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Objective To investigate the feasibility,safety and efficacy of endovascular recanalization of the symptomatic occlusion of large intracranial artery in anterior circulation.Methods From October 2015 to December 2017,13 patients with symptomatic non-acute occlusion of large intracranial artery in anterior circulation were enrolled into this study and underwent endovascular recanalization.The initial procedural results,including the rate of successful recanalization and perioprocedural complications,and angiographic and clinical follow-up results were collected.The functional outcome was evaluated at discharge and 90 days.Results Recanalization was successful in 11 out of 13 patients.Perioperative complications occurred in 8 cases,including distal embolization in 7 cases (3 with symptom and 4 without),in which intracerebral hemorrhage associated with embolectomy was found in 1 case;and distal embolization concomitant with artery dissection in 1 case.At discharge,the symptoms of 10 out of 11 patients with successful recanalization were improved and 1 was unchanged;one of 2 patients with recanalization failure was aggravated and 1 was unchanged.After the procedure,1 patient with successful recanalization,but complicated with intracerebral hemorrhage associated with embolectomy was lost at follow-up,thus angiographic follow-up was available in the remaining 10 patients.Of the 10 patients,1 patient developed in-stent restenosis at 12 months and 9 patients had no hemodynamic stenosis/reocclusion.The clinical follow-up was available in 12 patients.No recurrence of TIA or stroke was found in 9 cases with successful recanalization except for 1 case who developed in-stent stenosis and suffered from TIA.At the follow-up of 90 days,l0 patients with successful recanalization showed good function (mRS∶0-2),2 patients with recanalization failure were deteriorated.Conclusions In strictly selected patients with symptomatic non-acute occlusion of large intracranial artery in anterior circulation,endovascular recanalization was feasible and safe,which may improve patients' symptoms in a short term and reduce the recurrence rate of stroke,but its definite efficacy needs to be confirmed by studies with larger sample and longer follow-up.
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Objective To evaluate the primary application of drug eluting stent for treatment of vertebral stenosis. Methods One vertebral original stenosis was treated by CYPHER TM stent and the relative papers were reviewed. Results A male of 53 years old with paroxysmal vertigo and left hemiplegy revealed nothing abnormal by magnetic resonance imaging (Diffusion Weighted Imaging). But the DSC found his right vertebral origin 4.6 mm long stenosis (more than 90%), the remote artery was 2.6 mm in diameter, and angiography in the right vertebral origin showed right post inferior cerebellar artery (PICA) insufficiently filled and no development of basilar artery. When angiography in the left vertebral, there was no fill in the right PICA. The restenosis rate after vertebral origin stent posting was as high as 43.3%, but drug eluting stent can prevent restenosis. After preparation, a 2.75 mm?13 mm balloon-expandable Cypher stent was posted in on 2004-06-07. Angiography showed the stenosis disappeared, right PICA sufficiently filled, and basilar artery appeared. Antiplatelet agents were used afterwards. There was no attack of vertigo and hemiplegy in the followed-up month. Conclusions The success of using drug eluting stent in verebral artery offers a new choice on preventing ischemia stroke, the long time followed-up is necessary.
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Objective To evaluate the effciency of different embolic agents inducing the changes of the liver morphology and function in the selective portal vein embolization (PVE).Methods Forty five Spraque-Dawley rats were used in this experiment.Five were served as a control group and forty were randomly divided into 4 groups of 10 rats each.Right PVE was performed in each group by one of four different embolic agents respectively.Five rats from each group were sacrificed and dissected to inspect the morphological changes on 14th and 21st day after the procedure.The results of different groups were analyzed according to the weight ratios of the right lobe to the whole liver and the whole liver to the body,and the results were compared to each other and those of the control group using statistical Student“ t ”test. Results After the procedure,the embolized lobe was turned gray immediately with no significant differences between groups.Both on the 14th and 21st day after the procedure,the right lobe of the liver from the rats of group 1,2,3 were atrophied apparently with lots of spotty yellow scars in different sizes.There was no significant change of the embolized right lobe from group 4.By statistical analysis,the embolization using Lipiodol-ethanol 2∶1 mixture in group 2 resulted in better atrophy than group 1 ( P 0.05) and more than the gelfoam pieces ( P