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The Chinese expert consensus on operation specification of cerebral angiography was evaluated carefully and suggestions were made based on our experience and novel technique.Two-dimensional,three-dimensional and four-dimensional digital subtraction angiography should all be considered as gold standards for diagnosis of cerebral vascular diseases.A " directional rotation" method can be employed to facilitate the catheterization during angiography.
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OBJECTIVE@#To discuss the endovascular interventional treatment of pseudoaneurysm of extracranial segment of internal carotid artery.@*METHOD@#The clinical data of 5 cases with traumatic pseudoaneurysm of extracranial segment of internal carotid artery were retrospectively studied.@*RESULT@#All the patients were cured via endovascular interventional treatment, and performed with implanting covered stent into the parent artery. The patients recovered well with patency of the parent artery.@*CONCLUSION@#Endovascular interventional treatment with covered stent implantation was safe and effective in treatment of pseudoaneurysm of extracranial segment of internal carotid artery.
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Adolescent , Adult , Child , Female , Humans , Male , Young Adult , Aneurysm, False , Therapeutics , Blood Vessel Prosthesis Implantation , Carotid Artery, Internal , Retrospective Studies , Stents , Treatment OutcomeABSTRACT
Objective To study the feasibility and clinical significance of internal tourniquet (temporary arterial lumen blood flow occlusion by balloon catheter) for controlling the hemorrhage from traumatic neck and adjacent trunk arteries by temporarily occluding the arterial lumen blood flow.Methods The study involved 35 patients with traumatic neck and near trunk arteries who were firstly managed by internal tourniquet during operation to temporarily occlude the proximal aorta blood flow from May 1987 to February 2009.Each blocking time ranged from 30 to 70 minutes and the blocking was performed at an interval of 15 to 20 minutes.Then,surgical therapy was taken.Results After temporary proximal aorta blood flow occlusion with internal tourniquet,the operation presented few bleeding,with a clean operating field and clear anatomic structures.The total intraoperative blood loss was 100-400 ml.All patients were healed without ischemia of brains and limbs or relapse during the 3-14 years of followup.Conclusion Internal tourniquet,which can effectively reduce intraoperative blood loss and improve operation safety by temporarily occluding the proximal aorta blood flow,is an auxiliary approach for treating hemorrhage from traumatic neck and adjacent trunk arteries.
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Objective To investigate the effect of cerebral ischemia on functional parameters of affected arteries and probe into the possible pathogenesis of ischemia-reperfusion injury.Methods Intraluminal suture ischemic model was used by occlusion of left middle cerebral artery in rats.Two hours later,the middle cerebral artery segments were isolated from both ischemia and control groups for measurement of changes in vessel diameter induced by increasing pressure and vasoactive compounds.And then,distensibility,myogenic tone,reactivity to 5-HT and ACh were calculated and compared between groups.Results In lower pressure range,ischemic vessels showed an increased myogenic tone(at 40 mm Hg,1 mm Hg=0.133 kPa,19.3%±0.4% vs 10.0%±0.2%,t=20.568,P=0.000)and decreased diameter.In higher pressure range,ischemic vessels showed an increased diameter.distensibility and decreased myogenic tone(at 120 mm Hg,12.0%±0.2% vs 21.8%±0.4%,t=-23.575,P=0.000).In normal pressure range,myogenic tone was not altered after ischemia. Both groups constricted to 5-HT and dilated to ACh,however,the response was significantly diminished after ischemla.Conclusion These findings demonstrate that contractile and diastolic function of affected artery was impaired after ischemia,a result that may contribute to ischemia-reperfusion injury by losing upstream cerebrovascular resistance and increasing perfusion on the microcirculation.
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Objective To investigate the value of lumbar puncture in the diagnosis of subarachnoid hemor-rhage of aneurysms .Methods The clinical data of 13 patients diagnosed negative by computer tomography(CT) scanning and then as subarachnoid hemorrhage (SAH) followed by lumbar puncture and as aneurysms by catheter digital subtraction angiography(DSA) were retrospectively analyzed.Results The positive rate was 100% by lum-bar puncture.Conclusion Lumbar puncture is of great significance in the diagnosis of subarachnoid hemorrhage of aneurysms, which should be applied reasonably.
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Objective To study the clinical value of CT function supplied by DSA system. Methods 278 patients were scanned by Innova CT ,which was concomitant with Innova 3100 DSA system, to check fresh blood .In the PTC operation, Innova CT was used to direct the site,degree,deepness of needle. Results Innova CT found intracranial hemorrhage in 4 cases . The fresh blood were checked by helical -CT,too. Innova CT comparing with B type ultrasonograph ,the orientation of needle were more convenient, exact, faster. Conclusion Innova CT could perform CT scan in interventional room to save time for emergence patients. It is a great improvement that gets CT images by DSA system. There is better consistency between Helix CT and Innova CT.
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<p><b>OBJECTIVE</b>To assess the feasibility superselective embolization using microcatheters in treatment of intravertebral canal vascular malformation.</p><p><b>METHODS</b>In 128 patients with intravertebral canals vascular malformation, their AVMS or fistulae were treated with silk thread, Ivalon microspheres or tungsten microcoils.</p><p><b>RESULTS</b>In the 128 patients, 120 fistulae disappeared completely, but 8 were embolized 60% - 80%. Symptoms were improved in 113 patients. Improved muscular strength from grade I to IV was obtained in 8 patients, from grade II to III in 32, from grade III to IV in 32, and from grade IV to V in 41. The symptoms did not change in 15 patients.</p><p><b>CONCLUSION</b>Superselective embolization through microcatheter is effective in the treatment of intraspinal canal vascular malformations.</p>
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Arteriovenous Malformations , Diagnosis , Therapeutics , Embolization, Therapeutic , Methods , Spinal CanalABSTRACT
<p><b>OBJECTIVE</b>To assess the diagnosis and treatment of venous hypertensive myelopathy (VHM) caused by narrowing of the ascending lumbar vein.</p><p><b>METHOD</b>The data from 3 patients with VHM caused by narrowing of the ascending lumbar vein were analyzed retrospectively.</p><p><b>RESULTS</b>Once the narrowed site of the lumbar ascending vein was determined by myelographic or angiographic technique, an undetachable balloon was introduced and advanced to the proximal part of the narrowed segment. Satisfactory results were obtained in these patients.</p><p><b>CONCLUSION</b>Narrowing of the ascending lumbar vein is one of the causes for VHM, and endovascular balloon angioplasty is an optimal treatment.</p>
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Aged , Humans , Male , Middle Aged , Hypertension , Lumbar Vertebrae , Retrospective Studies , Spinal Cord Vascular Diseases , Venous PressureABSTRACT
Objective To evaluate the therapeutic efficacy of the method of standard large trauma craniotomy in combination with therapeutic moderate hypothermia.Method Patients with acute severe head injuries (GCS≤8)were assigned into two groups:Group I,30 cases(average GCS≤ 5.38) received standard large trauma craniotomy and moderate hypothermia for 5-7 days;Group Ⅱ,30 cases(average GCS≤5.46)were treated with traditional treatment as control.Mortality,GCS,GOS and intracranial pressure (ICP) were compared between these two groups.Result Both the GCS and GOS were higher in the group Ⅰ than group Ⅱ;while the mortality and ICP were obviously lower in the group Ⅰ than that of the control group.Conclusions Early standard large trauma craniotomy plus adequate decompression followed by postoperative therapeutic moderate hypothermia would be helpful in reducing the mortality moderate and morbidity of patients with severe head injuries,their level of living accommodation were improved as well.
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Objective To explore the in vitro culture conditions for neural stem cells to differentiate into neuron-like cells.Methods Neural stem cells were induced to differentiate by a medium containing bFGF and heparin through adhesive culture.Immunohistochemistry was used to identify the expressions of NSE and GFAP after differentiation.Results Positive cells for NSE were 47.3%?1.7% on the 7th day after induction.The number of NSE positive cells in the induction group was 3 times as many as that in the control group(P
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Objective To explore a way that induce human bone marrow mesenchymal stem cells to differentiate into neuron-like cells in vitro.Methods Bone marrow mesenchymal stem cells were cultivated in a medium containing serum by using density gradient centrifugation method and whole marrow method and were induced to differentiation by ?mercaptoethanol.Immunohistochemistry were used to identify the type of cells.Results The number of cells was((1.73)?(0.44))?10~(7)/ml by using whole marrow method and ((7.65)?(0.52))?10~(7)/ml by using density gradient centrifugation method at the 10th day cultivation respectively.There was statistically significant difference(P
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Traumatic pseudoaneurysms (TPA) were surgically produced in the right common carotid artery of 24 rabbits. Three to four weeks later the survived rabbits 16 were randomly divided into 3 groups: (1)control group; (2)treatment group with TPAs embolized with microcoils(MC); (3)treatment group with occlusion of the by parent artery with MC. Three months after embolizaton, the TPAs were examined by digital subtraction angiography (DSA). The results showed that the TPAs embolized with MC were proved to be completely occluded, and the parent artery remained patent. Histopathological examination showed that TPAs were replaced by a mass of scar tissues. In the rabbits with occlusion of the parent artery embolization with MC, the TPA also disappeared. However, all the untreated rabbits died of rupture of TPAs. Statistic analysis showed that both methods of treatment were effective in the treatment of TPA.