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Seung Joo Kang,Chung Hyun Tae,Chang Seok Bang,Ki-Nam Shim,Cheol Min Shin,Young-Hoon Jeong,Miyoung Choi,Joo Ha Hwang,Yutaka Saito,Philip Wai Yan Chiu,Rungsun Rerknimitr,Christopher Khor,Vu Van Khien,Ke 대한소화기내시경학회 2024 Clinical Endoscopy Vol.57 No.2
Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.
Anderson Chun On Tsang,Simon Sui Man Lai,Wai Choi Chung,Abraham Yik Sau Tang,Gilberto Ka Kit Leung,Alexander Kai Kei Poon,Alfred Cheuk Hang Yu,Kwok Wing Chow 대한초음파의학회 2015 ULTRASONOGRAPHY Vol.34 No.2
Purpose: The aim of this study was to validate a computational fluid dynamics (CFD) simulationof flow-diverter treatment through Doppler ultrasonography measurements in patient-specificmodels of intracranial bifurcation and side-wall aneurysms. Methods: Computational and physical models of patient-specific bifurcation and sidewallaneurysms were constructed from computed tomography angiography with use ofstereolithography, a three-dimensional printing technology. Flow dynamics parametersbefore and after flow-diverter treatment were measured with pulse-wave and color Dopplerultrasonography, and then compared with CFD simulations. Results: CFD simulations showed drastic flow reduction after flow-diverter treatment in bothaneurysms. The mean volume flow rate decreased by 90% and 85% for the bifurcation aneurysmand the side-wall aneurysm, respectively. Velocity contour plots from computer simulationsbefore and after flow diversion closely resembled the patterns obtained by color Dopplerultrasonography. Conclusion: The CFD estimation of flow reduction in aneurysms treated with a flow-divertingstent was verified by Doppler ultrasonography in patient-specific phantom models of bifurcationand side-wall aneurysms. The combination of CFD and ultrasonography may constitute a feasibleand reliable technique in studying the treatment of intracranial aneurysms with flow-diverting stents.