共查询到20条相似文献,搜索用时 31 毫秒
1.
Dierk Vorwerk Rolf W. Guenther Karl Schürmann 《Cardiovascular and interventional radiology》1997,20(5):359-363
Purpose: To report on the efficacy of fixing fresh venous thrombus to the venous wall by stent placement.
Methods: Seven patients underwent stenting to treat acute venous thrombosis. In two patients, the hemodialysis fistula was thrombosed
with the thrombus extending into the brachial veins. In three patients, the hemodialysis fistula was patent but massive swelling
of the ipsilateral arm was caused by proximal venous thrombosis. Two patients presented with iliac venous thrombosis within
stented pelvic veins. Stent placement was preceded by other mechanical thrombectomy methods in all cases.
Results: Attachment of thrombus to the venous wall was successful in all cases treated. Acute rethrombosis did not occur. Follow-up
patency in dialysis patients was 7.2 ± 2.1 months. One patient had rethrombosis of the dialysis graft 3 months after primary
treatment. Three patients developed restenosis within a mean period of 7.7 months. One shunt remained patent for 10 months
with no event of reobstruction during follow-up. In both patients with iliac stent placement, the vein remained patent over
a follow-up period of 8 and 12 months respectively.
Conclusion: Stenting fresh venous thrombus can achieve immediate venous patency. It may be used as an alternative approach when all other
percutaneous methods fail. Frequent restenosis within stented veins limits its use to very selected cases.
Received: 0/00/00/Accepted: 0/00/00 相似文献
2.
Christoph A. Binkert Eric Schoch Gerd Stuckmann Jon Largiader Pius Wigger Wolfdietrich Schoepke Christoph L. Zollikofer 《Cardiovascular and interventional radiology》1998,21(1):22-26
Purpose: The application of self-expanding metallic endoprostheses (stents) to treat symptomatic pelvic venous spurs as an alternative
to surgery.
Methods: Wallstents with a diameter from 14 to 16 mm and one Cragg stent were placed in the left common iliac vein of eight patients
(seven women, one man; mean age 42 years) with a symptomatic pelvic venous spur (left deep venous thrombosis or post-thrombotic
leg swelling). Four patients had surgical thrombectomy prior to stent placement.
Results: Technical success with immediate reduction of left leg circumference was achieved in all eight patients. A primary patency
rate of 100% was observed during an average follow-up of 3 years (range 10–121 months). There were no procedural or stent-related
complications.
Conclusion: The percutaneous transfemoral placement of self-expanding metallic stents is an effective minimally invasive alternative
to surgery in the treatment of symptomatic pelvic venous spur.
Received: 0/00/00/Accepted: 0/00/00 相似文献
3.
Interventional Sialography: A Single-Center Experience 总被引:1,自引:0,他引:1
Roger P. Davies Andrew M. Whyte Chok L. Lui 《Cardiovascular and interventional radiology》1997,20(5):331-336
Purpose: To evaluate interventional sialography for the treatment of chronic recurrent sialadenitis due to calculus and/or stricture.
Methods: We performed a retrospective review and follow-up of 12 patients treated over a 3-year period. The techniques for calculus
extraction by papillotomy and basket extraction, and stricture dilatation by a combination of predilation with lacrimal dilators
and then angioplasty balloons are described and the literature is reviewed.
Results: Follow-up of 1–40 months (mean 14.6 months) showed that 7 of 12 patients remained symptom free and 2 others became asymptomatic
after an interval. There were no major complications from the procedure.
Conclusion: Interventional sialography is a safe and acceptable alternative to surgery and can be considered as first-line therapy for
symptomatic salivary duct calculus and stricture.
Received: 0/00/00/Accepted: 0/00/00 相似文献
4.
Penetrating atherosclerotic ulcer of the descending thoracic aorta: Treatment by endovascular stent-Graft 总被引:3,自引:0,他引:3
Salvatore Murgo M.D. Luc Dussaussois Jafar Golzarian Jean Christophe Cavenaile Hicham Tarik Abada José Ferreira Julien Struyven 《Cardiovascular and interventional radiology》1998,21(6):454-458
Purpose: To present four cases of penetrating ulcer of the descending thoracic aorta treated by transfemoral insertion of an endoluminal
stent-graft.
Methods: Four patients with penetrating aortic ulcers were reviewed. Three cases were complicated by rupture, false aneurysm, or retrograde
dissection. All patients were treated by endovascular stent-graft and were followed by helical computed tomography (CT).
Results: Endovascular stent-graft deployment was successful in all patients. However, in one case we observed a perigraft leak that
spontaneously disappeared within the first month, and two interventions were needed for another patient. Following treatment,
one episode of transient spinal ischemia was observed. The 30-day survival rate was 100%, but one patient died from pneumonia
with cardiac failure 34 days after the procedure. In one patient, helical CT performed at 3 months showed a false aneurysm
independent of the first ulcer. This patient refused any further treatment and suddenly died at home (unknown cause) after
a 6-month follow-up period.
Conclusion: Transluminal placement of endovascular stent-grafts for treatment of penetrating ulcers of the descending thoracic aorta
appears to be a possible alternative to classical surgery. After treatment, follow-up by CT is essential to detect possible
complications of the disease. 相似文献
5.
Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices: A Feasibility Study 总被引:8,自引:0,他引:8
Tetsuo Sonomura Morio Sato Kazushi Kishi Masaki Terada Yasukazu Shioyama Masashi Kimura Kenzo Suzuki Yasumichi Kutsukake Takashi Ushimi Junji Tanaka Seishu Hayashi Satoshi Tanaka 《Cardiovascular and interventional radiology》1998,21(1):27-30
Purpose: To evaluate the clinical feasibility of balloon-occluded retrograde transvenous obliteration (BORTO) for gastric varices.
Methods: BORTO was performed in 14 patients with gastric varices due to liver cirrhosis. The gastric varices were confirmed by endoscopy,
and their feeding and draining veins were identified by contrast-enhanced computed tomography (CT) and angiography. A 6 Fr
Simmons-shaped balloon catheter was inserted into the gastrorenal shunt. The balloon was inflated, and 5% ethanolamine oleate
iopamidol was infused slowly through the catheter. Patients were followed up with endoscopy and enhanced CT at 1 week, 1,
3, and 6 months after the procedure and every 6 months thereafter.
Results: The gastric varices completely disappeared in 12 of 14 patients and was partially resolved in the remaining 2 patients. Neither
a recurrence nor an aggravation of gastric varices were found. No major complications were experienced.
Conclusion: BORTO is a safe and effective treatment for gastric varices.
Received: 0/00/00/Accepted: 0/00/00 相似文献
6.
Baran Önal Erhan T. Ilgit Cem Yücel Erdal Özbek Murat Vural Sergin Akpek 《Cardiovascular and interventional radiology》1998,21(5):386-392
Purpose: To evaluate the efficacy of primary stenting for complex atherosclerotic plaques in aortic and iliac stenoses that are not
amenable to balloon angioplasty alone.
Methods: Nineteen patients with complex atherosclerotic plaques were treated with a Palmaz stent (n= 19), Wallstent (n= 1), Strecker stent (n= 1), or Memotherm stent (n= 1). A total of 22 stenoses presenting with complex plaque morphology including ulcerated plaques, ulcerated plaques with
focal aneurysms, plaques with heavy calcification, severely eccentric plaques, plaques with overhanging edge, and plaques
with spontaneous dissection were stented. The lesions were in the aorta (n= 1), common iliac artery (n= 19), or external iliac artery (n= 2).
Results: Immediate angiography after stent placement revealed restoration of patency of the stented segment. Focal aneurysms and ulcerated
areas were occluded in the follow-up angiographies obtained 4–12 weeks after the procedure. In one case with poor distal runoff
and multiple complex lesions of the iliac artery, subacute occlusion occurred. Clinical and angiographic follow-up (3–46 months)
revealed patency of all other stented segments.
Conclusion: Primary stenting is an effective and reliable approach for complex plaques in stenoses. Patency of the arterial segment with
a smooth lumen can be created without the risk of acute complications such as distal embolization, dissection, or occlusion. 相似文献
7.
Klaus A. Hausegger Kurt Tiessenhausen Martin Klimpfinger Johann Raith Hubert Hauser Josef Tauss 《Cardiovascular and interventional radiology》1998,21(4):334-337
Three patients with dialysis access graft shunts, having a symptomatic pseudoaneurysm and a hemodynamically significant stenosis
at the anastomosis between the graft shunt and the subclavian vein, were treated with percutaneous transluminal angioplasty
and insertion of a Wallstent. Pseudoaneurysms were excluded by percutaneous insertion of a Cragg Endo-Pro stent-graft with
a diameter of 6 mm and a length of 6–10 cm. All three aneurysms were excluded successfully. In two patients, the stent-graft
was punctured repeatedly during follow-up and the aneurysms recurred after 7 and 8 months, respectively. The patency of the
dialysis shunt after stent-graft insertion was 8 (n= 1) and 9 months (n= 2). Due to the recurrence of the aneurysm (n= 2) or recurrent thrombosis (n= 1) the use of these shunts was discontinued. 相似文献
8.
Jae-Kyu Kim Yun-Hyeon Kim Sang-Yeung Chung Heoung-Keun Kang 《Cardiovascular and interventional radiology》1999,22(4):278-281
Purpose: To report the clinical results for recanalizations of an occluded iliac artery by a self-expanding spiral stent.
Methods: We attempted to recanalize 36 iliac artery occlusions in 34 patients [33 men, 1 woman, aged 51–75 years (average 61.6 years)].
The average lesion length was 6.92 cm (range 1–14 cm). The patients' chief complaints were intermittent claudication and resting
pain. Fontaine classification was assigned before and after the procedure. Technical and clinical success were also analyzed.
Results: Forty-five stents were successfully deployed in 34 patients. All 36 lesions (13 in the external iliac artery, 12 in the common
iliac artery, and 11 in both) were patently recanalized on angiography. The follow-up period ranged from 6 months to 36 months
(mean 11.9 months). Fourteen stents (39%) with incomplete expansion were dilated with a balloon catheter. Good technical (100%)
and clinical (94%) results were obtained. The only complication was one hematoma at the puncture site. Reocclusions were noted
in two lesions (5%) at 1 week and 15 months, respectively.
Conclusion: A self-expanding spiral stent is a safe and effective device for recanalization of an iliac artery occlusion as the primary
stent without any previous intervention. 相似文献
9.
Venous recanalization by metallic stents after failure of balloon angioplasty or surgery: Four-year experience 总被引:2,自引:0,他引:2
Gwen K. Nazarian M.D. William R. Austin Scott A. Wegryn Haraldur Bjarnason Daniel J. Stackhouse Wilfrido R. Castañeda-Zúñiga David W. Hunter 《Cardiovascular and interventional radiology》1996,19(4):227-233
Purpose: This retrospective study describes our updated experience in treating venous stenoses and occlusions with metallic endovascular
stents.
Methods: Gianturco, Palmaz, and Wallstent stents were placed in 55 patients over a 4-year period. Stent sites included the subclavian
veins (9), innominate veins (3), superior vena cava (4), inferior vena cava (3), iliac veins (29), femoral veins (5), and
portal veins (6). The most common indications for stent placement were malignant stenoses and chronic pelvic venous occlusions.
Venoplasty and/or urokinase were used as ancillary therapy. Patients were anticoagulated for 3–6 months. Follow-up included
clinical assessment and duplex ultrasound.
Results: Lifetable analysis shows 59%, 63%, and 72% primary, primary assisted, and secondary 1-year patency rates, respectively. The
4-year primary patency rates were the same. Duration of patency depended on the venous site. Death was a complication of stent
placement in 2 patients and 12 patients died within 6 months after stent placement from primary disease progression. Although
early failures were more common in stents placed across occlusions than stenoses, 1-year secondary patency rates were comparable.
Primary patency rates were only slightly lower in patients with malignant obstruction than in patients with benign disease.
Conclusion: Endovascular stent placement provides a nonsurgical alternative for reestablishment of venous flow and symptomatic relief
in patients with benign as well as malignant venous obstruction.
Received: 0/00/00/Accepted: 0/00/00 相似文献
10.
Jean-Paul Beregi Alain Prat Serge Willoteaux Marc-Antoine Vasseur Valérie Boularand Frédéric Desmoucelle 《Cardiovascular and interventional radiology》1999,22(1):13-19
Purpose: To evaluate initial and midterm results of percutaneous treatment of peripheral aneurysms using covered stents.
Methods: Between June 1994 and December 1997 we used covered stents (EndoPro System or Passager) on 19 patients with peripheral aneurysms
(7 iliac, 5 subclavian, 3 femoral, 3 popliteal, 1 carotid).
Results: Successful aneurysm exclusion was achieved in 18 of 19 patients (95%). In the short term (<30 days), one patient died of
puncture site hemorrhage complicated by myocardial infarction; two femoral stents were surgically removed because of leakage.
At subsequent follow-up (mean 20 months) two further unrelated deaths occurred. At 1 year (intention-to-treat) the stent was
patent in 13 of 19 patients (68%) and the aneurysm was excluded in 17 of 19 (89%).
Conclusion: Treatment of peripheral aneurysms with covered stents has a high rate of immediate procedural success. Continued exclusion
of the aneurysms is achieved in a large proportion of patients but there is a relatively high rate of stent thrombosis. 相似文献
11.
Manfred Cejna Siegfried Thurnher Johann Pidlich Klaus Kaserer Maria Schoder Johannes Lammer 《Cardiovascular and interventional radiology》1999,22(4):305-310
Purpose: To investigate whether placement of a polyester-covered stent-graft increases the primary patency of transjugular intrahepatic
portosystemic stent shunts (TIPSS).
Methods: Between 1995 and 1997 Cragg Endopro or Passager MIBS stent-grafts were used for the creation of TIPSS in eight male patients,
35–59 years of age (mean 48 years). All patients suffered from recurrent variceal bleeding and/or refractory ascites due to
liver cirrhosis. Seven stent-grafts were dilated to a diameter of 10 mm, one to 12 mm. Follow-up was performed with duplex
ultrasound, clinical assessment, and angiography.
Results: The technical success rate for creation of a TIPSS was 100%. The mean portosystemic pressure gradient decreased from 25 mmHg
to 12 mmHg. In seven of eight patients TIPSS dysfunction occurred between 2 days and 3 years after stent-graft placement.
In one patient the TIPSS is still primarily patent (224 days after creation). The secondary patency rates are 31 days to 3
years.
Conclusion: The primary use of polyester-covered stent-grafts for TIPSS did not increase primary patency rates in our small series. 相似文献
12.
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
13.
Therapeutic Consequences of Variation in Intraarterial Pressure Measurements After Iliac Angioplasty
Eric Tetteroo Cees Haaring Andries D. van Engelen Yolanda van der Graaf Willem P.T.M. Mali 《Cardiovascular and interventional radiology》1997,20(6):426-430
Purpose: To assess the accuracy of intraarterial measurement of transstenotic pressure gradients for the detection of hemodynamically
suboptimal iliac angioplasty.
Methods: In 14 patients, referred for diagnostic angiography, mean pressure gradients in the aorta and iliac artery were obtained
twice, using a double-sensor pressure catheter. Additional iliac measurements were performed during pharmacologically induced
flow augmentation. Repeatability was assessed by calculation of the mean difference plus standard deviation (MD ± SD) and
repeatability coefficient (2 × SD). These results were extrapolated to 137 iliac angioplasty procedures with secondary stenting
where there was a residual pressure gradient > 10 mmHg.
Results: MD ± SD for repeated measurements at rest and during flow augmentation were 0 ± 2 mmHg and 1 ± 3 mmHg, respectively. Repeatability
coefficients were 3 and 6 mmHg. Mean pressure gradients after hemodynamically insufficient angioplasty were 8 ± 7 mmHg at
rest and 17 ± 5 mmHg following vasodilatation. Inaccurate pressure recordings may have led to inappropriate stent placement
in less than 2.5%, and inappropriate denial of stent placement in less than 5% of the lesions.
Conclusion: Variability of intraarterial pressure measurements has little consequence in the detection of hemodynamically significant
stenosis after angioplasty.
Received: 0/00/00/Accepted: 0/00/00 相似文献
14.
Sanada J Matsui O Arakawa F Tawara M Endo T Ito H Ushijima S Endo M Ikeda M Miyazu K 《Cardiovascular and interventional radiology》2005,28(1):83-86
We report two cases of acutely infected pseudoaneurysms of the iliac arteries, successfully treated with endovascular stent-grafting. Two patients underwent stent-graft treatment for erosive rupture of the iliac artery caused by surrounding infection. The first case is that of a 61-year-old man who had undergone Miles operation for an advanced rectal cancer. Postoperatively, he developed intrapelvic abscess formation, from which methicillin-resistant Staphylococcus aureus was cultured, followed by rupture of the right external iliac artery. The second case is that of a 60-year-old man who had a pseudoaneurysm of the left common iliac artery, which was contiguous with a left psoas muscle abscess, from which Streptococcus agalactiae was cultured. Both patients were successfully treated with only a stent-graft and antibiotic therapy, and remained symptom-free 12 months and 10 months later. Although endovascular stent-grafting should not be considered standard therapy for infected aneurysms, our cases suggest that it can result in repair of infected aneurysms even in the uncontrolled active stage. 相似文献
15.
Endovascular treatment of proximal arsastomotic aneurysms after aortic prosthetic reconstruction 总被引:2,自引:0,他引:2
Tiesenhausen K Hausegger KA Tauss J Amann W Koch G 《Cardiovascular and interventional radiology》2001,24(1):49-52
Purpose: To describe the efficacy and value of endovascular stent-grafts for the treatment of aortic anastomotic pseudoaneurysms.
Methods: Three patients with proximal aortic anastomotic pseudoaneurysms 8–15 years after prosthetic reconstruction were treated by
transfemoral stent-graft implantation. In two patients the pseudoaneurysms were excluded by Talent prostheses [tube graft
(n = 1), bifurcated graft (n = 1)]. In one patient an uniiliac Zenith stent-graft was implanted and an extra-anatomic crossover bypass for revascularization
of the contralateral lower extremity was performed.
Results: All procedures were successful with primary exclusion of the pseudoaneurysms. During the follow-up (mean 16 months) one endoleak
occurred due to migration of the tube stent-graft. The endoleak was sealed successfully by implanting an additional bifurcated
stent-graft.
Conclusion: Stent-graft exclusion of aortic pseudoaneurysms offers a minimally invasive and safe alternative to open surgical reconstruction. 相似文献
16.
Clinical Experience with Covered Wallstents for Biliary Malignancies: 23-Month Follow-Up 总被引:4,自引:4,他引:0
Plinio Rossi Mario Bezzi Filippo M. Salvatori Claudio Panzetti Michele Rossi Gianluca Pavia 《Cardiovascular and interventional radiology》1997,20(6):441-447
Purpose: To evaluate the effectiveness of partially covered metallic Wallstents to prevent tumoral ingrowth in patients with neoplastic
obstruction of the biliary tract.
Methods: Twenty-one patients with malignant obstructive jaundice have been treated with Wallstents partially covered with a polyurethane
polymer. In total, 36 covered stents (8 and 10 mm in diameter, 70 and 90 mm long) were deployed. All the stents were free
from covering at both ends.
Results: Jaundice was successfully treated in 100% of cases. There were no problems related to the releasing system during stent positioning,
no major complications, and no incompatibility reactions to the materials composing the endoprostheses. At 23-month follow-up,
6 patients are still alive and 15 are dead; of these 15 patients, 11 died in the first 6 months and the last 4 died between
6 and 23 months. Seven patients had an obstructed stent; in four of these, cholangioscopy showed the presence of tumoral ingrowth
and in one it showed necrotic tissue with biliary pigments and inflammatory cells. No biopsy specimen was obtained in the
remaining two patients with stent obstruction. The follow-up, ranging from 7 to 23 months, showed a primary patency of 46.8%
and 24.6% and an assisted patency of 66.3% and 59% at 6 months and 23 months, respectively.
Conclusions: Covered metallic stents are effective and may produce improved survival in patients with malignant biliary obstruction (27.8%
at 23 months). Stent patency, however, is similar to that of uncovered stents. Modifications in the design of the covering
membrane may reduce stent obstruction resulting from disruption of the plastic covering.
Received: 0/00/00/Accepted: 0/00/00 相似文献
17.
Treatment of Acute Aortic Type B Dissection with Stent-Grafts 总被引:3,自引:0,他引:3
Hausegger KA Tiesenhausen K Schedlbauer P Oberwalder P Tauss J Rigler B 《Cardiovascular and interventional radiology》2001,24(5):306-312
Purpose: To evaluate the feasibility of endoluminal stent-grafts in the treatment of acute type B aortic dissections.
Methods: In five patients with acute aortic type B dissections, sealing of the primary intimal tear with an endoluminal stent-graft
was attempted. Indication for treatment was aneurysm formation in two patients and persistent pain in three patients. One
of the latter also had an unstable dissection flap compromising the ostium of the superior mesenteric artery. The distance
from the intimal tear to the left subclavian artery was <0.5 cm in four patients, who had typical type B dissections. In one
patient with an atypical dissection the distance from the primary tear to the left subclavian artery was 4 cm. This patient
had no re-entry tear. Talent tube grafts (World Medical Manufacturing Cooperation, Sunrise, FL, USA) were used in all patients.
Results: Stent-graft insertion with sealing of the primary tear was successful in all patients. The proximal covered portion of the
stent-graft was placed across the left subclavian artery in four patients (1× transposition of the left subclavian artery).
Left arm perfusion was preserved via a subclavian steal phenomenon in the patients in whom the stent-graft covered the orifice
of the left subclavian artery. The only procedural complication we observed was an asymptomatic segmental renal infarction
in one patient. In the thoracic aorta thrombosis of the false aortic lumen occurred in all patients. In one patient the false
lumen of the abdominal aorta thrombosed after 4 weeks; in the other three patients the status of the abdominal aorta remained
unchanged compared with the situation prior to stent-graft insertion. As a late complication formation of a secondary aneurysm
of the thoracic aorta was observed at the distal end of the stent-graft 3 months after the primary intervention. This aneurysm
was treated by coaxial insertion of an additional stent-graft without complications.
Conclusion: Endoluminal treatment of acute type B aortic dissections seems to be an attractive alternative treatment to surgical repair.
Thrombosis of the false lumen of the thoracic aorta can be induced if the primary tear is sealed with a stent-graft. This
could protect the dissected thoracic aorta from delayed rupture. 相似文献
18.
Preoperative Embolization of Cervical Spine Tumors 总被引:2,自引:0,他引:2
Sylvia C. Vetter Ernst-Peter Strecker Ludwig W. Ackermann Jürgen Harms 《Cardiovascular and interventional radiology》1997,20(5):343-347
Purpose: To assess the technical success rate, complications, and effect on intraoperative blood loss of preoperative transarterial
embolization of cervical spine tumors.
Methods: A retrospective analysis was performed on 38 patients with tumors of the cervical spine; 69 vertebrae were affected. Polyvinyl
alcohol particles, coils, gelfoam particles, either alone or in combination, were used for preoperative tumor embolization.
After embolization a total of 57 corporectomies with titanium basket implantation were performed.
Results: In 36 of 38 patients, complete (n= 27) or partial (n= 9) embolization was achieved. In 23 patients one vertebral artery was completely occluded by coil placement, and in one
patient the ipsilateral internal and external carotid arteries were occluded in addition. No neurological complications could
be directly related to the embolization, but two postoperative brain stem infarctions occurred. The mean intraoperative blood
loss was 2.4 L.
Conclusion: Transarterial embolization of cervical spine tumors is a safe and effective procedure to facilitate extensive surgery.
Received: 0/00/00/Accepted: 0/00/00 相似文献
19.
Endovascular Therapeutic Options for Isolated Iliac Aneurysms with a Working Classification 总被引:7,自引:5,他引:2
Fahrni M Lachat MM Wildermuth S Pfammatter T 《Cardiovascular and interventional radiology》2003,26(5):443-447
The purpose of this paper is to demonstrate a variety of stent-grafting and embolization techniques and describe a new classification for endovascular treatment of isolated iliac artery aneurysms. A total of 19 patients were treated for isolated iliac aneurysms. Depending on the proximal iliac neck and the uni-/bilaterality of common iliac artery aneurysms (CIAAs) the patient may be treated by a tube (Type Ia) or a bifurcated stent-graft (Type Ib) in addition to internal iliac artery embolization. Neck anatomy is also critical in determining therapeutical options for internal iliac artery aneurysms (IIAAs). These are tube stent-grafting plus internal iliac branch embolization (Type IIa), coiling of afferent and efferent internal iliac vessels (Type IIb) and IIAA packing (Type IIc). The average length of stay for these procedures was 3.8 days. During the mean follow-up of 20.9 months, aneurysm size remained unchanged in all but 4 patients. Reinterventions were necessary in option Type Ib (3/8 pat.) and Type Ia (1/7 pat.) due to extender stent-graft migration (n = 2) or reperfusion leaks (n = 2). We conclude that Iliac artery aneurysms may be successfully and safely treated by a tailored approach using embolization or a combination of embolization and stent-grafting. Long-term CT imaging follow-up is necessary, particularly in patients treated with bifurcated stent-grafts (Type Ib). 相似文献
20.
Adam A. Hatjidakis Spyros Karampekios Panos Prassopoulos Evaghelos Xynos Maria Raissaki Sophocles I. Vasilakis Nicholas C. Gourtsoyiannis 《Cardiovascular and interventional radiology》1998,21(1):36-40
Purpose: To assess the shortest time for catheter removal with regard to the transhepatic or transperitoneal approach in patients
undergoing percutaneous cholecystostomy (PC).
Methods: In this prospective study, 40 consecutive high-risk patients with acute cholecystitis (calculous, n= 22; acalculous, n= 18) underwent PC by means of a transhepatic (n= 20) or transperitoneal (n= 20) access route. In 28 patients (70%) computed tomography was used for puncture guidance, while in the remaining 12 (30%)
the procedures were performed under ultrasound control. A fistulography was performed on the 14th postprocedural day in all
patients and was repeated weekly if the tract was found to be immature. The catheter was removed only if a mature tract without
evidence of leakage was delineated.
Results: In 36 of 40 patients the procedure was technically successful (90%). Three of the unsuccessful punctures were attempted transperitoneally
and one transhepatically. Thirty-five of 36 patients showed rapid improvement within the first 48 hr following the procedure
(96%). Three of them died of their severe underlying disease (7.5%) and in another three the catheter was accidentally removed
prior to the first fistulography (7.5%). A total of 30 patients could be fully evaluated after the procedure: 15 with a transhepatic,
and 15 with a transperitoneal PC. Whereas 14 of 15 patients (93%) with transhepatic gallbladder access developed a mature
tract after 14 days and the remaining patient after 3 weeks, only 2 of 15 patients (13%) with a transperitoneal route presented
a mature tract after 2 weeks (p < 0.0001; χ2 test with Yates' correction). Eleven patients (73%) with transperitoneal access required 3 weeks and two patients (13%) 4
weeks for complete tract formation.
Conclusion: A period of 2 weeks suffices for the majority of patients to develop a mature tract when the transhepatic access route is
used; when using the trans- peritoneal route at least 3 weeks are required. We suggest that the transhepatic route is preferable
since it allows earlier removal of the catheter and reduces the incidence of complications and discomfort for the patients.
Received: 0/00/00/Accepted: 0/00/00 相似文献