ABSTRACT
Hemorrhage after prostate biopsy is common, but hemorrhagic shock is rare. We reported a case of sudden severe hematuria on the third day after prostate biopsy, which was considered to be bleeding at the puncture site. Conservative treatment was ineffective, and interventional embolization was performed. Bilateral bulbar urethral arteries were embolized, and the bleeding was stopped successfully. On the 4th day after embolization, the patient developed hypovolemic shock. Angiography showed bilateral prostatic artery bleeding, and the bleeding site and its superior branch arteries were embolized immediately. At 4 months after embolization, no bleeding related events occurred.
ABSTRACT
Objective:To explore the risk factors of intracranial aneurysm interventional embolization for subarachnoid hemorrhage (SAH) perioperative infection.Methods:A retrospective analysis of the clinical data of 236 SAH patients who underwent aneurysm interventional embolization in the Department of Neurosurgery, Huangshan Shoukang Hospital from May 2018 to December 2019, and statistics of the surgical treatment effects and postoperative conditions of all patients, according to the perioperative Infective status in the early stage, the patients were divided into infected group ( n=44) and non-infected group ( n=192) according to the perioperative infection, and the clinical indicators of the patients were recorded, including age, gender, history of drinking, smoking history, history of diabetes, and whether there was any temporary blockade during the operation, aneurysm location, triacylglycerol, lipoprotein type, CT-Fisher classification, history of hypertension, aneurysm diameter, number, albumin, Hunt-Hess classification, Glasgow coma score (GCS) at admission, number of punctures. Measurement data were expressed as the mean ± standard deviation ( Mean± SD), comparison between groups was by t-test; count data comparison between groups was by Chi-square test. Logistic regression was used to analyze the risk factors of infection in SAH patients during perioperative period. Results:The treatment success rate of all SAH patients was 100%; the results of univariate analysis showed that the history of hypertension, aneurysm diameter, number, albumin, Hunt-Hess classification, GCS score at admission, and number of punctures were compared between infected group and non-infected group, the difference was statistically significant ( P<0.05); the results of multivariate Logistic regression analysis showed that history of hypertension, aneurysm diameter ≥8 mm, a large number of aneurysms, albumin ≤35.12 g/L, Hunt-Hess classification Grade Ⅲ to Ⅳ, GCS score> 5 points at admission, and number of punctures>2 times were risk factors for perioperative infection in SAH treated by interventional embolization of intracranial aneurysm; the total score of all factors in the nomogram prediction model was 314.84 points, the corresponding value was 14.96% of the perioperative infection rate of intracranial aneurysm interventional embolization for SAH. Conclusions:Interventional embolization of intracranial aneurysm for SAH can achieve good clinical results. However, history of hypertension, aneurysm diameter ≥ 8 mm, a large number of aneurysms, albumin ≤ 35.12 g/L, Hunt-Hess grade Ⅲ to Ⅳ, GCS score > 5 points at admission, number of punctures> 2 times are all independent risk factors leading to perioperative infection in patients, and clinical attention should be paid to and actively prevented.
ABSTRACT
@#Herein is a case report of a 70 years old man with a tenacious benign prostatic hyperplasia (BPH). The aim of this manuscript is to briefly discuss the usage and advantage of EmbozeneTM Microsphere in embolization of the prostate arteries in the treatment of failed medical and surgical therapy for BPH.
ABSTRACT
Objective To observe the effect of Yanshu compound radix sophora injection on the clinical efficacy of patients after interventional embolization for liver cancer rupture and hemorrhage. Methods Sixty-four patients with hepatic cancer rupture and hemorrhage admitted into Department of Hepatobiliary and Pancreatic Surgery in Wuhan Central Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology to undergo interventional embolization and hemostasis from January 2013 to December 2017 were retrospectively analyzed. According to whether the Yanshu compound radix sophora injection was used or not after surgery, the patients were divided into two groups: the patients in western medicine routine treatment control group (32 cases) were given blood transfusion, drugs for pain relief, stopping vomiting, liver protection and symptomatic treatment; the patients in Yanshu compound radix sophora injection group (32 cases) were given besides the above western medicine routine treatment, Yanshu compound radix sophora injection 20 mL in 250 mL 0.9% sodium chloride intravenous drip was additionally applied, once a day for consecutive 10 days. The times of postoperative using analgesics, antiemetics and the proportions of occurring myelosuppression, liver function damage tumor re-bleeding, and decrease of alpha-fetoprotein (AFP) level were observed in two groups. Results The times of using analgesics and antiemetics in patients of compound radix sophora injection group were significantly less than those in the routine treatment group [times of using analgesics (times): 3.2±1.2 vs. 7.4±1.3, times of using antiemetics (times): 4.1±1.1 vs. 7.2±1.2, both P < 0.05], the incidences of adverse reactions such as myelosuppression, liver function damage, tumor re-bleeding rate and AFP reduction rate in patients of compound radix sophora injection group were significantly lower than those in the routine treatment group [myelosuppression: 28.1% (9/32) vs. 56.2% (18/32), liver function damage: 9.4% (3/32) vs. 21.9% (7/32), tumor re-bleeding: 3.1% (1/32) vs. 9.4% (3/32), AFP reduction: 21.9% (7 /32) vs. 15.6% (5/32), all P < 0.05]. Conclusion Yanshu compound radix sophora injection combined with interventional embolization for treatment of patients with hepatic cancer rupture and hemorrhage can significantly improve the clinical efficacy, reduce the incidence of adverse reactions and protect liver function.
ABSTRACT
Objective To investigate the short term and long term clinical efficacy of gemcitabine combined with lobaplatin interventional embolization therapy for the treatment of hepatitis B virus (HBV) infected hepa-tocellular carcinoma (HCC) and its influence on the levels of serum tumor biomarkers .Methods A total of 62 cases of HBV infected HCC in the first affiliated hospital of Chengdu Medical University from June 2012 to January 2015 were selected as the research subjects and randomly divided into the intravenous drip of gemcit-abine plus lobaplatin treatment group (control group) and gemcitabine plus lobaplatin via hepatic artery hy-perthermal perfusion chemotherapy embolism group (embolization group) ,31 cases in each group .The short term and long term clinical efficacy and the changes of serum tumor biomarkers levels were compared between the two groups .Results The total effective rate in the control group was 48 .39％ (15/31) ,which was signifi-cantly lower than 83 .87％ (26/31) in the embolization group ,the difference was statistically significant (P<0 .05);moreover ,the disease control rate in the embolization group was 93 .55％ (29/31) ,which also was sig-nificantly higher than 74 .19％ (23/31) in the control group ,the difference was statistically significant ( P<0 .05);however ,there were no statistically significant difference in the incidence rate of adverse reactions ,av-erage survival time ,1-year and 2-year survival rates between the two groups (P>0 .05);after treatment ,the serum tumor biomarkers CEA ,NSE ,CYFRA21-1 ,CA125 and CA19-9 levels in the two groups were signifi-cantly decreased compared with those before treatment (P<0 .05);the levels of serum tumor markers after treatment had statistical difference between the embolization group and control group (P<0 .05) .Conclusion Gemcitabine combined with lobaplatin interventional embolization therapy can significantly improve the clini-cal efficacy of HBV infected HCC ,and can significantly improve the level of serum tumor biomarkers .
ABSTRACT
Objective To investigate the clinical effect of microsurgical resection combined with preoperative interventional embolization in the treatment of solid intracranial hemangioblastomas, and to analyze the effect of pre-operative embolization on tumor resection,and to discuss the surgical technique and perioperative management of mi-crosurgery. Methods From September, 2010 to September, 2015, the clinical signs, preoperative embolization, mi-crosurgery and prognosis of 18 patients with solid hemangioblastomas were retrospectively analyzed. The patients were examined by CTA and MRI,18 patients underwent DSA tumor arterial embolization and tumor microsurgery. Results The tumor diameter was 2.5-4.0 cm, the proportion of preoperative embolization tumor was 100% in 4 cases, 80% -95% in 9 cases,60%-70% in 3 cases and 60% in 2 cases.16 cases(88.9%)were subtotal tumors,2 cases(11.1%) were subtotal resection, 1 case died. No patients with intraoperative blood transfusion.followed up for 2 years without tumor recurrence. Conclusion The risk of postoperative hemangioblastomas is high, and the intervention of em-bolization for tumor artery will reduce the risk of operation.Microsurgery is the preferred treatment,and skilled micro-surgery is the key to treatment.
ABSTRACT
OBJECTIVE:To investigate chemotherapeutic efficacy and safety of Paclitaxel combined with lobaplatin by inter-ventional embolization for cervical cancer. METHODS:Totally 68 cases of cervical cancer patients selected from our hospital dur-ing May 2010-Mar. 2014 were divided into control group and observation group according to therapy plan,with 34 cases in each group. Control group was given Paclitaxel liposome for injection 175 mg/m2 added into 5% Glucose injection 250 mL,ivgtt+Loba-platin for injection 80 mg/m2 added into 5% Glucose injection 250 mL,ivgtt. Observation group was given Paclitaxel liposome for injection 175 mg/m2+Lobaplatin for injection 80 mg/m2+5% Glucose injection 10 mL via percutaneous catheter after selecting uter-ine artery and tumor vessel by arterial catheterization arteriography,gelfoam embolization. Both groups were treated in the first day of every treatment course,21 d as a treatment course,for 3 courses. Clinical efficacies were observed in 2 groups as well as the levels of T lymphocyte subsets(CD4+,CD8+,CD4+/CD8+)before and after treatment. The occurrence of ADR during treatment,lo-cal recurrence and metastasis after 2 years,and survival situation were recorded. RESULTS:The total response rate of observatio group(85.29%)was significantly higher than that of control group(61.76%),with statistical significance(P0.05). After treat-ment,CD4+and CD4+/CD8+of 2 groups were increased significantly,while CD8+was decreased significantly;above indexes of ob-servation group were improved significantly compared to control group,with statistical significance (P0.05). CONCLUSIONS:Paclitaxel combined with lobaplatin by interventional embolization show definite chemotherapeutic efficacy for cervical cancer,and can improve the levels of T lymphocyte subset with good safety.
ABSTRACT
Objective To treat hydrosalpinx by using interventional embolization of fallopian tube or laparoscopic salpingectomy before the performance of auxiliary reproductive technology,i.e.in vitro fertilization and embryo transplant (IVF-ET),and to compare the clinical effect,technical advantages and disadvamages between the two methods.Methods A total of 170 patients with tubal infertility who had received IVF-ET were selected,the clinical data were retrospectively analyzed.The patients were divided into three groups:(1) interventional embolization group (n=65),using interventional embolization for hydrosalpinx;(2) laparoscopic salpingectomy group (n=55),adopting laparoscopic salpingectomy for hydrosalpinx;and (3) control group (n=50):for these patients bilateral proximal fallopian tube obstruction was performed,and IVF-ET was directly carried out if the patient had no hydrosalpinx.Results No statistically significant differences in the used dosage of gonadotropin (Gn),E2 level on HCG-injection day,the number of follicles on HCG-injection day,the number of retrieved oocytes,the fertilization rate,cleavage rate,clinical pregnancy rate,abortion rate,and ectopic pregnancy rate existed between each other among the three groups (P＞0.05).The technical success rate in both interventional embolization group and laparoscopic salpingectomy group was 100％.No severe complications occurred.The interventional embolization procedure had some advantages,it could be completed at clinic room,the operation time was short,no anesthesia was needed,the medical cost was low,etc.Conclusion Interventional embolization of fallopian tube and laparoscopic resection are equally effective in treating hydrosalpinx before IVF-ET is conducted.Both methods can improve pregnancy outcome,but interventional embolization method is more simple,safe,economical and effective,which deserves to be the preferred method of treatment.
ABSTRACT
Objective To discuss the feasibility of using 3D printing-assisted precise microcatheter shaping technology in the embolization of intracranial aneurysms.Methods From November 2015 to April 2016,a total of 13 patients with intracranial aneurysm were treated with interventional embolization therapy.During the performance of the procedure,3D printing-assisted precise microcatheter shaping technology was employed.The accuracy of microcatheter position and the stability of the microcatheter were used to evaluate the shaping effect.Results During the performance of interventional embolization,the microcatheter was precisely placed to the right site in all 13 patients with intracranial aneurysm,the catheter tip position remained stable and the aneurysm was densely obstructed.In ten patients,no complications such as rupture of aneurysm occurred,and postoperative recovery was fine.One patient,whose Hunt-Hess classification was grade V,died after the treatment.One patient developed rupture of aneurysm during the procedure,which was considered to occur probably during the anesthesia induction process.One patient developed bleeding due to re-rupture of the aneurysm before the procedure.Conclusion With the help of 3D printing-assisted precise microcatheter shaping technology,the precisely shaped microcatheter can be smoothly inserted to,and can keep stable in,the right site,which is helpful for successfully accomplishing the operation and effectively reducing the occurrence of procedure-related complications.
ABSTRACT
Objective To investigate the effect of interventional embolization on the clinical outcome and cognitive function of patients with anterior communicating artery aneurysm rupture .Methods The data of 120 patients with anterior communicating artery aneurysm rup-ture in our hospital from January 2016 to January 2017 were retrospectively analyzed ,in which 71 cases were treated by the spring coil emboli-zation,21 cases received balloon-assisted coiling,23 cases received stent-assisted coil embolization .At the same time,50 healthy people were collected as control group .The preoperative , postoperative cognitive function and the clinical effect of the patients were evaluated .Results Coil embolization group completed embolism in 29 cases,40 cases of most embolism ,2 cases of partial embolization;balloon-assisted coiling group completed embolism in 16 cases,4 cases of most embolism ,1 cases of partial embolization;17 cases of stent assisted coil embolization group completed embolism ,3 cases of most embolism ,3 cases of partial embolism .There was statistically significant difference in embolization rate of coil embolization group(χ2 =6.8862,P=0.0320),balloon-assisted coiling group(χ2 =15.900,P=0.0004) and stent assisted coil embolization group(χ2 =7.280,P=0.0262).After the treatment,the difference in cognitive function of coil embolization group (24.0 ± 0.2) and balloon-assisted coiling group(24.3 ±0.2) was statistically significant (t=86.0386,P=0.0000);the difference between coil embolization group(24.0 ±0.2) and balloon-assisted coiling group(24.3 ±0.2) was statistically significant(t=46.3848,P=0.0000);the difference between balloon-assisted coiling group(24.3 ±0.2) and stent assisted coil embolization group (21.5 ±0.2) points was statisti-cally significant(t=52.1002,P=0.0000).Conclusion Different interventional embolization techniques can improve the cognitive func-tion of patients with ruptured anterior communicating artery aneurysm ,which has more obviously effect on the cognitive function of patients with stent assisted coil embolization .
ABSTRACT
Objective To analyze the influence factors for complete embolization of intracranial aneurysms. Methods The clinical data of 546 inpatients with single intracranial aneurysm underwent interventional embolization at the Department of Neurosurgery,Anhui Provincial Hospital Affiliated to Anhui Medical University from January 2013 to January 2017 were analyzed retrospectively. They were divided into either a complete embolization group (n=255) or a incomplete embolization group (n=291) according to the immediate embolism degree of aneurysms. Single factor,multiple factors logistic regression analyses were used to analyze the factors associated with complete embolization of intracranial aneurysms. Results Univariate analysis showed that there were significant differences in the rupture status,anatomical morphology,Hunt-Hess grade, aneurysm size and neck width, different treatment regimens, and aneurysm angle between the patients in the complete embolism group and the incomplete embolism group ( all P<0. 05). The results of multivariate regression analysis showed that aneurysm size ( OR,0. 344,95%CI 0. 204-0. 578,P<0. 01),aneurysm rupture status (OR,0. 568,95%CI 0. 314-0. 947,P=0. 030), embolism ways (OR,3. 699,95%CI 2. 223-6. 153,P<0. 01),neck width of aneurysm (OR,0. 326, 95%CI 0. 198-0. 539,P=0. 003),aneurysm angle (OR,0. 647,95%CI 0. 451-0. 928,P=0. 018),and aneurysm morphology (OR,1. 689,95%CI 1. 118-2. 552,P =0. 013) were the independent factors of affecting the complete embolization of intracranial aneurysms. Conclusion Tiny, unruptured, narrow-neck, small inclination angle,regular-shaped aneurysms,stent-assisted or balloon-assisted embolization of intracranial aneurysms are easier to embolize the aneurysms completely.
ABSTRACT
Objective To analyze the influence factors for complete embolization of intracranial aneurysms. Methods The clinical data of 546 inpatients with single intracranial aneurysm underwent interventional embolization at the Department of Neurosurgery,Anhui Provincial Hospital Affiliated to Anhui Medical University from January 2013 to January 2017 were analyzed retrospectively. They were divided into either a complete embolization group (n=255) or a incomplete embolization group (n=291) according to the immediate embolism degree of aneurysms. Single factor,multiple factors logistic regression analyses were used to analyze the factors associated with complete embolization of intracranial aneurysms. Results Univariate analysis showed that there were significant differences in the rupture status,anatomical morphology,Hunt-Hess grade, aneurysm size and neck width, different treatment regimens, and aneurysm angle between the patients in the complete embolism group and the incomplete embolism group ( all P<0. 05). The results of multivariate regression analysis showed that aneurysm size ( OR,0. 344,95%CI 0. 204-0. 578,P<0. 01),aneurysm rupture status (OR,0. 568,95%CI 0. 314-0. 947,P=0. 030), embolism ways (OR,3. 699,95%CI 2. 223-6. 153,P<0. 01),neck width of aneurysm (OR,0. 326, 95%CI 0. 198-0. 539,P=0. 003),aneurysm angle (OR,0. 647,95%CI 0. 451-0. 928,P=0. 018),and aneurysm morphology (OR,1. 689,95%CI 1. 118-2. 552,P =0. 013) were the independent factors of affecting the complete embolization of intracranial aneurysms. Conclusion Tiny, unruptured, narrow-neck, small inclination angle,regular-shaped aneurysms,stent-assisted or balloon-assisted embolization of intracranial aneurysms are easier to embolize the aneurysms completely.
ABSTRACT
Objective:Characteristics of the retroperitoneal tumor blood supply arteries were analyzed to evaluate the safety and effec-tiveness of preoperative interventional embolization for benign and malignant retroperitoneal tumors. Methods:A total of 241 cases were divided into benign retroperitoneal tumor group and malignant retroperitoneal tumor group. Each group was divided into groups A, B, and C according to the long diameter of the tumor tissue. Group A>10.0 cm, 5.0 cm0.05). Significant differences in intraoperative bleeding and intraoperative blood transfusion were found between groups A and B (P<0.05). Main arteries of the abdominal retroperitoneal tumor are the lumbar, internal iliac, and adrenal arteries. The main artery of pelvic retroperitoneal tumor is the internal iliac artery. Conclusion:Preoperative interventional embolization can effec-tively reduce the risk of bleeding during malignant retroperitoneal tumor surgery and improve the perioperative safety of patients. No significant benefit of benign retroperitoneal tumors and no increased risk of bleeding during surgery were observed. Retroperitoneal tumor preoperative embolization should focus on investigating the lumbar, internal iliac, and adrenal arteries.
ABSTRACT
Objective To assess the feasibility and efficacy of Amplatzer duct occluder Ⅱ (ADOⅡ) in occlusion of aortopulmonary collateral arteries. Methods Seven patients,6 males and 1 female, with aortopulmonary collateral circulation diagnosed previously by cardiac Computed Tomograpy or cardioangiography from Mar 2014 to Apr 2015 were enrolled. All of them were treated with ADO Ⅱ. Results The age of the patients ranged between 5 - 71 months old and weight 4. 2 - 22. 0 kg. Successful hybrid approach was achieved in 6 of 7 patients. One patient failed the occlusion because of severe hypoxemia and mild-moderate residual shunt after catheter intervention. Total 15 aortopulmonary collateral vessels were embolized by 7 ADO-Ⅱ, 22 non-detachable coils ( Cook corp. ) and 2 detachable micro-coils ( Boston Scientific corp. ). Complete embolization was achieved in 2 patients,4 patients had mild residual shunt and 1 patient had mild-moderate residual shunt after the embolisation. No interventional complications recorded. Conclusions ADO Ⅱ has high controllability and suitable for application through small delivery catheter for minimally-invasive procedures to the vessels. It is a preferable alternative in treating pediatric patients with large and tortuous aortopulmonary collateral arteries.
ABSTRACT
Objective To compare the efficacies between interventional embolization and surgical clipping in treatment of ruptured intracranial aneurysms to provide an evidence‐based basis for selecting the clinical treatment scheme .Methods The related randomized controlled trail(RCT) literatures on the effects of interventional embolization and surgical clipping were retrieved from the databases of Pubmed ,Cochrane ,Medline and Embase .The screening was independently performed by two researchers according to the including and excluding criterion .The occurrence rate of adverse reactions ,postoperative 1‐year mortality rate ,re‐bleeding rate ,occurrence rate of vasospasm and ischemic cerebral infarction served as the measurement indicators .The data were extracted and performed the meta analysis by the RevMan5 .3 software .Results Sixteen RCT literatures were included for conducting analy‐sis ,involving 7 373 patients ,in which 3 092 cases adopted interventional embolization and 4 281 cases adopted surgical clipping .The occurrence rate of adverse events(OR=1 .25 ,95% CI ,1 .12-1 .40 ;P<0 .000 1) and re‐bleeding rate(OR=0 .43 ,95% CI ,0 .28 -0 .66 ;P=0 .000 1) in the interventional embolization group were lower than those in the surgical clipping group ;however ,there were no statistical differences between the interventional embolization group and surgical clipping group in the postoperative 1‐year mortality rate(OR=1 .13 ,95% CI ,0 .92-1 .39 ;P=0 .23) ,incidence rate of vasospasm (OR=1 .41 ,95% CI ,0 .99-2 .02 ;P=0 .06) and incidence rate of ischemic cerebral infarction(OR=0 .66 ,95% CI ,0 .42 -1 .05 ;P=0 .08) .Conclusion The current clinical re‐search evidences indicate that using the interventional embolization in treating ruptured intracranial aneurysms can obviously reduce the occurrence rate of adverse events than the surgical clipping ,but increases the re‐bleeding rate .The postoperative 1‐year mortali‐ty rate ,incidence rate of vasospasm and incidence rate of ischemic cerebral infarction have no obvious difference between these two kinds of operation .
ABSTRACT
Objective To evaluate the clinical efficacy of super-selective prostatic arterial embolization(PAE) for the treatment of benign prostatic hyperplasia(BPH).Methods From February 2012to March 2015,a total of 17 patients with BPH who failed in medical treatment,or unwilling to accept surgery were selected for PAE as the study group.The mean age was 73 years (range 61-84 years) and the mean prostatic volume was 64.6 ml (ranging 50-85 ml).The study group underwent super selective arterial embolization.The internal iliac artery angiography was performed and the main blood vessel of prostate was showed.The femoral artery was punctured under local anesthesia and X-ray monitoring,a F4-5 Cobra catheter was inserted,and then the Embosphere microspheres were implanted.A total of 40 patients who underwent transurethral resection of the prostate(TURP) were selected as the control group.The mean age was 70 years (ranging 59-87 years).The mean prostatic volume was 68.7 ml(ranging 55-90 ml).All cases were followed up for 1 year.The changes of prostatic volume (PV),international prostate symptom score(IPSS),quality of life (QOL),pre-and post-treatment peak urinary flow (Qmax) were evaluated.Results For the 17 patients who underwent PAE,the PV decreased from (64.6 ± 10.2) ml to(42.0 ± 7.5) ml,the IPSS decreased from 23.9 ±4.9 to 13.1 ±3.5,QOL decreased from 4.1 ±0.7 to 2.1 ±0.7,and Q increased from (9.5 ± 3.7) ml/s to(21.8 ± 4.2) ml/s,which were statistically significant (P ＜ 0.05) compared with the pre-treatment parameters.The post-operative parameters of the control group were also significantly improved compared with the preoperative parameters (P ＜ 0.05).Conclusions PAE is safe and effective in treating BPH,especially for those failing in medical treatment,or unwilling to accept surgery.
ABSTRACT
Objective To analyze the complications and clinical effects of interventional embolization and surgical clipping for the treatment of posterior communicating artery aneurysms, and to compare the results between the two methods.Methods A total of 90 patients with confirmed posterior communicating artery aneurysm, who were admitted to the Second Affiliated Hospital of Zhengzhou University during the period from August 2013 to March 2015, were enrolled in this study. Of the 90 patients, 49 received interventional embolization therapy (interventional embolization group) and 41 underwent surgical clipping treatment (surgical clipping group). Before the treatment the patient's condition was evaluated according to Hunt-Hess classification, after the treatment the therapeutic effect was assessed with Glasgow prognosis scale (GOS). The postoperative GOS scores and complications in patients with different Hunt-Hess classification were compared between the two groups. Results In patients of Hunt-Hess 0-Ⅲ grade, no statistically significant differences in postoperative GOS scores existed between the interventional embolization group and the surgical clipping group (t=0.842,P>0.05), while the postoperative GOS scores in patients of Hunt-HessⅣgrade of the interventional embolization group was remarkably higher than that in patients of Hunt-HessⅣgrade of the surgical clipping group, the difference was statistically significant (t=1.713,P<0.05). The incidence of complications in the interventional embolization group was significantly lower than that in the surgical clipping group (x2=1.036,P<0.05). Conclusion For the treatment of Hunt-Hess 0-Ⅲgrade posterior communicating artery aneurysms, the interventional embolization and the surgical clipping show no difference in their therapeutic effects; while for the treatment of Hunt-Hess Ⅳ grade posterior communicating artery aneurysms, the interventional embolization in superior to the surgical clipping, as the interventional embolization carries lower operation risk and complication incidence, and it also has reliable effect.
ABSTRACT
Objective To evaluate the clinical application and therapeutic effect of interventional embolization in treating renal pseudoaneurysms. Methods The clinical data of 11 patients with renal pseudoaneurysm, who had received interventional embolization management at authors’ hospital, were retrospectively analyzed. The embolic agents used in the embolization procedure included conventional steel coil, gelatin sponge particles, PVA, etc. All the patients were followed up for 6-24 months. Results Single renal pseudoaneurysm was found in all the 11 patients. Clinically, symptom of bleeding was seen in 3 cases. The renal pseudoaneurysm was located at the upper (n=1), middle (n=4) and lower (n=5) renal artery of the kidney, and in one case the renal pseudoaneurysm was situated at the accessory renal artery. In performing renal artery embolization, pure PVA was used in one case, spring steel coil in one case, PVA together with spring steel coil in one case, and gelatin sponge combined with spring coil in 8 cases. After the embolization, the pseudoaneurysm was no more visualized, the contrast extravasation disappeared, and the parent artery was manifested as a residual root. During the operation the patients had no obvious discomfort. Within one week after embolization therapy, 2 patients developed hemorrhage, and their hemoglobin, white blood cell count and hematocrit were significantly increased. During the follow-up period, all patients showed no recurrence signs, and routine urine tests were normal. Conclusion For the treatment of renal pseudoaneurysms, interventional embolization is minimally-invasive, safe and reliable; this technique can maximally protect the normal kidney tissue, quickly control the bleeding and effectively save the life of patient. Therefore, it is worth promoting this treatment in clinical practice.
ABSTRACT
Objective To observe cerebral revascularization procedures in patients with refractory intracranial aneurysm surgery with analysis and prognosis.Methods According the digital table,89 patients with refractory intracranial aneurysm surgery were divided,the control group uesed the intervention operation,and the observation group with vessel revascularization.The complications after the operation,cerebrospinal fluid of red blood cells and pressure indicator,and postoperative quality of life in the two groups were observed.Results Observation group of patients with postoperative cerebral vasospasm (CVS) rate was 20.00％,which was significantly lower than that in the control group 40.00％ (x2 =6.79,P ＜ 0.05).Psychological state (SAS,SDS),self esteem (SES) and other related quality of life evaluation score,the observation group was obviously better than the control group (t =6.27,8.69,7.45,all P ＜ 0.05).Cerebrospinal fluid pressure of red blood cells and obviously than the control group after treatment (t =6.18,8.38,17.82,0.57,all P ＜ 0.05).Conclusion Cerebral revascularization in patients with refractory intracranial aneurysm has better reduce operation and operation complications as well as the ability to relieve mental depression,improve the quality of life,is worth the clinical promotion.
ABSTRACT
@#Objective To explore the effect of individual nursing care on persistent headache in patients with intracranial aneurysm who accepted interventional embolization. Methods 100 patients with intracranial aneurysms were divided into observation group (n=50) and control group (n=50). The routine headache nursing care was taken in the control group and the individual nursing care was applied in the observation group. They were assessed with Visual Analogue Scale (VAS). Results The score of VAS reduced more in the observation group than in the control group (P<0.05), and the headache endurance and the satisfaction for nursing care were significantly better in the observation group than in the control group (P<0.05). Conclusion The individual nursing may relieve the pain, and improve the endurance of headache and the satisfaction for nursing care.