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The complication and management of percutaneous intra-arterial femoral port-catheter system implatation

Journal of Interventional Radiology.2001;0(05):-.

Objective To evaluate the cause and treatment of complication of percutaneous intra-arterial femoral port-catherter system(PCS) implatation. Methods Two hundreds and two patients with malignant tumors in the thorax, abdomen, pelvis and limbs were treated by using chemotherapy and lipiodol embolization via PCS. The related complications rate was 17.3%(35/202). Results The complication included incision infection delayed healing, and wound dehiscence 17.1%(6/35); local hemorrhage 5.7%(2/35); falling down and detachment of catheter of PCS 5.71%(2/35) and 2.86%(1/35) respectively loosening 2.86%(1/35) and changing direction 2.86%(1/35). The indwelling catheter blockage was 31.4%(11/35) and migrating of catheter tip was 28.6%(10/35). Most of these cases were recovered after appropriate management without any fatal and serious outcomes. Conclusions The Technique of percutaneous intra-arterial femoral port-catheter system implantation is safe and reliable. The related complication is slight and easy for management.

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Evaluation of the optimal temperature for interventional thermochemotherapy treatment of hepatic carcinoma

Jiaxing ZHANG ; Shufeng FAN ; Jiaping ZHENG

Journal of Interventional Radiology.2001;0(05):-.

Objective To explore a safe and effective hyperthermia interventional therapy temperature for hepatic carcinoma. Methods Eight swines were divided into four groups according to trans-arterial hyperthermic perfusion temperature, 45 ?C , 50 ?C ,55 ?C , and 60 ?C (catheter flowing temperature) groups. The hepatic and renal functions and blood coagulation function were examined before and after the procedur and then all swines were sacrificed and the livers were pathologically analysed,simultoneously with the evaluation of the safe hyperthermic temperature 35 hepatic carcinomas were carried out under this interventional hyperthermochemotherapy via the arterial catheter (80 cm, 5F) placed into the tumoral artery with the perfusion agents warmed to 60～65 ?C (catheter flowing temperature was 47.55?0.44 ?C ). Results The hyperthermic coagulation necrosis, hepatic dysfunction level and fever were found after 55 ?C and 60 ?C hyperthermic perfusion while those of 45 ?C and 50 ?C groups basically remained normal. The tumor growth rate and total efficacy rate were -(0.35?0.32) and 79.2%, respectively, and 0.5, 1, 1.5 year survival rates were 100%, 80%, 60% respectively after follow-up. The adverse effects of the interventional hyperthermochemotherapy was similar to the routine TACE. Conclusions 45 ?C and 50 ?C (catheter flowing temperature) hyperthermochemotherapy for hepatic carcinoma is safe and effective.

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Construct canine intracranial aneurysm model by endovascular technique

Xiaodong LIANG ; Yizhi LIU ; Caifang NI

Journal of Interventional Radiology.2001;0(05):-.

Objective To construct canine bifurcation aneurysms suitable for evaluating the exploration of endovascular devices for interventional therapy by endovascular technique.Methods The right common carotid artery of six dogs was expanded with a pliable balloon by means of endovascular technique, then embolization with detached balloon was taken at their originations DAS examination were performed on 1,2,3 d after the procedurse. Results 6 aneurysm models were created in six dogs successfully with the mean width and height of the aneurysms decreasing in 3 days.Conclusions This canine aneurysm model presents the virture in the size and shape of human cerebral bifurcation saccular aneurysms on DSA image, suitable for developing the exploration of endovascular devices for aneurismal therapy. The procedure is quick, reliable and reproducible.

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Treatment of hilar cholangiocarcinoma with inserting biliary double stents

Guangzhi JIA ; Zidong ZHANG ; Xuejing WANG

Journal of Interventional Radiology.2001;0(05):-.

Objective To investigate the inserting technique of biliary double stents in treating hilar cholangiocarcinoma. Methods 6 patients with hilar cholangiocarcinoma (Bismuth Ⅳ) were treated by percutaneous transhepatic insertion of biliary stents. Double stents were inserted in each patient. Different inserting methods were adopted acording to the branch angles formed by left and right hepatic ducts. Results The jaundice of all patients alleviated or disappeared obviously after stent implantation. The average difference between post-and pre-operation in the serium total bilirubin level was (104?29) ?mol/L(P

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Cryotherapy of employing Argon/Helium assisted with TACE in treating unresectable primary liver carcinoma

Zhiliang ZHANG ; Xuedong YANG ; Yongwei CAO

Journal of Interventional Radiology.2001;0(05):-.

Objective To investigate the effect of cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma. Methods 124 cases with primary liver carcinoma were randomly divided into two groups:60 cases were treated by TACE and cryotherapy; the other 64 cases were simply done by TACE as control. In general, TACE was undertaken once a month and altogether three times for a course. Cryotherapy was undergone 1-3 times for a course. Results The total effective rates (CR+PR) were 45.3% for the control group and 68.3% for the combined therapy group, with an obvious difference between the two groups, 0.5,1,1.5 years survival rate were 81.3%,62.5%,43.8% respectively in the control group;93.3%,83.3%,63.3% respectively for the combined group. There was an obvious difference between the two groups of 1,1.5 years of survival rates. Conclusions Cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma is feasible with raising the effective rate and prolonging survival time.

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Interventional ovarian tube catheterization in treating tubal ectopic pregnancy

Yi HU ; Linhui XIONG ; Pianqin DU

Journal of Interventional Radiology.2001;0(05):-.

Objective To explore the feasibility and curative effect of treating tubal pregnancy through the fallopian tube with interventional catheterization decrease the difficulty of the procedure and shorten the consuming time. Methods Applying the method of interventional catheterization of fallopian tube and injecting 0.5mg atropine at the cervix beforehand, then 70mg MTX was administered into the fallopian tube. Results 113 patients were successfully recovered with health except one without any adversary complication. Conclusions The interventional fallopian tube catheterization for treating ectopic pregnancy is a simple, safe, minitraumatic, quick and effective method.

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The clinical application of domestic biliary metallic stents

Zuyan LUO ; Fanghong CHEN ; Jianhua YUAN

Journal of Interventional Radiology.2001;0(05):-.

Objective To determine the clinical efficacy and safety of domestic biliary metallic stents in the management of biliary obstruction. Methods 75 domestic biliary metallic stents were implanted in 66 of 72 patients with obstructive jaundice due to malignant (n=70) and benign stenoses (n=2). Results The technical successful rate was 92.7% (64/66). Palliation with rid of jaundice was achieved in 96.9% (64/66) within 1 month. The 30-day mortality rate was 3% (2/66). Early complications occurred in 7.6% (5/66). 44 patients were followed from 2 to 24 months after treatment. 33 (33/42) of 42 patients with malignancy died after a median survival of 5.3 months (range 2-23 months). The remaining 9 patients (9/42) remained alive with a mean follow-up of 11.6 months. The stent patency rates were 92.8%,89.9% and 79.4% at 3,6,12 months respectively. 6 patients (6/42) presented stent occlusion within a median period of 3 months. One of two patients with benign stenoses sustained a patency duration time of 24 months. One patient died 3 months after treatment. Conclusions The domestic biliary metallic stent implantation is efficacy and safety in the management of biliary obstruction.

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Balloon catheter dilation of esophageal caustic ingestion stenosis in children

Juming YU ; Guoping FAN ; Weixin ZHONG

Journal of Interventional Radiology.2001;0(05):-.

Objective To evaluate the methods and effect of balloon catheter dilation of esophageal caustic ingestion stenosis in children. Methods We analysed 18 cases, including 10 cases of esophageal stenosis due to ingestion of sulphuric acid, 7 cases of esophageal stenosis caused by ingestion of sodium carbonate and the last one through ingestion of chemical materials include zinc sulphate. Barium esophagogram was taken before dilation for every patient and the balloon size varied from 4 mm?40 mm to 16 mm?40 mm or 20 mm?40 mm in diameter was selected for the procedure. Results 18 cases were all successful in dilation by balloon catheter, without esophageal perforation and other complications. The satisfactory results maintained from six months to thirty months with remarkable improvement clinicoly. Conclusions Balloon catheter dilation is a simple, safe and reliable method for the treatment of esophageal caustic ingestion stenosis in children, and should be recommended as the first choice.

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The correlation among ~(18)F-FDG PET imaging, CT pattern of lipiodol retention and serum AFP in evaluating the effect of TACE for HCC

Jianbiao SHANG ; Yanhao LI ; Fangying LIU

Journal of Interventional Radiology.2001;0(05):-.

Objective To investigate the relationship among 18 F-fluorodexyglucose (FDG) PET, pattern of lipiodol retention CT and serum ?-fetoprotein(AFP) in evaluating the effect of transcatheter arterial chemoembolization(TACE) for hepatocellular carcinoma (HCC). Methods TACE was performed in thirty-five patients with HCC. 18 F-FDG PET and lipiodol-CT examination were performed after TACE, and thus the patterns of lipiodol retention, and the tumor necrosis rates semi-quantitatively by 18 F-FDG PET were obtained with simultaneous calculation of the decrease percentage of serum AFP before and after TACE. Results The patterns of lipiodol retention were divided into four types; A. dense type (n=12), B. rarity type (n=13), C. scattering type (n=7) and D. empty type (n=3). The positive correlation between the tumor necrosis rate (7%～95%) and the decrease percentage of AFP(0～100%) were found (r=0.761 P

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Treatment and prevention of serious complications after arterial perfusion chemotherapy of esophageal cancer

Yaoyong ZHANG ; Taiming SONG ; Hongqiang GUO

Journal of Interventional Radiology.2001;0(05):-.

Objective To investigate the cause of severe complications after arterial perfusion for esophageal cancer and the methods of prevention. Methods 368 cases of esophageal cancer were treated with arterial perfusion of drugs for chemotherapy. The treatment numbers were 909 including 215 males and 153 females with the age ranging from 39 to 86. These patients were verified as esophageal cancers histopathologically. Selective angiography of the relevant esophageal segments and drugs for perfusion chemotherapy were undertaken. Results The complications included one case of paralysis due to spinal cord injury, two cases with esophageal perforation and three cases of necrotic esophagitis. The case of paralysis died of original disease one month after the treatment. Of the cases of esophageal perforation, one formed the esophgus-trachea fistula and survived for eight months after being esophageal stent implantation and the other formed esophagus-mediastinum fistula and died of massive hemorrhage after six weeks. Three cases of necrotic esophagitis occurred at the normal segments of the esophagus and formed esophgeal perforation. Of these three cases, one formed esophago-broncheal fistula and survived up to now after creating drainage stoma of stomach. Two cases of the esophgus-mediastinum and esophgus-bronchius fistula died of severe infection. Conclusions Severe complications of esophageal arterial catheterization with drugs for chemotherapy are rare. Less harmful, non-ionization contrast medium, low cellular toxicity drugs for chemotherapy with proper doses and concentrations should be selected together with optimal speed of infusion. Esophageal internal stent placement drainage stoma creation of stomach should be the useful adjunct for severe complications.

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