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Gyung-Ho Chung

Publications and source records attributed to Gyung-Ho Chung.

6 recordsLinked to original sources
PubMed2005

Stents in common iliac vein obstruction with acute ipsilateral deep venous thrombosis: early and late results.

PURPOSE: To evaluate, by imaging and clinical follow-up, the effectiveness and long-term results of stent placement in cases of common iliac vein obstruction associated with ipsilateral deep vein thrombosis (DVT). MATERIALS AND METHODS: Retrospective analysis of 22 patients (13 women, nine men; median age, 58 years) with common iliac vein obstruction with ipsilateral DVT was performed for this study. All patients presented with leg edema or pain and were treated with catheter-directed thrombolysis (1,000-2,000 U urokinase per kg body weight per hour; n = 19), aspiration thrombectomy (n = 21), or angioplasty (n = 14) followed by stent placement (n = 22) via an ipsilateral popliteal vein approach (right, n = 2; left, n = 20) under ultrasonographic (US) guidance. Patients were then followed by duplex US, and patency rates were determined by Kaplan-Meier survival analysis. RESULTS: The mean procedure time was 15 hours (range, 1-23 hours) and the mean urokinase dose was 1,980,000 U (range, 600,000-3,600,000 U) before the implantation of 27 stents. Three patients did not receive urokinase. The technical success rate was 96% (26 of 27 stents) and the clinical success rate was 95% (21 of 22 patients). The causes of common iliac vein obstruction were May-Thurner syndrome (n = 16), pelvic mass (n = 2), and unknown (n = 4). The early complications included upward stent migration in one patient and a spinal epidural hematoma in another. The late complication was partial stent obstruction, which was successfully treated by thrombolysis and angioplasty in one patient. Follow-up lasted 1-41 months (mean, 21.4 months). Overall, the 1-year and 2-year primary patency rates were both 95% and the 1-year and 2-year secondary patency rates were both 100%. CONCLUSION: Directed catheter thrombolysis and aspiration of DVT are relatively safe, and the use of stents improves patency results in cases of common iliac vein obstruction.

Adult↗
PubMed2005

Comparison of renal damage by iodinated contrast or gadolinium in an acute renal failure rat model based on serum creatinine levels and apoptosis degree.

This study was undertaken to compare renal damage, as determined by serum creatinine and degree of apoptosis, caused by iodinated contrast or gadolinium in an acute renal failure (ARF) rat model. Rats were divided into three groups; controls (n=3), a CT contrast medium group (n=9), and an MR contrast medium group (n=9). The CT and MR groups were further subdivided into three groups, namely, low, standard, and high dose subgroups. Renal function was evaluated by determining serum creatinine levels; before ARF, and 48 hr after ARF and contrast administration. Apoptosis was assayed by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). No significant creatinine level differences were observed between the CT and MR groups (p=0.116). Degrees of apoptosis in the renal cortex and medulla were more severe in the CT contrast medium group than in the control or MR contrast medium group (p<0.05). The study shows that CT contrast medium did not aggravate renal function more so than MR contrast medium in this ARF rat model. However, apoptosis examination in the renal cortex and medulla indicated that CT contrast medium induced more severe apoptosis than MR contrast medium (p<0.05). We conclude that CT contrast medium can be used for renal imaging studies when subjects are well hydrated and preventive medication is administered.

Acute Kidney Injury↗
PubMed2003

Flared polyurethane-covered self-expandable nitinol stent for malignant biliary obstruction.

PURPOSE: To determine the technical efficacy and safety of a flared polyurethane-covered self-expandable nitinol stent in the management of malignant biliary obstruction and to evaluate its clinical efficacy by estimating stent patency and patient survival rates. MATERIALS AND METHODS: Thirteen patients with common bile duct strictures (nonhilar) caused by malignant disease were treated by placement of 13 nitinol stents. The stents used include a flared section in the proximal portion (12 mm in diameter and 10 mm in length) and a section in the remnant portion that is fully covered with high-elasticity polyurethane, with an unconstrained diameter of 10 mm and a total length of 50-80 mm. Patient survival and stent patency rates were calculated with use of Kaplan-Meier survival analysis. The follow-up bilirubin and serum amylase and lipase levels were calculated, and the differences in means were evaluated with use of a Wilcoxon signed-rank test. The average follow-up duration was 22.9 weeks (range, 8-56 weeks). RESULTS: Placement was successful in all cases. The 30-day mortality rate was 0%. The survival rates were 38% and 24% at 20 and 50 weeks, respectively. Seventy-seven percent of study patients had adequate palliative drainage during their the remainder of their lives. The stent patency rates were 71% and 48% at 20 and 50 weeks, respectively. Three patients (23%) presented with stent occlusion requiring repeat intervention. There were no procedure-related complications such as proximal or distal migration. No complications occurred other than stent occlusion. One patient's stent was removed under endoscopic guidance 15 weeks after its insertion. Bilirubin levels had significantly decreased 1 week after stent insertion (P <.001). CONCLUSION: Preliminary results suggest that placement of a flared polyurethane-covered self-expandable nitinol stent is feasible and effective in achieving biliary drainage. The stents do not migrate, but there is tumor ingrowth into the flared portion of the stent. Treatment of a larger group of patients will be mandatory to validate these long-term results.

Adult↗
PubMed2002

Polyurethane-covered self-expandable nitinol stent for malignant biliary obstruction: preliminary results.

PURPOSE: To evaluate the immediate and long-term results in ten patients with malignant biliary obstruction using a polyurethane-covered, self-expandable nitinol stent. METHODS: A nitinol stent, fully covered with high-elasticity polyurethane, with an unconstrained diameter of 10 mm and a total length of 60-80 mm, was placed transhepatically under fluoroscopic guidance in ten patients. The length of the biliary obstruction varied between 30-50 mm. The follow-up examination included a clinical assessment, serum bilirubin measurement, and ultrasound examinations at one-month intervals in all patients. RESULTS: Initial stent deployment was successful in eight patients. Two patients experienced proximal migration, which was solved by insertion of two, uncovered Wallstents. One patient had the stent removed after two weeks because of severe nausea and vomiting. One patient had delayed migration of the covered stent after 40 weeks. The follow-up duration was 3-40 weeks (Mean: 16.9 weeks). Seven patients died (3-26 weeks) and three patients survived (24-40 weeks). The bilirubin measurements in all patients had significantly decreased one week after stent insertion. The levels of amylase and lipase had did not increase after stent insertion. CONCLUSIONS: A polyurethane-covered, self-expandable nitinol stent can be used effectively and safely in the treatment of malignant biliary obstruction. The preliminary results are favorable, but there is a need for further large studies to determine both long-term survival and patency.

Adult↗
PubMedDate not supplied

Spinal epidural hematoma after thrombolysis for deep vein thrombosis with subsequent pulmonary thromboembolism: a case report.

A 38-year-old male was initially admitted for left leg swelling. He was diagnosed as having deep vein thrombosis (DVT) in the left leg and a pulmonary thromboembolism by contrast-enhanced chest computed tomography (CT) with delayed lower extremity CT. The DVT was treated by thrombolysis and a venous stent. Four hours later, he complained of severe back pain and a sensation of separation of his body and lower extremities; he experienced paraplegia early in the morning of the following day. Magnetic resonance imaging showed a spinal epidural hematoma between T11 and L2, which decompressed following surgery. We, therefore, report a case of a spinal epidural hematoma after thrombolysis in a case of DVT with a pulmonary thromboembolism.

Adult↗