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Prostatic Arterial embolization with Small Sized Particles for the Treatment of Lower Urinary Tract Symptoms Due to Large Benign Prostatic Hyperplasia： Preliminary Results

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Chinese Medical Journal 2015年第15期128卷 2072-2077页

作者： Qiang Li Feng Duan Mao-Qiang Wang Guo-Dong Zhang Kai Yuan Department of Radiology 309^th Hospital of People's Liberation Army Beijing 100091 China Department of Interventional Radiology Chinese People's Liberation Army General Hospital Beijing 100853 China

Background：The clinical failure after prostatic artery embolization （PAE） with conventional particles was relatively high,in treatment for lower urinary tract symptoms （LUTS） due to benign prostatic hyperplasia （BPH）.We reported the results of PAE with combined polyvinyl alcohol particles 50 μm and 100 μm in size as a primary treatment in 24 patients with severe LUTS secondary to large BPH.Methods：From July 2012 to June 2014,we performed PAE in 24 patients （65-85 years,mean 74.5 years） with severe LUTS due to large BPH （≥80 cm^3） and refractory to medical therapy.embolization was performed using combination of 50 μm and 100 μm in particles size.Clinical follow-up was performed using the International Prostate Symptom Score （IPSS）,quality of life （QoL）,peak urinary floW （Qmax）,postvoid residual （PVR） volume,the International Index of Erectile Function （IIEF）,prostatic specific antigen （PSA）,and prostatic volume measured by magnetic resonance imaging at 1,3,6,and every 6-month thereafter.Technical success was defined when PAE was completed in at least one pelvic side.Clinical success was defined as the improvement of both symptoms and QoL.A Student＇s t-test for paired samples was used.Results：PAE was technically successful in 22 patients （92%）.Bilateral PAE was performed in 19 （86%） patients and unilateral in 3 （14%） patients.Follow-up data were available for 22 patients observed for mean of 14 months.The clinical improvement at 1,3,6,and 12-month was 91%,91%,88%,and 83%,respectively.At 6-month follow-up,the mean IPSS,QoL,PVR,and Qmax were from 27 to 8 （P =0.001）,from 4.5 to 2.0 （P =0.002）,from 140.0 ml to 55.0 ml （P =0.002）,and from 6.0 ml/s to 13.0 ml/s （P =0.001）,respectively.The mean prostate volume decreased from 110 cm3 to 67.0 cm3 （mean reduction of 39.1%;P =0.00 1）.The PSA and IIEF improvements after PAE did not differ from pre-PAE significantly.No major adverse events were noted.Conclusions：The combination of 50μm and 100 μm particles for PAE is a safe and effective treatment method for patients with sever

关键词： Angiography Benign Prostatic Hyperplasia embolization Lower Urinary Tract Symptoms Prostatic Artery embolization Therapeutic

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Effect of Transcatheter embolization by Autologous Fat Particles in the Treatment of Coronary Artery Perforation During Percutaneous Coronary Intervention

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Chinese Medical Journal 2015年第6期128卷 745-749页

作者： Li-Yun He Jiang-Li Han Li-Jun Guo Fu-Chun Zhang Ming Cui Wei Gao Department of Cardiology Peking University Third Hospital Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides Ministry of Health Key Laboratory of Molecular Cardiovascular Sciences Ministry of Education Beijing 100191 China

Background:Coronary artery perforation (CAP) is a rare but severe complication of percutaneous coronary intervention (PCI).The aim of our study was to evaluate the effect and safety of transcatheter embolization by autologous fat particles in the treatment of CAP.Methods:Once the CAP was confirmed,a little autologous subcutaneous fatty tissue was obtained from the groin of the patient and then was made into 1 mm× 1 mm fat particles.The perforated vessel was embolized by fat particles via a micro-catheter.There were eight patients undergoing transcatheter embolization by autologous fat particles in the treatment of CAP during PCI in Peking University Third Hospital from February 2009 to June 2014,and the clinical data of these patients were collected and analyzed retrospectively.Results:The lesion morphology of the patients was classified based on the American College of Cardiology/American Heart Association Task Force classification,there were one patient with Class B2 lesion and seven patients with Class C lesions (there were five patients with chronic total occlusion lesions).According to the Ellis classification of CAP,there were six patients with Class Ⅱ perforations and two patients with Class Ⅲ perforations.The causes of perforation included that seven patients induced by guide wire and one patient by balloon predilation.Three patients had pericardial effusion.All of the eight patients with CAP underwent transcatheter embolization by autologous fat particles.Coronary angiography confirmed that all of them were embolized successfully.There was no severe complication after the procedure.The coronary angiography of one patient at l week and another patient at 2 years after the embolization showed that the embolized arteries had recanalized.The median follow-up time was 20.3 months (8.8-50.2 months),the event-free survival rate was 100％.Conclusions:Transcatheter embolization by autologous fat particles was an effective,safe,cheap,and easy way to treat the perforation of small vessels during PCI.

关键词： Autologous Fat Particles Coronary Artery Perforation embolization Percutaneous Coronary Intervention

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Rescue associating liver partition and portal vein ligation for staged hepatectomy after portal embolization: Our experience and literature review

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World Journal of Clinical Oncology 2017年第4期8卷 351-359页

作者： Charlotte Maulat Antoine Philis Bérénice Charriere Fatima-Zohra Mokrane Rosine Guimbaud Philippe Otal Bertrand Suc Fabrice Muscari Department of Visceral Surgery Toulouse-Rangueil University Hospital Department of Radiology Toulouse-Rangueil University Hospital Department of Digestive Oncology Toulouse-Rangueil University Hospital

AIM To report a single-center experience in rescue associating liver partition and portal vein ligation for staged hepatectomy(ALPPS), after failure of previous portal embolization. We also performed a literature review.METHODS Between January 2014 and December 2015, every patient who underwent a rescue ALPPS procedure in Toulouse Rangueil University Hospital, France, was included. Every patient included had a project of major hepatectomy and a previous portal vein embolization(PVE) with insufficient future liver remnant to body weight ratio after the procedure. The ALPPS procedure was performed in two steps(ALPPS-1 and ALPPS-2), separated by an interval phase. ALPPS-2 was done within 7 to 9 d after ALPPS-1. To estimate the FLR, a computed tomography scan examination was performed 3 to 6 wk after the PVE procedure and 6 to 8 d after ALPPS-1. A transcystic stent was placed during ALPPS-1 and remained opened duringthe interval phase, in order to avoid biliary complications. Postoperative liver failure was defined using the 50-50 criteria. Postoperative complications were assessed according to the Dindo-Clavien Classification.RESULTS From January 2014 to December 2015, 7 patients underwent a rescue ALPPS procedure. Median FLR before PVE, ALPPS-1 and ALPPS-2 were respectively 263 cc(221-380), 450 cc(372-506), and 660 cc(575-776). Median FLR/BWR before PVE, ALPPS-1 and ALPPS-2 were respectively 0.4%(0.3-0.5), 0.6%(0.5-0.8), and 1%(0.8-1.2). Median volume growth of FLR was 69%(18-92) after PVE, and 45%(36-82) after ALPPS-1. The combination of PVE and ALPPS induced a growth of median initial FLR of +408 cc(254-513), leading to an increase of +149%(68-199). After ALPPS-2, 4 patients had stage Ⅰ-Ⅱ complications. Three patients had more severe complications(one stage Ⅲ, one stage Ⅳ and one death due to bowel perforation). Two patients suffered from postoperative liver failure according to the 50/50 criteria. None of our patients developed any biliary complication during the ALPPS procedure.CONCLUSION Rescue ALPPS may be an

关键词： Rescue associating liver partition and portal vein ligation for staged hepatectomy Associating liver partition and portal vein ligation for staged hepatectomy Portal vein embolization Liver resection Future liver remnant

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Superselective transcatheter arterial embolization to control renal hemorrhage after partial nephrectomy for renal tumors:A report of 9 cases and a literature review

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Journal of Interventional Medicine 2019年第3期2卷 134-138页

作者： Mengxuan Zuo Hui Yuan Shunling Ou Jinhua Huang Department of Minimal Invasive Intervention Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicinePR China

Objective:This study aimed to evaluate the efficacy and safety of selective arterial embolization for hemorrhage after renal surgery and to summarize the clinical experience.Materials and methods:A total of 9 patients underwent arterial embolization after partial nephrectomy from 2010 to 2018.Results:Technical success was achieved in all patients;however,3 patients underwent a secondary arterial embolization because of short-term re-hemorrhage or the co-occurrence of accessory renal arterial hemorrhage.No serious complications occurred during the follow-up.Conclusions:Superselective arterial embolization is an effective and minimally invasive treatment for hemorrhage after partial nephrectomy.To improve the success rate of surgery,attention should be paid to the evaluation of accessory renal arteries and the management of suspected bleeding arteries.

关键词： Renal tumor Postoperative hemorrhage Selective arterial embolization

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Prostate artery embolization for the treatment of urinary retention caused by large(>80 mL) benign prostatic hyperplasia: Results of 21 patients

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Journal of Interventional Medicine 2020年第3期3卷 142-145页

作者： Bing Yuan Yan Wang MaoQiang Wang Jinlong Zhang Jieyu Yan Kai Yuan Jinxin Fu Xiuqi Wang Department of Interventional Radiology Chinese PLA General Hospital28 Fu-xing Rd.Beijing100853PR China

Objective:A large prostate size(>80 m L)of benign prostatic hyperplasia(BPH)is technically challenging to treat surgically.This study aimed to investigate the safety and efficacy of super-selective prostatic artery embolization(PAE)for the treatment of urinary retention caused by large BPH.Methods:A total of 21 patients with urinary retention,indwelling urinary catheter,or suprapubic cystostomy as a consequence of giant BPH(prostate volume[PV]>80 mL)who sought treatment between January 2013 and December 2017 were enrolled.A microcatheter(1.9–2.7 Fr)and a"two-step embolization"combining 50-μm and100-μm polyvinyl alcohol embolization particles were used in all patients.International Prostate Symptom Score(IPSS),quality of life(QoL),PV,and prostate-specific antigen(PSA)were evaluated at 3,6,and 12 months postPAE.Clinical success was defined as removal of urinary catheter or suprapubic cystostomy and ability to void spontaneously.Results:The clinical success rate was 95.2%(20/21).Compared with pre-procedural values,IPSS,QoL,PV,and PSA showed statistically significant differences at 3,6,and 12 months post-PAE(P<0.05).There were no serious complications after PAE.Conclusions:PAE was safe and effective for the treatment of urinary retention caused by large BPH in patients without surgical treatment options.

关键词： Benign prostatic hyperplasia embolization Interventional radiology Urinary retention

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