[Atherectomy in Peripheral Artery Disease: Current and Future]. / 말초동맥질환에서의 ì£½ì¢ ì ˆì œìˆ : 현재와 미래.

Atherectomy has become a promising treatment option for peripheral artery disease caused by diabetes mellitus or end-stage renal disease. Atherectomy refers to the removal of atheromatous tissue by mechanical method, resulting in an enlarged lumen of the treated blood vessel. Based on this method, the term is limited to the percutaneous minimally invasive approach, and there are currently two types of atherectomy devices available in Korea. The increased prevalence of atherectomy has led to the concept of "vascular preparation" and a new treatment concept of "leave nothing behind." Various studies have proven the safety and effectiveness of atherectomy; however, there are some limitations. We need to remain focused on patient selection and subsequent large-scale research.

Anatomical Features and Early Outcomes of Endovascular Repair of Abdominal Aortic Aneurysm from a Korean Multicenter Registry.

PURPOSE: To introduce a nation-based endovascular aneurysm repair (EVAR) registry in South Korea and to analyze the anatomical features and early clinical outcomes of abdominal aortic aneurysms (AAA) in patients who underwent EVAR. MATERIALS AND METHODS: The Korean EVAR registry (KER) was a template-based online registry developed and established in 2009. The KER recruited 389 patients who underwent EVAR from 13 medical centers in South Korea from January 2010 to June 2010. We retrospectively reviewed the anatomic features and 30-day clinical outcomes. RESULTS: Initial deployment without open conversion was achieved in all cases and procedure-related 30-day mortality rate was 1.9%. Anatomic features showed the following variables: proximal aortic neck angle 48.8±25.7° (mean±standard deviation), vertical neck length 35.0±17.2 mm, aneurysmal sac diameter 57.2±14.2 mm, common iliac artery (CIA) involvement in 218 (56.3%) patients, and median right CIA length 34.9 mm. Two hundred and nineteen (56.3%) patients showed neck calcification, 98 patients (25.2%) had neck thrombus, and the inferior mesenteric arteries of 91 patients (23.4%) were occluded. CONCLUSION: Anatomical features of AAA in patients from the KER were characterized as having angulated proximal neck, tortuous iliac artery, and a higher rate of CIA involvement. Long-term follow-up and ongoing studies are required.

A case of secondary hypertension associated with the nutcracker phenomenon.

A 25-year-old Korean woman was referred for uncontrolled hypertension. Laboratory examination revealed increased plasma renin activity and microscopic hematuria. Computed tomography demonstrated compression of the left renal vein (LRV) between the aorta and superior mesenteric artery; however, both renal arteries were intact and there was no adrenal mass. Renal vein catheterization showed external compression with a pressure gradient of up to 8 mm Hg between the LRV and the inferior vena cava. Plasma renin activity in the LRV was almost five times higher than that in the right renal vein. In this patient, renin-dependent hypertension was caused by renal congestion due to LRV obstruction.

Chronic periaortitis with antiphospholipid syndrome.

Chronic periaortitis (CP) is a rare disease, the common denominator of which is a retroperitoneal periaortic fibroinflammatory tissue that frequently obstructs neighboring structures. CP has already been reported in association with various autoimmune disorders, such as Hashimoto's thyroiditis, systemic lupus erythematosus and Sjögren's syndrome. The association with autoimmune disorders suggests that CP is a manifestation of a systemic autoimmune process. We describe the first case of antiphospholipid syndrome in a patient with CP.

An unusual clinical manifestation of Takayasu's arteritis: spinal cord compression.

Takayasu's arteritis is a chronic inflammatory vasculitis, involving mainly the aorta and its main branches and the pulmonary arteries, with characteristic of stenotic and occasionally dilated lesions. Neurologic manifestations of Takayasu's arteritis range from simple headache to catastrophic neurologic impairments, including visual loss, stroke and transient ischemic attack. However, spinal cord compression has never been described as a complication of Takayasu's arteritis. We describe a case of Takayasu's arteritis complicated by spinal cord compression due to thoracolumbar inflammatory epiduritis.