Application of in situ needle puncture fenestration of left subclavian artery during thoracic endovascular aortic repair with the short proximal landing zone / 中华放射学杂志

Objective:To evaluate the feasiblity and safety of in situ fenestration during the endograft of thoracic endovascular aortic repair (TEVAR) via the left subclavian artery (LSA).Methods:A total of 23 patients, including 17 patients with thoracic aortic dissection and 6 patients with thoracic aortic aneurysm, were respectively enrolled from October 2018 to June 2019 at Nanfang Hospital, Southern Medical University. All of the patients underwent in situ fenestration of LSA via the thoracic artery endograft following the TEVAR procedure. A 21 G preflex hollow needle was used to puncture the endograft from the medial segment of LSA for in situ feneatration. The success rate, clinical effect and complications were recorded on 1, 3 and 6 months after in situ fenestration.Results:The success rate was 100% in all the 23 patients with needle puncture in situ fenestration of LSA. The rechecked thoracic aorta angiography showed that both thoracic aortic main endograft and the LSA branch cover stent were well expanded, and there were no endoleaks occurred around the LSA branch cover stent. No hematoma was found in the supraclacicular fossa within all the perioperative period. A small pneumatothorax in the left pleural cavity which did not need treatment was being detected in 1 patient on the chest film 3 days after the procedure. The mean follow-uptime was (4.2±1.4) months. There were no retrograde tearing happened in the proximal end of the endograft, and no endoleak happened around the LSA branch cover stent either.Conclusion:The technique of needle puncture fenestration of LSA via the thoracic artery endograft is considered as a simple, safe, and effective method of in situ LSA reconstruction.

Endovascular repair or medication for the management of uncomplicated type B aortic dissection / 介入放射学杂志

Objective To compare the curative effect of thoracic endovascular repair (TEVAR) plus medication with that of pure medication in treating uncomplicated type B aortic dissection,and to discuss the treatment strategy for uncomplicated type B aortic dissection.Methods The clinical data of 118 patients with definitely confirmed uncomplicated type B aortic dissection,who were admitted to authors' hospital during the period from 2004 to 2015,were retrospectively analyzed.Among the 118 patients,57 patients received TEVAR plus medication (TEVAR group) and 61 patients were treated with pure medication (drug group).The complications and mortality within one month and during follow-up period in both groups were calculated respectively,and Kaplan-Meier survival curves were used to compare the survival rate between the two groups.Results The incidences of complications and morbidity during hospitalization and within one month after treatment in TEVAR group were 5.2％ and 0％ respectively,which in the drug group were 0％ and 0％ respectively.The patients were followed up for 1-110 months,with a mean of (43.3±36.7) months.The incidence of main complications and the mortality in TEVAR group were 7.0％ and 5.3％ respectively,which in the drug group were 6.6％ and 8.1％ respectively.The one-,2-,4-and 7-year cumulative survival rates in TEVAR group were 100％,97.1％,93.5％ and 78.0％ respectively,which in the drug group were 98.4％,96.4％,90.8％ and 72.7％ respectively,the differences between the two groups were not statistically significant (~=0.019,P=0.890).Conclusion For the treatment of uncomplicated type B aortic dissection,TEVAR plus medication is superior to pure drug therapy in reducing expansion rate of false cavity,but TEVAR carries some procedure-related complications,besides,TEVAR can not improve the survival rate.(J Intervent Radiol,2017,26:266-269)

Clinical application of ExoSealTM vascular closure device in interventional management via retrograde femoral artery access / 介入放射学杂志

Objective To discuss the safety and efficacy of using ExoSealTM vascular closure device to obtain rapid hemostasis of puncture site in interventional procedure via retrograde femoral artery access.Methods The clinical data of 124 patients,who were admitted to authors' hospital during the period from March 2016 to April 2016 to receive interventional procedure via retrograde femoral artery access,were retrospectively analyzed.During the performance of intervention,ExoSealTM vascular closure device (ExoSealTM group,n=52) or manual compression (MC group,n=72) was employed to make femoral artery puncture point hemostasis.The time spent for hemostasis,the manual compression time,the limb immobilization time,the amount of blood loss during compression process,and the procedure-related complications were recorded and the results were compared between the two groups.Results Technical success rate in ExoSealTM group was 98.1％(51/52).In ExoSealTM group and MC group,the time spent for hemostasis was (0.28±0.08) min and (5.83±1.46) min respectively,the manual compression time was (2.65 ±0.57) min and (7.70± 1.88) min respectively,the limb immobilization time was (2.72±0.43) h and (6.15±0.69) h respectively;all the differences between the two groups were statistically significant (P＜0.01).In ExoSealTM group subcutaneous hemotoma occurred in one patient,while in MC group subcutaneous hemotoma occurred in 3 patients and pseudoaneurysm in one patient;the complication rates were 1.92％ (1/52) and 5.56％ (4/72) respectively,but the difference was not statistically significant (P＞0.05).In MC group the amount of blood loss during compression process was (1.11±0.86) ml,which was remarkably less than (7.83±2.08) ml in ExoSealTM group,the difference between the two groups was statistically significant (P＜0.01).Conclusion For hemostasis of puncture site in interventional management via retrograde femoral artery access,the use of ExoSealTM vascular closure device is safe and effective.

"Application of ""sandwich"" technique according to area calculation in endovascular repair of aortoiliac diseases" / 中国介入影像与治疗学

Objective To investigate the clinical applications of sandwich technique according to area calculation in endovascular aneurysm repair of patients with aorta and iliac artery lesions.Methods Six patients with aortoiliac artery disease confirmed by CT were treated using sandwich technique according to area calculation.The diameter of the main stent and two branches stents were chosen according to the area calculation.Technical success rate,patency of the stent graft and complications were observed.Results Technical success rate was 100％ (6/6),and no complications occurred in all the 6 patients.The clinical symptoms were significantly improved.Gutter endoleak was found in 1 patient 2 months after the procedure,and was managed by coil embolization successfully.No endoleak occurred in other patients during follow-up of 6-31 months.Conclusion For patients with special anatomy of aorta and iliac artery lesions,the application of area calculation in the sandwich technique provides a feasible approach in choosing the matching size of the main body stent and two side branches stents.

The optimal liquid-to-air ratio for the preparation of 1% lauromacrogol foam sclerosant / 介入放射学杂志

Objective To investigate the stability of 1% lauromacrogol foam sclerosant prepared with different liquid-to-air ratio in order to find out the optimal liquid-to-air ratio. Methods According to Tessari technique, two 10 ml disposable plastic syringes and one three-way plastic stopcock were used to mix 1%lauromacrogol with room air, and liquid-to-air ratios from 1∶1 to 1∶9 were separately employed to make the preparation of the foam sclerosant. Each kind of liquid-to-air ratio was used to separately make bubbles for 5 times, the foam half-life time (FHT), the foam drainage time (FDT) and the foam coalescence time (FCT) were recorded, and their mean values were calculated. The optimal liquid-to-air ratio was defined as the intermediate values of all the above measured indexes. Results When the liquid-to-air ratio was 1 ∶ 1, 1 ∶2, 1 ∶ 3, 1 ∶ 4, 1 ∶ 5, 1 ∶ 6, 1 ∶ 7, 1 ∶ 8 and 1 ∶ 9, the FHT of 1% lauromacrogol foam sclerosant was 184.8, 169.3, 135.9, 110.8, 111.5, 92.6, 76.3, 74.7 and 49.9 seconds respectively; the FDT was 10.6, 17.8, 14.6, 13.7, 13.0, 12.3, 10.7, 11.5 and 12.6 seconds respectively; while the FCT was 108.4, 79.8, 41.8, 20.3, 10.4, 0, 0, 0 and 0 seconds respectively. Conclusion Based on Tessari technique, the indoor air, two 10 ml disposable plastic syringes and one three-way plastic stopcock are used to prepare 1%lauromacrogol foam sclerosant, and the optimal liquid-to-air ratio is 1 ∶ 2.

Long-term follow-up of the femoral artery after total percutaneous endovascular aortic repair with preclose technique using a vascular closure device / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the long-term outcome of the femoral artery following total percutaneous endovascular aortic repair (EVAR) with preclose technique using a vascular closure device (VCD).</p><p><b>METHODS</b>From July, 2009 to July, 2012, total percutaneous EVAR was performed in 113 patients (106 males, 7 females; mean age 59.4∓13.5 years) with pre-close technique, including 60 with Stanford type B aortic dissection, 3 with thoracic aortic aneurysm, and 48 with infra-renal abdominal aortic aneurysm, and 2 with thoracic and abdominal aortic aneurysms. The Technical success and complication rates were evaluated, and the outcomes of the femoral artery were followed up with computed tomography or color Doppler ultrasound.</p><p><b>RESULTS</b>The overall technical success rate was 97.6% (161/165) with conversion to open surgery in 4 cases. The size of the sheaths used were 24Fr (n=37), 22Fr (n=29), 20Fr (n=24), 18Fr (n=25), 16Fr (n=12) and 14 Fr (n=38), and 347 VCDs were used for hemostasis of 165 femoral sites; 147 femoral sites were closed using 2 VCDs. Four access-related adverse events, including femoral arterial-venous fistula, acute femoral thrombosis, bleeding, and lower extremity ischemia, occurred in 4 (2.4%) of the 165 cases. In cases using ≤18Fr sheaths, the success rate of closure using 2 VCDs was 98.7%, as compared to 81.1% in cases using larger (≥20Fr) sheaths (P=0.0003). The success rate of the 82 anterior sites was lower than that of the 82 posterior sites (82.9% vs 95.2%, P=0.013). No lower extremity ischemia was observed, nor was femoral artery stenosis detected during the follow-up for 26∓9 months (12-50 months) in these cases.</p><p><b>CONCLUSION</b>Total percutaneous EVAR with preclose technique using VCD provides a safe and effective alternative to open femoral surgery. The sheath size can be a predictor of percutaneous access failure to require conversion to open femoral surgery or using more than 2 devices for suture. Total percutaneous endovascular aortic repair using VCD with preclose technique is safe and effective, which can be adopted as an alternative technique of surgically femoral arterial cut-down operation when the surgeon reduce the learning curve.</p>

The preventive transhepatic interventional therapy for primary liver cancer after surgical resection:comparison study between TACE and TAI / 介入放射学杂志

Objective To compare the therapeutic efficacy of preventive transcatheter arterial chemoembolization (TACE) with that of preventive transhepatic arterial infusion (TAI) for patients with primary hepatocellular carcinoma (HCC) after hepatectomy. Methods During the period from June 2011 to June 2012 at authors’ hospital, preventive transhepatic interventional therapy was employed in 79 HCC patients within three months after hepatectomy. The followed-up endpoint was in June 2013. The clinical data were retrospectively analyzed. The patients were divided into TACE group (n=41) and TAI group (n=38). No significant differences in age, sex, preoperative liver function, Child-Pugh scores, tumor size and AFP level existed between the two groups. During interventional procedure , catheterization of proper hepatic artery was performed first, which was followed by angiography in order to clarify that there were no newly-developed tumor vessels or tumor lesions in the residual liver, then the chemotherapeutic agents were infused through the catheter. The emulsion of iodized oil with chemotherapeutic agent was used in the patients of TACE group, while only chemotherapeutic agent was adopted in the patients of TAI group. By using Chi-square test the one-year recurrence rate was determined. Kaplan-Meier estimation method was used to calculate the disease-free survival time, and t test was adopted to estimate the mean hospitalization days. The results were compared between the two groups. Results Of the 79 patients, postoperative recurrence was confirmed in 11, and the overall one-year recurrence rate was 13.9%. The one-year recurrence rate of TACE group and TAI group was 12.20% and 15.79% respectively , and no significant difference in one- year recurrence rate existed between TACE group and TAI group (χ2= 0.213, P = 0.645). The average disease-free survival time of TACE group and TAI group was (21.60 ± 1.52) months and (17.38 ± 3.01) months respectively, the difference between the two groups was of statistical significance (P = 0.038). The mean hospitalization days of TACE group and TAI group were (6.30 ± 1.84) days and (5.89 ± 2.08) days respectively, and the difference between the two groups was not statistically significant (P = 0.522). Conclusion No significant difference in one-year recurrence rate exists between the patients receiving preventive TACE and the patients receiving preventive TAI after hepatectomy for HCC. Nevertheless , preventive TACE can probably improve the disease-free survival time after hepatectomy.

Image-Guided Percutaneous Lipiodol-Pingyangmycin Suspension Injection Therapy for Sacral Chordoma

A 74-year-old man presented with a progressively worsening pain in sacrum and was diagnosed to have a sacral chordoma by biopsy in May, 2004. Percutaneous intratumoral injection with lipiodol-pingyangmycin suspension (LPS) was carried out under image guidance and repeated when the pain in sacrum recurred and the tumor increased. During a 6-year follow-up period, three sessions of this treatment were executed. CT imaging and Karnofsky Performance Score were used to evaluate the size of tumor and quality of life, respectively. The patient was free of pain after each procedure and had a high quality of life with a Karnofsky Performance Score above 80 points. The tumor lesion in sacral area was effectively controlled. No complications were observed. Percutaneous intratumoral injection with LPS under image guidance may be an effective and safe alternative for the patients with sacral chordoma.

Long-term drainage following PTCD for treatment of ischemic-type biliary lesion after liver transplantation / 中华肝胆外科杂志

Objective To evaluate the effectiveness, safety and clinical feasibility of long-term drainage following percutaneous transhepatic cholangiography and drainage (PTCD) for the treatment of ischemic-type biliary lesion (ITBL) after liver transplantation. Methods There were 11 patients with ITBL after liver transplantation. Of the 11 patients with a mean age of 42. 3, 10 were male and 1 female. All 11 cases were diagnosed by PTC or ERC (endocopic retiogiade cholangiogiaphy) before PTCD, and they responded poorly to medication or draining and stenting with ERCP. Long-term drainage following PTCD was performed, whereas adjuvant percutaneous aspiration through double guidewire technique was used for the patients with large quantities of chole mud. Results There were three types of ITBL: type Ⅰ (extrahepatic lesions, n=7), type Ⅱ (intrahepatic lesions, n= 1), and type Ⅲ (intra- and extra-hepatic alterations, n=3). PTCD was performed in all 11 patients successfully. The values of total bilirubin (TBIL) and direct reacting bilirubin (DBIL) were 206.70±54.18μmol/L, 170. 65±53. 97μmol/L and 90. 63± 13.00μmol/L, 63. 83± 13.61μmol/L before and 1 week after PTCD, respectively. The follow-up period was from 3 through 71 months (mean 20 months). During the follow-up, TBIL values ranged between 23.70 μmol/L and 241.0 μmol/L (mean 55.3±15.6 μmol/L), and DBIL values were between 8. 1 and 162.0 μmol/L (mean 32. 53±10. 21 μmol/L). Hepatic functions were good in 9 cases including 5 cases in which the drainage tube was withdrawn after long-time drainage (6～ 12 months, mean= 8.2 months) and 4 cases in which drainage continued. The other 2 cases received liver retransplantation for the grafts dyssynthesis of albumen after drainage for 3 and 8 months. Conclusion Long-term drainage following PTCD is an effective and safe approach for ITBL following liver transplantation.

Preliminary investigation of esophageal stent dys-seal syndrome / 介入放射学杂志

Objective To investigate the causes and managements of dys-seal syndrome (DSS) developed after esophageal stent placement. Methods From June 2001 to June 2008, esophageal stenting was performed in 98 consecutive patients with malignant esophageal obstruction. A total of 99 metallic stents were used. Of 98 patients. gastroesophageal anastomosis stricture was seen in 19, preoperative radiotherapy history in 26 and tracheoesophageal fistula in 34. Results DSS occurred in 7 patients, with an occurrence rate of 7.14% ,which was significant higher than that in patients with preoperative radiotherapy history and in patients showing marked dilated esophagus proximal to the obstructed site (X~2=0.017, 0.005, P=0.036, 0.013, respectively). After treatment, such as fasting, IPN or nasogastric feeding,only 1 case retumed to semi-liquid diet. Among the rest 6 cases of DSS, an additional stent was employed in one (but in vain), nasogastric feeding tube was used in 2, and removal of the stent under endoscopic guidance was carried out in 3. Conclusion DSS is one of the complications developed after esophageal stent placement, its prognosis is rather poor. Removal of the inserted stent may be the optimal treatment. The prevention of DSS includes proper pre-operation evaluation, selection of suitable stent, enhancement of perioperative nutritional support, etc.

Risk factors of esophageal stent dys-seal phenomenon / 中国介入影像与治疗学

Objective To evaluate the conditions and risk factors of esophageal stent dys-seal phenomenon (ESDP) .Methods Ninety-eight patients with malignant esophageal obstruction underwent metallic stent placement and 7 patients with ESDP were analyzed.The possible contributing factors,including age,gender,obstruction segment,esophagorespiratory fistula,surgical intervention,radiotherapy,the degree of upper obstruction segment expansion,stent with bellmouth,application of covered stent were investigated.All factors mentioned above were analyzed with Logistic regression analysis.Results ESDP was observed in 7 patients (7/98,7.14%) and defined as a space between the esophageal wall and the proximal part of stent without contrast agent obstruction within stent.The clinical situations of patients with ESDP included dysphagia,bucking and constantly chest pain,especially at foodintake.The results of Logistic regression analysis indicated radiotherapy (P=0.005) and the degree of upper obstruction segment expansion (P=0.017) were significantly correlated with ESDP.Conclusion ESDP is one of the complications after esophageal stent placement.It is prudent to implant esophageal stent for those patients with radiotherapy and significant upper obstruction segment expansion.

Evaluation of Fluency stent-grafts in transjugular intrahepatic portosystemic shunts / 中华放射学杂志

Objective To evaluate the efficacy of Fluency stent-graft (Bard Corp) in transjugular intrahcpatic portosystemic shunt (TIPS).Methods The clinical data of 21 consecutive patients treated by TIPS using Fluency stent-grafts were retrospectively reviewed.All of them were recurrent variceal bleeding secondary to portal vein hypertension,1 was bleeding secondary to primary hepatic carcinoma with port vein thrombns,and 1 was Budd-Chiari syndrome.They were followed-up after (10.1 ± 4.6) months (2.0 to 24.0 months).Stent-grafts patancy,portal vein pressure and liver function were recorded and compared.Results Twenty-five stent-grafts were successfully implanted in 21 patients,23 stent grafts were 8 mm 2 were 10 mm in diameter.The covered length of the stents varied from 6 to 8 cm.The bleeding was stopped and the portal vein pressure decreased significantly from (25.4 ± 3.5) mm Hg to (15.4 ± 2.8) mm Hg (t = 12.495,P < 0.01).During the follow-up period,The patient with primary HCC and portal vein thrombosis died 4 months after the procedure. One case had a new primary HCC during the follow-up and died 24 months after the procedure.One ease with variceal bleeding secondary to portal vein hypertension died of muhisystem organ failure.One case occluded in the hepatic vein and had another stcnt graft implanation.The other 17 cases had no stenosis after 7 to 17 months follow-up.Ultrasound showed that the stents were patent 1 week before the patients died.Three cases had transient symptoms of hepatic encephalopathy and recovered after treatment.The Child scores of the 19 patients survived more than 6 months were 6.3 ±1.4 before and 6.4 ± 1.9 after the procedure without significant difference (t = 0.645,P > 0.05).Conclusion The Fluency stent-grafts could increase the patency of the TIPS,but its efficacy on the long-term effect and hepatic encephalopathy need further investigation.

Percutaneous intratumoral injection of lipiodol and chemotherapeutic agents emulsion for primary liver cancer / 中华普通外科杂志

Objective To evaluate percutaneous intratumoral injection of chemotherapeutic agents lipiodol emulsion (CALE) for the treatment of primary liver cancer. Methods This study included 57 patients of hepatocellular carcinoma (n=49) and intrahepatic cholangiocarcinoma (n=8).53 were male and 4 were female,with a mean age of 48.02 years(range,19～70 years).In all,ninety CALE injections were assigned to 90 target areas within the lesions.Before the procedures,transcathetcr arterial chemoembolization (n=55) or infusion (n=2) was carried out in these patients.By arteriography,low blood supply of target areas was showed or it was concluded that superselective catheterization of supply arteries of lesions could not accomplished.Percutaneous intratumoral CALE injection was carried out under fluoroscopy or CT guidance.Therapeutic effect,side effect and complications were assessed based on clinical manifestation,laboratory examination and fluoroscopy or CT one week after procedure.Follow-up was carried out after 1,3,6 months and 1 year,and once every six months thereafter.Local recurrences were treated according to patients'will.Results 90 sessions of percutaneous injection were successfully performed on 57 patients,with 100% technique success rate.The volume of CALE iniected per session ranged 3.0-7.0 ml(mean,6.0 ml) in target size less than 3 cm,12.0-20 ml(mean,15 ml)in target size of 3-5 cm and 24-40 ml in target larger than 5 cm.Serum AFP was positive in 43 patients and decreased to normal in 14 patients(28%).54 lesions(60%)were with well distribution of the lipiodol-chemotherapy mixture on CT 1 month after procedure.Follow-up ranged from 2 months to six years(mean,16 months).The median survival time was 400 d.The cumulative survival rates at 200 d,600d was 85%and 30%,respectively.Complications included fever (n=22,24.4%),nausea and vomit(n=11,12.2%),and pain at the puncture site (n=17,18.9%).Conclusions Percutaneous intratumor CALE injection is safe and effective for the treatment of primary liver cancer.

Intra-arterial embolization with pingyangmycin-lipiodol emulsion for the treatment of hepatic cavernous hemangioma: an analysis of factors affecting therapeutic results / 介入放射学杂志

Objective To analyze the factors that might affect the therapeutic results of pingyangmycin-lipiodol emulsion intra-arterial sclerosing embolization (PLE-IASE) in treating symptomatic cavernous hemangioma of liver (SCHL). Methods PLE-IASE was performed in 89 patients with SCHL (32 males and 57 females). Before treatment the mean diameter of the hemangioma was (8.3±3.8) cm. Of 89 patients, 53 experienced anxiety, 35 suffered from right upper abdominal pain and the remaining one developed Kasabach-Merrit syndrome. Before PLE-IASE, the arteriographic classification was conducted based on hepatic arteriographic findings. Then pingyangmycin-lipiodol emulsion (PLE) was injected through the feeding artery. The dosage of pingyangmycin (PYM) was (9.8±4.4) mg and the dosage of lipiodol (LP) was (5.9±2.9) ml. The lipiodol deposition status was judged by the follow-up spot film taken immediately after PLE-IASE. The observations of the occurrence of complications, the relief of symptoms and the minification of SCHL were followed for 6-72 months after PLE-IASE. The linear regression analysis statistics was conducted by taking the minification as dependent variable and taking the arteriographic classification, lipiodol deposition status, the dosage of PYM, the dosage of lipiodol and the preoperative SCHL diameter as independent variable. Results Of all 89 cases of SCHL, hypervascular type was seen in 51, hypovascular type in 26 and arteriovenous shunt (AVS) type in 12. Good lipiodol deposition status was found in 64 patients and poor deposition in 25 patients after PLE-IASE. After PLE-IASE, the symptom of anxiety in 53 patients was relieved and the right upper abdominal pain was reduced in 33 cases although intermittent pain still remained in 2 patients. The blood platelet count of the patient with Kasabach-Merrit syndrome returned to normal after the treatment. The symptomatic relieve rate was 98.7%. No serious complications occurred in the follow-up period. The linear regression analysis showed that arteriographic classification, lipiodol deposition status and PYM dosage used in treatment had statistically significant impact on tumor minification, while the preoperative diameter of SCHL and lipiodol dosage used in treatment had no statistically significant impact on it. Conclusion PLE-IASE is an effective and safe interventional treatment for SCHL. Arteriographic classification, lipiodol deposition status and PYM dosage used in treatment have a significant correlation with the minification of SCHL, while the preoperative diameter of SCHL and lipiodol dosage used in treatment bear no relationship to the minification of SCHL.

Synthesis of phenyloxyisobutyric acid derivatives and their antidiabetic activity in vitro / 药学学报

Aim To design and synthesize new phenyloxyisobutyric acid analogues as antidiabetic compounds. Methods Eight new target compounds were synthesized by combination of lipophilic moieties and acidic moiety with nucleophilic replacement or Mitsunobu condensation. The eight compounds were confirmed by 1H NMR, 13C NMR, IR and MS. Results In vitro insulin-sensitizing activity (3T3-L1adipocyte) demonstrated, that the cultured glucose concentration of up-clear solution detected with GODpioglitazone, compounds A and B were added to the insulin-resistant system. Conclusion In vitro insulin-sensitizing activity of target compound A is in between that of rosiglitazone and pioglitazone, and activity of target compound B is slightly less than that of pioglitazone.

Uterine artery embolization with Pingyangmycin lipiodol emulsion for treatment of symptomatic uterine fibroids / 中华放射学杂志

Objective To evaluate the effectiveness and side effects of uterine arterial embolization with Pingyangmycin(a homogenous bleomycin) lipiodol emulsion(PLE) for symptomatic uterine fibroids. Methods Uterine arterial embolization with PLE was performed in 25 patients.The improvement of symptoms and uterine size changes were followed up in 3-18 months(mean 6 months) after the procedure. Results All but 2 cases were successfully treated bilaterally.Superselective angiography showed enlargement of uterine artery,accompanied by tortuous branches.The uterine size was increased.The uterus itself was significantly stained and emptied slowly. Coagulation necrosis was found in resected fibroids after embolization in 3 patients. One month after the procedure, a mean 40% reduction of uterine volume was obtained in 18 followed up cases.The clinical symptoms were relieved significantly. The main side effects were hypogastic pain(13/25),which was intense in 6 cases. Conclusion Uterine arterial embolization with PLE is a good non surgical therapy in symptomatic uterine fibroids with mild side effects.