Approximately 20%-30% of the patients with acute ischemic stroke do not have an angiographically demonstrable arterial occlusion. This article reviews the possible explanations for the absence of angiographically documented occlusion, the risk and the occurrence rate of cerebral infarction, the prognosis, and the effectiveness as well as the safety of thrombolytic therapy.

By introducing patient education into the nursing care of interventional therapy, the medical workers can effectively help and encourage the patients to actively participate in and cooperate with the interventional therapy and related nursing care service. Besides, the relevant education and guidance can greatly help the patients to promote functional restoration and psychological recovery. This article systematically describes the approaches, the principles, the choice of the right moment for health education and the education contents in clinical interventional work.

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.

Objective To discuss the skills and effects of several endovascular mechanical techniques for the recanalization of subclavian artery total occlusion. Methods Endovascular mechanical recanalization of subclavian artery total occlusion was performed in 32 patients with symptomatic subclavian artery total occlusion. The re-open rate and the therapeutic results were observed and analyzed. Results Several endovascular mechanical techniques, including percutaneous transluminal angioplasty, were employed in treating 32 patients with subclavian artery total occlusion. After the procedure, the ischemic 8ymptoms of posterior circulation and/or upper extremity were markedly relieved. Conclusion It is safe and feasible using appropriate endovascular mechanical technique for re-canalizing the occluded subclavian artery.

Objective To discuss the management, complication and effectiveness of establishing a prolonged hemodialysis access with a long-term venous indwelling catheter. Methods During the penod of July 2007-February 2009, a total of 64 long-term venous indwelling catheters for hemodialysis were placed in 62 patients with terminal chronic renal insufficiency. Results Of the total 64 catheter-placements, 62 were pereformed under DSA guidance and 2 at bed-side. Because of blocked flow, adjustment of the catheter was carried out in 4 cases, replacement of catheter in 2 cases and thrombolytic therapy in one case. In 62 patients, the arterial flow rate after the procedure reached to 230-300ml/min. In 57 cases the indwelling catheter remained in working condition so far. Five cases died within 6 months. Conclusion For establishing a prolonged hemodialysis access. The placement of a long-term venous indwelling catheter is feasible. The main complication is the blocked flow. Which is mainly related to the disposition of the catheter itself or its tip. The right intemal jugular vein is the indwelling site of choice, the tip of double-lumen catheter should be within the superior vein cava. With the help of DSA guidance, the procedure can be performed accurately, safely and easily.

Objective To summarize the therapeutic results and experience of the interventional managements for pseudoaneurysms occurred after surgery. Methods Five pseudoaneurysms with different location that occurred after surgery in five patients were treated with different interventional managements. One patient suffered from a ruptured pseudoaneurysm of left common iliac artery, which was treated by obstructing the diseased artery with balloon via the abdominal aorta followed by the replacement of vascular prostheses. One patient had a pseudoaneurysm of right subclavian artery and endovascular covered stent was employed to isolate it. The remaining three patients were affected by pseudoaneurysm of terminal arteries and intraarterial embolization with gelfoam and/or steel coils was camed out. Results Complete closing of the pseudoaneurysm was obtained in all five patients and no therapy-related complications occurred. Conclusion Pseudoaneurysms occurred after surgery can be effectively treated with different interventional managements, it is worth popularizing this technique in clinical practice.

Objective To evaluate the therapeutic efficacy of agitating thrombolysis technique for Budd-Chiari syndrome complicated with inferior vena cava (IVC) fresh thrombus. Methods From August 2004 to March 2009, 5 patients of Budd-Chiari syndrome (four males and one female, aged 36-48 years) with IVC fresh thrombus were treated with agitating thrombolysis technique. After anpography of IVC the recanalization of IVC was performed, which was followed by agitating thrombolytic therapy. Finally,IVC was dilated with percutaneous transluminal balloon angioplasty. Clinical follow-up of IVC patency was conducted by color Doppler sonography. Results After agitating thrombolysis. The thrombi were completely disappeared in all 5 patients without single occurrence of pulmonary embolism. In all patients, IVC remained patency on color Doppler ultrasonograph after following up for a mean period of 23.8 months. Conclusion Agitating thrombolysis technique is a safe and effective treatment for Budd-Chiari syndrome complicated with IVC fresh thrombus.

Objective To investigate the effectiveness and safety of transcatheter radiofrequency ablation guided by a three-dimensional mapping system (Ensite or Carto) for the treatment of complex cardiac arrhythmias. Methods A cohort of 123 consecutive hospitalized inpatients during the period from February 2006 to December 2008 were selected for this study. These patients suffered from various arrhythmias, including paroxysmal atrial fibrillation (n=58). Persistent or permanent atrial fibrillation (n=10), atrial flutter (n=13), atrial tachycardia (n=12) and ventricular tachycardia or frequent ventricular premature beats (n=30). Transcatheter radiofrequency ablation for arrhythmias was performed under the guidance of an EnSite3 000/NavX or Array mapping system in 80 cases, and under the guidance of a CARTO mapping system in the remaining 43 cases. Results Successful ablation of arrhythmias was obtained by single operation in 106 cases(86.18%). Including 59 cases with atrial fibriUation,11 cases with atrial flutter, 10 cases with atrial tachycardia, and 26 cases with ventricular tachycardia or premature ventricular beat. Ablation procedure was carried out and was successful in 10 cases with a successful rate of 94.31%, including 5 cases with atrial fibrillation. 1 case with recurred atrial flutter, 1 case with recurrent atrial tachycardia, and 3 cases with ventricular tachycardia or premature ventricular beat. After operation, complications occurred in 6 cases, including cardiac tamponade in 4 cases, distal embolism of the left anterior descending coronary artery in 1 case, and pulmonary embolism in 1 case. Conclusion Three-dimensional mapping system can clearly and stereoscopically display the cardiac structures. Therefore, this technique is of great value in guiding the transcatheter radiofrequency ablation for complex arrhythmias, in improving the success rate of ablation and in increasing the safety of the procedure.

Objective To evaluate the home-made occluder in the treatment of VSD and its mid-term and long-term results. Methods From Jan. 2004 to May 2007, percutaneous VSD closure therapy under X-ray monitoring was performed in 78 consecutive VSDpatients, including 43 males and 35 females with an average age of (16.5±8.6) years (ranged 3-37 years). TTE, ECG and Holter examinations were performed in 1 week, 3 months, 1 year and 2 years after the procedure. Results Seventy-three home-made occluder devices with a diameter of 5-16 mm (10.3±3.2 mm) were implanted successfully, with a technical successful rate of 93.6% (73/78). The whole course follow-up were carried out in all 73 successful cases (100%). One week after the procedure ITE detected residual shunt in 8 cases, and three months later the residual shunt was observed in 5 cases. Follow-up check at one and two years after the treatment the residual shunt disappeared completely. For the observation of arrhythmia, occasional atrial premature beats or ventricular premature beats occurred in 28 cases (38.4%) within one week after the procedure, and two patients developed grade Ⅲ complete atrioventricular block at the third day after the surgery. The arrhythmia disappeared after medication of prednisone and nutrient drugs for 4-10 days. Bundle branch blocks were observed in 8 cases (10.1%) at one-year and two-year follow-up. Conclusion For the treatment of VSD, the home-made Amplatzer occluder device is reliable and effective, although a close foUow-up is required after the surgery.

Objective To observe the therapeutic efficacy of ozone injection in treating lumbar disc herniation. Methods One hundred and four patients with CT or MRI proved lumbar disc herniation, including 144 diseased lumbar discs, were enrolled in this study. The main complains were severe pain or numbness in the low back and lower limbs. Under the X-ray guidance, a 21 G needle was punctured into the disc, followed by an injection of 4-40 ml ozone (50 ug/ml) and 40 mg prednisolone acetate into intradiscal and paravertebral space. Results All patients were followed up for 3 to 84 months with an average time of 38 months. The last follow-up check was carried out in March of 2009. The total effective rate was 77.1%, with no occurrence of any serious complications. Conclusion The percutaneous injection of medical ozone into disc and paravertebral space is an effective and safe method for the treatment of lumbar disc herniation.