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Recanalization of anastomotic occlusion following rectal cancer surgery using a rendezvous endoscopic technique with transillumination:A case report 被引量:1
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作者 Jun Chi Guang-Yu Luo +3 位作者 Hong-Bo Shan Jun-Zhong Lin Xiao-Jun Wu Jian-Jun Li 《World Journal of Gastroenterology》 SCIE CAS 2024年第37期4149-4155,共7页
BACKGROUND Colorectal anastomotic occlusion is a serious complication of colorectal cancer surgery.Although several treatment strategies have been proposed,the mana-gement of anastomotic occlusion remains challenging.... BACKGROUND Colorectal anastomotic occlusion is a serious complication of colorectal cancer surgery.Although several treatment strategies have been proposed,the mana-gement of anastomotic occlusion remains challenging.In this report,we present a case of anastomotic occlusion recanalization performed using a novel technique involving two endoscopes,one for radial incision and the other serving as a guide light.This novel technique offers significant advantages in terms of operational feasibility,reduced invasiveness,rapid recovery,and shortened hospital stay.CASE SUMMARY A 37-year-old man underwent low anterior resection and prophylactic double-lumen ileostomy for rectal cancer in June,2023.Two months later,complete anastomotic occlusion was observed on colonoscopy.Therefore,we developed a novel atresia recanalization technique.Two endoscopes were placed,one through the colonic anastomosis and the other through the anus.A radial incision was successfully made from the colonic side,guided by the light of the endoscope from the anal side.Atresia recanal-ization was performed within 20 minutes.Three weeks after recanalization,colonoscopy revealed that the diameter of the colorectal anastomosis was approximately 16 mm and the patient therefore underwent stoma reversal in September.During the follow-up period of approximately one year,the patient remained well and no stenosis or obstruction symptoms were observed.CONCLUSION Endoscopic atresia recanalization of colorectal anastomotic occlusion assisted by an opposing light source is safe and effective. 展开更多
关键词 Endoscopy Atresia recanalization Anastomotic occlusion Light source Case report
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Recanalization of extracranial internal carotid artery occlusion A 12-year retrospective study 被引量:21
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作者 Liqun Jiao Gang Song +4 位作者 Yang Hua Yan Ma Yanfei Chen Yabing Wang Feng Ling 《Neural Regeneration Research》 SCIE CAS CSCD 2013年第23期2204-2206,共3页
This study aimed to summarize therapy experience of carotid endarterectomy, carotid endarterec- tomy combined with Fogarty catheter embolectomy, and hybrid surgery for the treatment of extrac- ranial internal carotid ... This study aimed to summarize therapy experience of carotid endarterectomy, carotid endarterec- tomy combined with Fogarty catheter embolectomy, and hybrid surgery for the treatment of extrac- ranial internal carotid artery occlusion. The study included 65 patients with extracranial internal ca- rotid artery occlusion who underwent carotid endarterectomy, carotid endarterectomy combined with Fogarty catheter embotectomy, or hybrid surgery in the Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, China between January 2006 and December 2012. Prior to surgery, all patients underwent perfusion CT or xenon CT to evaluate the occlusion. The procedure for each patient was chosen according to digital subtraction angiography data. The carotid artery was successfully recanalized in 46 of 51 patients who underwent carotid endarterectomy, 9 of 10 patients who underwent carotid endarterectomy combined with Fogarty catheter embolectomy, and 3 of 4 patients who underwent hybrid surgery. In patients with symptomatic carotid artery occlusion, the carotid artery can be recanalized by choosing a treatment procedure based on imaging ex- amination findings. 展开更多
关键词 neural regeneration carotid occlusion CAROTID carotid artery stenting carotid endarterectorny recanalization retrospective study grants-supported paper NEUROREGENERATION
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Long-term outcomes of staged recanalization for concurrent chronic total occlusion in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention 被引量:10
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作者 Kong-Yong CUI Fei YUAN +9 位作者 Hong LIU Feng XU Min ZHANG Wei WANG Ming-Duo ZHANG Yun-Lu WANG Dong-Feng ZHANG Xiao ZHANG Jin-Fan TIAN Shu-Zheng LYU 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2020年第1期16-25,I0002-I0007,共16页
Background In patients with acute ST-segment elevation myocardial infarction(STEMI)who undergo primary percutaneous coronary intervention(PCI),approximately 10%are concomitant with a chronic total occlusion(CTO)in a n... Background In patients with acute ST-segment elevation myocardial infarction(STEMI)who undergo primary percutaneous coronary intervention(PCI),approximately 10%are concomitant with a chronic total occlusion(CTO)in a non-culprit vessel.However,the impact of staged CTO recanalization on prognosis in this cohort remains disputable.This study aimed to compare the long-term outcomes of staged CTO recanalization versus medical therapy in patients with STEMI after primary PCI.Methods Between January 2005 and December 2016,a total of 287 patients were treated with staged CTO-PCI(n=91)or medical therapy(n=196)after primary PCI in our center.The primary endpoint was major adverse cardiovascular and cerebrovascular event(MACCE),defined as a composite of all-cause death,nonfatal myocardial infarction(MI),stroke or unplanned revascularization.After propensity-score matching,77 pairs of well-balanced patients were identified.Results The mean follow-up period was 6.06 years.Overall,the incidence of the primary endpoint of MACCE was significantly lower in staged CTO-PCI group than that in medical therapy group in both overall population(22.0%vs.46.9%;hazard ratio(HR)=0.48,95%CI:0.29-0.77)and propensity-matched cohorts(22.1%vs.42.9%;HR:0.48,95%CI:0.27-0.86).In addition,staged CTO-PCI was also associated with reduced risk of the composite of cardiac death,nonfatal MI or stroke compared with medical therapy in both overall population(9.9%vs.26.5%;hazard ratio(HR)=0.39,95%CI:0.19-0.79)and propensity-matched cohorts(9.1%vs.22.1%;HR:0.40,95%CI:0.16-0.96).After correction of the possible confounders,staged CTO-PCI was independently associated with reduced risks of MACCE(adjusted HR:0.46,95%CI:0.28-0.75),the composite of cardiac death,nonfatal MI or stroke(adjusted HR:0.45,95%CI:0.22-0.94)and all-cause mortality(adjusted HR:0.32,95%CI:0.13-0.83).Moreover,the results of sensitivity analysis were almost concordant with the overall analysis.Conclusions In patients with STEMI and a concurrent CTO who undergo primary PCI,successful staged recanalization of CTO in the non-culprit vessels is associated with better clinical outcomes during long-term follow-up. 展开更多
关键词 Concurrent chronic total occlusion Long-term outcome Staged recanalization ST-segment elevation myocardial infarction
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Sonographic features of umbilical vein recanalization for a Rex shunt on cavernous transformation of portal vein in children 被引量:3
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作者 Yu-Qing Zhang Qing Wang +6 位作者 Mei Wu Ya Li Xiu-Liang Wei Fei-Xue Zhang Yan Li Guang-Rui Shao Juan Xiao 《World Journal of Clinical Cases》 SCIE 2020年第22期5555-5563,共9页
BACKGROUND The Rex shunt was widely used as the preferred surgical approach for cavernous transformation of the portal vein(CTPV)in children that creates a bypass between the superior mesenteric vein and the intrahepa... BACKGROUND The Rex shunt was widely used as the preferred surgical approach for cavernous transformation of the portal vein(CTPV)in children that creates a bypass between the superior mesenteric vein and the intrahepatic left portal vein(LPV).This procedure can relieve portal hypertension and restore physiological hepatopetal flow.However,the modified procedure is technically demanding because it is difficult to make an end-to-end anastomosis of a bypass to a hypoplastic LPV.Many studies reported using a recanalized umbilical vein as a conduit to resolve this problem.However,the feasibility of umbilical vein recanalization for a Rex shunt has not been fully investigated.AIM To investigate the efficacy of a recanalized umbilical vein as a conduit for a Rex shunt on CTPV in children by ultrasonography.METHODS A total of 47 children who were diagnosed with CTPV with prehepatic portal hypertension in the Second Hospital,Cheeloo College of Medicine,Shandong University,were enrolled in this study.Fifteen children received a recanalized umbilical vein as a conduit for a Rex shunt surgery and were enrolled in group I.Thirty-two children received the classic Rex shunt surgery and were enrolled in group II.The sonographic features of the two groups related to intraoperative and postoperative variation in terms of bypass vessel and the LPV were compared.RESULTS The patency rate of group I(60.0%,9/15)was significantly lower than that of group II(87.5%,28/32)7 d after(on the 8th d)operation(P<0.05).After clinical anticoagulation treatment for 3 mo,there was no significant difference in the patency rate between group I(86.7%,13/15)and group II(90.6%,29/32)(P>0.05).Moreover,3 mo after(at the beginning of the 4th mo)surgery,the inner diameter significantly widened and flow velocity notably increased for the bypass vessels and the sagittal part of the LPV compared to intraoperative values in both shunt groups(P<0.05).However,there was no significant difference between the two surgical groups 3 mo after surgery(P>0.05).CONCLUSION For children with hypoplastic LPV in the Rex recessus,using a recanalized umbilical vein as a conduit for a Rex shunt may be an effective procedure for CTPV treatment. 展开更多
关键词 Cavernous transformation of the portal vein Rex shunt recanalization Umbilical vein ULTRASONOGRAPHY
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Modified subintimal plaque modification improving future recanalization of chronic total occlusion percutaneous coronary intervention 被引量:3
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作者 Ruo-Fei JIA Long LI +11 位作者 Yong ZHU Cheng-Zhi YANG Shuai MENG Yang RUAN Xiao-Jing CAO Hong-Yu HU Wei CHEN Jing NAN Xiao-Wei XIONG Jing-Jin LI Jia-Yu WANG Ze-Ning JIN 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2020年第7期393-399,共7页
Background Subintimal plaque modification(SPM) is often performed to restore antegrade flow and facilitate subsequent lesion recanalization. This study aimed to compare the safety and efficacy of modified SPM with tra... Background Subintimal plaque modification(SPM) is often performed to restore antegrade flow and facilitate subsequent lesion recanalization. This study aimed to compare the safety and efficacy of modified SPM with traditional SPM. Methods A total of 1454 consecutive patients who failed a chronic total occlusion percutaneous coronary intervention(CTO PCI) attempt and underwent SPM from January 2015 to December 2019 at our hospital were reviewed retrospectively. Fifty-four patients who underwent SPM finally were included in this study. We analyzed the outcomes of all the patients, and the primary endpoint was recanalization rate, which was defined as Thrombolysis in Myocardial Infarction(TIMI) grades 2-3 flow on angiography 30 to 90 days post-procedure. Results The baseline characteristics were similar between the two groups. In the follow-up, the recanalization rate was noticeably higher in the modified SPM group compared with the traditional SPM group(90.9% vs. 62.5%, P < 0.05). The proposed strategy in the modified group was more aggressive, including a larger balloon size(1.83 ± 0.30 vs. 2.48 ± 0.26 mm, P < 0.05) and longer subintimal angioplasty(0.59 ± 0.16 vs. 0.92 ± 0.12 mm, P < 0.05). Also, the common use of a Stingray balloon and guide catheter extension resulted in improvement of patients in the modified SMP group(12.5% vs. 100%, P < 0.05). Conclusion Modified SPM, which is associated with a high likelihood of successful recanalization, is an effective and safe CTO PCI bail out strategy. 展开更多
关键词 Chronic total occlusion recanalization Subintimal plaque modification
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Comprehensive classifications for the endovascular recanalization of vertebral artery stump syndrome 被引量:1
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作者 Wenbin Zhang Chao Li +4 位作者 Mingchao Shi Jie Zhou Feixue Yue Kangjia Song Shouchun Wang 《Journal of Interventional Medicine》 2023年第2期81-89,共9页
Background:and purpose:To share our single-center vertebral artery stump syndrome(VASS)treatment experience and assess the role of comprehensive classification based on anatomic development,proximal conditions,and dis... Background:and purpose:To share our single-center vertebral artery stump syndrome(VASS)treatment experience and assess the role of comprehensive classification based on anatomic development,proximal conditions,and distal conditions(PAD).Materials and methods:Data were retrospectively collected from patients who underwent endovascular thrombectomy(EVT)at the Stroke Center of the First Hospital of Jilin University between January 2016 and December2021.Among patients with acute ischemic stroke in the posterior circulation,those with acute occlusion of the intracranial arteries and occlusion at the origin of the vertebral artery confirmed by digital subtraction angiography were selected.The clinical data were summarized and analyzed.Results:Fifteen patients with VASS were enrolled in the study.The overall success rate of surgical recanalization was 80%.The successful proximal recanalization rate was 70.6%,and the recanalization rates for P1,P2,P3,and P4 were 100%,71.4%,50%,and 66.67%,respectively.The mean operation times for the A1 and A2 types were124 and 120 min,respectively.The successful distal recanalization rate was 91.7%,and the recanalization rates for types D1,D2,D3,and D4 were 100%,83.3%,100%,and 100%,respectively.Five patients experienced perioperative complications(incidence rate:33.3%).Distal embolism occurred in three patients(incidence rate:20%).No dissection or subarachnoid hemorrhage occurred in any patient.Conclusion:EVT is a technically feasible treatment for VASS,and comprehensive PAD classification can,to a certain extent,help initially estimate the difficulty of surgery and provide guidance for interventional procedures. 展开更多
关键词 Vertebral artery stump syndrome Endovascular thrombectomy Angiographic classification recanalization Acute ischemic stroke
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Research progress of anti-adhesion after tubal obstructive infertility recanalization
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作者 Lu-Yao Huan Ding-Qing Feng Bin Ling 《Journal of Hainan Medical University》 2021年第18期59-64,共6页
Tubal obstructive infertility is one of the most common causes of female infertility.At present,the main treatment is surgical mechanical dredging and restoration of tubal anatomy.Although the success rate of recanali... Tubal obstructive infertility is one of the most common causes of female infertility.At present,the main treatment is surgical mechanical dredging and restoration of tubal anatomy.Although the success rate of recanalization is high,the postoperative reocclusion rate is also high.In addition to the destruction of fallopian tubal function,it seriously affects the long-term pregnancy rate of women.Therefore,how to reduce the re-adhesion rate after recanalization is a more concerned issue at present.This article reviews the research progress of drug therapy for anti-adhesion after recanalization of tubal obstructive infertility. 展开更多
关键词 Tubal obstruction INFERTILITY recanalization ANTI-ADHESION Research progress
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Stent-assisted recanalization of atherosclerotic intracranial stenosis
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作者 Soo Mee Lim Dae Chul 《介入放射学杂志》 CSCD 2006年第9期571-574,共4页
关键词 TIA Stent-assisted recanalization of atherosclerotic intracranial stenosis
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Evaluation of vascular recanalization rate and nerve injury of mechanical thrombectomy combined with rt-PA thrombolysis in treatment of acute cerebral infarction
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作者 Ming-Shu Zhang Ming-Ze Chang Meng Lin 《Journal of Hainan Medical University》 2019年第12期32-36,共5页
Objective:To investigate the vascular recanalization rate of mechanical thrombectomy combined with recombinant tissue-type plasminogen activator (rt-PA) thrombolysis in the treatment of acute cerebral infarction and t... Objective:To investigate the vascular recanalization rate of mechanical thrombectomy combined with recombinant tissue-type plasminogen activator (rt-PA) thrombolysis in the treatment of acute cerebral infarction and the effect on the nerve injury in patients.Methods:A total of 90 patients with acute cerebral infarction who were treated in our hospital between January 2016 and January 2019 were retrospectively analyzed and divided into the control group (n=46) receiving rt-PA thrombolysis and the observation group (n=44) receiving mechanical thrombectomy combined with rt-PA thrombolysis. The differences in vascular recanalization rate 24 h after treatment as well as serum levels of inflammatory mediators [interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-7 (IL-7), interleukin-17 (IL-17) and hypersensitive C-reactive protein (hs-CRP)], nerve injury markers [brain-derived neurotrophic factor (BDNF), neuron-specific enolase (NSE) and S100B protein (S100B)] and neurotransmitters [glutamate (Glu) and 5-hydroxytryptamine (5-HT)] before and after treatment were compared between the two groups of patients.Results: 24 h after treatment, the vascular recanalization rate of the observation group was higher than that of the control group (P<0.05). 24 h after treatment and 1 week after treatment, serum IL-1, IL-6, IL-7, IL-17 and hs-CRP levels in the observation group were lower than those in the control group;BDNF level was higher than that in the control group, while NSE and S100B levels were lower than those in the control group;Glu and 5-HT levels were lower than those in the control group (P<0.05). Conclusions: Mechanical thrombectomy combined with rt-PA thrombolysis can increase the early postoperative vascular recanalization rate in patients with acute cerebral infarction, and it also plays an active role in alleviating nerve injury. 展开更多
关键词 Acute cerebral INFARCTION Mechanical THROMBECTOMY RT-PA THROMBOLYSIS VASCULAR recanalization rate Nerve injury
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Immunoregulatory Role of In vitro-induced Regulatory T Cells in The Treatment of Ischemic Stroke
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作者 MA Yin-Zhong 《生物化学与生物物理进展》 北大核心 2025年第4期803-803,共1页
Kang et al.published a research article on the treatment of ischemic stroke using engineered Treg cells(Kang et al.,Prog Biochem Biophys,2025,52(4):946-956.DOI:10.16476/j.pibb.2025.0019).Their study mainly explores th... Kang et al.published a research article on the treatment of ischemic stroke using engineered Treg cells(Kang et al.,Prog Biochem Biophys,2025,52(4):946-956.DOI:10.16476/j.pibb.2025.0019).Their study mainly explores the immunoregulatory role of regulatory T(Treg)cells in ischemic stroke,providing an innovative therapeutic strategy.Neuroinflammation is a major driver of secondary injury after stroke.Existing treatments focus on vascular recanalization while neglecting immune regulation.Their study proposes to modulate neuroinflammation through in vitro-induced Treg cells,offering a novel approach distinct from traditional thrombolysis and endovascular interventions. 展开更多
关键词 therapeutic strategyneuroinflammation NEUROINFLAMMATION immune regulationtheir regulatory T cells treatment ischemic stroke engineered treg cells kang vascular recanalization ischemic stroke
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Endoscopic management of complete colorectal anastomotic occlusion:Where do we stand?
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作者 Kyriaki Tsagkidou Konstantinos Argyriou +1 位作者 Andreas Kapsoritakis Anastasios Manolakis 《World Journal of Gastroenterology》 2025年第9期183-187,共5页
We recently read with interest the article by Chi et al published in the World Journal of Gastroenterology.In this article,the authors reported a novel technique for re-establishing luminal continuity in a completely ... We recently read with interest the article by Chi et al published in the World Journal of Gastroenterology.In this article,the authors reported a novel technique for re-establishing luminal continuity in a completely occluded colorectal anastomosis involving two endoscopes,one for radial electrical incision and the other serving as a guide light.However,this technique can be applied only in selected cases.Given the absence of a standardized guideline-based algorithm for the management of complete anastomotic obstruction,by reviewing the available literature,we provide a brief overview of relevant endoscopic techniques while underlining their importance in the management of this postoperative complication to provide clinicians with the necessary knowledge to improve their daily practice. 展开更多
关键词 Colorectal anastomotic occlusion TRANSILLUMINATION Rendez-vous endoscopic technique Anastomotic stricture recanalization Stricturotomy
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A new technique focusing on retrograde wire externalization in recanalization of coronary chronic total occlusion 被引量:2
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作者 Jiyan Chen 《Science Bulletin》 SCIE EI CSCD 2019年第4期222-223,共2页
Active greeting technique (AGT) is a new technique that facilitates retrograde wire externalization in recanalization of coronary chronic total occlusion (CTO) lesions published by Prof. Ge [1]. This technique provide... Active greeting technique (AGT) is a new technique that facilitates retrograde wire externalization in recanalization of coronary chronic total occlusion (CTO) lesions published by Prof. Ge [1]. This technique provides an active capture system that assists CTO retro-grade wire externalization and improves procedural quality. 展开更多
关键词 AGT CTO recanalization
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Clinical Study in Treating Fallopian Tube Obstruction withCatheter Recanalization and Blood Slasis Rernoving Herbal Drugs 被引量:1
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作者 连方 赵斌 胡安常 《Chinese Journal of Integrative Medicine》 SCIE CAS 1996年第2期108-110,共3页
The 100 patients with fallopian tube obstruction were firstly treated by catheter recanaliza-tion, and then randomiy divided into two groups : Chinese medicine group (CMG) was treated with Tongjing-bao (痛经宝) and An... The 100 patients with fallopian tube obstruction were firstly treated by catheter recanaliza-tion, and then randomiy divided into two groups : Chinese medicine group (CMG) was treated with Tongjing-bao (痛经宝) and Angelicae Complex Injection, and Western medicine group (WMG) as the control wastreated with gentamycin, dexamethasone and Cliotrypsin. The course of the treatment was three months andliemorlieology change was analysed before and atter the treatment. After the above treatment , hystero salp-ingography was again performed on all patients except those with subsequent pregnancy . The results showedtliat the effective rate of catheter recanalization was 94% , and the pregnancy rate was 30% in CMG and16% in WMG (P<0. 05) . The reocclusion rate of fallopian tube was 9. 3% in CMG and 29. 9% in WMG (P<0. 05) . The difference of hemorheology change was significant between the two groups (P< 0. 01 ) andbetween betore and atter treatment in CMG (P< 0 . 01 ) . This study showed that catheter recanalization waseffective in mechanically recanalizing the occluded tallopian tube and that the Chinese medicine used in thetreatment effective in lowing tlie concentration of blood and thus inhibiting the reocclusion and re-adhesion ofthe fallopian tube. 展开更多
关键词 catheter recanalization Tongjingbao Angelicae Complex Injection fallopian tube obstruc-tion
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Selection of treatment modalities for Budd-Chiari Syndrome in China:A preliminary survey of published literature 被引量:16
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作者 Xing-Shun Qi Wei-Rong Ren +1 位作者 Dai-Ming Fan Guo-Hong Han 《World Journal of Gastroenterology》 SCIE CAS 2014年第30期10628-10636,共9页
AIM: To evaluate the frequency of use of various treatment modalities for Budd-Chiari syndrome (BCS) in China by conducting a preliminary survey of relevant literature.
关键词 Budd-Chiari syndrome Treatment SURGERY Percutaneous recanalization Transjugular intrahepatic portosystemic shunt
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Application of retrievable Solitaire AB stents in the endovascular treatment of acute ischemic stroke 被引量:27
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作者 Teng-Fei Zhou Liang-Fu Zhu +8 位作者 Tian-Xiao Li Zi-Liang Wang Wei-Xing Bai Jiang-Yu Xue Guang Feng Li Li Ying-Kun He Li-Heng Wu Bu-Lang Gao 《Journal of Interventional Medicine》 2018年第2期77-81,共5页
Purpose: Retrievable stents are widely used in acute ischemic stroke(AIS); however, the results remain unclear in Chinese patients. This study aimed to explore the usefulness of Solitaire AB stents in AIS. Materials a... Purpose: Retrievable stents are widely used in acute ischemic stroke(AIS); however, the results remain unclear in Chinese patients. This study aimed to explore the usefulness of Solitaire AB stents in AIS. Materials and Methods: Seventy-three AIS patients treated with Solitaire AB stents for thrombectomy of large artery occlusion of anterior circulation in January 2014-June 2015 were retrospectively evaluated. Recanalization was assessed with the Thrombolysis In Cerebral Ischemia(TICI) scale. Clinical outcomes were assessed according to the National Institute of Health Stroke Scale(NIHSS) and the modified Rankin Scale(mRS). Operation-related complications were recorded. The main factors affecting successful recanalization with Solitaire AB were analyzed. Results: The 73 patients enrolled included 39 males and 34 females(median age of 59 [31-78] years); 77 Solitaire AB stents were used. The initial recanalization rate with Solitaire AB as the first thrombectomy method was 53.42%(39/73; recanalization group). Among the 34 patients with failed stent retrieval, 32 underwent other treatments; the final arterial recanalization rate was 89.04%(65/73). Perioperative embolization events and symptomatic intracranial hemorrhage(sICH) occurred in 5 and 8 patients, respectively. The mean NIHSS score was 9.12±3.86 one week after thrombectomy, significantly lower compared with admission values. In 31 patients(42.47%), NIHSS score decreased by >8. Good functional independence(mRS score≤2) was achieved in 39 patients(53.42%) at 90 days; 12 patients(16.44%) died. Compared with the recanalization group, the remaining patients showed lower AF and higher LAA percentages. Conclusion: Solitaire AB stents are useful in the endovascular treatment of AIS. 展开更多
关键词 Acute ISCHEMIC stroke SOLITAIRE stent Artery occlusion recanalization therapy INTRACRANIAL HEMORRHAGE
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Computed tomography angiography-guided percutaneous coronary intervention in chronic total occlusion 被引量:7
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作者 Ping LI Lu-yue GAI Xia YANG Zhi-jun SUN Qin-hua JIN 《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 SCIE CAS CSCD 2010年第8期568-574,共7页
Objective: The aim of this study is to investigate if dual-source computed tomography (DSCT) could guide the percutaneous coronary intervention (PCI) of chronic total occlusion (CTO). Methods: We enrolled pati... Objective: The aim of this study is to investigate if dual-source computed tomography (DSCT) could guide the percutaneous coronary intervention (PCI) of chronic total occlusion (CTO). Methods: We enrolled patients who were confirmed to have at least one native coronary artery CTO by DSCT before they underwent selective PCI in the period from December 2007 to October 2008. A CTO was defined as an obstruction of a native coronary artery with no luminal continuity. The CT-guided PCI procedure involved placing CT and fluoroscopic images side-by-side on the screen. DSCT images were analyzed for location, segment, plaque characteristics, calcification, and proximal lumen diameter of the CTO before PCI. The guidewire was advanced and manipulated under CT guidance. The PCI was carried out and the results were compared. Results: Seventy-four CTOs were assessed. PCI was successful in 57 cases of CTOs (77.0%). According to the results, CTOs were divided into two groups: successfuI-PCI and failed-PCI. All coronary artery paths of CTOs were clearly recognized by DSCT. In the successfuI-PCI group, soft plaques were detected much more often than those in the failed-PCI group, but fibrous and calcified plaques were seen more often in the failed-PCI group. Calcification severity in CTO segments showed a significant difference between the groups (P=0.014). Calcified plaques were detected in 20 (35.1%) lesions in the successfuI-PCI group. More than 70% of the failures were calcified plaques, of which there were two arc-calcified and one circular-calcified lesions. Occlusions were longer in the failed-PCI group than those in the successfuI-PCI group [(38.8±25.0) vs. (18.0±15.3) mm, respec- tively, P〈0.01]. Fewer guidewires were used in the successfuI-PCI group compared with the failed-PCI group (1.7±1.0 vs. 2.5±0.9, respectively, P〈0.01). The logistic regression analysis indicated that predictors of recanalization of CTOs included occlusion length (P=-0.0035, risk ratio (RR)=0.93) and calcification severity (P=0.05, RR=0.27). Multi-linear trends analysis showed that the factors affecting procedural time were CTO location (P=-0.0141) and occlusion length (P=0.0035). Conclusions: DSCT could delineate the path of CTOs and characterize plaques. The outcomes of PCI were related to thrombolysis in myocardial infarction (TIMI) flow grade, CTO characteristics, severity of calcified plaques and the length of occlusive segments. Occlusion length and calcification severity were independent predictors of CTOs. Occlusion length and CTO segments could also help to estimate the duration of interventional procedures. 展开更多
关键词 Dual-source computed tomography (DSCT) Chronic total occlusion (CTO) ANGIOGRAPHY recanalization
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Therapeutic anticoagulation for splanchnic vein thrombosis in acute pancreatitis: A national survey and case-vignette study 被引量:3
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作者 Noor J Sissingh Jesse V Groen +10 位作者 Hester C Timmerhuis Marc G Besselink Bas Boekestijn Thomas L Bollen Bert A Bonsing Frederikus A Klok Hjalmar C van Santvoort Robert C Verdonk Casper H J van Eijck Jeanin E van Hooft Jan Sven D Mieog 《World Journal of Gastroenterology》 SCIE CAS 2023年第21期3328-3340,共13页
BACKGROUND Splanchnic vein thrombosis(SVT)is a major complication of moderate and severe acute pancreatitis.There is no consensus on whether therapeutic anticoagulation should be started in patients with acute pancrea... BACKGROUND Splanchnic vein thrombosis(SVT)is a major complication of moderate and severe acute pancreatitis.There is no consensus on whether therapeutic anticoagulation should be started in patients with acute pancreatitis and SVT.AIM To gain insight into current opinions and clinical decision making of pancreatologists regarding SVT in acute pancreatitis.METHODS A total of 139 pancreatologists of the Dutch Pancreatitis Study Group and Dutch Pancreatic Cancer Group were approached to complete an online survey and case vignette survey.The threshold to assume group agreement was set at 75%.RESULTS The response rate was 67%(n=93).Seventy-one pancreatologists(77%)regularly prescribed therapeutic anticoagulation in case of SVT,and 12 pancreatologists(13%)for narrowing of splanchnic vein lumen.The most common reason to treat SVT was to avoid complications(87%).Acute thrombosis was the most important factor to prescribe therapeutic anticoagulation(90%).Portal vein thrombosis was chosen as the most preferred location to initiate therapeutic anticoagulation(76%)and splenic vein thrombosis as the least preferred location(86%).The preferred initial agent was low molecular weight heparin(LMWH;87%).In the case vignettes,therapeutic anticoagulation was prescribed for acute portal vein thrombosis,with or without suspected infected necrosis(82%and 90%),and thrombus progression(88%).Agreement was lacking regarding the selection and duration of long-term anticoagulation,the indication for thrombophilia testing and upper endoscopy,and about whether risk of bleeding is a major barrier for therapeutic anticoagulation.CONCLUSION In this national survey,the pancreatologists seemed to agree on the use of therapeutic anticoagulation,using LMWH in the acute phase,for acute portal thrombosis and in the case of thrombus progression,irrespective of the presence of infected necrosis. 展开更多
关键词 Acute pancreatitis Splanchnic vein thrombosis Therapeutic anticoagulation BLEEDING recanalization OUTCOMES
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Primary balloon angioplasty for chronic occlusion of intracranial internal carotid artery: A case report 被引量:3
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作者 Tianli Li Zhaolong Zhang +7 位作者 Chengjian Sun Guoping Liu Xiaolong Zhao Liming Shao Xuan Zheng Yixing Xie Changxin Wang Rui Xu 《Journal of Interventional Medicine》 2022年第4期213-216,共4页
Chronic occlusion of large intracranial arteries is the main cause of ischemic stroke in China.Patients with symptomatic intracranial artery occlusion and hemodynamic impairment are at high risk of recurrent stroke.Ch... Chronic occlusion of large intracranial arteries is the main cause of ischemic stroke in China.Patients with symptomatic intracranial artery occlusion and hemodynamic impairment are at high risk of recurrent stroke.Chronic occlusion of the intracranial segment of the internal carotid artery is a common type of intracranial artery occlusion.Medical management is regarded as the standard treatment for this disease.With the development of endovascular treatment,some patients with chronic cerebral artery occlusion have achieved satisfactory results with endovascular therapy.We reported a patient with symptomatic chronic occlusion of the ophthalmic segment of the internal carotid artery.Simple balloon angioplasty was performed,and the occluded ophthalmic segment of the internal carotid artery was successfully recanalized without perioperative complications.At 4 months followup,the internal carotid artery remained patent and perfusion of the right cerebral hemisphere improved dramatically.In addition,we briefly reviewed the relevant literature. 展开更多
关键词 Chronic occlusion Internal carotid artery Endovascular recanalization Primary balloon angioplasty
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Outcomes of Endovascular Treatment of Intracranial Aneurysms at Bifurcation Sites
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作者 Ahmed Saied Mohamed Gomaa +2 位作者 Talal Amer Mohamed Saad Demetrius Lopes 《World Journal of Neuroscience》 2018年第4期432-443,共12页
Background and Purpose: Endovascular coiling is widely used for treatment of both ruptured and unruptured aneurysms. Intracranial bifurcation aneurysms were classically considered unsuitable for endovascular treatment... Background and Purpose: Endovascular coiling is widely used for treatment of both ruptured and unruptured aneurysms. Intracranial bifurcation aneurysms were classically considered unsuitable for endovascular treatment because of the risk of coil protrusion into the parent vessel. The introduction stent assisted coiling has allowed the bifurcation aneurysms to be endovascularly treated. The present study aims to evaluate the efficacy of the endovascular treatment of the intracranial bifurcation aneurysms. Methods: This study was conducted on 76 patients with radiologically documented intracranial aneurysms at bifurcation sites either ruptured (12 aneurysms) or unruptured (64 aneurysms). Endovascular coiling of intracranial aneurysms was done for all patients in our study aided in some with single or Y-configuration stenting. The radiological outcome was assessed immediately postoperative, and at follow-up at 6 and 12 month with grading of the angiograms on the basis of modified 3-point Raymond scale. Results: In terms of the Raymond grading (RG), the initial angiographic outcome was complete occlusion (RG1) in 45 aneurysms (59.2%), neck remnant (RG2) in 20 aneurysms (26.3%), and body filling (RG3) in 11 aneurysms (14.5%), while the final angiographic outcome at 1 year was RG1 in 55 aneurysms (72.4%), RG2 in 13 aneurysms (17.1%), and RG3 in 8 aneurysms (10.5%). Eleven aneurysms (14.5%) showed recanalization. The aneurysm size and the neck width were the statistically significant factors affecting the initial RG (P = 0.0005, 0.001 respectively), final RG (P = 0.015, 0.012 respectively), and the recanalization rate (P = 0.012, 0.01 respectively). Conclusions: Endovascular treatment of intracranial aneurysms at bifurcation sites is safe and effective. Stent assisted coiling (SAC) has enabled us to offer a safe and effective endovascular treatment for bifurcation aneurysms by preventing coils herniation. Smaller aneurysm size and neck size are indicators of complete occlusion and lower recanalization rate. 展开更多
关键词 BIFURCATION ANEURYSM STENT Assisted COILING recanalization Simple COILING
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Clinical Experience of Intravenous Thrombolytic Therapy of Butylphthalide Combined with Urokinase in Acute Cerebral Infarction
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作者 LUOZhijun 《外文科技期刊数据库(文摘版)医药卫生》 2022年第2期173-176,共4页
Objective: to explore the clinical experience of intravenous thrombolysis of butylphthalide combined with urokinase in the treatment of acute cerebral infarction. Methods: from January 2018 to January 2020 in our hosp... Objective: to explore the clinical experience of intravenous thrombolysis of butylphthalide combined with urokinase in the treatment of acute cerebral infarction. Methods: from January 2018 to January 2020 in our hospital during the treatment of acute cerebral infarction in patients with a random sample of 72 as analysis data, by different treatment to the patients into two groups were analyzed, and the control group and observation group, all the 36 patients, to its traditional general treatment, two groups, control group in the traditional general treatment conditions, intravenous urokinase thrombolytic therapy was applied, while the observation group was given butylphthalide combined with urokinase intravenous thrombolytic therapy. Finally, the actual therapeutic effects of the two groups were compared. Conclusion: joint urokinase for acute cerebral infarction patients butyl phthalide intravenous treatment, can rise to improve curative effect, can also be very good to improve the function of nerve defect and the normal life ability, moreover, to improve blood vessels and treatment rate of security, reduce complications, in the treatment of acute cerebral infarction patients has important significance. 展开更多
关键词 BUTYLPHTHALIDE intravenous thrombolysis with urinary hormone enzyme acute cerebral infarction NIHSS vascular recanalization rateIntroduction
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