Safety and efficacy of transcatheter arterial angiography and embolization for endoscopic refractory gastrointestinal bleeding / 中国介入影像与治疗学

Objective To evaluate the diagnostic and therapeutic value and safety of transcatheter arterial angiography and embolization in patients with endoscopic refractory gastrointestinal bleeding.Methods Thirty-one cases of endoscopic refractory gastrointestinal bleeding were performed DSA and treated with transcatheter arterial angiography and embolization.The safty and efficacy was evaluated.Results Angiographic positive rate of bleeding was 80.65％ (25/31);28 cases was treated with embolization.The success rate of first embolization was 75.00％ (21/28),and the total success rate was 82.14 ％ (23/28) by the second embolization.Seven patients received surgical resection after interventional therapy,including 2 cases of jejunal stromal tumors and 5 cases of gastric malignant tumors.Four cases of gastric cancer patients underwent rebleeding within 30 days after interventional therapy,of which 2 died of heart or lung function failure due to basic diseases.Except for 1 patient of anastomotic bleeding after gastrointestinal anastomosis occurred anastomotic fistula after embolization,who recovery with the support treatment,no other cases occurred serious gastrointestinal ischemic necrosis.Conclusion Interventional diagnosis and treatment for gastrointestinal bleeding hemostasis is effective and safety,and also can achieve good results especially for malignant gastric tumor hemorrhage,which can be used for endoscopic refractory gastrointestinal bleeding patients.

Interventional therapy of pseudoaneurysm in extremities or kidneys / 介入放射学杂志

Objective To evaluate the value of covered metallic stent and arterial embolization in the management of pseudoaneurysm of extremities or kidneys.Methods Endovascular covered stent graft was inserted for isolation of peripheral extremity pseudoaneurysm in 3 patients and intraarterial embolization was performed with gelfoam in 2 patients for pseudoaneurysm in kidney.Results All 5 pseudoaneurysms kept occluded after the treatment.Distal arterial pulse was normal in 2 patients treated with stent graft;new thrombosis formed within the stent during the procedure but disappeared after thrombolytic therapy through catheter in 1 case;and still another new pseudoaneurysm presented at puncture site in 1 other case due to other factors.Conclusions Pseudoaneurysms in extremities or kidneys can be effectively treated with interventional techniques of covered stent graft and percutaneous arterial embolization.The long-term investigation is needed.

Clinical application of covered self-expending stent for malignant esophageal and duodenal strictures or fistulas / 介入放射学杂志

Objective To evaluate the value of covered self-expending metallic stent in the management of malignant esophageal and duodenal strictures or fistulas and explore the treatment for the associated common complications.Methods With interventional procedure under fluoroscopic guidance,95 self-expending mesh stents were implanted in 87 patients,including esophageal carcinoma(50 cases),esophagogastric anastomotic stenosis(23 cases),gastroduodenal malignant stenosis(5 cases),esophagobronchial fistula(3 cases),esophagogastric anastomotic fistula(6 cases).Results Stent placement was successful in all patients at the first trial,having no instant complication except one acute bleeding during the procedure and all of them with relief of stenostic complaint,restoration of clictelic function and closure of fistulas.The long-term curative effect showed something to do with different kind of disease,and the related treatment.Conclusion Self-expending metallic covered mesh stent is safe,effective and less complication;and could be further promoted with addition of radiotherapy and(or)chemotherapy.