Journal of Yeungnam Medical Science

Case report

Transpedal lymphatic embolization for lymphorrhea at the graft harvest site after coronary artery bypass grafting: Jung Guen Cha, Sang Yub Lee, Jihoon Hong, Hun Kyu Ryeom, Gab Chul Kim, Young Woo Do; Yeungnam Univ J Med. 2021;38(1):74-77. Published online July 20, 2020; DOI: https://doi.org/10.12701/yujm.2020.00297

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Lymphorrhea is a rare but potentially severe complication that occurs after various surgical procedures. Untreated lymphorrhea may lead to wound dehiscence, infection, and prolonged hospital stay. Currently, there is no standard effective treatment. Early management usually includes leg elevation, drainage, and pressure dressing. However, these methods are associated with prolonged recovery and high recurrence rates. We report a case of lymphorrhea from a calf wound after endoscopic great saphenous vein (GSV) harvesting for coronary artery bypass grafting (CABG). The patient presented with intractable oozing from the postoperative wound on the right calf. Lymphorrhea perGsisted for 6 weeks despite negative-pressure wound therapy with a long-acting somatostatin. We performed unilateral pedal lymphangiography that confirmed wound lymphorrhea, followed by glue embolization. No recurrence was observed after 8 months of follow-up. This case report demonstrates the successful use of lymphangiography with glue embolization in the control of lymphorrhea after GSV harvesting for CABG.

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Supermicrosurgical lymphatic venous anastomosis for intractable lymphocele after great saphenous vein harvesting graft
Hirofumi Imai, Shuhei Yoshida, Toshiro Mese, Solji Roh, Isao Koshima
Journal of Vascular Surgery Cases, Innovations and Techniques.2022; 8(1): 45. CrossRef
Update February 2021
Francine Blei
Lymphatic Research and Biology.2021; 19(1): 96. CrossRef
Lymphatic complications after harvesting venous conduits in coronary artery bypass grafting surgery
D. V. Manvelyan, Yu. Y. Vechersky, V. V. Zatolokin, M. S. Kuznetsov, B. N. Kozlov
The Siberian Journal of Clinical and Experimental Medicine.2021; 36(3): 27. CrossRef

Original article

Feasibility and efficacy of coil embolization for middle cerebral artery aneurysms: Jae Young Choi, Chang Hwa Choi, Jun Kyeung Ko, Jae Il Lee, Chae Wook Huh, Tae Hong Lee; Yeungnam Univ J Med. 2019;36(3):208-218. Published online April 25, 2019; DOI: https://doi.org/10.12701/yujm.2019.00192

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Abstract PDF

Background
The anatomy of middle cerebral artery (MCA) aneurysms has been noted to be unfavorable for endovascular treatment. The purpose of this study was to assess the feasibility and efficacy of coiling for MCA aneurysms.
Methods
From January 2004 to December 2015, 72 MCA aneurysms (38 unruptured and 34 ruptured) in 67 patients were treated with coils. Treatment-related complications, clinical outcomes, and immediate and follow-up angiographic outcomes were retrospectively analyzed.
Results
Aneurysms were located at the MCA bifurcation (n=60), 1st segment (M1, n=8), and 2nd segment (M2, n=4). Sixty-nine aneurysms (95.8%) were treated by neck remodeling techniques using multi-catheter (n=44), balloon (n=14), stent (n=8), or combination of these (n=3). Only three aneurysms were treated by single-catheter technique. Angiographic results were 66 (91.7%) complete, five (6.9%) remnant neck, and one (1.4%) incomplete occlusion. Procedural complications included aneurysm rupture (n=1), asymptomatic coil migration to the distal vessel (n=1), and acute thromboembolism (n=10) consisting of eight asymptomatic and two symptomatic events. Treatment-related permanent morbidity and mortality rates were 4.5% and 3.0%, respectively. There was no bleeding on clinical follow-up (mean, 29 months; range, 6-108 months). Follow-up angiographic results (mean, 26 months; range, 6-96 months) in patients included one major and three minor recanalizations.
Conclusion
Coiling of MCA aneurysms could be a technically feasible and clinically effective treatment strategy with acceptable angiographic and clinical outcomes. However, the safety and efficacy of this technique as compared to surgical clipping remains to be ascertained.

Citations

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Adverse events during endovascular treatment of ruptured aneurysms: A prospective nationwide study on subarachnoid hemorrhage in Sweden
Bryndís Baldvinsdóttir, Paula Klurfan, Johanna Eneling, Elisabeth Ronne-Engström, Per Enblad, Peter Lindvall, Helena Aineskog, Steen Friðriksson, Mikael Svensson, Peter Alpkvist, Jan Hillman, Erik Kronvall, Ola G. Nilsson
Brain and Spine.2023; 3: 102708. CrossRef
Microsurgical Clipping versus Advanced Endovascular Treatment of Unruptured Middle Cerebral Artery Bifurcation Aneurysms After a “Coil-First” Policy
Muriel Pflaeging, Christoph Kabbasch, Marc Schlamann, Lenhard Pennig, Stephanie Theresa Juenger, Jan-Peter Grunz, Marco Timmer, Gerrit Brinker, Roland Goldbrunner, Boris Krischek, Lukas Goertz
World Neurosurgery.2021; 149: e336. CrossRef

Review Article

Comprehensive understanding of vascular anatomy for endovascular treatment of intractable oronasal bleeding: Sungjun Moon; Yeungnam Univ J Med. 2018;35(1):7-16. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.7

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Abstract PDF

Oronasal bleeding that continues despite oronasal packs or recurs after removal of the oronasal packs is referred to as intractable oronasal bleeding, which is refractory to conventional treatments. Severe craniofacial injury or tumor in the nasal or paranasal cavity may cause intractable oronasal bleeding. These intractable cases are subsequently treated with surgical ligation or endovascular embolization of the bleeding arteries. While endovascular embolization has several merits compared to surgical ligation, the procedure needs attention because severe complications such as visual disturbance or cerebral infarction can occur. Therefore, comprehensive understanding of the head and neck vascular anatomy is essential for a more effective and safer endovascular treatment of intractable oronasal bleeding.

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Endovascular intervention for the treatment of epistaxis: cone beam CT review of anatomy, collateral, and treatment implications/efficacy
Madeline Hoover, Robert Berwanger, John A Scott, Andrew DeNardo, Krishna Amuluru, Troy Payner, Charles Kulwin, Eytan Raz, Daniel Gibson, Daniel H Sahlein
Journal of NeuroInterventional Surgery.2024; 16(2): 192. CrossRef
Effectiveness of Calcium Alginate Dressing in Combination with Nasal Endoscopic Bipolar Electrocoagulation and Low-Temperature Plasma Knife Treatment on Bleeding Volume, Nasal Ventilation, Stress Response, and Recurrence Rate in Patients with Refractory E
Yi Su, Xinye Guo, Yan Nie
Journal of Biomedical Nanotechnology.2023; 19(12): 2196. CrossRef
Woodruff’s plexus—arterial or venous?
Cezar Octavian Morosanu, Craig Humphreys, Stephanie Egerton, Claire M. Tierney
Surgical and Radiologic Anatomy.2022; 44(1): 169. CrossRef

Case Reports

Preoperative arterial embolization of heterotopic ossification around the hip joint: Jin Hyeok Kim, Chankue Park, Seung Min Son, Won Chul Shin, Joo Yeon Jang, Hee Seok Jeong, In Sook Lee, Tae Young Moon; Yeungnam Univ J Med. 2018;35(1):130-134. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.130

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Abstract PDF

Heterotopic ossification (HO) around the hip joint is not uncommon following neurological injury. Often, surgical treatment is performed in patients with restricted motion and/or refractory pain due to grade III or IV HO according to Brooker classification. The major complication that occurs as a result of surgical HO removal is perioperative bleeding due to hyper-vascularization of the lesion. Here, we report a case of preoperative embolization in a 51-year-old male patient presenting with restricted bilateral hip range of motion (ROM) due to HO following a spinal cord injury. In the right hip without preoperative arterial embolization, massive bleeding occurred during surgical removal of HO. Thus, the patient received a transfusion postoperatively due to decreased serum hemoglobin levels. For surgery of the left hip, preoperative embolization of the arteries supplying HO was performed. Surgical treatment was completed without bleeding complications, and the patient recovered without a postoperative transfusion. This case highlights that, while completing surgical removal for ROM improvements, orthopedic surgeons should consider preoperative arterial embolization in patients with hip HO.

Citations

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Embolization followed by resection of the heterotopic hip joint ossification with spinal cord injury
Takahiro Igei, Satoshi Nakasone, Masato Ishihara, Masamichi Onaga, Kotaro Nishida
Journal of Orthopaedic Science.2024; 29(1): 454. CrossRef
Preoperative Arterial Embolization for Heterotopic Ossification of the Hip
Nicolas Papalexis, Giuliano Peta, Costantino Errani, Marco Miceli, Giancarlo Facchini
Journal of Vascular and Interventional Radiology.2023; 34(4): 608. CrossRef
Neurogenic heterotopic ossification: A review. Part 2
Vladimir A. Novikov, Alina M. Khodorovskaya, Valery V. Umnov, Evgenii V. Melchenko, Dmitry V. Umnov
Pediatric Traumatology, Orthopaedics and Reconstructive Surgery.2023; 11(4): 557. CrossRef

Coil embolization of ruptured intrahepatic pseudoaneurysm through percutaneous transhepatic biliary drainage: Jee Young An, Jae Sin Lee, Dong Ryul Kim, Jae Young Jang, Hwa Young Jung, Jong Ho Park, Sue Sin Jin; Yeungnam Univ J Med. 2018;35(1):109-113. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.109

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Abstract PDF

A 75-year-old man with chronic cholangitis and a common bile duct stone that was not previously identified was admitted for right upper quadrant pain. Acute cholecystitis with cholangitis was suspected on abdominal computed tomography (CT); therefore, endoscopic retrograde cholangiopancreatography with endonasal biliary drainage was performed. On admission day 5, hemobilia with rupture of two intrahepatic artery pseudoaneurysms was observed on follow-up abdominal CT. Coil embolization of the pseudoaneurysms was conducted using percutaneous transhepatic biliary drainage. After several days, intrahepatic artery pseudoaneurysm rupture recurred and coil embolization through a percutaneous transhepatic biliary drainage tract was conducted after failure of embolization via the hepatic artery due to previous coiling. After the second coil embolization, a common bile duct stone was removed, and the patient presented no complications during 4 months of follow-up. We report a case of intrahepatic artery pseudoaneurysm rupture without prior history of intervention involving the hepatobiliary system that was successfully managed using coil embolization through percutaneous transhepatic biliary drainage.

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The efficacy and clinical outcomes of transarterial embolization in acute massive upper gastrointestinal bleeding: a single-center experience
Mehmet TAHTABASI, Mehmet KOLU
Marmara Medical Journal.2021; 34(2): 180. CrossRef
Percutaneous Trans-Hepatic Embolization of an Iatrogenic Extra-Hepatic Pseudoaneurysm of the Right Hepatic Artery in a Patient With Previous Occlusion of the Proper Hepatic Artery: An Endovascular Procedure to Avoid a Difficult Surgical Repair
Giuseppe S. Gallo, Roberto Miraglia, Luigi Maruzzelli, Francesca Crinò, Christine Cannataci, Salvatore Gruttadauria
Vascular and Endovascular Surgery.2021; 55(8): 878. CrossRef

Lipiodol-induced pneumonitis following transarterial chemoembolization for ruptured hepatocellular carcinoma.: Haewon Kim, Yong Hoon Kim, Hong Jin Yoon, Kwang Hoon Lee, Seung Moon Joo, Min Kwang Byun, Jung Il Lee, Kwan Sik Lee, Ja Kyung Kim; Yeungnam Univ J Med. 2014;31(2):117-121. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.117

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Abstract PDF

Transarterial chemoembolization (TACE) is a widely accepted nonsurgical modality used for the treatment of multinodular hepatocellular carcinoma (HCC). The careful selection of the candidate is important due to the risk of developing various side effects. Fever, nausea, abdominal pain, and liver enzyme elevation are commonly known side effects of TACE. Hepatic failure, ischemic cholecystitis, and cerebral embolism are also reported, although their incidence might be low. Pulmonary complication after TACE is rare, and the reported cases of lipiodol pneumonitis are even rarer. A 53-year-old man was treated with TACE for ruptured HCC associated with hepatitis B virus infection. On day 19 after the procedure, the patient complained of dyspnea and dry cough. Chest computed tomography showed diffuse ground glass opacities in the wholelung fields, suggesting lipiodol-induced pneumonitis. After 2 weeks of conservative management, the clinical symptoms and radiologic abnormalities improved. Reported herein is the aforementioned case of lipiodol-induced pnemonitis after TACE, with literature review.

Citations

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Lipiodol Pneumonitis Following Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma
Sungkeun Kim, Hee Yeon Kim, Su Lim Lee, Young Mi Ku, Yoo Dong Won, Chang Wook Kim
Journal of Liver Cancer.2020; 20(1): 60. CrossRef
Secondary adrenal insufficiency caused by sorafenib administration in a patient with hepatocellular carcinoma
Soo Yeon Jo, Soo Hyung Ryu, Mi Young Kim, Jeong Seop Moon, Won Jae Yoon, Jin Nam Kim
Yeungnam University Journal of Medicine.2016; 33(2): 155. CrossRef

A Case of Ruptured Mycotic Hepatic Artery Aneurysm Successfully Treated Using Arterial Embolization.: Gi Ae Kim, Han Chu Lee, Young Joo Jin, Jee Eun Yang, Min Jung Lee, Ji Hyun Park, Bo Young Lee; Yeungnam Univ J Med. 2012;29(1):24-27. Published online June 30, 2012; DOI: https://doi.org/10.12701/yujm.2012.29.1.24

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Abstract PDF

Mycotic hepatic artery aneurysms (HAAs) have become very rare due to antibiotics. Untreated, they have a high possibility of rupture and mortality. In this paper, on the case of a 67-year-old male who had severe right-upperquadrant abdominal pain and a history of infective endocarditis is reported. The computed tomography (CT) and arterial angiography findings led to a diagnosis of a ruptured mycotic HAA. The CT showed an HAA and the formation of an intrahepatic hematoma caused by aneurysmal rupture. The arterial angiography showed a mycotic HAA that arose from the right posterior hepatic artery. Percutaneous transcatheter arterial embolization was used to successfully treat the HAA. Since then, the patient has been doing well, without symptoms.

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A mycotic hepatic artery aneurysm, a rare complication of aortic valve endocarditis.
Jaime López-Sánchez , José Quiñones Sampedro , Luis Muñoz-Bellvís
Revista Española de Enfermedades Digestivas.2020;[Epub] CrossRef
Hepatic Artery Mycotic Aneurysm Associated with Staphylococcal Endocarditis with Successful Treatment: Case Report with Review of the Literature
Dhara Chaudhari, Atif Saleem, Pranav Patel, Sara Khan, Mark Young, Gene LeSage
Case Reports in Hepatology.2013; 2013: 1. CrossRef

Original Article

The effect of Transarterial Chemoembolization(TAE) on Lung metastasis of Hepatocellular Carcinoma.: Heon Ju Lee, Jong Ryul Eun, Young Doo Song, Chan Won Park; Yeungnam Univ J Med. 2000;17(1):66-74. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.66

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Abstract PDF: BACKGROUND
During follow up period after transarterial embolization(TAE), cases of pulmonary metastasis were more prevalent in TAE-treated patients than in TAE-untreated patients. Therefore, a study was conducted to evaluate whether TAE increases the incidence of pulmonary metastasis of hepatocellular carcinoma and to clarify the risk factors for pulmonary metastasis. METHODS: From march 1991 to march 1995, 156 patients who had been diagnosed with hepatocellular carcinoma by serology, and radiographic and histologic method at Yeungnam university hospital were involved in this study. We excluded 12 patients with lung metastasis on initial diagnosis and the others. The remaining 144 patients had been followed up for at least 5 months, and divided into four groups according to lung metastasis and trans-arterial embolization treatment, and evaluated the age, sex, child-pugh score, liver cirrhosis, and the level of AFP. RESULTS: Pulmonary metastasis was found in 18.0% (26/144), of witch 92.3%(24/26) and 7.7%(2/26) of the patients with and without transarterial chemoembolization, respectively. Of thepatients, 23.5% (24/102) with TAE had lung metastais during follow-up periods and 4.7% (2/42) without TAE had lung metastasis. there was more likelihood for lung metastasis after TAE, but there was no difference between two groups in age, sex, child-pugh class, the presence of liver cirrhosis, and AFP. CONCLUSIONS: The incidence of pulmonary metastasis of hepatocellular carcinoma after TAE was higher. child-pugh class was the only related clinical precipitating factors for pulmonary metastasis in TAE in our study. Our results suggest that regular chest X-ray check-up may be more frequently needed by patients who had TAE treatment for hepatocellular carcinoma.

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