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강준혁,나승운,이대인,김수아,이재형,강승훈,임성윤,최병걸,Amro Elnagar,김선원,임성일,한성우,나진오,최철웅,임홍의,김진원,김응주,박창규,서홍석,오동주 대한심장학회 2012 Korean Circulation Journal Vol.42 No.3
A 0.035-inch guide wire fracture and entrapment in a peripheral artery is a very rare complication, but when it does occur it may lead to lifethreatening complications, such as perforation, thrombus formation, embolization, and subsequent limb ischemia. We describe our experience of successfully retrieving a fractured 0.035-inch Terumo guide wire in the external iliac artery using a biopsy forcep.
나승운,Kang-Yin Chen,오동주,Yong-Jian Li,Zhe Jin,Kanhaiya Lal Poddar,Sureshkumar Ramasamy,Yoshiyasu Minami,Amro Elnagar,최병걸,Sang Pyo Hong,Byoung Won Cheon,Sang Ki Moon,Sung Il Im,Sun Won Kim,나진오,홍영준,임홍의,김진원 대한심장학회 2012 Korean Circulation Journal Vol.42 No.6
Background and Objectives: Although the use of heterogeneous overlapping drug-eluting stents (DES) is not uncommon in clinical practice, whether the implantation sequences of heterogeneous DES will influence the endothelialization or arterial responses differently remains unclear. Materials and Methods: Twenty-one rabbits were randomized to receive overlapping stents in the iliac artery for 3 months {distal siroli-mus-eluting stent (SES, Cypher TM )+proximal paclitaxel-eluting stent (PES, Taxus TM ) (C+T, n=7), distal Taxus+proximal Cypher (T+C, n=7) and bare metal stent (BMS)+BMS (B+B, n=7)}. Endothelial function was evaluated by the acetylcholine provocation test during follow-up an-giography. Histopathological changes in proximal, overlapped, and distal stented segments were evaluated. Results: Although the overall angiographic outcomes were comparable, late loss (mm) in the distal stented segment was higher in the B+B (0.39±0.07) and C+T (0.40±0.20) than that in the T+C (0.06±0.02) group (p<0.001). The incidence of acetylcholine-induced spasm was higher in the DES groups compared with BMS, regardless of the implantation sequences (85.7% in C+T vs. 14.3% in B+B vs. 71.4% in T+C,p=0.017). Notably, only the distal Cypher implantation group (C+T) had three cases of stent fracture. A histopathological analysis showed that despite similar arterial injury scores, Taxus and Cypher stents had higher inflammatory reactions at the overlapped and distal segments compared with those of BMS. Conclusion: Despite similar arterial injury, higher inflammatory reactions were observed in overlapping DES segments regardless of the im -plantation sequence compared with that of BMS. Moreover, DES was associated with impaired endothelial function on the adjacent non-stented segments.