ABSTRACT
BACKGROUND@#This study was designed to evaluate the clinical and radiographic outcomes of patients with nutcracker syndrome (NCS) who were treated with three-dimensional printing (3DP) extravascular titanium stents (EVTSs). The 3DP EVTS was expected to release the hypertension of the left renal vein (LRV) produced by its compression between the superior mesenteric artery (SMA) and the aorta without causing any complications.@*METHOD@#The pre-operative kidney model of each patient was printed out to enable surgical planning. After that, the EVTS was designed based on the LRV's primitive physiologic structure using computer-aided design software, and each stent was printed out with a precision setting of 20 μm. Seventeen patients who had been suffering from NCS underwent laparoscopic 3DP EVTS placement. The surgical procedure was designed for the placement of EVTS, taking great care in positioning and fixing the stent. Surgical data, which included patient demographic characteristics as well as pre- and post-operative test results, were collected and analyzed.@*RESULTS@#The mean duration of surgery was 75 ± 9 min, and the mean blood loss was 20 ± 5 mL. Computed tomography examinations revealed that the pre- and post-operative angle between the SMA and the aorta ranged from 18.7° ± 4.3° to 48.0° ± 8.8° (P < 0.05); in patients with left varicocele, the mean diameter of the left spermatic vein ranged from 3.7 ± 0.5 to 1.3 ± 0.2 mm (P < 0.05). Moreover, Doppler ultrasound examinations showed that the peak velocity of blood flow at the hilar area ranged from 12.4 ± 3.3 to 18.5 ± 3.4 cm/s (P < 0.05). No side effects were observed in the 24 to 42 months following surgery.@*CONCLUSION@#The findings after 2 years of follow-up suggest that the 3DP EVTS is a safe and effective minimally invasive alternative for the treatment of NCS.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Minimally Invasive Surgical Procedures , Methods , Printing, Three-Dimensional , Renal Nutcracker Syndrome , General Surgery , Retrospective Studies , Stents , Titanium , ChemistryABSTRACT
Background@#This study was designed to evaluate the clinical and radiographic outcomes of patients with nutcracker syndrome (NCS) who were treated with three-dimensional printing (3DP) extravascular titanium stents (EVTSs). The 3DP EVTS was expected to release the hypertension of the left renal vein (LRV) produced by its compression between the superior mesenteric artery (SMA) and the aorta without causing any complications.@*Method@#The pre-operative kidney model of each patient was printed out to enable surgical planning. After that, the EVTS was designed based on the LRV’s primitive physiologic structure using computer-aided design software, and each stent was printed out with a precision setting of 20 μm. Seventeen patients who had been suffering from NCS underwent laparoscopic 3DP EVTS placement. The surgical procedure was designed for the placement of EVTS, taking great care in positioning and fixing the stent. Surgical data, which included patient demographic characteristics as well as pre- and post-operative test results, were collected and analyzed.@*Results@#The mean duration of surgery was 75 ± 9 min, and the mean blood loss was 20 ± 5 mL. Computed tomography examinations revealed that the pre- and post-operative angle between the SMA and the aorta ranged from 18.7° ± 4.3° to 48.0° ± 8.8° (P < 0.05); in patients with left varicocele, the mean diameter of the left spermatic vein ranged from 3.7 ± 0.5 to 1.3 ± 0.2 mm (P < 0.05). Moreover, Doppler ultrasound examinations showed that the peak velocity of blood flow at the hilar area ranged from 12.4 ± 3.3 to 18.5 ± 3.4 cm/s (P < 0.05). No side effects were observed in the 24 to 42 months following surgery.@*Conclusion@#The findings after 2 years of follow-up suggest that the 3DP EVTS is a safe and effective minimally invasive alternative for the treatment of NCS.
ABSTRACT
Objective To explore the value of quantitative measurement of carotid intima-media thickness and elasticity for evaluating the degree of coronary heart disease by radio frequency ultrasonography. Methods From February 2011 to June 2012, a total of 142 subjects in cardiovascular internal medicine of the fourth military medical university Tangdu hospital with suspected CAD were enrolled in this study and were divided into non CAD group (n=35), atherosclerosis group in which coronary stenosis rate was less than 50%and no hemodynamic changes were detected (n=33), single artery involved group in which coronary stenosis rate was more than 50% (n=36) and multi-artery involved group in which coronary stenosis rate was more than 50%(n=38) based on the results of the coronary angiography (CAG). Measure the left common carotid artery intima-media thickness (IMT) and blood vessel elasticity index including the left common carotid artery pulse wave velocity (PWV) and stiffness index (β). Receiver operating characteristic (ROC) curves were used to calculate and compare the degrees of coronary heart disease, area under the curve of the left carotid artery elasticity parameters, cut-off value,sensitivity, speciifcity and Youden's index. Results LIMT, LPWV and Lβhad statistical signiifcance differences among four groups (F=3.621, 4.769 and 4.756, all P<0.05). The maximum values of parameter area under ROC curve were all observed in multi-artery involved groups and were 0.759 (LIMT), 0.770 (LPWV) and 0.764 (Lβ). The maximum value of Youden's index of the left common carotid artery intima-media thickness was observed in the coronary atherosclerosis group and was 0.513. The maximum value of Youden's index of the left common carotid artery pulse wave velocity and stiffnessβwere both observed in the multi-artery involved group and were 0.524 and 0.469. For diagnosing multivessel lesions, the sensitivities of LIMT, LPWV and Lβwere 71.0%, 77.4%and 71.0%, and the speciifcities were 73.4%, 74.7%and 75.9%. Conclusions The carotid elastic parameters have better predictive value for multivessel lesions. LPWV and Lβhave higher predictive value for coronary arterial disease than LIMT.
ABSTRACT
Objective To evaluate carotid intima-media thickness(IMT) and elasticity in patients with pregnancy-induced hypertension(PIH) using ultrasound radio-frequency data(RF-data) technology.Methods Twenty-seven PIH women(mean brachial blood pressure:108 mm Hg,1 mm Hg=0.133 kPa)were included and thirty age- and gestational week-matched normal pregnant women served as controls.Carotid IMT and stiffness were evaluated using quality IMT(QIMT) and quantitative artery stiffness(QAS)techniques with color Doppler.Results Carotid IMT and elasticity parameters,including pulse wave velocity,pressure at T1,arterial augmented pressure(AP) and arterial augmented pressure index(AIx) were significantly higher in PIH group than in the normal group[IMT:(466.84±118.50)μm vs (386.58±125.79)μm;PWV:(7.09±1.97)m/s vs (5.95±1.11) m/s;PT1:(127.50±14.29) mm Hg vs (105.89±11.02)mm Hg;AP:(5.14±3.39) mm Hg vs (1.98±2.19)mm Hg;AIx:(7.58±8.73)% vs (-4.79±7.92)%)], and there were significant differences(t=2.660,2.660,3.460,3.460,3.460,all P＜0.01).Conclusions PIH women have significantly increased carotid IMT and decreased elasticity compared with normal pregnant women.Radio-frequency technique could reliably reflect the changes of the carotid arterial structure and elasticity in patients with pregnancy-induced hypertension.