ABSTRACT
Objective To assess the clinical value of ultrasound-guided para-aneurysmal saline injection (PASI) in the treatment of iatrogenic femoral pseudoaneurysm, i.e. postcatheterization femoral artery pseudoaneurysm (FAP). Methods A total of 18 patients developed FAP after receiving interventional therapy through femoral artery puncturing, the diagnosis was confirmed by clinical and color ultrasonography examinations in all patients. Under real-time color Doppler ultrasound guidance and ECG monitoring, PASI was carried out. Local anesthesia was performed by injection of 5-10 ml of 1％ lidocaine, which was followed by percutaneous puncturing with a 21-gauge needle, that was connected to a plastic syringe filled with 0.9％ sodium chloride solution, into the site about 2-5mm away from the fistula between the pseudoaneurysm and the formal artery, then, the saline was continuously and slowly injected into this area until the abnormal blood flow signal within the fistula disappeared. Manual compression was applied on the local area for about 5 minutes. The dose of injected saline and the total time of the procedure were recorded. Clinical and color Doppler ultrasound reexaminations were conducted at 24 hours, one week and one month after the treatment, and the local pulsation, murmur, intra-pseudoaneurysmal blood flow and thrombosis were tested. Results Successful treatment with single procedure was achieved in 17 patients (17/18, 94.4％). In one patient continuous blood flow signal within the pseudoaneurysm was still observed at 24 hours after PASI, and successful closure of the pseudoaneurysm was obtained after the second time of PASI. The time of the procedure was 14-30 min, with a mean of (19.2±8.0) min. The injection volume of saline was 40-150 mL, with a mean of (67.2±29.3) mL. The treatment process could be well tolerated by all patients, only one patient developed transient bradycardia due to vagus reflex. Postoperative 30-day follow-up examination showed that no recurrent blood flow was detected within the pseudoaneurysm, no complications such as venous thrombosis, limb ischemia or local infection were observed, and the pseudoaneurysmal hematoma was completely absorbed. Conclusion For the treatment of postcatheterization FAP, ultrasound-guided PASI is technically-simple and clinically-safe with low medical cost, besides, this therapy can be well tolerated by patients. Therefore, PASI is worthy of clinical application.
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To explore the optimum laser power and energy in porcine thyroid ablation in vitro with 1 064 nm Nd:YAG laser of different power and energy guided by ultrasound after comparison of size and pathology of ablation lesions. The experimental results showed that Laser ablation effect of porcine thyroid in vitro is definite, the size of ablation lesions increases as the laser power and energy increases, when the laser power and energy are 3 W and 1 800 J, the ablation lesion effect reaches ideal level.
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Animals , Laser Therapy , Methods , Lasers, Solid-State , Swine , Thyroid Gland , Diagnostic Imaging , General Surgery , UltrasonographyABSTRACT
Objective To evaluate the color Doppler ultrasound in diagnosing venous diseases of lower extremity, and to compare it with DSA. Methods By using color Doppler ultrasound (CDUS)apparatus, two-dimensional spectrum, color Doppler flow image, pulse wave Doppler and Valsalva examination were performed in 48 patients with suspected venous diseases of lower extremity. The CDUS findings were compared with DSA findings. Results Of 48 cases with suspected lower extremity venous diseases, deep vein thrombosis formation was confirmed in 27, among them 15 were accompanied with lower extremity deep venous valvular incompetence, 8 were complicated by lower extremity varicosity and 2 were associated with both conditions. Another one had cyst in the left popliteal fossa and popliteal venous thrombosis. Decreased blood flow in iliac veins was found in some cases. Pure lower extremity venous valvular incompetence was seen in 5 cases and pure lower extremity superficial varicosity in 6 cases. Six cases suffered both valvular incompetence and superficial varicosity. CDUS showed normal findings in 4 cases, of them DSA demonstrated compressed iliac vein in 2. When taking DSA as golden standard, the accuracy of CDUS was 95.83%. By using the uniformity test, Kappa value was 0.65. Conclusion CDUS is of great clinical usefulness in diagnosing venous diseases of lower extremity as well as in evaluating the therapeutic effect.