Objective To evaluate the therapeutic efficacy and complications of fluoroscopically guided double balloon dilation in the treatment of benign colorectal anastomotic strictures. Methods Under fluoroscopic guidance, 17 patients with benign colorectal anastomotic strictures underwent transanal double balloon dilation, including 13 patients underwent resection for malignant disease, and 4 for benign conditions. 16 out of 17 patients had difficulty or frequent defecation due to partial obstruction. The remaining one patient had the stricture detected by endoscopy and barium enema after total proctocolectomy and a temporary ileostomy for ulcerative colitis. Therapeutic efficacy and complications were evaluated in the follow-up visits. Results Seventeen patients received double balloon dilation in a single session. The diameter of double balloon catheter was arranged from 30 to 40 mm. Technical success achieved in all 17 patients with complete release (n = 12, 71%) or incomplete one (n = 5, 29%) and 100% improvement of symptoms was achieved in all patients, together with no major complications such as perforation or severe hemorrhage. During the mean follow-up of 23 months (range, 1 - 62 months), one patient (6%) developed a recurrent stricture and needed a second balloon dilation six months after the initial balloon dilation. Conclusions Fluoroscopically guided double balloon dilation is an effective and safe method for treating benign colorectal anastomotic strictures. (J Intervent Radiol, 2006, 15: 543-546)

Although the interventional radiology, a rapidly expanding medical specialty, has already been widely popularized and generally accepted for many years, it is still facing lots of challenges and turf wars, such as the brain drain, understaffed and the gap between the old and the young. This article attempts to analyze the reasons through investigating the current teaching situation of interventional radiology in medical coUeges and finding out the undergraduates' attitude to interventional radiology, in order to explore possible paths for solving the imbalance between supply and demand of qualified personnel.

Although the interventional radiology, a rapidly expanding medical specialty, has already been widely popularized and generally accepted for many years, it is still facing lots of challenges and turf wars, such as the brain drain, understaffed and the gap between the old and the young.This article attempts to analyze the reasons through investigating the current teaching situation of interventional radiology in medical colleges and finding out the undergraduates' attitude to interventional radiology, in order to explore possible paths for solving the imbalance between supply and demand of qualified personnel.

Objective To discuss the feasibility of using three-dimensional simulation positioning of puncture route that is sketched according to the transversal and sagittal CT images to design percutaneous vertebroplasty (PVP) plan. Methods A total of 58 patients with 63 diseased vertebral bodies were enrolled in this study. Before PVP, the simulation puncture route was delineated according to the transversal and sagittal CT images, and the simulation puncture parameters were determined by using the software of PACS, in this way the three-dimensional simulation puncturing route was established , and the skin needle entry point as well as the puncture angle were calculated. Unilateral transpedicular approach was used when the simulation puncture route could meet the requirements of unilateral approach. Otherwise , bilateral transpedicular approach would be employed. Three months after PVP visual analogue score (VAS) was used to evaluate the degree of pain relief, and the result was compared with that determined before PVP. SPSS 13.0 software was used for statistical analysis. The estimating data were statistically analyzed with paired t-test and the results were expressed in the form of (x ± s). Results The measurement results showed that significant differences in the puncture angles and skin needle entry points existed between different vertebral bodies. Guided by the preoperatively determined simulation puncture route , PVP was successfully accomplished in all patients. The success rate of single puncturing was 100% (63 vertebral bodies in total). Among 63 vertebral bodies, unilateral transpedicular approach was adopted in 55 and the operation time was (28.5 ± 5.5) minutes, while bilateral transpedicular approach was carried out in 8 and the operation time was (37.5 ± 5.5) minutes. After PVP, complete pain relief was achieved in all patients. No serious complications occurred during the follow-up period. Conclusion Three-dimensional simulation positioning of puncture route that is sketched according to preoperative transversal and sagittal CT images is very useful in precisely determining the puncturing route before PVP, which is very helpful to increase the success rate of single puncture and to improve the procedural safety.

Objective To evaluate the method and result of thyroid artery embolization as a new therapy for Graves disease.Methods Ten patients with Graves disease underwent selective thyroid artery embolization. Totally 25 thyroid arteries were embolized with PVA microspheres. The indications to this therapy were as following: Graves disease with recurrent clinical symptoms or with leucopenia during the period of treating with administration of antithyroid drugs or recurrence after subtotal thyroidectomy. Results Serum level of thyroid hormones dropped significantly [median FT 3 from 20.90pmol/L(13.36～50.92pmol/L) to 7.81pmol/L(3.67～35.3pmol/L), median FT 4 from 57.9pmol/L(30.96～57.9pmol/L) to 28.13pmol/L(20.44～39.60pmol/L), ( P

Objective To analyze the reaction in rabbit's esophagus after inserting metallic nitinal stent and obtaining suggestion for the clinical application.Methods The selfexpanding nitinal stent was placed in each of eight rabbits's esophagus. The rabbits were killed at 2,4,6,8 weeks after implantation. Tissue around the stent was investigated with naked eye and microscopy. Results Chronic inflammation and edema were seen in the submucous tissue 2 week after stenting. Slight stenosis occurred at the regions of two ends of the stent and scattered vegetations like polyp were seen with naked eye at 4 weeks, with inflammatory cell infiltration, partial mucous polypoid hyperplasia under microscopy. The pathological changes were more obvious at 6 weeks comparing with the 4 weeks. The lower end of one stent was embedded in esophageal wall. Two rabbits of 8 weeks' group died of obstruction with food tarried inside the stents.Conclusions The restenosis after stenting were mainly seen at the region of terminals of stent. Thus reformation of stent should be taken place urgently especially at the terminals for the prevention of restenosis.

Objective To solve the difficulty of intubation of nasojejunal feeding tube under digital subtraction angiography (DSA) system when conventional methods were failed.Methods Seventy-one patients who failed to place the nasojejunal feeding tube by single guide wire under DSA conventional methods.With the methods of decreasing the stomach volume,changing the body posi-tion,and using a catheter or gastrointestinal motility,the nasojejunal feeding tube was placed into the proper position (more than 30cm far away from Treitz or gastrointestinal anastomosis).Results All the procedures were successfully accomplished.No compli-cations,such as throat damage,abdominal pain,perforation and hemorrhage of digestive tract were found.The mean duration under DSA was four minutes (2-7min).Conclusion With the help of various methods above,we can improve the success rate of intuba-tion and reduce the duration of the nasojejunal feeding tube placement,when conventional methods were failed.

PURPOSE: To evaluate the efficacy of a paclitaxel-eluting expandable metallic stent in reducing tissue hyperplasia following stent placement in a canine tracheal model. MATERIALS AND METHODS: Nine paclitaxel-eluting stents (drug stent, DS) consisting of a proximal bare part and a distal polyurethane-covered part were placed in the trachea of nine dogs and nine control stents (control stent, CS) were placed in the other nine dogs. The dogs were scheduled to be sacrificed 12 weeks after stent placement. Gross and histological factors, such as epithelial erosion/ulcer, granulation tissue thickness and inflammatory cell infiltration were evaluated after each dog was sacrificed. RESULTS: There were no procedure-related complications or malpositioning of any of the stents. One CS migrated less than eight weeks following stent placement. Four dogs (one DS and three CS dogs) died between three and five weeks following stent placement. Therefore, pathologic specimens were obtained from eight DS and five CS dogs. Epithelial erosion/ulcer or inflammatory cell infiltration was slightly more prominent in the DS cases than in the CS cases, in both the bare part and the covered part. However, the data was not statistically significant. Granulation tissue thickness was lower in the DS cases than in the CS cases in both the bare part (mean, 3.63-mm vs. 4.37-mm) and the covered part (mean, 1.75-mm vs. 2.78 mm), but the data was also statistically insignificant. CONCLUSION: Although the data was not statistically significant, placement of paclitaxel-eluting expandable metallic stent demonstrates a tendency toward a decrease in granulation tissue thickness in canine tracheal models.
Animals ; Dogs ; Granulation Tissue ; Hyperplasia* ; Stents* ; Trachea