• Title/Summary/Keyword: Vascular Stent

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Superior Vena Cava Syndrome Caused by Tumor Thrombus from Papillary Thyroid Carcinoma (갑상선 유두암의 암성 혈전으로 인한 상공 정맥 증후군 1예)

  • Yun, Ji-Sup;Lee, Jan-Dee;Lim, Chi-Young;Nam, Kee-Hyun;Chung, Woong-Youn;Park, Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.2
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    • pp.188-191
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    • 2006
  • Papillary thyroid carcinoma is rarely associated with macroscopic vascular invasion or tumor thrombosis. Especially, superior vena cava syndrome(SVCS) resulted from tumor thrombosis of papillary thyroid carcinoma is extremely rare. We present herein a case of SVCS caused by tumor thrombosis from papillary thyroid carcinoma which was successfully solved by intravascular placement of self-expandable stent in 74-year-old woman.

A Study on Fatigue Characteristic of Stent Using Finite Element Analysis (나이티놀 와이어 스텐트의 피로도 특성에 대한 유한요소 해석)

  • Kim, Han-Ki;Shin, Il-Gyun;Kim, Dong-Gon;Kim, Seong-Hyeon;Lee, Ju-Ho;Ki, Byoyng-Yun;Suh, Tae-Suk;Kim, Sang-Ho
    • Progress in Medical Physics
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    • v.20 no.3
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    • pp.119-124
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    • 2009
  • Stents are frequently used throughout the human body. They keep pathways open in vascular or nonvascular duct for a long time. Therefore its stability is very important factor. In recent years, aconsiderable amount of research has been carried out in order to estimate mechanical properties of the stent such as expansion pressure behavior, radial recoil and longitudinal recoil using FEM (Finite element analyses). However, published works on simulation of stent fatigue behavior using FEM are relatively rare. In this paper, a nonlinear finite-element methodwas employed to analyses the compression of a stent using external pressure and fatigue behavior. Finite element analyses for the stent system were performed using NASTRAN FX. In conclusion this paper shows how the stent is behaved in the body, and its fatigue behavior.

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Endovascular Stent Placement in a Patient with a Posttraumatic Isolated Superior Mesenteric Artery Dissection with Focally Progressing Dissecting Aneurysms and a Severely Compressed True Lumen (외상 후 단독 상장간막동맥박리 후에 국소적으로 진행된 박리성 동맥류와 심한 진강의 압박이 있는 환자에서 혈관내 스텐트설치술 1례)

  • Kim, Young-Kyu;Her, Kyu Hee;Kim, Seung Hyoung;Kim, Kwangsik
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.266-271
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    • 2015
  • Reports on a posttraumatic isolated superior mesenteric artery (SMA) dissection are rare. Recently, endovascular stent placement via percutaneous access, instead of vascular surgery, has been widely accepted as the initial treatment for a patient with an isolated SMA dissection or its complications. A 60-year-old female patient was transferred to our hospital due to an isolated SMA dissection after a car accident. The SMA dissection was 8.5 cm in length, and it involved the true lumen, which was severely compressed by the thrombosed false lumen. The patient was closely observed because she did not complain of any specific visceral pain. On the seventh hospital day, she underwent computed tomography (CT) to decide on a further treatment plan, irrespective of the presence of the abdominal symptom. The findings of the follow-up CT showed no difference compared to those of the previous CT. She was discharged with anti-coagulants. One month later, the follow-up CT revealed focally progressing dissecting aneurysms in the false lumen of the dissected SMA and a more severely compressed true lumen. Two self-expandable metallic stents were successfully placed in the true lumen of the dissected SMA, covering two aneurysmal lesions. Herein, we report a successful endovascular treatment with stent placement for treating focally progressing dissecting aneurysms and a severely compressed true lumen in a patient with a posttraumatic isolated SMA dissection.

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Improving Smoothness of Hydrophilic Natural Polymer Coating Layer by Optimizing Composition of Coating Solution and Modifying Chemical Properties of Cobalt-Chrome Stent Surface (코팅 용액의 조성 최적화 및 코발트-크롬 금속스텐트의 화학적 표면개질을 통한 친수성 천연 고분자 코팅층의 표면 거칠기 개선)

  • Kim, Dae Hwan;Kum, Chang Hun
    • Journal of Chitin and Chitosan
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    • v.23 no.4
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    • pp.256-261
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    • 2018
  • Recently, the number of cardiovascular disease-related deaths worldwide has increased. Therefore, the importance of percutaneous cardiovascular intervention and drug-eluting stents (DES) has been highlighted. Despite the great clinical success of DES, the re-endothelialization at the site of stent implantation is retarded owing to the anti-proliferative effect from the coated drug, resulting in late thrombosis or very late restenosis. In order to solve this problem, studies have been actively carried out to excavate new drugs that promote rapid re-endothelialization. In this study, we introduced hydrophilic drug, tauroursodeoxycholate (TUDCA), that improves the proliferation of endothelial progenitor cells and promotes apoptosis of vascular smooth muscle cells. In addition, we utilized shellac, which is a natural resin from lac bug to coat TUDCA on the surface of the metal. When using conventional coating method including biodegradable polymers and organic solvents, phase separation between polymer and drug occurred in the coating layer that caused incomplete incorporation of drug into the polymer layer. However, when using shellac as a coating polymer, no phase separation was observed and drug was fully covered with the polymer matrix. In addition, by adjusting the composition of coating solution and modifying the hydrophilicity of the metal surface using oxygen plasma, the surface roughness decreased due to the increased affinity between coating solution and metal surface. This result provides a method of depositing a hydrophilic drug layer on the stent.

Hemodynamic Consideration for Endoleak and Aneurysm Size Change after the Stent-Graft Application of Aortic Aneurysm

  • Park, Jea-Hyung;Jae, Hwan-Joon;Lee, Whal;Chung, Jin-Wook
    • International Journal of Vascular Biomedical Engineering
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    • v.2 no.2
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    • pp.10-15
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    • 2004
  • Purpose: In the treatment of aortic aneurysm, endovascular stent-graft application has become an established method of treatment. To observe the outcomes of the procedure as the size change of aneurysm in relation with endoleak, a retrospective analysis was done for the consecutive cases who undertook the procedure. Materials & Method: Stent-graft was applied to the aortic aneurysm in 33 patients. The location of the aneurysm was thoracic in 11 patients and abdominal in 22 patients. CT angiographic was done for the follow-up evaluation to analyze the aneurysm size and the presence of endoleak. Results: Technical success rate was 97% (32/33). The primary success rate without endoleak was 84% (28/33). The secondary success was 90% (30/33). During the follow-up period of 3 months to 7years and 6months in 26 patients, a secondary endoleak developed in 5 cases. Post-implantation syndrome developed in 17 cases (51%). Among the 14 cases with follow-up imaging data for size, endoleak was negative in 10 cases. The aneurysm decreased in 5 cases, stable in size in 4 cases and enlarged in one case (10%).Among the 4 cases with endoleak positive, the aneurysm enlarged in two cases (50%). Conclusion: In the stent-graft application for aortic aneurysm, there is high chance of decrease of aneurysm size in those cases with endoleak negative. However, the aneurysm may increase and eventually rupture in the cases with en do leak positive. Close observation with CT angiography is necessary for the evaluation for the presence of endoleak and size change.

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A Right Intercosto-Bronchial Artery Derived from the Thyrocervical Trunk: An Unusual Cause of Type II Endoleak Post Thoracic Aortic Stenting

  • Choong, Andrew Mtl;Mitchell, Ken;Jenkins, Jason
    • Journal of Chest Surgery
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    • v.48 no.2
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    • pp.139-141
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    • 2015
  • The aetiology, incidence and management of type II endoleaks in standard infrarenal endovascular aortic aneurysm repair is well described. Far less data is available for thoracic stent grafting. We present a rare and interesting case of a type II endoleak post thoracic aortic stenting and highlight the aberrant anatomy that can cause this phenomenon in such cases.

Intracardiac Migration of a Renal Stent from the Left Renal Vein to the Right Ventricle during the Treatment of Nutcracker Syndrome - A case report - (Nutcracker Syndrome를 위해 왼콩팥정맥에 삽입한 스텐트의 우심실 이동 - 1예 보고 -)

  • Kim, JaeBum;Choi, Sae-Young;Park, Nam-Hee;Kum, Dong-Yoon;Park, Hoon;Hwang, Eun Ah
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.100-103
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    • 2010
  • We report her on a rare case of a renal stent that migrated into the right ventricle in a patient with nutcracker syndrome. A 29-year-old woman was admitted to the hospital and she was suffering from flank pain. The computed tomography of the abdomen demonstrated that the left renal vein was compressed between the abdominal aorta and the superior mesenteric artery (nutcracker syndrome). A self expandable stent was placed across the left renal vein for treating her nutcracker syndrome. The next day after the procedure, the follow up chest radiograph showed that the displaced stent had migrated into the right ventricle. After percutanous endovascular stent removal had failed, the stent was ultimately removed by performing cardiac surgery. At the $6^{th}$ postoperative month, there have been no abdominal or cardiac symptoms.

3D Image Evaluation of Aneurysm in Cerebral Angiography (뇌혈관조영검사에서 동맥자루 3D 영상 평가)

  • Kyung-Wan Kim;Kyung-Min Park;In-Chul Im
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.335-341
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    • 2023
  • In this study, four algorithms (Standard, Bone, Dual volume, and Stent Follow up) were applied to the image of the aneurysm in cerebral angiography to reconstruct the image in 3D, and quantitatively evaluate Noise, SNR, and CNR based on the reconstructed image to find out the optimal algorithm. As an analysis method, Image J program, which can analyze images and calculate area and pixel values, was used for images reconstructed with four algorithms. In order to obtain Noise, SNR, and CNR, the region of interest (ROI) is measured by designating the point where the abnormal artery (aneurysm) is located and the surrounding normal artery in the image are measured, and the mean value and SD value are obtained. Background noise was set to two surrounding normal artery to increase reliability. The values of SNR and CNR were calculated based on the given formula. As a result, the noise was the lowest in the stent follow-up algorithm, and the SNR and CNR were the highest. Therefore, the stent follow-up algorithm is judged to be the most appropriate algorithm. The data of this study are expected to be useful as basic data for 3D image evaluation of the vascular and aneurysm in cerebral angiography, and it is believed that appropriate algorithm changes will serve as an opportunity to further improve image quality.

Efficacy and Safety of Sirolimus-Eluting Stent With Biodegradable Polymer UltimasterTM in Unselected Korean Population: A Multicenter, Prospective, Observational Study From Korean Multicenter Ultimaster Registry

  • Soohyung Park;Seung-Woon Rha;Byoung Geol Choi;Jae-Bin Seo;Ik Jun Choi;Sung-Il Woo;Soo-Han Kim;Tae Hoon Ahn;Jae Sang Kim;Ae-Young Her;Ji-Hun Ahn;Han Cheol Lee;Jaewoong Choi;Jin Soo Byon;Markz RMP Sinurat;Se Yeon Choi;Jinah Cha;Su Jin Hyun;Cheol Ung Choi;Chang Gyu Park
    • Korean Circulation Journal
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    • v.54 no.6
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    • pp.339-350
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    • 2024
  • Background and Objectives: UltimasterTM, a third-generation sirolimus-eluting stent using biodegradable polymer, has been introduced to overcome long term adverse vascular events, such as restenosis or stent thrombosis. In the present study, we aimed to evaluate the 12-month clinical outcomes of UltimasterTM stents in Korean patients with coronary artery disease. Methods: This study is a multicenter, prospective, observational registry across 12 hospitals. To reflect real-world clinical evidence, non-selective subtypes of patients and lesions were included in this study. The study end point was target lesion failure (TLF) (the composite of cardiac death, target vessel myocardial infarction [MI], and target lesion revascularization [TLR]) at 12-month clinical follow up. Results: A total of 576 patients were enrolled between November 2016 and May 2021. Most of the patients were male (76.5%), with a mean age of 66.0±11.2 years. Among the included patients, 40.1% had diabetes mellitus (DM) and 67.9% had acute coronary syndrome (ACS). At 12 months, the incidence of TLF was 4.1%. The incidence of cardiac death was 1.5%, MI was 1.0%, TLR was 2.7%, and stent thrombosis was 0.6%. In subgroup analysis based on the presence of ACS, DM, hypertension, dyslipidemia, or bifurcation, there were no major differences in the incidence of the primary endpoint. Conclusions: The present registry shows that UltimasterTM stent is safe and effective for routine real-world clinical practice in non-selective Korean patients, having a low rate of adverse events at least up to 12 months.

Ex vivo Morphometric Analysis of Coronary Stent using Micro-Computed Tomography (미세단층촬영기법을 이용한 관상동맥 스텐트의 동물 모델 분석)

  • Bae, In-Ho;Koh, Jeong-Tae;Lim, Kyung-Seob;Park, Dae-Sung;Kim, Jong-Min;Jeong, Myung-Ho
    • Journal of the Korean Society of Radiology
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    • v.6 no.2
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    • pp.93-98
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    • 2012
  • Micro-computed tomography (microCT) is an important tool for preclinical vascular imaging, with micron-level resolution. This non-destructive means of imaging allows for rapid collection of 2D and 3D reconstructions to visualize specimens prior to destructive analysis such as pathological analysis. Objectives. The aim of this study was to suggest a method for ex vivo, postmortem examination of stented arterial segments with microCT. And ex vivo evaluation of stents such as bare metal or drug eluting stents on in-stent restenosis (ISR) in rabbit model was performed. The bare metal stent (BMS) and drug eluting stent (DES, paclitaxel) were implanted in the left or right iliac arteries alternatively in eight New Zealand white rabbits. After 4 weeks of post-implantation, the part of iliac arteries surrounding the stent were removed carefully and processed for microCT. Prior to microCT analysis, a contrast medium was loaded to lumen of stents. All samples were subjected to an X-ray source operating at 50 kV and 200 ${\mu}A$ by using a 3D isotropic resolution. The region of interest was traced and measured by CTAN analytical software. Objects being exposed to radiation had different Hounsfield unit each other with values of approximately 1.2 at stent area, 0.12 ~ 0.17 at a contrast medium and 0 ~ 0.06 at outer area of stent. Based on above, further analyses were performed. As a result, the difference of lengths and volumes between expanded stents, which may relate to injury score in pathological analysis, was not different significantly. Moreover, ISR area of BMS was 1.6 times higher than that of DES, indicating that paclitaxel has inhibitory effect on cell proliferation and prevent infiltration of restenosis into lumen of stent. And ISR area of BMS was higher ($1.52{\pm}0.48mm^2$) than that of DES ($0.94{\pm}0.42mm^2$), indicating that paclitaxel has inhibitory effect on cell proliferation and prevent infiltration of restenosis into lumen of stent. Though it was not statistically significant, it showed that the extent of neointema of mid-region of stents was relatively higher than that of anterior and posterior region in parts of BMS as showing cross-sectional 2-D image. suggest that microCT can be utilized as an accessorial tool for pathological analysis.