[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 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 diagnostic value of selective angiography for unknown reason gastrointestinal hemorrhage. Methods: 32 patients with acute or chronic gastrointestinal recurrent hemorrhage were examined. Among them, 26 patients had upper gastrointestinal hemorrhage and 6 with inferior gastrointestinal hemorrhage. All patients were under gone DSA and/or Puck angiography with Seldinger's technique. Results: The accuracy of localization was 84.38% (27/32) and the coincident rates with the operation or pathology was 78.95%(15/19). In all of patients, tumor of 9 case were shown and 15 cases of vascular diseases, namely, 9 with vascular malformation, 2 with small intestinal aneurysm, 3 with arteriosclerosis and 1 with broken gallbladder aneurysm; 3 cases of ulcer or nonspecific inflammation and 5 cases were negative. 23 cases (71.87%) showed the direct hemorrhagic sign, namely the contrast media extra vacation. Conclusions: Selective angiography is very helpful for determining the location and the character of unknown reasoned acute or chronic gastrointestinal hemorrhage, especially for the hemorrhage of the small intestine and biliary tracts

[en] Objective: To explore the effects of selective intra-arterial chemotherapy for preoperative gastric cancer. Methods: 35 cases of gastric cancer treated by selective intra-arterial perfusion of chemotherapy before operation, together with clinical manifestations findings in operation, pathological changes and clinical effects were retrospectively reviewed. Results: The total effective rate proved by pathology was 81%, of them slight efficiency was in 14 patients (45%), moderate in 11 patients (36%). The clinical relieve rate was 77%, complete relieve in 5 patients (14%), partial relieve in 14 patients (45%). Conclusions: Interventional intra-arterial perfusion chemotherapy of gastric cancer before operation is an effective method for elevating resection rate of gastric cancer

[en] Objective: To evaluate the effects of delayed PTCA on left ventricular function and cardiac functional in patients with acute myocardial infarction (AMI). Methods: 38 patients underwent delayed PTCA two weeks after AMI (group I) and additional 37 patients received conventional medical therapy (group II). In all patients, global left ventricular ejection fraction was assessed by emission computer tomography and regional wall motion abnormality score was determined by two-dimensional echocardiography. Occurrence of cardiac events was recorded. Results: Similar means of left ventricular ejection fractions in the two groups were obtained but 22 patients in group I and only 11 patients in group II had significant improvement in global left ventricular function (an increase in ejection fraction of >5%) (P < 0.01). The occurrence rates of cardiac events and cardiac death were lower in group I (28.9% and 2.6%) than in group II (67.6% and 21.6%) (all P < 0.05). The left ventricular regional wall motion abnormality score was decreased in both groups (group I: 10.1 +- 5.3 versus 9.0 +- 2.9, P < 0.01; group II: 11.6 +- 3.2 versus 10.2 +- 3.9, P < 0.05). Conclusions: Delayed PTCA could improve left ventricular function and decrease long-term cardiac events and death for patients after AMI

[en] Objective: To evaluate the clinical curative effect and methods for recurring NPC with treatment of intracavitary radiotherapy after interventional chemotherapy. Methods: 32 cases of recurring NPC were divided into two groups, each of which consisted of 16 cases. Group one was treated with intracavitary chemotherapy plus intracavitary radiotherapy. On the third day after interventional chemotherapy, the first intracavitary radiotherapy was performed (5 Gy) and the second treatment was done next day. Group two was only performed with intracavitary radiotherapy. The dose and interval were the same. The time of re-examination was two weeks later. Results: In the first group, clinical symptoms were improved, local swelling lymph nodes were shrunk, secretion on the nasopharyngeal surface was hardly left or disappeared. Tumours were shrunk and atrophy. On the intracavitary radiotherapy group, clinical symptoms changed a little, except the secretion on the mass surface was reduced. The white blood counts of the two groups showed no difference and there were no functional changes of liver, kidney and digestive system in the interventional group. Conclusions: It is a new and effective therapy to treat recurring NPC with interventional chemotherapy plus intracavitary radiotherapy

[en] Objective: To evaluate the clinical efficacy of cutting balloon angioplasty (CBA) for treating lesions in small coronary arteries. Methods: The diameter for reference of coronary artery is less than 2.7 mm which is considered as 'small vessel'. CBA procedures were performed on 25 lesions in 22 patients. Results: The procedure was successfully obtained in 21 lesions (84%). Seven severe stenotic lesions (diameter of stenosis ≥ 90%) underwent dilatation with small conventional balloon (1.5 mm diameter). Bail-out stenting was performed in 2 lesions because of severe dissections. Failure of cutting balloon to pass through the stenosis in one lesion. During follow-up, 5 patients had recurrence of coronary angina and 3 of them underwent coronary angiography for check up, In-stent restenosis (ISR) occurred in one patient, which was successfully re-dilated using CBA. One patient had total occlusion of the diagonal branch with ISR of LAD. One patient developed new lesion in other coronary artery. Conclusions: CBA is safe and effective, and provides a new therapeutic strategy for lesions in the small coronary arteries

[en] Objective: To assess the clinical effects of uterine arterial embolization on uterine leiomyoma. Methods: The authors treated 21 patients with uterine leiomyoma by Seldinger's uterine arterial embolization. The 4.0 F Cobra catheter was laced into the double uterine arteries with Polyvinyl Alcohol Foam (PVA) particles as the embolization. At 3 and 6 months postoperatively, the authors investigated the effects of the embolization. Results: After uterine arterial embolization, the volume of uterine leiomyoma decreased and menorrhagia was under controlled. The symptoms of anemia and oppression were relieved. The physiologic functions of ovary and uterus were preserved completely. Conclusions: Uterine arterial embolization is an effective and less invasive way to treat uterine leiomyoma

[en] Objective: To evaluate the safety and short-term outcome of stent-assisted angioplasty for extracranial carotid stenosis. Methods: From October 2000 to September 2002, 93 cases of extracranial carotid stenosis, including 86 cases of carotid bifurcation stenosis, 4 of extracranial internal carotid stenosis, 2 of common carotid stenosis and 1 of functional external carotid stenosis, were treated by self-expandable stent placement and angioplasty. Results: Stent placement and angioplasty were successfully administered in all the 93 patients. The average stenosis rate was reduced from (79.5 ± 14.6)% before treatment to (11.2 ± 7.8)% after stent-assisted angioplasty. There were only 1 case of TIA (1.1%) and 1 case of minor stroke (1.1%) during the operation, without mortality or major stroke. No cerebral ischemic attach occurred in the 91 patients during clinical follow up for a period of 3-25 months with an average of 7.9 months. twenty-nine patients were angiographically followed up 6 months after treatment with only one asymptomatic restenosis (3.4%). Conclusions: Endovascular stent-assisted angioplasty for extracranial stenosis is safe and effective with considerable good short-term outcome