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<channel><title><![CDATA[Vascular surgeon Po-Jen Ko MD &#34880;&#31649;&#22806;&#31185; &#26607;&#21338;&#20161;&#37291;&#24107; - Blog]]></title><link><![CDATA[https://www.pojenko.com/blog]]></link><description><![CDATA[Blog]]></description><pubDate>Tue, 14 Apr 2026 22:32:46 +0800</pubDate><generator>Weebly</generator><item><title><![CDATA[Varicose vein treatment in Taiwan]]></title><link><![CDATA[https://www.pojenko.com/blog/the-best-vein-treatment-in-taiwan]]></link><comments><![CDATA[https://www.pojenko.com/blog/the-best-vein-treatment-in-taiwan#comments]]></comments><pubDate>Fri, 28 Feb 2025 07:17:24 GMT</pubDate><category><![CDATA[Vein]]></category><guid isPermaLink="false">https://www.pojenko.com/blog/the-best-vein-treatment-in-taiwan</guid><description><![CDATA[Varicose vein treatment in TaiwanDo you have the problem of varicose vein? Are you seeking for the best treatment in Asia? Come to Taiwan you get what you want.PW Clinic - Taiwan's Premier Varicose Vein Treatment CenterWorld-Class Varicose Vein Treatment in TaiwanPW Clinic is a leading specialist in **minimally invasive varicose vein treatments** in Taiwan, providing cutting-edge therapies that ensure **fast recovery, minimal discomfort, and superior results**. We specialize in:Venous Glue (Vena [...] ]]></description><content:encoded><![CDATA[<h2 class="wsite-content-title" style="text-align:left;">Varicose vein treatment in Taiwan</h2><div class="paragraph" style="text-align:left;">Do you have the problem of varicose vein? Are you seeking for the best treatment in Asia? Come to Taiwan you get what you want.</div><div><!--BLOG_SUMMARY_END--></div><div><div id="496400123270927565" align="left" style="width: 100%; overflow-y: hidden;" class="wcustomhtml"><meta charset="UTF-8"><meta name="viewport" content="width=device-width, initial-scale=1.0"><meta name="description" content="PW Clinic is Taiwan&rsquo;s premier center for advanced varicose vein treatment, offering venous glue (VenaSeal) and laser ablation (EVLT) with world-class care."><meta name="keywords" content="Varicose Vein Treatment, PW Clinic, Taiwan, VenaSeal, EVLT, Vein Specialist, Minimally Invasive"><meta name="author" content="PW Clinic"><header>PW Clinic - Taiwan's Premier Varicose Vein Treatment Center</header><div class="container"><h1>World-Class Varicose Vein Treatment in Taiwan</h1><p><strong>PW Clinic</strong> is a leading specialist in **minimally invasive varicose vein treatments** in Taiwan, providing cutting-edge therapies that ensure **fast recovery, minimal discomfort, and superior results**. We specialize in:</p><ul><li><strong>Venous Glue (VenaSeal&trade;)</strong> &ndash; Revolutionary non-surgical treatment requiring no compression stockings.</li><li><strong>Endovenous Laser Ablation (EVLT)</strong> &ndash; Minimally invasive laser therapy for effective vein closure.</li></ul><h2>Why Choose PW Clinic?</h2><ul><li>&#10004; <strong>Highly Experienced Team</strong> &ndash; Thousands of successful procedures.</li><li>&#10004; <strong>Painless, Outpatient Treatment</strong> &ndash; No hospital stay required.</li><li>&#10004; <strong>Premium, Patient-Centered Care</strong> &ndash; Modern facilities with private consultation rooms.</li></ul><h2>Our Advanced Treatments</h2><h3>&#10004; Venous Glue (VenaSeal&trade; Closure System)</h3><p>This FDA-approved treatment uses medical adhesive to seal varicose veins **without the need for compression stockings**. Learn more about this breakthrough:</p><a class="cta" href="https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/venous/venaseal.html" target="_blank">Discover VenaSeal&trade; Technology</a><h3>&#10004; Endovenous Laser Ablation (EVLT)</h3><p>A minimally invasive procedure using laser energy to close diseased veins. Read clinical research on EVLT:</p><a class="cta" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2818490/" target="_blank">Read Scientific Studies on EVLT</a><h2>Schedule a Consultation</h2><p>We welcome **international patients** seeking **expert varicose vein treatment** in Taiwan. Our English-speaking medical team ensures a smooth, hassle-free experience from **consultation to recovery**.</p><a class="cta" href="https://www.pwclinic.tw/contact" target="_blank">Contact PW Clinic for an Appointment</a></div><footer>&copy; 2025 PW Clinic | <a href="https://www.pwclinic.tw" style="color: white; text-decoration: underline;">www.pwclinic.tw</a></footer></div></div>]]></content:encoded></item><item><title><![CDATA[February 25th, 2024]]></title><link><![CDATA[https://www.pojenko.com/blog/february-25th-2024]]></link><comments><![CDATA[https://www.pojenko.com/blog/february-25th-2024#comments]]></comments><pubDate>Sun, 25 Feb 2024 13:38:51 GMT</pubDate><category><![CDATA[Vein]]></category><guid isPermaLink="false">https://www.pojenko.com/blog/february-25th-2024</guid><description><![CDATA[Understanding and Managing Leg Pain: A Focus on Varicose VeinsLeg pain is a common ailment that affects many peopleUnderstanding and Managing Leg Pain: A Focus on Varicose VeinsLeg pain is a common ailment that affects many people at different stages of their lives. It can arise from a variety of causes, including injuries, nerve issues, vascular problems, and certain medical conditions. To effectively address leg pain, it's crucial to obtain a proper diagnosis. Treatment options can vary widely [...] ]]></description><content:encoded><![CDATA[<h2 class="wsite-content-title" style="text-align:left;">Understanding and Managing Leg Pain: A Focus on Varicose Veins</h2><div class="paragraph" style="text-align:left;"><br><br>Leg pain is a common ailment that affects many people</div><div><!--BLOG_SUMMARY_END--></div><div><div id="381769843545677753" align="left" style="width: 100%; overflow-y: hidden;" class="wcustomhtml"><meta charset="UTF-8"><meta name="viewport" content="width=device-width, initial-scale=1.0"><div class="container"><h1>Understanding and Managing Leg Pain: A Focus on Varicose Veins</h1><p>Leg pain is a common ailment that affects many people at different stages of their lives. It can arise from a variety of causes, including injuries, nerve issues, vascular problems, and certain medical conditions. To effectively address leg pain, it's crucial to obtain a proper diagnosis. Treatment options can vary widely, from simple measures like rest and therapy to more involved approaches such as medication or surgery. In this article, we will specifically focus on one of the vascular causes of leg pain&mdash;varicose veins&mdash;and how they can be managed for better health and comfort.</p><h2>What Causes Leg Pain?</h2><p>Leg pain can stem from several factors. Injuries such as sprains, fractures, and muscle strains are among the most apparent causes. However, pain can also result from nerve damage or compression, leading to conditions like sciatica, where the pain radiates down the leg from the lower back. Vascular issues, where blood flow through the veins and arteries is compromised, can also lead to discomfort and pain in the legs. Medical conditions, including arthritis and diabetes, can further exacerbate or cause leg pain.</p><h2>Varicose Veins: A Common Culprit</h2><p>Varicose veins are one of the vascular issues that can cause leg pain. These veins are enlarged, twisted veins that usually occur in the legs. While they are primarily a cosmetic concern for many, varicose veins can cause discomfort and lead to more serious health problems. They result from faulty valves within the veins that fail to properly regulate blood flow, causing blood to pool and veins to enlarge.</p><h2>Symptoms and Signs of Varicose Veins</h2><p>Recognizing the symptoms and signs of varicose veins is the first step towards management. Common symptoms include:</p><ul><li>Visible, bulging veins that are blue or dark purple</li><li>Aching, heavy legs, especially after standing or sitting for long periods</li><li>Swelling, throbbing, and muscle cramping in the lower legs</li><li>Itching around one or more of your veins</li><li>Skin discoloration near the varicose veins, indicating more severe vascular issues</li></ul><h2>Managing Varicose Veins</h2><p>The management of varicose veins includes a variety of strategies aimed at alleviating symptoms and preventing further complications. Treatment options vary depending on the severity of the condition and may include:</p><ul><li><strong>Lifestyle Changes:</strong> Regular exercise, maintaining a healthy weight, and avoiding prolonged standing or sitting can help reduce the pressure on your veins and alleviate symptoms.</li><li><strong>Compression Stockings:</strong> Wearing specially designed stockings can help by applying gentle pressure to your legs, promoting blood flow towards your heart.</li><li><strong>Medication:</strong> In some cases, medication to reduce inflammation and treat associated symptoms might be prescribed. Surgical and Minimally Invasive Treatments: For more severe cases, procedures such as sclerotherapy, laser or glue therapy, or vein stripping may be recommended to close off or remove varicose veins.<div class="conclusion"><h2>Conclusion</h2><p>Leg pain, particularly from varicose veins, can significantly impact your quality of life. Understanding the causes and symptoms of this condition is the first step towards effective management. With the right combination of lifestyle adjustments, medical treatment, and possibly surgery, it's possible to alleviate the pain and discomfort associated with varicose veins. If you suspect you have varicose veins or experience persistent leg pain, seeking medical advice is essential to prevent further complications and improve your overall health and well-being.</p></div></li></ul></div></div></div><div><div id="590130738359347607" align="left" style="width: 100%; overflow-y: hidden;" class="wcustomhtml"><meta charset="UTF-8"><meta name="viewport" content="width=device-width, initial-scale=1.0"><a href="https://www.pwclinic.tw" class="button">PW Clinic</a> </div></div><div><div class="wsite-image wsite-image-border-none" style="padding-top:10px;padding-bottom:10px;margin-left:0;margin-right:0;text-align:center"><a><img src="https://www.pojenko.com/uploads/2/8/5/6/28563661/p161.png" alt="Picture" style="width:auto;max-width:100%"></a><div style="display:block;font-size:90%"></div></div></div>]]></content:encoded></item><item><title><![CDATA[How to be a good access interventionist]]></title><link><![CDATA[https://www.pojenko.com/blog/how-to-be-a-good-access-interventionist]]></link><comments><![CDATA[https://www.pojenko.com/blog/how-to-be-a-good-access-interventionist#comments]]></comments><pubDate>Sat, 28 Jun 2014 14:01:21 GMT</pubDate><category><![CDATA[Uncategorized]]></category><guid isPermaLink="false">https://www.pojenko.com/blog/how-to-be-a-good-access-interventionist</guid><description><![CDATA[A few words for interventional nephrologist colleagues(Any question , feel free to ask me )&nbsp;​email        body {            font-family: Arial, sans-serif;            line-height: 1.6;            margin: 0;            padding: 0;            background-color: #f4f4f4;        }        .container {            max-width: 800px;            margin: auto;            padding: 20px;            background: #fff;            box-shadow: 0 0 10px rgba(0, 0, 0, 0.1);        }        h1 {            col [...] ]]></description><content:encoded><![CDATA[<div class="paragraph" style="text-align:justify;"><br><em><strong>A few words for interventional nephrologist colleagues</strong></em><br>(Any question , feel free to ask me )&nbsp;<br>&#8203;<a href="mailto:pojenko@gmail.com">email</a></div><div><!--BLOG_SUMMARY_END--></div><div><div id="219099358724928918" align="left" style="width: 100%; overflow-y: hidden;" class="wcustomhtml"><meta charset="UTF-8"><meta name="viewport" content="width=device-width, initial-scale=1.0"><meta name="description" content="Learn how to be a competent vascular access interventionist as an interventional nephrologist with expert advice and practical tips."><style>        body {            font-family: Arial, sans-serif;            line-height: 1.6;            margin: 0;            padding: 0;            background-color: #f4f4f4;        }        .container {            max-width: 800px;            margin: auto;            padding: 20px;            background: #fff;            box-shadow: 0 0 10px rgba(0, 0, 0, 0.1);        }        h1 {            color: #333;            text-align: center;        }        h2, h3 {            color: #555;        }        p {            margin: 1em 0;        }        ul {            list-style-type: disc;            margin-left: 20px;        }</style><div class="container"><h1>Be a Competent Vascular Access Interventionist</h1><h2>A Few Words for Interventional Nephrologist Colleagues</h2><p>Interventional nephrology is a relatively new subspecialty that has emerged in recent years. Among the procedures commonly practiced by interventional nephrologists, hemodialysis access management comprises a significant portion. A good vascular access is essential for successful renal replacement treatment and quality dialysis care.</p><p>With the advancement of interventional techniques and development of related medical devices, the treatment for dysfunctional dialysis access has evolved from traditional open surgery to minimally invasive vascular interventions. As an interventional nephrologist, you should be adept at handling vascular access issues in a less invasive way. Here is some advice from a senior access surgeon.</p><h2>Be Passionate</h2><p>The goal of performing interventions on dialysis access is to correct the failing access and make it functional again with minimal intervention cost. One must always consider the quality of life of patients. Performing interventions ourselves instead of referring patients to others, such as vascular surgeons, is crucial. We believe in the benefits of minimally invasive vascular interventions and the ability of interventional nephrologists to perform these procedures effectively and affordably.</p><p>Remember that "minimal invasiveness" is the gold standard in all procedures. While it's impossible to access the human vascular system and fix lesions without creating any wounds or bleeding, our responsibility is to minimize invasiveness. Often, vascular interventions are preferable to traditional open surgery in terms of reducing complications and improving quality of life.</p><p>As an interventionist, be passionate about "minimally invasive" techniques. Trust in your training and design minimally invasive treatments for your patients' dialysis access problems.</p><h2>Learn Fundamental Skills</h2><p>Vascular intervention for dialysis access involves treating lesions using diagnostic angiography and interventional radiology. It may be performed in a fixed angiography room or an operating room with a mobile C-arm unit. Although interventional radiology training is not typically part of nephrology training, there are essential skills and knowledge areas to master before performing clinical treatments.</p><ul><li>Radiation safety</li><li>Sterile technique</li><li>Contrast agents</li><li>Interventional tools (wires, catheters, balloons, stents, etc.)</li></ul><p>Additionally, understanding access creation/revision and access monitoring/surveillance is crucial. Familiarity with clinical guidelines on dialysis access interventions is also important.</p><h2>Keep Up-to-Date</h2><p>Medical knowledge for dialysis patients has grown exponentially in recent decades. Interventional techniques have also rapidly evolved. With new interventional equipment introduced annually, keeping up-to-date with the latest advancements is vital.</p><p>Stay informed through peer-reviewed journals, annual scientific meetings, and international symposiums on endovascular therapies. These are valuable sources for the latest knowledge and techniques in dialysis intervention.</p><h2>Practice, Practice, Practice</h2><p>Hemodialysis access management is a routine part of an interventional nephrologist's clinical work. Continuous practice is essential for becoming a competent vascular access interventionist. In our institution, surgical fellows must assist or perform at least a thousand vascular access interventions during their two-year training to qualify as independent surgeons.</p><p>No procedure is perfect, but practice brings us closer to perfection. Through consistent practice, interventionists can improve workflow, reduce operation time, and minimize patient stress and radiation exposure. Experience from various clinical scenarios helps refine procedures toward minimal invasiveness and zero complications.</p><h2>Teamwork</h2><p>Patient care involves teamwork. While nephrologists adopt interventional techniques to enhance dialysis access care, it is impossible to provide complete care alone. Permanent access creation remains a surgical task, and surgical backup is necessary to ensure patient safety.</p><p>Maintain good relationships and communication with surgical colleagues. Establishing a vascular access intervention team with several interventionists, knowledgeable nurses, and radiology technicians is essential for providing timely and quality care. The team should have its angiography facility and offer urgent services at least six days a week for acute access dysfunction cases.</p><p>Spread the concept and techniques of vascular access intervention within your unit to create a patient-friendly environment for dialysis patients. An institution without a robust teamwork mechanism cannot provide reliable care for patients with dialysis access problems.</p></div></div></div><div class="paragraph"><span>Any question , feel free to ask me&nbsp;</span><br><span>&#8203;</span><a href="mailto:pojenko@gmail.com">email</a></div><div><div class="wsite-image wsite-image-border-none" style="padding-top:10px;padding-bottom:10px;margin-left:0;margin-right:0;text-align:center"><a><img src="https://www.pojenko.com/uploads/2/8/5/6/28563661/dall-e-2024-06-10-23-19-00-an-illustration-depicting-an-interventional-nephrologist-performing-a-minimally-invasive-vascular-access-procedure-the-scene-should-show-a-modern-cl_orig.webp" alt="Picture" style="width:auto;max-width:100%"></a><div style="display:block;font-size:90%"></div></div></div>]]></content:encoded></item><item><title><![CDATA[Tips to make aortic treatment less invasive]]></title><link><![CDATA[https://www.pojenko.com/blog/tips-to-make-aortic-treatment-less-invasive]]></link><comments><![CDATA[https://www.pojenko.com/blog/tips-to-make-aortic-treatment-less-invasive#comments]]></comments><pubDate>Sun, 08 Jun 2014 16:54:31 GMT</pubDate><category><![CDATA[stentgraft]]></category><guid isPermaLink="false">https://www.pojenko.com/blog/tips-to-make-aortic-treatment-less-invasive</guid><description><![CDATA[5 tips to make aortic treatment less invasive:1. Percutaneous approach for every case!2. Minimal invasive anesthesia...no intubation!3. Choose the right stentgraft!4. Less is more5. Team workOur team had kept up with the tips and make our most of our elective aortic treatments office procedures. [...] ]]></description><content:encoded><![CDATA[<div class="paragraph" style="text-align:left;">5 tips to make aortic treatment less invasive:<br />1. Percutaneous approach for every case!<br />2. Minimal invasive anesthesia...no intubation!<br />3. Choose the right stentgraft!<br />4. Less is more<br />5. Team work<br /><br />Our team had kept up with the tips and make our most of our elective aortic treatments office procedures.<br /><br /><br /></div>]]></content:encoded></item><item><title><![CDATA[5 tips to be a competent endovascular surgeon?]]></title><link><![CDATA[https://www.pojenko.com/blog/5-tips-to-be-a-competent-endovascular-surgeon]]></link><comments><![CDATA[https://www.pojenko.com/blog/5-tips-to-be-a-competent-endovascular-surgeon#comments]]></comments><pubDate>Sun, 18 May 2014 09:47:20 GMT</pubDate><category><![CDATA[Uncategorized]]></category><guid isPermaLink="false">https://www.pojenko.com/blog/5-tips-to-be-a-competent-endovascular-surgeon</guid><description><![CDATA[(eBeing a vascular surgeon nowadays, it is imperative to learn to be an endovascualr surgeon. after all, minimal invasiveness is a must for modern doctors performing any kind of treatment.How to become a competent endovascular surgeon/ interventinist?1. Believe in endovascular therapyPassion is the fundamental element of being a competent Endovascular surgeon. Passion is everything. You have to from the start believe that endovascular therapy is the right way to do. Most of us have been trained  [...] ]]></description><content:encoded><![CDATA[<div class="paragraph" style="text-align:left;">(eBeing a vascular surgeon nowadays, it is imperative to learn to be an endovascualr surgeon. after all, minimal invasiveness is a must for modern doctors performing any kind of treatment.<br />How to become a competent endovascular surgeon/ interventinist?<br /><br />1. Believe in endovascular therapy<br />Passion is the fundamental element of being a competent Endovascular surgeon. Passion is everything. You have to from the start believe that endovascular therapy is the right way to do. Most of us have been trained well in open/traditional techniques to solve the clinical problems. However, when you are facing vascular problems nowadays, please do not stick only to the traditional way of treatment. Think over and over again the advantages of endovascular treatment in contrast to traditional cut and shooters, you would then be confident in what you're doing.<br />2. Be open minded<br />Always be humble. Interventionists are not almighty. We cannot really cure diseases, we help. We are merely doing what we can to improve our patients' quality of life and make them happier. So, stay hungry and foolish. Be ready to listen to the ones who need our help.<br />Endovascular therapy is an art of interaction. Be sure to know the culprit lesion then decide the best/suitable intervention policy. It's not only about giving treatment, it's about communication with the heart of caring.<br />3. Update! update! update!<br />in this ever hanging world, the rationale, technique and devices evolve so fast that you may miss the catching-up-with easily. With the passion for Endovascular surgery, an Endovasculat surgeon should keep on updating his knowledge on the treatment not only because of his own curiosity but also for the calling deep in his mind. Make sure to read the latest informations, attend up-to-date symposiums and take part in every events (ex.<a href="http://www.pojenko.com/blog/vascular-intervention-attachment-program" target="_blank"> vascular attachment program in CGMH</a>) which may refresh and energize surgeons' concept and technique of patient care.<br />4. Find your mentor<br />Surgeons learn a lot from clinical practice. And during the practice, we want to minimize the complications as possible. Find a good clinical interventionist as your Endovascular mentor. Try to copy his procedures to treat your patients at your infant stage of clinical practice. Senior staffs' back up are always your patients' safety net. Learn the concept, attitude, technique, and knowledge from your role model in Endovasculat society. And thus the learning curve will be overcome within the shortest period of time.<br />5. Team work<br />Commending a modern endovascular therapy is like flying a jumbo jet. It takes a good teamwork two make sure that the procedure doesn't go wrong. Multidisciplinary professionals can guarantee to provide the best up-to-date technique in each steps during the whole procedure. Good preoperative study, and comprehensive preprocedure planning, Clea operation image acquisition, dedicate intervention technique, and available surgical bail-outs and back-ups are the keys to the success of modern endovascular procedures. The concept of team work can never be too important for anybody who wants to become a competent endovascular surgeon.</div>]]></content:encoded></item><item><title><![CDATA[Case study: Dialyaia graft outlet surgical revision]]></title><link><![CDATA[https://www.pojenko.com/blog/dialyaia-graft-outlet-surgical-revision]]></link><comments><![CDATA[https://www.pojenko.com/blog/dialyaia-graft-outlet-surgical-revision#comments]]></comments><pubDate>Mon, 05 May 2014 15:18:52 GMT</pubDate><category><![CDATA[case]]></category><category><![CDATA[dialysis]]></category><category><![CDATA[stenosis]]></category><guid isPermaLink="false">https://www.pojenko.com/blog/dialyaia-graft-outlet-surgical-revision</guid><description><![CDATA[Dialysis graft outelt stricture is one of the most frequent complication/situation that a dialysis surgeon faces in his dailiy practice. To cope with the stenotic lesion, the oldest way, probably the most reliable, is to do surgical revision.There are two ways of surgical revision of the graft outlet. Here shows the so called" patch angioplasty" method. If the stenotic lesion is a focal or short lesion, we can just longitudinally incise teh graft outlet, and apply a ePTFE patch (which is the sam [...] ]]></description><content:encoded><![CDATA[<div class="paragraph">Dialysis graft outelt stricture is one of the most frequent complication/situation that a dialysis surgeon faces in his dailiy practice. To cope with the stenotic lesion, the oldest way, probably the most reliable, is to do surgical revision.<br /><span style=""></span><br /><span style=""></span>There are two ways of surgical revision of the graft outlet. Here shows the so called" patch angioplasty" method. If the stenotic lesion is a focal or short lesion, we can just longitudinally incise teh graft outlet, and apply a ePTFE patch (which is the same material of the graft) to augment the outelt space. after the operation, the graft outlet should be widely open.<br /><span style=""></span><br /><span style=""></span>The operation usually takes around 1 hour to perform. ofcourse, reoperation sometimes will be troublesome. However, most of the stenotic lesion can be fixed by patch angioplasty. Only if the lesion is too long, then we will try to fix the lesion using a jump graft.<br /><span style=""></span><br /><span style=""></span><br /><br /><span style=""></span><br /><span style=""></span>Ofcourse nowadays most of the graft outelt stenotic lesion are first treated with angioplasty balloons/ stenting, which is less invasive. However, surgeon should always keep himself familiar with the open procedure. and once the PTA doesnt work, we still can provide a feasible choice of treatment instead of giving up the graft!<br /><span style=""></span><br /><span style=""></span></div>  <div><div class="wsite-image wsite-image-border-thin " style="padding-top:10px;padding-bottom:10px;margin-left:0;margin-right:0;text-align:center"> <a> <img src="https://www.pojenko.com/uploads/2/8/5/6/28563661/1042547_orig.jpg" alt="Picture" style="width:100%;max-width:400px" /> </a> <div style="display:block;font-size:90%"></div> </div></div>  <div><div class="wsite-image wsite-image-border-thin " style="padding-top:10px;padding-bottom:10px;margin-left:0;margin-right:0;text-align:center"> <a> <img src="https://www.pojenko.com/uploads/2/8/5/6/28563661/4835612_orig.jpg" alt="Picture" style="width:100%;max-width:400px" /> </a> <div style="display:block;font-size:90%"></div> </div></div>]]></content:encoded></item><item><title><![CDATA[Case study: Stentgrafting for dialysis graft outlet stenosis]]></title><link><![CDATA[https://www.pojenko.com/blog/case-study-stentgrafting-for-dialysis-graft-outlet-stenosis]]></link><comments><![CDATA[https://www.pojenko.com/blog/case-study-stentgrafting-for-dialysis-graft-outlet-stenosis#comments]]></comments><pubDate>Wed, 23 Apr 2014 15:44:37 GMT</pubDate><category><![CDATA[case]]></category><category><![CDATA[dialysis]]></category><category><![CDATA[stenosis]]></category><category><![CDATA[stentgraft]]></category><guid isPermaLink="false">https://www.pojenko.com/blog/case-study-stentgrafting-for-dialysis-graft-outlet-stenosis</guid><description><![CDATA[HistoryA patietn of ESRD on regular dialysis vie her left upper arm graft. graft outlet segmental stricture was noted and the stenosis was refratory to repeated PTA (percutaneous balloon angioplasty).Operative findingDuring the venography study, graft outelt segmental stricture was noted. Due to the elasticity of the stricture, definite treatment is needed.StrategyDefinite repair of the outlet stricture was needed. The options were:1. Surgical revision, which is more invasive and time consuming. [...] ]]></description><content:encoded><![CDATA[<div class="paragraph" style="text-align:left;"><strong><em>History</em></strong><br /><span style=""></span><br /><span style=""></span>A patietn of ESRD on regular dialysis vie her left upper arm graft. graft outlet segmental stricture was noted and the stenosis was refratory to repeated PTA (percutaneous balloon angioplasty).<br /><span style=""></span><br /><span style=""></span><em><strong>Operative finding<br /></strong></em><span style=""></span><br /><span style=""></span>During the venography study, graft outelt segmental stricture was noted. Due to the elasticity of the stricture, definite treatment is needed.<br /><span style=""></span><br /><span style=""></span><strong><em>Strategy<br /></em></strong><span style=""></span><br /><span style=""></span>Definite repair of the outlet stricture was needed. The options were:<br /><span style=""></span><br /><span style=""></span>1. Surgical revision, which is more invasive and time consuming. In addition, the lesion extended up to the high axillary vein make the revision more difficult. General anesthesia was needed to do the jump graft revision which will add on more anesthesia risk.<br /><span style=""></span><br /><span style=""></span>2. PTA with stent insertion. Covered-stent insertion over the stricture segment can prohibit immediate recoil and may prevent recurrent stricture in the long run. In addition, it's only a percutaneous procedure which is low risk to the patient. Thus we had proceed with covered-stent implantation to deal with the graft outlet recurrent stricture.<br /><span style=""></span><br /><span style=""></span></div>  <div><div class="wsite-image wsite-image-border-thin " style="padding-top:10px;padding-bottom:10px;margin-left:0;margin-right:0;text-align:center"> <a> <img src="https://www.pojenko.com/uploads/2/8/5/6/28563661/2562150_orig.jpg" alt="Picture" style="width:100%;max-width:400px" /> </a> <div style="display:block;font-size:90%"></div> </div></div>  <div><div class="wsite-image wsite-image-border-thin " style="padding-top:10px;padding-bottom:10px;margin-left:0;margin-right:0;text-align:center"> <a> <img src="https://www.pojenko.com/uploads/2/8/5/6/28563661/6248478_orig.jpg" alt="Picture" style="width:100%;max-width:400px" /> </a> <div style="display:block;font-size:90%"></div> </div></div>]]></content:encoded></item></channel></rss>