[en] Objective: To evaluate the preliminary experience of the combined self-expanding neurovascular stent (Neuroform stent) with detachable coils in the management of intracranial wide neck aneurysms. Methods: Self-expanding neurovascular stents with detachable coils were used in treating 27 intracranial wide neck aneurysms of 25 patients including cavernous segment ICA aneurysms in 3, ophthalmic arterial anemysm in 1, PcomA in 18, AcomA in 2, MCAM1 in 1, MCA bifurcation in 1, and basilar trunk in 1. Among them, 2 cases consisted of multi-aneurysms, 2 aneurysms coincide with absolute wide neck (> 4 mm) and 6 with comparatively wide neck (> 7 mm). Nemoform stents were deployed across the neck of aneurysm and detachable coils were released to embolize the aneurysm through stent mesh. Results: Twenty-six Neuroform stents were successfully deployed in 25 patients including 4 Neuroform II stents, and 22 Neurofom III stents(all combined with spring coils). Total occlusion was achieved in 7 patients with residual neck in 9 nearly complete occlusion and partial occlusion in 11. 2 patients were rebleeding and other 2 showed intra-stent thrombosis during the operations. The latter 2 included 1 with post-operative limb paraplegia and 1 died. Still another 1 had transient ischemic attack after the operation. Twenty-three patient recovered well. Twenty-four patients were under clinical followed up from 0.5 to 28 months with an average of 10.8 months. There was no bleeding. Three patients were angiographically followed up for 3-6 months after the procedure, with only 1 case of in-stent thrombosis and no change in other 2 aneurysms with neck remnant. Conclusions: The Neuroform stent is technically feasible and safe for treating intracranial wide neck aneurysms unsuitable for clipping because of its prevention for coil protruding into parent artery. The long term effect still need to be further investigated. (authors)

[en] In-stent restenosis after interventional treatment remains an unsolved and important clinical problem. The proliferation and migration of arterial smooth muscle cells are key events frequently followed by vascular restenosis after angioplasty and continuous inflammation may also be the other important factor for the restenosis after stenting. Study of the pathogenesis of restenosis may find some potentially novel therapeutic pathways for attenuating in-stent restenosis. (authors)

[en] Objective: To evaluate the mid- and long-term radiological outcomes of cerebral aneurysms with GDCs embolization. Methods: One hundred and sixty-two patients with 173 aneurysms embolized with GDCs underwent angiographic follow-up from 1 to 54 months post-operatively and were retrospectively reviewed. Three neuro-radiologists reviewed each angiogram and made a comparison between initial and follow-up angiograms. Morphological outcomes were evaluated as follows: unchanged; progressive thrombosis; and re-opening or re-growth. Results: Of 173 aneurysms with GDC embolization, 142 aneurysms had total or nearly total occlusion, 23 subtotal occlusion and 8 partial occlusion shown on initial angiograms. The incidence of re-opening was 17.1% (13/76) in less than 3 months, and 6.2% (6/97) between 3 and 6 months postoperatively. Four aneurysms showed recurrency (2.3%) on second follow-up angiography in one year after procedure and one-year cumulative recurrent rate was 13.3% of 56 aneurysms with the third follow-up angiography in the post-operation period of 12 to 54 months, four showed a little enlargement and the cmnulative recurrent rate so far was 20.2% (35/173). Conclusions: The direct and main causes for aneurysmal recurrence are incomplete and loosening packing. The first angiographic follow-up is recommended to be performed at 3 months or earlier after the procedure, especially in aneurysms with initial incomplete occlusion. Re-treatment with balloon- or stent-assisted coil embolization is recommended in re-opening aneurysms. (authors)

[en] Objective: To investigate the effects of uterine resection and uterine arterial embolization on the function of ovary. Methods: The serum concentrations of estrin (E₂), progestogen (P), follicle-stimulating hormone (FSH), luteotropic hormone (LH) and prolactin (PRL) were measured in 15 patients with uterine resection and 22 patients with uterine arterial embolization; including 23 patients with uterine leiomyoma and 29 normal women. Authors compared the results of the five hormones in each group. Results: The serum concentrations of E₂ and P in the group of uterine resection were lower than the normal control group, there was a significant difference between them. Compared the serum concentrations of E₂ and P in the group of uterine arterial embolization and normal control group, there was no significant difference. The serum concentration of PRL in the group of uterine leiomyoma was higher than the normal control group with significant difference. When the uterus was resected or uterine artery was embolized, the serum concentration of PRL decreased remarkably. Conclusions: Uterine resection has effects on the function of ovary, but uterine arterial embolization would not. PRL may be one of the factors causing the formation of uterine leiomyoma

[en] Objective: To analyze the technical aspects of uterine artery embolization with dextran microspheres and to evaluate the effectiveness of this technique as the primary treatment of uterine fibroids in a series of 50 patients. Methods: Thirty-eight women (age range, 24-51 years; mean age, 38.2 years) with symptoms caused by uterine fibroids (menorrhagia, mass-related symptoms, pelvic pain) were included in this study. Authors performed embolization with a single Headhunter catheter through the right-femoral artery approach with injection of dextran microspheres ( 225-450 μm), and an absorbable gelatin sponge. Follow-up study included clinical and sonographic examinations at one-month interval for half a year. Results: Embolization was performed successfully in all the patients. Post-procedural pain control was good in 46 (92%) of the patients. In most patients, symptoms were improved within 3 months (96%). Clinical failure of the treatment occurred in only two patients (4%). Progressive reduction in tumor size was revealed during sonographic follow-up, and the reduction rate at the sixth month after embolization reached 68% on average. Conclusions: Uterine artery embolization with dextran microspheres is a mini-invasive method for the treatment of uterine fibroids showing effective in most patients with progressive reduction in size of the masses

[en] Objective: To design the mushroom covered stent and study the primary application for gastroesophageal anastomosis-thoracic cavity fistula. Methods: On the base of the peculiar anatomic structure and the pathological changes of gastroesophageal anastomosis-thoracic cavity fistula, authors designed the mushroom covered stent. Under the fluoroscopic guidance, 6 mushroom covered stents were placed in 5 patients. Results: The fistula oral of the patients with post-operative perforation were closed with the mushroom covered stent, the food intake ability and nurturer of all patients were improved. Conclusions: The structure of the mushroom covered stents is reasonable, which is effective and safe for treating the patient with gastroesophageal anastomosis-thoracic cavity fistula

[en] Objective: To investigate into the indications and related anatomic foundation of transjugular intrahepatic portosystemic shunt (TIPS) creation by direct transcaval approach in patients with portal hypertension cirrhosis suffering unusual anatomy between the hepatic veins and portal bifurcation; and to evaluate the security, feasibility and clinical significance. Methods: Direct transcaval approach TIPS were performed in 65 patients including active variceal bleeding (n=52), intractable ascites (n=12), and as a bridge to liver transplantation (n=1). Results: Technical and functional success were achieved in all patients. The success rate was 100% without related complications including the technique and primary patency rate is obvious higher than classical TIPS. Conclusion: In patients with unusual anatomy between the hepatic veins and portal bifurcation, and inaccessible or inadequate hepatic veins, transcaval TIPS creation is secure and feasible. The results suggest that the direct transcaval approach offering favorable primary patency because the shunt has a straight line in construction

[en] Objective: To evaluate the methods and effect of balloon catheter dilation of esophageal caustic ingestion stenosis in children. Methods: The authors analysed 18 cases, including 10 cases of esophageal stenosis due to ingestion of sulphuric acid, 7 cases of esophageal stenosis caused by ingestion of sodium carbonate and the last one through ingestion of chemical materials include zinc sulphate. Barium esophagogram was taken before dilation for every patient and the balloon size varied from 4 mm x 40 mm to 16 mm x 40 mm or 20 mm x 40 mm in diameter was selected for the procedure. Results: 18 cases were all successful in dilation by balloon catheter, without esophageal perforation and other complications. The satisfactory results maintained from six months to thirty months with remarkable improvement clinically. Conclusions: Balloon catheter dilation is a simple, safe and reliable method for the treatment of esophageal caustic ingestion stenosis in children, and should be recommended as the first choice. (authors)

[en] Objective: To investigate the effect of cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma. Methods: 124 cases with primary liver carcinoma were randomly divided into two groups: 60 cases were treated by TACE and cryotherapy; the other 64 cases were simply done by TACE as control. In general, TACE was undertaken once a month and altogether three times for a course. Cryotherapy was undergone 1-3 times for a course. Results: The total effective rates (CR + PR) were 45.3% for the control group and 68.3% for the combined therapy group, with an obvious difference between the two groups, 0.5, 1, 1.5 years survival rate were 81.3%, 62.5%, 43.8% respectively in the control group; 93.3%, 83.3%, 63.3% respectively for the combined group. There was an obvious difference between the two groups of 1, 1.5 years of survival rates. Conclusions: Cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma is feasible with raising the effective rate and prolonging survival time. (authors)

[en] Objective: To assess the value of implanting remedial or prophylactic cardioverter defibrillator in patients with Brugada syndrome for protecting from malignant ventricular arrhythmias and to estimate the initial out-comes in one-month follow-up. Methods: Implantable cardioverter defibrillators (ICDs) were implanted in 21 consecutive patients (9 symptomatic and 12 asymptomatic) with Brugada syndrome using standard procedure under general anesthesia. Patients presented the typical ECG changes of Brugada syndrome with or without sodium channel blockers but without structural heart disease in all the cases. Electrophysiological examinations were performed in all patients. Eight asymptomatic patients had spontaneous or induced malignant ventricular arrhythmias and 4 asymptomatic patients had single positive family history. Results: Sixteen single chamber ICDs (VVI) and 5 double chamber ICDs (DDD or DDDR) were implanted. The DDD- or DDDR-ICDs were applied for patients with sinus node dysfunction and/or atrioventricular conduction disturbances. Battery/lead status measurements of ICDs were good and met with standards of implantation during the procedure. No complications occurred after ICD implantation and also no changes of various electrophysiological parameters during re-hospitalization in one-month follow-up. There were no events' record of antitachycardia pacing or cardiovertion or defibrillation for ventricular arrhythmias in the memory of treatment by ICDs. Conclusions: ICDs were implanted successfully with safety in patients with Brugada syndrome showing good function for the initial outcomes in one-month follow-up. (authors)