Endovenous ablation of truncal veins

The latest techniques for endovenous occlusion using RF ablation catheters or endoluminal laser targeting water are our preferred methods to treat saphenous related varicose veins. Our clinical experience with endovenous techniques in more than 1000 patients shows a high degree of success with minimal side effects, most of which can be prevented or minimized with use of tumescent anesthesia. Tumescent anesthesia is critical to the safety of endovenous techniques. Within the next 5 years, these minimally invasive endovenous ablative procedures involving saphenous trunks should have virtually replaced open surgical strippings. More than 100,000 patients already have been treated worldwide.     

黄金微针射频与超脉冲CO2点阵激光治疗面部痤疮所致的不同类型凹陷性瘢痕的疗效比较

 目的 比较黄金微针射频与超脉冲CO₂点阵激光治疗不同类型面部凹陷性痤疮瘢痕的临床疗效及安全性。方法 选取我院门诊2019年8月—2021年8月诊治的80例凹陷性痤疮瘢痕患者为研究对象,采用随机数字表法分为治疗组和对照组,每组各40例。治疗组采用黄金微针射频治疗;对照组采用超脉冲CO₂ 点阵激光治疗。比较两组疗效,并按临床亚型（V型、U型和M型）对患者进行分类和评价。结果 两组患者治疗后痤疮瘢痕临床评分量表（ECCA）权重评分均降低,但差异无统计学意义（t=0.46, P=0.644）。 两组患者总体有效率比较差异无统计学意义（X²=1.89,P=0.176）。两组瘢痕亚型比较,治疗组M型瘢痕疗效较好（t=2.34, P＜0.05）,对照组V型瘢痕疗效较好（t=-2.36, P＜0.05）,而两组U型瘢痕疗效无明显差异（t=0.24, P＞0.05）。治疗组患者术中疼痛程度、术后红肿期程度评分均低于对照组,痂皮脱落愈合时间短于对照组,差异均有统计学意义(均P＜0.05)。结论 黄金微针射频与CO₂点阵激光均能有效地改善面部凹陷性痤疮瘢痕,其中前者对M型瘢痕疗效显著,后者对V型瘢痕疗效显著。提示临床工作中可对痤疮瘢痕进行亚型分析,进而选择性治疗,必要时可联合治疗,起到协同作用。     

Safety and efficacy analysis of one‐stop intervention for treating nonvalvular atrial fibrillation

1 Background

Nonvalvular atrial fibrillation (AF) is a common arrhythmia. The treatment strategy for AF mainly includes controlling symptoms and decreasing the rate of complications. Our study aimed to evaluate the safety and efficacy of combination treatment of catheter ablation and left atrial appendage (LAA) closure (one‐stop intervention) in patients with nonvalvular AF.

2 Methods and results

Thirty‐four patients with symptomatic AF (mean CHA₂DS₂‐VASc score 4.1 ± 1.3, mean HAS‐BLED score 3.8 ± 1.2) were included. Patients first received radiofrequency‐based left atrial ablation, and then the Watchman device (Boston Scientific, Natick, MA, USA) or AMPLATZER Cardiac Plug (ACP) (St. Jude Medical, Inc., St. Paul, MN, USA) was implanted for LAA closure. Follow‐up was performed at 45 days and 3 months after LAA closure to assess for recurrence of AF and prevent stroke. Radiofrequency ablation and LAA closure were successful in 100% of patients without evidence of residual flow at the final transesophageal echocardiography evaluation. A Watchman device was implanted in 29 (85.3%) patients, and an ACP was implanted in five (14.7%) patients. No device‐related thrombus formation or embolization was identified at the 45‐day or 3‐month follow‐up. Serious complications, including death, transient ischemic attack, ischemic or hemorrhagic stroke, or major bleeding, were also not identified during the follow‐ups.

3 Conclusion

For symptomatic patients with nonvalvular AF and a high risk of stroke, the one‐stop intervention is feasible, safe, and efficacious.     

Resolution of protein‐losing enteropathy after radiofrequency perforation and subsequent stent implantation for relief of complete occlusion of a redirected left superior vena cava

The application of radiofrequency (RF) technologies in the treatment of congenital heart defects has provided a safe and effective alternative to conventional therapies in the restoration of vascular patency for a variety of arterial and venous occlusions. This report concerns an 8‐year old girl that developed protein‐losing enteropathy and elevated central venous pressure after occlusion of a surgically redirected anomalous draining left superior vena cava (SVC). Cardiac catheterization revealed complete obstruction of the anastomosis of the SVC into the coronary sinus. Transcatheter recanalization by RF perforation and subsequent stent implantation led to the restoration of upper venous blood flow and the resolution of her symptoms. © 2006 Wiley‐Liss, Inc.     

Molecular surface tailoring of biomaterials via pulsed RF plasma discharges

A pulsed RF plasma glow discharge is employed to demonstrate molecular level controllability of surface film deposits. Molecular composition of plasma deposited films is shown to vary in a significant manner with the RF duty cycle. Three fluorocarbon monomers are used to illustrate the process. All three exhibit a trend towards increased surface CF₂ content with decreasing pulsed RF duty cycle, including exclusion of oxygen. Significant variations in carbon-fluorine surface functionalities are obtained over a controllable range of film thickness. Film growth rate measurements reveal the occurrence of surface reactions during significant portions of the off portion of the duty cycle. Albumin adsorption on fluorocarbon-treated PET films is unchanged from PET controls for a 100-fold range of bulk concentrations and 60-fold range of adsorption times. However, increased retention of albumin is observed following incubation with protein-denaturing sodium dodecyl sulfate solution, the retention decreasing with increasing bulk concentration of albumin. The increased retention of albumin suggests the treated surfaces may have promise as biocompatible materials.     

新型射频治疗女性性功能障碍的疗效分析

目的研究新型射频治疗对女性性功能障碍的治疗效果。方法回顾性分析在湖南省妇幼保健院2020年7月至2021年2月期间门诊就诊的性功能障碍女性患者35例行新型射频治疗前后的临床资料。患者平均年龄(36.0±6.7)岁,均为经产妇。性生活满意度问卷(SSQ)评价中非常不满意13例,差19例,中等3例,对患者予以新型射频治疗(每次25分钟,每14天治疗一次,5次为一个疗程),1个疗程后对患者进行随访,采用女性性功能指数评估(FSFI),阴道松弛度问卷(VLQ),外阴阴道松弛度问卷(VVLQ)及盆底肌肌力等级评价治疗疗效。结果患者治疗后FSFI评分由(12.4±2.6)分上升至(23.4±2.9)分,治疗前后差异具有统计学意义(P<0.05),74.3%患者盆底肌恢复至III级以上。结论新型射频在治疗女性患者性功能障碍方面,具有显著的临床疗效,具有推广价值。     

Ablation of frequent premature ventricular complex in an athlete

Premature ventricular complex are common findings in the exam of many athletes. There is no extensive scientific evidence in the management of this situation particularly when associated with borderline contractile function of the left ventricle. In this case report, we present a 35‐year‐old asymptomatic healthy athlete with high incidence (over 10 000 beats in 24 h) of premature ventricular complex and left ventricular dilatation with dysfunction, which persisted after a resting period of 6 months without training. We performed radiofrequency ablation of the premature ventricular complex focus. After 1‐year follow‐up, he was asymptomatic without arrhythmia and the left ventricle normalized its size and function as shown by echocardiogram and cardiac magnetic resonance.