Different methods for treating pulmonary arteriovenous malformation under multi-disciplinary treatment model / 中国介入影像与治疗学

Objective To observe the effectiveness and safety of different methods under multi-disciplinary treatment(MDT)model for treating pulmonary arteriovenous malformation(PAVM).Methods MDT were retrospectively performed in 31 patients with PAVM.The effectiveness and safety of interventional therapy,surgical treatment and conservative therapy for PAVM were compared.Results Among 31 cases of PAVM,22 cases underwent interventional therapies(interventional group),4 cases received surgical treatments(surgical group)and 5 cases underwent conservative therapies(conservative group).In interventional group,PAVM was successfully embolized in all 22 cases,with the technical success rate was 100％(22/22).Pleurisy was occurred in 3 cases(3/22,13.64％),while recurrence of PAVM was noticed in 4 cases(4/22,18.18％)during follow-up.No recurrence occurred in interventional group after the second interventional therapies.In surgical group,4 cases were successfully treated with thoracoscopic lobectomy,with the technical success rate of 100％(4/4).No postoperative complication occurred,while recurrence of PAVM was noticed in 2 cases(2/4,50.00％)during follow-up,including 1 case underwent interventional therapy and 1 case underwent conservative therapy.In conservative group,progressive PAVM was observed in 3 cases(3/5,60.00％),including 2 cases who were cured with interventional therapy and 1 case died of stroke after conservative therapy.Conclusion Individualized treatments of PAVM were feasible under MDT model.Compared with surgical treatments and conservative therapies,interventional therapies of PAVM were more effective and relatively safe.

Brief introduction and compliance research of 2017 Fleischner society lung nodules guidelines / 中国介入影像与治疗学

In this article,2017 Fleischner society lung nodules guidelines for management of lung nodules accidentally discovered and lung nodule measurement were briefly introduced.Electronic questionnaires were sent to doctors nationwide,and their familiarity and consistency with these recommendations were assessed.The results showed relatively high familiarity with the guideline,but the consistency in clinical practice was still unsatisfactory,suggesting that further promotion of these guidelines is necessary in the future.

Effect of catheter-based peripheral sympathetic denervation on peripheral artery sympathetic tone of New Zealand rabbits / 中国介入影像与治疗学

Objective To investigate the effect of catheter-based peripheral sympathetic denervation (CPSD) on peripheral artery sympathetic tone of New Zealand rabbits.Methods Twenty New Zealand rabbits were randomly divided into CPSD group and control group (each n =10).Endovascular radiofrequency ablation above the bifurcation of the abdominal aorta was performed on the rabbits in CPSD group.Norepinephrine was infused with continuous trans-arterial pumping in both two groups.And laser Doppler flowmetry was used to measure the peripheral microperfusion and temperature of right hindlimb of rabbits.The changes of the peripheral microperfusion and temperature before (resting state) and after norepinephrine infused (norepinephrine load state) were compared between the two groups.Results Eight rabbits completed the procedure in each group.The change of peripheral microperfusion between resting and norepinephrine load states in CSPD group was lower than that in control group ([-37.19±22.56]％ vs [-57.02％±10.12]％,P=0.04),whereas the change of temperature was not significantly different between the two groups ([0.35±0.50]℃ vs [-0.21± 1.83]℃,P=0.43),while significant difference was noticed when two rabbits with abnormal temperature change in control group were neglected ([0.34± 0.50] ℃ vs [-1.14 ±0.72] ℃,P＜0.01).Conclusion CPSD can be used to decrease the peripheral artery sympathetic tone of New Zealand rabbits,and may play an important role in relieving symptoms of critical limb ischemia.

Super-selective renal arterial embolization in treating huge renal angiomyolipoma / 中国介入影像与治疗学

Objective To evaluate the efficacy and safety of super-selective renal arterial embolization (SRAE) for treatment of huge renal angiomyolipoma (RAML).Methods Data of 16 patients with huge RAML treated with SRAE were retrospectively analyzed.The clinical symptoms,tumor size,serum creatinine and complications were compared before and after SRAE.Results A total of 26 SRAE treatments were performed on 16 patients with huge RAML.The technical success rate of SRAE was 100％ (26/26).Seven cases (7/16,43.75 ％) received one SRAE treatment,whereas 8 (8/16,50.00％) required two SRAE treatments.Only one case (1/16,6.25％) received three SRAE treatments.The mean follow-up period was (16.60± 15.60) months.The maximum diameter of the tumor reduced significantly after SRAE at final follow-up than before embolization ([9.00±2.80]cm vs [12.60±2.40]cm,t=12.41,P＜0.01).The symptoms of flank pain and hematuria gradually relieved after SRAE.And there was no statistical difference of mean serum creatinine before and after SRAE ([76.00±14.90]μmol/L] vs [79.10±12.80]μmol/L,t=0.89,P=0.39).Fourteen cases (14/ 16,87.50％) experienced post-embolization syndrome including varying degrees of fever,local pain or nausea on 1-3 days after embolization.No serious complications occurred.Conclusion SRAE is an effective method for stopping bleeding of ruptured huge RAML,as well as relieving symptoms and reserving nephron.