简介:Massivehemoptysisisoneofthemostdreadedofallrespiratoryemergenciesandcanhaveavarietyofunderlyingcauses.Itismostlycausedbybleedingfrombronchialcirculation.Bronchialarteryembolizationisnowconsideredtobethetreatmentofchoiceforacutemassivehemoptysis.Bronchialarteryembolization(BAE)isasafeandeffectivenonsurgicaltreatmentforpatientswithmassivehemoptysis.However,nonbronchialsystemicarteriescanbeasignificantsourceofmassivehemoptysisandacauseofrecurrenceaftersuccessfulBAE.Soknowledgeofthebronchialarteryanatomy,togetherwithanunderstandingofthepathophysiologicfeaturesofmassivehemoptysis,areessentialforplanningandperformingBAEinaffectedpatients.Inaddition,interventionalradiologistsshouldbefamiliarwiththetechniques,results,efficacy,safetyandpossiblecomplicationsofBAEandwiththecharacteristicsofthevariousembolicagents.Bronchialarterialcatheterisationinhumanviaapercutaneousapproachhasbeenpracticedfor32years(1973)intheworldand20years(1986)inChina,initiallyfordirectchemotherapytreatmentforbronchialmalignanciesandthenfortheembolizationofpatientswithmassivehaemoptysis.Areviewofclinicalexperiencetoevaluatetechnique,embolicmaterials,outcomeandcomplicationsofBAEispresented.
简介:INTRODUCTIONWiththedevelopmentofeconomyandimprovementoflifequality,theincidencesofhypertension,hyper-cholesterolemia,diabetes,obesityandsmokinghavebeenincreasedinChina,whichhasledtoasignificantincreaseinthemorbidityandmortalityofcoronaryarterydisease(CAD)~1.SinceitwasintroducedintoChinain1984,coronaryintervention(PCI)hasdevelopedrapidlyandhasbecomethemajortreatmentofCADbecauseofitsuniquecharacteristicsofminimalinvasiveand
简介:DearEditor,Wearewritingthislettertoreportanunexpectedrarecaseofcentralretinalarteryocclusion(CRAO)happenedafterstent-assistedcoilingforinternalcarotidartery(ICA)aneurysminafemalepatient.CRAOisadevastatingocularemergencywithpoorvisualprognosisandnouniversalacceptedtreatmentatpresent.CRAOisusuallyassociatedwitharterialhypertension,diabetesmellitus,renaldisease.
简介:Objective:Toexplorethecausesoftheformationoftraumaticcarotid-cavernousfistulasandthetherapeuticeffectofdetachableballoonand/orcoilembolizationandthepreventionofitscomplications.Methods:FromOctober,1992toMarch,2002,17patientswithtraumaticcarotid-cavernousfistulasweretreatedwithdetachableballoonand/orcoilembolizationinourhospital.TheclinicaldataandimagingfeaturesofCT,MRandselectiveangiogramofthesepatientswereanalyzed.Results:Oneweekaftertreatmentwithembolization,theclinicalsymptomsofthe17patientswereremitted,andopticcacophony,nystagmus,exophthalmosanddropsyofconjunctivadisappeared.Twopatientsmanifestedsurgicalcomplications,onepatientdied.Sixteenpatientssurvived.Theywereallfollowedupformorethan2years,whichshowedonepatienthadhandicapinmovement,andinonepatientthesignsandsymptomsoftraumaticcarotid-cavernousfistulasreoccurred2monthsaftertreatment.Conclusions:Thedetachableballoonand/orcoilembolizationissafeandreliable.Itisagoodmethodtotreattraumaticcarotid-cavernousfistulas.
简介:AbstractImportance:Pediatric hypervascular primary airway tumors are progressive, fatal lesions with a low incidence, and the disease is often more serious than that in adults.Objective:To evaluate the clinical efficacy and safety of interventional therapeutic bronchoscopy combined with conservative treatment and bronchial arterial embolization in children with primary airway tumors.Methods:We retrospectively analyzed the clinical data of four pediatric patients with hypervascular primary airway tumor between 2017 and 2019 at Beijing Children’s Hospital.Results:Two patients were low-grade bronchial mucoepidermoid carcinoma, one patient was pleomorphic adenoma, and one was bronchial leiomyoma. Interventional therapeutic bronchoscopy combined with bronchial arterial embolization was used for treatment (all four patients received general anesthesia). The tumors were safely resected in all patients via interventional bronchoscopy. There were no severe complications related to the procedures. All patients were followed up for 5-12 months, and one low-grade bronchial mucoepidermoid carcinoma recurred.Interpretation:Interventional therapeutic bronchoscopy combined with bronchial arterial embolization appears to be a safe and efficient therapeutic method associated with less trauma and fewer complications, including no serious adverse events, in children with hypervascular primary airway tumors without bronchus wall infiltration.
简介:Theabilitytomodulatethefutureliverremnant(FLR)isakeycomponentofmodernoncologichepatobiliarysurgerypracticeandhasextendedsurgicalcandidacyforpatientswhomayhavebeenpreviouslythoughtunabletosurviveliverresection.MultipletechniqueshavebeendevelopedtoaugmenttheFLRincludingportalveinembolization(PVE),associatingliverpartitionandportalveinligation(ALPPS),andtherecentlyreportedtranshepaticlivervenousdeprivation(LVD).PVEisawell-establishedmeanstoimprovethesafetyofliverresectionbyredirectingbloodflowtotheFLRinanefforttoselectivelyhypertrophyandultimatelyimprovefunctionalreserveoftheFLR.ThisarticlediscussesthecurrentpracticeofPVEwithfocusonsummarizingthelargenumberofpublishedreportsfromwhichoutcomesbasedpracticeshavebeendeveloped.BothtechnicalaspectsofPVEincludingvolumetry,approaches,andembolizationagents;andclinicalaspectsofPVEincludingdatasupportingindications,anditsroleinconjunctionwithchemotherapyandtransarterialembolizationwillbehighlighted.PVEremainsanimportantaspectofoncologiccare;inlargepartduetothesubstantialfoundationofinformationavailabledemonstratingitsclearclinicalbenefitforhepaticresectioncandidateswithsmallanticipatedFLRs.