OBJECTIVETo observe the effect of electro-needling at acupoints of the yangming meridian on the expression of platelet associated complement-1 (PAC-1) and lower limb functions in acute cerebral infarction (ACI) patients.

METHODS58 ACI patients were randomly assigned to the treatment group and the control group. Conventional therapies were given to all patients. Additionally, the electro-needling at acupoints of the yangming meridian was given to patients in the treatment group. Changes of PAC-1 were detected using flow cytometry. Effect of lower limbs functions of ACI patients before and after electro-needling was assessed using Fugl-Meyer Index. Meanwhile, 20 healthy subjects were selected for reference value.

RESULTSIn the acute stage, the PAC-1 level in ACI patients were significantly higher than that in healthy subjects (P<0.05). The PAC-1 level in the electro-needling group was obviously lowered after treatment (P<0.01). There was no significant difference in the control group between before and after treatment. Significant difference was found in Fugl-Meyer index in the same group between before and after two-week treatment (P<0.05). It was higher in the electro-needling group than in the control group, showing significant difference (P<0.01).

CONCLUSIONSPlatelet activation exists in the acute stage of ACI. Electro-needling at acupoints of the yangming meridian showed obvious inhibition on PAC-1 levels, could improve lower limbs functions of ACI patients. It was inferred that electro-needling at acupoints of the yangming meridian promoted the recovery of paralyzed lower limbs at the early stage mainly by regulating PAC-1 levels, thus postponing the progress of ACI.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Cerebral Infarction ; metabolism ; rehabilitation ; therapy ; Electroacupuncture ; Female ; Humans ; Lower Extremity ; Male ; Middle Aged ; Platelet Membrane Glycoproteins ; metabolism ; Recovery of Function ; Stroke Rehabilitation ; Treatment Outcome

Objective To analyze the risk of embolization of brain AVMs,study the angioarchitectural factors affecting the difference of embolization level,and to establish the angioarchitecture grading system for embolization of brain AVMs.Methods The clinical data,angioarchitectural features, embolism complication and embolism level were retrospectively analyzed.Multivariate statistical analysis was performed to determine if any of the variables was predictive of a poor outcome of embolization(death or permanent neurological deficit),and if any of the variables was predictive of the percentage obliteration achieved by embolization.Based on the above results,we established the angioarchitecture grading system.Results Endovascular procedures for embolization were performed 324 times in 189 patients during an 11-year period.Embolization was performed using N-butyl cyanoacrylate.In those patients,3(1.6%) died and 5(2.6%)had a permanent neurological deficit as a result of the embolization.The AVMs were given a score from 0 to 5 based on the size,number of the first grade feeding artery,and number of the second grade feeding artery.The assigned scores were as follows:nidus size(AVF=0,

Objective To evaluate the treatment of aneurysms rupture during endovascular embolization.Methods Nine aneurysms ruptured during the embolization and were treated with endovascular embolization.The reasons of aneurysms rupture during embolization,the prevention and the first aid after aneurysms rupture were analysed.Results Seven patients recovered and 2 died.Conclusions The optimal treatment of aneurysms rupture during endovascular embolization is effective,(J Intervent Radiol,2007,16: 132-134)

Objective To investigate the causes,consequences and management of injuries to the draining veins after embolization of brain arteriovenous malformations(BAVMs)with ?-n-butyl cyanoacrylate (NBCA).Methods The angiographic imaging data of 189 BAVMs patients who underwent NBCA embolization were studied retrospectively.The status of the draining veins before and after NBCA embolization was observed and compared.The intracerebral hemorrhage(ICH)complications and their relation to their angiographic features were analyzed.Results Twenty-three patients out of 189 patients showed injuries to the draining venous system,including 10 low-grade injury,6 moderate injury,and 7 high- grade injury.Six patients suffered from ICH after embolization,of whom 4 patients were due to injuries of the draining veins(2 moderate and 2 high-grade).In the 3 months follow-up evaluation of 4 patients with ICH, one died,one was in vegetative state,and the other two patients suffered from residual severe or minor (1 patient for each)permanent neurological deficits.Conclusion Our findings suggest that injury of the draining veins is the major cause of ICH and may lead to serious consequences after embolization of BAVMs with NBCA.

Objective To explore the clinical skills and curative efficacy of Glubran (NBCA-MS) embolization of cerebral arteriovenous malformations. Methods Ninety-six cases of cerebral arteriovenous malformations were treated by 187 endovascular embolizations with different concentrations of Italy GEM company's Glubran (NBCA-MS). Follow-up was performed to 96 cases of cerebral arteriovenous malformation with NBCA-MS embolization. Results During the follow-up in 96 cases, clinical symptoms completely disappeared in 92, were improved in 3 and reoccurred in 1. The malformation was totally got rid of in 44 of 48 cases DSA examinated, and the 80%-90% embolization was achieved in the rest who need further γ-knife therapy. In all cases, γ-knife therapy was performed in 32 cases after embolization, and among them 26 cases received DSA examination 1-2 years after γ-knife therapy, and 21 cases were proved to have no malformation. Conclusions The method ofendovascular emdolization with NBCA-MS is safe, reliable and effective to treat the cerebral arteriovenous malformation.

Objective To study the short-term and long-term effectiveness of intracranial aneurysm occlusion with expandable hydrocoil. Methods Forty-one patients with intracranial aneurysms (n=45) were treated by endovascular occlusion with expandable hydrocoil. Follow-up interviews in the forms of DSA, CTA or MRA were conducted to the 41 patients within 6-24 months after the treatment to find out the tumor recurrence and complications. Results In the 41 patients, 1 died, 1 suffered from recurrence, 3 developed cerebral infarction, 1 got oculomotor paralysis, 2 got hydrocephalus. According to modified Rankin scale, grade 0 in 8 cases, grade 1 in 19, grade 2 in 7, grade 3 in 3, grade 4 in 2, grade 5 in 1 and grade 6 in 1. Conclusions Endovascular embolization with expandable hydrocoil is an effective treatment method for intracranial aneurysms, especially for parent artery occlusion, but it may be able to cause more complications in the treatment of small aneurysms (＜5mm), so the caution should be taken.

OBJECTIVETo study the surgical approach and curative effect of the "interlocking basket" technique in interventional therapy for longitudinal intracranial aneurysm.

METHODSThirty-eight Hunt and Hess Grade I-III patients with longitudinal intracranial aneurysm underwent interventional therapy using the "interlocking basket" technique. During the operation, the aneurysm was divided into two segments based on its length and occluded with two coils. The first coil with a transverse diameter matching that of the aneurysm was deployed to form a "basket", which was densely occluded, and a portion of this coil out of the "basket" was interlocked with the second coil to form another "basket" crossing the aneurysmal neck to prevent the coils from escaping till the neck of the aneurysm was densely occluded.

RESULTSThirty-five aneurysms (92.1%) were completely embolized, and 3 (7.9%) were 95% embolized. No coil escaping from the aneurysm neck or other complications occurred. Twenty-five patients were discharged with a GOS score of 5 (65.8%), 7 (18.4%) with a score of 4, and 6 (15.8%) had a score of 3. In the follow-up for 3-25 months after the embolization, angiography was performed in 28 cases, and recurrence was found in 2 cases (7.14%).

CONCLUSIONThe "interlocking basket" technique can increase the coil stability in longitudinal intracranial aneurysm and allows reliable block of the aneurysm neck and dense embolization of the aneurysm to improve the clinical outcomes of the patients.

Aged ; Embolization, Therapeutic ; methods ; Female ; Humans ; Intracranial Aneurysm ; therapy ; Male ; Middle Aged ; Treatment Outcome

Objective To evaluate the effect ofendovascular embolization on intracranial aneurysms with detachable coil and detachable balloon and to emphasize the mainpoint of embolization technique.Methods 1328 patients underwent complete cerebral angiography using microcatheter under DSA imaging. 85 cases with 90 aneurysms were embolized by MDS, 825 cases with 847 aneurysms were embolized by GDC, 418 cases with 433 aneurysms were embolized by EDC. 37 of 67 giant aneurysms were embolized by detachable balloon, 18 aneurysms by GDC, 11 aneurysms by EDC, 1 by MDS. Results 1328 patients with 1370 aneurysms were cured successfully; 1 322 cases recovered clinically, 6 patients died. 1 281 aneurysms achieved 100 % occlusion, 65with 95 % occlusion, 20 with 90 % occlusion, and 4with 80 % embolization. 9 aneurysms reputured during the embolization, 5 patients had cerebral infarction, 1 patient died of intractable cerebral vasospasm for microcoil escape. 2 recurrent cases were cured by second GDC embolization. Conclusion The method of endovascular embolization to treat intracranial aneurysm is safe, reliable and effective. Those cases with giant aneurysms will have high recurrence. Patients who suffer from SAH repeatedly may have great possibility of aneurysm rupture during embolization.

Objective To evaluate the clinical effect of embolization of cerebral dural atreriovenous fistulas (cDAVF) of the eavemous sinus through the superior ophthalmic vein approach. Methods Twnety-seven patients with eDAVF of the cavernous sinus were embolized through the superior ophthalmic vein approach. Cerebral angiography and follow-up examination of the patients were performed to evaluate the effect ofernbolization. Results The fistulae showed complete angiographic disappearance in 15 patients, and 12 patients had blood velocity flow reduction at the fistula orifice. Ocular proptosis and chemosis deteriorated transiently in 11 patients after the procedure. The patients were followed-op for 3 to 48 months, and clinical cure was achieved in 17 patients, and 10 showed significant symptom relief. Conclusion cDAVF of the cavernous sinus can be effectively embolized through the superior ophthalmic vein approach.