ABSTRACT
Objective To investigate the feasibility,efficacy and key points of individually designed endovascular embolization for ruptured tiny aneurysms of anterior communicating arteries. Methods The clinical,DSA imaging,interventional treatment and follow-up data of 21 patients with ruptured tiny aneurysms (21 aneurysms)of anterior communicating arteries from March 2009 to March 2014 were analyzed retrospectively. Thirteen of them were treated with coil embolization only,6 were embolized with microcatheter-assisted technique,and 2 were embolized with balloon-assisted technique. Results (1)One patient was failed to embolize because of technical reason. Immediate postoperative angiography found that in the other 20 patients:14 were packed densely,6 had residual aneurysm necks. (2)Intraoperative complications:One patient had acute occlusion of ipsilateral anterior cerebral artery,the blood vessel was patent after thrombolytic method;2 patients had intraoperative ruptured aneurysm. (3)The modified Rankin scale (mRS)scores of 20 patients with successful embolization at discharge:0-1 in 14 cases,2 in 4 cases, and 3-4 in 2 cases. (4)Follow-up study:20 patients were followed up for 12 months after discharge. The mRS scores:0-1 in 18 cases,2 in 1 case,and 3-4 in 1 case. Clinical follow-up for 6 to 60 months,no aneurysm ruptured. Fifteen patients were followed up for 6 to 60 months with DSA,one of them recurred,and he was treated with supplementary dense packing. Conclusion Endovascular embolization for ruptured tiny aneurysms of anterior communicating arteries is difficult,but it is feasible and effective. The proficient surgical skill,individualized surgical design and appropriate embolism are the keys to improve the embolization effect.
ABSTRACT
Objective To investigate the safety, efficacy and key points of technology of endovascular embolization for ruptured wide-necked aneurysms of anterior communicating arteries. Methods The clinical, DSA imaging, interventional treatment and follow-up data of 35 patients with ruptured wide-neck aneurysms of anterior communicating arteries were analyzed retrospectively. Results Immediate postoperative angiography of the 35 patients found 100% occlusion were achieved in 29 (82.9%), 90% occlusion were achieved in 5 (14.3%), and 80%occlusion was achieved in 1 (2.8%). One patient had occlusion in ipsilateral anterior cerebral artery , whose blood vessel was patent after thrombosis. One patient had intraoperative aneurysm rupture. One patient had cerebral infaraction of anterior cerebral artery after the operation. Clinical follow-up was made from 6 to 60 months , and no aneurysms ruptured was found. 21 patients were followed up for 6 to 60 months with DSA. Two of them experienced recurrence, and they were not treated with supplementary packing. Conclusion Endovascular embolization for ruptured wide-necked aneurysms of anterior communicating arteries is more difficult , but it is safe and effective. Flexible choosing of various kinds of embolism technique and designing the most optimal embolism treatment plan are the keys to the improvement of embolization effect.
ABSTRACT
Objective To investigate the effect of glutamine (Gln) on the content of reduced glutathione hormone (GSH) and aminoglutaminic acid (Glu) of spinal cord following ischemia-reperfusion injury. Methods Totally 40 healthy adult male rabbits were randomly divided into five groups: sham-operation group (S group), ischemia-reperfusion injury group (I/R group), low-dose glutamine group (L Gln group), median-dose glutamine group (M Gln group) and high-dose glutamine group (H Gln group). After glutamine preconditioning, the model of spinal cord ischemia-reporfasion injury was established according to Zivin's method. The general status of animals was observed and the changes of Jacobs scoring were recorded in each group. Malondialdehydes (MDA), GSH, Glu and superoxide dismutase (SOD) activity in lumbar spinal cord tissues were determined using chemical colorimetry. The neuron number and deviation rate in spinal cord anterior horn were observed histopathologically. Results There was no significant difference between L Gin group and I/R group in behavior scoring, SOD activity, content of MDA and Glu, neuron number and deviation rate of spinal cord (P>0.05); however, there was a significant difference in GSH content of spinal cord (P<0.05). M Gln group and I/R group differed significantly (P<0.05) in behavior scoring, SOD activity, content of MDA, Glu, GSH, neuron number and deviation rate of spinal cord. Between H Gln group and M Gln group, there was no significant difference in behavior scoring, content of MDA and Glu, SOD activity, neuron number and aberration rate in spinal cord (P>0.05), whereas there was a significant difference in SOD activity and Giu content (P<0.05). Conclusion Pretreatment with medium-dose glutamine has a protective effect on spinal cord ischemia-reporfasion injury in rabbits, which may be related to the maintenance of GSH content, increase of SOD activity and reduction of MDA.