Objective To evaluate the usefulness of balloon-occluded retrograde transvenous obliteration(B-RTO)in treating varices of gastric fundus.Methods Total 11 patients with liver cirrhosis-combined gastric varices were treated by B-RTO.Transfemoral approach was used in all cases.A balloon catheter was inserted into left adrenal vein,then sclerosing material(5% ethanolamine oleate)was injected into the gastric varices via a gastrorenal shunt with the balloon inflated,the balloon was kept in place for 60 minutes.Follow-up was made by enhanced CT and endoscopy.Results 9 varices of the 11 were disappeared or remarkably decreased in size,and no recurrence or rupture was found during the follow-up period(2-12 months).1 of the remaining two varices decreased after second B-RTO procedure.No definitive change of liver or renal function was noted.Conclusion B-RTO is effective,reliable and less invasive for the treatment of gastric varices.

Objective To evaluate the relationship between the volume of spleen and zebra enhancement pattern on CTAP(CT arterial portography).Methods Total 219 cases of hepatocellular carcinoma underwent CTAP were retrospectively analyzed.The patients were divided into three groups according to the CTAP enhancement patterns:group l,patchy heterogeneous enhancement(zebra pattern);group 2,homogeneous enhancement with remarkable hypodensity of the liver parenchyma(hypodensity pattern);group 3,homogeneous enhancement with definitive contrast(normal pattern).The volume of spleen was measured based on CT findings and compared among the groups.Results In the total 219 cases,there were 10 cases showing zebra enhancement pattern(4.6%),16 cases of homogeneous hypodensity(7.3%)and 193 of normal enhancement pattern(88.1%).The average volumes of the spleen of the three groups were (588.3?331.5) cm 3,(883.2?296.5) cm 3 and (474.4?275.0) cm 3,respectively.There was no significant difference of the splenic volume between groups 1 and 3,and the difference between groups 2 and 3 was significant.Conclusion There is no definitive relationship between the zebra enhancement pattern on CTAP and the volume of spleen,while the homogeneous hypodense enhancement is positively and significantly correlated with the volume of spleen.

Purpose To investigate the diagnostic and therapeutic value of vascular interventional technology dealing with acute massive gastrointestinal hemorrhage. Materials and methods 59 patients with acute massive gastrointestinal hemorrhage underwent the arteriography of mesenteric arteries and abdominal arteries. When positive signs of bleeding appeared, super-selective catheterization and embolization with micro-coil and gelfoam was applied immediately. Results Positive signs of bleeding were detected in 28 of 59 patients, among which 25 patients underwent embolization, and successful hemostasis was achieved in 21 cases with an achievement ratio of 84%. And there were 10 cases eventually turning to surgery.Conclusion Vascular interventional technology such as arteriography and embolization played an important role in diagnosis and treatment of acute massive gastrointestinal hemorrhage.

Objective To investigate the effectiveness of endovascular technique in treatment of acute arterial hemorrhage of abdominal organs.Methods Totally 159 cases (145 patients) acute arterial hemorrhage of abdominal organs were enrolled.All patients underwent emergency transarterial angiography.Endovascular treatment by spring coil,gelatin sponge,or covered stent were in 40 cases.The success rate of immediate and long-term hemostasis was judged by the postoperative radiography,symptoms and the changes of vital signs and laboratory results.Results The positive signs in angiography were observed in 47 among the total 159 cases (47/159,29.56％).Seventy-seven postoperative hemorrhage cases underwent angiography and 29 cases (29/77,37.66 ％) were positive,82 non-operative hemorrhage cases underwent angiography and 18 cases (18/82,21.95％) were positive.The difference was statistical significant (P＜0.05).Endovascular treat ment were performed in 40 cases (33 by spring coils,4 by gelatin sponge and 3 by covered stent).Hemorrhages were con trolled immediately in all the 40 cases after embolization and the success rate were 100％.Conclusion Endovascular tech nique is minimal invasive,and it is an effective method for treatment of acute arterial hemorrhage in abdominal organs.

Objective To evaluate the safety and effectiveness of TACE with radiofrequency ablation (RFA) in treatment of renal cell carcinoma.Methods Data of 23 cases of renal cell carcinoma were retrospectively analyzed.Firstly all patients were treated with renal TACE,and then RFA under the guidance of ultrasound and CT was performed 3 to 4 weeks later.The therapeutic effects were evaluated by enhanced CT or MR scans during the follow-up period.Meanwhile,the changes of Karnofsky Performance Status (KPS) scores and renal functions between preoperative and postoperative periods were also evaluated.Results To the end of the follow-up,in all 23 patients 21 cases (21/23,91.30％) survived and 2 cases died (2/23,8.70 ％).KPS scores and serum creatinine levels were observed in all 23 patients at the initial stage and the end of the follow-up period,there were no significant differences (all P＞0.05).At the end of follow-up,16 cases were complete remission,5 were partial remission and 2 were progressive disease.Conclusion TACE combined with RFA is a safe and effective method in treatment of renal cell carcinoma with less trauma,less complication and more effective.

Objective To assess the safety and efficacy of extended liver resection using preoperative PTCD (percutaneous transhepatic cholangial drainage) and PVE (portal vein embolization) to treat patients with locally advanced hilar cholangiocarcinoma.Methods We collected and analyzed the clinical data of 27 patients with Bismuth types Ⅲ and Ⅳ hilar cholangiocarcinoma who underwent extended hepatecomy using preoperative PTCD and PVE in our hospital.Results There were 21 patients with R0 resection and 6 patients with R1 resection.The mortality rate was 0％.Eight patients died of cancer recurrence.Conclusion Preoperative PTCD and PVE combined with extended hepatectomy were safe and efficacious in treating patients with locally advanced hilar cholangiocarcinoma,which resulted in potential cure.

Objective To evaluate the safety and efficacy of the endovascular treatment of subclavian artery stenosis.Methods From January 2010 to December 2015,the clinical data of 93 patients with subclavian artery stenosis were analyzed retrospectively.All the patients were received angiography and endovascular treatment.Results The technical success rate was 97.9％.Clinical symptom remission rate was 97.8％ after the treatment.There was no procedure related death.During the procedure,limited arterial dissection was encountered in two cases.One patient had minor cerebellar hemorrhage.The follow-up time was 12 to 60 months.Median follow-up time was 36 months.Restenosis was occurred in nine cases.The patency rate of 5 years was 81.0％.Conclusions Endovascular treatment was a safe and effective treatment as the result of our data.It should be used as the preferred treatment of choice for subclavian artery stenosis.

Objective To evaluate the efficacy and stability of a newly designed retrievable inferior vena cava (IVC) filter in vitro experiment.Methods In the flow model,thrombus capture rate and stability of the new IVC filter,and the Recovery retrievable filter were tested in varied thrombus size,tube diameters and positions.The process was repeated with a piece of cow aorta to observe the capture rate and stability.Results The emboli capture rate of different embolism diameter (2,3,5 mm) was 91.50%,96.50%and 99.50%,respectively.For two tube diameter (21,28 mm) was 98.00%and 93.67%,respectively.For the two directions (horizontal,vertical) was 94.33%,97.33%,and the total capture rate was 95.83%.Under those different conditions,the capture rates of Recovery filter was 81.00%,91.00%,95.00%;92.33%,85.67% and 87.67%,90.33%,respectively.while the total capture rate was 89.00%.Using the cow vessel,the capture rate was 88.50%,94.00%,98.00%;94.67%,92.33%;91.33%,95.67%,respectively;and the total rate was 93.50%.During experiment,two types of filter did not move or deflect.Conclusion The newly designed retrievable IVC filter is effective and stable in vitro study,and the capability of trapping emboli is better than that of Recovery filter.

Objective To evaluate the effect of transcatheter hepatic artery embolization with lipiodol on perfused radiofrequency ablation (PRFA) on mini-porcine.Methods Ten Chinese mini-porcine were randomly divided into embolization group and control group (each n=5) .A standard PRFA with infusing cooling procedure was done in control group,while transcatheter hepatic artery embolization with lipiodol was done before PRFA in embolization group.CT and MR scan were performed after PRFA.Then a comparative analysis of the shape and volume of the lesions in the liver were performed.Resuits In both two groups,distinct spherical margin of the PRFA lesions was obtained.The minimal diameter was (31.76±3.43) mm in embolization group and (27.23±3.49) mm in control group (t=2.675,P＜0.05) .The average volume of the embolization group was (54.47±9.98) cm~3,while in the control group was (20.90±5.68) cm~3 (t=10.424,P＜0.05) .Conclusion Transcatheter hepatic artery embolization with lipiodol before PRFA can enlarge the ablation size of mini-porcine's liver.

Objective To evaluate the efficacy and safety of super-selective renal artery embolization in treatment of iatrogenie renal pseudoaneurysm and arteriovenous fistula.Methods Twenty-nine patients with iatrogenic renal pseudoaneurysm and arteriovenous fistula underwent renal angiography after ineffective conservative treatment.After identifying the location and characteristic of lesions by DSA,super-selective renal artery embolization was performed.Symptoms and signs,renal function changes before and after embolization and complications were recorded to evaluate the therapeutic effect.Results The technical success rate of super-selective renal artery embolization was 100％ (29/29),and clinical success rate was 96.55 ％ (28/29).The serum creatinine level before and after embolotherapy was (93.26 ± 28.79) mmol/L and (91.51 ± 27.68) mmol/L respectively,and there were no significant differences (t=1.28,P=0.22).No serious complications such as nephrapostasis or renal failure occurred in the study.Conclusion Super-selective renal artery embolization has technically and clinically high success rate with limited effect on renal function.It is a safe and effective therapy method in patients with iatrogenic renal pseudoaneurysm and arteriovenous fistula.