The disc herniation occurs in 1/3 population in the world but 3% of this population had clinical symptoms that need a treatment. 87 patients received the method of percutaneous laser disc decompression has show that the successful rate was 80%. There had no major complications. There was only case suffering from the small abscess at the back of spine
Angioplasty, Balloon, Laser-Assisted ; Abscess

There are several advantages of percutaneous laser. Candidates for this technique are patients who have CT or MRI imaging findings showed that the spinal disc(s) were displaced but remained to be intact, with correlative pain symptoms and received conservative treatment for at least three months without success. The patients have only to suffered regional anesthesia, have not to hospitalize, free from scar, have not any spinal problem, time of immobilization and activity limitation was shorter
Angioplasty, Balloon, Laser-Assisted ; contraindications ; Magnetic Resonance Imaging

OBJECTIVETo investigate the effects of traditional transmyocardial laser revascularization (T-TMLR) and non-transmural myocardial laser revascularization (N-TMLR) on myocardial ischemic and necrotic areas and angiogenesis.

METHODSIn 30 rabbit models, Evans blue -TTC staining and HE staining were used for measuring ischemic and necrotic areas and observing angiogenesis.

RESULTSThe ischemic areas in the MI + T-TMLR (30.6 +/- 1.0)% and the MI + N-TMLR group (30.2 +/- 0.4)% were significantly decreased compared with the MI group (37.2 +/- 0.2)% (F = 21.04, P < 0.01). The necrotic areas in the MI + T-TMLR (17.0 +/- 0.7)% and the MI + N-TMLR group (16.9 +/- 0.6)% was not different from that in the MI group (17.9 +/- 0.5)% (F = 1.73, P > 0.05). The angiogenesis in the MI + T-TMLR (1.8) and the MI + N-TMLR (1.6) was significantly increased compared with that in the MI group (0.6) (F = 15.32, P < 0.01).

CONCLUSIONSMI + N-TMLR can achieve the same effects of MI + T-TMLR. Inducing angiogenesis via laser channels and decreasing ischemic area may be one of the predominant mechanisms of TMLR, whereas whether laser channels themselves are patent is not relation to the effects of TMLR.

Angioplasty, Balloon, Laser-Assisted ; Animals ; Disease Models, Animal ; Laser Therapy ; Male ; Myocardial Infarction ; surgery ; Myocardial Revascularization ; Neovascularization, Physiologic ; Rabbits

OBJECTIVEConflicting results exist on the therapeutic effects of percutaneous myocardial laser revascularization (PMR) in patients with refractory angina pectoris. This study assessed the effects of PMR on myocardial innervation and perfusion in patients with refractory angina pectoris.

METHODSPatients with refractory angina unsuitable for standard revascularization treatment (PTI and CABG) were randomly divided into medication plus PMR (PMR, n = 17) and medication group (M, n = 13). Coronary sinus noradrenaline (NE) and epinephrine (E) levels, heart rate variability (HRV), total ischemic burden (TIB), and ischemic ST segmental events (STI), myocardial perfusion were evaluated at pre-, immediately post and 12 months post treatment (mean followed up time = 11.6 +/- 4.9 months).

RESULTSIn PMR group, one patient developed non-persistent ventricular tachycardia, 2 developed pericardial tamponade and another one patient developed heart failure at 24 h after operation. Coronary sinus NE and E were significantly lower 60 min post PMR compared to pre-PMR and HRV was significantly increased 24 h post PMR. One year post treatments, angina grade was significantly decreased in PMR (1.7 +/- 0.3) than that in M group (0.4 +/- 0.2, P < 0.05) while other parameters were similar between the groups.

CONCLUSIONSPMR induced an early transient denervation and decreased angina grade one year post treatment in patients with refractory angina.

Aged ; Angina Pectoris ; therapy ; Angioplasty, Balloon, Laser-Assisted ; Autonomic Denervation ; Female ; Heart ; innervation ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; therapy ; Myocardial Revascularization ; methods

Transmycardial laser revascularization has made its position as a sole therapy for patients with chronic angina nonamenable to maximal medical therapy, percutaneous transluminal coronary angioplasty, and coronary artery bypass grafting. We report three cases of transmyocardial laser revascularization as a sole therapy for patients with recurrent angina after CABG.
Angioplasty, Balloon, Coronary ; Coronary Artery Bypass ; Humans ; Transmyocardial Laser Revascularization

OBJECTIVETo analyze the clinical features idiopathic ventricular tachycardia (IVT) and evaluate the effect of radiofrequency ablation therapy for their management.

METHODSAn retrospective analysis was conducted in 165 IVT patients who received radiofrequency ablation therapy. IVT was classified into 3 types according to the site of origin, namely the right ventricular outflow tract (RVOT-IVT, 86 cases), left ventricular septum (LV-IVT, 75 cases), and left Valsalva sinus (4 cases).

RESULTS AND CONCLUSIONRVOT-IVT was more frequent in female patients than in male patients (60 vs 26, M/F ratio of 0.43). In LV-IVT, male patients prevailed (54 vs 21, M/F ratio of 2.57), suggesting a gender difference in the incidence of IVT. IVT occurred mainly in young and middle-age patients. Most RVOT-IVT occurred in the third to fourth decade of life (mean 36-/+12 years), and LV-IVT occurred at a younger age than did RVOT-IVT (mean 26-/+15 years, P<0.01). Twelve-lead ECGs revealed left bundle branch block morphology in RVOT-IVT, and most of them presented with frequent premature ventricular contraction and/or non-sustained ventricular tachycardia. All the RVOT-IVT patients were successfully ablated by radiofrequency energy in pace mapping. LV-IVT patients with right bundle branch block morphology presented sustained ventricular tachycardia for most of the time, and 97% of the patients were successfully managed with radiofrequency ablation in activation mapping. Four IVT patients were characterized by atypical bundle branch block, an inferior axis, and an R/S ratio >1 in lead V3 or V2, and their tachycardia was ablated successfully in the left sinus of Valsalva using pace mapping. Radiofrequency ablation is currently an effective procedure for IVT management.

Adult ; Aged ; Angioplasty, Laser ; methods ; Catheter Ablation ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tachycardia, Ventricular ; pathology ; therapy ; Treatment Outcome

OBJECTIVETo approach the long term safety and efficacy of transmyocardial laser revascularization (TMLR, holmium: YAG) combined with off-pump coronary artery bypass (OPCAB) compared with OPCAB alone in patients with ischemic cardiac disease.

METHODSBetween 1999 and 2005, 80 patients with diffusely diseased target vessels from two centers in Beijing were enrolled to the study and randomized to receive either TMLR/OPCAB (n = 40) or OPCAB (n = 40) operation. Baseline demographics and operative characteristics were similar between groups. Follow-up (mean 3.4 +/- 1.7 years) included CCS angina class and NYHA classification assessments, 6 minutes walking test (6MWT) and echocardiography.

RESULTSPerioperative mortality was 5% in both groups. No death occurred during follow up. At the end of follow-up, patients at both groups experienced significant improvement on angina score compared with baseline, and angina score was also significantly lower (1.21 +/- 0.42 vs. 1.57 +/- 0.87, P = 0.03) and 6MWT-distance significantly increased (518.0 +/- 65.5 m vs. 473.8 +/- 65.8m, P = 0.006) in OPCAB/TMLR group than that in the OPCAB group. Fewer patients developed recurrent severe angina and received re-CABG/PCI in OPCAB/TMLR group than that in the OPCAB (1 vs. 6 cases, P = 0.113). NYHA and LVEF were similar between the groups at the end of follow up.

CONCLUSIONOur study showed that the addition of TMLR to OPCAB is superior in improving angina and exercise tolerance, but there is no further improvement in cardiac function compared to OPCAB alone.

Aged ; Angioplasty, Laser ; Combined Modality Therapy ; Coronary Artery Bypass, Off-Pump ; Coronary Disease ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Revascularization ; methods ; Prospective Studies ; Retrospective Studies

OBJECTIVETo explore the techniques and outcomes of the surgical treatment for varicose vein.

METHODSTotally 2 200 patients with varicose vein received surgical treatment in our hospital from July 2000 to January 2006. The latest techniques for endovenous occlusion were used for most cases, among which 1 802 cases were treated with endovenous laser treatment (EVLT) combined with transilluminated powered phlebectomy (TIPP), 82 cases with radiofrequency endovenous occlusion (RFO) combined with TIPP, and 218 cases with limited invaginated vein stripping and foam sclerotherapy. The remaining 98 cases were treated with laser, radiofrequency or ligation for saphenous vein trunk, and with resection, electric coagulation, and transfixation for vein clusters as additional methods. Perforators were also cut and ligated as well.

RESULTSSatisfied surgical results were obtained in all cases. The average operative time was 40 minutes (range 20-78 minutes).

CONCLUSIONSLimited invaginated vein stripping, EVLT, and RFO can be used to treat saphenous vein reflux. Surgical resection, transfixation, electric coagulation, and sclerotherapy are reasonable options for vein cluster or tributaries. Transection and ligation of the perforators are important. TIPP is ideal for the treatment of vein clusters.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angioplasty, Laser ; methods ; Catheter Ablation ; methods ; Combined Modality Therapy ; Electrocoagulation ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Saphenous Vein ; surgery ; Sclerotherapy ; methods ; Treatment Outcome ; Varicose Veins ; surgery ; therapy ; Vascular Surgical Procedures ; methods ; Young Adult