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1.
Purpose: To evaluate the technical success and outcome of fallopian tube recanalization (FTR) in salpingitis isthmica nodosa (SIN).
Methods: SIN is a well-recognized pathological condition affecting the proximal fallopian tube and is associated with infertility
and ectopic pregnancy. We reviewed the presentations, films, and case records of all patients attending for FTR for infertility
from 1990 to 1994. Technical success and total, intrauterine, and ectopic pregnancy rates at follow-up were determined.
Results: SIN was observed in 22 of 349 (6%) patients. FTR was attempted in 34 tubes in these 22 patients. Technical success was achieved
in 23 of 34 (68%) tubes affected by SIN. In 5 of the 11 failed recanalizations, failure was due to distal obstruction. At
least one tube was patent on selective postprocedural salpingography in 17 of 22 (77%) patients. There were no recorded perforations
or complications. At follow-up (mean 14 months), total, intrauterine, and ectopic pregnancy rates were 23%, 18%, and 4.5%,
respectively.
Conclusion: FTR in SIN is technically successful and, compared with previously reported results in unselected infertility patients, is
associated with only a slightly less favorable intrauterine pregnancy rate and a comparable ectopic pregnancy rate. The findings
of SIN at FTR should not discourage attempted fluoroscopic transcervical recanalization.
Received: 0/00/00/Accepted: 0/00/00 相似文献
2.
目的:探讨利用自制装置对子宫显著屈曲合并输卵管梗阻的不孕患者进行输卵管再通术的插管方法并分析其疗效。方法:经子宫输卵管造影证实子宫显著屈曲伴单侧或双侧输卵管阻塞患者48例,共66争输卵管阻塞,应用自制装置,配合使用各种手术器械,施行选择性输卵管造影及再通术。采用复通率及妊娠率(随访2年)评价输卵管再通术的治疗效果,并将其与子宫位置正常患者进行比较。结果:48例患者均插管成功,施行再通术后,有56条输卵管复通,复通率为84.8%,随访2年后9例妊娠,妊娠率18.8%,妊娠率低于子宫位置正常患者,而复通率与子宫位置正常患者相近。结论:使用自制装置能够较方便完成显著屈曲子宫的输卵管再通术,各种手术器械的配合使用有利于成功插管。 相似文献
3.
Lee JM Han YM Lee SY Kim CS Yang DH Lee SO 《Cardiovascular and interventional radiology》2001,24(1):25-30
Purpose: To evaluate the efficacy of the placement of covered metallic stents for palliation of gastrointestinal anastomotic strictures
secondary to recurrent gastric cancer.
Methods: Under fluoroscopic guidance, placement of one or two self-expandable covered metallic stents was attempted perorally in 11
patents (aged 48–76 years) with anastomotic stenoses due to recurrent gastric malignancies. The strictures involved both the
afferent and efferent loops in three patients. All patients had poor peroral food intake with severe nausea and vomiting after
ingestion. The technical and clinical success was evaluated.
Results: Placement of the covered stent was technically successful in 13 of 15 (87%) attempts in ten patients. After the procedure,
9 of 11 (82%) patients overall were able to ingest at least a liquid diet and had markedly decreased incidence of vomiting.
During the follow-up of 2–31 weeks (mean 8.5 weeks) there were no major complications.
Conclusion: These preliminary results suggest that flexible, covered stents may provide effective palliation of malignant anastomotic
stricture secondary to recurrent gastric cancer. 相似文献
4.
Malignant Gastric and Duodenal Stenosis: Palliation by Peroral Implantation of a Self-Expanding Metallic Stent 总被引:11,自引:0,他引:11
Isabel T. Pinto 《Cardiovascular and interventional radiology》1997,20(6):431-434
Purpose: To assess the use of self-expanding metallic stents in patients with inoperable malignant antrum-pylorus-duodenal obstruction.
Methods: Six patients underwent implantation of a Wallstent self-expanding metallic endoprosthesis (20 mm in five patients and 16
mm in one). In five patients a catheter (Berenstein) was introduced perorally into the stomach. A guidewire (Terumo) was introduced
through the catheter and advanced through the antrum-pylorus-duodenal stenosis. The guidewire was removed and a 260-cm-long,
0.035″ superstiff guide (Amplatz) was introduced. After the catheter was removed the stent assembly was introduced. In the
last patient the stent was implanted through a percutaneous gastrostomy.
Results: Treatment of inoperable gastric outlet obstruction caused by tumor compression is difficult and unsatisfactory. Peroral implantation
of self-expanding metallic stents resulted in successful palliative therapy of antrum-pylorus-duodenal stenosis in six patients
in whom surgery was not possible because of advanced disease and poor general condition. On average, patients were able to
eat during 41 days. One patient is tolerating oral intake at 3 months.
Conclusion: Implantation of stents resulted in palliative relief of malignant antrum-pylorus-duodenal obstructions.
Received: 0/00/00/Accepted: 0/00/00 相似文献
5.
Heini K. Söder Hannu I. Manninen Pekka J. Matsi 《Cardiovascular and interventional radiology》1999,22(3):219-223
Purpose: To evaluate the angiographic patterns of clinically manifest recurrent disease after infrainguinal percutaneous transluminal
angioplasty (PTA) of stenoses and total occlusions.
Methods: Among 326 infrainguinal PTAs on 263 consecutive patients, selective angiography was performed on 61 limbs of 52 patients
1–60 months after the primary intervention because of clinically suspected recurrent disease. Lesion-specific and patient-related
factors were analyzed for 75 angiographically confirmed recurrent lesions in 57 limbs of 48 patients.
Results: Recurrent disease was more frequently a stenosis when the original target lesion was a stenosis (92%, 44/48) than when the
original lesion was a total occlusion (59%, 16/27; p < 0.001). When the original target lesion was a stenosis, the total length of the recurrent disease was longer than that
of the original lesion [3.9 ± 3.9 cm (mean ± standard deviation) vs 2.8 ± 2.7 cm; p= 0.03], while in the subgroup of original total occlusions the length of the recurrent lesion was shorter than that of the
original occlusion (7.1 ± 5.0 cm vs 9.9 ± 6.9 cm; p= 0.02). Half the restenoses (22/44) extended beyond one or both ends of the original stenosis and 38% (6/16) of the reocclusions
extended beyond the distal end of the original occlusion.
Conclusions: The type of recurrent disease depends on the original lesion type and the restenotic lesion frequently extends beyond one
or both ends of the original target lesion. 相似文献
6.
Efficacy and complications of the gianturco-Z tracheobronchial stent for malignant airway stenosis 总被引:1,自引:0,他引:1
Yasuo Nakajima Yasuyuki Kurihara Hiroshi Niimi Shoko Konno Tohru Ishikawa Hiroaki Osada Hiroshi Kojima 《Cardiovascular and interventional radiology》1999,22(4):287-292
Purpose: To describe our experience using the Gianturco Z-stent (G-Z stent) for the management of malignant tracheobronchial stenosis,
with special reference to complications.
Methods: Thirty-six stents were used in 22 patients with 28 lesions. Thirteen patients were grade 5 according to the Hugh-Jones classification.
The technical success rates, follow-up results, and complications were reviewed on the basis of the patients' charts and radiographs.
Results: All stents were successfully placed in the ideal position without procedure-related complications. After the procedure, respiratory
status improved in 95% (21/22) of patients, and performance status improved in 77% (17/22). Mean survival after stent placement
was 15 weeks. Four patients suffered from increased thick secretions requiring multiple suctioning and aspiration by bronchoscopy.
One of these patients died from asphyxiation 2 weeks after placement. Stent disruption and/or migration was observed in six
patients. Of these six, four experienced life-threatening hemoptysis; all four had received aggressive anticancer treatment.
Conclusion: G-Z stents are useful for palliation of malignant tracheobronchial obstruction. However, complications of stent strut fracture
and migration give cause for concern. 相似文献
7.
Complications of lower-limb percutaneous transluminal angioplasty: A prospective analysis of 410 procedures on 295 consecutive patients 总被引:3,自引:0,他引:3
>
Purpose: To evaluate complications and their predictors in percutaneous transluminal angioplasty (PTA) of lower-limb arteries.
Methods: Complications in 410 angioplasty procedures in 295 consecutive patients (192 claudicants and 103 suffering from chronic critical
ischemia) were prospectively analyzed.
Results: The total complication rate was 10.5% (43/410). There were 21 major complications (5%), eight of which required surgical
treatment, including four hematomas, two arteriovenous fistulae, and two pseudoaneurysms at the puncture site, two retroperitoneal
hematomas, and 11 thrombotic/thromboembolic complications. There were significantly more complications with treatment of occlusions
compared with stenoses (18% vs 7%,
p= 0.002). Women had significantly more bleeding complications than men (15% vs 6%, p= 0.032). The 30-day mortality rate in patients with critical ischemia was 10%. Conclusion: In lower-limb PTA a few target lesion- and patient-related determinants of complications could be identified. In patients
with critical ischemia, the 30-day mortality was rather high and mainly due to associated coronary and cerebrovascular diseases. 相似文献
8.
目的:探讨液体加压冲击法联合导丝技术介入治疗输卵管阻塞性不孕的价值.方法:在DSA引导下利用液体加压冲击法以及导丝技术对36例(54条输卵管)输卵管阻塞性不孕症患者进行输卵管再通治疗,记录输卵管再通率、患者的不良反应等.结果:采用液体加压冲击法达到复通的输卵管共29条,采用液体加压冲击法及导丝技术达到复通的输卵管为24条.液体加压冲击法联合导丝技术介入治疗输卵管阻塞再通成功率可达100%.结论:液体加压冲击法联合导丝技术治疗输卵管阻塞,在DSA直视下完成操作,准确性和成功率高,疗效确切,是一种可行的手术方式. 相似文献
9.
介入性输卵管再通术及碘化油应用初步研究 总被引:9,自引:0,他引:9
目的 探讨介入性输卵管再通术在治疗输卵管阻塞性不孕症的临床效果及碘化油的应用价值。方法 观察组 2 1例 42条输卵管阻塞。对照组 16例 3 2条输卵管阻塞 ,对照组仅行介入性输卵管再通术 ,观察组在再通术成功后向输卵管内注入超液态碘化油丁胺卡那霉素乳剂。所有病例 6个月后复查。结果 观察组与对照组的再通率、术后受孕率分别为 81.0 %、81.3 %;2 8.6%、2 5 %。术后再通输卵管粘连复发率观察组 5 .88%、对照组 2 6.9%,比较两者差异具有显著性意义 (x2 =6.3 6,Ρ <0 .0 5 )。结论 介入性输卵管再通术是治疗输卵管阻塞性不孕的一项有效方法 ,碘化油应用可明显降低再通术后输卵管粘连复发率 相似文献
10.
Michael A. Braun M.D. Steven J. Smith Timothy N. Merrill 《Cardiovascular and interventional radiology》1996,19(6):428-430
We describe a technique that extracted a ruptured angioplasty balloon which had become entrapped by a calcified left common
iliac artery stenosis. The balloon catheter had been advanced crossover from the right and could not be retracted directly
into a sheath across the aortic bifurcation. Therefore, a guidewire was inserted through the balloon catheter and captured
by a loop snare advanced from the left femoral artery. The loop snare was also used to free the balloon wings from the stenosis.
The balloon was then pulled into a 10 Fr sheath and removed as a unit with the sheath. 相似文献
11.
Ernst-Peter K. Strecker M.D. Dieter Göttmann Irene B. L. Boos Sylvia Vetter 《Cardiovascular and interventional radiology》1998,21(5):375-379
Purpose: To examine the efficacy of the low-molecular-weight heparin, reviparin, for prevention of femoropopliteal stent restenosis.
Methods: Forty-two patients who had implantation of flexible tantalum stents for the treatment of stenosis (n= 24) or occlusion (n= 18) of the femoral (n= 27) or popliteal (n= 15) arteries were included in this study protocol. An intraarterial bolus of 5000 IU heparin was given before percutaneous
transluminal angioplasty (PTA), and in the case of stent implantation due to unsuccessful PTA, an additional dose of reviparin
(3500 anti-factor Xa IU) was given. Postprocedurally, 10,500 anti-factor Xa IU of reviparin were administered intravenously
over 24 hr, followed by 3500 anti-factor Xa IU subcutaneously twice a day for 23 days. Oral aspirin (100 mg/day) was prescribed
for the long term. Follow-up criteria (maximum follow-up 37 months) were clinical symptoms, Doppler ankle arm indices, color
and duplex sonography, and angiography for suspicion of restenosis.
Results: Early stent thromboses were not observed. Overall primary patency rate (PPR) was 88% ± 6.0% (1 year) and 74% ± 10.1% (2 years).
Major hemorrhagic complications have not occurred.
Conclusion: Reviparin administered in a high dose over a period of 24 days is a safe medication regimen and provides excellent patency
rates after stent implantation. 相似文献
12.
Laura Paúl Díaz Isabel Pinto Pabón Rosa Fernández Lobato Carmen Montes López 《Cardiovascular and interventional radiology》1999,22(1):29-36
Purpose: To assess the effectiveness and safety of self-expanding metallic stents as a primary palliative treatment for inoperable
malignant colorectal strictures.
Methods: Under radiological guidance 20 self-expanding metallic Wallstents were implanted in 16 consecutive patients with colorectal
stenoses caused by malignant neoplasms, when surgical treatment of the condition had been ruled out. The patients were followed
up clinically for 1–44 months, until death or termination of this study.
Results: The stents were successfully implanted in all cases and resolved the clinical obstruction in all the patients except one,
who underwent subsequent colostomy. During follow-up of the remaining 15 patients, clinical complications arising from the
procedure were pain (two patients), minor rectal bleeding (one patient), and severe rectal bleeding (one patient) (26%). There
were three cases of stent migration and three cases of stent occlusion, and reintervention by us was necessary in 20% of cases
(3/15). The mean life span following the procedure was 130 days, and none of the patients exhibited clinical symptoms of obstruction
at the time of death (12 patients) or termination of the study (3 patients).
Conclusion: Deployment of metallic stents under radiologic guidance is an effective alternative as a primary palliative measure in malignant
colorectal obstruction, though the possible clinical complications and need for repeat intervention during follow-up should
be taken into account. 相似文献
13.
Jeannette Bakker Jaap J. Beutler Otto E. H. Elgersma Eduard E. de Lange Gérard A. P. de Kort Frederik J. A. Beek 《Cardiovascular and interventional radiology》1999,22(6):475-480
Purpose: To determine the accuracy and optimal threshold values of duplex ultrasonography (US) in assessing restenosis of renal artery
stents.
Methods: Twenty-four consecutive patients with 33 renal arteries that had previously been treated with placement of a Palmaz stent
underwent duplex US prior to intraarterial digital subtraction angiography (DSA), which was the reference standard. Diagnostic
accuracy of in-stent peak systolic velocity (PSV) and reno-aortic ratio (RAR = PSV renal stent/PSV aorta) in detecting > 50%
in-stent restenosis were evaluated by the receiver operating characteristic curve. Sensitivity and specificity were determined
using the optimal threshold values, and using published threshold values: RAR > 3.5 and in-stent PSV > 180 cm/sec.
Results: Six examinations were technically inadequate. Nine stents had residual or restenosis > 50% at DSA. The two duplex parameters
were equally accurate since areas under the curves were similar (0.943). With optimal threshold values of 226 cm/sec for PSV
and 2.7 for RAR, sensitivities and specificities were 100% and 90%, and 100% and 84%, respectively. Using the published duplex
criteria resulted in sensitivities and specificities of 100% and 74% for PSV, and 50% and 89% for RAR.
Conclusion: Duplex US is a sensitive modality for detecting in-stent restenosis if laboratory-specific threshold values are used. 相似文献
14.
Wohlgemuth WA Weber H Loeprecht H Tietze W Bohndorf K 《Cardiovascular and interventional radiology》2000,23(1):9-16
Purpose: To provide follow-up data on endovascular intervention for venous stenoses in the pelvis.
Methods: Between 1985 and 1995, 35 patients presented with 42 stenoses of the pelvic veins after operative thrombectomy and creation
of an arteriovenous fistula, combined with intraoperative venous angioscopy. All patients underwent angioplasty and, if unsuccessful,
percutaneous insertion of an endovascular stent (n = 7).
Results: Angioplasty with and without endovascular stenting was technically successful in 34 of 35 patients (97%). Average length
of the stenoses was 20.6 mm (range 10–90 mm), average diameter before dilation 4.1 mm (range 2–6 mm), and average diameter
after dilation 10.1 mm (range 5–18 mm). Intraoperative angioscopy showed pathologic findings (intimal laceration or residual
thrombotic material) in 14 patients. After an average follow-up period of 4.13 years, 24 (69%) patients had patent veins.
The difference in the primary patency rate between patients with angioscopically abnormal veins (6 of 14 patients, corresponding
to a patency rate of 43%) and patients with angioscopically normal veins after thrombectomy (18 of 21 patients, corresponding
to a patency rate of 86%) was statistically significant (p < 0.01, log rank test).
Conclusions: Percutaneous transluminal angioplasty and/or stenting are good treatment modalities for pelvic vein stenosis following surgical
thrombectomy. Angioscopically abnormal veins have a poorer long-term patency, regardless of the type of intervention. 相似文献
15.
Jan Harnek Wojciech Cwikiel Evita Zoucas Birgitta Seiving Unne Stenram 《Cardiovascular and interventional radiology》1998,21(1):57-62
Purpose: To evaluate the effect of intratumorally injected ethanol, mitomycin, mitomycin with hyaluronidase, and hyaluronidase on
tumor growth in an experimental model.
Methods: A suspension of 1 × 106 cells of chemically induced adenocarcinoma was implanted into the liver of 52 rats. Seven days later the rats were divided
into groups according to treatment and injected via a midline laparotomy with ethanol, mitomycin, mitomycin with hyaluronidase,
or hyaluronidase. A control group was treated with saline. The rats were killed 7 days after treatment. The tumor growth ratio
was calculated, and the results compared for the different groups. Wilcoxon's rank sum test was used for statistical evaluation.
Results: The tumor growth ratio was significantly reduced after injection of mitomycin (p < 0.01) but not after ethanol. Hyaluronidase alone did not reduce the tumor growth ratio and had no synergetic effect with
mitomycin.
Conclusion: In an animal model intratumoral treatment of adenocarcinoma of the liver with mitomycin was significantly more efficient
than similar treatment with saline or ethanol.
Received: 0/00/00/Accepted: 0/00/00 相似文献
16.
A case of varicocele is reported. The dilated veins were situated in the left testis. The diagnosis required color Doppler
sonography. Successful treatment was performed by transcatheter embolization of the left spermatic vein. The control sonogram
revealed complete regression. A literature search yielded only three previous cases of intratesticular varicocele. No data
were found on the treatment of this entity.
Received: 0/00/00/Accepted: 0/00/00 相似文献
17.
Sung-Gwon Kang Gyu Sik Jung Soon Gu Cho Jae Gyu Kim Joo Hyung Oh Ho Young Song Eun Sang Kim 《Korean journal of radiology》2002,3(2):79-86
Objective
To evaluate the efficacy of newly designed covered and non-covered coated colorectal stents for colonic decompression.Materials and Methods
Twenty-six patients, (15 palliative cases and 11 preoperative) underwent treatment for the relief of colorectal obstruction using metallic stents positioned under fluoroscopic guidance. In 24 of the 26, primary colorectal carcinoma was diagnosed, and in the remaining two, recurrent colorectal carcinoma. Twenty-one patients were randomly selected to receive either a type A or type B stent; for the remaining five, type C was used. Type A, an uncovered nitinol wire stent, was lightly coated to ensure structural integrity. Type B (flare type) and C (shoulder type) stents were polyurethane covered and their diameter was 24 and 26mm, respectively. The rates of technical success, clinical success, and complications were analyzed using the chi-square test, and to analyse the mean period of patency, the Kaplan-Meier method was used.Results
Thirty of 31 attempted placements in 26 patients were successful, with a technical success rate of 96.8% (30/31) and a clinical success rate of 80.0% (24/30). After clinically successful stent placement, bowel decompression occurred within 1-4 (mean, 1.58 ± 0.9) days. Five of six clinical failures involved stent migration and one stent did not expand after successful placement. In the preoperative group, 11 stents, one of which migrated, were placed in ten patients, in all of whom bowel preparation was successful. In the palliative group, 19 stents were placed in 15 patients. The mean period of patency was 96.25 ± 105.12 days: 146.25 ± 112.93 for type-A, 78.82 ± 112.26 for type-B, and 94.25 ± 84.21 for type-C. Complications associated with this procedure were migration (n=6, 20%), pain (n=4, 13.3%), minor bleeding (n=5, 16.7%), incomplete expansion (n=1, 3.3%), and tumor ingrowth (n=1, 3.3%). The migration rate was significantly higher in the type-B group than in other groups (p=0.038).Conclusion
Newly designed covered and non-covered metallic stents of a larger diameter are effective for the treatment of colorectal obstruction. The migration rate of covered stents with flaring is higher than that of other types. For evaluation of the ideal stent configuration for the relief of colorectal obstruction, a clinical study involving a larger patient group is warranted. 相似文献18.
Le Blanche AF Rossert J Wassef M Lévy B Bigot JM Boudghene F 《Cardiovascular and interventional radiology》2000,23(5):368-374
Purpose: To assess in vivo 1) MR-guided percutaneous transluminal renal angioplasty (PTRA) in experimental bilateral rabbit renal artery stenosis (RAS);
2) postprocedural follow-up by gadolinium-enhanced MR angiography versus histomorphometry.
Methods: Fifteen male NZW rabbits of mean weight 4.0 kg (range 3.5–4.2 kg) underwent bilateral RAS induction by combined overdilation–deendothelialization
with a gadolinium-filled balloon, passively MR-guided by the artifact of a 0.014-inch guidewire. After 4 weeks the rabbits
were randomized into two groups: group A (n = 8) underwent right-sided PTRA for treatment of RAS, group B (n = 7) underwent left-sided PTRA. After another 4 weeks the rabbits were killed to assess by histomorphometry recurrent stenosis
and contralateral induction injury stenosis lesions. Each step was preceded by gadolinium-enhanced three-dimensional MR angiography,
and the cortex-to-aorta (C/A) signal intensity ratio was calculated.
Results: RAS induction was successful in all cases. Fourteen arteries developed restenosis and 13 only initial stenosis. MR-guided
PTRAs were feasible in 22 arteries (73%). For a successful catheterization of the ostium (20 arteries, 66% success rate),
10–25 steps were required. Five to eight steps were required for balloon localization and inflation for each PTRA. The restenosis
effect was reflected by a 16% (12%–27%) decrease in C/A values on MR angiograms (p < 0.05).
Conclusion: MR guidance and MR angiography represent a feasible, less invasive alternative for performing and assessing experimental
PTRA in RAS. 相似文献
19.
Maria A. Rivero Dennis W.W. Shaw Robert T. Schaller Jr. 《Cardiovascular and interventional radiology》1999,22(1):81-83
An 18-year-old man with a gastrointestinal hypomotility syndrome required lifelong parenteral nutrition. Both the superior
and inferior vena cava were occluded. Computed tomography guidance was used to place a long-term central venous catheter via
a large tributary to the azygos vein. 相似文献
20.
Jeannette Bakker M.D. Pierre P. Goffette Michel Henry Willem P. T. M. Mali Jean-Pierre Melki Jon G. Moss Claudio Rabbia Eric Therasse Kenneth R. Thomson Siegfried Thurnher Claudio Vignali 《Cardiovascular and interventional radiology》1999,22(6):468-474
Purpose: To assess, in a multicenter setting, safety, technical results, and restenosis rate of the Palmaz stent for treatment of
atherosclerotic ostial renal artery stenosis.
Methods: Ten centers enrolled 106 patients (120 treated renal artery stenoses) in the study. Patient selection was based on unsuccessful
percutaneous transluminal renal angioplasty (residual stenosis ≥ 20%) performed for treatment of ostial stenosis ≥ 50%, in
patients with hypertension and/or impaired renal function. Safety was assessed by means of the complication rate, and technical
results by the number of successful stent placements and occurrence of restenosis (>50%) at intraarterial angiographic follow-up.
Results: Stent placement was successful (n = 112) or partially successful (n = 5) in 117 (98%) arteries. Complications occurred in 19 procedures; seven were of serious clinical significance. Angiographic
follow-up was performed in 89 of 117 (76%) cases, at a mean of 8 months (range 2.5–18 months). Fifteen stents (16.9%) showed
restenosis (at a mean of 8.5 months), of which 10 were successfully redilated.
Conclusion: Renal artery stenting has a high technical success rate, a complication rate comparable to percutaneous transluminal renal
angioplasty, and a low rate of restenosis at 8 months angiographic follow-up. 相似文献