AIM: To demonstrate the outcomes of endoscopic endonasal dacryocystorhinostomy(En-DCR) with an novel lacrimal ostium stent(LOS) which was performed in patients with recurrent epiphora after failed external dacryocysto...AIM: To demonstrate the outcomes of endoscopic endonasal dacryocystorhinostomy(En-DCR) with an novel lacrimal ostium stent(LOS) which was performed in patients with recurrent epiphora after failed external dacryocystorhinostomy(Ex-DCR) and analyze the causes of failed Ex-DCR.METHODS: From September 2015 and December 2017, the clinic data of 29 cases suffered from recurrent epiphora after failed Ex-DCR was reviewed.The LOS were implanted into the ostium at the end of the revisional surgery.The causes of failed Ex-DCR were analyzed before revisional surgeries.Outcome of revisional surgeries with the new device were evaluated as well.RESULTS: The major causes of failure of the external approach were synechiae formation in the nasal ostium(29/29), followed by inadequate removal of the bony wall(21/29), nasal synechiae formation between lateral wall of nose and middle turbinate(11/29), and the bone opening was not in good location(7/29).The rate of success after revisional surgery was 82.76%.Re-obstruction of the ostiums were found in 5 failed cases.CONCLUSION: Endoscopic approach with a novel LOS may be an effective procedure to manage recurrent epiphora after previous failed Ex-DCR surgery.Synechiae formation in the nasal ostium and inadequate removal of the bony wall were the major causes of failure of Ex-DCR.展开更多
BACKGROUND Percutaneous coronary intervention can be challenging for ostial coronary artery lesions due to calcium burden and elastic fiber content.Excimer laser coronary atherectomy(ELCA)is a less common treatment fo...BACKGROUND Percutaneous coronary intervention can be challenging for ostial coronary artery lesions due to calcium burden and elastic fiber content.Excimer laser coronary atherectomy(ELCA)is a less common treatment for severe calcified coronary ostium lesions.CASE SUMMARY An 81-year-old male presented to the Cardiology Department of Qingdao Municipal Hospital with a 1-year history of chest pain.Coronary angiography showed severe calcific stenosis(approximately 90%)in the right coronary artery ostium.The right coronary artery ostium was unable to be advanced using a 2.5 mm×12.0 mm balloon(NC Sprinter,Medtronic,United States)or dilated using a 2.0 mm×12.0 mm balloon(Sprinter,Medtronic,United States).The patient underwent successful ELCA and balloon dilation of the calcified coronary ostium lesion.CONCLUSION ELCA appears to be a safe and effective treatment for the management of severe calcified coronary ostium lesions.展开更多
目的:对比分析椎动脉起始部狭窄(VAOS)经桡动脉入路(TRA)与经股动脉入路(TFA)介入治疗的安全性及有效性。方法:回顾性纳入2023年1月至2024年3月行VAOS支架植入术的55例病人,按入路方式分为TRA组(27例)和TFA组(28例)。比较2组病人基线特...目的:对比分析椎动脉起始部狭窄(VAOS)经桡动脉入路(TRA)与经股动脉入路(TFA)介入治疗的安全性及有效性。方法:回顾性纳入2023年1月至2024年3月行VAOS支架植入术的55例病人,按入路方式分为TRA组(27例)和TFA组(28例)。比较2组病人基线特征、手术参数(目标血管狭窄率、穿刺时间、手术时长、残余狭窄率)、术后恢复指标(住院时间、穿刺点并发症、90 d预后评分)。结果:2组病人术前资料包括年龄、性别、体质量指数(BMI)、相关危险因素(高血压、糖尿病、吸烟饮酒史)、起病形式、术前美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、改良Rankin量表(modified rankin scale,mRS)评分差异均无统计学意义(P>0.05);手术参数方面,2组目标血管狭窄率和穿刺时长差异均无统计学意义(P>0.05),TRA组手术时长短于TFA组(P<0.01),术后即刻残余狭窄均<5%;术后恢复方面,TRA组术后住院时间更少(P<0.01),术后90 d mRS和NIHSS评分组间差异无统计学意义(P>0.05);并发症方面,TRA组总并发症发生率与TFA组差异无统计学意义(P>0.05),其中TFA组假性动脉瘤和血管迷走反射各1例,TRA组未发生。结论:TRA与TFA治疗VAOS的有效性相当,但TRA具有手术时间短、术后恢复快、并发症少等优势,可作为优选入路。展开更多
基金Supported by Wenzhou Science and Technology Bureau Program (No.Y2020362)。
文摘AIM: To demonstrate the outcomes of endoscopic endonasal dacryocystorhinostomy(En-DCR) with an novel lacrimal ostium stent(LOS) which was performed in patients with recurrent epiphora after failed external dacryocystorhinostomy(Ex-DCR) and analyze the causes of failed Ex-DCR.METHODS: From September 2015 and December 2017, the clinic data of 29 cases suffered from recurrent epiphora after failed Ex-DCR was reviewed.The LOS were implanted into the ostium at the end of the revisional surgery.The causes of failed Ex-DCR were analyzed before revisional surgeries.Outcome of revisional surgeries with the new device were evaluated as well.RESULTS: The major causes of failure of the external approach were synechiae formation in the nasal ostium(29/29), followed by inadequate removal of the bony wall(21/29), nasal synechiae formation between lateral wall of nose and middle turbinate(11/29), and the bone opening was not in good location(7/29).The rate of success after revisional surgery was 82.76%.Re-obstruction of the ostiums were found in 5 failed cases.CONCLUSION: Endoscopic approach with a novel LOS may be an effective procedure to manage recurrent epiphora after previous failed Ex-DCR surgery.Synechiae formation in the nasal ostium and inadequate removal of the bony wall were the major causes of failure of Ex-DCR.
文摘BACKGROUND Percutaneous coronary intervention can be challenging for ostial coronary artery lesions due to calcium burden and elastic fiber content.Excimer laser coronary atherectomy(ELCA)is a less common treatment for severe calcified coronary ostium lesions.CASE SUMMARY An 81-year-old male presented to the Cardiology Department of Qingdao Municipal Hospital with a 1-year history of chest pain.Coronary angiography showed severe calcific stenosis(approximately 90%)in the right coronary artery ostium.The right coronary artery ostium was unable to be advanced using a 2.5 mm×12.0 mm balloon(NC Sprinter,Medtronic,United States)or dilated using a 2.0 mm×12.0 mm balloon(Sprinter,Medtronic,United States).The patient underwent successful ELCA and balloon dilation of the calcified coronary ostium lesion.CONCLUSION ELCA appears to be a safe and effective treatment for the management of severe calcified coronary ostium lesions.
文摘目的:对比分析椎动脉起始部狭窄(VAOS)经桡动脉入路(TRA)与经股动脉入路(TFA)介入治疗的安全性及有效性。方法:回顾性纳入2023年1月至2024年3月行VAOS支架植入术的55例病人,按入路方式分为TRA组(27例)和TFA组(28例)。比较2组病人基线特征、手术参数(目标血管狭窄率、穿刺时间、手术时长、残余狭窄率)、术后恢复指标(住院时间、穿刺点并发症、90 d预后评分)。结果:2组病人术前资料包括年龄、性别、体质量指数(BMI)、相关危险因素(高血压、糖尿病、吸烟饮酒史)、起病形式、术前美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、改良Rankin量表(modified rankin scale,mRS)评分差异均无统计学意义(P>0.05);手术参数方面,2组目标血管狭窄率和穿刺时长差异均无统计学意义(P>0.05),TRA组手术时长短于TFA组(P<0.01),术后即刻残余狭窄均<5%;术后恢复方面,TRA组术后住院时间更少(P<0.01),术后90 d mRS和NIHSS评分组间差异无统计学意义(P>0.05);并发症方面,TRA组总并发症发生率与TFA组差异无统计学意义(P>0.05),其中TFA组假性动脉瘤和血管迷走反射各1例,TRA组未发生。结论:TRA与TFA治疗VAOS的有效性相当,但TRA具有手术时间短、术后恢复快、并发症少等优势,可作为优选入路。
