ABSTRACT
Objective To assess the safety and diagnostic accuracy of manual carbon dioxide (C02) digital angiography in performing endovascular therapy (EVT) for arteriosclerosis obliterans (ASO) of lower extremity in patients who have renal insufficiency or iodine allergy. Methods The clinical data of 19 patients with lower extremity ASO complicated by renal insufficiency or iodine allergy, who were admitted to authors' hospital to receive EVT of lower extremity with intraoperative C02 angiography during the period from January 2013 to March 2015, were retrospectively analyzed. Using manual bolus injection of C02, or with additional use of minimum dose of iodinated contrast media, CO2 angiography was performed so as to guide EVT procedure. The safety and diagnostic accuracy of manual C02 angiography were evaluated. Results A total of 21 endovascular treatments were performed in 19 patients with lower extremity ASO, and a total of 28 arterial segment lesions were treated. The technical success rate was 100％. Ankle-brachial index (ABI) was improved from preoperative 0. 56±0. 08 to postoperative 0. 74±0. 07, the difference was statistically significant (t= -20. 605, P＜0. 00l). The mean serum creatinine (sCr) levels tested at 48 h and one week after the treatment were (159. 91±33. 21) μmol/L and (143. 44±43. 59) μmol/L respectively, which were not significantly different from preoperative (139. 5±37. 6) μmol/L (t=-1. 098, P=0. 285), and none of these results met the standard of contrast nephropathy. Among the 21 times of EVT procedure, additional use of iodinated contrast media was employed in 13 procedures, the average used amount of iodine contrast agent was (12±5. 5) mL. After the treatment, sCr level was elevated, the estimated glomerular filtration rates (eGFR) were lower than 50 mL· min-1 · 1. 73 m-2, which restored to preoperative level in one week. CO2 angiography showed that the image quality of all arteries above the knee joint met the requirements of treatment, except for one patient whose images could not accurately display the length and extent of the stenosis due to restenosis of the superficial femoral artery. The image quality of the arteries below the knee level was usual. Conclusion In performing EVT procedure to treat lower extremity ASO the use of C02 angiography is safe. The image quality of all arteries above the knee joint is satisfactory, it can significantly reduce, or even avoid, the use of iodine contrast agents. Therefore, this technique is especially suitable for patients who have renal insufficiency or iodine allergy. (J Intervent Radiol, 2018, 27:211-214)
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Objective To explore the therapeutic effect of arterial PVA perfusion embolization in treating mid and advanced pulmonary carcinoma. Methods Thirty-one patients with pulmonary carcinoma in the mid or late stage diagnosed pathologically underwent selective angiographic studies of the bronchial arteries and intercostal arteries to provide information of the hypervascular feeding vessels, and then performed the perfusion with 5-FU? THP? DDP; followed by PVA grain embolization under fluoroscopic control. Results Abnormal tumor feeding vessels of pulmonary carcinoma were found deriving from bromehial arteries in 21 cases, and from intercostal arteries in 10. After arterial infusion of chemotherapy combined with embolization of PVA,alleviation of clinical symptoms was observed in all 31 cases(100%)without severe complication. The total effectiveness(CR plus PR) reached 80.6%(25/31). Conclusions Arterial embolization of PVA is safe, effective with less complication for treatment of mid or advanced pulmonary carcinoma.
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OBJECTIVE:To promote rational use of traditional Chinese medicines. METHODS:The practical importance of applying basic pharmacoeconomic theory to the rational use of traditional Chinese medicines was analyzed and the measures regarding how to apply the pharmacoeconomic theory to guide rational use of traditional Chinese medicines were put forward. RESULT & CONCLUSION: It is quite necessary and practical to apply the basic pharmacoeconomic theory to the rational use of traditional Chinese medicine, which plays a positive role in promoting rational use of traditional Chinese medicines.