Biomedical subjects

Yangsoo Jang

Publications and source records attributed to Yangsoo Jang.

98 records · Page 6Linked to original sources

PubMed2002

Percutaneous stent-graft repair of mycotic common femoral artery aneurysm.

PURPOSE: To report successful percutaneous repair of a peripheral mycotic aneurysm as a bridge to standard surgical therapy. CASE REPORT: An aneurysm of the left common femoral artery was diagnosed in a 43-year-old man with subacute infective endocarditis. A Jostent stent-graft was percutaneously deployed to exclude the mycotic lesion. Computed tomography at 8 months after the procedure documented aneurysm regression and stent-graft patency without evidence of infection. Arteriography at 18 months has confirmed continued stent-graft patency and the patient remains asymptomatic. CONCLUSIONS: The standard management of mycotic aneurysms is usually by surgical resection and repair. However, this case suggests that percutaneous stent-graft implantation may be an option for the treatment of mycotic aneurysms.

Adult↗

PubMed2002

Treatment of thoracic aortic dissection with stent-grafts: midterm results.

PURPOSE: To evaluate the early and midterm outcomes after stent-graft implantation for dissection in the descending thoracic aorta. METHODS: Sixteen custom-made endovascular stent-grafts were implanted in 15 patients (10 men; mean age 55.9 +/- 13.7 years, range 32-82) with descending thoracic aortic dissection. Indications for stent-graft implantation were persistent symptoms unresponsive to medical treatment or progressive enlargement of the false lumen. Clinical and imaging surveillance with computed tomography was performed within 1 month of the procedure and at 3 to 6-month intervals in follow-up. RESULTS: Endovascular stent-graft implantation at the target site was successful in 14 (93%) patients; 1 device migrated, leaving the false lumen open to flow in the failed case. One (7%) patient who was treated emergently for rupture died suddenly 2 days after the procedure. Over an average follow-up of 31.5 +/- 23.8 months, 1 (7%) patient died and 2 (14%) patients underwent surgical treatment due to recurrent dissection. The remaining 10 patients showed complete thrombosis of the false lumen; in 3, the false lumen completely resolved. CONCLUSIONS: Endovascular stent-graft implantation in descending thoracic aortic dissection is a feasible, safe, and effective treatment modality. However, further studies are necessary in a greater number of patients to determine if wider application of this minimally invasive procedure is justified.

Adult↗

PubMed2002

Association of G-33A polymorphism in the thrombomodulin gene with myocardial infarction in Koreans.

Thrombomodulin (TM), a thrombin receptor expressed on the endothelial surface, is known to play an important role in the anti-thrombogenic system in vivo. In this study, we examined the effects of 3 single-nucleotide polymorphisms (SNPs) in the TM gene (G-33A, C1418T and C1922T) on the development of myocardial infarction (MI) in Koreans. We found that G-33A was a common SNP (the minor allele frequency was 0.09) in Koreans. Eighty-five MI patients who had received coronary angiography were enrolled and were divided into 3 groups according to the number of coronary arteries in which stenosis was found angiographically (1-vessel disease (1VD) to 3-vessel disease (3VD)). The criterion of coronary stenosis was 50% or more stenosis on angiography. In addition, 102 controls (CONT) who had no significant stenosis were employed. The number of AA/GA genotypes of G-33A was found to be significantly greater in the 1VD than in the CONT (p=0.004 by chi2-test) while no significant difference was found between the multivessel disease (2-3VD) and the CONT. Multiple logistic analysis showed that G-33A was an independent risk factor for the 1VD with an odds ratio of 4.63 (95% confidence interval; 1.62-13.3). C1418T and C1922T were both in linkage disequilibrium with G-33A; however, they were not independent risks for either the 1VD or the 2-3VD. A reporter gene assay showed that G-33A had a significant effect on the TM promoter activity. These results indicated that G-33A polymorphism in TM might be a genetic risk factor for myocardial infarction.

Adult↗

PubMedDate not supplied

Stent-graft placement for femoral artery pseudoaneurysm in a patient with idiopathic multiple arterial aneurysmal disease.

A 34-year-old man presenting with a left inguinal mass was diagnosed as having idiopathic multiple aneurysmal disease and pseudoaneurysm of a left superficial femoral artery. A stent-graft was successfully deployed percutaneously at the left superficial femoral artery pseudoaneurysm. Less invasive treatment should be used to avoid vascular complications in patients with idiopathic multiple aneurysmal disease, especially in those who have a progressive course or a history of prior complications after surgical repair.

Adult↗

PubMedDate not supplied

Percutaneous treatment of deep vein thrombosis in May-Thurner syndrome.

BACKGROUND/PURPOSE: May-Thurner syndrome is an uncommon disease entity in which the left common iliac vein is compressed by the right common iliac artery with subsequent development of deep vein thrombosis and chronic venous insufficiency. We report our experience on the treatment of extensive iliofemoral deep venous thrombosis due to May-Thurner syndrome using endovascular techniques. METHODS: The study group comprised 21 patients (8 men, 13 women; mean age 51 years) diagnosed with May-Thurner syndrome by venogram. Eighteen patients were treated with catheter-guided thrombolysis; 3 patients with short segment involvement did not require thrombolysis. After completion of the thrombolytic therapy, the residual venous narrowing was treated by balloon angioplasty and/or placement of a self-expandable stent. RESULTS: The mean total dose of urokinase was 4.28 +/- 1.89 million units, and the mean duration of infusion was 72 +/- 35 hr. Eighteen of the 21 patients received stent deployment. The mean diameter of the stents was 12.9 +/- 2.0 mm. Initial technical successes with immediate symptom resolution were achieved in 20 of the 21 patients (95%). We performed a follow-up venogram 6 months after procedure and checked clinical symptoms at outpatient clinics (mean follow-up duration 10.8 months). Among the patients who received stent implantation, 2 had recurrent thrombotic occlusion during the follow-up period. Three patients, who did not receive stent implantation, all had recurrent thrombosis. There were no major bleeding complications except in 1 patient who developed retroperitoneal hematoma. CONCLUSION: Catheter-guided thrombolysis and angioplasty with stent implantation is a safe and effective method for the treatment of May-Thurner syndrome.

Adult↗

PubMedDate not supplied

Intracoronary 166Holmium brachytherapy combined with cutting balloon angioplasty for the treatment of in-stent restenosis.

BACKGROUND: Brachytherapy is the only effective treatment for in-stent restenosis (ISR). The preliminary data regarding cutting balloon angioplasty (CBA) are encouraging and suggest a possible additive effect of CBA with combination with vascular brachytherapy. Hence, in this study, we evaluated the efficacy, feasibility and safety of cutting balloon angioplasty followed by intracoronary Holmium (166Ho) brachytherapy for the treatment of in-stent restenosis. METHODS AND MATERIALS: Fifty-six patients with in-stent restenosis were treated with cutting balloon angioplasty and intracoronary 166Ho brachytherapy. For irradiation, a balloon approximately 10 mm longer than the initially deployed stent was filled with liquid 166Ho and placed at the in-stent restenosis lesion. The patients were followed angiographically at 6 months and clinically for 19.0+/-9.8 months. RESULTS: The initial procedures were successful in all of the patients. The preprocedural average minimal luminal diameter (MLD) and stenosis rate were 0.57+/-0.30 mm and 80.2+/-11.6%, respectively. The MLD and residual stenosis immediately after the procedure was 2.43+/-0.37 and 13.8+/-9.9%, respectively. Thirty-nine (69.6%) patients have completed their angiographic follow-up at 6 months. The MLD, late loss and loss index at follow-up were 1.97+/-0.79 mm, 0.72+/-0.69 mm and 0.36+/-0.34, respectively. The target lesion restenosis rate was 20.5% and the target lesion revascularization rate was 3.6%. None of these patients presented with adverse coronary events such as MI, sudden cardiac death or stent thrombosis during the follow up period. CONCLUSION: The combination therapy using cutting balloon angioplasty and intracoronary 166Ho brachytherapy may be an effective new treatment modality for in-stent restenosis.

Aged↗

PubMedDate not supplied

Coronary stenting after rotational atherectomy in diffuse lesions of the small coronary artery: comparison with balloon angioplasty before stenting.

The purpose of this randomized trial was to evaluate the role of debulking and balloon predilation on acute and long-term results of stent implantation in diffuse stenosis of small vessels. Patients with symptomatic diffuse stenosis of the native left anterior descending coronary artery between 2 and 2.9 mm in size were randomly assigned to rotational atherectomy (group I, n = 21) or balloon dilation (group II, n = 20) before stenting. The primary end point of the study was the incidence of angiographic restenosis at follow-up; adverse clinical events, such as death, myocardial infarction, stroke, or target vessel revascularization, were assessed as secondary end points. Acute gain was significantly greater in group I than in group II (p = 0.038), but net gain at follow-up was similar in both groups (p = 0.24). There was no significant difference in angiographic restenosis rate (33.3% vs 31.3%, p = 0.80), target vessel revascularization (23.8% vs 15%, p = 0.21) or 1-year event-free survival rate (72.8% vs 84.6%, p = 0.28). In conclusion, rotational atherectomy before stenting showed no additional benefit over balloon dilation with stenting in the management of diffuse lesions in small coronary vessels.

Angioplasty, Balloon, Coronary↗

PubMedDate not supplied

Feasibility and diagnostic accuracy of whole heart coronary MR angiography using free-breathing 3D balanced turbo-field-echo with SENSE and the half-fourier acquisition technique.

OBJECTIVE: We wanted to assess the feasibility and diagnostic accuracy of whole heart coronary magnetic resonance angiography (MRA) with using 3D balanced turbo-field-echo (b-TFE) with SENSE and the half-Fourier acquisition technique for identifying stenoses of the coronary artery. MATERIALS AND METHODS: Twenty-one patients who underwent both whole heart coronary MRA examinations and conventional catheter coronary angiography examinations were enrolled in the study. The whole heart coronary MRA images were acquired using a navigator gated 3D b-TFE sequence with SENSE and the half-Fourier acquisition technique to reduce the acquisition time. The imaging slab covered the whole heart (80 contiguous slices with a reconstructed slice thickness of 1.5 mm) along the transverse axis. The quality of the images was evaluated by using a 5-point scale (0 - uninterpretable, 1 - poor, 2 - fair, 3 - good, 4 - excellent). Ten coronary segments of the heart were evaluated in each case; the left main coronary artery (LM), and the proximal, middle and distal segments of the left anterior descending (LAD), the left circumflex (LCX) and the right coronary artery (RCA). The diagnostic accuracy of whole heart coronary MRA for detecting significant coronary artery stenosis was determined on the segment-by-segment basis, and it was compared with the results obtained by conventional catheter angiography, which is the gold standard. RESULTS: The mean image quality was 3.7 in the LM, 3.2 in the LAD, 2.5 in the LCX, and 3.3 in the RCA, respectively (the overall image quality was 3.0 +/- 0.1). 168 (84%) of the 201 segments had an acceptable image quality (> or =grade 2). The sensitivity, specificity, accuracy, negative predictive value and positive predictive value of the whole heart coronary MRA images for detecting significant stenosis were 81.3%, 92.1%, 91.1%, 97.9%, and 52.0%, respectively. The mean coronary MRA acquisition time was 9 min 22 sec (+/-125 sec). CONCLUSION: Whole heart coronary MRA is a feasible technique, and it has good potential to evaluate the major portions of the coronary arteries with an acceptable image quality within a reasonable scan time.

Adult↗