OBJECTIVE: To improve the rat model of cervical spondylosis of vertebral artery type (CSA) induced by injecting sclerosing agent. To evaluate the efficacy of injecting sclerosing agent to induce CSA. METHODS: Forty Health SPF SD rats(20 males and 20 females), were randomly divided into two groups:the model group (20) and the blank group (20). All the animals were followed up for 4 weeks for the observation of general situation, transcranial Doppler(TCD) detection of blood flow velocity, pulsatility index and resistive index of the vertebral artery, measurement of mental distress by open-field test. RESULTS: One to two days after establish the animal model, rats in the model group appeared apathetic with decreased autonomic activities, trembling, squinting, increased eye excrement, etc., and no rats died during the experiment. The mean blood flow velocity of the model group was lower than that of the blank group (P<0.05), and the pulsatilit index and resistive index of the model group were higher than that of the blank group (P<0.05). The mental distress of the model group was significantly higher than that of the blank group. CONCLUSION The modified injection of sclerosing agent is a practical method to establish the rat model of CSA, with high success rate, high stability, low mortality and simple operation.
Male ; Animals ; Female ; Rats ; Sclerotherapy ; Sclerosing Solutions/therapeutic use* ; Rats, Sprague-Dawley ; Spondylosis/therapy* ; Spine ; Vertebral Artery

OBJECTIVETo explore the curative effect of surgery and selerotherapy for massive venous malformations of the tongue.

METHODSFrom January 2005 to December 2014, subtotal resection or debulking for 15 cases of massive venous malformation in the tongue was undertaken with multiple sessions of pre- and post-operative injection therapy of pingyangmycin, lauromacrogol and absolute ethanol.

RESULTSAll signs associated with the lesions including eating, sleep and speech disorders disappeared after treatment. Complete or near complete resolution was achieved in 9 cases, and a significant reduction in size in a further 6 cases after surgical excision and peri-operative sclerotherapy.

CONCLUSIONSFor massive venous malformations of the tongue, surgical excision combined with multiple sessions of sclerotherapy is a good treatment option.

Bleomycin ; analogs & derivatives ; therapeutic use ; Combined Modality Therapy ; methods ; Ethanol ; therapeutic use ; Humans ; Injections, Intralesional ; Polyethylene Glycols ; therapeutic use ; Sclerosing Solutions ; therapeutic use ; Sclerotherapy ; Tongue ; blood supply ; Treatment Outcome ; Vascular Malformations ; therapy ; Veins ; abnormalities

OBJECTIVETo investigate the safe and effective treatment for painful venous malformation (VM) in limbs.

METHOD(1) 97 cases with painful VM underwent MRI to detect the location of VM, as well as its size and structure, its relationship with the surrounding tissue. Statistical analysis was also performed. (2) The embolic agent (ethanol) was first injected to embolize the draining vessels of VM, then the Polidocanol plus Methotrexate (MTX) was followed to keep the embolization effect on VM. The therapeutic effect was observed and analyzed.

RESULTSFrom January 2010 to January 2012, 97 patients with painful VM were treated. A Spearman correlation analysis showed no significant correlation between symptoms of pain and lesion growth, volume, or MRI grades (P > 0.05). The lesions in the muscle space are more likely to have the symptoms of pain (P < 0.01), followed by the lesions in the muscle, then the lesions in the joint and subcutaneous tissue. The pain relieve percentage was 95.9% (93/97) after one time embolic sclerotherapy. No severe complication, such as distant embolization, nerve damage, or muscle atrophy happened. No pain reoccurrence happened after 0.5-1.5 years of follow-up period.

CONCLUSIONSThe treatment of embolic scleratherapy is minimal invasive, safe and effective for painful VM with stable results.

Ethanol ; therapeutic use ; Extremities ; blood supply ; Humans ; Methotrexate ; therapeutic use ; Pain ; etiology ; Pain Management ; methods ; Polyethylene Glycols ; therapeutic use ; Sclerosing Solutions ; therapeutic use ; Sclerotherapy ; methods ; Statistics, Nonparametric ; Vascular Malformations ; complications ; pathology ; therapy ; Veins ; abnormalities

BACKGROUND/AIMS: To evaluate the efficacy of proton pump inhibitors (PPIs) in reducing rebleeding and bleeding-related death rates after endoscopic gastric variceal obliteration (GVO) using N-butyl-2-cyanoacrylate (NBC). METHODS: This study enrolled 341 patients who were consecutively diagnosed with and treated for bleeding gastric varices. The patients were divided into PPI and non-PPI groups, and their endoscopic findings, initial hemostasis outcomes, rebleeding and bleeding-related death rates, and treatment-related complications were analyzed. RESULTS: The rate of initial hemostasis was 97.1%. rebleeding occurred in 2.2% of patients within 2 weeks, 3.9% of patients within 4 weeks, 18.9% of patients within 6 months, and 27.6% of patients within 12 months of the GVO procedure. A previous history of variceal bleeding (relative risk [RR], 1.955; 95% confidence interval [CI], 1.263 to 3.028; p = 0.003) and use of PPIs (RR, 0.554; 95% CI, 0.352 to 0.873; p = 0.011) were associated with rebleeding. Child-Pugh class C (RR, 10.914; 95% CI, 4.032 to 29.541; p < 0.001), failure of initial hemostasis (RR, 13.329; 95% CI, 2.795 to 63.556; p = 0.001), and the presence of red-colored concomitant esophageal varices (RR, 4.096; 95% CI, 1.320 to 12.713; p = 0.015) were associated with bleeding-related death. CONCLUSIONS: The prophylactic use of PPIs reduces rebleeding after GVO using NBC in patients with gastric variceal hemorrhage. However, prophylactic use of PPIs does not reduce bleeding-related death.
Adult ; Aged ; Aged, 80 and over ; Chi-Square Distribution ; Enbucrilate/*administration & dosage/adverse effects ; Endoscopy, Gastrointestinal ; Esophageal and Gastric Varices/complications/diagnosis/mortality/*therapy ; Female ; Gastrointestinal Hemorrhage/diagnosis/etiology/mortality/*therapy ; Hemostasis, Endoscopic/adverse effects/*methods/mortality ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Proton Pump Inhibitors/adverse effects/*therapeutic use ; Recurrence ; Retrospective Studies ; Risk Factors ; Sclerosing Solutions/*administration & dosage/adverse effects ; Sclerotherapy/adverse effects/*methods/mortality ; Time Factors ; Treatment Outcome ; Young Adult

OBJECTIVE: To explore the safe method with anhydrous ethanol injection in the treatment of venous malformation.
 METHODS: A total of 96 patients with venous malformation were conducted anhydrous ethanol injection for 245 times through percutaneous puncture by three-point method. The complications were observed. In animal experiment, according to the different concentrations of anhydrous ethanol injection, rats were divided into an anhydrous ethanol group, a 75% ethanol group, a 50% ethanol group and a 25% ethanol group (n=5 in each group), and the damage of vessels after ethanol injection was observed.
 RESULTS: The successful rate for three-point ethanol injection was 88%. The incidence for both skin ulcer and numbness was 0.9% without severe complications in lung and heart. In the animal experiments, the entire vessel wall including outer membrane was damaged in the anhydrous ethanol group. Part of vessel walls, including the inner membrane and muscle layer, were damaged in both the 75% ethanol group and the 50% ethanol group. However, there was no damage in the vessels in the 25% ethanol group.
 CONCLUSION With the decrease in ethanol concentration, the vascular damage is decreased and eventually disappeared. Three-point anhydrous ethanol injection is safe and effective.
Animals ; Ethanol ; administration & dosage ; therapeutic use ; Humans ; Injections ; methods ; Rats ; Sclerosing Solutions ; therapeutic use ; Sclerotherapy ; Vascular Malformations ; therapy

BACKGROUNDAlcohol has been used for treating simple renal cysts since 1981. Since then, various observational studies have examined the technique, but they differ significantly in the details of the procedures and efficacy measures used. This has made it difficult to assess the safety and efficacy of this technique. We carried out a randomized controlled trial to evaluate the efficacy and safety of ultrasound-guided alcohol sclerotherapy involving single-session multiple injections to treat simple renal cysts.

METHODSA total of 144 patients with simple renal cysts were randomly allocated to either the treatment group (ultrasound-guided percutaneous drainage and alcohol sclerotherapy with single-session multiple injections) or control group (ultrasound-guided simple percutaneous drainage). Follow-up CT scans of ablated cysts were collected 3 and 6 months after the procedure. The outcome was considered successful if cyst volume between baseline and 6 months decreased by at least 87.5%.

RESULTSIntention-to-treat analysis revealed an average volume reduction of 94.2% in the treatment group and 50.8% in the control group (P < 0.0001). The percentage of patients achieving successful outcomes was 88.9% (95%CI 77.0% - 100.0%) in the treatment group and 22.2% (95%CI 6.54% - 37.9%) in the control group (P < 0.0001). The corresponding results in the per-protocol analysis were an average volume reduction of 96.4% in the treatment group and 50.8% in the control group (P < 0.0001). The percentage of patients achieving a successful outcome was 94.3% (95%CI 85.6% - 100.0%) in the treatment group and 22.2% (95%CI 6.54% - 37.9%) in the control group (P < 0.0001).

CONCLUSIONAlcohol sclerotherapy involving single-session multiple injections is safe and efficacious in the treatment of renal cysts.

Adolescent ; Adult ; Aged ; Female ; Humans ; Kidney Diseases, Cystic ; therapy ; Male ; Middle Aged ; Sclerosing Solutions ; therapeutic use ; Sclerotherapy ; methods ; Treatment Outcome ; Young Adult

Duodenal varices result from retroperitoneal portosystemic shunts that usually come from the pancreaticoduodenal vein and drain into the inferior vena cava. Because they are a rare but fatal cause of gastrointestinal bleeding, a prompt hemostatic intervention is mandatory. A 62-year-old man who had a history of excessive alcohol consumption presented with massive hematemesis and melena. Emergent endoscopy revealed ruptured varices with an adhering whitish fibrin clot on the postbulbar portion of the duodenum. Abdominal computed tomography demonstrated a cirrhotic liver with venous collaterals around the duodenum and extravasated contrast in the second and third portions. The collaterals originated from the main portal vein and drained via the right renal vein into the inferior vena cava. Endoscopic injection sclerotherapy with cyanoacrylate was successful in achieving hemostasis, and resulted in the near eradication of duodenal varices at a 6-month follow-up.
Cyanoacrylates/therapeutic use ; Duodenal Diseases/diagnosis/etiology/*therapy ; Duodenum/*blood supply ; Endoscopy, Gastrointestinal ; Gastrointestinal Hemorrhage/etiology/*therapy ; Humans ; Male ; Middle Aged ; Portal Vein ; Rupture ; Sclerosing Solutions/therapeutic use ; *Sclerotherapy ; Tomography, X-Ray Computed ; Varicose Veins/complications/*therapy

OBJECTIVETo evaluate the efficacy of B-ultrasound-guided aspiration and sclerotherapy with 2% iodophor for treatment of renal cysts.

METHODSTwenty-eight cases of sympotomatic renal cysts were treated with B-ultrasound-guided aspiration followed by sclerotherapy with 2% iodopher, which was maintained for 20 min. After extraction of iodopher, another injection of 2% iodopher (5-10 ml) into the cysts was given. The patients were followed up for 6 months to 18 months.

RESULTSFull recovery was achieved in 25 cases and improvement in 2 cases. Recurrence was found in 1 case after the treatment.

CONCLUSIONSB-ultrasound-guided aspiration and sclerotherapy with 2% iodophor is safe, minimally invasive, and highly effective for treatment of symptomatic renal cysts.

Aged ; Biopsy, Fine-Needle ; Female ; Humans ; Iodophors ; therapeutic use ; Kidney Diseases, Cystic ; therapy ; Male ; Middle Aged ; Sclerosing Solutions ; therapeutic use ; Sclerotherapy ; methods ; Ultrasonography, Interventional

OBJECTIVETo investigate the effect and safety of imaging-guided percutaneous catheterization drainage and alcohol sclerosis for treatment of renal cysts.

METHODSThirty-six patients with primary renal cysts, including 22 men and 14 women aged 18-65 years (mean 42.5 years), were treated with imaging-guided percutaneous puncture catheterization drainage and alcohol sclerosis treatment. The location of the renal cysts and puncture route, angle and depth were determined by ultrasound or CT scan. Paracentesis and catheterization external drainage were carried out under fluoroscope. Absolute alcohol was used as the sclerosis agent.

RESULTSThirty-eight cysts were detected in the 36 patients, locating at the upper pole (n=21), subtus pole (n=10) and intermediate pole (n=7). The length of renal cysts was 4.5-8.5 cm (mean 5.5 cm). Puncture was performed through the lumbar back and the success rate was 100%. Thirty-eight multi-lateral holes 5-7F drainage catheters were placed in the 38 cysts. Alcohol was injected for 169 times through the drainage tube and the average volume was 25 ml, with an average injection of 4.45 times. During the follow-up for 1 to 6 years (mean 3.5 years), 37 renal cysts disappeared and 1 cyst was reduced in a patient with polycystic kidney. The total cure rate was 97% in this series, and no serious complications occurred after the operation.

CONCLUSIONImaging-guided percutaneous puncture catheterization drainage and alcohol sclerosis is effective and safe for treatment of renal cysts.

Adolescent ; Adult ; Aged ; Catheterization ; Drainage ; methods ; Ethanol ; administration & dosage ; Female ; Humans ; Kidney Diseases, Cystic ; diagnostic imaging ; therapy ; Male ; Middle Aged ; Sclerosing Solutions ; administration & dosage ; therapeutic use ; Sclerotherapy ; methods ; Ultrasonography ; Young Adult

OBJECTIVE: We wanted to assess the long-term results of cyst ablation with using N-butyl cyanoacrylate (NBCA) and iodized oil in patients with autosomal dominant polycystic kidney disease (ADPKD) and symptomatic cysts. MATERIALS AND METHODS:Cyst ablation using a mixture of NBCA and iodized oil was performed in 99 cysts from 21 patients who had such symptoms as abdominal distension and pain. The collapse or reaccumulation of the ablated cysts after the procedure was assessed during the follow-up period of 36 to 90 months. The treatment effects, including symptom relief, and the clinical data such as the blood pressure and serum creatinine levels were also assessed, together with the complications. RESULTS: The procedure was technically successful in all 99 cysts from the 21 patients. Any procedure-related significant complications were not detected. Seventy-seven of 99 cysts (78%) were successfully collapsed on the follow-up CT. Twenty-two cysts showed reaccumulation during long-term follow-up period. The clinical symptoms were relieved in 17 of the 21 patients (76%). Four of 12 patients (33%) with hypertension and two of six patients (33%) with azotemia were improved. End stage renal disease (ESRD) occurred in six of the 21 patients (28%) during the follow-up period. The mean age of ESRD in our patients was 57 years. The mean time interval for the development of ESRD was 19 months. CONCLUSION: Ablation using a mixture of NBCA and iodized oil may be an effective, safe method for obtaining symptom relief in patients with ADPKD.
Adult ; Aged ; Enbucrilate/administration & dosage/*therapeutic use ; Female ; Follow-Up Studies ; Humans ; Iodized Oil/administration & dosage/*therapeutic use ; Male ; Middle Aged ; Polycystic Kidney, Autosomal Dominant/*surgery ; Sclerosing Solutions/administration & dosage/*therapeutic use