다양한 Balloon catheter의 풍선 확장에 대한 연구

이승민,한진효,윤동욱,김정민 대한인터벤션영상기술학회 2022 대한인터벤션영상기술학회지 Vol.25 No.1

목 적 : 다양한 Balloon catheter에서 표준으로 제시하는 Balloon size와 그에 해당하는 기압을 가했을 때 Balloon catheter의 측정값 간의 차이가 발생하는지 비교해 보고, 더 나아가 초기 상태의 Balloon catheter를 1회 ballooning 하였을 때의 balloon size와 수차례의 Re-ballooning 하였을 때 Balloon catheter의 size 변화에 대해 In-vitro 실험을 통해 분석 및 평가하고자 한다. 대상 및 방법 : PTCA Balloon catheter, PTA Balloon catheter #1, PTA Balloon catheter #2, Non-vascular Balloon catheter 총 4가지 제품으로 규정압력의 절반(1/2 Nominal pressure), 규정압력(Nominal pressure), 정격파열 압력 (Rated burst pressure) 총 3가지 조건을 적용하여 각 조건 당 5번의 실험을 진행하였다. 실험을 통하여 얻게 된 영상으로 Angiography system의 measurement 기능 및 Image-J program 총 2가지 방법을 이용하여 Balloon catheter의 size를 측정하고 각각의 방법을 통해 얻게 된 측정값과 제품에서 제시하는 기준값을 비교 및 분석하였다. 결과 : Nominal pressure 조건에서 각 제품에서 제시된 기준값과 실제 기압을 가했을 때의 Balloon size를 Image J program으로 측정값을 구한 결과, 그 차이는 PTCA Balloon catheter는 1.7%, PTA Balloon catheter #1은 6.41%, PTA Balloon catheter #2는 6.53%, Non-vascular Balloon catheter 7.16%를 나타냈다. 1회 Ballooning을 시행한 Balloon catheter size와 수차례의 Re-ballooning을 한 Balloon catheter size의 측정값 차이는 Nominal pressure 조건에서 Angiography system의 measurement는 PTCA Balloon catheter는 3.86%, PTA Balloon catheter #1은 2.29%, PTA Balloon catheter #2는 4.87%, Non-vascular Balloon catheter 1.07%를 나타냈다. 결론 : 각각의 balloon catheter 제품에 제시된 기준값과 A/M 측정값 간의 차이는 약 8.97 – 15.94% 나타났고, 아울러 1회 ballooning의 balloon size의 측정값과 수차례의 re-ballooning 후 balloon size의 측정값 차이는 약 0.37 – 5.33% 나타났다. 따라서, 위의 제시된 결과를 참고하여 balloon catheter를 이용하는 시술에 적용한다면 더 정확하고 안전한 시술에 도움이 될 것이라 사료된다.

풍선확장술 직후 시간경과에 따른 혈관의 변화 : Intravascular Ultrasound Balloon Catheter

김동수,장양수,권혁문,홍범기,김현승 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.2

Mechanics of stretchable electronics on balloon catheter under extreme deformation

Su, Y.,Liu, Z.,Wang, S.,Ghaffari, R.,Kim, D.H.,Hwang, K.C.,Rogers, J.A.,Huang, Y. Pergamon Press ; Elsevier Science Ltd 2014 International journal of solids and structures Vol.51 No.7

Stretchable electronics has been applied to balloon catheters for high-efficacy ablation, with tactile sensing integrated on the surface, to establish full and conformal contact with the endocardial surface for elimination of the heart sink caused by blood flow around their surfaces. The balloon of the catheter folds into uniform 'clover' patterns driven by the pressure mismatch inside (~vacuum) and outside of the balloon (pressure ~1atm). The balloon catheter, on which microelectrodes and interconnects are printed, undergoes extreme mechanical deformation during its inflation and deflation. An analytic solution is obtained for balloon catheter inflation and deflation, which gives analytically the distribution of curvatures and the maximum strain in the microelectrodes and interconnects. The analytic solution is validated by the finite element analysis. It also accounts for the effect of inflated radius, and is very useful to the optimal design of balloon catheter.

풍선카테터 부비동확장술

김준호,이상덕 대한이비인후과학회 2015 대한이비인후과학회지 두경부외과학 Vol.58 No.7

Balloon sinuplasty (BSP) is a newly developed catheter-based technique for dilating sinus ostia to improve sinus ventilation and drainage. BSP has been in clinical use since 2005, but there has been many debates and criticism between early movers and mainstream doctors. But, recently, many evidences strongly support its safety, efficacy, and growing popularity among patients and physicians. The objective of this clinical review is to present its theoretical background, technical considerations, and treatment outcomes. BSP will be an additional tool for treating sinusitis, either alone or with conventional sinus surgery technique.

Efficacy of Balloon-Guiding Catheter for Mechanical Thrombectomy in Patients with Anterior Circulation Ischemic Stroke

Oh, Jae-Sang,Yoon, Seok-Mann,Shim, Jai-Joon,Doh, Jae-Won,Bae, Hack-Gun,Lee, Kyeong-Seok The Korean Neurosurgical Society 2017 Journal of Korean neurosurgical society Vol.60 No.2

Objective : To evaluate the efficacy of balloon guiding catheter (BGC) during thrombectomy in anterior circulation ischemic stroke. Methods : Sixty-two patients with acute anterior circulation ischemic stroke were treated with thrombectomy using a Solitaire stent from 2011 to 2016. Patients were divided into the BGC group (n=24, 39%) and the non-BGC group (n=38, 61%). The number of retrievals, procedure time, thrombolysis in cerebral infarction (TICI) grade, presence of distal emboli, and clinical outcomes at 3 months were evaluated. Results : Successful recanalization was more frequent in BGC than in non-BGC (83% vs. 66%, p=0.13). Distal emboli occurred less in BGC than in non-BGC (23.1% vs. 57.1%, p=0.02). Good clinical outcome was more frequent in BGC than in non-BGC (50% vs. 16%, p=0.03). The multivariate analysis showed that use of BGC was the only independent predictor of good clinical outcome (odds ratio, 5.19 : 95% confidence interval, 1.07-25.11). More patients in BGC were successfully recanalized in internal carotid artery (ICA) occlusion with small retrieval numbers (<3) than those in non-BGC (70% vs. 24%, p=0.005). In successfully recanalized ICA occlusion, distal emboli did not occur in BGC, whereas nine patients had distal emboli in non-BGC (0% vs. 75%, p=0.001) and good clinical outcome was superior in BGC than in non-BGC (55.6% vs. 8.3%, p=0.01). Conclusion : A BGC significantly reduces the number of retrievals and the occurrence of distal emboli, thereby resulting in better clinical outcomes in patients with anterior circulation ischemic stroke, particularly with ICA occlusion.

Ballooning Catheter를 이용한 갑상선 기원 종격동 종괴의 수술 술기

이잔디(Jandee Lee),임치영(Chee-Young Lim),남기현(Kee-Hyun Nam),윤종호(Jong-Ho Yoon),장항석(Hang-Seok Chang),정웅윤(Woong Youn Chung),박정수(Cheong Soo Park) 대한외과학회 2006 Annals of Surgical Treatment and Research(ASRT) Vol.70 No.1

Efficacy of Proximal Aspiration Thrombectomy for Using Balloon-Tipped Guide Catheter in Acute Intracranial Internal Carotid Artery Occlusion

Kim, Yong-Won,Kang, Dong-Hun,Hwang, Yang-Ha,Park, Jaechan,Kim, Yong-Sun The Korean Neurosurgical Society 2016 Journal of Korean neurosurgical society Vol.59 No.4

Objective : Mechanical thrombectomy (MT) for acute intracranial internal carotid artery (ICA) occlusion is often complicated by difficult revascularization and non-involved territory embolization possibly related with larger clot-burden. This study aims to evaluate the efficacy of proximal aspiration thrombectomy (PAT) using a balloon-tipped guide catheter for clot-burden reduction in such cases with period-to-period analysis (period 1 : standard MT without PAT; period 2 : PAT first, then standard MT for the remaining occlusion). Methods : Eighty-six patients who underwent MT for acute intracranial ICA occlusion were included in this analysis from the prospectively maintained stroke registry (33 patients in period 1 and 53 in period 2). In period 2, 'responder' was defined as a case where some amount of clot was retrieved by PAT and the following angiography showed partial or full recanalization. Results : Fifteen of fifty-three patients in period 2 (28.3%) were 'responders' to PAT. There was a significantly higher incidence of atrial fibrillation in the 'responder' subgroup. Period 2 showed a significantly shorter puncture-to-reperfusion time (94.5 minutes vs. 56.0 minutes; p=0.002), a significantly higher Thrombolysis in Cerebral Infarction of 2b-3 reperfusion (45.5% vs. 73.6%; p=0.009), but only a trend for better 3-month favorable outcome (mRS 0-2; 36.4% vs. 54.7%; p=0.097). There was no increase in the incidence of procedure-related complications or intracranial hemorrhage in period 2. Conclusion : A strategy of PAT before standard MT may result in shorter puncture-to-reperfusion time and better angiographic outcome than a strategy of standard MT for acute intracranial ICA occlusion.

Spontaneous Perinephric Urinoma after the Removal of a Foley Catheter in a Girl with Acute Kidney Injury

양태환,임형은,유기환,Yang, Tae Hwan,Yim, Hyung Eun,Yoo, Kee Hwan Korean Society of Pediatric Nephrology 2013 Childhood kidney diseases Vol.17 No.2

요낭종이란 신장 및 비뇨기계로부터 누출된 소변이 신장 및 신우 주위에 캡슐상의 낭종을 형성하는 드문 질환으로 자연발생적인 신우의 파열로 인한 누출은 매우 드물며, 대부분 요로와 신우 내강의 압력 증가에 의해 발생한다. 본 증례에서 18세 여자 환아는 내원 7일 전부터 시작된 고열과 핍뇨 및 호흡곤란을 주소로 내원하였다. 환아는 출생시 다운 증후군을 진단받았으며 평소 배뇨는 원활하였다. 입원 후 환아는 패혈증 쇼크 및 급성 신손상, 급성 호흡 곤란 증후군 진단 하에 항생제 및 스테로이드 충격 요법 시행 후 핍뇨, 호흡곤란 및 혈액검사 호전 소견 보였으나 7일 동안 유치된 도뇨관 제거 후 환아는 요 폐색 소견이 관찰되었다. 복부 전산화 단층 촬영상 좌측 신장 주위에 요낭종이 확인되어 좌측 요관에 Double-J catheter가 삽입 되었으며 신우의 파열 부위에 조영제 누출이 확인되었다. 시술 후 요 폐색 소견은 호전되었고, 배뇨성 방광 요도 조영술 상 좌측 신장의 4단계 방광 요관 역류가 관찰되었다. Double-J catheter 제거 3개월 후 좌측 신장 주변의 요낭종은 대부분 소실되었고, 좌측 신장의 방광 요관 역류는 보이지 않았다. 저자들은 급성 신부전 환아에서 유치 도뇨관 제거 후 배뇨곤란 및 요 폐색 소견을 보인 신 주위 요낭종 1례를 경험하였기에 보고하는 바이다. Urinomas can occur after renal trauma or perforation of the collecting system during an endosurgical procedure. However, spontaneous urinomas are very rare. Here we report a case of a spontaneous perinephric urinoma following the removal of a Foley catheter in an 18-year-old girl with acute kidney injury caused by septic shock. The patient had been treated for septic shock, acute kidney injury, and acute respiratory distress syndrome, and had a Foley catheter in place for seven days. After Foley catheter removal, the patient complained of consistent voiding difficulty. An abdominal computed tomography scan showed a large amount of left perinephric fluid, and the aspirated fluid included urothelial cells, confirming the diagnosis of a urinoma. The urinoma was successfully treated by insertion of a double-J stent into the left ureter. This report discusses the available literature on urinomas, and their clinical features, diagnosis, and treatment.

외상성 경동맥 해면정맥동루 : 증례보고

엄진화,강창구,김동희,김대조,박희영 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.6

A case of traumatic carotico-cavernous fistula was managed by intravascular occlusion using detachable balloon catheter. The great advantage of this technique is that the cerebral blood flow can usually be preserved after the occlusion of the fistula. The fistula was obliterated by this procedure. The radiological feature, symptomatology and management were discussed with brief review of the literature.

증예(症例) : 제왕절개 반흔 부위 자궁외 임신: 성공적인 보존적 치료 2예

채희숙 ( Hee Suk Chai ),이정헌 ( Jeong Heon Lee ),노경옥 ( Kyoung Ok Rho ),김영란 ( Young Ran Kim ),김선영 ( Sun Young Kim ),진세진 ( Se Jin Jin ),정영주 ( Young Ju Jeong ),조성남 ( Sung Nam Cho ) 전북대학교 의과학연구소 2006 全北醫大論文集 Vol.30 No.2

The pregnancy within a cesarean section scar is the rarest form of ectopic pregnancy. This pregnancy may encounter the life-threatening conditions such as uterine scar rupture and massive hemorrhage even in the first trimester. So inevitable hysterectomy may be needed for lifesaving, however it is tragic option for young woman who want to maintain fertility. If this ectopic pregnancy is diagnosed early, conservative managements are capable of preserving the uterus. We present two cases of successful conservative treatment of cesarean section scar pregnancy through methotrexate (MTX) administration into the gestational sac by transabdominal ultrasound-guidance and quick curettage followed by compression utilizing balloon catheter.