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Ding P, Ma Y, Zhu X, Wu Y, Ong J, Liu P, Xiao J, Zhuge Y. Safety and Effectiveness of a Novel Tips Access Set with Steerable Cannula in a Swine Model. Cardiovasc Intervent Radiol 2023; 46:1394-1400. [PMID: 37723354 PMCID: PMC10547805 DOI: 10.1007/s00270-023-03544-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/18/2023] [Indexed: 09/20/2023]
Abstract
PURPOSE This study aimed to assess the safety, effectiveness, and feasibility of the Liverty™ transjugular intrahepatic portosystemic shunt (TIPS) access set, which has an ergonomic handle that allows for in situ cannula tip deflection and a distal steerable cannula angle, versus the COOK® Rosch-Uchida Transjugular Liver Access Set (RUPS-100) in healthy pigs. METHODS Twelve pigs randomly underwent TIPS with the Liverty™ set or the RUPS-100 set. Three interventionalists performed 4 TIPS procedures, 2 with each set. The primary outcome was procedural success, defined as successful establishment of the intrahepatic portosystemic shunt and stent placement. RESULTS The shunt was successfully established in 11 pigs. The procedural success was achieved in all 6 pigs in the Liverty™ group and 5 out of 6 pigs for the RUPS-100 group (Fisher exact test, P > 0.999). The mean duration of puncture was shorter in the Liverty™ group versus the RUPS-100 group (12.3 ± 4.5 min vs. 16.2 ± 8.5 min), but without significant statistical difference (two sample t test, P = 0.359). The cannula angle was adjusted 69% of passes in the Liverty™ group, which was significantly higher than that in the RUPS-100 group (12%, P = 0.004). Overall, the TIPS procedural performance was comparable between the groups. Both sets were safe. No intraabdominal hemorrhage, vascular injuries, tissue or organ injuries, porto-biliary fistula, biliary peritonitis, and infection or abscess occurred in either group. CONCLUSION The Liverty™ set is safe and has similar procedural metrics to the COOK® RUPS-100 set. It allows in situ adjustment of the angle of the stiffening cannula without increasing procedure time and lessens the occurrences of periprocedural complications.
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Affiliation(s)
- PengXu Ding
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yujia Ma
- Department of Radiology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Xiaoxia Zhu
- Medical Affairs, Becton, Dickinson and Company, Shanghai, China
| | - Yijie Wu
- Medical Affairs, Becton, Dickinson and Company, Shanghai, China
| | - John Ong
- Research & Development, Becton, Dickinson and Company, Shanghai, China
| | - Pu Liu
- Animal Lab, Shanghai Harborside Medical Technology Co.,Ltd, Shanghai, China
| | - Jiangqiang Xiao
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Gulou District, Nanjing, 210008, China.
| | - Yuzheng Zhuge
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Road, Gulou District, Nanjing, 210008, China.
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Ding PX, Liu C, Han XW, Lee EW. Congenital intrahepatic portosystemic shunt with invasive hepatocellular carcinoma. Dig Liver Dis 2022; 54:558-559. [PMID: 33408058 DOI: 10.1016/j.dld.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Peng-Xu Ding
- Department of Intervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
| | - Chao Liu
- Department of Intervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xin-Wei Han
- Department of Intervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Edward Wolfgang Lee
- Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Division of Liver and Pancreas Transplant Surgery, Department of Surgery, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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Abstract
OBJECTIVES To evaluate the safety of irreversible electroporation (IRE) on swine pancreatic tissue including its effects on peripancreatic vessels, bile ducts, and bowel. METHODS Eighteen Yorkshire pigs underwent IRE ablation of the pancreas successfully and without clinical complications. Contrast-enhanced computed tomography angiography and laboratory studies before the IRE ablation with follow-up computed tomography angiography, laboratory testing, and pathological examination up to 4 weeks postablation were performed. RESULTS In a subset of cases, anatomic peripancreatic vessel narrowing was seen by 1 week postablation, persisting at 4 weeks postablation, without apparent functional impairment of blood flow. Laboratory studies revealed elevated amylase and lipase at 24 hours post-IRE, suggestive of acute pancreatitis, which normalized by 4 weeks post-IRE. There was extensive pancreatic tissue damage 24 hours after IRE with infiltration of immune cells, which was gradually replaced by fibrotic tissue. Ductal regeneration without loss of pancreatic acinar tissue and glandular function was observed at 1 and 4 weeks postablation. CONCLUSIONS In our study, we demonstrated and confirmed the safety and minimal complications of IRE ablation in the pancreas and its surrounding vital structures. These results show the potential of IRE as an alternative treatment modality in patients with pancreatic cancer, especially those with locally advanced disease.
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Affiliation(s)
| | - Puja Shahrouki
- From the Division of Interventional Radiology, Department of Radiology, UCLA Medical Center
| | - Stephanie Peterson
- From the Division of Interventional Radiology, Department of Radiology, UCLA Medical Center
| | - Bashir A Tafti
- From the Division of Interventional Radiology, Department of Radiology, UCLA Medical Center
| | - Peng-Xu Ding
- From the Division of Interventional Radiology, Department of Radiology, UCLA Medical Center
| | - Stephen T Kee
- From the Division of Interventional Radiology, Department of Radiology, UCLA Medical Center
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Abstract
Online supplemental material is available for this article.
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Affiliation(s)
- Peng-Xu Ding
- From the Department of Intervention, First Affiliated Hospital of Zhengzhou University, No. 1, East Jian She Rd, Zhengzhou 450052 China (P.X.D.); and Division of Interventional Radiology, Department of Radiology, and Division of Liver and Pancreas Transplant Surgery, Department of Surgery, UCLA Medical Center, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, Calif (E.W.L.)
| | - Edward Wolfgang Lee
- From the Department of Intervention, First Affiliated Hospital of Zhengzhou University, No. 1, East Jian She Rd, Zhengzhou 450052 China (P.X.D.); and Division of Interventional Radiology, Department of Radiology, and Division of Liver and Pancreas Transplant Surgery, Department of Surgery, UCLA Medical Center, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, Calif (E.W.L.)
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Ding PX, Liu C, Lu HB, Wang L, Li ZM, Lee EW. Giant mediastinal lymphocele after esophagectomy successfully treated with thoracic duct embolization. J Vasc Surg Cases Innov Tech 2021; 7:215-218. [PMID: 33997556 PMCID: PMC8093313 DOI: 10.1016/j.jvscit.2020.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 12/23/2020] [Indexed: 11/30/2022]
Abstract
A 64-year old man had developed a giant mediastinal lymphocele after undergoing esophagectomy for the treatment of esophageal squamous cell carcinoma. The thoracic duct was embolized with six micro-coils, followed by embolization using a 1:3 mixture of N-butyl-2-cyanoacrylate (Histoacryl; B. Braun, Melsungen, Germany) and ethiodized oil. Resolution of the lymphocele was achieved within 5 days after embolization. To the best of our knowledge, ours is the first reported case of thoracic duct embolization for the treatment of mediastinal lymphocele.
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Affiliation(s)
- Peng-Xu Ding
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chao Liu
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui-Bin Lu
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ling Wang
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zong-Ming Li
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Edward Wolfgang Lee
- Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, Calif
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Zhang WW, Ren JZ, Han XW, Chen PF, Li FZ, Kuang DL, Zhou PL, Ding PX, Bi YH. [Clinical application and efficacy of TIPS combined with AngioJet mechanical thrombectomy for liver cirrhosis with extensive portal vein thrombosis]. Zhonghua Yi Xue Za Zhi 2020; 100:533-537. [PMID: 32164106 DOI: 10.3760/cma.j.issn.0376-2491.2020.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To assess the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with AngioJet mechanical thrombectomy for liver cirrhosis with extensive portal vein thrombosis. Methods: From March 2018 to April 2019, a total of 11 patients with liver cirrhosis and extensive portal vein thrombosis were treated by TIPS combined with AngioJet mechanical thrombectomy, including 6 males and 5 females, with the age of 37-71 (46±9) years old, 3 cases of Child-Pugh grade A, 8 cases of grade B and 0 cases of grade C. The intraoperative immediate thrombus clearance rate, perioperative complication rate, postoperative thrombus recurrence rate, rebleeding rate, the incidence of hepatic encephalopathy and the rate of stent patency of all cases were collected and analyzed. Results: All the patients were treated successfully. The immediate complete thrombus clearance (grade Ⅲ) rate of portal vein trunk was 9/11, and grade Ⅱ was 2/11, The average dose of urokinase was 30-60 (40±5) ten thousand U, slight puncture point bleeding occurred in 3 cases, and recurrence of PVT in portal vein trunk occurred in 1 case with Ⅱ grade clearance rate after operation, rebleeding occurred in 1 case, hepatic encephalopathy occurred in 2 cases, the primary patency rate of stents was 9 cases. Conclusion: TIPS combined with AngioJet mechanical thrombectomy can treat the liver cirrhosis with extensive portal vein thrombosis effectively and safely, and postoperative portal vein patency rate and intrahepatic shunt patency rate are high.
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Affiliation(s)
- W W Zhang
- Department of Interventional Radiology, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450000, China
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Zhang WW, Ren JZ, Zhou PL, Ding PX, Chen PF, Li FZ, Kuang DL, Han XW. [Application of real-time image fusion technique in transjugular intrahepatic portosystemic shunt]. Zhonghua Yi Xue Za Zhi 2019; 99:3554-3557. [PMID: 31826570 DOI: 10.3760/cma.j.issn.0376-2491.2019.45.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To assess the feasibility and value of real-time image fusion technique guiding the procedure of transjugular intrahepatic portosystemic shunt(TIPS). Methods: From July 2017 to May 2018,a total of 48 consecutive patients complicated by portal venous hypertension due to cirrhosis who underwent TIPS were prospectively allocated into two groups that 27 cases underwent normal TIPS and 21 cases underwent image fusion guided TIPS. There were 25 males and 23 females with a mean age of 29-74(51±10) years. The differences of portal vein(PV) between image fusion angiographyand digital subtraction angiography(DSA), and the times of puncture PV, X-ray exposure dose and exposure time and contrast agent amount of all cases were collected and analyzed. Results: The longitudinal and traverse difference of PV between image fusion angiography and DSA were 1.7-2.5(2.1±0.2) mm and 0.9-1.8(1.4±0.3) mm, respectively.The times of puncture PV, X-ray exposure time and dose, and contrast agent amount between normal TIPS group and image fusion guided TIPS group were 1-7(3.8±0.6) times vs 1-3(2.0±0.6) times, 41-63(53±8)min vs 27-42(35±5) min, 513-787(644±96) mGy vs 357-524(423±59) mGy,102-196(151±23) ml vs 87-145(105±14) ml(all P<0.05), respectively. Conclusions: There are minor differences between image fusion angiography of PV and DSA. Real-time image fusion guided TIPS is feasible and valuable to reduce intraprocedural X-ray exposure time and dose and contrast agent amount of TIPS.
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Affiliation(s)
- W W Zhang
- Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China
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Hao WJ, Zhang H, Yu Y, Zhao J, Ge ZJ, Ding PX, Sun XX, Liu H, Wen SY, You J. [Clinical significance and cost-benefit analysis of serum calcitonin assay in diagnosis and treatment of medullary thyroid carcinoma]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 54:506-509. [PMID: 31315357 DOI: 10.3760/cma.j.issn.1673-0860.2019.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the clinical significance of serum calcitonin in the diagnosis and treatment of medullary thyroid carcinoma and to analyze its cost-benefit. Methods: One hundred and forty one patients with medullary thyroid carcinoma who undertook calcitonin test and frozen pathological examination were enrolled in this study from Oct 2012 to Mar 2018. Using the method of χ(2) test, the positive rate of calcitonin test and frozen pathological examination in diagnosis of medullary thyroid carcinoma(MTC) were compared. Firstly, we compared the correct checkout cost of calcitonin test and that of frozen pathological examination (total number of patients×cost of examination/the correctly detected number of patients) . Secondly, we calculated whether calcitonin test help patients save money(average cost of treatment in hospital for MTC×number of patients who were evaluated to be candidate for surgery-cost of calcitonin test×total number of patients)/total number of patients. Results: 139 patients were positive in calcitonin test among 141 patients, and the positive rate was 98.58%. 91 patients were positive in frozen pathological examination, and the positive rate was 64.54% (χ(2)=97.821, P<0.000 1) . Cost-benefit analysis showed that the correct checkout cost of calcitonin test and frozen pathological examination were 71.01 yuan and 426.10 yuan, also,1 371 938.64 yuan could be saved totally and 9 730.06 yuan could be saved per patient because of calcitonin test. Conclusion: Serum calcitonin test had a significant effect on the diagnosis and treatment of medullary thyroid carcinoma and was economical and practical.
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Affiliation(s)
- W J Hao
- Department of General Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - H Zhang
- Department of Prevention, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
| | - Y Yu
- Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
| | - J Zhao
- Department of Ultrasound Diagnosis and Treatment, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
| | - Z J Ge
- Department of General Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - P X Ding
- Department of General Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - X X Sun
- Department of General Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - H Liu
- Department of General Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - S Y Wen
- Department of General Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - J You
- Department of General Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
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Ding PX, Han XW, Liu C, Zhang Y, Cheng AL, Wu Y, Liang XX, Gao XM, Lee EW. Long-term outcomes of individualized treatment strategy in treatment of type I Budd-Chiari syndrome in 456 patients. Liver Int 2019; 39:1577-1586. [PMID: 30963702 DOI: 10.1111/liv.14114] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/17/2019] [Accepted: 04/02/2019] [Indexed: 12/14/2022]
Abstract
AIM To evaluate individualized treatment strategy (ITS) and long-term outcomes of endovascular treatment of Budd-Chiari syndrome (BCS) with obstructed inferior vena cava (IVC) based on different degrees of hepatic vein (HV) involvement. METHODS From January 2006 to June 2017, 456 consecutive patients with BCS with obstructed IVC underwent endovascular treatment with ITS. All patients received IVC recanalization. Then, 426 patients with at least one patent HV received no additional treatment. Twenty-fivepatients with membranous or segmental occlusion of HVs underwent HV recanalization and for the remaining five patients with diffuse HVs occlusion, a transjugular intrahepatic portosystemic shunt (TIPS) was performed. RESULTS The endovascular treatment was technically successful in 455 of the 456 patients (99.8%). The complication rate was 5.0% (23/456), with major complications in 13 patients (2.8%) and minor complications in 10 patients (2.2%). Median follow-up time was 60.5 months (range, 4-120 months). The cumulative 1-, 2-, 5- and 10-year primary vessel patency rates were 93.6%, 89.9%, 80.5% and 74.3% respectively and the cumulative 1-, 2-, 5-, 10- year secondary patency rates were 99.8%, 99.8%, 98.2% and 97.2% respectively. The cumulative 1-, 2-, 5- and 10-year survival rates were 98.4%, 95.8%, 91.2% and 76.5% respectively. Illness duration and decreased serum albumin were independent predictors of survival. CONCLUSION The ITS for Asian BCS with obstructed IVC and varying degrees of HV involvement appears to be effective and with good long-term outcomes.
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Affiliation(s)
- Peng-Xu Ding
- Department of Intervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin-Wei Han
- Department of Intervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chao Liu
- Department of Intervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Zhang
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - An-Ling Cheng
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Wu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiao-Xue Liang
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xue-Mei Gao
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Edward Wolfgang Lee
- Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA
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Abstract
Budd-Chiari syndrome (BCS) is a heterogeneous group of disorders characterized by hepatic venous outflow obstruction. Abernethy malformation is a congenital vascular malformation defined by diversion of portal blood away from the liver. Both conditions are rare vascular diseases. We report here the first case of a patient with combined type II Abernethy malformation and BCS from China. The inferior vena cava obstruction was treated with percutaneous balloon angioplasty; close follow-up was elected for the Abernethy malformation.
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Affiliation(s)
- Peng-Xu Ding
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
| | - Xin-Wei Han
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Chao Liu
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Ding PX, Han XW, Liu C, Ren KW. Inferior vena cava filter misplacement in the right ovarian vein and successful removal by loop-snare technique in a patient with inferior vena cava agenesis. J Vasc Surg Cases Innov Tech 2018; 4:324-326. [PMID: 30761379 PMCID: PMC6298937 DOI: 10.1016/j.jvscit.2017.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 12/14/2017] [Indexed: 11/04/2022]
Abstract
Misplacement of an inferior vena cava (IVC) filter in a gonadal vein is a rare complication of IVC filter placement. We report a case of a filter misplaced in the ovarian vein of a pregnant woman with agenesis of the infrarenal IVC and bilateral lower extremity deep venous thrombosis. The filter was removed by a loop-snare technique through an internal jugular vein. IVC agenesis and dilated right gonadal vein should be kept in mind when an IVC filter is being inserted in the infrarenal location through the jugular approach.
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Affiliation(s)
- Peng-Xu Ding
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin-Wei Han
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chao Liu
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ke-Wei Ren
- Department of Intervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Ding PX, Han XW, Hua ZH. Extrahepatic Portal Vein Aneurysm at the Portal Bifurcation Treated with Transjugular Intrahepatic Portosystemic Shunt. J Vasc Interv Radiol 2018; 28:764-766. [PMID: 28431653 DOI: 10.1016/j.jvir.2016.12.1228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 12/29/2016] [Accepted: 12/29/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Peng-Xu Ding
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, 1 East Jian She Rd., Zhengzhou, Henan 450052, China
| | - Xin-Wei Han
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, 1 East Jian She Rd., Zhengzhou, Henan 450052, China
| | - Zhao-Hui Hua
- Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, 1 East Jian She Rd., Zhengzhou, Henan 450052, China
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Ding PX, Han XW, Hua ZH, Liu C. Stent Fracture and Fragment Migration to Chordae Tendineae of the Tricuspid Valve after Transjugular Intrahepatic Portosystemic Shunt Procedure. J Vasc Interv Radiol 2017; 28:1293-1295. [DOI: 10.1016/j.jvir.2017.03.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/17/2017] [Accepted: 03/19/2017] [Indexed: 12/15/2022] Open
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Ding PX, Zhang SJ, Li Z, Fu MT, Hua ZH, Zhang WG. Long-term safety and outcome of percutaneous transhepatic venous balloon angioplasty for Budd-Chiari syndrome. J Gastroenterol Hepatol 2016; 31:222-8. [PMID: 26102208 DOI: 10.1111/jgh.13025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/21/2015] [Accepted: 06/15/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS The restenosis following percutaneous transluminal balloon angioplasty (PTBA) is high for Budd-Chiari syndrome (BCS) patients with hepatic venous obstruction (HVO). We aim to evaluate the safety and long-term outcome of PTBA with a large balloon catheter in a large series of patients with HVO. METHODS Between January 2005 and December 2013, 93 consecutive BCS patients with HVO were referred for PTBA and subsequently underwent color Doppler ultrasonography or angiography follow-up. Data were retrospectively collected, and follow-up observations were performed at 1-, 2-, 2- to 5-, and 5- to 8-years postoperatively. RESULTS Percutaneous transluminal balloon angioplasty was technically successful in all patients. Ninety-one patients (97.85%) were treated with PTBA and two with PTBA and stent. Major procedure-related complications occurred in six of the 93 patients (6.45%). The cumulative 1-, 2-, 2- to 5-, and 5- to 8-year primary patency rates were 97.5%, 92.9%, 90%, and 86.5%, respectively. Cumulative 1-, 2-, 2- to 5-, and 5- to 8-year secondary patency rates were 100%, 100%, 98.6%, and 97.3%, respectively. Mean and median primary patency rates were 51.50 ± 3.01 months and 55.0 ± 3.63 months, respectively. Cumulative 1-, 2-, 2- to 5-, and 5- to 8-year survival rates were 98.75%, 98.6%, 100%, and 100%, respectively. Mean and median survival times were 53.10 ± 3.04 months and 55.0 ± 3.64 months, respectively. CONCLUSION Percutaneous transluminal balloon angioplasty with a large balloon is a safe and effective treatment that could provide excellent rates of long-term patency and survival for the majority of Chinese patients with BCS and HVO.
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Affiliation(s)
- Peng-Xu Ding
- Department of Vascular and Endovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Shui-Jun Zhang
- Department of Vascular and Endovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhen Li
- Department of Vascular and Endovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ming-Ti Fu
- Department of Vascular and Endovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhao-Hui Hua
- Department of Vascular and Endovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Wen-Guang Zhang
- Department of Vascular and Endovascular Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Ren JZ, Huang GH, Ding PX, Wu G, Han XW, Wang YL. Outcomes of Thrombolysis With and Without Predilation of the Inferior Vena Cava (IVC) in Patients With Budd–Chiari Syndrome With Old IVC Thrombosis. Vasc Endovascular Surg 2013; 47:232-8. [PMID: 23417125 DOI: 10.1177/1538574413478495] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To compare the efficacy of thrombolysis with and without predilation of the inferior vena cava (IVC) for Budd–Chiari syndrome (BCS) with old IVC thrombosis. Methods: We divided 40 patients with BCS with old IVC thrombosis into 2 groups, group A (n = 21), thrombolysis after dilation of the obstructed IVC and group B (n = 19), thrombolysis without predilation of the obstructed IVC. Thrombolysis was performed via urokinase administration through the dorsal vein of the foot. Results: Color Doppler ultrasonography at 30 days showed complete resolution of the thrombus in 21 (100%) group A patients and 6 group B patients (31.6%; P < .001). Thrombolysis was achieved using a lower dose of urokinase and within a shorter time frame in group A than in group B ( P < .001). Conclusions: Thrombolysis after dilation was superior to thrombolysis alone and was safe and efficacious in patients with BCS with old IVC thrombosis.
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Affiliation(s)
- Jian-Zhuang Ren
- Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Guo-Hao Huang
- Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Peng-Xu Ding
- Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Gang Wu
- Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xin-Wei Han
- Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yan-Li Wang
- Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China
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Jiao DC, Zhou Q, Han XW, Wang YF, Wu G, Ren JZ, Wang YL, Ding PX, Ma J, Fu MT. Microwave ablation treatment of liver cancer with a 2,450-MHz cooled-shaft antenna: pilot study on safety and efficacy. Asian Pac J Cancer Prev 2012; 13:737-42. [PMID: 22524853 DOI: 10.7314/apjcp.2012.13.2.737] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
To evaluate efficacy of microwave ablation in a primary clinical study, sixty patients (44 men, 16 women; mean age 53 years) with 96, 1-8 cm (mean 3.20 ± 0.17 cm) liver cancers were treated with 2,450-MHz internally cooled-shaft antenna. Complete ablation (CA) and local tumor progression (LTP) rates as well as complications were determined. CA rates in small (<3.0 cm), intermediate (3.1-5.0 cm) and large (5.1-8.0 cm) liver cancers were 96.4% (54/56), 92.3% (24/26) and 78.6% (11/14), respectively. During a mean follow-up period of 17.17 ∓ 6.52 months, LTP occurred in five (5.21%) treated cases. There was no significant difference in the CA and LTP rates between the HCC and liver metastasis patient subgroups (P<0.05). Microwave ablation provides a reliable, efficient, and safe technique to perform hepatic tumor ablation.
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Affiliation(s)
- De-Chao Jiao
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Yue SW, Guo H, Zhang YG, Gao JB, Ma XX, Ding PX. The clinical value of computer tomographic angiography for the diagnosis and therapeutic planning of patients with pulmonary sequestration. Eur J Cardiothorac Surg 2012; 43:946-51. [PMID: 22956521 PMCID: PMC3619944 DOI: 10.1093/ejcts/ezs484] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study was conducted to evaluate the clinical value of computed tomographic (CT) angiography for diagnosis and therapeutic planning in patients with pulmonary sequestration. METHODS Forty-three patients with suspected pulmonary sequestration underwent CT angiography before undergoing digital subtraction angiography or surgery. For each patient, CT angiography was used to determine whether the pulmonary sequestration was suitable for coil embolization, surgical resection or conservative treatment. The treatments planned using CT angiography were compared with actual treatment decisions made or treatments administered using digital subtraction angiography or surgery. RESULTS Digital subtraction angiography and/or surgery confirmed pulmonary sequestration in 37 patients; six patients had no pulmonary sequestration. The diagnostic performance of CT angiography for pulmonary sequestration in the patient-based evaluation yielded an accuracy of 97.7%, sensitivity of 97.3%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 85.7%. The aberrant systemic artery-based evaluation yielded an accuracy of 98.0%, sensitivity of 97.8%, specificity of 100%, PPV of 100% and NPV of 85.7%. Treatments could be correctly planned using CT angiography with 100% accuracy, sensitivity, specificity, PPV and NPV according to the aneurysm-based evaluation. CONCLUSIONS We have obtained promising results with a CT angiography-based protocol, rather than a digital subtraction angiography-based protocol, as the only diagnostic and pretreatment planning tool in patients with pulmonary sequestration. The CT angiography-based selection of treatment strategies seems to be safe and effective in the majority of patients with pulmonary sequestration.
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Affiliation(s)
- Song-Wei Yue
- Department of Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China
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Wang YL, Ma J, Li YD, Ding PX, Han XW, Wu G. Application of the Willis covered stent for the management of posttraumatic carotid-cavernous fistulas: an initial clinical study. Neurol India 2012; 60:180-4. [PMID: 22626700 DOI: 10.4103/0028-3886.96397] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIMS To evaluate the feasibility of using the Willis covered stent in the management of patients with traumatic carotid-cavernous fistulas (CCFs). MATERIALS AND METHODS Twelve consecutive patients with 14 post-traumatic CCFs referred for treatment with Willis covered stents were enrolled in this prospective study. Data on technical success, initial and final angiographic results, mortality, morbidity and final clinical outcome were collected. Follow- up was at one, three, six, and 12 months, and yearly thereafter. RESULTS Deployment of covered stents was technically successful in all the patients without complications. One covered stent was placed in eight patients and two covered stents in four. Angiographic results following stent placement showed a complete occlusion in nine patients with 11 CCFs, and an incomplete occlusion in three patients. Angiographic follow-up (mean, 14.00 ± 6.93 months; range, 6-24 months) revealed complete occlusion and no obvious in-stent stenosis in all the patients. Clinical follow-up (mean, 17.75 ± 7.05 months; range, 7-28 months) demonstrated full recovery in 11 patients, and improvement in one. CONCLUSION This initial experience indicates that the use of the Willis covered stent is a feasible procedure and may be an alternative treatment option for CCFs.
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Affiliation(s)
- Yan-Li Wang
- Department of Interventional Radiology, The First Affiliated Hospital, Zhengzhou University, Henan Province, Zhengzhou, China
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Wang YL, Ding PX, Li YD, Han XW, Wu G. Comparative study of predilation with stent filter for Budd-Chiari syndrome with old IVC thrombosis: A nonrandomized prospective trial. Eur J Radiol 2012; 81:1158-64. [DOI: 10.1016/j.ejrad.2011.03.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 03/04/2011] [Indexed: 11/26/2022]
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Zhang WG, Ding PX, Han XW, Li Z, Zhou PL, Ma HX, Ma YG. Age trends in the prevalence of Budd-Chiari syndrome in Henan Province. Shijie Huaren Xiaohua Zazhi 2010; 18:3259-3261. [DOI: 10.11569/wcjd.v18.i30.3259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To analyze the changes in the age of patients with Budd-Chiari syndrome in Henan Province, China between 1995 and 2009, and to analyze the possible etiological factors contributing to such changes.
METHODS: The clinical data for 909 patients with Budd-Chiari syndrome treated at the Department of Interventional Radiology of the First Affiliated Hospital of Zhengzhou University from 1995 to 2009 were analyzed using the SPSS 13.0 statistical software.
RESULTS: The mean age of patients with Budd-Chiari syndrome is 39.17 ± 11.40. An ascending trend was observed for the mean age of patients with Budd-Chiari syndrome in Henan Province from 1995 to 2009 (P < 0.05). Patients aged 35-44 years accounted for 19.87% during 1995-1997, and 38.51% during 2007-2009. The percentage of patients aged 35-44 years showed an upward trend. In contrast, the percentage of patients aged 25-34 years showed a downward trend during this period. The percentages of other age groups of patients did not change greatly (all P > 0.05).
CONCLUSION: The age at diagnosis of patients with Budd-Chiari syndrome shows an upward trend in Henan Province from 1995 to 2009.
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Ding PX, Li YD, Han XW, Wu G. Agitation thrombolysis for fresh iatrogenic IVC thrombosis in patients with Budd-Chiari syndrome. J Vasc Surg 2010; 52:782-4. [PMID: 20471769 DOI: 10.1016/j.jvs.2010.02.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2009] [Revised: 02/05/2010] [Accepted: 02/06/2010] [Indexed: 11/16/2022]
Abstract
Three patients with Budd-Chiari syndrome (BCS) and fresh inferior vena cava (IVC) thrombosis were treated by agitation thrombolysis as a mechanical thrombectomy procedure and followed up by duplex ultrasonography. Agitation thrombolysis was technically and clinically successful in all patients. Inferior vena cavagrams after the procedure showed complete resolution of the iatrogenic, fresh IVC thrombi without occurrence of pulmonary embolism. Duplex ultrasonography follow-ups after 12, 24, and 28 months, respectively, confirmed complete patency of the IVC without rethrombosis and reobstruction. The results indicate that agitation thrombolysis may be a safe and feasible approach for BCS patients with iatrogenic, fresh IVC thrombosis.
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Affiliation(s)
- Peng-Xu Ding
- Department of Radiology, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China
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Han XW, Ding PX, Li YD, Wu G, Li MH. Retrieval Stent Filter: Treatment of Budd Chiari Syndrome Complicated With Inferior Vena Cava Thrombosis—Initial Clinical Experience. Ann Thorac Surg 2007; 83:655-60. [PMID: 17258004 DOI: 10.1016/j.athoracsur.2006.06.084] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2006] [Revised: 06/20/2006] [Accepted: 06/27/2006] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the initial clinical efficacy of a retrieval stent filter for the management of Budd Chiari syndrome complicated with inferior vena cava thrombosis. DESCRIPTION The retrieval stent filter consists of two parts (ie, the filter and the Z-stent). The filter was composed of seven legs arranged in the shape of a cone with a retrieval hook at its apex. The filter and the Z-stent were connected with each other, and the retrieval of the stent filter was performed with an Amplatz gooseneck snare (MicroVena [White Bear Lake, MN]). Eight consecutive patients were treated with the stent filters. EVALUATION The stent filter placement was technically successful in all patients. Inferior vena cavography demonstrated that all of the inferior vena cavae were patent without incidental pulmonary embolism after deploying the stent filter. A 3-11 months follow-up study showed that all of the stent filters were removed after approximately 5 to 24 days of placement. All patients were still alive with resolution of the symptoms. CONCLUSIONS The use of a retrieval stent filter proved to be expedient, safe, and effective in the treatment of Budd Chiari syndrome complicated with inferior vena cava thrombosis.
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Affiliation(s)
- Xin-Wei Han
- Department of Radiology, The First Affiliated Hospital, Zheng zhou University, Zheng zhou, Henan Province, China.
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