Endovascular treatment of isolated bilateral common iliac artery aneurysm (CIAA) requires salvage of at least one internal iliac artery to prevent complications such as ischemic buttock claudication. We treated a case of bilateral CIAAs using an internal iliac branched stent graft. We report a case of a 58-year-old man who presented with bilateral CIAAs. The left internal iliac artery was occluded with coil embolization. The right internal iliac artery was saved by using a branched stent graft. The aneurysms were excluded with conventional endovascular aneurysm repair. Completion angiography showed technical success. Follow up computed tomography angiogram at three months showed complete exclusion of bilateral CIAAs, no endoleaks, and patent right internal iliac artery. There was no pelvic ischemic complication. We treated successfully a case of isolated bilateral CIAAs using an iliac branched stent graft.
Aneurysm* ; Angiography ; Blood Vessel Prosthesis* ; Buttocks ; Embolization, Therapeutic ; Endoleak ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Iliac Artery* ; Middle Aged

PURPOSE: To analyze high-resolution CT findings(HRCT) of pulmonary lymphangitic carcinomtosis(PLC) and to correlated the HRCT findings with the results of pulmonary function test(PFT). MATERIALS AND METHODS: In Twenty eight patients with radiologically and clinically proved PLC, we retrospectively reviewed HRCT scans and PFT(N=12). PLC was classified by extent and distribution of metastatic nodules and interstitial thickenings on HRCT and the findings were correlated with the results of PFT and impairment of PFT according to the degree of FEVl(forced expiratory volume in one second). RESULTS: On the basis of distribution of PLC, HRCT findings showed 20 cases of peripheral type, 3 cases of central type, and 5 cases of mixed type. In the patients with PFT diffuse type was 10 cases and localized type was 2 cases. In diffuse types, the restrictive pattern occurred in 7 cases (p<0.05) and in localized types, restrictive pattern occurred in 2 cases. Marked impairment of vital capacity was shown as restrictive pattern in 7 cases all of which were diffuse type and were consisted of peripheral type in 4 cases and mixed type in 3 cases. CONCLUSION: HRCT findings of lymphangitic carcinomatosis correlated well the type and degree of impairment of PFT. Especially in diffuse type of lymphangitic carcinomatosis, the result of pulmonary function test were prominent restrictive patterns. Marked impairment of pulmonary function occurred in patients with diffuse type and types with peripheral interstitial thickening(periphral and mixed types).
Carcinoma* ; Humans ; Respiratory Function Tests* ; Retrospective Studies ; Vital Capacity

BACKGROUND: The number of cases employing thoracic endovascular aortic repair (TEVAR) has been increasing due to lower morbidity and mortality compared to open repair technique. The aim of this study is to evaluate the outcome of TEVAR for thoracic aortic diseases. MATERIALS AND METHODS: Sixteen patients underwent TEVAR from October 2003 to April 2010. Mean age at operation was 59 years (20~78 years), and 11 were male. Indications for TEVAR were large aortic diameter (>5.5 cm) upon presentation in 6 patients, increasing aortic diameter during the follow-up period in 4, traumatic aortic rupture in 3, persistent chest pain in 2, and ruptured aortic aneurysm in one. The mean diameter, length and the number of the stents were 33 mm (26~40 mm), 12 cm (9.5~16.0 cm), and 1.25 (1~2), respectively. Aortography employing Multi-detector computerized tomography (MDCT) technique was performed at one week, and patients were followed up in the out-patient department at one month, 6 months, and one year postoperatively. RESULTS: Primary technical success showing complete exclusion of the aneurysm was achieved in 15 patients. One patient showed a small endo-leak (type 1). Four patients developed perioperative stroke: Three recovered without sequelae, and one showed mild right-side weakness. There was no operative mortality. Diameter of the thoracic aorta covered by stent graft changed within 10% range in 12 patients, decreased by more than 10% in 3, and increased by more than 10% in one during mean follow-up duration of 18 months (1~73 months). There was no recurrence-related death during this period. CONCLUSION: Intermediate-term outcome after TEVAR was encouraging. Indications for TEVAR could be extended for other thoracic aortic diseases.
Aneurysm ; Aorta ; Aorta, Thoracic ; Aortic Aneurysm ; Aortic Diseases ; Aortic Rupture ; Aortography ; Chest Pain ; Follow-Up Studies ; Humans ; Male ; Outpatients ; Stents ; Transplants

PURPOSE: The purpose of this study is to evaluate treatment outcomes in patients with symptomatic deep vein thrombosis (DVT) who had undergone a catheter-directed thrombolysis with conventional aspiration thrombectomy for the treatment of lower extremity deep vein thrombosis. MATERIALS AND METHODS: The authors retrospectively reviewed the records of 74 patients (mean age 61 +/- 15) that underwent a catheter-directed thrombolysis with conventional aspiration thrombectomy. A retrieval inferior vena cava (IVC) filter was placed to protect against a pulmonary embolism in 60 patients (81%). Stenting and balloon angioplasty were performed in 37 patients (50%) under the left common iliac vein compression. RESULTS: Sixty-seven patients (91%) showed a clinical improvement within 48 hours, but seven patients (9%) showed no improvement. Multi detector computerized tomographic venography (MDCT venography) at discharge showed no thrombus in 15 patients (20%) and partial thrombus in 52 (70%). Twenty-eight patients (38%) developed post-thrombotic syndrome at 3.0 +/- 4.2 months postoperatively. Six patients (8%) were admitted due to DVT recurrence at a mean of 5.6 +/- 7.4 months postoperatively. Sixty-nine patients underwent follow up MDCT venography at 5.7 +/- 5.6 months. fifty (72%) of these showed no thrombus, 15 (22%) partial thrombus, and 4 (6%) showed obstruction. Twentyeight of 61 (46%) were asymptomatic, twentyeight (46%) had moderate improvement, and four (6%) were mildly improved by a telephone interview (81%) at 22.8 +/- 10.7 months postoperatively. CONCLUSION: Catheter-directed thrombolysis with conventional aspiration thrombectomy is an effective treatment for lower extremity deep vein thrombosis and produces satisfactory clinical results.
Aged ; *Catheterization ; Female ; Humans ; Male ; Middle Aged ; Thrombectomy/*methods ; Thrombolytic Therapy/*methods ; Venous Thrombosis/*therapy

Through a systematic review and meta-analysis of epidemiological studies on dementia, we assessed the prevalence of dementia and its subtypes-Alzheimer' disease (AD) and vascular dementia (VaD)-in Korea. We searched for epidemiological studies on dementia published in 1990-2013 using PubMed, Scopus, EMBASE, KoreaMed, KISS, and RiCH. Dementia prevalence in elderly patients (aged> or =65 yr) was 9.2% (95% confidence interval [CI], 8.2%-10.4%) from 11 studies, which was higher than those from Western and other Asian countries. AD was the most prevalent dementia type, with a prevalence of 5.7% (95% CI, 5.0%-6.4%) from 10 studies compared with 2.1% (95% CI, 1.6%-2.7%) for VaD from 9 studies. The age-specific prevalence of dementia approximately doubled with each 5.8-yr increase of age. Although a significant increasing trend of dementia prevalence was not observed, it increased slightly from 7.3% to 8.7% after 2005; AD prevalence increased after 1995 and VaD prevalence decreased after the early 2000s. The AD/VaD ratio increased from 1.96 in the early 1990s to 4.13 in the 2010s, similar to the worldwide ratio. Owing to this high prevalence in the aging population, dementia will impose significant economic burdens to Korean society.
Age Factors ; Alzheimer Disease/epidemiology ; Asian Continental Ancestry Group ; Databases, Factual ; Dementia/*epidemiology ; Dementia, Vascular/epidemiology ; Humans ; Prevalence ; Quality Assurance, Health Care ; Republic of Korea

Submitral left ventricular aneurysm (SMLVA) is a rare disease entity that exclusively occurs in the black population. We herewith report on a surgical case of SMLVA in a 68-year-old male who presented with ventricular tachycardia. He underwent surgical repair under standard hypothermic cardiopulmonary bypass. In the state of apical elevation, a vertical ventriculotomy was made directly over the aneurysm, which was located at the posterobasal aspect of the left ventricle. Radiofrequency ablation was performed on the endocardium all around the neck of the aneurysm and then patch endoaneurysmorrhaphy was carried out with particular care not to injure the mitral valve and subvalvular structure. His postoperative recovery was uneventful. There has been no dysfunction of the mitral valve or recurrence of the ventricular tachycardia at 2 years' follow-up.
Aged ; Aneurysm ; Cardiopulmonary Bypass ; Endocardium ; Follow-Up Studies ; Heart Aneurysm ; Heart Ventricles ; Humans ; Male ; Mitral Valve ; Neck ; Rare Diseases ; Recurrence ; Tachycardia, Ventricular

Recently, Minimally invasive direct coronary artery bypass(MIDCAB) procedure eliminating cardiopulmonary bypass becomes one of the rapidly developing strategies in cardiac surgery. Here, we report a case of minimally invasive axillocoronary bypass as coronary reoperative procedure in which the previous LAD graft was occluded and the left internal mammary flow was deemed inadequate. The methodology is described with review of the relevant literature.
Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Vessels ; Reoperation* ; Surgical Procedures, Minimally Invasive ; Thoracic Surgery ; Transplants

The surgical treatment of postinfarct aneurysm on the posterobasal aspect of left ventricle is seldom reported compared to apical aneurysm although the actual incidence is higher than expected, partly because of the complexity of the operation and unpredictable postoperative results. Here, we present a case of postinfarct posterobasal left ventricular aneurysm in which endoventricular circular patch plasty technique was applied successfully. The methodology is described with review of the relevant literature.
Aneurysm* ; Heart Ventricles ; Incidence

The ovarian hyperstimulation syndrome (OHSS) is a rare but serious complication of ovulation induction therapy with gonadotropin. The pathogenesis of OHSS is unclear, but the proposed mechanisms are the production of vasoactive substances that increase local capillary permeability resulting in shifting of fluid from the intravascular space to the third space. The clinical manifestations varies from ascites, hypovolemia, oliguria, hemoconcentration, thromboembolism, and even death. We have experienced a case of severe OHSS with severe ascites, pleural effusion and bilateral enlarged ovaries associated with spontaneous pregnancy without any ovarian stimulation for ovulation induction.
Ascites ; Capillary Permeability ; Female ; Gonadotropins ; Hypovolemia ; Oliguria ; Ovarian Hyperstimulation Syndrome* ; Ovary ; Ovulation Induction* ; Ovulation* ; Pleural Effusion ; Pregnancy* ; Thromboembolism

Spontaneous resolution of the arterial obstruction in Takayasu's arteritis is rarely reported. We reported a case of spontaneous resolution of an obstruction of the left subclavian artery in a young female. The patient underwent a bilateral coronary patch ostioplasty for both coronary ostial lesions complicated by Takayasu's arteritis at the age of 28. Concomitant left subclavian obstruction was seen at that time but left untreated. Surprisingly, the 10-year follow-up angiogram revealed complete resolution of the left subclavian artery obstruction. Meanwhile, no specific medical treatment was administered.
Arteritis ; Female ; Follow-Up Studies ; Humans ; Subclavian Artery* ; Takayasu Arteritis*