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Clinical data of 23 patients with T2a bladder cancer admitted from March 2008 to August 2013 were retrospectively analyzed.Among 23 patients,11 cases were treated with transurethral resection (TURBT) plus arterial catheterization chemotherapy (study group) and 12 cases were treated with radical cystectomy (control group).The overall survival time and recurrence free survival time of two groups were compared.Patients in study group were followed up for 20-68 months,recurrence occurred in 5 cases (5/11),including 4 cases of invasive recurrence;patients in control group were followed up for 2 ～86 months,1 case had superficial recurrent and underwent TURBT,2 cases dead due to bladder tumor.During the course of chemotherapy,the main adverse effects were digestive reaction (7/11),fever (4/11),bone marrow suppression (2/11),symptomatic treatment was given,which was tolerated.There were no significant differences in overall survival time and recurrence free survival time between two groups (P ＞ 0.05).The quality of life of study group was better than that of control group (P ＜ 0.05).It is suggested that the arterial interventional chemotherapy combined with transurethral resection for T2a stage invasive bladder cancer has a certain curative effect with the advantage of preservation of bladder function and higher quality of life.
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OBJECTIVE: To evaluate the value of early identification and endovascular treatment of iliac vein compression syndrome (IVCS), with or without deep vein thrombosis (DVT). MATERIALS AND METHODS: Three groups of patients, IVCS without DVT (group 1, n = 39), IVCS with fresh thrombosis (group 2, n = 52) and IVCS with non-fresh thrombosis (group 3, n = 34) were detected by Doppler ultrasonography, magnetic resonance venography, computed tomography or venography. The fresh venous thrombosis were treated by aspiration and thrombectomy, whereas the iliac vein compression per se were treated with a self-expandable stent. In cases with fresh thrombus, the inferior vena cava filter was inserted before the thrombosis suction, mechanical thrombus ablation, percutaneous transluminal angioplasty, stenting or transcatheter thrombolysis. RESULTS: Stenting was performed in 111 patients (38 of 39 group 1 patients and 73 of 86 group 2 or 3 patients). The stenting was tried in one of group 1 and in three of group 2 or 3 patients only to fail. The initial patency rates were 95% (group 1), 89% (group 2) and 65% (group 3), respectively and were significantly different (p = 0.001). Further, the six month patency rates were 93% (group 1), 83% (group 2) and 50% (group 3), respectively, and were similarly significantly different (p = 0.001). Both the initial and six month patency rates in the IVCS patients (without thrombosis or with fresh thrombosis), were significantly greater than the patency rates of IVCS patients with non-fresh thrombosis. CONCLUSION: From the cases examined, the study suggests that endovascular treatment of IVCS, with or without thrombosis, is effective.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Angioplasty, Balloon , Constriction, Pathologic/therapy , Diagnostic Imaging , Iliac Vein/pathology , Peripheral Vascular Diseases/complications , Retrospective Studies , Stents , Thrombectomy , Vascular Patency , Vena Cava Filters , Venous Thrombosis/complicationsABSTRACT
Massive hemoptysis is one of the most dreaded of all respiratory emergencies and can have a variety of underlying causes. It is mostly caused by bleeding from bronchial circulation. Bronchial artery embolization is now considered to be the treatment of choice for acute massive hemoptysis. Bronchial artery embolization (BAE) is a safe and effective nonsurgical treatment for patients with massive hemoptysis. However, nonbronchial systemic arteries can be a significant source of massive hemoptysis and a cause of recurrence after successful BAE. So knowledge of the bronchial artery anatomy, together with an understanding of the pathophysiologic features of massive hemoptysis, are essential for planning and performing BAE in affected patients. In addition, interventional radiologists should be familiar with the techniques, results, efficacy, safety and possible complications of BAE and with the characteristics of the various embolic agents. Bronchial arterial catheterisation in human via a percutaneous approach has been practiced for 32 years (1973) in the world and 20 years (1986) in China, initially for direct chemotherapy treatment for bronchial malignancies and then for the embolization of patients with massive haemoptysis. A review of clinical experience to evaluate technique,embolic materials,outcome and complications of BAE is presented.
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Objective To report a simple, minimally invasive method of palliative drainage for symptomatic malignant ascites, in order to avoid repeated trips to hospital for paracentesis.Methods Since July 2000, 57 patients with symptomatic, large volume refractory ascites underwent percutaneous placement of Arrow catheter through a modified Seldinger technique with straight coaxial needles. There were 41 men and 16 women Age ranged from 34～83 years old with an average of 63, including 28 patients of primary liver cancer, 17 metastatic liver cancer, 5 Budd Charri syndrom, 4 pancreatic cancer, 2 peritoneal metastasis of gastric cancer and one with overian cancer. All patients underwent ascites drainage with Arrow catheter accompanied by medical treatment. Results The Arrow catheter had detained for 1 19 days with an average of 5.7 days. Draining amount of ascites was 800 12 000 ml, average 7 200 ml. No complication of sepsis, peritonitis, or significant hypotension after catheter placement but with 7 cases of persistent leakage around the catheter, 2 accidentally detached cathere, 2 cases of unfluent drainage and one case of inferior epigastric blood vessel injury.Conclusions Percutaneous placement of Arrow catheter using a modified Seldinger technique with coaxial needles is a safe, simple, and effective method for palliative drainage of malignant ascites that improves patients life quality.
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Objective To explore the interventional methods to treat recurrent jaundice after palliative bilio intestinal anastomosis in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods Ten patients with recurrent jaundice after bilio intestinal anastomoasis were retrospectively evaluated. Nine of ten underwent PTCD with metallic stent placement, one underwent the inner outer draining catheter procedure. The patients were evalualed with comparison in regard to preoperative conditions, TBIL,ALT,GTP and AKP values.Results Stent placement was successful only once in all 10 cases with successful rate of 100%. TBIL,ALT,GTP and AKP values were significantly lower 7 days postoperative by than that preoperation. Subsidence of jaundice was satisfactory for 100% in all patients after the treatment. Conclusions Percutaneous placement of biliary metallic stents is a safety, simple, low complication method for managing recurrent jaundice after palliative bilio intestinal anastomosis for the terminal stage of malignant obstructive jaundice.
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Objective To discuss and prove the clinic effect of interventional reversal of ligated fallopian tubes in treating fallopian tubes stenosis and value of lipiodol for the procedure. Methods We select randomly 30 patients in the year 1996-1998 with 60 fallopian tubes as the control group. And 30 patients in the year 1999-2000 with 60 fallopian tubes as the monitor group. We analyzed the procedure effect on the 60 patients with 120 fallopian tubes. Results The reversal rate, post procedure pregnant rate and post procedure adhesive rate between the control group and the monitor group are 83.3% , 88.3% ; 23.3% , 26.6% ; 34.3% , 11.5% respectively. Conclusions The interventional repatency of fallopian tubes is effective for the fallopian infertility. Application of 40% lipiodol for the procedure can decrease the recurrence of fallopian tube adhesion.
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Objective To evaluate the application of transcatheter closure of patent ductus arteriosus (PDA) with severe pulmonary hypertention using the Amplatzer occluder device.Methods Fifty-one cases of PDA with severe pulmonary hypertention were treated by transcatheter closure with Amplatzer occluder. Patients mean age was 9.4 years (ranging 3 months to 60 years) and the mean weight was (18.7?13.8) kg (ranging 5.0 to 65.0 kg). The mean PDA diameter at its narrowest segment was (7.0?2.4) (ranging 3.0 to 15.0) mm. The achievement of permanent transcatheter closure was decided according to the change of the pulmonary arterial pressure, aortic pressure and oxygen saturation. Results The devices were successfully placed in all patients except one failure owing to the resistance of pulmonary hypertention. The systolic pulmonary pressure decreased from (84.7?13.5) (range 70 to 137) to mmHg to (46.1?14.9) (24 to 109)mmHg, and the mean pulmonary pressure decreased from (65.0?11.5) (42 to 97) mmHg to (31.3?11.6) (14 to 69) mmHg. Complete angiographic closure was seen 10 minutes after the device deployment in 30 out of 50 patients (60%), while trivial to small leak was present in 20 (40%). Complete echocardiographic closure was demonstrated in 49 out of 50 patients (98%) at 10 min, and 100% at 6-month follow-up in all patients. There were no PDA recanalization and migration of devices after the complete occlusion during following up.Conclusion Transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention by using the Amplatzer occluder is a safe and effective interventional method with excellent short-term and middle-term results.
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50%) underwent renal artery stent implantation and percutanous coronary intervention, only 10 of them with merely renoarterial stenosis undergone renal artery stent implantation. The successful rates of the procedure and complication together with the volumes of contrast media were recorded respectively. And the serum creatitine before and 12 hours after the successful procedure were also measured. Results Both rates of procedural success and complication were similar among the three groups. The serum creatitine levels, 12 hours after the procedure, showed no difference in comparing with the baseline. Conclusion Non-ionic contrast media (Iopamiro 370) could be safely used in patients with RAS.
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Objective To evaluate the clinical efficacy of intraarterial infusion chemotherapy in patients with advanced and/or recurrent breast cancer. Methods From February 2000 to March 2003, 18 patients with advanced and/or recurrent breast cancer were treated with interaarterial chemotherapy (IAC). The Seldinger's technique was used in all patients. IAC was administered for 2-3 courses every 3-4 weeks for each patient. Results The proceduce was successfully performed in all 18 patients including one with a complete response, 12 of a partial response, none in 3, and with progression in 2. The overall response rate was 72.2%. The frequent adverse effects were fever, leukopenia, nausea, and vomiting but no severe complication occurred. Conclusion Intraarterial infusion chemotherapy is a safe, simple, complication-free and effective in the patients with advanced and/or recurrent breast cancer.
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Objective To summarize the early experience and results of endovascular stenting for symptomatic stenosis of middle cerebral artery. Methods We performed percutaneous endovascular stent assisted angioplasty in 20 patients with symptomatic high grade stenosis of MCA, who had either recurrent transient ischemic attacks (TIAs) resistant to medical therapy or perfusion problems. After stenting, the patients was administrated with antiplatelet drug and followed up with DSA、TCD and SPECT. Results Stent placement and angioplasty were successfully performed in all patients except one with MCA rupture during the procedure. The mean degree of stenosis reduced from (78.3?4.7)% to (15.6?4.4)%, and the degree of residual stenosis were less than 30%. None of these patients developed TIAs or stroke during the follow up period. Angiography revealed no evidence of restenosis. TCD and SPECT suggested significant improvement of cerebral perfusion. Conclusions Endovascular stenting for MCA stenosis seems to be a safe and effective therapeutic method. Further study is needed for long term outcome.
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Objective To evaluate the effect of double interventional thrombolysis for treatment of acute venous thrombosis in lower limb and discuss the problems of its clinical use. Methods 24 patients with acute venous occlusive disease associated with thrombus formation were treated by double interventional thrombolysis including 17 cases of femoral venous approach and 7 with femoral artery catheterization. The total dosage of urokinase was from 2 500 000 U to 5 000 000 U. Results All together 24 cases were undengone this proceduce; outcoming with complete thrombolysis in18(75%), partial and noneffective in 3(12.5%) and 3 (12.5%) respectively. The total effective rate was 87.5%. Conclusions Double interventional thrombolysis is highly effective to the patients with acute venous thrombosis.
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Objective:To assess the feasibility of dilute sulfuric acid injected into the rabbit liver in vivo,and to provide experimental proof for the interventional therapy on hepatocellular carcinoma.Methods:10 big white rabbits were randomly divided into two groups.10% sulfuric acid was injected into liver at a dose of 1ml.In the first group,the biochemical changes in serum were examined before and immediately,3,7,and 15 days after the procedure.In the second group,histopathological findings of the liver were observed after 10% sulfuric acid injected into liver immediately,3,7,15 and 30days postoperatively.Results:The ALT and AST level in serum had transient elevation,but shortly returned to the same level as before the procedure.There was no significant elevation of ALB,ALP,?-GGT,TBIL,DBIL and BUN level after the procedure.Pathological changes indicated hepatocellular degeneration,coagulative necrosis,inflammatory cells infiltration and granulation tissue proliferation.Conclusion:Diluted sulfuric acid have strong power of cells inactivation,but without obvious toxicity and side-effect,which could be a new type of tumor cells inactivation material for the treatment of hepatocellular carcinoma local ablation.