Stent Compression in Iliac Vein Compression Syndrome Associated with Acute Ilio-Femoral Deep Vein Thrombosis

OBJECTIVE: This study was conducted to evaluate stent compression in iliac vein compression syndrome (IVCS) and to identify its association with stent patency. MATERIALS AND METHODS: Between May 2005 and June 2014, after stent placement for the treatment of IVCS with acute ilio-femoral deep vein thrombosis, follow-up CT venography was performed in 48 patients (35 women, 13 men; age range 23-87 years; median age 56 years). Using follow-up CT venography, the degree of the stent compression was calculated and used to divide patients into two groups. Possible factors associated with stent compression and patency were evaluated. The cumulative degree of stent compression and patency rate were analyzed. RESULTS: All of the stents used were laser-cut nitinol stents. The proportion of limbs showing significant stent compression was 33%. Fifty-six percent of limbs in the significant stent compression group developed stent occlusion. On the other hand, only 9% of limbs in the insignificant stent compression group developed stent occlusion. Significant stent compression was inversely correlated with stent patency (p < 0.001). The median patency period evaluated with Kaplan-Meier analysis was 20.0 months for patients with significant stent compression. Other factors including gender, age, and type of stent were not correlated with stent patency. Significant stent compression occurred most frequently (87.5%) at the upper end of the stent (ilio-caval junction). CONCLUSION: Significant compression of nitinol stents placed in IVCS highly affects stent patency. Therefore, in order to prevent stent compression in IVCS, nitinol stents with higher radial resistive force may be required.

BYPASS SURGERY BY GRAFTING ARTERY MAMMARIA INTERNA ONTO CORONARY ARTERY DURING OPEN HEART SURGERY / Шинэ санаа Шинэ нээлт

According to the 2013 WHO survey, the world’s leading cause of death is a coronary heart disease which is accounted for 12.9%. Bypass surgery by grafting Artery mammaria interna to the left anterior descending coronary artery is more clinically significant and has long become an international standard. Aim: To study the outcomes in patients who undergone a bypass surgery ofgrafting the Artery mammaria interna to the left anterior descending coronary artery in an open heart surgery. In 2014 in the case-control study conducted at the Shastin 3rd National Central Hospital, 8 patients who undergone a bypass surgery of grafing Artery mammaria internasinistra to the left anterior descending coronary artery were selected for a case group and 8 patients with bypass grafting of a superficial vein of the leg to the coronary artery were selected as a control group. Related diseases, heart function, type of grafting performed, and post-operative complications were studied. The successful bypass surgeries of grafting the Artery mammaria interna sinistra to the left anterior descending coronary artery without complications in the case group in 2014 has demonstrated that the Mongolian cardiosurgical team was able to successfully and fully introduce this innovative approach that has become an international standard of coronary artery surgery. The introduction of this method enables to eliminate angina pectoris symptoms in patients, restore and improve heart contractions, reduce the chances of a repeat heart attack, and thus, to improve the patient’s ability to live and work normally.

Risk factors of stent occlusion in chronic pancreatitis / 中华胰腺病杂志

Objective To investigate the stent occlusion rate and its risk factor in chronic pancreatitis (CP). Methods From November 2006 to January 2010 a total of 77 pancreatic endoprostheses from 64 patients with CP were tested by simulating the pathophysiologically increased main pancreatic duct (MPD)pressure. The water flow during 15 seconds was recorded 4 times at a pressure of 10 cm water. Kaplan Meier method was used to evaluate the univariate relationship between risk factor and stent occlusion, and Cox regression survival analysis was used to evaluate the multivariate relationship between risk factor and stent occlusion. Results 64 patients with CP were included, with 43 males and 21 females, the mean age was 38 years (range, 4 ～ 80 years). The stents had been placed for a mean of 263 days ( range 26 ～ 759 days).Average stent diameter was 8F (range, 5 ～ 10 F). The overall occlusion rate was 67.5% (52/77), the nonocclusion rates at 90, 180, 360, 540 d were 96. 1% (74/77) , 72.7% (56/77) ,58.4% (45/77) and 35.1% (27/77). In the Cox regression analysis, endoprosthesis diameter ≥8.5F was shown to be the only risk factors for stent occlusion. Conclusions A significant proportion of stents placed after 180 d were not occluded, and were significantly lower than those reported from similar studies overseas. Pancreatic endoprosthesis diameter ≥8. 5F was prone to occlusion.

A Case of the Pancreatic Duct Change after a Long-term Pancreatic Stenting in Pancreas Divisum and the Fine Structural Analysis of Occluded Pancreatic Polyethylene Stent / 대한소화기학회지

The pancreatic duct stenting is now recognized as the treatment option for a number of pancreatic disorders. Although the stent-induced ductal changes may result, there is little information regarding the frequency of these stent-induced changes in chronic pancreatitis. Pancreatic stents may occlude with time, but there is only little information available on the nature of the clogging process. Although a short-term efficacy of endoscopic pancreatic duct stenting has been proved, the long-term efficacy continues to be controversial. The aim of this study was to report a case of chronic pancreatitis with pancreatolith after the incidental long-term pancreatic stenting for 3 years due to a pancreas divisum with acute pancreatitis. Also, this study described the analysis of the ultrastructural changes in the surface of an occluded pancreatic stent. A scanning and transmission electron microscopy showed an amorphous protein matrix in whole stent that arranged as a network in some areas but arranged as the layers in other areas. A variable number of bacteria of mixed species, calcium carbonate or calcium oxalate crystal, round leukocyte were scattered in the protein matrix. The yeast and plant material were seen in some part of the stent as well.