성 고분자의 전기분사를 이용한 약물방출 스텐트용 금속표면 코팅 및 ALA방출 거동 (Metal Surface Coating Using Electrospray of Biodegradable Polymers and $\alpha$-Lipoic Acid Release Behavior for Drug-Eluting Stents)

  • 김동민;이봉수;박철호;박귀덕;손태일;정명호;한동근
    • 폴리머
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    • 제34권2호
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    • pp.178-183
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    • 2010
  • 의료용 금속스텐트는 관상동맥계 심장질환을 앓고 있는 환자에 시술되어 상대적으로 생존율을 높여 준다. 그러나, 재협착 및 후기 혈전증으로 인하여 새로운 스텐트의 개발이 시급하게 되었다. 이러한 문제점을 해결하기 위해서 신생내막 과대증식을 막을 수 있는 것으로 알려진 alpha lipoic acid(ALA)를 생분해성 고분자인 poly(lactide-coglycolide)(PLGA), poly(L-lactide)(PLLA) 및 poly($\varepsilon$-caprolactone)(PCL)과 혼합하여 전기분사 방식으로 스테인레스 스틸 표면 위에 코팅하였다. 코팅된 고분자로부터 약물방출 거동은 고분자의 종류와 농도, 용출속도 및 용매의 종류에 따라서 조사하였다. 약물방출 속도는 유리전이온도($T_g$)가 낮은 PCL에서 가장 빨랐으며 PLGA, PLLA 순서를 보였다. 고분자 표면의 거친정도는 용출속도가 증가함에 따라서 증가하였고, 용매의 비등점의 차이에 의해서 약물방출속도가 변화됨을 알 수 있었다. 이러한 약물방출 거동을 조절함으로써 ALA가 담지된 생분해성 고분자로 코팅된 약물방출 스텐트를 실제 임상적용이 가능할 것으로 기대된다.