1.Airway stent: the current situation and recent advances in animal experiments
Journal of Interventional Radiology 1992;0(01):-
In recent years, interventional radiology has effectively solved lots of difficult clinical problems related to airway disorders, and has rapidly developed with the technique being widely practiced in the clinical work. However, the complications caused by airway stent have occurred more and more common, one reason for it is that there are few necessary fundamental studies in animal model. The paper aims to summarize the current situation and progress in animal experiment with regard to airway stent both at home and abroad in order to lay a foundation for promoting relevant basic researches.
2.Retrievable stent filter placement for the treatment of Budd-Chiari syndrome complicated with inferior vena cava thrombosis: its mid-term results
Journal of Interventional Radiology 1994;0(04):-
Objective To investigate the mid-term efficacy of retrievable stent filter placement for the treatment of Budd-Chiari syndrome (BCS) complicated with inferior vena cava (IVC) thrombosis. Methods Eight patients of BCS complicated with IVC thrombosis were enrolled in this study. IVC thrombosis included segmental occlusion (n = 2) and membranous occlusion (n = 6). In all patients, the IVC was re-canalized by using blunt wire after anticoagulation and thrombolytic therapy, then, the re-canalized site was expanded with small balloon, which was followed by the placement of retrievable stent filter, and, finally, IVC size was dilated with larger balloon. Anticoagulation and thrombolytic therapy was given after the procedure. And all the retrievable stent filters were withdrawn from the IVC through internal jugular vein when the thrombus in IVC was dissolved. In patients with segmental occlusion of IVC, in addition to the placement of retrievable stent filter a "Z" type vessel stent was also placed during the same interventional session. Follow-up examination with color Doppler sonography was conducted in all patients. Results Technical success was achieved in all 8 patients without pulmonary infarction or other complications both during and after the operation. Immediately after the thrombus completely disappeared, the retrievable stent filter was successfully taken out in all patients. During a following-up period of 3-12 months, color Doppler sonographs showed that the IVC remained patent in 6 patients and had a recurrence of stenosis in 2 patients. Conclusion Placement of retrievable stent filter is a safe and effective treatment for BCS complicated with IVC thrombosis.
3.Scientific attitude towards the interventional treatment of the lesions of esophagus and esophagogastric junction
Journal of Interventional Radiology 1994;0(02):-
The diseases of esophagus and stomach possess highest morbidity in China. For decades the interventional radiology has effectively solved a lot of clinical puzzles upon the lesions of esophagus and esophagogastric junction. Rapid development and extensive application offen induce the exaggeration of indication and improper choice of the proceduce, resulting in clinical disposal for various complications. Scientific attitude should be taken on the utilization of interventional method: possessing rich imaging and clinical knowledge; understanding the property of various interventional instruments; strictly grasping indications of arterial infusion chemotherapy, balloon catheter dilation and stent placement; perfectly mastering the operation technology; well controlling complications.
4.The interventional treatment for recurrent jaundice after palliative bilio-intestinal anastomosis in patients with malignant obstructive jaundice due to cholangiocarcinoma
Xinwei HAN ; Yongdong LI ; Tianxiao LI
Journal of Interventional Radiology 2001;0(05):-
Objective To explore the interventional methods to treat recurrent jaundice after palliative bilio intestinal anastomosis in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods Ten patients with recurrent jaundice after bilio intestinal anastomoasis were retrospectively evaluated. Nine of ten underwent PTCD with metallic stent placement, one underwent the inner outer draining catheter procedure. The patients were evalualed with comparison in regard to preoperative conditions, TBIL,ALT,GTP and AKP values.Results Stent placement was successful only once in all 10 cases with successful rate of 100%. TBIL,ALT,GTP and AKP values were significantly lower 7 days postoperative by than that preoperation. Subsidence of jaundice was satisfactory for 100% in all patients after the treatment. Conclusions Percutaneous placement of biliary metallic stents is a safety, simple, low complication method for managing recurrent jaundice after palliative bilio intestinal anastomosis for the terminal stage of malignant obstructive jaundice.
5.The interventional treatment for biliary recurrent obstruction after palliative T tube drainage in patients with obstruction due to cholangiocarcinoma
Xinwei HAN ; Yongdong LI ; Sheng GUAN
Journal of Interventional Radiology 2001;0(05):-
Objective To explore the interventional method to treat biliary recurrent jaundice after T tube drainage in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods 7 bili ary metallic stents were placed in 7 patients with recurrent jaundice after T tube drainage in cholangiocarcinoma cases. Results Stent placement was once successful in all 7 cases with successful rate of 100%. For all cases, TBIL,ALT,GTP and AKP values 7 days postoperatively were significantly lower than that of preoperation together with subsidence of jaundice satisfactorily for 100% after the treatment.Conclusions Percutaneous placement of biliary metallic stents was effective economic, minimal invasive and safe for palliation of biliary recurrent jaundice after T tube drainage in cholangiocarcinoma induced obstructive jaundice.
6.New way in pathologic diagnosis of biliary obstructive jaundice: a clinical study in percutaneous transhepatic cholangiobiopsy
Xinwei HAN ; Yongdong LI ; Xuemei GAO
Journal of Interventional Radiology 2001;0(05):-
Objective To explore the technical feasibility and sensitivity of percutaneous transhepatic cholangiobiopsy in malignant obstructive jaundice, together with the guidance for clinical managements.. Methods 31 patients with obstructive jaundice after percutaneous transhepatic cholangiography and drainage were undesgone percutaneous transhepatic cholangiobiopsy. The technique was performed through an preexisted percutaneous transhepatic tract with a 8 Frerch sheath, multiple specimens were obtained after passing the forceps for the biopsy. The specimens were fixed with formalin, and then taken for histopathologic diagnosis. Results The histopathologic diagnosis was acquired in 30 of 31 patients(sensitivity, 96.8%). Conclusions Percutaneous transhepatic cholangiobiopsy is an accurate, safety and reliable way, easy to perform with a histopathologic diagnosis sensitivity rate of 96.8%.
7.The diagnostic value of percutaneous transhepatic cholangiography imaging characteristics in pancreaticobiliary maljunction
Xinwei HAN ; Zhen LI ; Gang WU
Chinese Journal of Radiology 2008;42(8):797-801
Objective To investigate the diagnostic value and feasibility of PTC diagnosis on pancreaticobiliary maljunction (IBM), and to summarize the PTC radiological characteristics of PBM. Methods Clinical findings and cholangiopancreatographic results were analyzed retrospectively for a group of consecutive 363 patients with obstructive jaundice receiving the PTCD therapy. Meanwhile the standard selected for cases and diagnostic conditions were established. The length and diameter of pancreaticobiliary common duct, the diameter of pancreatic duct and common bile duct and the confluence angle were measured respectively. The t test and rank sum test were used to analyze the result statistically. Results Thirty-eight cases were radiologicaUy diagnosed as PBM owing to the reference standard and the detection rate was 10.5% (38/363). The length of common duct was (12.6±7.9)mm. The significant difference existed between it and normal value (6ram) (t=5.15 , P <0.05). The site of duodenal papilla had influence on the length of common duct. The diameter of common bile duct, pancreatic duct and common duct near the confluence are (3.7±1.9 ) mm, (2.4±1.3) mm, (3.3±1.4 ) mm, respectively. There was no statistical difference between them and the normal value (t=1.79,2.85,5.72, P>0.05). Fifteen patients' duodenal papilla located the middle of descending duodenum. The length of common duct was (10.6±9.1)mm , the confluence angle was 51.1°±28.0°, the number of the duodenal papilla locating in the inferior 1/3 of descending duodenum, juncture , horizontal part of duodenum was 10, 8,5, respectively. The length of common duet were (9.9±3.7), ( 18.6±8.9), ( 13.9±3.5 ) mm, respectively. The confluence angle were 54.0°±18.6°、48.7°±12.6°、74.4°±18.5°, respectively . The site of duodenal papilla had significant influence on the length of common duct(X2=14.51, P <0.05). Conclusion PTC is a safe, feasible, method to diagnose PBM, and it demonstrates the characteristic findings of PBM.
8.Interventional Treatment of Renal Artery Pseudoaneurysms
Qingliang CHEN ; Zongming LI ; Xinwei HAN
Chinese Journal of Minimally Invasive Surgery 2015;(7):619-621
Objective To evaluate the clinical value of percutaneous renal artery angiography and embolization of the renal artery pseudoaneurysms. Methods A retrospective analysis was made on 15 cases of postoperative urethral bleeding following urinary calculi surgery from January 2012 to February 2014, which were diagnosed of renal artery pseudoaneurysms via the renal artery angiography.Superselective catheter placement was carried out into the proximal of parent artery and the pseudoaneurysm was embolized by using a coil and gelatin sponge. Results Renal artery angiography clearly displayed pseudoaneurysms in the 15 cases, which were located in interlobular artery in 11 cases, arcuate artery in 3 cases, and minor interlobular artery in 1 case.Urethral bleeding was stopped after using gelatin sponge and spring coil embolization.Among them urethral bleeding recurred in 1 case after two days, and a second embolization was conducted.After the embolization, transient renal colic happened in 2 cases and a fever of 37.8-39.3 ℃lasting for 3-8 d was seen in 7 cases.Follow-ups for 3-24 months ( mean, 15 months) showed no renal dysfunction and urinary tract bleeding. Conclusion The transcatheter embolization and angiography can diagnose and treat renal artery pseudoaneurysms, with safe and effective outcomes.
9.Budd-Chiari syndrome:the feasibility study of PTA with diameter 30mm balloon catheter for obstruction of the inferior vena cava
Xinwei HAN ; Pengxu DING ; Gang WU
Journal of Interventional Radiology 1994;0(04):-
Objective To evaluate the feasibility and safety of percutaneous transluminal angioplasty(PTA)using ? 30 mm balloon catheter to dilate the obstructive lesion of inferior vena cava(IVC)in Budd-Chiari syndrome(BCS). Methods From January 2002 to July 2006,146 consecutive patients with BCS(94 men,52 women)underwent color Doppler sonography including enhanced multislice CT(n = 47),and were confirmed by IVC angiography. All patients but 1 microsomia case were treated by PTA using ? 30 mm balloon catheter for dilation. IVC angiography were immediately performed to show patency of IVC and occurrence of any rupture or not after PTA. Follow-up color Doppler sonography was taken to evaluate the IVC patency and the PTA-related complication about 1 week after PTA. Results The mean transversial and longitudinal diameters of IVC at the junction level of right atrium and IVC were(25.09 ? 6.09) mm and(17.57 ? 3.93) mmrespectively in 46 cases with 3 D multi-slice CT preoperatively(1 case without measurement was due to the closest site with right atrium). There were no IVC rupture during the procedure. Conclusions Treatment of BCS by PTA using ? 30 mm big balloon catheter is feasible and safe.
10.The Clinical Manifestation of Thoracostomach-Airway Fistula and Its Imaging Diagnosis
Xinwei HAN ; Gang WU ; Xuemei GAO
Journal of Medical Research 2006;0(03):-
Objective To analyse the clinical manifestation of thoracostomach-airway fistula in order to improve the recognition.Methods The clinical information in 20 cases with thoracostomach-airway fistulas was analyzed retrospectively.Results The main clinical manifestations were choke after drinking or eating,inhalation pneumonia,fever,becoming thin ness,aridity,turbulence of water and electrolyte,et al.The stomach radiography showed thoracostomach-tracheal fistulas in six cases,thoracostomach-carina fistula in fwo cases,thoracostomach-left main bronchial fistulas in 10 cases and thoracostomach-right main bronchial fistula in two cases,vespectively.Conclusions Thoracostomach-airway fistula could be diagnosed according to the specific clinical significances and stomach radiography.