Efficacy and safety of prostaglandins vs double balloon catheter in inducing labor: a meta-analysis

Background: To compare the efficacy and safety of double‐balloon catheter with prostaglandin E2 (PGE2) in induction of labor.Methods: We searched electronic sources from Medline, Scopus, PubMed, Science Direct and Cochrane Library Database of Systematic Reviews. Only randomized controlled trials and observational studies comparing the PGE2 agents with double-balloon catheter for cervical ripening and labour induction in women with unfavorable cervix were included in the analysis. The main outcomes included vaginal delivery rate within 24 hours and cesarean delivery rates. We calculated relative risks and mean differences using fixed effects and random‐effects models.Results: Prostaglandin was more favourable for vaginal delivery within 24 hours compared to double balloon catheter, but was not statistically significant (RR 1.17: 95% CI 0.96-1.42 p =0.12). The induction to delivery time yielded a non-significant result that again favors prostaglandin (SMD 0.02 CI:0.18,0.22, p = 0.86). There was no significant difference in the cesarean delivery rates between the two groups (RR 1.02: 95% CI 0.92-1.14, p = 0.68). Uterine hyperstimulation and Neonatal Intensive Care Unit (NICU) admissions were significantly higher with prostaglandin. (RR 0.09: CI 0.04, 0.22 p<0.00001 and RR 0.75 CI: 0.62,0.90 p=003).Conclusions: There is no significant difference in the success of induction of labour between use of PGE2 and double balloon catheter. Uterine hyperstimulation and NICU admissions were significantly higher in Prostaglandin group.

Comparative study of mifepristone versus balloon catheter for cervical ripening and induction of labour in previous caesarean section

Background: The objective of this present study was to compare the efficacy of oral mifepristone and balloon catheter for cervical ripening and induction of labour in women with previous caesarean section.Methods: This prospective study was conducted on 130 pregnant women with previous 1 caesarean section and term singleton pregnancy admitted for induction of labour. Sixty-five patients were induced with oral mifepristone (Group 1) and in another 65 transcervical balloon catheter (Group 2) was inserted for induction of labour. Both groups were than compared with respect to change in bishop score, induction to active phase interval, induction to delivery interval, dose of oxytocin in milliunits, mode of delivery, maternal complication and fetal outcomes.Results: Change in bishop score after induction was more in mifepristone group than balloon catheter group (p=0.002). Favorable bishop score was more in Group 1 (83.07%) than Group 2 (66%), p=0.05. There was significant difference in mode of delivery between two groups, 61.53% in Group 1, and 32.3% in Group 2 delivered vaginally (p<0.001).Conclusions: Present study showed that mifepristone is an alternative to balloon catheter for induction of labour in women with previous one caesarean section with poor bishop score.

Application of liquid pressurization under obstruction of healthy-side uterine horn with catheter tip combined with guidewire recanalization in treating unilateral obstruction of fallopian tube / 介入放射学杂志

Objective To investigate the clinical application of liquid pressurization under obstruction of healthy-side uterine horn with the tip of double lumen balloon catheter combined with guidewire recanalization in treating unilateral obstruction of fallopian tube.Methods Hysterosalpingography was performed in infertility patients.A total of 50 patients with unilateral obstruction of fallopian tube were selected.Attempt was made to use catheter tip to obstruct the healthy-side uterine horn,then liquid pressurization was carried out to reopen fallopian tube,and the relationship between the success of recanalization and uterine morphology was analyzed;further guidewire recanalization was employed when liquid pressurization method failed,and the recanalization rate was calculated.Results In 33 among the 50 patients,the distance from the uterine horn to the cervical internal orifice was shorter than the catheter length that was inserted into the uterus,besides,the width of the uterine horn was smaller than the catheter diameter,thus the uterine horn was tightly occluded by the catheter tip.Recanalization of the fallopian tube was obtained in 19 patients,and recanalization of the fallopian tube failed in 14 patients because the obstruction was very severe.In 17 among the 50 patients,the distance from the uterine horn to the cervical internal orifice was longer than the catheter length that was inserted into the uterus,besides,the width of the uterine horn was larger than the catheter diameter,thus the uterine horn could not be tightly occluded by the catheter tip,resulting failure of recanalization of fallopian tube.Further guidewire recanalization had to be carried out for the 33 patients whose recanalization of fallopian tube with liquid pressurization method failed,and recanalization of fallopian tube was achieved in 22 patients.Conclusion Liquid pressurization under obstruction of healthy-side uterine horn with the tip of double lumen balloon catheter can reopen the obstructed fallopian tube in some patients,and the success of recanalization is closely related to the uterine morphology.Additional use of guidewire recanalization technique can significantly improve the recanalization rate for unilateral fallopian tube obstruction.

Ablación de fibrilación auricular: primera serie colombiana de crioablación con balón / Atrial fibrillation ablation: first Colombian series of balloon cryoablation

Resumen Introducción: El aislamiento de las venas pulmonares mediante la crioablación con balón es una técnica innovadora para el manejo de la fibrilación auricular con una alta tasa de efectividad. Su reciente introducción y aprobación por el Instituto Nacional de Vigilancia de Medicamentos y Alimentos de Colombia en nuestro medio aporta una alternativa al aislamiento tradicional punto a punto con la radiofrecuencia. Métodos: A partir de mayo de 2014, todos los pacientes que fueron llevados a aislamiento de las venas pulmonares con la crioablación fueron registrados de manera prospectiva en un formulario previamente diseñado para tal fin. Resultados: Entre mayo de 2014 y agosto de 2015 se realizaron 31 procedimientos de la crioablación con balón en 31 pacientes (23 hombres, 74%) con una edad promedio de 59 ±11,4 años (rango de 34 a 72 años). La indicación más común fue la fibrilación auricular paroxística (23 pacientes, 74%), con 4 casos de la fibrilación auricular persistente (13%) en presencia de un corazón estructuralmente sano. El procedimiento tuvo una duración total de 152,6 ± 46,1 minutos con un tiempo de la fluoroscopia de 51± 16 minutos, observándose una disminución en los tiempos a medida que se progresó en la curva de aprendizaje. Tres de los 31 pacientes (9,7%) presentaron parálisis diafragmática; dos de ellos recuperaron la motilidad durante el mismo procedimiento y el otro paciente recuperó la motilidad al mes. Conclusiones: La crioablación es una técnica rápida y reproducible para el aislamiento de las venas pulmonares en un servicio de electrofisiología de alta complejidad. Con una curva de aprendizaje corta, es una alternativa valiosa al aislamiento eléctrico punto a punto con la radiofrecuencia, en un grupo con experiencia previa en el aislamiento de venas pulmonares por la técnica convencional de radiofrecuencia. La tasa de complicaciones menores fue comparable a lo reportado en la literatura y no se presentaron complicaciones mayores en este grupo inicial.

Abstract Introduction: Pulmonary vein isolation using balloon cryoablation is a innovative technique for managing atrial fibrillation with a high efficacy rate. Its recent introduction and approval by the Colombian National Institute for Medicine and Food Surveillance in our field offers an alternative to the traditional point-by-point radiofrequency isolation. Methods: Starting May 2014, all patients who underwent pulmonary vein isolation with cryoablation were registered prospectively in a form that had been previously designed specifically for this purpose. Results: Between May 2014 and August 2015, 31 balloon cryoablations were performed in 31 patients (23 men, 74%) with an average age of 59 ± 11.4 years (range from 34 to 72 years). The most frequent indication was paroxysmal atrial fibrillation (23 patients, 74%), with 4 cases of persistent atrial fibrillation (13%) in the presence of a structurally normal heart. The procedure lasted a total of 152.6 ± 46.1 minutes with a fluoroscopy time of 51 ± 16 minutes, observing a decrease in the time as the learning curve progressed. Three of the 31 patients (9.7%) developed diaphragmatic paralysis, two of whom recovered motility during the procedure and the other patient recovered motility after one month. Conclusions: Cryoablation is a fast and reproducible technique for pulmonary vein isolation in a high complexity electrophysiology service. With a short learning curve, it is a valuable alternative to point-by-point radiofrequency isolation, in a group with previous experience in pulmonary vein isolation by means of the traditional radiofrequency technique. Minor complications rate was similar to what was reported in literature and no major complications were developed in this initial group.

Experiencia con un dispositivo para dilatación cervical controlada / Experience with a device for controlled cervical dilation

Resumen OBJETIVO: Observar y valorar la eficacia y seguridad en humanos de este nuevo dispositivo para dilatación cervical. MATERIALES Y MÉTODOS: Estudio prospectivo, experimental y de intervención, efectuado en pacientes atendidas entre los meses de enero a diciembre de 2015 en el Hospital General Santa María del Puerto (España) a quienes se realizaron procedimientos diagnósticos y terapéuticos ginecológicos que requirieron dilatación cervical; se utilizó el dispositivo Aqueduct-100®. RESULTADOS: se estudiaron 50 pacientes con edad media de 50 años. Hubo dos grupos de tratamiento: 1) 38 pacientes con dilatación de 5 minutos y 2) 12 con 3 minutos. La indicación más frecuente del procedimiento fue la histeroscopia diagnóstica (44%). El diámetro cervical medio, inicial y posterior al procedimiento, fue de 2.8 y 7.7 mm, respectivamente. La valoración del dispositivo por los especialistas fue de buena a excelente. No se registraron complicaciones relacionadas con el proceso de dilatación cervical. CONCLUSIONES: El dispositivo estudiado es una alternativa sencilla y efectiva para la realización de maniobras de dilatación cervical, previas a diversos procedimientos intrauterinos y endometriales.

Abstract OBJECTIVE: To observe and assess the efficacy and safety of this new cervical dilator device, for the first time in humans. Thus, if the study is successful, raise a second phase through a randomized clinical trial, which purpose shall be to show if there is a superiority of this device with respect to common mechanics dilators. MATERIALS AND METHODS: Prospective, experimental intervention study, in patients undergoing gynecological diagnostic and therapeutic procedures, requiring cervical dilatation, using the Aqueduct - 100®, the Hospital General Santa María del Puerto (Spain). The study included 50 patients who met the criteria for inclusion, in the period January-December 2015. RESULTS: The mean age of the patients was 52.6 years. They were divided into two treatment groups: 38 patients were subjected to a process of expansion of 5 minutes and 12 3-minute processes. The description of the most frequent procedure was the realization of a diagnostic Hysteroscopy (44%). The cervical diameter medium, both initial and subsequent procedure was 2.8 and 7.7 mm, respectively. The valuation of the device by the specialists who used it, ranged between good and excellent rating for all items. There was no complication associated with the process of cervical dilatation with the device. CONCLUSIONS: The Aqueduct - 100® device can be a simple and effective alternative to perform cervical dilatation maneuvers necessary for performing gynecological procedures, intrauterine and endometrial level.

The application of hypothermic perfusion via renal artery balloon catheter in laparoscopic partial nephrectomy / 介入放射学杂志

Objective To evaluate the feasibility and safety of hypothermic perfusion via renal artery balloon catheter before laparoscopic partial nephrectomy.Methods A total of 35 patients,who were arranged to receive laparoscopic partial nephrectomy during the period from March 2013 to December 2016 at the General Hospital of PLA,China,were enrolled in this study.The tumor was located in the left kidney in 22 patients and in the right kidney in 13 patients.The long diameter of the tumors was 2.3-7.0 cm,with a mean of (4.1±1.2) cm.Before laparoscopic partial nephrectomy,the implantation of renal artery balloon catheter was performed in all patients.The intraoperative renal cold-ischemia time,the time spent for operation and the amount of intraoperative blood loss were recorded.The creatinine clearance rate (Ccr) and estimated glomerular filtration rate (eGFR) were determined before operation as well as at one,3 and 7 days after operation.The intraoperative and postoperative complications were analyzed.Results Successful implantation of renal artery balloon catheter was accomplished in all 35 patients,with the technical success rate being 100％.Slipping of balloon catheter before laparoscopic partial nephrectomy occurred in one patient;in 2 patients incomplete occlusion of renal artery was found during operation and artery forceps had to be used to occlude the renal artery.In the other 32 patients,laparoscopic partial nephrectomy under the condition of hypothermic perfusion via renal artery balloon catheter was successfully carried out.No severe complications occurred during and after the operation.The average cold-ischemia time of the diseased kidney was 45 (20-125) min,the mean time for interventional procedure was 28 (20-40) min,the average surgery time was 147(95-235) min,the average amount of intraoperative blood loss was 180(50-1000) ml.The Ccr values determined before and at one,3,7 days after nephrectomy were (96.5±15.1),(75.2±10.5),(54.3±13.8) and (91.8±14.1) ml/min respectively.The eGFR values determined before and at one,3,7 days after nephrectomy were (99.5±15.3),(70.3±12.5),(65.5±11.7) and (96.8±12.3) ml·min-1·m-2 respectively.Statistical analysis indicated that in both groups the preoperative and 7-day postoperative Ccr values and eGFR values were significantly different from their one-day and 3-day postoperative values (P＜0.01),but no statistically significant differences existed between preoperative values and 7-day postoperative ones (P＞0.05).Conclusion Hypothermic perfusion via renal artery balloon catheter before laparoscopic partial nephrectomy is clinically safe and feasible,it can prolong the safe time of renal ischemia and protect renal function.

Reduction of the Isolated Anterior Wall of the Maxillary Sinus Fracture with Double Urinary Balloon Catheters and Fibrin Glue

BACKGROUND: Conservative treatment is performed for isolated anterior wall of the maxillary sinus fractures, in many cases when the fracture is clinically not severe and asymptomatic. Despite the absence of symptoms, complications such as sinusitis, rhinitis, and chronic purulent secretion may develop; therefore, successful reduction is required. We attempted to reduce the risk of complications using an alternative technique: reduction of the fracture with two urinary balloon catheters inserted through the maxillary ostium and fixation using fibrin glue, which minimizes the damage to the bony fragments and sinus mucosa. METHODS: In this study, 38 patients who were diagnosed with an isolated anterior wall of the maxillary sinus fracture at our hospital between January 2014 and January 2017 were enrolled. The fracture site was exposed via the Caldwell-Luc approach followed by reduction through the insertion of two urinary balloon catheters using a nasal endoscope and fixation with fibrin glue. The sex, cause of fracture, physical examination, and presence of complications were examined and patient's medical records and facial bone computed tomography scans were analyzed. RESULTS: Radiological evaluation showed that there was no evidence of collapsed reduction fragments. Although some patients had remaining symptoms of hypoesthesia (15%; 3 patients), there were no complications such as infection, rhinitis, sinusitis, and chronic purulent secretion at the surgical site. CONCLUSION: In this study, we present an alternative surgical technique using two urinary balloon catheters and fibrin glue for the successful reconstruction of an isolated anterior wall of the maxillary sinus fracture. This technique enables precise restoration with a reduced risk of complications.

Eficacia y seguridad del taponamiento uterino para control de hemorragia y disminución de histerectomía obstétrica: cohorte histórica en Nuevo León, México, 2013 / Efficacy and safety of uterine tamponade to control bleeding and reduce obstetric hysterectomy: historic cohort in Nuevo León, México, 2013

Objetivo: realizar una aproximación a la eficacia y seguridad del taponamiento uterino para el control de la hemorragia obstétrica y reducir la necesidad de histerectomía obstétrica.Materiales y métodos: cohorte histórica de mujeres mayores de edad con diagnóstico de hemorragia obstétrica secundaria a atonía que no respondían a manejo inicial, con sangrado del lecho placentario secundario a placentación anormal o secundaria a aborto incompleto, a las cuales se les realizó taponamiento uterino, en la Unidad Médica de Alta Especialidad No. 23 de Ginecología y Obstetricia de la ciudad de Monterrey, hospital de concentración de tercer nivel de atención, ubicado en el estado de Nuevo León (México), de enero a diciembre de 2013. A partir del expediente clínico se registraron las características sociodemográficas y clínicas basales, los datos de laboratorio previo al evento obstétrico y posterior al taponamiento, así como el tiempo de taponamiento en horas, cantidad de insuflación del balón uterino, indicación para el procedimiento, cantidad de sangrado estimado durante el evento obstétrico y posterior a la colocación del balón, control de la hemorragia y necesidad de histerectomía. Se utilizó estadística descriptiva, medidas de dispersión y de tendencia central.Resultados: se incluyeron 161 pacientes con diagnóstico de hemorragia obstétrica, 147 posterior a parto o cesárea y 14 posterior al aborto, entre 16 y 42 años de edad. Se documentó un resultado satisfactorio en más del 95 % posterior al parto o la cesárea, y en más del 93 % posaborto. La permanencia del taponamiento para ambos casos tuvo una media de 20 horas.Conclusiones: este estudio soporta el uso de taponamiento uterino como medida terapéutica eficaz y segura para controlar la hemorragia y evitar una laparotomía o histerectomía, con una disminución de la morbilidad.

Objective: Examine the efficacy and safety of uterine tamponade for controlling obstetric bleeding and reducing the need for obstetric hysterectomy.Materials and methods: Historic cohort of adult women diagnosed with obstetric bleeding secondary to uterine atony that did not respond to the initial management, with bleeding of the placental bed secondary to abnormal placentation or to incomplete abortion, subjected to uterine tamponade at the Highly Specialized Gynaecology and Obstetrics Medical Unit No. 23, a Level III Hospital in the city of Monterrey, state of Nuevo Leon, Mexico, between January and December 2013. Information about social, demographic and baseline clinical characteristics, laboratory values before the obstetric event and after the tamponade procedure, as well as the inflation volume of the balloon, the indication of the procedure, the estimated amount of bleeding during the event and after placement of the tamponade balloon, control of bleeding, and need for hysterectomy, was derived from the clinical record. Descriptive statistics, scatter measurements, and central trends were used.Results: Overall, 161 patients between the ages of 16 and 42 years, with a diagnosis of obstetric haemorrhage were included, 147 following delivery or caesarean section, and 14 following miscarriage. A satisfactory result was documented in more than 95 % of cases after delivery or caesarean section, and in more than 93 % post abortion cases. The mean tamponade time for both groups was 20 hours.Conclusions: This study supports the use of uterine tamponade as an effective and safe therapeutic measure to control bleeding and avoid laparotomy or hysterectomy, and to reduce morbidity.

Effects of tirofiban combined with nitroprusside injection through the rapid exchange balloon catheter on no-reflow phenomenon during elective PCI / 重庆医学

Objective To investigate the effects of tirofiban combined with nitroprusside injection through the rapid exchange balloon catheter with self-made side holes on no-reflow (NR)phenomenon during elective percutaneous coronary intervention (PCI).Methods A total of 49 patients with NR phenomenon were randomly divided into the balloon catheter group (n=25)and the guiding catheter group (n=24).Tirofiban combined with nitroprusside were used in both groups.Thrombolysis in myocardial infarction (TIMI)grade and corrected TIMI frame count (CTFC)of target coronary artery at 10 minutes after administration were assessed.Results At 10 minutes after drugs injection,there were 21 (84.0%)patients with target of coronary TIMI 3 grade in the balloon catheter group,and 13 (54.2%)patients in the guiding catheter group.The CTFC was (33.5±12.5)frame in the balloon catheter group,and (41.9±1 5.3)frame in the guiding catheter group.The difference in TIMI and CTFC between the two groups was significantly (P <0.05).Conclusion Injection tirofiban combined with nitroprusside through the rapid exchange balloon cathe-ter with self-made side holes in NR patients during elective PCI might be feasible and effective.

Temporary aortic balloon occlusion in management of cesarean section for pernicious placenta previa/accreta / 实用放射学杂志

Objective To explore the application of temporary balloon occlusion in multidisciplinary management of cesarean sec-tion for patients with pernicious placenta previa/accreta.Methods 42 patients with a diagnosis of placenta previa /accrete accepted the temporary aortic balloon occlusion in cesarean section in DSA hybrid operation room were retrospectively studied.Before cesare-an section,intravascular balloon catheter was placed in abdominal aortic.After delivery,the midpoint of filling state balloon was placed at the midpoint of the two renal arteries openings before placental dissection.The amount of blood loss and blood transfusion, operation time,the infants'radiation doses and postoperative complications were determined.Results All patients were successfully fulfilled cesarean section and conserved uteri.The amount of blood loss,blood transfusion,operation time,occlusion time and the infants’radiation doses were (586±355)mL,(422±283)mL,(75.5±1 1.9)min,(22.4±7.2)min and (4.2±2.9)mGy,respec-tively.During follow-up,complications were not found during operation and after operation.Conclusion In women with pernicious placenta previa/accreta,temporary aortic balloon occlusion can effectively control postpartum hemorrhage and reduce the risk of un-desirable hysterectomy.

Cervical Ripening Balloon for Induction of Labour in High Risk Pregnancies

Background: The Cervical Ripening Balloon (CRB) is a novel mechanical method for induction of labour (IOL), reducing the risks of hyperstimulation associated with pharmacological methods. However, there remains a paucity of literature on its application in high risk mothers, who have an elevated risk of uterine rupture, namely those with previous scars and grandmultiparity. Methodology: A retrospective study on IOL using the CRB in women with previous caesarean section or grandmultiparity between January 2014 and March 2015. All cases were identified from the Sarawak General Hospital CRB request registry. Individual admission notes were traced and data extracted using a standardised proforma. Results: The overall success rate of vaginal delivery after IOL was 50%, although this increases to about two-thirds when sub analysis was performed in women with previous tested scars and the unscarred, grandmultiparous woman. There was a significant change in Bishop score prior to insertion and after removal of the CRB. The Bishop score increased by a score of 3.2 (95% CI 2.8-3.6), which was statistically significant (p<0.01) and occurred across both subgroups, not limited to the grandmultipara. There were no cases of hyperstimulation but one case of intrapartum fever and scar dehiscence each (1.4%). Notably, there were two cases of change in lie/presentation after CRB insertion. Conclusion: CRB adds to the obstetricians’ armamentarium and appears to provide a reasonable alternative for the IOL in women at high risk of uterine rupture. Rates of hyperstimulation, maternal infection and scar dehiscence are low and hence appeals to the user.

Balloon Sinuplasty / 대한이비인후과학회지

Balloon sinuplasty (BSP) is a newly developed catheter-based technique for dilating sinus ostia to improve sinus ventilation and drainage. BSP has been in clinical use since 2005, but there has been many debates and criticism between early movers and mainstream doctors. But, recently, many evidences strongly support its safety, efficacy, and growing popularity among patients and physicians. The objective of this clinical review is to present its theoretical background, technical considerations, and treatment outcomes. BSP will be an additional tool for treating sinusitis, either alone or with conventional sinus surgery technique.

Neumostomía con sonda de balón en colecciones purulentas del pulmón / Neumostomy with a balloon catheter in supurative lung collections

Introducción: el desarrollo de los antimicrobianos provocó que el drenaje externo dejara de realizarse en pacientes con absceso de pulmón, en quienes la resección pulmonar es la opción ante el fracaso médico. En los últimos años, la neumostomía ha resurgido por la necesidad de asistir a enfermos con un marcado deterioro físico que impide una intervención quirúrgica resectiva. Objetivo: caracterizar a los pacientes con supuración pulmonar tratados quirúrgicamente mediante drenaje percutáneo externo y neumostomía con sonda de balón (método de Monaldi) practicados con anestesia local. Métodos: se realizó un estudio descriptivo longitudinal retrospectivo en el período de 1995 a 2012 en el Hospital Universitario Comandante Manuel Fajardo. El universo estuvo conformado por 8 pacientes a los que se les practicó el método de Monaldi. En todos los casos se utilizaron sondas de goma de balón de 24 unidades F, de tres ramas. Resultados: cuatro pacientes padecían de absceso del pulmón y el resto de bullas enfisematosas voluminosas infectadas. Todos los casos tuvieron resolución de la colección infectada en un período inferior a las 2 semanas, y no hubo complicaciones ni mortalidad quirúrgica. Conclusiones: el drenaje percutáneo con anestesia local utilizando sondas de balón es un instrumento adecuado para el tratamiento de colecciones pulmonares en enfermos con deterioro físico por el cuadro infeccioso. Con él se logra la resolución de la lesión pulmonar, y es efectivo tanto en los abscesos pulmonares como en las bullas enfisematosas infectadas(AU)

Introduction: with the advent of the antibiotic therapy, external drainage ceased to be performed in lung abscess patients for whom the pulmonary resection is the choice. In the last few years, pneumostomy has reemerged due to the need of giving assistance to patients with remarkable physically deterioration that hinders resective surgery. Objectives: to characterize patients with pulmonary suppuration and surgically treated by means of external percutaneous drainage with balloon catheter pneumostomy (Monaldi method) using local anesthesia. Methods: retrospective, descriptive and longitudinal study of eight patients, who underwent Monaldi method-based surgery, conducted from 1995 through 2012 at Manuel Fajardo university hospital. Three branch twenty-four F unit balloon rubber catheters were used in all these cases. Results: out of the eight, four had been diagnosed with lung abscess and the other four had large septic emphysematous sacs. The infected collection was eliminated in all these patients in less than 2 weeks with no complication and no surgical death. Conclusion: The percutaneous drainage with local anesthesia using balloon catheter as an instrument was adequate and useful in the treatment of septic lung collections in patients with very poor physical condition. This method manages to eliminate the pulmonary lesion and is good for both pulmonary abscesses and infected emphysematous sacs(AU)

Clinical application of neotype controllability artificial nephrohydrosis in percutaneous nephrolithotomy / 局解手术学杂志

Objective To explore clinical application of neotype controllability artificial nephrohydrosis in percutaneous nephrolithoto-my. Methods 400 patients with renal lithiasis or superior segment ureter lithiasis in our hospital were divided into group A and group B. 200 cases of group A received neotype controllability artifiicial nephrohydrosis;200 cases of group B received conventional artificial nephro-hydrosis. The puncture duration, amount of bleeding and times of puncture of the two groups were compared. Results 195 cases in Group A were developed renal tract for PCNL effectively,157 cases were developed renal tract for PCNL effectively in Group B. The puncture duration, amount of bleeding and times of puncture of group A and group B were respectively (1. 8 ± 0. 7) vs. (2. 5 ± 1. 2) min,(112. 7 ± 51. 0) vs. (270. 2 ± 89. 3) mL,(1. 1 ± 0. 2) vs. (1. 8 ± 0. 7) times. The differences were significant. Conclusion Neotype controllability artificial nephrohydrosis can develop renal tract for PCNL effectively.

Balloon dilation of pulmonary valve stenosis with 10 F domestic balloon catheter in children≥10 kg / 中国介入心脏病学杂志

Objective To assess the safety and efficacy of balloon dilation of pulmonary valve stenosis with 10 F domestic balloon catheter in children ≥ 10 kg. Methods From May 2009 to June 2014, eighty-three consecutive children with weight ≥ 10 kg and age of (4.5±2.8)(ranged from 1-12) years underwent percutaneous balloon pulmonary valvoloplasty(PBPV) with 10 F domestic balloon catheter. Indication for treatment, procedural details, catheterization data, complication rate, peak-to-peak systolic gradient across the valve and pulmonary insufficiency on echocardiography were respectively analyzed. Forty-four patients were followed up 6-44 months after procedure. Results All procedures were completed successfully. The peak-to-peak systolic gradient across the pulmonary valve decreased from (67.7±26.2) mmHg to (15.4±11.6) mmHg (P < 0.01) immediately after PBPV. Two patients developed reactive infundibular spasm after dilation. They were relieved at 6 months post PBPV. No patient had severe pulmonary insufficiency, tricuspid regurgitation or reintervetion. Conclusions PBPV with 10 F domestic balloon catheter in children with weight≥10 kg is a safe and effective method.

Changes of the Electrophysiological Study in Dogs with Acute Spinal Cord Injury / 대한신경손상학회지

OBJECTIVE: This study describes a method for inducing spinal cord injuries in dogs by using balloon catheters via laminectomy and the subsequent changes in the electrophysiological response. METHODS: Female Beagle (Orient Bio, Seongnam, Korea) dogs weighing 10 kg at the time of injury were used. Under inhalation anesthesia, a posterior midline approach laminectomy was performed. A silicone balloon catheter (size 6 Fr; Sewoon Medical, Cheonan, Korea) was then inserted into the vertebral canal at the center of T10. The balloon was inflated to the maximum volume for 1, 2, or 3 days. Open field testing was performed for evaluating motor functions of the hindlimbs. Motor evoked potentials (MEPs) induced by electrical and magnetic stimulation were recorded before and after spinal cord injury. RESULTS: Open field testing yielded locomotor scores of 0 or 1 for dogs subjected to compression for 3 days. These dogs showed no obvious improvement throughout the observation period, and the tonus of their hindlimbs was flaccid. In contrast, motor functions of dogs that had experienced compression for 1 or 2 days were variable, and all dogs showed spastic tonus in their hindlimbs. In dogs subjected to after compression for 3 days, electrically stimulated MEPs for the hindlimbs showed a significant amplitude reduction. Further, hindlimb movements were not evoked by magnetic stimulation of the cervical spine and vertex area. CONCLUSION: Compression for 3 days with a balloon catheter is a safe, reproducible, and reliable method for evaluating electrophysiological changes in a dog model of complete spinal cord injury.

N-Butyl Cyanoacrylate Embolization with Blood Flow Control of an Arterioportal Shunt That Developed after Radiofrequency Ablation of Hepatocellular Carcinoma

We present a case of a patient with rapid deterioration of esophageal varices caused by portal hypertension accompanied by a large arterioportal shunt that developed after radiofrequency ablation of hepatocellular carcinoma. We used n-butyl cyanoacrylate (NBCA) as an embolic material to achieve pinpoint embolization of the shunt, because the microcatheter tip was 2 cm away from the shunt site. Under hepatic arterial flow control using a balloon catheter, the arterioportal shunt was successfully embolized with NBCA, which caused an improvement in the esophageal varices.

In vitro experiment of marked capacities of different types balloon catheters / 中国医学装备

Objective:To explore the significance of the marked capacities on balloon catheters in different types. Methods: To choose the type 8 to type 20 double-cavity balloon catheters, different doses of 0.9%sterile saline was injected according to the capacities marked on different types of balloon catheters, the shapes and the largest volumes in which balloon catheters could endure were observed under different doses of fluid. Results:The optimal injected saline dose was the marked capacities for type 8 to 14 balloon catheters, but not for type 16, 18 and 20 balloon catheters. Conclusion:The marked capacities of type 8 to 14 balloon catheters were the optimal injected doses, the optimal injected doses for type16 balloon catheter were 15 to 20 ml respectively, at the same time, the optimal dose of type 18, 20 was 20 ml. The largest volumes which balloon catheters could endure under different doses of fluid is not the same yet.

Surgical treatment of ruptured abdominal aortic aneurysm / 国际外科学杂志

Objective To evaluate surgical management of ruptured abdominal aortic aneurysm (RAAA).Methods Clinical data of 36 RAAA patients undergoing emergent graft replacement or endovascular aortic repair (EVAR) from May 2002 to July 2013 were retrospectively analyzed.25 and 21 patients were associated with hypertension and chronic obstructive pulmonary disease respectively.33 patients were treated with graft replacement.3 patients received endovascular treatment and 1 patient converted to open surgery.Results Perioperative death occurred in 3 patients including severe hemorrhagic shock in 1 patient,cardiac arrest in 1 patient and multiple organ failure in 1 patient.During follow up for 3 to 61 months,no operation related complication,such as artificial graft infection happened.Conclusions Emergent operation including open surgery and EVAR is crucial for RAAA treatment.Early diagnosis,excellent operative techniques and effective perioperative management are measures conducive to lowering the mortality rate of RAAA.

Percutaneous epidural balloon catheter insertion for establishing a sheep model of acute cervical spinal cord injury / 第二军医大学学报

Objective To develop a percutaneous technique with expandable balloon catheter for establishing a sheep model of acute cervical spinal cord compression injury. Methods Twelve adult male sheep were randomized into 3 groups: control (A, n = 4), 0. 6 mL compression (B, n = 4) and 1 mL compression (C, n = 4) groups. All animals received epidural balloon catheter (3Fr) insertion using a percutaneous trans-lumbosacral interlaminar space technique similar to the method used in vascular access for angiography. The balloon catheter was advanced under fluoroscopic guidance until its distal tip reached the C6/7 level. One week later, the balloons of group B and C were inflated by 0. 6 mL and 1 mL half-strength contrast material; the balloons were left inflated for 1-hour and then deflated. Animals in group A received no treatment. CT and MR images were taken before and after surgical procedures. Quantitative assessment of spine canal occupying rate was accomplished by using a software program based on CT results. Motor functions of animals were assessed by modified Tarlov scale. Two animals were sacrificed each time at 24 h and 48 h after inflation in each group. Spinal segments of the injured level were then obtained for pathologic examination. Results Balloon catheters were successfully inserted in all animals, and the spinal-canal-occupying rates were (9. 1±0. 2)% in group A, (9. 1±0. 2)% in group B, and (8. 9±0. 2)% in group C after insertion. After inflation, the rates increased to (45. 5 ± 2. 5)% in group B and (78. 3±2. 3) % in group C, and MRI findings indicated ventral compression of the cervical spinal cord. Hind limb movement remained normal after catheter insertion in all groups. Animals in group B and C became paraplegic after inflation, and a positive correlation between injection volume and Tarlov score was observed. Pathological results demonstrated neuron atrophy, increased gap around the neurons, mild demyelinated and vacuolar degeneration in both group B and C at C6/7 level 24 h after injury. Pathological changes deteriorated at 48 h after injury. Conclusion Percutaneous epidural balloon catheter insertion can avoid surgical exposure of normal tissues around the spinal cord, and it may serve as a method for establishing acute cervical spinal cord injury model simulating the clinical condition.