• Title/Summary/Keyword: Subacute in-stent thrombosis

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Superficial Temporal Artery-Middle Cerebral Artery Anastomosis for Internal Carotid Artery Occlusion by Subacute In-Stent Thrombosis after Carotid Artery Stenting

  • Choi, Hoi Jung;Kim, Sung Tae;Jeong, Yeong Gyun;Jeong, Hae Woong
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.551-554
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    • 2012
  • Alternative to carotid endarterectomy, carotid artery stenting (CAS) can be performed for symptomatic severe stenosis of internal carotid artery, especially for high-risk patients. Among several complications after CAS, subacute in-stent thrombosis is rare but important, because patient's condition can deteriorate rapidly. Subacute in-stent thrombosis with carotid artery occlusion can be managed by superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. We report two cases of STA-MCA anastomosis for internal carotid artery occlusion by subacute in-stent thrombosis after CAS.

Occurrence and Prognosis for the Thrombosis in the Drug-Eluting Stents and Bare-Metal Stents (약물 용출 스텐트와 일반 금속 스텐트에서 혈전증에 대한 발생과 예후)

  • Kim, In-Soo;Choi, Nam-Gil;Jang, Seong-Joo;Han, Jae-Bok;Jang, Young-Ill
    • The Journal of the Korea Contents Association
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    • v.12 no.7
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    • pp.273-283
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    • 2012
  • Drug-eluting stents (DES) have significantly reduced in-stent restenosis, compared to bare-metal stents (BMS). However, there remains concern for the increased risk of stent thrombosis (ST) associated with DES. The present study sought to evaluate the incidence, clinical characteristics and outcome of ST in patients with acute myocardial infarction (MI) during a 1-year follow-up. 80 patients who developed ST were divided into 2 groups according to stent type: group I (DES-ST, n = 57 ) and group II (BMS-ST, n = 23 ). There were no differences between group I and II in the overall incidence of ST (2.7% vs. 4.3%, p=0.064) and in the incidence of each type of ST: acute ST (8.8% vs. 2.3%), subacute ST (50.9% vs. 60.9%), late ST (19.3% vs. 8.7%), and very late ST (21.1% vs. 17.4%) (p=0.605). Predictors of 1-year mortality were the occurrence of ST (OR 8.12, 95% CI 2.83-23.61, p<0.001), left ventricular ejection fraction<40% (OR 6.41, 95% CI 2.42-16.96, p<0.001), and age${\geq}$75 years (OR 4.98, 95% CI 1.95-12.74, p=0.001).

Improved Biocompatibility of Intra-Arterial Poly-L-Lactic Acid Stent by Tantalum Ion Implantation : 3-Month Results in a Swine Model

  • Kim, Kangmin;Park, Suhyung;Park, Jeong Hwan;Cho, Won-Sang;Kim, Hyoun-Ee;Lee, Sung-Mi;Kim, Jeong Eun;Kang, Hyun-Seung;Jang, Tae-Sik
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.853-863
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    • 2021
  • Objective : Biodegradable poly-L-lactic acid (PLLA) with a highly biocompatible surface via tantalum (Ta) ion implantation can be an innovative solution for the problems associated with current biodegradable stents. The purpose of this study is to develop a Taimplanted PLLA stent for clinical use and to investigate its biological performance capabilities. Methods : A series of in vitro and in vivo tests were used to assess the biological performance of bare and Ta-implanted PLLA stents. The re-endothelialization ability and thrombogenicity were examined through in vitro endothelial cell and platelet adhesion tests. An in vivo swine model was used to evaluate the effects of Ta ion implantation on subacute restenosis and thrombosis. Angiographic and histologic evaluations were conducted at one, two and three months post-treatment. Results : The Ta-implanted PLLA stent was successfully fabricated, exhibiting a smooth surface morphology and modified layer integration. After Ta ion implantation, the surface properties were more favorable for rapid endothelialization and for less platelet attachment compared to the bare PLLA stent. In an in vivo animal test, follow-up angiography showed no evidence of in-stent stenosis in either group. In a microscopic histologic examination, luminal thrombus formation was significantly suppressed in the Ta-implanted PLLA stent group according to the 2-month follow-up assessment (21.2% vs. 63.9%, p=0.005). Cells positive for CD 68, a marker for the monocyte lineage, were less frequently identified around the Ta-implanted PLLA stent in the 1-month follow-up assessments. Conclusion : The use of a Ta-implanted PLLA stent appears to promote re-endothelialization and anti-thrombogenicity.

Surgical Venous Thrombectomy for Chronic May-Thurner Sysndrome - 2 cases report - (만성 메이-터너 증후군에서 시행한 외과적 혈전 제거술 - 2예 보고 -)

  • Yie, Kil-Soo;Kim, Yong-Hoon;Min, Sun-Kyung;Kim, Hyoung-Rae;Lee, Bong-Ki;Kang, Seong-Sik
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.677-683
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    • 2009
  • May-Thurner syndrome is a deep vein thrombosis of the ilio-femoral vein due to compression of the left common iliac vein by the overlying right common iliac artery. Although, catheter directed thrombectomy (CDT) and thrombolysis with stent insertion has become the standard treatment method for acute or subacute May-Thurner syndrome, because of technical feasibility and lower recurrence rate, however, sometimes this methods make fatal complications. Furthermore, there are few reports on optimal treatment strategies for patients in a chronic state of May-Thurner syndrome. We now present two cases of chronic (> 1 month since onset of symptoms) May-Thurner syndrome treated by surgical thrombectomy and femoral arteriovenous shunt with simultaneous stent insertion after failed endovascular treatment. This technique may provide a significant benefit for patients who are not suitable for conventional endovascular treatment.