1.Bronchial artery embolization for hemoptysis: a consensus statement by the Chinese College of Interventionalists
World Journal of Emergency Medicine 2025;16(3):197-205
Hemoptysis is defined as bleeding originating from the respiratory tract distal to the larynx and is associated with a wide spectrum of underlying conditions, including bronchiectasis, pulmonary malignancies, tuberculosis, aspergillosis, and vascular malformations.[1-3] A meta-analysis involving patients with massive hemoptysis reported a mortality rate of 3.5%.[4] This underscores the critical importance of prompt and effective embolization of the responsible artery to improve outcomes, particularly in patients presenting with life-threatening hemoptysis.
2.TIPS with bare stents and covered stents for the treatment of portal hypertension:analysis of its long-term efficacy
Shengli YANG ; Linqiang LAI ; Jingjing SONG ; Dengke ZHANG ; Zhongwei ZHAO ; Jianfei TU ; Jiansong JI ; Yingjun BAO ; Junpeng GU ; Weixin REN
Journal of Interventional Radiology 2024;33(3):295-299
Objective To evaluate the long-term efficacy of transjugular intrahepatic portosystemic shunt(TIPS)with bare stents and Fluency covered stents in the treatment of portal hypertension,and to discuss its clinical value.Methods The clinical data of 29 patients with intractable ascites or esophagogastric fundus varices rupture and hemorrhage caused by cirrhotic portal hypertension,who received TIPS with bare stents and covered stents at the First Affiliated Hospital of Xinjiang Medical University of China(25 patients)and the Lishui Municipal Central Hospital of China(4 patients)between August 2012 and December 2017,were retrospectively analyzed.The patients were regularly followed up to check the survival status.The postoperative cumulative shunt patency rate and cumulative survival rate of the patients were analyzed by Kaplan-Meier method.Results The technical success rate of TIPS was 100%.The mean portal vein pressure was decreased from preoperative(40.21±3.24)cmH2O to postoperative(24.55±3.55)cmH2O(P<0.05).The patients were followed up for 5.1-10.5 years.The postoperative 1-,3-,5-,7-year primary cumulative patency rates of the shunt were 89.7%,75.9%,75.9% and 52.5%,respectively.The postoperative 5-,7-,9-and 10-year cumulative survival rates were 100%,66.9%,66.9% and 33.4%,respectively.The incidence of hepatic encephalopathy was 13.8%(4/29).Conclusion Using bare stents combined with Fluency covered stents for TIPS is clinically safe and effective in the treatment of portal hypertension.This technique carries higher long-term shunt patency rate and low incidence of hepatic encephalopathy.Therefore,it can be used as a substitute for Viatorr stent when necessary.(J Intervent Radiol,2024,33:295-299)
3.Technical details and latest progress of bronchial artery chemoembolization
Dengke ZHANG ; Liai LV ; Linqiang LAI ; Jianfei TU ; Risheng YU
Journal of Interventional Radiology 2024;33(3):330-334
At present,bronchial arterial chemoembolization(BACE)is a well-established,local minimally-invasive palliative treatment technique for mid-to-advanced primary lung cancer.However,its technical details are still controversial,and it is difficult to standardize each technical detail.Through reviewing the literature,this paper provides a detailed review of BACE,focusing on the source of lung cancer blood supply,embolization materials,particle size of embolization materials,number of treatments,embolization endpoints,selection of anti-tumor drugs,complications,therapeutic effect,etc.(J Intervent Radiol,2024,33:330-334)
4.Comparative study of medical tissue glue in the treatment of acute hemoptysis by bronchial arterial embolization
Jingjing SONG ; Shengli YANG ; Zhongwei ZHAO ; Jianfei TU ; Jiansong JI
Journal of Practical Radiology 2024;40(11):1884-1887
Objective To evaluate the clinical application value of medical tissue glue in the treatment of acute hemoptysis by bronchial arterial embolization(BAE).Methods The clinical data of 78 patients who underwent emergency BAE for hemoptysis were retrospectively collected.Among them,18 patients who underwent embolization with medical tissue glue were selected as a study group,and other 18 patients who underwent embolization with absorbent gelatin sponge particles and spring coil were selected as a control group.The technical success rates,average surgical operation time,average surgical cost,postoperative hemoptysis recur-rence rate,and incidence of adverse reactions of the two groups were compared and analyzed.Results The technical success rates of the two groups were both 100%.There were no statistically significant differences in recurrence rate of postoperative hemoptysis and incidence of adverse reactions between the two groups(P>0.05).The average surgical operation time of study group and control group were 53.4 min[(53.4±2.2)min]and 65.4 min[(65.4±2.8)min],and the average surgical cost were 3 651 yuan[(3 651±102.7)yuan]and 5 094 yuan[(5 094±136.3)yuan],respectively.Compared with the control group,the average surgical operation time and aver-age surgical cost of the study group were shorter,and the differences were statistically significant(P<0.05).Conclusion Compared with absorbent gelatin sponge particles combined with spring coil embolization,the use of medical tissue glue for embolization is also safe and effective in the treatment of acute hemoptysis patients by BAE.The average surgical operation time is shorter,and the surgical cost for patients is lower.It is worth promoting in clinical practice.
5.The Classification and Management Strategy of Spontaneous Isolated Superior Mesenteric Artery Dissection.
Zhongzhi JIA ; Jianfei TU ; Guomin JIANG
Korean Circulation Journal 2017;47(4):425-431
Spontaneous isolated superior mesenteric artery dissection (SISMAD) is an uncommon but potentially catastrophic pathology. Multiple classification schemes have been proposed for this occurrence. Although no consensus has emerged regarding which classification should be used, Li's classification scheme is more precise and complete compared to other classification systems and can be used to guide the treatment of SISMAD. Initial conservative treatment is promising, with favorable early and long-term outcomes for most patients; endovascular treatment is recommended for patients with persistent/recurrent symptoms after conservative treatment; surgical treatment should be performed without delay for patients with arterial rupture, intestinal necrosis, or failed endovascular treatment.
Classification*
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Consensus
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Humans
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Mesenteric Artery, Superior*
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Necrosis
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Pathology
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Rupture
6.Primary clinical application of Y-shaped jogged stent in patients with malignant hilar biliary obstruction
Zufei WANG ; Jingjing SONG ; Jiansong JI ; Xiaoxi FAN ; Jianfei TU ; Fazong WU ; Hongyuan YANG ; Zhongwei ZHAO
Chinese Journal of Radiology 2017;51(5):377-381
Objective To evaluate the feasibility, safety, and efficacy of Y-shaped jogged stent in patients with malignant hilar biliary obstruction. Methods During the period of January 2010 to June 2015,We retrospectively reviewed 98 cases of malignant hilar biliary obstruction who were received implantation of biliary tract stent. 17 consecutive patients who were treated with Y-shaped jogged stent were identified (group A) during January 2012 to June 2015. Group A was carefully matched according to patients' age, sex, type of tumor, stage, type of biliary obstruction, level of bilirubin at diagnosis, presence of metastasis and treatment, and 17 patients who were underwent unilateral stent placement alone with PTCD were chosen as control group (group B). Patients' baseline characteristics, stenting strategy, complications, stent patency time and survival rates were analyzed, and continuous variables of the two groups were compared using Student's t-test. Categorical variables were analyzed using the Fisher exact test. Results Y-shaped jogged stent implantation group and control groups were closely matched in terms of patients' age, sex, type of tumor, stage, type of biliary obstruction, level of bilirubin at diagnosis, presence of metastasis and treatment ( P>0.05). The bilirubin decreased rate in the two groups was 88.2%and 53.0%respectively (P<0.05). The median time of stent patency after stent implantation was(7.3 ± 1.0)months and(5.7 ± 0.9) months respectively (χ2=4.04,P=0.044), and the median survival time was(9.1 ± 1.5)months and(7.2 ± 1.1)months (χ2=4.60,P=0.032), with significant difference according to Kaplan-Meier analysis. There were no severe complications such as massive hemorrhage, perforation, biliary fistula and severe pancreatitis, which were associated with stent implantation. Conclusions The application of Y-shaped jogged stent is safe, feasible and effective in patients with malignant hilar biliary obstruction. It can relieve the clinical symptoms of biliary obstruction effectively with prolongation of stent patency time and survival rate significantly.
7.Quantitative Determination of Ferulic Acid Content in Chrysanthemum Morifolium cv. ( Chuju) Continuous Cropping Soil Using Near Infrared Spectroscopy
Yue XIE ; Cheng ZHOU ; Cong TU ; Zuliang ZHANG ; Jianfei WANG
Chinese Journal of Analytical Chemistry 2017;45(3):363-368
A near infrared spectroscopy ( NIRS) method was used for rapid quality evaluation of ferulic acid content in chrysanthemum morifolium cv. ( Chuju) continuous cropping soil. Standard leverage, studentized residual and Mahalanobis distance were calculated to eliminate abnormal samples. After the initial near infrared spectrum was treated by two second derivative and Norris smoothing filter noise, 6000-4000 cm-1 wave number range and 7 factors were chosen for partial least squares ( PLS) calibration model. The results showed that good correlation was presented between the calibration set/validation set and the values determined by high performance liquid chromatography, and the calibration correlation coefficient ( Rc ) and validation correlation coefficient ( Rcv ) were 0. 9914 and 0. 9935, respectively. Root mean square error of calibration (RMSEC), root mean square error of validation (RMSEP) and root mean square error of cross-validation (RMSECV) were 0. 484, 0. 539 and 0. 615, respectively. This method was accurate, reliable, simple, rapid and nondestructive, and could be applied to the fast analysis for ferulic acid in continuous cropping soil.
8.Clinical efficacy and safety of transcatheter arterial chemoembolization combined with ;radiofrequency ablation for hepatocellular carcinoma under liver capsular
Zhongwei ZHAO ; Jiansong JI ; Guoliang SHAO ; Jingjing SONG ; Jianfei TU ; Fazong WU ; Xulu WU ; Min XU ; Jiaping ZHENG
Chinese Journal of Radiology 2016;50(5):380-383
Objective To evaluate the clinical efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treating hepatocellular carcinoma (HCC) under liver capsular. Methods Forty three patients with 62 lesions of HCC under liver capsular received TACE followed by CT?guided percutaneous RFA after 1 to 2 weeks were analyzed retrospectively. The subjects were observed and follow?up imaging with enhanced MRI was performed to evaluate the therapeutic efficacy after combined treatment. The patients were followed up for 10 to 69 months. The patients with residual lesions received a second RFA, the patients with recurrence or new lesions received another TACE combined with RFA. The overall survival rates, median survival time and median time to progression were calculated by using Kaplan?Meier. Results A total of 55 TACE and 68 ablations were performed in 43 patients with 62 lesions. The procedure was successfully accomplished in all patients. The complete ablation rate after the first ablation was 90.3%(56/62). The 1, 3, 5?year overall survival rates were 95.3%, 78.1%and 43.9%, the median survival time was 58 months and the median time to progression was 32 months. Conclution For the treatment of hepatocellular carcinoma under liver capsular, TACE combined with RFA is safe and effective.
9.A discussion of reasons and methods of prevention and cure for serious complications of radiofrequency ablations in the treatments of hepatocellular carcinomas
Dengke ZHANG ; Jiansong JI ; Jianfei TU ; Zhongwei ZHAO ; Xiaoxi FAN ; Xihui YING ; Fazong WU ; Jingjing SONG ; Li CHEN ; Weibin YANG
Chinese Journal of Radiology 2016;50(3):213-216
Objective To investigate the reasons and the methods of prevention and cure for serious complications of radiofrequency ablations in the treatments of hepatocellular carcinomas. Methods A total of 410 patients with BCLC at A or B stage of hepatocellular carcinomas in our hospital were enrolled between November 2014 and June 2009. These patients underwent a total of 504 times radiofrequency ablations for the treatments of liver lesions. This retrospective study analysed the reasons and the strategies of prevention and cure for the serious complications. Results In the patients with a total of 504 times radiofrequency ablations, 2 patients had massive hemorrhage caused by puncture injuries, 2 patients had the tumors which were close to the liver capsules and 1 patient had bile peritonitis caused by the injury of thermal ablation on the gallbladder. The maximum diameter of tumor was 5 cm. That tumor was close to the gallbladder. 2 patients had needle tract metastases caused by incompletely needle path ablations. 1 of the 2 patients had a tumor near the liver capsule, and the other patient had un-enough temperature for needle path ablation. Tumor outbreaks were happened in 2 patients. 1 of the 2 patients had a tumor which was located in the liver capsule and close to the portal vein. The other patient had a 12 cm diameter tumor with rich blood supplement. 2 patients had liver abscesses. 1 of the 2 patients had a tumor near the ascending colon, and the other patient had diabetes. 1 patient had colonic perforation caused by thermal ablation. The tumor in that patient was located in the right hepatic lobe segment and adjacent to the ascending colon. The incidence of serious complications was 1.98% (10/504). Conclusions The incidence of the serious complications of radiofrequency ablations for the treatments of hepatocellular carcinomas is relatively low. The main reasons for the serious complications were direct injuries caused by punctures, heat radiation injuries, tumors adjacent to large blood vessels, gallbladders and intestines, tumors with abundant blood supplement, needle paths fail to cross normal liver tissues, low scores of liver function, weak immune system and diabetes. The key points for avoiding and reducing the serious complications are preoperative evaluations of patients' basic situations, choices of appropriate puncture channels and control ranges of ablations when tumors are close to important blood vessels, intestines and gallbladders.
10.The clinical application of TACE combined with RFA and sorafenib in treating recurrent hepatocellular carcinoma after surgery
Yuan FU ; Jiansong JI ; Jianfei TU ; Jingjing SONG
Journal of Interventional Radiology 2015;24(12):1067-1071
Objective To assess the clinical value of transcatheter arterial chemoembolization (TACE) together with radiofrequency ablation (RFA) and sorafenib in treating recurrent hepatocellular carcinoma (HCC) after surgery.Methods A total of 40 patients with recurrent HCC after surgery, who were encountered at authors' hospital during the period from December 2009 to May 2014, were collected. The patients were divided into the study group (n=20) receiving TACE combined with RFA and sorafenib and the control group (n=20) receiving TACE plus RFA. Within 7-10 days after TACE, RFA was carried out. In the study group, oral sorafenib therapy (400 mg, two times everyday) started at 4 days after TACE. Withdrawal of sorafenib would be ordered if drug resistance occurred. Each patient underwent TACE combined with RFA not less than two times. Results The median survival time of the study group and the control group was 31.0 months and 24.8 months respectively, and statistically significant difference existed between the two groups (P<0.05). The one-year, 2-year and 3-year survival rates of the study group were 85%, 70% and 50%respectively, while the one-year, 2-year and 3-year survival rates of the control group were 80%, 55% and 30% respectively; the differences between the two groups were not statistically significant (P>0.05). The progression free survival (PFS) time of the study group and the control group was 6.8 months and 5.7 months respectively, the difference between the two groups was statistically significant (P<0.05). Conclusion TACE combined with RFA and sorafenib can prolong the overall survival time and the progression free survival time of patients with recurrent HCC after surgery.


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