• Journal of Korean Neurosurgical Society
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• v.56 no.4
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• pp.344-347
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• 2014

Stent thrombosis is a major limitation of stent-assisted coiling, which is an effective method for treating wide-necked aneurysms. Although early in-stent thrombosis has been reported, very late stent thrombosis (VLST) (>1 year) has not been reported following implantation of a single self-expandable stent designed for coiling. Herein, the authors present a case of VLST that occurred 14 months after single stent implantation in a large paraclinoid aneurysm with an ultra-wide neck involving the parent artery circumferentially. This case indicates the need for establishing guidelines regarding the optimal duration of prophylactic antiplatelet therapy following stent-assisted coiling, which remains undefined in the neuroendovascular field.

• Journal of Korean Neurosurgical Society
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• v.48 no.6
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• pp.485-489
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• 2010

Objective : To introduce the frequency and segment analysis of in-stent stenosis for intracranial stent assisted endovascular treatment on complex aneurysms. Methods : A retrospective study was performed in 158 patients who had intracranial complex aneurysms and were treated by endovascular stent application with or without coil embolization. Of these, 102 patients were evaluated with catheter based angiography after 6, 12, and 18 months. Aneurysm location, using stent, time to stenosis, stenosis rate and narrowing segment were analyzed. Results : Among follow-up cerebral angiography done in 102 patients, 8 patients (7.8%) were shown an in-stent stenosis. Two patients have unruptured aneurysm and six patients have ruptured one. Number of Neuroform stents were 7 cases (7.5%) and Enterprise stent in 1 case (11.1%). Six patients demonstrated in-stent stenosis at 6 months after stent application and remaining two patients were shown at 12 months, 18 months, respectively. Conclusion : In-stent stenosis can be confronted after intracranial stent deployment. In our study, no patient showed symptomatic stenosis and there were no patients who required to further treatment except continuing antiplatets medication. In-stent stenosis has been known to be very few when they are placed into the non-pathologic parent artery during the complex aneurysm treatment, but the authors found that it was apt to happen on follow up angiography. Although the related symptom was not seen in our cases, the luminal narrowing at the stented area may result the untoward hemodynamic event in the specific condition.

• Journal of Veterinary Clinics
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• v.27 no.4
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• pp.457-461
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• 2010

Three dogs were presented with signs of recurrence of coughing, dyspnea and difficulty of barking after endotracheal stent placement. On the basis of history taking, physical examination, laboratory tests and radiography, complications of endotracheal stent were suspected. Dog 1 had unfitted stent diameter (stent diameter is larger than tracheal diameter) and getting disentangled of proximal tracheal stent wire. Dog 2 was suspected a foreign body reaction. Dog 3 had the migration of stent caudally. Based on these cases, the veterinarian should accurately evaluate the indicated patients before endotracheal stent and has to select the appropriate stent (diameter, length and location) to prevent complications after endotracheal stent and concern the regular follow-ups to assure proper endotracheal stent placement.

• Korea-Australia Rheology Journal
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• v.21 no.4
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• pp.281-288
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• 2009

Numerical investigations have been conducted on the assessment of the performance of drug-eluting stent. Computational fluid dynamics is applied to investigate the flow disturbances and drug distributions released from the stent in the immediate vicinity of the given idealized stent in the protrusion into the flow domain. Our simulations have revealed the drug concentration in the flow field due to the presence of a drug-eluting stent within an arterial segment. Wall shear stress increases with Reynolds number for a given stent diameter, while it increases with stent diameter for a given Reynolds number. The drug concentration is dependent on both Reynolds number and stent geometry. In pulsatile flow, the minimum drug concentration in the zone of inter-wire spacing occurs at the maximum acceleration of the inlet flow while the maximum drug concentration gains at the maximum deceleration of the inlet flow. These results provide an understanding of the flow physics in the vicinity of drug-eluting stents and suggest strategies for optimal performance of drug-eluting stent to minimize flow disturbance.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.29 no.9 s.240
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• pp.1042-1048
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• 2005

Numerical investigation has been made on the stent design to minimize the neointimal hyperplasia. Computational fluid dynamics is applied to investigate the flow distributions in the immediate vicinity of the given idealized stent implanted in the blood vessel. Parametric study on the variations of the number of stouts, stent diameters, stent spacings and Reynolds numbers has been conducted using axi-symmetric Navier-Stokes equations. An initial difficulty in the study is to determine the optimal stent design to understand the flow physics of the flow disturbance induced by stent. The size of recirculation zone around stent is depend on the stent diameter, number of stent wire and Reynolds number but is insensitive to the stent wire spacing. It is also found that when the flow is in acceleration, the flow sees a more favorable pressure gradient, and the separation zones are smaller than the steady flow case. When the flow is in deceleration and the flow sees a more adverse pressure gradient so that the separation zones are larger.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.35 no.10
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• pp.1053-1060
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• 2011

This study is performed to determine the drug concentration profiles of drug-eluting stents (DES) for an ideal circular ring stent and intertwined stent models for various Reynolds numbers (Re = 200, 400, and 800). The Navier.Stokes equations coupled with the advection-diffusion equation are solved numerically in order to determine how the flow patterns and drug deposition are affected in the in-stent and post-stent regions where flow separation and recirculation occur. The presence of DES within the arterial segment affects the local drug distribution in the flow field. As a result, the drug concentration for the intertwined stent is higher over the in-stent region in comparison with the ideal stents. For a given stent geometry, the local drug concentration in the in-stent region decreases with Reynolds number, while for a given Reynolds number, the local drug concentration is relatively insensitive to the stent geometry. The results show that drug concentration along the arterial wall is significantly higher within the in-stent and post-stent regions for the intertwined stent geometry than for the ideal stent geometries.

• Gut and Liver
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• v.12 no.6
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• pp.722-727
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• 2018

Background/Aims: Although endoscopic bilateral stent-instent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic re-intervention. This study aimed to evaluate the technical accessibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Methods: Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Results: Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases of technical success. Stent occlusion occurred in 63.2% of the patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months postoperatively, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Conclusions: Large cell-type stents for endoscopic bilateral stent-in-stent placement had acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.

• Journal of Veterinary Clinics
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• v.37 no.3
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• pp.115-122
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• 2020

The aim of this study was to evaluate double-pigtail ureteral stent fixation in cats. Medical records of 19 cats (23 ureters) with complete ureteral obstruction that double-pigtail ureteral stent placement were carried out were retrospectively reviewed. The cats were randomly classified into two groups; 13 cats (16 ureters) with double-pigtail ureteral stent fixed to urinary bladder (SF group) and 6 cats (7 ureters) with not fixed to urinary bladder (SNF group). The average age and weight of the cats was 7.4 years and 3.73 kg, respectively. Postoperative complications included chronic renal failure (n = 11), lower urinary track diseases (cystitis, hematuria, pollakiuria) (n = 7), stent migration (n = 6), anemia (n = 5), ascites (n = 2), hyperthermia (n = 1), enteritis (n = 1), oliguria (n = 1), hypotension (n = 1), ureteritis (n = 1), and pyelonephritis (n = 1). Stent migration did not occur in the 16 ureters of the cats in SF group but did occur in 4 out of 7 ureters of the cats in SNF group. The prevention of stent migration by stent fixation was significant (P = 0.04). Among the 13 cats in SF group, only 2 cats developed lower urinary track diseases, while 4 of the 6 cats in SNF group showed symptoms of lower urinary track disease. Thus, the cats that underwent double-pigtail ureteral stent fixation to the urinary bladder developed significantly fewer lower urinary diseases (P = 0.046). In conclusion, double-pigtail ureteral stent fixation to the urinary bladder for treatment of complete ureteral obstruction in cats can effectively prevent stent migration, which is common complication of stent placement.

• Journal of Korean Neurosurgical Society
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• v.51 no.4
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• pp.222-226
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• 2012

The waffle-cone technique is a modified stent application technique, which involves protrusion of the distal portion of a stent into an aneurysm fundus to provide neck support for subsequent coiling. The authors report two cases of wide necked basilar bifurcation aneurysms, which were not amenable to stent assisted coiling, that were treated using the waffle-cone technique with a Solitaire AB stent. A 58-year-old woman presented with severe headache. Brain CT showed subarachnoid hemorrhage and angiography demonstrated a ruptured giant basilar bifurcation aneurysm with broad neck, which was treated with a Solitaire AB stent and coils using the waffle-cone technique. The second case involved an 81-year-old man, who presented with dizziness caused by brain stem infarction. Angiography also demonstrated a large basilar bifurcation unruptured aneurysm with broad neck. Solitaire AB stent deployment using the waffle-cone technique, followed by coiling resulted in near complete obliteration of aneurysm. The waffle-cone technique with a Solitaire AB stent can be a useful alternative to conventional stent application when it is difficult to catheterize bilateral posterior cerebral arteries in patients with a wide-necked basilar bifurcation aneurysm.

• Journal of the Korean Society for Precision Engineering
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• v.23 no.10
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• pp.121-125
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• 2006

In this paper, results are presented by nonlinear finite element simulations in order to analy the interactions between the stent and artery or plaque. Maximum of von Mises stress was calculated in the contacting areas between the stent and the artery. The simulated results show that the distal end of stent, which tilts after expansion, may injure the artery wall. In conclusion, this study may help designing new stents.