• Title/Summary/Keyword: vascular embolization

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Treatment of Multiple Pulmonary Arteriovenous Fistulas with Therapeutic Embolization in Osler-Rendu-Weber Syndrome (Osler-Rendu-Weber 증후군 환자에서 색전요법을 이용한 다발성 폐동정맥루 치험 1예)

  • Kim, Jae-Hag;Choi, Taek-Hee;Nam, Seung-Mo;Chang, Jae-Jin;Park, Yeon-Hee;Hur, Nam-Hyun;Choe, Du-Hwan;Lee, Byung-Hee;Kim, You-Cheoul;Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.914-921
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    • 1997
  • Hereditary hemorrhagic telangiectasia(Osler-Rendu-Weber Syndrome) is characterized by telangiectasia of the skin and mucous membranes and intermittent bleeding from vascular abnormalities. About 20% of patients with this syndrome have pulmonary arteriovenous fistulas. Pulmonary arteriovenous fistula is uncommon malformation which has an abnormal connection between the pulmonary capillary bed, in which venous blood in the pulmonary artery is shunted through the fistula into the pulmonary vein without exposure to alveolar oxygen and result in unoxygenated, desaturated systemic arterial blood, polycythemia, cyanosis and clubbing. Death often results from cerebral abscess and rupture of the malformation with massive hemorrhage. Therapeutic intervention is recommended for all symptomatic patients because of the risk of those serious complications. Treatment options include surgery and transcatheter obliteration with steel coils or detachable balloons. Therapeutic embolization has the advantages that multiple bilateral pulmonary arteriovenous fistulas can be occluded and also that the procedure can be repeated if necessary. Recently we experienced a case of the multiple bilateral pulmonary arteriovenous fistulas associated with telangiectatic change of hepatic artery and multiple angiodysplasia on the gastric mucosa in 41 years old female patient who had mild dyspnea of exertion(NYHA class II). clubbing finger, severe iron deficiency anemia. She was treated with embolization technique using steel coils and iron replacement. After the therapeutic embolization. significant improvement of dyspnea of exertion with disappearance of multiple pulmonary nodule on follow-up simple chest x-ray was noted. During the subsequent six months follow-up period, she had the improvement of symptoms and iron deficiency anemia.

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Transarterial Coil Embolization in Two Maltese Dogs with Patent Ductus Arteriosus Using a Mini Cobra-tip Angiocatheter (말티스 견에서 시술된 미니코브라 카테터와 코일을 이용한 동맥관 개존증의 치료 2 증례)

  • Han, Dong-Hyun;An, Hyo-Jin;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.740-745
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    • 2010
  • Patent ductus arteiosus (PDA) is the persistent opening of ductus arterious located between pulmonary artery and descending aorta after birth. Although PDA can be occluded by surgical ligation, interventional closure of PDA using various devices is being rapidly replaced to surgical ligation, because of its non-invasive nature of treatment and minimal post-care after treatment. Main problem encountering in interventional treatment in toy breed dogs is vascular inaccessibility due to small size of artery. Although transvenous approach using jugular veins has been developed, this technique requires experienced skill to locate occlude devices into PDA and has high risk of accidental dislodgement of occluding devices (i.e. embolization coils or vascular plugs). Therefore, in this study, we developed a modified technique for coil embolization using mini-angiocatheter with trans-femoral approach in toy breed dogs (< 3.0 kg of body weight). With this modified method, we were successfully treated two toy breed (Maltese) dogs with the left to right shunted PDA.

Two Cases of Fractured and Embolized Implanted Central Venous Chemoports in Lung Cancer (폐암환자에서 발생한 피하매몰 중심정맥포트 골절 및 색전증 2예)

  • Ju, Jin Yung;Cho, Jae Yeong;Lim, Jung Hwan;Cho, Gye Jung;Chae, Dong Ryeol;Oh, In Jae;Kim, Kyu Sik;Kim, Yu Il;Lim, Sung Chul;Kim, Young Chul;Song, Sang Yoon;Na, Kook Ju;Kim, Yun Hyun;Kim, Jae Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.449-453
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    • 2007
  • Totally implanted central venous access devices for chemotherapy (chemoport) are being used increasingly in lung cancer patients. Vascular catheters are associated with various complications including infection, thrombosis as well as spontaneous fractures and embolization of the catheter, which is known as 'pinch-off syndrome'. 'Pinch-off syndrome' refers to the compression of a subclavian central venous catheter between the clavicle and first rib resulting in an intermittent or permanent obstruction, which can lead to tears, transection, or embolization. We report two cases of fractured and embolized implanted subclavian venous catheters in which the fragments were removed percutaneously. A 62-year-old man presented with back pain with a duration of a few weeks. The chest radiograph revealed complete transsection and embolization of the catheter into the right atrium. In addition, a 47-year-old woman with a chemoport had a grade 3 pinch-off sign in a chest radiograph demonstrating complete transsection and embolization of the catheter into the pulmonary artery. Both cases were managed by retrieving the embolized distal fragment percutaneously and removing the proximal section of the catheter.

Angioembolization performed by trauma surgeons for trauma patients: is it feasible in Korea? A retrospective study

  • Soonseong Kwon;Kyounghwan Kim;Soon Tak Jeong;Joongsuck Kim;Kwanghee Yeo;Ohsang Kwon;Sung Jin Park;Jihun Gwak;Wu Seong Kang
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.28-36
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    • 2024
  • Purpose: Recent advancements in interventional radiology have made angioembolization an invaluable modality in trauma care. Angioembolization is typically performed by interventional radiologists. In this study, we aimed to investigate the safety and efficacy of emergency angioembolization performed by trauma surgeons. Methods: We identified trauma patients who underwent emergency angiography due to significant trauma-related hemorrhage between January 2020 and June 2023 at Jeju Regional Trauma Center. Until May 2022, two dedicated interventional radiologists performed emergency angiography at our center. However, since June 2022, a trauma surgeon with a background and experience in vascular surgery has performed emergency angiography for trauma-related bleeding. The indications for trauma surgeon-performed angiography included significant hemorrhage from liver injury, pelvic injury, splenic injury, or kidney injury. We assessed the angiography results according to the operator of the initial angiographic procedure. The term "failure of the first angioembolization" was defined as rebleeding from any cause, encompassing patients who underwent either re-embolization due to rebleeding or surgery due to rebleeding. Results: No significant differences were found between the interventional radiologists and the trauma surgeon in terms of re-embolization due to rebleeding, surgery due to rebleeding, or the overall failure rate of the first angioembolization. Mortality and morbidity rates were also similar between the two groups. In a multivariable logistic regression analysis evaluating failure after the first angioembolization, pelvic embolization emerged as the sole significant risk factor (adjusted odds ratio, 3.29; 95% confidence interval, 1.05-10.33; P=0.041). Trauma surgeon-performed angioembolization was not deemed a significant risk factor in the multivariable logistic regression model. Conclusions: Trauma surgeons, when equipped with the necessary endovascular skills and experience, can safely perform angioembolization. To further improve quality control, an enhanced training curriculum for trauma surgeons is warranted.

Clinical Experiences of Arteriovenous Fistula on The Face (안면부에 발생한 동정맥루의 치험례)

  • Choi, Soo Jong;Oh, Heung Chan;Bae, Yong Chan;Nam, Su Bong;Moon, Jae Sul;Oh, Chang Keun;Kim, Chang Won
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.399-402
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    • 2007
  • Purpose: Arteriovenous fistula is one of high flow vascular malformations. Recently, arteriovenous fistula has been regarded as one of the type of arteriovenous malformations. The patients were diagnosed as arteriovenous malformation Schobinger clinical stage II. Even though arteriovenous fistula rarely occurs on head and neck, treatment of that is difficult due to frequent recurrence. In treating the arteriovenous fistula, chemical embolization, surgical excision and other treatment modalities were used, but the results were not satisfactory. The authors experienced three cases of arteriovenous fistula and treated them with surgical excision. Methods: In cases, warmth, enlargement, pulsation, thrill, and bruit were found. For the accurate evaluation before the operation, angiography and MRI were checked in advance. Incision was made on the site of pulsation. The artery and vein connected to the arteriovenous fistula were dissected widely, individually ligated, and divided. And then the entire mass was totally removed. Results: All surgical sites were healed well without complications and there was no evidence of recurrence in all cases up to for 2 years of follow-up examination. Conclusion: The arteriovenous fistula on face is a very rare disease and has difficulties in treatment. The authors experienced three cases of arteriovenous fistula with complete surgical removal and no recurrence was found in all cases.

Successful Treatment of Duodenal Variceal Bleeding with Coil-Assisted Retrograde Transvenous Obliteration: A Case Report (코일을 이용한 역행성 경정맥 폐색술에 의한 십이지장 정맥류 출혈의 성공적 치료: 증례 보고)

  • Se Jin Park;Young Hwan Kim;Ung Rae Kang;Seung Woo Ji
    • Journal of the Korean Society of Radiology
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    • v.81 no.1
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    • pp.231-236
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    • 2020
  • Duodenal varices can develop in patients with portal hypertension secondary to liver cirrhosis. Although upper gastrointestinal bleeding is often severe and fatal, the definite treatment or guideline has not been established. Although endoscopy is the primary therapeutic modality, the use of radiologic interventions, such as transjugular intrahepatic portosystemic shunt, balloon or vascular plug-assisted retrograde transvenous obliteration, and percutaneous transhepatic variceal obliteration, can be considered alternative treatment methods for duodenal varices. Herein, we report a case of duodenal varix in a patient with poor hepatic functional reserve and vascular anatomy, which are contraindications for an occlusion balloon or a vascular plug, successfully treated with coil-assisted retrograde transvenous obliteration.

Artery to Collecting System Communication after Abdominal Trauma (복부 외상 후 발생한 동맥-집뇨계 간 연결)

  • Lee, Chang Ug;Kwon, O Jung;Bang, Sung Hak;Choi, Nak Young;Lee, Chang Sub;Ahn, Seung Hyun
    • Journal of Trauma and Injury
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    • v.19 no.2
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    • pp.192-195
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    • 2006
  • Degenerative vascular disease, previous arterial surgery, long-term ureteral stenting, pelvis surgery, and radiotheraphy are reported as causes of artery-to-collecting-system communication.. Artery-to-collecting-system- communication associated with blunt trauma is rare, but potentially fatal. The diagnosis is very difficult and requires a high degree of suspicion. We were able to make the diagnosis based on the characteristic finding of contrast-enhanced computed tomography (CT) obtained in the early phase, equivalent to the finding obtained in the corticomedullary phase of the kidney. We report a case of artery to collecting system communication due to blunt abdominal trauma following a fall, which was treated by embolization.

Craniospinal Metastasis from a Metastasizing Mixed Tumor of Salivary Gland : Unusual Presentation

  • Ye, Hyun-Hee;Cho, Chang-Won;Jeon, Mi-Young;Kim, Dae-Jo
    • Journal of Korean Neurosurgical Society
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    • v.41 no.3
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    • pp.186-189
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    • 2007
  • Metastasizing mixed tumors [MMT] of salivary glands are inexplicably metastasize maintaining benign histology. There is no pathologic and flow cytometric analysis criteria to predict the metastasis. MMT is known to metastasize by local implantation, vascular and lymphatic embolization after multiple surgery to local recurrences of primary tumor. However, multiple metastasis including cranium and spine occurred even without surgery to the primary tumor in this case. No pathological evidence of malignancy could be found in both primary and metastatic tumor. MMT is considered as an low grade malignancy based on clinical behavior rather than histologic evidence, such as low mortality rate, long delay of metastasis after primary lesion. Cranial metastasis is also extremely rare and only two cases have been reported. We report this unusual case with a literature review.

False aneurysm of right common carotid artery due to gun shot wound: report of a case (총창으로 인한 우측 총경동맥의 가성 동맥류 치험 1)

  • 남구현
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.488-491
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    • 1984
  • Vascular injuries from gun shot wound is rare in these days, in Korea. A Case of false aneurysm of the right common carotid artery due to penetrating injury to the neck by carbine. The confirmatory diagnosis was made by right carotid angiogram which revealed bean-sized aneurysmal sac at the mid-portion of the right common carotid artery. Despite of no symptoms, emergency false aneurysmectomy and reconstruction with on-lay vein patch graft using left greater saphenous vein for threat of rupture and embolization from mural thrombi. During repair of common carotid artery, cerebral circulation was maintained with internal shunt. The postoperative course was uneventful except limit of motion of right upper extremity due to initial injury.

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A Case of Cerebral Aneurysmal Subarachnoid Hemorrhage in Fabry's Disease

  • Chang, Youn Hyuk;Hwang, Sung-Kyun
    • Journal of Korean Neurosurgical Society
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    • v.53 no.3
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    • pp.187-189
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    • 2013
  • We report an unusual case of cerebral aneurysmal subarachnoid hemorrage (SAH) with Fabry's disease. A 42-year-old woman presented with aneurysmal SAH originated from a saccular aneurysm of the right posterior communicating artery. The patient was treated by an endovascular coil embolization of aneurysm. Postoperatively the patient recovered favorably without any neurological deficit. During her admission, the patient had a sign of proteinuria in urine analysis. The pathologic findings of kidney needle biopsy implied nephrosialidosis (mucolipidosis of lysosomal stroage disease), which is consistent with a Fabry's disease. It is uncommon that Fabry's disease is presented with aneurysmal SAH, especially in middle-aged patients, but could be a clinical concern. Further investigations are needed to reveal risk factors, vascular anatomy, and causative mechanisms of Fabry's disease with aneurysmal SAH.