ABSTRACT
Objective To investigate the safety, reliability and effectiveness of supra - aortic artery stenting angioplasty via transradial access in treating supra-aortic artery occlusion or stenosis. Methods The clinical data of 325 consecutive patients with supra-aortic artery occlusion or stenosis, who were admitted to authors' hospital during the period from January 2012 to January 2016 to receive stenting angioplasty, were retrospectively analyzed. According to patient's own will, the 325 patients were divided into transradial access group (n=52) and transfemoral access group (n=273). The results of the puncturing, the operative results, the duration of operation, the amount of intraoperative blood loss, the postoperative complications, the time of postoperative rest in bed, the average time of hospitalization of both groups were recorded. Results No statistically significant differences in the success rate of puncturing, the success rate of operation and the amount of intraoperative blood loss existed between the two groups (P＞0. 05). In 73. 1％ of patients (38/52) of the transradial access group the duration of operation was ≤30 min, while only in 43. 2％ of patients (118/ 273) of the transfemoral access group the duration of operation was ≤30 min, the difference between the two groups was statistically significant (P＜0. 000 1). After the operation, in transradial access group puncture point bleeding was seen in 8 patients and hematoma at the puncture site in one patient, the complication rate was 17. 3％ (9/52), while in transfemoral access group puncture point bleeding was observed in 23 patients, hematoma at the puncture site in 7 patients, pain of puncture site in one patient, and cerebral hemorrhage in one patient, the total complication rate was 11. 7％ (32/273); but the difference between the two groups was not statistically significant (χ2=1. 236, P=0. 266). Patients in the transradial access group could get out of bed immediately after the operation. No statistically significant difference in the average time of hospitalization existed between the two groups (P＞0. 05). Conclusion In performing endovascular stenting angioplasty for supra-aortic artery occlusion or stenosis, both transradial access and transfemoral access are safe, reliable and effective. Transradial access can be used as a replacement of transfemoral access. (J Intervent Radiol, 2018, 27:207-210)
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Objective To discuss the application of cephalocervical CT angiography (CTA) and ABCD2 score in evaluating arterial characteristics and interventional curative effect for patients with transient ischemic attack (TIA). Methods During the period from Jan. 2010 to Jan. 2012, a total of 64 patients with clinically-diagnosed TIA were admitted to authors’ hospital. ABCD2 score evaluation and cephalocervical CTA examination were performed in all patients. The correlation of stenotic degree and distribution of the cephalocervical arteries with the ABCD2 score was analyzed. According to the stenotic degree of the cephalocervical arteries, the patients were divided into low-risk group and mid-to-high-risk group. Twenty-two patients in mid-to-high-risk group received stenting angioplasty treatment. Follow-up was made at 3, 6 and 12 months after the treatment. Results Of 64 TIA patients, cephalocervical artery stenosis was found in 52(81.25%) A total of 149 arterial segments were involved, including intracranial segment (n=81, 54.36%) and extracranial segment (n = 68, 45.64%). Patients in low-risk group mainly suffered slight or moderate arterial stenosis, while patients in mid-to-high-risk group had moderate or serious arterial stenosis (χ2 =10.126, P=0.018). The preoperative ABCD2 score was (6.41 ± 0.50). The ABCD2 scores determined at 3, 6 and 12 months after the treatment decreased to(2.88 ± 0.69), (2.82 ± 0.63) and(3.00 ± 0.71), respectively. The differences were statistically significant (F = 86.657, P < 0.05). Conclusion Cephalocervical CT angiography and ABCD2 score can reliably evaluate the arterial stenosis and interventional curative results in TIA patients.
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Objective To evaluate the safety, performability and long-term clinical efficacy of stenting angioplasty for treating symptomatic internal carotid artery (ICA) stenosis in the origin part in elderly patients. Methods Stenting angioplasty was performed on 29 patients with symptomatic ICA stenosis in the origin part. Results 29 stents were placed in 29 patients. Operations were performed 100%successfully. After an average 24 months of follow-up visits, restenoses were detected in 2cases reexamined by DSA 6 months after stenting, both presented with less than 50% stenoses. 1 case was found not regularly taking statins and antiplatelet drugs after stenting, severe restenosis occurred 6 months later, stent implantation performed again, no recurrence of transient ischemic attack (TIA) was noted during 2 years′follow-up visit. Cerebral ischemic strokes occurred in 2 cases , and both of them had balloon dilatation after stenting. 1 case was completely recovered after treatment and 1 was left with weakness in right extremities, unabling to walk. No cases of posterior circulation ischemia, death and myocardial infarction were detected. Conclusions Stenting angioplasty can be performed in treating symptomatic internal carotid artery stenosis in elderly patients. It showed a relatively good mid-long-term clinical effects and can be a secondary prevention option.
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Objective To discuss the skills and effects of several endovascular mechanical techniques for the recanalization of subclavian artery total occlusion. Methods Endovascular mechanical recanalization of subclavian artery total occlusion was performed in 32 patients with symptomatic subclavian artery total occlusion. The re-open rate and the therapeutic results were observed and analyzed. Results Several endovascular mechanical techniques, including percutaneous transluminal angioplasty, were employed in treating 32 patients with subclavian artery total occlusion. After the procedure, the ischemic 8ymptoms of posterior circulation and/or upper extremity were markedly relieved. Conclusion It is safe and feasible using appropriate endovascular mechanical technique for re-canalizing the occluded subclavian artery.