• Journal of Korean Neurosurgical Society
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• v.46 no.3
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• pp.226-231
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• 2009

Objective : We describe our clinical experiences and outcomes in patients who had thromboembolic complications occurring during endovascular treatment of intracerebral aneurysms with a review of the literature. The types of thromboembolic complications were divided and the treatment modalities for each type were described. Methods : Between August 2004 and March 2009 we performed endovascular embolization with Guglielmi detachable coils for 173 patients with 189 cerebral aneurysms, including ruptured and unruptured aneurysms at our hospital. Sixty-eight patients were males and 105 patients were females. The age of patients ranged from 22-82 years (average, 58.8 years). We retrospectively evaluated this group with regard to complication rates and outcomes. The types of thromboembolic complications were classified into the following three categories: mechanical obstruction, distal embolic stroke, and stent-induced complications, which corresponded to types I, II, and III, respectively. A comparison of the clinical results was made for each type of complication. Results : Only eight patients had a thromboembolic complication during or after a procedure (4.6%). Of the eight patients, two had a mechanical obstruction as the causative factor; the other three patients had distal embolic stroke as the causative factor. The remaining three patients had stent-induced complications. In cases of mechanical obstruction, recanalization occurred due to the use of intra-arterial thrombolytic agents in one of two patients. Nevertheless, a poor prognosis was seen. In the cases of stent-induced complications, in one of three patients in whom a thrombus developed following stent insertion, a middle cerebral artery territory infarct developed with a poor prognosis despite the use of wiring and an intra-arterial thrombolytic agent. In the cases of distal embolic stroke, all three patients achieved good results following the use of antiplatelet agents. Conclusion : Treatment for thromboemboic complications due to mechanical obstruction and stent-induced complications include antiplatelet and intra-arterial thrombolytic agents; however, this cannot guarantee a sufficient extent of effectiveness. Therefore, active treatments, such as balloon angioplasty, stent insertion, and clot extraction, are helpful.

• Journal of the Korean Society of Radiology
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• v.14 no.4
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• pp.439-445
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• 2020

The purpose of this study was to investigate the feasibility of stent placement and the evaluation of tissue hyperplasia caused by bare metallic stent placement in a mouse colon model. In a pilot study, C57BL/6 mouse were used to verify diameter of colon. Mean diameter size was 4.05 mm. Twenty C57BL/6 mice were divided into two groups to assess differing stent diameters (Group A, 5 mm diameter; Group B. Group B, 4 mm diameter). Follow-up, 1-week fluoroscopic imaging, 4-week endoscopic imaging were obtained. Mice were sacrificed 4-week after stent placement. Microscopic findings were evaluated. Stent placement was technically successful except one mouse in Group A. Data from the mouse was omitted. During follow-up, five mice in Group A died within 7 days after stent placement, and one stent in Group B was migrated into the rectum. The incidence of stent-related complication was 60% and 10% between group A and Group B, respectively. Gross and Endoscopic findings showed tissue hyperplasia through the mesh, and all the stents had become incorporated into the wall of the colon. Microscopic findings were no statistically significant difference. colonic stent placement was technically feasible, and stent-induced tissue hyperplasia was evident in a mouse model. With stent large size, there was the highest incidence of colon perforation.

• Journal of Chest Surgery
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• v.54 no.5
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• pp.425-428
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• 2021

Aortobronchial fistula (ABF) induced by an infected pseudoaneurysm of the thoracic aorta is a life-threatening condition. As surgical treatment is associated with significant mortality and morbidity, thoracic endovascular aneurysm repair (TEVAR) may be an alternative for the treatment of ABF. However, the long-term durability of this intervention is largely unknown and the recurrence of ABF is a potential complication. We experienced a case of recurrent ABF after stent grafting as an early procedure for an infected pseudoaneurysm of the thoracic aorta. Remnant ABF, bronchial and/or aortic wall erosion, vasa vasorum connected with ABF, and recurrent local inflammation of the thin aortic wall around ABF might cause recurrent hemoptysis. As a result, we suggest that TEVAR should be considered as a bridge therapy for the initial treatment of ABF resulting from an infected pseudoaneurysm, and that several options, such as second-stage surgery, should be considered to prevent the recurrence of ABF.