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Obiective To evaluate the current status of studies on interventional recallalization of fallopian tube.Methods According to the standard of evidence-based medicine,literatures were analyzed by two readers in three time periods:1997 to 2000,2001 to 2004 and 2005 t0 2008.Two separate evaluation results were tested by the statistical method Kappa to test its consistency.Scores of clinical controlled trials (CCT)and randomized controlled trials(RCT)were calculated according to Jadad score scale.The accurate criteria of case selection,case exclusion,and effect determination;the method of randomization;the number of samples:the comparability of baseline;the blinded procedure;the therapeutic method;the method of statistical analysis:the follow-up cases; the drop-out cases and the conclusions derivation of RCT and CCT into descriptive analysis were evaluated Results One hundred and fifty seven therapeutic articles were searched and 30 RCT and CCT articles(25 RCT and 5 CCT)were analyzed.The Kappa value was 0.85 and P＜0.05 indicating that the evaluation was in good consistency.2,15 and 8 RCT received 0 point,1 point and 2 points respectively in Jadad score scale.RCT and CCT contained 9 articles(30.0%)fulfilled the accurate criteria of case selection and exclusion:12 articles(40.0%)met the accurate criteria of effect determination:4 articles(13.3%)utilized the definite method of randomization;27 articles (90.0%)had the number of sample beyond 60;14 articles(46.7%)met the baseline comparability;only 1 article(3.3%)used the single-blinded method,17 articles(56.7%)utilized the method of statistical analysis;13(43.3%)mentioned follow-up in articles;4(13.3%)mentioned drop-out cases in the articles and 14(46.7%)articles had the conclusions derived by considering the statistical significance and clinical significance.Conclusion The quality of studies on interventional recanalization of fallopian tube is poor and could not meet the standard of evidence-based medicine.
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Objective To assess the technical feasibility and efficacy of the combined application of a flexible,self-expanding neurovascular stent(Neuroform)and Gugliebni detachable coils(GDC)in the management of wide-necked intracranial aneurysms in humans.Methods Sixty-five wide-necked aneurysms which underwent 65 endovascular procedures were performed by using intracranial stent and GDC.There was a total of 30 aneurysms at basilar artery including 16 at the basilar tip,9 at the basilar trunk and 5 at the beginning of the basilar artery.And there were 30 aneurysms located at the posterior communicating artery, and 5 aneurysms located at the vertebral artery.The Neuroform stents were deployed to cover the neck of aneurysms.Another microcatheter was introduced into the aneurysm sac through the stent interstices and then detachable coils were released to embolize the aneurysms.Results The combined procedures were successful in all of the 65 patients with wide-necked aneurysms.The stent could pass smoothly through the intracranial artery and got released.Complete occlusion was achieved in 60 patients and incomplete occlusion in 5 patients.In-stent thrombosis occurred in 2 patients.All patients recovered well.Forty-two patients had followe-up angiography at 3 to 6 months after the procedure.Among them,no filling was found for the 39 aneurysms which were densely packed,and 3 aneurysms had neck remnant.Conclusion The implantation of Neuroform stent as a complimentary device to GDC coiling is easy and safe for embolization of wide-necked intracranial aneurysms.It has great advantage for treatment of wide-necked intracranial aneurysms.
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Objective To investigate the causes,consequences and management of injuries to the draining veins after embolization of brain arteriovenous malformations(BAVMs)with ?-n-butyl cyanoacrylate (NBCA).Methods The angiographic imaging data of 189 BAVMs patients who underwent NBCA embolization were studied retrospectively.The status of the draining veins before and after NBCA embolization was observed and compared.The intracerebral hemorrhage(ICH)complications and their relation to their angiographic features were analyzed.Results Twenty-three patients out of 189 patients showed injuries to the draining venous system,including 10 low-grade injury,6 moderate injury,and 7 high- grade injury.Six patients suffered from ICH after embolization,of whom 4 patients were due to injuries of the draining veins(2 moderate and 2 high-grade).In the 3 months follow-up evaluation of 4 patients with ICH, one died,one was in vegetative state,and the other two patients suffered from residual severe or minor (1 patient for each)permanent neurological deficits.Conclusion Our findings suggest that injury of the draining veins is the major cause of ICH and may lead to serious consequences after embolization of BAVMs with NBCA.