Objective To strengthen the training effect of the neuro-interventional surgeons using staged target teaching method. Methods A total of 39 neurosurgeons from all over the country were trained at the Department of Interventional Radiology,Xuanwu Hospital,Capital Medical University from March 2012 to March 2013. In the one-year training period,the training was divided into 4 stages (each stage for 3 months). All the learning contents were phased to focus on teaching and set the target at each stage,which had a clear purpose. Questionnaires were sent to the refresher doctors at 6 months and 12 months after they returned to their original work in order to obtain the conditions about their independent work after training. Results All the 39 neurosurgeons achieved their desired goal from theory to practical operation. They mastered the holistic treatment principles of ischemic cerebrovascular disease and were familiar with and mastered the whole brain DSA and stenting techniques. At the fourth stage,as an operator, everyone had finished at least 5 extracranial artery stentings. The recovered questionnaires after the end of training showed that 95. 8%(23/24)neurosurgeons were able to perform whole brain DSA independently and held≥5 surgeries monthly;87. 5%(21/24)neurosurgeons could complete stenting independently (1 patient/month). Conclusion The staged target teaching method is a practical and effective teaching means for special technical training of neurointervention.

Objective To investigate the effect of medicinal charcoal tablets combined with blood purification therapy on on renal function, inflammatory mediators, oxygenation index and intestinal barrier function in patients postoperative severe abdominal infection.Methods 65 cases with severe abdominal infection from the hospital were selected and randomly divided into control group (32 cases) and experiment group (33 cases) by random digital table method.The control group were treated by clinical routine therapy and experiment group were treated on the basis of control group with medicinal charcoal tablets combined with blood purification therapy.The renal function, inflammatory mediators, oxygenation index, intestinal barrier function and efficacy were tested.ResuIts Compared with control group after treatment, the renal function of serum creatinine (Scr), blood urea nitrogen (BUM), uric acid (UA) levels were lower (P<0.05), the inflammatory mediators of tumor necrosis factor α(TNF-α), interleukin-6 (IL-6) and interleukin-8 (IL-8) levels were lower (P<0.05), the oxygenation index (OI) was higher(P<0.05), the intestinal barrier function indicators of plasma diamine oxidase (DAO) and endotoxin of lipopolysaccharide (LPS) were lower (P<0.05), the total efficiency were higher (χ2 =3.91, P<0.05) in experimental group.ConcIusion The medicinal charcoal tablets combined with blood purification could effectively improve renal function, reduce inflammatory mediators levels, improve intestinal barrier function, and increase oxygenation index in patients with severe abdominal infection, which has a good clinical curative effect for postoperative severe abdominal infection .

A total of 33 patients with isolated lilac artery aneurysms, 19 males and 14 females, who received treatment between January 1997 and June 2007, were retrospectively analyzed. Among these patients, 29 suffered from unilateral iliac artery aneurysm and 4 from bilateral iliac artery aneurysm. Under general anesthesia, all patients were subjected to aneurysmectomy, followed by vascular prosthesis implantation for vascular reconstruction. Results revealed that among 4 cases of bilateral iliac artery aneurysm, there was 1 case who was subjected to aorta-bilateral femoral artery vascular prosthesis implantation, and there were 3 cases who underwent aorta-bilateral lilac artery vascular prosthesis implantation; among 29 cases of unilateral lilac artery aneurysm, there was 1 case receiving aorta-common lilac artery vascular prosthesis implantation, 3 cases undergoing iliac-femoral artery vascular prosthesis implantation, 21 cases subjected to common-external iliac artery vascular prosthesis implantation, and 4 cases undertaking common -common lilac artery bypass. Color Doppler ultrasonic examination, spiral CT angiography, or digital subtraction arteriography was performed 3, 6 months, 1, 3, 5, 8, and 10 years after surgery. The mean follow-up time was 5 years. Three cases died of acute cerebral infarction, myocardial infarction, and traffic accident 3, 6, and 2 years after surgery, respectively. The remaining cases well survived as determined by no recurred Uiac artery aneurysm, anastomotic stoma stenosis or lower limb ischemia found. These results indicated that aneurysmectomy and subsequent vascular prosthesis implantation remained a good and primary means for treatment of isolated iliac artery aneurysm under the present medical condition.

BACKGROUND: A total of 300 SD rats were used for blood sampling. In abdominal aorta approach, the best puncture point was the abdominal aortic bifurcation 1-3 mm towards the heart, with a success rate of 93.6%. In posterior orbital venous plexus approach, the needle was vertically inserted into the inner canthus and rotated toward the eyeground to open venous plexus (success rate 89.9%). In cardiac puncture approach, below the xiphoid process, the needle punctured into the skin with 25°-30° oblique upward, through the diaphragm until 2.5-3.0 cm deep (success rate 83.4%). In tail end approach, surgical scissors cut off 5-10 mm tail top (success rate 94.4%). In jugular vein approach, the needle was horizontally inserted along the fourth rib into the skin until the jugular vein, about 5 mm deep, at 30°-40° with the chest surface (success rate 80.9%). A large blood volume could be obtained by abdominal aorta approach, which leads to less haemolysis and no hurt to organs, no gas embolism or haemostasis caused by inappropriate operation. But each approach has advantages and drawbacks, the selective principle should be based on experimental require.

OBJECTIVETo assess the value of stent-assistant angioplasty for intracranial vascular diseases.

METHODSThirteen patients with intracranial vascular diseases were treated consecutively by stent-assistant angioplasty for different purposes. Of these patients 7 had symptomatic intracranial artery stenosis, 3 intracranial wide-neck aneurysms, 2 intracranial pseudoaneurysms, and 1 bilateral transverse sinus stenosis. Clinical procedures and technical data of the patients were retrospectively analyzed.

RESULTSIn the 7 patients, the degree of intracranial artery stenosis reduced from 83% to 5%. Three months after the operation they exhibited good patency of stented lesions. Intracranial wide neck aneurysms (with 2 pseudoaneurysms) were successfully embolized with GDC in 5 patients. The patients with bilateral transverse sinus stenosis were implanted a self-expanded stent in the right transverse sinus. One patient failed because of the tortuous configuration of the left jugular bulb, but the patient's symptoms were improved quickly after the procedure.

CONCLUSIONStent-assistant angioplasty is a useful technique for selected intracranial vascular diseases, and it needs further investigation.

Adult ; Angioplasty, Balloon ; methods ; Cerebrovascular Disorders ; therapy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome

Objective To assess the outcome of percutaneous vertebroplasty for symptomatic vertebral hemangiomas. Methods Five cases with 7 symptomatic vertebral hemangiomas were treated with percutaneous vertebroplasty. Aggressive lesions were treated with absolute alcohol injection in addition. Patients were followed-up and clinical manifestations were observed and CT, MRI and X-ray plain film were compared between before and after vertebroplasty. Results Procedures were successful without complications. Most of the symptoms resolved within 24 hours after vertebraplasty. All patients were followed-up for 12～50 months and free of neurological deficits and symptoms. Imaging follow-up showed no vertebral collapse, nor recurrance of hemangiomas. Conclusion With effective long-term follow-up and quick elimination of symptoms, precutaneous vertebroplasty, added with absolute alcohol injection in aggressive cases, proves to be a safe and effective treatment for symptomatic vertebral hemangiomas.

Objective To evaluate the short term results of endovascular laser for the treatment (ELVT) of great saphenous varicosity. Methods Twenty one cases (a total of 27 lower extremities) were enrolled. Treatment included EL combined with ligation and resection of communicating branches. One patient underwent high ligation and resection of the great saphenous vein for the purpose of pathology after ELVT treatment. Result Twenty patients were followed-up for a period of 2～6 months. Color Duplex ultrosonography was conducted 2 weeks,4 weeks,and 6 mos,respectively. Thrombotic obliteration was found in all cases. Pathology study showed perforation of the vein with intimal injury and thrombosis. Conclusion The short term efficacy of EL treatment is definite with insignificant side-effect,and quick patient recovery. The mechanism is related to direct thermal injury of laser to the venous intima resulting in thrombotic obliteration.

Objective To review the experience of multiple modality endovascular treatment for intracranial venous thrombosis, and to evaluate the efficacy and risk of endovascular thrombolysis for intracranial venous thrombosis.Methods From October, 2000 to October, 2001, 12 patients with intracranial venous thrombosis confirmed by CT, MRI, MRV, and/or DSA were treated with multiple modality endovascular thrombolysis including intravenous thrombolysis, mechanical thrombus maceration, intraarterial thrombolysis, and stenting.After thrombolysis, treatment aimed at the primary diseases was continued and warfarin was used for 6 months.The patients were followed-up for 17-29 months, averaged 23 months.Results Of the twelve patients, all underwent transvenous thrombolysis, ten underwent combined transvenous thrombolysis and clot maceration, seven underwent transvenous infusion of urokinase combined with transarterial infusion of urokinase.Two underwent transvenous infusion of urokinase combined with transarterial infusion of urokinase.The thrombolysis duration was from one to three days.The infusion dose of urokinase was 800 000 to 2 900 000 IU, the averaging dosage of urokinase was less than 1 000 000 IU per day.All patients achieved from recanalization of sinuses as confirmed on postprocedural angiography, MRI, and MRV studies prior to hospital discharge.At discharge, all the patients improved neurologically, and GCS improved from averaged 12 of pre-operation to 14 of post-operation.During the averaging 23 months follow-up, no patient recurred. Conclusion Combined multiple modality endovascular treatment is an effective and safe procedure for potentially catastrophic intracranial venous thrombosis.

OBJECTIVE: To evaluate the safety of the balloon occlusion test(BOT) and therapeutic occlusion of the internal carotid artery(ICA). METHODS: The data of 43 patients hospitalized consecutively with traumatic intractable carotid cavernous fistulas (TICCF) were analyzed. Therapeutic occlusion of ICA was performed on 39 cases and BOT was only performed on the remaining 4 cases. Our assessment consisted of: (1) angiographic evaluation of collateral circulation with or without BOT of ICA, and (2) evaluation of clinical tolerance to therapeutic occlusion of ICA with hypotensive challenge for 30 minutes. Complications of BOT and therapeutic occlusion of ICA were also analyzed retrospectively. RESULTS: Complications related to BOT occurred in 1 case (2.3%) without causing permanent deficits. Complications related to therapeutic occlusion of ICA occurred in 4 cases (10%), including 1 technical (2.5%), 2 temporary (5%) and 1 permanent (2.5%) deficit. There was no fistula recurrence or mortality. CONCLUSIONS: BOT of ICA is safe and economical. The reliability of the results is almost the same compared with that of other more complicated methods of assessing therapeutic occlusion of ICA. And it is easy to treat TICCF with therapeutic occlusion of ICA.

Objetive: To investigate the operative method of the true aneurysm in the initial part of splenic artery, and to summary clinic therapeutic experiences. Methods: To summary the 7 patients who suffered from the initial splenic true aneurysm from 1996 to 2006, and which cases were identified by color ultrasound, CT scan and angiography. All splenic aneurysm were cut off including splenic artery revascularlization on 5 patients. Results: All patients were cured and discharged from hospital in the 10th-14th day, and which patients were followed-up for 1-9 years. 5 cases were healthy except one died of acute myocardiac infarction 2 years later post operation. Conclusion: To cut off the initial splenic true aneurysm and to revasculize splenic artery is a better operative method to cure this disease.