Objective To investigate the clinical effect and value of interventional therapy for post-thrombosis syndrome (PTS).Methods Clinical data of 91 patients with PTS who had received interventional therapy were retrospectively analyzed.The patients were in prone position in surgery.We selected puncture approach of popliteal vein and established a working guidewire channel, and then performed balloon dilatation and stent placement.Results The technical success rate was 98.9% (90/91), with complete recanalization of the stenosis or occluded vessel and restoration of the normal blood flow.There was 1 case of failure to traverse the left common iliac vein segment, but the collateral circulation was rich enough to compensate.The 90 patients were followed up for 6-30 months, with a mean of (18.5±2.3) months.The 6, 12, and 24-month patency rates were 93.3% (84/90), 81.3% (61/75), and 71.4%(20/28), respectively.No stent migration or ulcer recurrence occurred in the 90 patients during the follow-ups.Conclusion For the treatment of PTS, endovascular treatment has high technical success rate.With satisfactory clinical effect, this therapy is safe and effective.

Objective To investigate the cause, diagnosis and management of Wunderlich's syndrome.Methods Clinical data of 13 cases of Wunderlich's syndrome were reviewed retrospectively. Results There were nine cases of tumorous disease, 2 cases of non-tumorous disease and 2 cases of unknown causes in the group. The most common cause in this series was renal angiomyolipoma. Surgical management was performed in 8 cases. Conservative treatment was adopted in the rest 5 cases. Pathological study confirmed that there were 2 cases of renal cell carcinoma, 4 cases of angiolipoleiomyoma and 1 case of congenital polycystic kidney. Conclusions The cause of Wunderlich's syndrome is complicated, renal neoplastic origin disease appears to be the most common cause. Comprehensive analysis of multiple imaging examinations and clinical features is most important in the etiological diagnosis. The appropriate management depends on the underlying etiological diagnosis and the patient's hemodynamic status. Carefully watching is required for patients who have not been made a definite etiological diagnosis.

Objective To evaluate the efficacy of endovascular interventional minimally invasive techniques in treatment of acute brachial artery injury.Methods A retrospective case series study was designed to analyzed data of 16 cases (11 males and 5 females) sustaining acute brachial artery injury treated from March 2011 to August 2016.Mean age was 47.9 years (range,27-66 years).Left upper extremity vascular injury occurred in 7 cases and right upper extremity vascular injury occurred in 9.There were 13 cases of arterial intima injury and 3 of arterial pseudoaneurysm.All patients underwent endovascular therapy including stent implantation and balloon dilatation.Angiography was used to evaluate the repair of brachial artery and the operation time was recorded.Improvements of distal limb arterial pulse and limb ischemic symptoms were observed,and the patients who were followed up with stent lumen stenosis more than 50％ received endovascular treatment again.Results The procedures was successful in all patients,with operation time of 30-75 minutes (mean,45 minutes).After the insertion of a stent,recovered brachial artery blood flow and disappeared pseudoaneurysm were observed on angiography,without occurrence of stent stenosis or contrast extravasation.Symptoms of local pain and numbness were alleviated,and blood supply of the distal brachial artery was improved after operation.All patients were followed up for 3-36 months(mean,16.7 months).The false aneurysm did not recur.Two cases of stent stenosis more than 50％ had a second balloon dilation procedure and the blood flow returned to normal.Stent patency was found in 14 cases with stent stenosis of less than 50％.During the follow-up period,no ischemic necrosis,displacement of the stent or stent fracture were found.Conclusion For acute brachial artery injury,endovascular management exhibits higher technical success rate and good clinical outcome with a low incidence of complications.

Objective To explore the effect and application value of percutaneous transhepatic various interventional technique for treatment of common bile duct stones.Methods 46 patients with common bile duct stones were treated.All patients were treated by percutaneous transhepatic cholangiopancreatography in order to confirm the number and location and size of the stones.Place me-chanical lithotripsy net according to the size of stones.Then percutaneous transhepatic balloon dilation.Postoperatively biliary tract was drained for 2 weeks.Results 45 operations were successful,The successful rate was 97.83%.Complete stone removal was obtained with one session in 41 patients and two sessions in 4 cases,respectively.There was no serious complications occurred during the operation. There was no perforation and bleeding,but hyperamylasemia occurred in 3 patients and acute pancreatitis occurred in 1 patient and bile perito-nitis occurred in 2 patients.Conclusion Percutaneous transhepatic various interventional technique can keep the function of papillary sphincter and is a valuable methed for patients suffering from common bile duct stones with a high successful rate and safety.

Objective To discuss the clinic efficiency and value of intravascular infusion and PTA for treatment of acute and chronic arterial occlusion.Methods 37 patients,23 males and 14 females,aged 23～81 years,mean 52.9 years,underwent Seldinger techniqe.Percutaneous puncture femoral artery anterograde or retrocatheterism with pulsed-spray or injection thrombolysis.The concentration of urokinase was 10000 u/ml,total 300～800 thousands u,mean 550 thousands u.17 patients with chronic arterial occlusion were theated with PTA.Results The rate of success all patients with interventional therapy was 95 percent(35/37).The rate of success with acute arterial occlusion was 91 percent(21/23).In 23 cases,18 were obtained thrombolysis completely(78 percent )and thrombolysis partly were 3(13 percent )and unaffected were2(9 percent).In chronic patients thrombolysis partly was 93 percent.The rate of success with PTA was 100 percent(14/14).Conclusion The thrombolysis therapy is a first selection therapy for acute and chronic arterial occlusion and is a accessory treatment for PTA.

Objective To discuss the value of emergency angiography and embolization treatment of hemorrhage of digestive tract.Methods Give emergency angiography and embolization treatment for 15 patients with hemorrhage of digestive tract.Male is 12.Famale is 3.Adopt to Seldinger technic and method of coaxial duct,the head of ducts accesses to the region of bleeding,with gelatin foam or suture to embolism.Results All 15 patients were sucessful embolismed and get objective of hemostasis.Angiography appeared contrast medium overflowing and the humens,mucosa development.All patients were not bleeding again.Conclusion Clinic efficiency of emergeney ;embolization treatment for hemorrhage of digestive tract is assurance and explanation the principle and events of attention.

Objective To evaluate the long-term results of balloon dilatation for benign esophageal stricture and stent implantation for malignant esophageal stricture.Methods Balloon dilatation and stent implantation were performed in 156 cases,of which 12 cases received balloon dilatation in benign esophageal stricture and 134 cases received metallic stents,9 cases received balloon dilatation in malignant esophageal stricture of 143 cases.Results During a follow-up period of 1～48 months,61 cases died with a mean survival period of 8.9 months(1～33 months).Recurrent stenosis occurred in 63 cases(47%)who had to receive ballon dilatation or another stent implantation procedure,the stent was obstructed due to food and mucus in 3 cases,stricture at the upper end in 19 cases and the both ends in 8 cases.Conclusion Stent implantation is an effective palliative treatment for esophageal carcinoma with severe dysphagia.Tumor and hamartoplasia are the main cause of recurrent stricture.Covered stents can reduce the rate of recurrent stricture.

Objective To evaluate the clinical effect and feasibility in treating urethral stricture caused by benign prostatic hyperplasia in elder with transurethral implanted stent(Memotherm) under X-ray guided.Methods 47 patients included in this study,they ranged in age from 72 to 93 years,with an average age of 78.3 years,the symptom of dysuria ranged from 7 to 21 years.After 1% Lidocaine urethra mucous membrane anaesthesia,the processes of transurethral implanted stents at the most narrowing area of the urethra under X-ray guided were performed.Results The treating processes were successful in all cases(100%) one time,of them,the micturition in 43 cases was free and could act on one's own immediately after stent implantation.None having urethral restricture and lithiasis occured.Conclusion The clinical therapeutic effect was obvious using the memory alloy net-like stent for the treatment of urethral stricture caused by benign prostatic hyperplasia,it is worth promoting application in clinic.

Objective To explore the clinical effect of two-points approach vascular stenting technique (via both the femoral artery and posterior tibial artery of the affected side) in repairing blunt popliteal artery injuries.Methods The clinical data of eleven patients with blunt popliteal arterial injuries,who were treated with two-points approach vascular stenting technique during the period from March 2011 to March 2015 as single-approach stenting repair failed,were retrospectively analyzed.First,antegrade puncture of the femoral artery on the affected side with subsequent angiography was performed to evaluate the arterial injury,when the attempt to push the guide-wire to pass the injured arterial segment by twisting manipulation failed the puncture of posterior tibial artery was immediately carried out,then,a 4-French single-bend catheter together with a goose neck snare was inserted.Guide-wire capture technique was used to gasp the guide-wire in the injured artery segment,and then the guide-wire was pulled to pass through the injured artery segment.In this way,the guide-wire working circle was reliably established,and along the guide-wire the vascular stent was inserted and delivered to the right site to repair the injured artery.A 6-French guiding catheter was inserted to perform thrombus aspiration for eliminating the distal outflow obstruction caused by thrombus.Thrombolytic therapy with small dose of urokinase through a indwelling catheter was employed for the treatment of peripheral arterial thrombosis.Results The technical success rate was 100％.Angiography revealed that partial transection of artery was detected in 7 patients,and complete transection of artery in 4 patients.A total of 16 stents were implanted.No perioperative mortality or procedure-related complication occurred.All patients were followed up for 13-24 months,with a mean of (18.7±3.8) months.In-stent thrombosis occurred in 2 patients,which was treated with thrombolytic therapy and the blood flow recovered;severe in-stent stenosis (＞70％) was seen in 3 patients,in whom the blood flow returned to normal after balloon dilation therapy;mild in-stent stenosis (＜30％) was found in 6 patients,and no special treatment was given.During the follow-up period,no stent fracture,deformation,or displacement was seen,and no patient needed to have an amputation surgery.Conclusion In treating blunt popliteal artery injuries,two-points approach vascular stenting technique can effectively reduce the operation time,rapidly recover the blood flow of the injured popliteal artery,and shorten the time of limb ischemia.This technique has very satisfactory clinical shortterm effect.

Objective To explore the technique of implantation of double-J stent via the guide-wire track, which was established through percutaneous renal puncturing, for the treatment of ureteral stricture and obstruction, and to evaluate its therapeutic effect. Methods A total of 75 patients with ureteral stricture or obstruction, who failed to respond to cystoscopic catheterization, were enrolled in this study. The lesions included benign stricture(n=60) and malignant stricture(n=15). Ureteral guide-wire track was established through percutaneous renal puncturing, which was followed by the dilatation of the stricture with balloon catheter and subsequent implantation of double-J stent via the guide-wire track. After the double-J stent was removed, the patients were followed up for 3 months to five years. Results The success rate of the procedure was 98.7%(74/75). Technical failure occurred in one patient with benign ureteral stricture. The cure rate was 70.7%(53/75), the improvement rate was 26.7%(20/75), and no improvement was seen in one case (1.35%). The total effective rate was 97.3%(73/75). Conclusion For the treatment of ureteral stricture and obstruction, the implantation of double-J stent via the guide-wire track, which is established through percutaneous renal puncturing, is a safe and effective method.