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Objective To discuss the clinical application value of 256-slice helical CT 3D-imaging in guiding interventional occlusion therapy for patent ductus arteriosus (PDA).Methods A total of 40 patients with sonography-proved PDA were randomly divided into group A (angiography group) and group B (CT-guided group) with 20 patients in each group.For the patients of group A,occlusion of PDA was performed based on the intraoperative angiography findings;and for the patients of group B,occlusion of PDA was carried out according to CT examination results.Intraoperative cardiac ultrasound monitoring was adopted and the curative effect was evaluated.Results The morphology of PDA demonstrated on CT 3Dimaging in group B was highly consistent with the configuration of PDA displayed on intraoperative angiography in group A.The most narrow diameters of PDA in group B and group A were (3.88±1.59) mm and (3.63±1.41) mm respectively,and the lengths of PDA in group B and group A were (6.1±1.06) mm and (6.82±0.74) mm respectively;the differences between the two groups were not statistically significant (P＞0.05).The time spent for surgery in group B and group A was (34.3±9.11) min and (17.33±5.81) min respectively,and the intraoperative X-ray radiation doses in group B and group A were (33.93±11.0) mGy and (66.48±9.77) mGy respectively;the differences between the two groups were statistically significant (P＜0.001).In group B,the preoperative X-ray radiation dose from CT examination was (119.79±29.45) mGy,when it was added to the intraoperative X-ray radiation dose the total cumulative radiation dose of group B was strikingly higher than that of group A.Conclusion Contrast-enhanced 256-slice helical CT scan and 3D-imaging technique can replace intraoperative angiography to get accurate anatomical imaging information of PDA,which are very helpful for the performance of interventional occlusion of PDA,meanwhile,it can effectively reduce the damage to the punctured artery and shorten the operation time.However,the radiation dose is a factor that should be taken into consideration.(J Intervent Radiol,2017,26:206-209)
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Objective To evaluate the feasibility and safety of prostatic artery embolization (PAE)via transradial approach in treating prostatic hyperplasia.Methods The clinical data of 18 patients with prostatic hyperplasia,who received C-arm CT-guided PAE via left or right radial artery access,were retrospectively analyzed.The following indexes were recorded:arterial spasm and injury of upper limbs,incidence of puncture point bleeding,postoperative radial artery pulse and congestion,blood supply and nerve injury of fingers,the surgical success rate,incidence of perioperative cerebral vascular complications,operation time,radiation dose and clinical curative effect.Results Among the 18 patients,PAE via left radial artery access was employed in 14,and PAE via right radial artery access was performed in 4.Bilateral PAE was carried out in 16 patients,and only unilateral PAE was able to be successfully accomplished in 2 patients as the prostatic artery opening of the other side was tortuous with stenosis.After PAE,decreased radial pulse was observed in one patient and ultrasound examination revealed decreased blood flow.The operation time ranged from 96 min to 245 min.The radiation dose received by the patient varied from 2435 mGy to 4958 mGy with a mean of (3342±156) mGy,which was not significantly different from the radiation dose received by the patients who underwent PAE via femoral artery access during the same study period (P=0.1167).Conclusion In treating prostatic hyperplasia,PAE by using transradial approach is clinically safe and technically feasible.