51
|
Park S, Choi J, Ahn S, Park H. Dosimetric Analysis of the Effects of a Temporary Tissue Expander on the Radiotherapy Technique. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
52
|
Arslan M, Li H, Lee H, Mikula M, Ahn S. Calretinin-Positive Mucosal Innervation (C-mi) as a Potential Biomarker to Predict Fibrosis in Crohn’s Disease (CD): A Pilot Study. Am J Clin Pathol 2020. [DOI: 10.1093/ajcp/aqaa161.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction/Objective
There is no reliable biomarker to predict the degree of fibrosis in CD. Quantification of C-mi has been used as a surrogate for enteric neural structures in Hirschsprung disease. The quantity of C-mi at the proximal margin may correlate with the degree of fibrosis in resected CD.
Methods
Ileocolonic resection cases for 20 CD and 3 trauma (control) were retrieved. Cases with severe mucosal inflammation at the margins were excluded. The proximal and distal margin sections were subjected to calretinin immunohistochemistry. Random mucosal images were captured from scanned slides (x200, JPEG), submucosa was edited out, and C-mi was calculated by image processing and analysis. rC-mi was defined as the mean C-mi of proximal margin normalized by that of distal margin. Cases with rC-mi less than the mean rC-mi + 2 SD of the controls were excluded. The maximum thicknesses of submucosa and muscularis propria were measured at the most stenotic site, microscopically. Pearson’s correlation test and Student’s t-test were performed to correlate the parameters and compare the means, respectively.
Results
A total of 216 images were captured (mean 9.3 images per case; range 7 to 10). The mean rC-mi of CD (1.26) was greater than the controls (mean 0.43) (p<0.05). The mean rC-mi + 2 SD of the control group was 0.91, thus 2 CD cases were excluded from final analysis. The rC-mi of CD showed an inverse relationship with maximum submucosal thickness (mean 3.4 mm, range 0.2 to 5.9) at the site of stenosis (r=-0.47; p<0.05), but not with muscularis propria.
Conclusion
The rC-mi of CD was inversely correlated with submucosal fibrosis. Altered stromal integrity, impaired intercellular signaling, progressive reduction and loss of telocytes induced by submucosal fibrosis may reduce the regenerative capacity of enteric neural structures in CD. Therefore, a decreasing trend in rC-mi may predict fibrosis progression in CD.
Collapse
|
53
|
Cho S, Han A, Ahn S, Min S, Ha J, Jae HJ, Min SK. Directional Atherectomy for Treating In-Stent Restenosis of the Superficial Femoral Artery. Vasc Specialist Int 2020; 36:136-143. [PMID: 32665454 PMCID: PMC7531303 DOI: 10.5758/vsi.200017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/22/2020] [Accepted: 06/07/2020] [Indexed: 11/20/2022] Open
Abstract
Purpose The optimal treatment for in-stent restenosis (ISR) of the superficial femoral artery (SFA) is still in debate. This study aimed to evaluate the safety and effectiveness of directional atherectomy (DA) as a primary treatment modality for ISR in SFA. Materials and Methods A retrospective single-center analysis was conducted. In total, 617 stents were deployed in 242 limbs for SFA diseases during the study period. ISR was identified in 29 limbs (12.0%); 14 limbs were treated with DA and 15 limbs with balloon angioplasty (BAP) alone. Technical success rate, target lesion revascularization (TLR) and patency rates (PRs) at 12 months, and any complications were evaluated. Results DA group included complete occlusions in 50% of patients and BAP group included in 40%. Mean improvement in the ankle-brachial index was 0.29 and 0.32, respectively (P=0.638). Technical success was achieved in all patients. The procedural success rates were 85.7% and 73.3%, respectively (P=0.651). There was no significant difference regarding residual stenosis, distal embolization, or flow-limiting dissection. Primary PRs at 1 year were 85.7% and 73.3%, secondary PRs were 100.0% and 93.3%, and TLR rates were 14.3% and 20.0% (P=0.411, 0.326, and 0.684, respectively). Conclusion Short-term outcomes after DA for ISR were not different from those after BAP but showed a tendency of better primary PR and TLR. Larger multicenter prospective studies are needed to define the role of DA in ISR treatment.
Collapse
|
54
|
Kim MS, Min SK, Ahn S, Kim HG, Choi C, Mo H, Han A, Ha J. Modified Brachio-basilic/brachial Arteriovenous Fistula Creation with Short-segment Elevation Preserving the Axilla. Ann Vasc Surg 2020; 67:448.e1-448.e10. [DOI: 10.1016/j.avsg.2020.02.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 10/24/2022]
|
55
|
Ko H, Ahn S, Min S, Hur S, Jae HJ, Min SK. Recanalization of an Occluded Vena Cava Filter and Iliac Veins with Kissing Stents to Treat Postthrombotic Syndrome with a Venous Stasis Ulcer. Vasc Specialist Int 2020; 36:116-121. [PMID: 32611844 PMCID: PMC7333087 DOI: 10.5758/vsi.200010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/18/2020] [Accepted: 05/28/2020] [Indexed: 11/20/2022] Open
Abstract
Inferior vena cava filters (IVCFs) are effective in preventing pulmonary embolism and their usage has rapidly increased over the past decades. However, complications have also significantly increased, as IVCF occlusion causes serious chronic venous insufficiency. Herein, we report a case of infrarenal IVCF occlusion that was successfully treated with the introduction of kissing stents through the IVCF into both iliac veins. A 54-year-old male presented with non-healing ulcers on his left leg. He had undergone IVCF implantation and warfarin medication due to deep vein thrombosis 4 years earlier in another hospital. Computed tomography (CT) revealed the filter-bearing IVC occlusion. Endovascular IVCF removal was attempted but failed. Kissing stents were deployed across the IVCF and extended into both iliac veins. Cone beam CT showed well-deployed stents just behind the occluded IVCF. Venous flow was restored without complications, and the recurrent ulcer healed immediately.
Collapse
|
56
|
Ahn S, Jo E, Min SK, Min S, Ha J, Park KW, Min KB. Predictive Value of Abnormal and Borderline Ankle-Brachial Index for Coronary Re-Intervention and Mortality in Patients with Coronary Artery Disease: An Observational Cohort Study. Vasc Specialist Int 2020; 36:89-95. [PMID: 32611841 PMCID: PMC7333080 DOI: 10.5758/vsi.200012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/05/2020] [Accepted: 05/27/2020] [Indexed: 11/20/2022] Open
Abstract
Purpose This study aimed to investigate the abnormal and borderline ABIs for predicting coronary re-intervention and mortality in patients with coronary artery disease (CAD). Materials and Methods Data from a previous study were obtained and used to investigate the prevalence of peripheral arterial disease among Korean patients with CAD (n=285) in 2010. All patients underwent follow-up coronary angiography as scheduled (asymptomatic: 2-, 5-, and 7-month intervals) or as clinically indicated (symptomatic). Results In total, 33 patients had an abnormal ABI (ab-ABI: <1.0 or >1.4), and 252 had a normal ABI (nl-ABI: 1.0≤ABI≤1.4). The mean follow-up was 47 months. The mortality was significantly higher in the ab-ABI group than in the nl-ABI group (18.2% vs. 6.7%, P=0.0233). MACEs were significantly more common in the ab-ABI group (60.6% vs. 34.5%, P=0. 0036). Moreover, the ab-ABI group had a greater CAD progression than the nl-ABI group (48.5% vs. 31.3%, P=0.0496). The incidence of clinically indicated coronary re-intervention was significantly higher in the ab-ABI group than in the nl-ABI group (33.3% vs. 13.1%, P=0.0025). After adjusting for age, diabetes, dyslipidemia, dialysis, smoking, and obesity, the incidence of clinically indicated re-intervention was significantly higher in the ab-ABI group than in the nl-ABI group (HR, 2.80; 95% CI, 1.24 to 6.34). Conclusion Abnormal and borderline ABI significantly increased the incidence of clinically indicated coronary revascularization and all-cause mortality during a 4-year follow-up among patients with CAD. Hence, ABI could be used to stratify extremely high-risk patients with CAD who may require aggressive surveillance or treatment.
Collapse
|
57
|
Kim SM, Han A, Ahn S, Min SI, Min SK, Ha J. Klotho as a potential predictor of deceased donor kidney transplantation outcomes. Ann Surg Treat Res 2020; 98:332-339. [PMID: 32528913 PMCID: PMC7263887 DOI: 10.4174/astr.2020.98.6.332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/19/2020] [Accepted: 04/28/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose Klotho is an antiaging factor mainly produced by renal tubular cells. Klotho is reportedly decreased in an animal model of acute kidney injury and patients with chronic kidney disease. However, information on Klotho expression after kidney transplantation is limited. We analyzed the correlation between donor Klotho expression and clinical outcomes of kidney transplantation. Methods Sixty patients who underwent deceased donor kidney transplantation between March 2015 and October 2017 were enrolled. Serum and tissue Klotho expression levels were measured by enzyme-linked immunosorbent assay and immunohistochemistry, respectively. Graft function was assessed by estimated glomerular filtration rate (eGFR). Results Patients were divided into 2 groups according to donor Klotho expression in renal tissues. A greater improvement in eGFR was observed at 1 week after transplantation in patients receiving kidneys with higher Klotho expression (47.5 ± 21.9 mL/min/1.73 m2vs. 63.9 ± 28.2 mL/min/1.73 m2, P = 0.030). Patients were also classified into 2 groups according to donor serum Klotho level. There was a tendency for a higher eGFR at 12 months after transplantation in patients receiving kidneys from donors with a higher Klotho level (51.0 ± 18.0 mL/min/1.73 m2vs. 61.2 ± 16.5 mL/min/1.73 m2, P = 0.059). When subgrouped into patients with or without biopsy-proven acute rejection, 12-month eGFR remained higher in patients receiving kidneys from donors with higher serum Klotho. Conclusion Our data demonstrated that donor tissue expression of Klotho correlated with early recovery of eGFR after kidney transplantation. Donor serum Klotho level tended to be associated with posttransplant 12-month eGFR. Donor Klotho expression might be a new predictor for deceased donor kidney transplantation outcome.
Collapse
|
58
|
Ahn S, Min JY, Kim HG, Mo H, Min SK, Min S, Ha J, Min KB. Outcomes after aortic aneurysm repair in patients with history of cancer: a nationwide dataset analysis. BMC Surg 2020; 20:85. [PMID: 32357930 PMCID: PMC7195758 DOI: 10.1186/s12893-020-00754-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/22/2020] [Indexed: 12/03/2022] Open
Abstract
Background Synchronous cancer in patients with abdominal aortic aneurysm (AAA) increases morbidity and mortality after AAA repair. However, little is known about the impact of the history of cancer on mortality after AAA repair. Methods Patients with intact AAA who were treated with endovascular aneurysm repair or open surgical repair were selected from the Health Insurance and Review Assessment data in South Korea between 2007 and 2016. Primary endpoints included the 30- and 90-day mortality and long-term mortality after AAA repair. The Cox proportional hazards models were constructed to evaluate independent predictors of mortality. Results A total of 1999 patients (17.0%, 1999/11785) were diagnosed with cancer prior to the AAA repair. History of cancer generally had no effect in short-term mortality at 30 and 90 days. However, short-term mortality rate of patients with a history of lung cancer was more than twice that of patients without it (3.07% vs. 1.06%, P = 0.0038, 6.14% vs. 2.69%, P = 0.0016). Furthermore, the mortality rate at the end of the study period was significantly higher in AAA patients with a history of cancer than in those without a history of cancer (21.21% vs. 17.08%, P < .0001, HR, 1.31, 95% CI, 1.17–1.46). Conclusions The history of cancer in AAA patients increases long-term mortality but does not affect short-term mortality after AAA repair. However, AAA repair could increase both short- and long-term mortality in patients with lung cancer history, and those cases should be more carefully selected.
Collapse
|
59
|
Ahn S. Adjunctive Procedures for Challenging Endovascular Abdominal Aortic Repair: When Needed and How Effective? Vasc Specialist Int 2020; 36:7-14. [PMID: 32274372 PMCID: PMC7119153 DOI: 10.5758/vsi.2020.36.1.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 11/20/2022] Open
Abstract
Endovascular aneurysm repair (EVAR) is now considered the first choice treatment modality for abdominal aortic aneurysm (AAA) treatment. Advocates for endovascular strategies will try to treat all AAA by EVAR, regardless if the anatomy is conducive for treatment or not. However, the long-term outcomes of EVAR outside the instructions for use (IFU) due to a hostile aneurysmal neck or iliac artery anatomy are known to be poor. The EVAR procedures can be classified according to the technical difficulty, IFU, and need for visceral revascularization: standard, adjunctive, and complex EVAR. The situation required for adjunctive procedures can be classified as the following four steps: a hostile neck (i.e., short or severely angled); large inferior mesenteric or lumbar artery; tough iliac artery anatomy, such as a short common iliac artery and stenotic external iliac artery; and limitations in vascular access. This article will discuss the adjunctive procedures to overcome hostile aneurysm neck and unsuitable iliac artery anatomy.
Collapse
|
60
|
Lee S, Ahn S, Choi J, Ko BR, Semertzidis YK. Axion Dark Matter Search around 6.7 μeV. PHYSICAL REVIEW LETTERS 2020; 124:101802. [PMID: 32216429 DOI: 10.1103/physrevlett.124.101802] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/18/2020] [Indexed: 06/10/2023]
Abstract
An axion dark matter search with the CAPP-8TB haloscope is reported. Our results are sensitive to axion-photon coupling g_{aγγ} down to the QCD axion band over the axion mass range between 6.62 and 6.82 μeV at a 90% confidence level, which is the most sensitive result in the mass range to date.
Collapse
|
61
|
Mitsuyama R, Reinert S, Ahn S. 3:18 PM Abstract No. 366 Imaging features and clinical factors as predictors of endovascular therapy and outcomes in rectus sheath hematoma. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
62
|
Son J, Carr C, Chambers LM, Michener C, Meng Y, Yen T, Beavis A, Stone R, Wethington S, Burkett W, Richardson D, Staley AS, Ahn S, Gehrig P, Torres D, Dowdy S, Sullivan M, Modesitt S, Watson C, Secord A, Veade A, Havrilesky L, Loreen A, Griffin K, Jackson A, Fader AN, Ricci S. Adjuvant treatment in high intermediate risk early stage endometrial cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2019.11.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
63
|
Sinha I, Aluthge D, Ahn S. 3:45 PM Abstract No. 132 Machine learning may assist in the selection of candidates for outpatient liver ablation. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
64
|
Sinha I, Aluthge D, Ahn S. 3:27 PM Abstract No. 55 Predicting mortality following transjugular intrahepatic portosystemic shunt: a machine learning approach. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
65
|
Rauschert L, Purkayastha S, Zhao Y, Xi I, Wang R, Khurana S, McGirr A, Soulen M, Zhang Z, Silva A, Stavropoulos S, Ahn S, Bai H. 3:18 PM Abstract No. 292 Differentiation of malignant and benign renal tumors using magnetic resonance–based radiomics. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
66
|
Park L, Dibble E, Baird G, George P, Ahn S. 4:12 PM Abstract No. 216 What medical students know (or think they know) about interventional radiology. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
67
|
Park L, Dibble E, Baird G, George P, Ahn S. 3:09 PM Abstract No. 209 Diversity in interventional radiology: motivations and deterrents to interventional radiology among female and underrepresented minority medical students. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
68
|
Park L, Dibble E, Baird G, George P, Ahn S. 4:21 PM Abstract No. 217 What medical students think about interventional radiology: motivations and deterrents. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
69
|
Lee N, Jae Y, Kim M, Cho T, Lee C, Hong YR, Hyeon DY, Ahn S, Kwon H, Kim K, Jung JH, Chae S, Shin JO, Bok J, Byun Y, Hwang D, Koo J. A pathogen-derived metabolite induces microglial activation via odorant receptors. FEBS J 2020; 287:3841-3870. [PMID: 32003140 DOI: 10.1111/febs.15234] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/10/2019] [Accepted: 01/27/2020] [Indexed: 12/21/2022]
Abstract
Microglia (MG), the principal neuroimmune sentinels in the brain, continuously sense changes in their environment and respond to invading pathogens, toxins, and cellular debris, thereby affecting neuroinflammation. Microbial pathogens produce small metabolites that influence neuroinflammation, but the molecular mechanisms that determine whether pathogen-derived small metabolites affect microglial activation of neuroinflammation remain to be elucidated. We hypothesized that odorant receptors (ORs), the largest subfamily of G protein-coupled receptors, are involved in microglial activation by pathogen-derived small metabolites. We found that MG express high levels of two mouse ORs, Olfr110 and Olfr111, which recognize a pathogenic metabolite, 2-pentylfuran, secreted by Streptococcus pneumoniae. These interactions activate MG to engage in chemotaxis, cytokine production, phagocytosis, and reactive oxygen species generation. These effects were mediated through the Gαs -cyclic adenosine monophosphate-protein kinase A-extracellular signal-regulated kinase and Gβγ -phospholipase C-Ca2+ pathways. Taken together, our results reveal a novel interplay between the pathogen-derived metabolite and ORs, which has major implications for our understanding of microglial activation by pathogen recognition. DATABASE: Model data are available in the PMDB database under the accession number PM0082389.
Collapse
|
70
|
Ahn S, Lee D, Jeong H, Moon D, Park H, Park N. 024 Advanced Glycation End-products Measuring with Skin Auto Fluorescence: Correlation with Diabetic Erectile Dysfunction and Non-diabetic Erectile Dysfunction. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2019.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
71
|
Jo E, Ahn S, Min SK, Mo H, Jae HJ, Hur S. Initial Experience and Potential Advantages of AFX2 Bifurcated Endograft System: Comparative Case Series. Vasc Specialist Int 2019; 35:209-216. [PMID: 31915665 PMCID: PMC6941765 DOI: 10.5758/vsi.2019.35.4.209] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/12/2019] [Accepted: 09/16/2019] [Indexed: 12/29/2022] Open
Abstract
Purpose Materials and Methods Results Conclusion
Collapse
|
72
|
Choi C, Ahn S, Min SI, Ahn M, Ha J, Yoon HJ, So R, Choi SH, Min SK. Nationwide Epidemiologic Study of Abdominal Aortic Aneurysms in Korea: A Cross-Sectional Study Using National Health Insurance Review and Assessment Service Data. Vasc Specialist Int 2019; 35:193-201. [PMID: 31915663 PMCID: PMC6941766 DOI: 10.5758/vsi.2019.35.4.193] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/03/2019] [Accepted: 12/06/2019] [Indexed: 11/20/2022] Open
Abstract
Purpose The prevalence and treatment patterns of abdominal aortic aneurysm (AAA) vary according to ethnicity and region. This study analyzed nationwide data on the epidemiology, practice patterns, and mortality rates of AAA in Korea. Materials and Methods Data from patients treated for AAA from 2012 to 2016 were extracted from the Korean Health Insurance Review and Assessment (HIRA) database. Results A total of 30,766 patients in Korea had treatment codes for AAA and 2,618 patients were treated for ruptured AAA. Of the 6,356 patients treated surgically, 1,849 and 4,507 underwent open surgical aneurysmal repairs (OSAR) or endovascular aneurysmal repairs (EVAR), respectively. The number of surgical treatments performed annually for AAA increased from 1,129 cases in 2012 to 1,501 cases in 2016. The number of EVAR cases increased from 753 to 1,109 during these five years, while the number of OSAR cases remained similar, at 376 and 392, respectively. The 30-day mortality rates after EVAR and OSAR were 4.2% and 10.6%, respectively. The mortality rates were significantly higher in patients with hypertension, dyslipidemia, chronic renal disease, diabetes mellitus, and congestive heart failure. There were significant differences in the prevalence, proportion of EVAR, and mortality rates according to the regional area. Conclusion The prevalence of AAA and the proportion of EVAR in Korea increased in the past 5 years, while the rupture rate and the proportion of OSAR remained similar. To minimize mortality and regional discrepancies, nationwide registry and treatment standardization are needed.
Collapse
|
73
|
Park WK, Park KL, Cho YS, Han A, Ahn S, Min SK. Intravascular Epithelioid Angiosarcoma in the Abdominal Aorta Mimicking an Infected Aneurysm. Vasc Specialist Int 2019; 35:232-236. [PMID: 31915668 PMCID: PMC6941772 DOI: 10.5758/vsi.2019.35.4.232] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/19/2019] [Accepted: 11/25/2019] [Indexed: 12/31/2022] Open
Abstract
Primary aortic angiosarcoma is very rare, and preoperative diagnosis is challenging with resultant poor prognosis. Angiosarcoma may mimic an infected aneurysm or a mural thrombus. Clinical suspicion of angiosarcoma is vital for an early diagnosis and proper surgical treatment, especially in cases with atypical rapid growth of an aortic abdominal aneurysm with a thrombotic mass. Herein, we report a case of angiosarcoma in the abdominal aorta mimicking an infected aneurysm and present computed tomography and positron emission tomography findings.
Collapse
|
74
|
Kang JM, Park KH, Ahn S, Cho S, Han A, Lee T, Jung IM, Kim JY, Min SK. Rivaroxaban after Thrombolysis in Acute Iliofemoral Venous Thrombosis: A Randomized, Open-labeled, Multicenter Trial. Sci Rep 2019; 9:20356. [PMID: 31889152 PMCID: PMC6937283 DOI: 10.1038/s41598-019-56887-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 11/10/2019] [Indexed: 01/13/2023] Open
Abstract
Recently non-Vitamin K antagonist oral anticoagulants (NOAC) is replacing warfarin for the treatment of deep vein thrombosis (DVT). However, the role of NOAC after thrombolysis of acute iliofeomral DVT (IFDVT) is not yet defined. This randomized clinical trial aimed to compare the safety and efficacy of rivaroxaban versus warfarin after catheter directed thrombolysis of an IFDVT. Patients with acute DVT of both the iliac and the femoral vein (n = 72) were recruited and randomized to either standard anticoagulation (enoxaparin and warfarin, n = 35) or rivaroxaban (n = 37) after successful thrombolysis or mechanical thrombectomy. Primary efficacy outcome was a recurrence of any venous thromboembolism (VTE) within 6 months. Secondary safety outcomes included major bleeding, clinically relevant non-major bleeding (CRNMB), other adverse event, and all-cause mortality. Rate of recurrent VTE were similar in both groups (11.4% versus 12.5%; p = 0.94). Major bleeding or CRNMB was less in rivaroxaban group without significance (2.9% versus 9.4%, HR, 0.31; 95% CI, 0.03–2.96; p = 0.31). Recurrence-free survival and major bleeding-free survival at 6 months were not different in both groups. After thrombolysis of acute IFDVT, rivaroxaban was as safe and effective as warfarin in preventing DVT recurrence.
Collapse
|
75
|
Ko A, Park HJ, Lee ES, Park SB, Kim YK, Choi SY, Ahn S. Comparison of the diagnostic performance of the 2017 and 2018 versions of LI-RADS for hepatocellular carcinoma on gadoxetic acid enhanced MRI. Clin Radiol 2019; 75:319.e1-319.e9. [PMID: 31858990 DOI: 10.1016/j.crad.2019.11.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 11/13/2019] [Indexed: 12/18/2022]
Abstract
AIM To compare the diagnostic performance of the 2017 (v2017) and 2018 versions (v2018) of the Liver Imaging-Reporting and Data System (LI-RADS) for hepatocellular carcinoma (HCC) using gadoxetic acid-enhanced magnetic resonance imaging (Gd-EOB-MRI) and to evaluate the effect in v2018. MATERIALS AND METHODS Treatment-naive patients at high-risk for HCC who underwent Gd-EOB-MRI were included. The LI-RADS categories were assigned according to v2017 and v2018. The diagnostic performances were compared between v2017 and v2018 according to the size and combination of imaging features. RESULTS A total of 117 patients with 137 observations were identified, including 89 HCCs; 76.2% (64/84) of observations with threshold growth were re-classified as subthreshold growth when using v2018 instead of v2017. The final categories changed in nine (14%) cases. For the combination of LR-5/LR-5V, there were no significant differences in sensitivity and specificity between the two versions (sensitivity, 64% versus 58.4%; specificity, 87.5% versus 85.4%; all p>0.05). For the combination of LR-4 and LR-5/5V, the diagnostic performance of v2018 was inferior to that of v2017 when considering only major features (accuracy, 86.1% versus 80.3%, respectively; p=0.013), particularly in observations measuring 10-20 mm, but was comparable after adding the ancillary features (accuracy, 86.9% versus 86.1%, respectively; p=1.00). CONCLUSION In LI-RADS v2018, although a considerable number of observations re-classified subthreshold growth, changes in the assigned categories were insignificant; overall diagnostic performance was comparable to that of v2017, but v2018 might emphasise the value of ancillary features in combination with major features for determining the probability of HCC.
Collapse
|