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Objective To assess the clinical application value of radiofrequency ablation (RFA) by using different-depth needle-puncturing through medial wall of oval foramen under fluoroscopic guidance in treating primary trigeminal neuralgia.Method A total of 32 patients with primary trigeminal neuralgia were enrolled in this study.Guided by fluoroscopic monitoring,RFA by using different-depth needle-puncturing through medial wall of oval foramen was carried out in all patients.The intraoperative exact replication rates of responsible nerve were recorded,and the postoperative one-day,one-week,3-month and one-year cure rates were calculated.Results During the operation,the precise replication rates the neuralgia of branch Ⅰ,branch Ⅱ and branch Ⅲ of the trigeminal nerve were 85.7％(6/7),96.4％ and 100％ respectively.The postoperative one-day,one-week,3-month and one-year cure rates were 87.5％,93.8％,93.8％ and 87.5％ respectively.Conclusion In treating trigeminal neuralgia with RFA,fluoroscopy-guided needle-puncturing through medial wall of oval foramen can accurately replicate the pain symptoms of the dominating region of responsible nerve,thus,the trigeminal neuralgia can be precisely treated.Being minimally-invasive and safe with reliable effectiveness,this technique is worthy of clinical application.
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Objective To evaluate the clinical effect of DSA-guided foam sclerotherapy for lower extremity varicose veins.Methods A total of 41 legs in 26 patients with lower extremity varicose veins were treated with foam sclerosing agent of lauromacrogol un-der DSA guidance.4 cases with venous return disorder (3 in iliac vein and 1 in inferior vena cava)were treated with balloon dilatation first,and then lauromacrogol foam sclerotherapy after 24 hours.For injection method,2 patients were injected sclerosing agent through a catheter inserted in the trunk of great saphenous vein of sick limb with retrograde catheterization,and the others were in-j ected sclerosing agent directly in the varicose veins.Results The sclerotherapy was successfully accomplished in all affected limbs of 26 patients.The average dose of lauromacrogol for each patient was 5.88 mL.No serious complications occurred during and after operation.In 1 to 12-month follow-up,varicose veins disappeared in 24 patients (92.3%),the soreness,fatigue and pigmentations disappeared in all patients,the ulcer healed in all limbs.Conclusion DSA-guided foam sclerotherapy is a micro-invasive,safe and ef-fective treatment for lower extremity varicose veins.
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Objective To compare the clinical efficacy of two different injection ways in treating lower extremity varicose veins with foam sclerotherapy of lauromacrogol. Methods During the period from Dec. 2010 to Dec. 2012 a total of 80 patients with clinically-proved lower extremity varicosis were admitted to authors’ hospital. The patients were randomly and equally divided into two groups:anterograde group (n=40) and retrograde group (n=40). For patients of anterograde group, under fluoroscopy guidance the needle was directly punctured into the distal end of the varicose vein with subsequent injection of 1%lauromacrogol foam sclerosing agent, while for patients of retrograde group the opposite femoral vein was punctured by using Seldinger technique, then a catheter was inserted into the proximal part of the great saphenous vein of the diseased side, and 1%lauromacrogol foam sclerosing agent was injected into the varicose vein. The operation time, recovery time, the dosage of the sclerosing agent used, the incidence of complications and the use of additional treatment were recorded, and the results were statistically analyzed. All the patients were followed up for 3 - 6 months. Results No significant difference in the overall effective rate existed between the two groups at 3-6 months after the treatment (P>0.05). The preoperative and postoperative CEAP scores of the anterograde group were 3.70 ± 0.63 and 0.88 ± 1.18 respectively, while the preoperative and postoperative CEAP scores of the retrograde group were 3.73 ± 0.59 and 0.88 ± 1.27 respectively. The difference in CEAP score between preoperative values and postoperative ones was statistically significant in both anterograde group and retrograde group (P < 0.05). Besides, the differences in the operation time, recovery time, the dosage of the sclerosing agent used, the incidence of complications and the use of additional treatment between the two groups were also statistically significant. Conclusion In treating lower extremity varicose veins with foam sclerotherapy of lauromacrogol, the overall effectiveness of anterograde injection and retrograde injection is quite the same. As each injection way has its own advantages and disadvantages, the therapeutic scheme should be individualized for each patient.