ABSTRACT
Objective To explore the endovascular therapeutic strategy for multiple occlusive lesions of aorta and iliac-femoral arteries, and to discuss the technical skill as well as the clinical significance. Methods A total of 8 patients with multiple occlusive lesions of aorta and iliac-femoral arteries were enrolled in this study. Preoperative CT angiography and MR angiography were performed in all the 8 patients. The lesions included complete occlusion of abdominal aorta below renal artery level (n = 2), distal abdominal aorta occlusion (n = 4), distal abdominal aorta stenosis (n = 1), distal abdominal aorta membranous occlusion (n = 1), and diseased iliac artery (n = 12), external iliac artery (n = 8), femoral artery (n = 1) and popliteal artery (n = 2). Endovascular interventional management, including opening channel, thrombolysis, balloon dilation, stent implantation, etc. was carried out via different routes. The results were analyzed. Results After endovascular interventional management the abdominal aorta was completely reopened in all the 8 patients. Of 12 diseased iliac arteries, 9 were successfully reopened by interventional treatment and the remaining 3 were not treated. All the diseased external iliac arteries were opened up. The involved femoral artery and popliteal arteries were not treated. The patients were followed up for 1 -12 months. During the follow-up period, ischemic symptoms of the lower limb disappeared in 5 patients and were obviously improved in 2 patients. Recurrence of thrombotic occlusion was observed in one case, which returned to normal after transcatheter thrombolysis therapy. Conclusion For the treatment of multiple occlusive lesions of aorta and iliac-femoral arteries, endovascular interventional management is safe, simple and effective with fewer complications. The ischemic symptoms of the lower limb can be significantly improved.
ABSTRACT
Objective To study the diagnostic value of 3T three-dimensional contrast-enhanced MR angiography (3D CE-MRA) of arteriosclerosis occlusive disease of lower extremities using a low dose of gadolinium.Methods 26 patients with arteriosclerosis occlusive disease of lower extremities were prospectively enrolled.DSA and 3D CE-MRA with a low dose of gadolinium were per-formed and directly compared by radiologists.Sensitivity,specificity,accuracy,positive and negative predictive values,Kappa val-ue of 3D CE-MRA were determined for significant stenoses and vessel occlusions (5 1%-100%).Results The diagnosis coincidence rate of 3D CE-MRA was 87.21%,over-and underestimation rates were 8.91% and 3.88%,respectively.Sensitivity,specificity, accuracy,positive and negative predictive values,Kappa value of 3D CE-MRA in the characterization of significant stenoses and oc-clusions were 91.67%,94.29%,93.22%,91.67%,94.29%,0.860,respectively,in aortoiliac arteries,and 90.63%,94.23%, 92.86%,90.63%,94.23%,0.849,respectively,in femoropopliteal arteries and 93.67%,75%,87.83%,89.1 6%,84.38%, 0.718,respectively,in infrapopliteal arteies.The overall sensitivity,specificity,accuracy,positive and negative predictive values, Kappa value in the lower extremity were 92.59%,88.62%,90.70%,89.93%,84.50% and 0.813.Conclusion 3T 3D CE-MRA with a low dose of gadolinium is an accurate method used to depict significant stenoses and occlusions comparable with that of DSA in lower extremity artery disease.
ABSTRACT
Objective To discuss the application of C-arm CT scanning technology in performing transcatheter arterial chemoembolization for hepatic cancer.Methods Seventy-seven patients of hepatic cancer were treated with selective transcatheter arterial chemoembolization(TACE),which was followed by C-arm CT scanning to observe the embolization effect.C-arm CT scanning was also performed before TACE in 13 cases.Three-dimension reconstruction of the images was carried out on Integris 3D-RA workstation.The therapeutic results were evaluated.Results The embolization state of both the peripheral margin and the body of the tumor could be clearly displayed on CT scans in all 77 patients.Some tiny liver lesions were also detected in 3cases.Conclusion C-arm CT scanning technology is a newly-developed high-tech examination.This examination is very helpful for making the proper operation scheme and for evaluating the curative effect of intravascular intervention.Compared to the traditional CT scanning,C-arm CT scanning can provide more accurate information and stereoscopic image of the lesions,therefore,the whole course of the interventional procedure can be entirely under the operator's control and the curative effect can be evaluated at any time during the operation.C-arm CT scanning can be effectively employed in interventional therapy for multisystemic disorders.