Objective To assess the clinical value of preoperative CT-guided microcoil positioning of small solitary pulmonary nodule (SPN) in assisting video-assisted thoracic surgery (VATS) procedure to more quickly and more precisely remove small pulmonary lesions.Methods The clinical data of 90 patients with SPN,who were admitted to authors' hospital during the period from June 2014 to May 2016 to receive VATS,were retrospective analyzed.Preoperative CT-guided microcoil positioning of SPN was employed in 45 patients (group A),while other 45 patients (group B) did not receive preoperative positioning of SPN.The pulmonary lobar wedge resection time,the transfer rate of changing to open chest operation,postoperative hospitalization time,the success rate of microcoil positioning of SPN,complications,etc.of both groups were statistically analyzed.The safety of preoperative CT-guided microcoil positioning of SPN was evaluated,and its benefit-enhancing value for VATS was discussed.Results In group A,the success rate of VATS was 100％ and the success rate of SPN positioning was 95.6％.Postoperative complications included pneumothorax (n=5),pulmonay surface hemorrhage (n=6),and dislodgement of microcoil (n=2).In group B,the success rate of VATS was 84.4％ and the transfer rate of changing to open chest operation was 15.6％.In group A,the manipulation time of VATS was (17.7±2.8) min,the postoperative hospitalization time was (6.2±1.7) days,and the transfer rate of changing to open chest operation was 0％,which were strikingly lower than those in group B;the differences between the two groups were statistically significant (P＜0.05).Conclusion Preoperative CT-guided microcoil positioning of small SPN can assist VATS procedure to remove small pulmonary lesions more quickly and more precisely,it can effectively reduce the transfer rate of changing to open chest operation,shorten the manipulation time of VATS as well as the postoperative hospitalization time.

Objective To investigate the characteristics of intracranial posterior circulation aneurysms,and to evaluate the clinical outcomes of interventional endovascular therapy.Methods The clinical and imaging data,interventional therapy and observed effect,postoperative follow-up results of 40 patients with intracranial posterior circulation aneurysms treated with interventional endovascular therapy were analyzed retrospectively.Results Forty-two posterior circulation aneurysms were detected in 40 patients,and were treated successfully.Endovascular treatments included simple coil embolization (n=8),stem-assisted coil embolization (n=28),simple Onyx embolotherapy (n =1),aneurysms and parent artery occlusion (n=5).DSA performed immediately after treatment revealed that complete occlusion were achieved in 30 aneurysms,nearly complete occlusion in 6 aneurysms and partial occlusion in 6 aneurysms.DSA performed 6 months after treatment revealed that complete occlusion were achieved in 36 aneurysms,nearly complete occlusion in 4 aneurysms and partial occlusion in 1 aneurysms.At the time of discharge,the modified Rankin scale (mRS) scores were 0 point in 35 patients,1 point in 3 patients,2 point in 1 patient and 6 point in 1 dead patient.Three to six months after discharge from hospital,the mRS scores were 0 point in 38 patients and 1 point in 1 patient.No new neurological dysfunction or aneurysms recurred.Conclusion The intracranial posterior circulation aneurysms have special clinical and imaging features,and most of intracranial posterior circulation aneurysms are complex.Endovascular treatment is safe and effective for the intracranial posterior circulation aneurysms.