麝香保心丸治疗冠心病支架植入术后110例临床疗效观察

目的探讨麝香保心丸在治疗冠心病支架植入术后的临床疗效。方法选择冠心病支架植入术后到我科门诊就诊或住院的患者110例,随机分为治疗组55例和对照组55例,在常规药物治疗的基础上加用麝香保心丸,6和12个月分别进行对比观察。结果治疗组在6、12个月的总有效率高于对照组。结论冠心病支架植入术后患者,在常规药物治疗的基础上加用麝香保心丸,可以改善患者的症状及预后,减少心绞痛发作次数。     

替罗非班治疗支架辅助弹簧圈栓塞动脉瘤术中急性血栓形成

目的探讨动脉内灌注盐酸替罗非班在处理支架辅助弹簧圈栓塞颅内动脉瘤时术中急性血栓的有效性及安全性。方法收集2013年1月至2017年6月11例行颅内动脉瘤栓塞术中发生血栓患者,发生血栓后,均于微导管内靶向灌注盐酸替罗非班6ml,同时静脉泵注5ml/h,然后每5~10分钟造影观察血管溶通情况,直至血栓消失或血管开通。术后进行CT或MRI随访,观察有无脑梗塞或脑出血。结果 11例术中造影血管均完全再通,术后第1天、第7天及术后1月行头颅CT或MRI检查,均未发现与手术相关脑梗塞和脑出血的发生。结论支架辅助弹簧圈栓塞颅内动脉瘤时,术中出现急性血栓并发症时,经动脉靶向灌注盐酸替罗非班是一种安全、有效的方法。     

Finite element analysis and fatigue of stents

Understanding the behaviour of implantable medical devices is of obvious importance. The potential for failure of a medical device can often be associated with issues related to cyclic loading of the device, and material fatigue. Detailed finite element simulations to evaluate the fatigue of stents allow the engineer to assess potential failures. The engineer can then use the analysis results to modify the design and prevent failure, without making and testing numerous physical devices. Complete understanding of the mechanical behaviour of a stent provided by finite element analysis has the benefits of facilitating effective design, helping to reduce time to market and minimising the potential for unwanted failures.     

Dissected Aorta Repair Through Stent Implantation trial: Canadian results

Objectives

We describe the Canadian results of the Ascyrus Medical Dissection Stent (AMDS), a novel partially uncovered aortic arch hybrid graft implanted antegrade during hypothermic circulatory arrest to promote true lumen expansion and enhance aortic remodeling.

移植肾动脉狭窄的介入治疗

目的研究移植肾动脉狭窄(TRAS)的临床特点及介入治疗的疗效。方法回顾性分析TRAS患者的临床资料,排除临床资料不完整者,分析总结其临床特点、诊断方法及介入治疗的疗效。结果共搜集病例31例,行介入手术35次。6例行单纯球囊扩张(PTA),24例行支架置入,1例手术失败。术后肾动脉狭窄程度、肾功能及血压明显改善,围手术期未发生严重并发症;平均随访29.6个月,PTA术后2例(33.3%)复发狭窄,行支架置入术无复发;支架术后3例(12.5%)再发狭窄,2例成功行PTA术后无复发。结论肾移植术后密切超声随访有利于早期诊断TRAS,介入治疗TRAS安全、有效且应被视为一线治疗方法。     

I125 irradiation stent for treatment of hepatocellular carcinoma with portal vein thrombosis: A meta-analysis

PurposeA meta-analysis aimed to systematically evaluate the safety and efficiency of I¹²⁵ irradiation stent placement for patients with hepatocellular carcinoma (HCC) combined with portal vein tumor thrombosis (PVTT).Materials and methodsThe Cochrane library, PubMed/Medline, EMBASE, CNKI, Wanfang Data and CQVIP were systematically screened out from the earliest to December 2019. The qualities of all included studies were assessed. The primary endpoints were the 6-month, 12-month stent cumulative patency rate and 6-month, 12-month, 24-month overall survival rate while the secondary endpoints were the objective response rate of PVTT, main portal venous pressure changes and treatment-related adverse events. Our meta-analysis was conducted using Stata 12.0 software.ResultsTotally seven studies with 1018 patients were included in the final analysis, in which 602 patients received TACE and I¹²⁵ irradiation stent placement, and 416 patients in control group underwent TACE and stent placement without endovascular brachytherapy (EVBT). Meta-analysis showed that the I¹²⁵ irradiation stent improved the cumulative stent patency rates in 6 months [OR = 1.65, 95% CI (1.32–2.05), P < 0.001] and 12 months [OR = 2.55, 95% CI (1.90–3.42), P < 0.001] and the survival rates in 6 months [OR = 1.77, 95% CI (1.41–2.22), P < 0.001], 12 months [OR = 3.14, 95% CI (2.24–4.40), P < 0.001] and 24 months [OR = 7.39, 95% CI (3.55–15.41), P < 0.001]. However, there was no difference in the objective response rate of PVTT [OR = 1.13, 95% CI (0.87–1.48), P = 0.365], main portal venous pressure and the occurrence adverse event [OR = 0.88, CI = 0.72–1.08, P = 0.212] between two groups.ConclusionI¹²⁵ irradiation stent seems to be more effective in treating hepatocellular carcinoma with portal vein tumor thrombosis. The usage of portal vein stent combined endovascular brachytherapy has the potential to act as an alternative therapy for HCC with PVTT. On account of the limitation of studies included, more studies with high-level evidence, such as RCTs, are requisite to support the above promising results.