• Title/Summary/Keyword: interventional radiology

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Three-Dimensional Printing Assisted Preoperative Surgical Planning for Cerebral Arteriovenous Malformation

  • Uzunoglu, Inan;Kizmazoglu, Ceren;Husemoglu, Resit Bugra;Gurkan, Gokhan;Uzunoglu, Cansu;Atar, Murat;Cakir, Volkan;Aydin, Hasan Emre;Sayin, Murat;Yuceer, Nurullah
    • Journal of Korean Neurosurgical Society
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    • v.64 no.6
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    • pp.882-890
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    • 2021
  • Objective : The aim of this study to investigate the benefits of patient-based 3-dimensional (3D) cerebral arteriovenous malformation (AVM) models for preoperative surgical planning and education. Methods : Fifteen patients were operated on for AVMs between 2015 and 2019 with patient-based 3D models. Ten patients' preoperative cranial angiogram screenings were evaluated preoperatively or perioperatively via patient-based 3D models. Two patients needed emergent surgical intervention; their models were solely designed based on their AVMs and used during the operation. However, the other patients who underwent elective surgery had the modeling starting from the skull base. These models were used both preoperatively and perioperatively. The benefits of patients arising from treatment with these models were evaluated via patient files and radiological data. Results : Fifteen patients (10 males and five females) between 16 and 66 years underwent surgery. The mean age of the patients was 40.0±14.72. The most frequent symptom patients observed were headaches. Four patients had intracranial bleeding; the symptom of admission was a loss of consciousness. Two patients (13.3%) belonged to Spetzler-Martin (SM) grade I, four (26.7%) belonged to SM grade II, eight (53.3%) belonged to SM grade III, and one (6.7%) belonged to SM grade IV. The mean operation duration was 3.44±0.47 hours. Three patients (20%) developed transient neurologic deficits postoperatively, whereas three other patients died (20%). Conclusion : Several technological innovations have emerged in recent years to reduce undesired outcomes and support the surgical team. For example, 3D models have been employed in various surgical procedures in the last decade. The routine usage of patient-based 3D models will not only support better surgical planning and practice, but it will also be useful in educating assistants and explaining the situation to the patient as well.

Emergency angioembolization performed in a hemodynamically unstable patient with grade V liver injury: The benefit of emergency angioembolization without computed tomography (혈역학적으로 불안정한 grade V 간손상에서 시행한 응급 혈관색전술: 전산화단층 촬영 없이 시행한 응급 혈관색전술의 이점)

  • Kang, Wu Seong;Park, Chan Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.235-239
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    • 2019
  • High-grade liver injury is associated with high morbidity and mortality rates. We report successful emergency angioembolization and early interventional radiology support to manage a high-grade liver injury in a 29-year-old man who presented following a fall during parachute training. Upon arrival, his blood pressure was 80/40 mmHg, and emergency ultrasonography showed a liver injury with perihepatic fluid collection. The patient's blood pressure reduced to 60/40 mmHg, and emergency angiography was performed without computed tomography (CT) (door to puncture time 36 min). After angioembolization, his blood pressure returned to 120/77 mmHg. Subsequent CT revealed no additional bleeding or hollow viscus injury. He was admitted to the Intensive Care Unit and discharged without complications 30 days after admission. In this case, emergency angioembolization (without performing CT) could successfully and safely treat a hemodynamically unstable patient with a high-grade liver injury.

Utility Evaluation of Supportive Devices for Interventional Lower Extremity Angiography (인터벤션 하지 혈관조영검사를 위한 보조기구의 유용성 평가)

  • Kong, Chang gi;Song, Jong Nam;Jeong, Moon Taek;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.613-621
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    • 2019
  • The purpose of this study is to evaluate the effectiveness of supportive devices which are for minimizing the patient's movement during lower extremity angiography and to verify image quality of phantom by analyzing of Mask image, DSA image and Roadmap image into SNR and CNR. As a result of comparing SNR with CNR of mask image obtained by DSA technique using the phantom alone and phantom placed on the supportive devices, there was no significant difference between about 0~0.06 for SNR and about 0~0.003 for CNR. The study showed about 0.11~0.35 for SNR and 0.016~0.031 for CNR of DSA imaging by DSA technique about only water phantom of the blood vessel model and the water phantom placed on the device. Analyzing SNR and CNR of Roadmap technique about water phantom on the auxiliary device (hardboard paper, pomax, polycarbonate, acrylic) and water phantom alone, there was no significant difference between 0.02~0.05 for SNR and 0.002~0.004 for CNR. In conclusion, there was no significant difference on image quality by using supportive devices made by hardboard paper, pomax, polycarbonate or acryl regardless of whether using supportive devices or not. Supportive devices to minimize of the patient's movement may reduce the total amount of contrast, exam-time, radiation exposure and eliminate risk factors during angiogram. Supportive devices made by hardboard paper can be applied easily during angiogram due to advantages of reasonable price and simple processing. It is considered that will be useful to consider cost efficiency and types of materials and their properties in accordance with purpose and method of the study when the operator makes and uses supportive devices.

Safety and Efficacy of Peripherally Inserted Central Catheters in Terminally Ill Cancer Patients: Single Institute Experience

  • Park, Kwonoh;Lim, Hyoung Gun;Hong, Ji Yeon;Song, Hunho
    • Journal of Hospice and Palliative Care
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    • v.17 no.3
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    • pp.179-184
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    • 2014
  • Purpose: We investigated the safety and efficacy of peripherally inserted central catheters (PICCs) in terminally ill cancer patients. Methods: A retrospective review was conducted on patients who underwent PICC at the hospice-palliative division of KEPCO (Korea Electric Power Corporation) Medical Center between January 2013 and December 2013. All PICCs were inserted by an interventional radiologist. Results: A total of 30 terminally ill cancer patients received the PICC procedure during the study period. Including one patient who had had two PICC insertions during the period, we analyzed a total of 31 episodes of catheterization and 571 PICC days. The median catheter life span was 14.0 days (range, 1~90 days). In 25 cases, catheters were maintained until the intended time (discharge, transfer, or death), while they were removed prematurely in six other cases (19%; 10.5/1000 PICC days). Thus, the catheter maintenance success rate was 81%. Of those six premature PICC removal cases, self-removal due to delirium occurred in four cases (13%; 7.0/1000 PICC days), and catheter-related blood stream infection and thrombosis were reported in one case, each (3%; 1.8/1000 PICC days). Complication cases totaled eight (26%; 14.1/1000 PICC days). The time to complication development ranged from two to 14 days and the median was seven days. There was no PICC complication-related death. Conclusion: Considering characteristics of terminally ill cancer patients, such as a poor general condition, vulnerability to trivial damage, and a limited period of survival, PICC could be a safe intravenous procedure.

Evaluation of Present Curriculum for Devlopment of Dept. of Radiological Science Curriculum (방사선학과 교육과정 개선을 위한 현 교육과정 평가)

  • Kang, Se-Sik;Kim, Chang-Soo;Choi, Seok-Yoon;Ko, Seong-Jin;Kim, Jung-Hoon
    • The Journal of the Korea Contents Association
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    • v.11 no.5
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    • pp.242-251
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    • 2011
  • A curriculum of study demands a change as period of time and society evolve. Therefore, at this point where changes are required, this study is to analyze and evaluate the curriculums which will enhance and improve current studies as a preceding stage. The research was based on the survey by groups of education experts and 19 universities with current curriculum of study in radiologic science, and their references. The study was focused on the scope of work by radiologic technologist, change of college systems, academic research about radiologic science, and the improvement and the future of radiologic science field in perspective to globalization and the digital era. In terms of work scope, angiography and interventional radiology at 6 to 8 schools, fluoroscopy at 4 schools, ultrasound and practices at 6 schools, magnetic resonance image at 2 schools were found to be unestablished. The basic medical subjects, humuan physiology, human anatomy and practices, medical terminology courses were set up at most schools; however, pathology at 5 schools, image anatomy at 6 schools, clinical medicine at 11 schools were yet opened. Among the basic science and engineering subjects, general biology and its practices at 11 schools, general physics and its practices at 14 schools, and general chemistry and its practices at 8 schools were established which is about a half from a total number of schools. Only 4-5 schools established digital subjects such as, health computer, computer programming, PACS which are the basic major subjects. In order to provide academic improvement in radiologic science, digitalized education and globalization, and basis for future-oriented education for the field of radiologic science, including expanded scope of work, it is acknowledged that curriculums that are opened and run at each school need to be standardized. Therefore, the need for introduction of certificate for the radiologic science education courses are suggested.