• Title/Summary/Keyword: Superior approach

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Treatment of a Carotid-Cavernous Sinus Fistula via the Superior Ophthalmic Vein Approach: A Case Report (상안정맥을 이용한 해면정맥동루의 색전술 치험례)

  • Moon, In-Sun;Shin, Han-Kyung;Kim, Dong-Il
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.116-119
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    • 2010
  • Purpose: Arteriovenous fistulas that involve the cavernous sinus often produce ophthalmologic symptoms and signs. Transvenous endovascular access is the method of choice for a carotid-cavernous sinus fistula. The superior ophthalmic vein is a safe and reasonable alternative route for the transvenous embolization of carotid-cavernous sinus fistula. We report a case of the embolization of a carotid-cavernous sinus fistula using the superior ophthalmic vein approach. Methods: A 58 year old female had conjunctival congestion, periocular pain and diplopia with a 2 month duration. Diagnostic orbital CT, brain MRI and cerebral angiography revealed a carotid-cavernous sinus fistula. The fistula occlusion was treated by coil embolization using the superior ophthalmic vein approach. Results: The initial presenting symptoms, conjunctival congestion, periocular pain and diplopia, decreased after surgery. Coil embolization via the superior ophthalmic vein approach was difficult because of the venous tortuosity and friability. During the follow up period, the patient was in a good condition without complications. Conclusion: Surgical exposure of the superior ophthalmic vein provides direct venous access to the cavernous sinus as well as an effective and safe treatment approach. The cooperation of the plastic surgeon and interventionist is a factor in successful treatment.

Unilateral, Single Needle Approach Using an Epidural Catheter for Bilateral Superior Hypogastric Plexus Block

  • Baik, Ji-Seok;Choi, Eun-Joo;Lee, Pyung-Bok;Nahm, Francis Sahn-Gun
    • The Korean Journal of Pain
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    • v.25 no.1
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    • pp.43-46
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    • 2012
  • The superior hypogastric plexus block (SHPB) is used for treating pelvic pain, especially in patients with gynecological malignancies. Various approaches to this procedure have been reported due to the anatomic obstacles of a high iliac crest or large transverse process of the $5^{th}$ lumbar vertebra. Here, we report a new technique of superior hypogastric plexus block using a unilateral single-needle approach to block the bilateral superior hypogastric plexus with a Tuohy needle and epidural catheter. We have confidence that this new technique can be another option in performing the SHPB when the conventional bilateral approach is difficult to perform.

Superior ophthalmic approach in carotid-cavernous fistula: Current concepts in indications, surgical techniques, and case reviews

  • Jungyul Park
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.3
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    • pp.245-252
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    • 2023
  • Carotid-cavernous fistulas, characterized by abnormal arteriovenous communication within the cavernous sinus (CS), can be classified as direct or indirect. Direct fistulas are defined as a direct connection between the internal carotid artery (ICA) and CS, whereas indirect fistulas result from an abnormal connection between the CS and dural arterial branches. The first-line treatment for both types of fistulas is endovascular intervention, most commonly accomplished through the transarterial and transvenous approaches of the conventional pathway, including the ICA, inferior and superior petrosal sinuses, or basilar plexus. Nonetheless, a retrograde approach through the superior ophthalmic vein may be necessary for individuals in whom conventional endovascular treatment fails. Herein, the current principles of surgical indication and technique are presented, along with case studies.

Transdiscal Superior Hypogastric Plexus Block with the Patient in Oblique Position -A case report- (사위에서 행한 경추간판적 상하복신경총 차단)

  • Shim, Jae-Chol;Kim, Dong-Won;Jeon, Young-Seok;Won, Seok-Kyu;Lee, Myoung-Eui
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.93-96
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    • 1997
  • Block of superior hypogastric plexus has been advocated as a useful technique in the palliation of various of pelvic pain syndromes. This technique has been performed under fluroscopic or CT guidance using bilateral placement of needles. We performed a modification of transdiscal approach with the patient in oblique position permitting successful superior hypogastric plexus block using a single needle placed under fluoroscopic guidance. Our experience suggest transdiscal approach performed in oblique position allows easier, safer, and more accurate needle placement for superior hypogastric plexus block.

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Persistent Left Sperior Vena Cava Draining into the Left Atrium with Absent Right Superior Vena Cava in Tetralogy of Fallot (우측상대정맥 없이 좌측 상대정맥이 좌심방으로 유입되는 활로씨 사징증의 수술치험 1례)

  • Kim, Hyuk;Kim, Byoung-Il;Kim, Nam-Su;Kim, Young-Hak;Chung, Won-Sang;Kang, Jung-Ho;Jee, Heng-Ok;Lee, Chul-Bum;Jeon, Seok-Chol
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1115-1117
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    • 1999
  • A persistent left superior vena cava draining into the coronary sinus is the most benign and widely encountered abnormality and can easily be explained embryologically as the persistence of the usual pattern of vnous circulation in the embryo,. However a persistent left superior vena cava draining into the left atrium with absent right superior vena cava is an extremely rare anomaly. We report this situation in an infant with tetralogy of Fallot. The most common approach has traditionally been intraatrial baffle repair to create a tunnel to the right atrium or rerouting of the left superior vena cava flow by directly anastomosing the left superior vena cava to the right atrium In the present study the left superior vena cava was transposed to the left pulmonary artery after the correction of tetralogy of Fallot. The most common approach has traditionally been intraatrial baffle repair to create a tunnel to the right atrium or rerouting of the left superior vena cava flow by directly anastomosing the left superior vena cava to the right atrium. In the present study the left superior vena cava was transposed to the left pulmonary artery after the correction of tetralogy of Fallot.

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Three Cases of Transdiscal Superior Hypogastric Plexus Block (경추간판적 상하복 신경총 차단 3예)

  • Lee, Sang-Hun;Lee, Keun-Sang;Woo, Nam-Sik;Lee, Ye-Chul;Kim, Chul-Ho;Kim, Ju-Woan
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.219-222
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    • 1996
  • Superior hypogastric plexus block is extensively recognized as a unique nerve block method for the treatment of low abdominal pain originating from organs of the pelvic area. This block is difficult to perform on older patients, especially those with osteophyte, as they will experience a high degree of pain with this technique. Therefore we reported trans-discal superior hypogastric plexus by method of approach needle through disc. This method is less painful to the patient as compared to bilateral approach; and easier to place the needle tip at precise and proper location.

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Trans-intervertebral Disc Approach of Superior Hypogastric Plexus Block for Pelvic Cancer Pain: A Retrospective Study (암성 골반통에 대한 경추간판적 상하복신경총 차단술의 효과)

  • Lee, Youn-Woo;Yoon, Duck-Mi;Lee, Gee-Moon;Han, Seung-Tak;Park, Hae-Jin
    • The Korean Journal of Pain
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    • v.13 no.2
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    • pp.202-207
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    • 2000
  • Background: Superior hypogastric plexus block has been advocated as a useful technique for the treatment of cancer related pelvic pain. The aim of this study was to evaluate the effect of neurolytic trans-intervertebrodiscal superior hypogastric plexus block for pelvic cancer pain. Methods: Twenty-eight patients with gynecologic, colorectal or genitourinary cancer who suffered intractable pain were studied. We performed superior hypogastric plexus block by trans-intervertebrodiscal approach at L5/S1 level under the C-arm fluoroscopic guide unilaterally or bilaterally. Ten ml of 100% dehydrated alcohol was injected through each needle. We evaluated the change of visual analog pain score (VAS; 0~100 mm) and daily dose of oral morphine sulphate at the time of pre-block and 7 days after the block. Results: Fourteen patients (50%) had satisfactory pain relief (VAS<30) while five patients (18%) had moderate pain control (VAS 30~60). The remaining nine patients (32%) had mild or little pain relief (VAS>60) and their daily oral morphine doses were above 160 mg. Additional pain control method may be needed for those patients who received high dose of opioid before neurolytic block. Conclusions: We conclude trans-intervertebrodiscal neurolytic superior hypogastric plexus block was effective in relieving pelvic cancer pain. Neurolytic block, earlier stage, may provide better effects for more comfortable life at the end stage for cancer patients.

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Multilevel approach for the local nanobuckling analysis of CNT-based composites

  • Silvestre, N.;Faria, B.;Duarte, A.
    • Coupled systems mechanics
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    • v.1 no.3
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    • pp.269-283
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    • 2012
  • In the present paper, a multilevel approach for the local nanobuckling analysis of carbon nanotube (CNT) based composite materials is proposed and described. The approach comprises four levels, all of them at nanoscale. The first level aims to propose the potential that describes the interatomic forces between carbon atoms. In the second level, molecular dynamics simulations are performed to extract the elastic properties of the CNT. The third level aims to determine the stiffness of the material that surrounds the CNT (matrix), using the annular membrane analysis. In the fourth level, finite strip analysis of the CNT elastically restrained by the matrix is performed to calculate the critical strain at which the CNT buckles locally. In order to achieve accurate results and take the CNT-matrix interaction into account, the $3^{rd}$ and $4^{th}$ steps may be repeated iteratively until convergence is achieved. The proposed multilevel approach is applied to several CNTs embedded in a cylindrical representative volume element and illustrated in detail. It shows that (i) the interaction between the CNT and the matrix should be taken into account and (ii) the buckling at nanoscale is sensitive to several types of local buckling modes.

The Superior Approach in Hemiarthroplasty for Femoral Neck Fracture: A Comparative Analysis with the Posterior Approach

  • Kenta Kamo
    • Hip & pelvis
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    • v.36 no.3
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    • pp.211-217
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    • 2024
  • Purpose: The concept of a superior approach (SA) involves the use of a tissue-sparing posterior approach (PA), with exposure of the piriformis muscle and gluteus medius/minimus muscles. The objective of this study was to clarify the features of hip hemiarthroplasty (HA) using a SA in regard to early recovery and mid-term outcomes, with a comparison of the outcomes of SA-HAs and HAs using a PA (PA-HAs). Materials and Methods: A total of 120 HAs for treatment of primary femoral neck fracture with a healthy opposite hip joint were performed in our hospital from 2013 to 2018. Propensity score matching in regard to age, sex, body mass index, walking ability before injury, place of residence, time to surgery, and American Society of Anesthesiologists-Physical Status was performed for 79 patients with SA-HAs and 41 patients with PA-HAs. The final analysis included 34 patients who underwent SA-HAs and 34 patients who underwent PA-HAs. Results: The duration of surgery was 57.1 minutes and 72.1 minutes (P=0.001) for SA-HAs and PA-HAs, respectively. The scores for walking ability at postoperative one week were 4.9±1.4 and 4.2±1.0 (P=0.021) for SA-HAs and PA-HAs, respectively. The Barthel index (BI) at the start of rehabilitation was 26.2±18.7 and 17.4±16.3 (P=0.042) for SA-HAs and PA-HAs, respectively. The 4-year complication-free survival rates were 74.2% and 56.3% for SA-HAs and PA-HAs, respectively (P=0.310). Conclusion: SA-HA can be performed without torsion of the muscles and ligaments around the hip joint. Early recovery of walking ability and BI was a significant feature of SA-HAs.

Quantitative and Qualitative Considerations to Apply Methods for Identifying Content Relevance between Knowledge Into Managing Knowledge Service (지식 간 내용적 연관성 파악 기법의 지식 서비스 관리 접목을 위한 정량적/정성적 고려사항 검토)

  • Yoo, Keedong
    • The Journal of Society for e-Business Studies
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    • v.26 no.3
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    • pp.119-132
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    • 2021
  • Identification of associated knowledge based on content relevance is a fundamental functionality in managing service and security of core knowledge. This study compares the performance of methods to identify associated knowledge based on content relevance, i.e., the associated document network composition performance of keyword-based and word-embedding approach, to examine which method exhibits superior performance in terms of quantitative and qualitative perspectives. As a result, the keyword-based approach showed superior performance in core document identification and semantic information representation, while the word embedding approach showed superior performance in F1-Score and Accuracy, association intensity representation, and large-volume document processing. This study can be utilized for more realistic associated knowledge service management, reflecting the needs of companies and users.