The use of a balloon guide catheter (BGC) in the endovascular management of acute ischemic stroke is known to improve the efficacy and efficiency of the procedure by reducing the risk of distal embolization. During the procedure, the balloon of the catheter causes a temporary arrest of cerebral blood flow. However, failure of the balloon to deflate during the BGC procedure can result in catastrophic complications, including aggravated hypoxic damage.
This paper aims to share the resolution and methodological analysis of our experience with BGC balloon deflation failure, which was confirmed by a reproducible experiment under similar conditions.

Progressive epidural hematoma is a form of acute epidural hematoma that graduallyexpands from a small initial hematoma; in cases that are clinically aggravated dueto the presence of a mental illness or neurological condition, patients should be surgicallytreated for evacuation of the hematoma, but poorer outcomes are expected ifthe patient has several medical co-morbidities for surgery. We experienced two casesof progressive epidural hematoma which were successfully managed by endovasculartreatment: an 85-year-old male with medical co-morbidities and a 51-year-oldfemale with a poor-grade subarachnoid hemorrhage resulting from the rupture of adissecting aneurysm of the vertebral artery. In both cases, a middle meningeal arteryembolization was performed and contrast leakage was observed and controlled usingcerebral angiography, halting the progression of their epidural hematomas. Thus,endovascular embolization of a middle meningeal artery may play a useful role in salvagetherapy in certain complicated situations that limit treatment of the hematomaby surgical evacuation.

Background: F-18 Fluorodeoxyglucose positron emission tomography (F-18 FDG PET), which can cover the body from the skull base to the thigh in one scan, is beneficial for evaluating distant metastasis. F-18 FDG PET has interested policymakers because of its relatively high cost. This study investigated the effect of the F-18 FDG PET reimbursement criteria amendment on healthcare behavior in breast cancer using an interrupted time series (ITS) analysis. Methods: We retrospectively analyzed the inpatient and outpatient data from Korea’s Health Insurance Review and Assessment Service (HIRA) from January 1, 2013 to December 31, 2018. ITS analysis was performed for the number of each medical imaging modality and the total medical imaging cost of the breast cancer patients. Results: The annual number of breast cancer patients has been increasing steadily since 2013. The trend of F-18 FDG PET increased before the reimbursement criteria was amended, but intensely decreased immediately thereafter. The chest and abdomen computed tomography scans showed a statistically significant increase immediately after the amendment and kept steadily increasing. A change in the total medical imaging cost for the breast cancer patient claimed every month showed an increasing trend before the amendment (β = 5,475, standard error [SE] = 1,992, P = 0.008) and rapid change immediately after (β = −103,317, SE = 16,152, P < 0.001). However, there was no significant change in the total medical imaging cost at the long-term follow-up (β = −912, SE = 1,981, P = 0.647). Conclusion Restriction of health insurance coverage for cancer may affect healthcare behaviors. To compensate for it, the policymakers must consider this and anticipate the impact following implementation.