1.Comparison belween diagnostic peritoneal lavage,CT scanning and ultrasonography in diagnosis of blunt abdominal trauma
Yinghong YANG ; Zhong LIU ; Zongyi LIN ;
Chinese Journal of General Surgery 2000;0(12):-
Objective To compare the accuracy of diagnostic peritoneal lavage (DPL),abdominal computed tomographic(CT) scanning,and abdominal B ultrasound for the diagnosis of blunt abdominal trauma. Methods Prospective study was made on 61 hemodynamically stable abdominal injury patients.The patients received both CT and B ultrasound before DPL ,A laparotomy was done on the condition that one of the three examinations had positive finding.The surgical findings were compared with that of the diagnostic studies. Results The sensitivity,specificity and accuracy were 97.4%,81.7% and 91.8% for DPL; 97.3% 91.3% ,and 95.1% for CT;and 92.3%,90.9% and 91.8% for B ultrasound.Although the sesitivity,specificity,and accuracy of B ultrasound in the diagnosis of blunt abdominal trauma were similar to DPL and CT, B ultrasound had more advantages than DPL and CT. Conclusions B ultrasound can replace DPL.CT as a supplementary method in the diagnosis of blunt abdominal trauma.
2.A nomogram model predicting futile recanalization in patients with acute anterior circulation large vessel occlusion after endovascular mechanical thrombectomy
Xiaojun WANG ; Zongyi WU ; Huiyuan PENG ; Duo LIN ; Xingchen LIU ; Jianheng WU ; Min YANG ; Junxiong WEN
Chinese Journal of Neuromedicine 2023;22(1):43-50
Objective:To investigate the risk factors for futile recanalization in patients with acute anterior circulation large vessel occlusion after endovascular mechanical thrombectomy (EMT), and establish a nomogram model predicting futile recanalization in these patients.Methods:One hundred and eighty-eight patients with acute anterior circulation large vessel occlusion after EMT were enrolled from Department of Neurology, Zhongshan Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine from January 2018 to December 2021. Patients were divided into futile recanalization group and effective recanalization group according to whether futile recanalization occurred; futile recanalization was defined as successful recanalization showed by immediate postoperative DSA (modified thrombolysis in cerebral infarction [mTICI] ≥2b), but poor functional outcome (modified Rankin Scale [mRS] scores>2 90 d after surgery). The clinical data were compared between futile recanalization group and effective recanalization group. Multivariate Logistic regression analysis was used to screen the risk factors for futile recanalization. R software was used to establish a nomogram model for futile recanalization. C-index was used to evaluate the differentiation of the model, and correction curve was used to evaluate the accuracy of the line graph model prediction. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficiency of the nomogram model.Results:Ninety-two patients had futile recanalization. Compared with the effective recanalization group, futile recanalization group had significantly older age, significantly higher hemoglobin A1c on admission, significantly longer time from puncture to vascular recanalization, significantly higher proportions of patients with hypertension history and poor collateral circulation, and significantly different severities of stroke and white matter hyperintensities (WMHs) and distribution of occlusive sites ( P<0.05). Multivariate Logistic regression analysis showed that age, history of hypertension, time from puncture to vascular recanalization, poor collateral circulation, severe WMHs, and moderate-severe stroke were independent risk factors for futile recanalization after EMT in patients with acute anterior circulation large vessel occlusion ( P<0.05). A nomogram model of futile recanalization was established according to the above 6 factors, with C-index of 0.862 ( 95%CI: 0.809-0.914); the calibration curve of the model was highly coordinated to the ideal model curve; area under the ROC curve of futile recanalization was 0.862 ( 95%CI: 0.809-0.914, P<0.001). Conclusions:Acute anterior circulation large vessel occlusion patients with older age, history of hypertension, longer time from puncture to vascular recanalization, poor collateral circulation, severe WMHs, and moderate-severe stroke trend to have futile recanalization after EMT. This nomogram can predict futile recanalization after EMT.
3.Solitaire FR with intracranial support catheter for mechanical thrombectomy in patients with progressive cerebral venous sinus thrombosis
Huiyuan PENG ; Xiaojun WANG ; Nan YANG ; Zongyi WU ; Duo LIN ; Jianheng WU ; Feng CHENG
International Journal of Cerebrovascular Diseases 2023;31(10):744-749
Objective:To investigate the safety and effectiveness of Solitaire FR with intracranial support catheter for mechanical thrombectomy (SWIM) in the treatment of cerebral venous sinus thrombosis (CVST).Methods:Patients with progressive CVST treated with SWIM technology in the Neurology Department, Zhongshan Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from June 2019 to March 2022 (including 4 patients with intracranial hemorrhage) were retrospectively included. The venous sinus recanalization after procedure and during follow-up was observed. The modified Rankin Scale (mRS) was used to evaluate the outcome at 3 months after procedure.Results:A total of 9 patients with progressive CVST were treated with SWIM technology, including 6 males with a median age of 37.0 years (range, 15-78). Immediately post-procedural angiography showed complete recanalization of the venous sinuses in 6 cases and partial recanalization in 3 cases. At 3 months after procedure, the mRS score showed that 3 cases was 0, 3 cases was 1, 2 cases was 2, and 1 case was 4.Conclusion:SWIM technology may be a safe and effective method in the treatment of progressive CVST.