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Niu Y, Zhang Q, Jiang Z, Li W, Chen Z. Middle meningeal artery embolization for the treatment of unilateral large chronic subdural hematoma patients with significant midline shift: A single-center experience. Interv Neuroradiol 2024:15910199241239706. [PMID: 38515352 DOI: 10.1177/15910199241239706] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND The amount of midline shift (MLS) considered safe for middle meningeal artery embolization (MMAE) in patients with chronic subdural hematoma (CSDH) has not been established. Whether MMAE could be used as upfront treatment for unilateral large CSDH patients with significant MLS (>1 cm) has not been reported. OBJECTIVE To investigate the efficacy and safety of MMAE in unilateral large CSDH patients with MLS > 1 cm. METHODS Eleven carefully selected CSDH patients with mild or moderate symptoms and significant MLS > 1 cm from 1 May 2021 to 31 August 2022 were included in the study. All patients were treated with MMAE using polyvinyl alcohol (PVA) particles. Outcomes were assessed clinically and with interval imaging studies at follow-up. RESULTS All 19 MMAs (unilateral embolization in three patients and bilateral embolization in eight patients) were successfully embolized. All 11 patients were followed for subsequent months, and there was no recurrence and enlargement of CSDH. Procedural adverse events, mortality, or complications were not observed. The average time to achieve a 50% reduction in MLS was approximately four weeks, while it took approximately eight weeks to achieve a 50% reduction in maximal volume. All 11 patients showed improvement in their neurological symptoms at three days post-operation, including four hemiplegic patients. CONCLUSIONS MMAE may demonstrate safety in carefully selected CSDH patients with significant midline shift (MLS > 1 cm), particularly in those who are not suitable for surgery, thus providing a potential alternative approach.
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Affiliation(s)
- Yin Niu
- Department of Neurosurgery, Third Military Medical University (Army Medical University), Southwest Hospital, Chongqing, China
| | - Qiang Zhang
- Department of Neurosurgery, The 961st Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Qiqihaer, Heilongjiang, China
| | - Zhouyang Jiang
- Department of Neurosurgery, Third Military Medical University (Army Medical University), Southwest Hospital, Chongqing, China
| | - Wenyan Li
- Department of Neurosurgery, Third Military Medical University (Army Medical University), Southwest Hospital, Chongqing, China
| | - Zhi Chen
- Department of Neurosurgery, Third Military Medical University (Army Medical University), Southwest Hospital, Chongqing, China
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Liu Z, Ma X, Yang T. Sudden cardiac arrest during endovascular embolization of carotid artery aneurysm: A case report and literature review. Medicine (Baltimore) 2024; 103:e36888. [PMID: 38277550 PMCID: PMC10817150 DOI: 10.1097/md.0000000000036888] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/18/2023] [Indexed: 01/28/2024] Open
Abstract
RATIONALE Endovascular embolization has been widely applied in carotid artery aneurysm due to less trauma and simpler procedures than open surgery. Sudden cardiac arrest is a rare event that may cause severe consequences during endovascular embolization. Risk factors of perioperative cardiac arrest include cardiac surgery, younger age, comorbid conditions, and emergency surgery. PATIENT CONCERNS A 62-year-old male patient had hypertension for 15 years and experienced sudden cardiac arrest of pulseless electrical activity during endovascular embolization. DIAGNOSES He was diagnosed with a 3.5 × 2.5 mm aneurysm. INTERVENTIONS Chest compression and effective interventions were given. OUTCOMES He was resuscitated by cardiopulmonary resuscitation and systematic therapy. LESSONS This case may provide experience in the management of sudden cardiac arrest during endovascular embolization of a carotid artery aneurysm.
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Affiliation(s)
- Ziqiang Liu
- Department of Anesthesiology, Weihai Municipal Hospital, Waihai, China
| | - Xuecai Ma
- Department of Anesthesiology, Weihai Municipal Hospital, Waihai, China
| | - Tianhui Yang
- Department of Anesthesia Surgery, Wuming Hospital Affiliated to Guangxi Medical University, Nanning, China
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Wu C, Dong X, Li Q, Liu S, He Y, Zhang Y, Zhang S. Changes of serum MMP-9, NSE, MPO levels and prognostic influencing factors in patients with intracranial aneurysm undergoing interventional embolization at different treatment timing. J Med Biochem 2024; 43:144-152. [PMID: 38496021 PMCID: PMC10943457 DOI: 10.5937/jomb0-44364] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/08/2023] [Indexed: 03/19/2024] Open
Abstract
Background To analyzes the changes in serum levels of matrix metalloproteinase-9 (MMP-9), neuroenolase (NSE), myeloperoxidase (MPO) and prognostic factors in patients with intracranial aneurysm (IA) undergoing interventional embolization at different treatment times. Methods A retrospective analysis was made of 200 IA patients admitted to our department from January 2018 to June 2021 was performed. All patients underwent interventional embolization. According to the timing of surgery, the patients were divided into an early group (n=120, onset to surgery ≤72 h) and a delayed group (n=80, onset to surgery >72 h). The effect of embolization, complications and neurological deficit scale (NDS) scores were compared between the two groups. Serum MMP-9, NSE and MPO levels were compared before and after surgery, and the prognosis of all patients within 2 years after surgery was assessed by the Glasgow outcome scale (GOS) and divided accordingly into the good prognosis group (n=147) and the poor prognosis group (n=53) accordingly, and the prognostic factors influencing the patients were analyzed univariately and multifactorially.
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Affiliation(s)
- Chunmiao Wu
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
| | - Xingyu Dong
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
| | - Qiang Li
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
| | - Shengming Liu
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
| | - Yuhao He
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
| | - Yang Zhang
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
| | - Sunfu Zhang
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
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Zhang Z, Liu JY, Xing HS, Ma JY, Li AJ. Microsurgical clipping and endovascular intervention for middle cerebral artery aneurysm: A meta-analysis. Medicine (Baltimore) 2023; 102:e34956. [PMID: 37653731 PMCID: PMC10470800 DOI: 10.1097/md.0000000000034956] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/12/2023] [Accepted: 08/04/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND The purpose of this study is to compare the prognosis and effective rate of interventional embolization and surgical clipping in the treatment of middle cerebral artery aneurysms, to provide evidence-based basis for the selection of clinical treatment. METHODS By searching PubMed, Cochrane library, Medline, Embase and other databases, we collected the related studies interventional embolization and surgical clipping in the treatment of middle cerebral artery aneurysms, whether it was a randomized controlled trial or not. According to the relevant inclusion and exclusion criteria, 2 researchers independently screened and extracted the relevant data. Quality of life, residual neck and recurrence rate, incidence of ischemic cerebral infarction, intracranial infection rate, incidence of vasospasm and rebleeding rate were measured. Revman5.4 software was used for Meta-analysis. RESULTS There were 3658 patients included in 30 literatures, including 1478 patients treated with interventional embolization and 2180 patients treated with surgical clipping. The rate of low quality of life (odds ratio [OR] = 1.68, 95% confidence interval [CI]: 1.36-2.07, P < .00001) and intracranial infection rate (OR = 8.79,95% CI: 4.47-17.27, P < .00001) in the interventional embolization group were lower than those in the surgical clipping group. The postoperative rebleeding rate (OR = 0.46, 95% CI: 0.29-0.73, P = .0009), residual neck and recurrence rate (OR = 0.32, 95% CI: 0.24-0.43, P < .00001) in the interventional embolization group were higher than those in the surgical clipping group. The heterogeneity of residual neck and recurrence rate were high, so subgroup analysis was performed. We divide them into short-term group (OR = 0.68, 95% CI: 0.40-1.13, P = .13) and long-term group (OR = 0.23, 95% CI: 0.16-0.33, P < .00001). The results showed that the residual neck and recurrence rate in the interventional embolization group were higher than those in the surgical clipping group. There was no significant difference in the incidence of cerebral vasospasm (OR = 1.09, 95% CI: 0.64-1.86, P = .74) and ischemic stroke (OR = 0.87, 95% CI: 0.63-1.19, P = .37) between the 2 treatments. CONCLUSION According to the current clinical research evidence, compared with interventional embolization in the treatment of middle cerebral artery aneurysms, the quality of life of patients after clipping is lower, the incidence of intracranial infection is higher, but the residual neck, and recurrence rate are reduced. The risk of rebleeding is also reduced. There was no significant difference in the incidence of vasospasm and ischemic stroke between the 2 groups.
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Affiliation(s)
- Zheng Zhang
- School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Jing Yi Liu
- Plastic Surgery Institute, Weifang Medical University, Weifang, Weifang City, Shandong Province, China
| | - Hong Shun Xing
- Department of Neurosurgery, Weifang People’s Hospital Affiliated to Weifang Medical University, Weifang, China
| | - Jin Yuan Ma
- Department of Neurosurgery, The Affiliated Hospital of Qing Dao Binhai University, Qingdao, China
| | - Ai Jun Li
- Department of Neurosurgery, The Affiliated Hospital of Qing Dao Binhai University, Qingdao, China
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Wang Y, Liu D, Xiao L, Zuo S, Ren T, Dong C, Li T. Effect of interventional embolization based on absolute ethanol for peripheral arteriovenous malformations. Biotechnol Genet Eng Rev 2023:1-12. [PMID: 37248733 DOI: 10.1080/02648725.2023.2217617] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Interventional embolization schedules based on absolute ethanol are usually used for peripheral arteriovenous malformations (PAVMs), and clinicians often choose the scheme according to the classification. AIM To evaluate different interventional embolization schedules based on absolute ethanol for PAVMs. METHODS A retrospective study was performed of 165 patients with PAVMs treated with interventional embolization based on absolute ethanol in Henan Provincial People's Hospital from January 2018 to May 2021. PAVMs were classified as type II (n = 67), type III (n = 81) and type IV (n = 17) according to the Yakes classification system, including 123 maxillofacial, 13 trunk and 29 limbs. Effectiveness of embolization was based on PAVM devascularization on angiography: 100% (total), 90%~99% (near-total), 70%~90% (substantial), 30%~70% (partial) and 0%~30% (failure). RESULTS PAVMs were classified as type II (n = 67), type III (n = 81) and type IV (n = 17) according to the Yakes classification system, including 123 maxillofacial (74.55%), 13 trunk (7.88%) and 29 limbs (17.58%). There are statistical differences in the angiographic outcomes among different Yakes classification and between different methods (P < 0.05), and there was a statistical difference in the failure rates among different Yakes classification (P < 0.05). CONCLUSIONS PAVMs occur maxillofacial usually, and Type II can achieve better effect by spring coil and absolute ethanol, while Type III and Type IV have no ideal effect by Pingyangmycin + iodized oil + PVA + absolute ethanol and spring coil + absolute ethanol, respectively. Both the two happen to be complications, and wound accounts the highest.
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Affiliation(s)
- Yanlin Wang
- Department of Hemangioma and Vascular Malformation, Zhengzhou University People's Hospital; Henan Provincial People's Hospital, Zhengzhou, China
| | - Dakan Liu
- Department of Hemangioma and Vascular Malformation, Zhengzhou University People's Hospital; Henan Provincial People's Hospital, Zhengzhou, China
| | - Li Xiao
- Department of Hemangioma and Vascular Malformation, Zhengzhou University People's Hospital; Henan Provincial People's Hospital, Zhengzhou, China
| | - Song Zuo
- Department of Hemangioma and Vascular Malformation, Zhengzhou University People's Hospital; Henan Provincial People's Hospital, Zhengzhou, China
| | - Tengfei Ren
- Department of Hemangioma and Vascular Malformation, Zhengzhou University People's Hospital; Henan Provincial People's Hospital, Zhengzhou, China
| | - Changxian Dong
- Department of Hemangioma and Vascular Malformation, Zhengzhou University People's Hospital; Henan Provincial People's Hospital, Zhengzhou, China
| | - Tianxiao Li
- Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China
- Henan Provincial NeuroInterventional Engineering Research Center, Henan International Joint Laboratory of Cerebrovascular Disease, and Henan Engineering Research Center of Cerebrovascular Intervention Innovation, Zhengzhou, China
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Zhou S, Zhang J, Meng X, Meng Y, Han X. Case Report: Bronchial artery embolization and chemoradiotherapy for central squamous cell lung carcinoma with rapid regression. Front Oncol 2022; 12:1026087. [PMID: 36591505 PMCID: PMC9795177 DOI: 10.3389/fonc.2022.1026087] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022] Open
Abstract
Background Interventional embolization is a common treatment for hemoptysis, one of the complications of lung cancer. However, there are no official guidelines for the use of this method in antitumor therapy. Case Description Herein, we describe a case of a patient who was pathologically diagnosed as central squamous cell lung cancer. The patient received chemotherapy, interventional embolization and radiotherapy successively. The tumor regressed rapidly within 48 hours of receipt of interventional embolization. Furthermore, the tumor decreased by more than 50% in size within 7 days during radiotherapy. Unfortunately, the patient has since developed lymph node metastases and remains under treatment. Conclusions Thus, finding the suitable blood vessel embolized may be a suitable option to reduce the local tumor load and can be considered as antitumor therapy in combination with other treatments. The patient's theoretical hypoxia state after interventional therapy still produced a good tumor regression after radiotherapy. However, so far, no related studies have reported the changes of tumor immune microenvironment in human body after intervention and radiotherapy.
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Affiliation(s)
- Siqi Zhou
- Department of Oncology, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Jianxin Zhang
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Xue Meng
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Yingtao Meng
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China,*Correspondence: Xiao Han, ; Yingtao Meng,
| | - Xiao Han
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China,*Correspondence: Xiao Han, ; Yingtao Meng,
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Geng Z, Zhang Q, Jia P, Miao J, Lin Q. Severe vaginal bleeding due to vaginal metastasis from renal cell carcinoma with inferior vena cava tumor thrombus: A case report. Medicine (Baltimore) 2022; 101:e28586. [PMID: 35060522 PMCID: PMC8772633 DOI: 10.1097/md.0000000000028586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/27/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Renal cell carcinoma (RCC) is the most common type of kidney cancer and is the second most common urologic neoplasm. Vaginal metastasis from RCC is extremely rare clinically. PATIENT CONCERNS A 56-year-old woman presented with intermittent vaginal bleeding that had persisted for 1 month. Enhanced computed tomography examination suggested a vaginal mass (3 × 2 × 2 cm), right kidney tumor (15 × 12 × 10 cm), and an inferior vena cava tumor thrombus. During gynecologic examination, the mass was necrotic and caused uncontrollable vaginal bleeding. DIAGNOSES Based on clinical and imaging examinations and the pathology, she was diagnosed as vaginal metastasis from RCC. INTERVENTIONS The patient received percutaneous transcatheter arterial embolization to stop uncontrollable vaginal bleeding, and then treated with targeted therapy. OUTCOMES Vaginal bleeding disappeared after interventional embotherapy. However, disease progressed, and the patient died 9 months later. LESSONS In cases of vaginal bleeding, the possibility of metastatic renal cell carcinoma should be considered. Percutaneous transcatheter arterial embolization is an effective and novel treatment for uncontrollable vaginal bleeding caused by vaginal metastasis of RCC.
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Affiliation(s)
- Zhihai Geng
- Department of Urology, Taizhou First People's Hospital, Zhejiang Province, China
| | - Qinghua Zhang
- Department of Urology, Taizhou First People's Hospital, Zhejiang Province, China
| | - Peng Jia
- Department of Radiology and Interventional Medicine, Taizhou First People's Hospital, Zhejiang Province, China
| | - Jia Miao
- Department of Urology, Taizhou First People's Hospital, Zhejiang Province, China
| | - Qian Lin
- Department of Urology, Taizhou First People's Hospital, Zhejiang Province, China
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Wei Q, Fan G, Li Z, Wang Q, Li K, Wang C, Li Z. Middle Meningeal Artery Embolization for the Treatment of Bilateral Chronic Subdural Hematoma. Front Neurol 2021; 12:651362. [PMID: 34777190 PMCID: PMC8582486 DOI: 10.3389/fneur.2021.651362] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Bilateral chronic subdural hematoma (bCSDH) is a frequent condition commonly linked to the need for retreatment; however, the reason for this high retreatment rate remains unclear. The middle meningeal artery (MMA) was found to have a relationship with the occurrence and development of chronic subdural hematomas. This study examines a possible method to reduce bCSDH recurrence using bilateral MMA embolization combined with bilateral burr-hole drainage. Materials and Methods: Ten patients with bCSDH who underwent bilateral MMA embolization combined with bilateral burr-hole drainage at our hospital between June 2018 and May 2020, were retrospectively analyzed. Patients' clinical information, prognoses, imaging results, as well as surgical results were documented and analyzed. Results: Ten patients were diagnosed with bCSDH with no comorbid brain diseases. They underwent bilateral MMA embolization combined with bilateral burr-hole drainage. We embolized the MMA immediately before burr hole drainage successfully and employed angiography to validate these results. All the patients attained relief of symptoms without adverse events, and no re-expansion or relapse was reported in the follow-up computed tomography. Conclusion: Bilateral MMA embolization combined with bilateral burr-hole drainage is an available treatment for patients with bCSDH and may have the potential for preventing recurrence.
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Affiliation(s)
- Qi Wei
- Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China
| | - Gangxian Fan
- Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China.,Department of Neurosurgery, Linyi People's Hospital, Linyi, China
| | - Zhenzhu Li
- Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China.,Department of Neursosurgery, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Qingbo Wang
- Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China
| | - Ke Li
- Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China
| | - Chao Wang
- Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China
| | - Zefu Li
- Department of Neurosurgery, Binzhou Medical University Hospital, Binzhou, China
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Li W, Tang H, Chen Y, Sun M, Wang Z. Effect of risk management combined with precision care in interventional embolization of cerebral aneurysm in elderly patients. Am J Transl Res 2021; 13:7687-7694. [PMID: 34377245 PMCID: PMC8340262] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 04/14/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the effect of risk management combined with intraoperative precision care on the efficacy and safety of interventional embolization therapy for elderly patients with cerebral aneurysms. METHODS In this prospective randomized controlled study, we included 60 elderly patients with cerebral aneurysm treated with interventional embolization. The patients were randomly divided into an experiment group (n=30) and a control group (n=30). The control group received conventional care during the interventional procedure, while the experiment group received risk management combined with precision care. The outcome of the procedure, time to disappearance of clinical symptoms, length of hospitalization, incidence of complications, neurological function and quality of life before and 3 months after the procedure in both groups were assessed and compared. RESULTS Compared with the control group, the experiment group had significantly less intraoperative bleeding, shorter operative time (all P<0.001), shorter time to disappearance of clinical symptoms and shorter hospitalization (all P<0.001), and a lower rate of surgical complications (P<0.05). Three months after the operation, the experiment group had better neurological function and quality of life, with significantly lower mRs scores (modified Rankin scale), NIHSS (National Institute of Health Stroke Scale) and higher SF-36 scores (MOS item short from health survey) than those of the control group (both P<0.001). CONCLUSION Risk management combined with precision care can effectively improve the surgical safety of interventional embolization in elderly patients with cerebral aneurysm, reduce the incidence of surgical complications, and thus improve the prognosis.
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Affiliation(s)
- Wei Li
- Department of Interventional Radiology, Xuanwu Hospital of Capital Medical University Beijing, China
| | - Hongyan Tang
- Department of Interventional Radiology, Xuanwu Hospital of Capital Medical University Beijing, China
| | - Yuan Chen
- Department of Interventional Radiology, Xuanwu Hospital of Capital Medical University Beijing, China
| | - Mengmeng Sun
- Department of Interventional Radiology, Xuanwu Hospital of Capital Medical University Beijing, China
| | - Zheng Wang
- Department of Interventional Radiology, Xuanwu Hospital of Capital Medical University Beijing, China
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Zhou D, Wei D, Xing W, Li T, Huang Y. Effects of craniotomy clipping and interventional embolization on treatment efficacy, cognitive function and recovery of patients complicated with subarachnoid hemorrhage. Am J Transl Res 2021; 13:5117-5126. [PMID: 34150100 PMCID: PMC8205842] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This research was designed to investigate the effects of craniotomy clipping and interventional embolization (IE) on the treatment efficacy, cognitive function and recovery of patients with subarachnoid hemorrhage (SAH). METHODS A total of 148 patients with aneurysmal subarachnoid hemorrhage (ASAH) who underwent surgery in our hospital from December 2017 to August 2019 were included. They were divided into the clipping group (CG) (68 cases) and intervention group (IG) (80 cases) according to different surgical methods. The former received craniotomy clipping, and the latter underwent IE. The postoperative clinical indexes of patients were observed. The immune function (IgG, IgM, IgA) and inflammatory indexes (TNF-α, IL-8, HS-CRP) were detected before and after operation. The improvement of cognitive function, neurological function and sleep quality before and after operation was evaluated. Three months after operation, the treatment efficacy was evaluated and the postoperative complications were recorded. RESULTS The time of operation and hospitalization of patients in the IG were dramatically less than those in the CG (P < 0.05). The levels of IgG, IgM and IgA in the IG were higher than those in the CG after operation, while those of TNF-α, IL-8 and hs-CRP in the IG were lower than those in the CG. The MOCA scores of patients in the IG were obviously higher than those in the CG (P < 0.05), and the NIHSS and PSQI scores of patients in the IG were markedly lower than those in the CG. The total effective rate of patients in the IG was remarkably higher than that in the CG (P < 0.05), while the total incidence of postoperative complications in the IG was markedly lower than that in the CG. CONCLUSION IE is effective in the treatment of SAH patients, reducing the damage of immune, cognitive and nerve functions, with a high efficacy.
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Affiliation(s)
- Dezhong Zhou
- Brain Center, Sanya People's Hospital Sanya 572000, Hainan Province, China
| | - Didai Wei
- Brain Center, Sanya People's Hospital Sanya 572000, Hainan Province, China
| | - Weizhou Xing
- Brain Center, Sanya People's Hospital Sanya 572000, Hainan Province, China
| | - Tinglong Li
- Brain Center, Sanya People's Hospital Sanya 572000, Hainan Province, China
| | - Yun Huang
- Brain Center, Sanya People's Hospital Sanya 572000, Hainan Province, China
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Niu Y, Chen T, Tang J, Jiang Z, Zhu G, Chen Z. Detachable balloon embolization as the preferred treatment option for traumatic carotid-cavernous sinus fistula? Interv Neuroradiol 2019; 26:90-98. [PMID: 31451026 DOI: 10.1177/1591019919871849] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE The purpose of the study was to investigate the treatments and outcomes of patients with traumatic carotid-cavernous sinus fistula (TCCF). METHODS All patients diagnosed with TCCF at our institution from January 2013 to December 2018 and meeting the inclusion/exclusion criteria were included in the study. RESULTS A total of 24 patients were included in this study. Of them, 21 (87.5%) were treated with detachable balloon embolization, 1 (4%) with coil embolization, 1 (4%) with balloon-assisted coil embolization, and 1 (4%) with balloon-assisted coil and glue embolization. Among the 21 patients treated with detachable balloon embolization, 10 underwent double-balloon technique embolization including double-detachable balloon embolization (n = 6) and balloon-assisted detachable balloon embolization (n = 4). The fistulas in 17 patients (17/21, 81%) were successfully occluded after the first attempt of detachable balloon embolization, while those in the remaining 4 patients were occluded after a second surgery due to TCCF recurrence or pseudoaneurysm development. Preservation of the internal carotid artery (ICA) was observed in 19 cases after the first treatment by detachable balloon embolization (19/21, 90.4%). ICA was occluded in the remaining two patients, as revealed by a complete angiographic evaluation of the circle of Willis. All patients achieved complete resolution of ocular and orbital manifestations as well as pulsatile bruit, except for three patients whose oculomotorius and/or abducens remained paralyzed during the follow-up period. CONCLUSION Although several endovascular treatment options are available for TCCF, the detachable balloon embolization is still the preferred method of TCCF, as evidenced in our study. Furthermore, double balloon technique, an improvement upon the conventional detachable balloon embolization, is extremely safe and can effectively treat patients with refractory TCCF.
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Affiliation(s)
- Yin Niu
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Tunan Chen
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Jun Tang
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - ZhouYang Jiang
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Gang Zhu
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Zhi Chen
- Department of Neurosurgery, Southwest Hospital, Army Medical University, Chongqing, China
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Xu W, Qi X, Wang X, Sun J. Effect of interventional embolotherapy on FHIT and p16 expression in hepatocellular carcinoma patients. Oncol Lett 2019; 17:871-876. [PMID: 30655841 PMCID: PMC6313009 DOI: 10.3892/ol.2018.9648] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 10/08/2018] [Indexed: 01/26/2023] Open
Abstract
Effects of interventional embolotherapy on the expression of fragile histidine triad (FHIT) and p16 in hepatocellular carcinoma (HCC) patients were investigated. Patients with primary HCC who were definitely diagnosed and treated in the Department of Gastroenterology in Qingdao Central Hospital from March 2014 to March 2016 were selected, and they underwent interventional embolotherapy. HCC and cancer-adjacent tissues of the patients were harvested for immunohistochemical staining. The correlation between the expression levels of FHIT and p16 was analyzed at the gene and protein level. Clinical data were collected, and whether they were correlated with the expression of FHIT and p16 was investigated. The expression levels of FHIT and p16 in primary HCC tissues were remarkably lower than that in cancer-adjacent tissues (P<0.05). In HCC tissues, FHIT expression was obviously positively correlated with p16 expression (Spearman's correlation coefficient, r=0.308; P=0.025). FHIT was related to HCC tumor-node-metastasis (TNM) staging, the differentiation degree in Edmondson-Steiner grading, lymph node metastasis and portal vein thrombosis (P<0.05 in all comparisons), whereas, p16 was associated with tumor size and the differentiation degree in Edmondson-Steiner grading (P<0.05 in all comparisons). The expression of FHIT and p16 genes and proteins in HCC tissues were obviously lower than those in cancer-adjacent tissues (P<0.05 in all comparisons). FHIT and p16 genes, as tumor suppressor genes, inhibit the proliferation of HCC, and there is a positive correlation between them. The proteins of the FHIT and p16 can be used as new indicators for clinical detection, thus providing a new method for clinical diagnosis.
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Affiliation(s)
- Wei Xu
- Department of Intervention, Qingdao Central Hospital, Qingdao Cancer Hospital, Qingdao, Shandong 266042, P.R. China
| | - Xiaogai Qi
- Department of Radiotherapy, Qingdao Cancer Hospital, Qingdao, Shandong 266042, P.R. China
| | - Xia Wang
- Department of Ultrasound, Qingdao Cancer Hospital, Qingdao, Shandong 266042, P.R. China
| | - Jize Sun
- Department of Intervention, Qingdao Central Hospital, Qingdao Cancer Hospital, Qingdao, Shandong 266042, P.R. China
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Zhang X, Chen L, Zheng F, Du Y. The efficacy of microsurgery in the treatment of cerebral aneurysm rupture and its effect on NF-κB, MCP-1 and MMP-9. Exp Ther Med 2017; 14:3744-3748. [PMID: 29042973 PMCID: PMC5639380 DOI: 10.3892/etm.2017.4928] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 08/03/2017] [Indexed: 12/15/2022] Open
Abstract
The clinical efficacy of microsurgical neck clipping for the treatment of cerebral aneurysm rupture and its effect on serum nuclear factor κ-light-chain-enhancer of activated β cells (NF-κB), monocyte chemoattractant protein-1 (MCP-1) and matrix metalloproteinase-9 (MMP-9) levels were investigated. A total of 56 patients with first occurrence of cerebral aneurysm rupture were enrolled from June 2015 to June 2016. These patients were divided into control (25 patients) and observation groups (31 patients) according to treatment received. The patients in the control group were treated with interventional embolization and extraventricular drainage, while the patients in the observation group were treated with microsurgical neck clipping. Serum NF-κB, MCP-1 and MMP-9 levels were measured by ELISA prior to the operation and at 6 h post-operation. Clinical effects were compared at the 6-month follow-up. There was no significant difference in the success rate of the operation between the two groups (p>0.05). The incidence of complications in the observation group was significantly lower than that in the control group (p<0.05). The Glasgow Outcome Scale score was significantly improved in the observation group (p<0.05) compared with the control group. Serum NF-κB, MMP-9 and MCP-1 were significantly decreased in both groups at 6 and 24 h after operation, but the observational group showed significantly lower levels for all three proteins than the control group (p<0.05). The application of early microsurgical neck clipping for the treatment of cerebral aneurysm rupture can reduce complications and improve clinical prognosis, and this may be related to a decrease in serum inflammatory response-related factors (NF-κB and MCP-1) and MMP-9.
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Affiliation(s)
- Xintong Zhang
- The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, P.R. China.,The Second Clinical Medical School of Inner Mongolia University for the Nationalities, Yakeshi, Inner Mongolia 022150, P.R. China
| | - Lei Chen
- Hulunbuir People's Hospital, Hulunbuir, Inner Mongolia 021000, P.R. China
| | - Feng Zheng
- Department of Neurosurgery, University Hospital of Cologne, D-50937 Cologne, Germany.,Department of Cerebrovascular Disease, Affilliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P.R. China
| | - Yanli Du
- The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, P.R. China
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Yuan SM, Cui L, Guo Y, Wang J, Hu XB, Jiang HQ, Hong ZJ. Surgical management of giant neurofibroma in soft tissue: a single-center retrospective analysis. Int J Clin Exp Med 2015; 8:5245-5253. [PMID: 26131098 PMCID: PMC4483935] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/17/2015] [Indexed: 06/04/2023]
Abstract
Neurofibroma, a common benign tumor in soft tissue, continues to grow, and often appears to be giant. In this study, we retrospectively analyzed the surgical treatment of 26 patients with giant neurofibromas in our clinic in the past 10 years from Jan. 2004 to Dec. 2013. The tumors were located in the head (n = 10), trunk (n = 9), limbs (n = 5), and multi-sites (n = 2). According to the location and extent of the lesion, as well as the adjacent anatomy, surgical management was performed to partially (n = 15) or almost completely (n = 11) resect the tumor. The wounds were repaired by skin flap or skin graft. Among them, one child with a giant tumor in the scalp underwent three times of skin expander treatment, and acquired complete removal of the tumor finally without baldness. Eleven cases underwent the interventional embolization of tumor's nutrient arteries, which successfully reduced the bleeding in operation. Most of the skin flap and skin graft survived well. After operation, the appearance of the patients and the function of the limbs were improved largely. In conclusion, for the giant neurofibroma, surgical treatment effectively reduces the tumor burden, rehabilitates the appearance and function, and so improves the quality of life. Skin expandor and interventional embolization of nutrient artery can be used when appropriate.
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Affiliation(s)
- Si-Ming Yuan
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University Nanjing 210002, Jiangsu, China
| | - Lei Cui
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University Nanjing 210002, Jiangsu, China
| | - Yao Guo
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University Nanjing 210002, Jiangsu, China
| | - Jun Wang
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University Nanjing 210002, Jiangsu, China
| | - Xin-Bao Hu
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University Nanjing 210002, Jiangsu, China
| | - Hui-Qing Jiang
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University Nanjing 210002, Jiangsu, China
| | - Zhi-Jian Hong
- Department of Plastic Surgery, Jinling Hospital, School of Medicine, Nanjing University Nanjing 210002, Jiangsu, China
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