Purpose: Carotid artery stenting (CAS) is an established alternative to carotid endarterectomy for selected patients with symptomatic carotid stenosis. Although predictors of periprocedural ischemic lesions detected on diffusion-weighted imaging (DWI) have been described, the relationship between these lesions and long-term functional outcomes remains incompletely understood. This study aimed to identify factors associated with early ischemic lesions after CAS and to evaluate whether these lesions are associated with 1-year clinical outcomes. Materials and Methods: We retrospectively analyzed 190 patients who underwent CAS for symptomatic carotid artery stenosis at a single tertiary center. The primary outcome was the occurrence of new ischemic lesions on DWI within 24 hours after CAS. Secondary outcomes included periprocedural ischemic or hemorrhagic complications, recurrent ischemic cerebrovascular events within 1-year, restenosis at 1-year, and functional outcome at 1-year assessed by the modified Rankin Scale (mRS). Univariable and multivariable logistic regression analyses were performed to identify predictors of early embolic lesions and good functional outcome (mRS 0–2). Results: New ischemic lesions on DWI were identified in 52 patients (27.4%). In multivariable analysis, atrial fibrillation was independently associated with early ischemic lesions (odds ratio, 4.747; 95% confidence interval, 1.133–19.888; P=0.033), whereas lesion severity and procedural factors were not. Periprocedural ischemic stroke with neurological deterioration occurred in 2.1% of patients, and symptomatic intracranial hemorrhage occurred in 1.1%. Good functional outcome (mRS 0–2) at 1-year was achieved in 82.1% of patients. New ischemic lesions were not independently associated with 1-year functional outcome, whereas baseline neurological severity was the primary determinant. Conclusion New ischemic lesions on DWI were frequently observed after CAS but were not associated with long-term functional outcome. CAS was associated with low periprocedural complication rates and favorable 1-year outcomes in symptomatic patients treated at an experienced center.

Background: Breakage of balloon-less Racz neuroplasty catheters is a rare complication of neuroplasty; however, shearing of balloon catheters during epidural neuroplasty has not been reported.Case: Herein, we report a case of a broken epidural balloon catheter during neuroplasty. A 76-year-old female underwent percutaneous epidural neuroplasty (PEN) using a Racz catheter, epidural steroid injection, and medial branch block for lumbar spinal stenosis 6 months ago. However, her symptoms did not improve. Subsequently, we performed a PEN using an inflatable balloon catheter. During the procedure, the epidural balloon catheter became trapped, broke, and could not be retrieved. Subsequently, the patient complained of leg pain and numbness. Therefore, surgery was performed to remove the broken catheter, resolving the leg pain and numbness. Conclusions This case report supports the surgical removal of broken catheters to avoid the aggravation of symptoms and the development of neurological deficits.

Purpose: This study aimed to evaluate the functional and anatomical effects of switching to faricimab in patients with polypoidal choroidal vasculopathy (PCV) refractory to other anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods: This retrospective study analyzed the medical records of patients with PCV who were switched to faricimab. Prior to the initial faricimab injections, all patients underwent spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography, and indocyanine green angiography. Changes in best-corrected visual acuity were recorded, while anatomic outcomes including central macular thickness (CMT), subfoveal choroidal thickness (SFCT), pigment epithelial detachment (PED) height, and presence of retinal fluid were measured by SD-OCT. Results: A total of 19 eyes from 17 patients were included. The mean age was 71.3 ± 7.3 years. Prior to faricimab treatment, patients had received a mean of 20.2 ± 9.5 (range 8–40) injections. The mean follow-up duration from the initial faricimab injection was 38.6 ± 17.6 weeks (range 16–68). At baseline, the mean CMT, PED height, and SFCT were 443.8 ± 220.9 µm, 331.0 ± 389.3 µm, and 289.5 ± 148.9 µm, respectively. During faricimab treatment, significant anatomical improvements were observed in CMT (314.9 ± 110.5 µm), PED height (158.0 ± 152.5 µm), and SFCT (239.0 ± 110.1 µm) (all p < 0.05). A good PED response (≥50% reduction in height) was achieved in 7 eyes (41.1%), a partial response (<50% reduction) in 7 eyes (41.1%), and a poor response (no change in height) in 3 eyes (17.6%). At the final visit, 11 eyes (57.8%) achieved a dry macula, representing the absence of intraretinal or subretinal fluid. Conclusions Faricimab may represent a safe and effective treatment strategy for improving anatomical outcomes, though larger patient cohorts are required to validate these findings. This drug could emerge as a valuable alternative for patients experiencing PCV refractory to other anti-VEGF injections.

Background: We aimed to investigate the characteristics of pediatric ulcerative colitis (UC) at diagnosis in Korea. Methods: This was a multicenter, registry-based, inception cohort study conducted in Korea between 2021 and 2023. Children and adolescents newly diagnosed with UC < 18 years were included. Baseline clinicodemographics, results from laboratory, endoscopic exams, and Paris classification factors were collected, and associations between factors at diagnosis were investigated. Results: A total 205 patients with UC were included. Male-to-female ratio was 1.59:1, and the median age at diagnosis was 14.7 years (interquartile range 11.9–16.2). Disease extent of E1 comprised 12.2% (25/205), E2 24.9% (51/205), E3 11.2% (23/205), and E4 51.7% (106/205) of the patients. S1 comprised 13.7% (28/205) of the patients. The proportion of patients with a disease severity of S1 was significantly higher in patients with E4 compared to the other groups (E1: 0% vs. E2: 2% vs. E3: 0% vs. E4: 24.5%, P < 0.001). Significant differences between disease extent groups were also observed in Pediatric Ulcerative Colitis Activity Index (median 25 vs. 35 vs. 40 vs. 45, respectively, P < 0.001), hemoglobin (median 13.5 vs.13.2 vs. 11.6 vs. 11.4 g/dL, respectively, P < 0.001), platelet count (median 301 vs. 324 vs. 372 vs. 377 × 103 /μL, respectively, P = 0.001), C-reactive protein (median 0.05 vs. 0.10 vs. 0.17 vs. 0.38 mg/dL, respectively, P < 0.001), and Ulcerative Colitis Endoscopic Index of Severity (median 4 vs. 4 vs. 4 vs. 5, respectively, P = 0.006). No significant differences were observed in factors between groups divided according to sex and diagnosis age. Conclusion This study represents the largest multicenter pediatric inflammatory bowel disease cohort in Korea. Disease severity was associated with disease extent in pediatric patients with UC at diagnosis.

Background: We aimed to investigate the characteristics of pediatric ulcerative colitis (UC) at diagnosis in Korea. Methods: This was a multicenter, registry-based, inception cohort study conducted in Korea between 2021 and 2023. Children and adolescents newly diagnosed with UC < 18 years were included. Baseline clinicodemographics, results from laboratory, endoscopic exams, and Paris classification factors were collected, and associations between factors at diagnosis were investigated. Results: A total 205 patients with UC were included. Male-to-female ratio was 1.59:1, and the median age at diagnosis was 14.7 years (interquartile range 11.9–16.2). Disease extent of E1 comprised 12.2% (25/205), E2 24.9% (51/205), E3 11.2% (23/205), and E4 51.7% (106/205) of the patients. S1 comprised 13.7% (28/205) of the patients. The proportion of patients with a disease severity of S1 was significantly higher in patients with E4 compared to the other groups (E1: 0% vs. E2: 2% vs. E3: 0% vs. E4: 24.5%, P < 0.001). Significant differences between disease extent groups were also observed in Pediatric Ulcerative Colitis Activity Index (median 25 vs. 35 vs. 40 vs. 45, respectively, P < 0.001), hemoglobin (median 13.5 vs.13.2 vs. 11.6 vs. 11.4 g/dL, respectively, P < 0.001), platelet count (median 301 vs. 324 vs. 372 vs. 377 × 103 /μL, respectively, P = 0.001), C-reactive protein (median 0.05 vs. 0.10 vs. 0.17 vs. 0.38 mg/dL, respectively, P < 0.001), and Ulcerative Colitis Endoscopic Index of Severity (median 4 vs. 4 vs. 4 vs. 5, respectively, P = 0.006). No significant differences were observed in factors between groups divided according to sex and diagnosis age. Conclusion This study represents the largest multicenter pediatric inflammatory bowel disease cohort in Korea. Disease severity was associated with disease extent in pediatric patients with UC at diagnosis.

Purpose: Few studies have reported the prevalence of inflammatory bowel disease unclassified (IBDU) among Korean pediatric IBD (PIBD) population. To address this gap, we used two tertiary centers and nationwide population-based healthcare administrative data to estimate the prevalence of Korean pediatric IBDU at the time of diagnosis. Methods: We identified 136 patients aged 2–17 years with newly diagnosed IBD (94 Crohn’s disease [CD] and 42 ulcerative colitis [UC]) from two tertiary centers in Korea between 2005 and 2017. We reclassified these 136 patients using the revised Porto criteria. To estimate the population-based prevalence, we analyzed Korean administrative healthcare data between 2005 and 2016, which revealed 3,650 IBD patients, including 2,538 CD and 1,112 UC. By extrapolating the reclassified results to a population-based dataset, we estimated the prevalence of PIBD subtypes. Results: Among the 94 CD, the original diagnosis remained unchanged in 93 (98.9%), while the diagnosis of one (1.1%) patient was changed to IBDU. Among the 42 UC, the original diagnosis remained unchanged in 13 (31.0%), while the diagnoses in 11 (26.2%), 17 (40.5%), and one (2.4%) patient changed to atypical UC, IBDU, and CD, respectively. The estimated prevalences of CD, UC, atypical UC, and IBDU in the Korean population were 69.5%, 9.4%, 8.0%, and 13.1%, respectively. Conclusion This study is the first in Korea to estimate the prevalence of pediatric IBDU.This prevalence (13.1%) aligns with findings from Western studies. Large-scale prospective multicenter studies on PIBDU are required to examine the clinical features and outcomes of this condition.

Background: We aimed to investigate the characteristics of pediatric ulcerative colitis (UC) at diagnosis in Korea. Methods: This was a multicenter, registry-based, inception cohort study conducted in Korea between 2021 and 2023. Children and adolescents newly diagnosed with UC < 18 years were included. Baseline clinicodemographics, results from laboratory, endoscopic exams, and Paris classification factors were collected, and associations between factors at diagnosis were investigated. Results: A total 205 patients with UC were included. Male-to-female ratio was 1.59:1, and the median age at diagnosis was 14.7 years (interquartile range 11.9–16.2). Disease extent of E1 comprised 12.2% (25/205), E2 24.9% (51/205), E3 11.2% (23/205), and E4 51.7% (106/205) of the patients. S1 comprised 13.7% (28/205) of the patients. The proportion of patients with a disease severity of S1 was significantly higher in patients with E4 compared to the other groups (E1: 0% vs. E2: 2% vs. E3: 0% vs. E4: 24.5%, P < 0.001). Significant differences between disease extent groups were also observed in Pediatric Ulcerative Colitis Activity Index (median 25 vs. 35 vs. 40 vs. 45, respectively, P < 0.001), hemoglobin (median 13.5 vs.13.2 vs. 11.6 vs. 11.4 g/dL, respectively, P < 0.001), platelet count (median 301 vs. 324 vs. 372 vs. 377 × 103 /μL, respectively, P = 0.001), C-reactive protein (median 0.05 vs. 0.10 vs. 0.17 vs. 0.38 mg/dL, respectively, P < 0.001), and Ulcerative Colitis Endoscopic Index of Severity (median 4 vs. 4 vs. 4 vs. 5, respectively, P = 0.006). No significant differences were observed in factors between groups divided according to sex and diagnosis age. Conclusion This study represents the largest multicenter pediatric inflammatory bowel disease cohort in Korea. Disease severity was associated with disease extent in pediatric patients with UC at diagnosis.