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Long-term results of extensive aortoiliac occlusive disease (EAIOD) treated by endovascular therapy and risk factors for loss of primary patency

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Chinese Medical Journal 2021年第8期134卷 913-919页

作者： Xiao-Lang Jiang Yun Shi Bin Chen Jun-Hao Jiang Tao Ma Chang-Po Lin Da-Qiao Guo Xin Xu Zhi-Hui Dong Wei-Guo Fu Institute of Vascular Surgery Department of Vascular SurgeryZhongshan HospitalFudan UniversityCenter for Vascular Surgery and Wound CareJinshan HospitalFudan UniversityShanghai 201508China

Background::Although endovascular therapy has been widely used for focal aortoiliac occlusive disease(AIOD),its performance for extensive AIOD(EAIOD)is not fully evaluated.We aimed to demonstrate the long-term results of EAIOD treated by endovascular therapy and to identify the potential risk factors for the loss of primary patency.Methods::Between January 2008 and June 2018,patients with a clinical diagnosis of the 2007 TransAtlantic Inter-Society Consensus II(TASC II)C and D AIOD lesions who underwent endovascular treatment in our institution were enrolled.Demographic,diagnosis,procedure characteristics,and follow-up information were reviewed.Univariate analysis was used to identify the correlation between the variables and the primary patency.A multivariate logistic regression model was used to identify the independent risk factors associated with primary patency.Five-and 10-year primary and secondary patency,as well as survival rates,were calculated by Kaplan-Meier analysis.Results::A total of 148 patients underwent endovascular treatment in our center.Of these,39.2%were classified as having TASC II C lesions and 60.8%as having TASC II D lesions.The technical success rate was 88.5%.The mean follow-up time was 79.2±29.2 months.Primary and secondary patency was 82.1%and 89.4%at 5 years,and 74.8%and 83.1%at 10 years,respectively.The 5-year survival rate was 84.2%.Compared with patients without loss of primary patency,patients with this condition showed significant differences in age,TASC II classification,infrainguinal lesions,critical limb ischemia(CLI),and smoking.Multivariate logistic regression analysis showed ageendovascular therapy was an effective treatment for EAIOD with encouraging patency and survival rate.Age<61 years,CLI,and smoking were independent risk factors for the loss of pr

关键词： Critical limb ischemia endovascular therapy Extensive aortoiliac occlusive disease Mortality Primary patency Risk factors

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endovascular treatment vs drug therapy alone in patients with mild ischemic stroke and large infarct cores

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World Journal of Clinical Cases 2022年第28期10卷 10077-10084页

作者： Wen-Hui Kou Xiao-Qin Wang Jin-Shui Yang Nan Qiao Xiao-Hui Nie Ai-Mei Yu Ai-Xia Song Qian Xue Department of Neurology First Affiliated Hospital of Hebei North UniversityZhangjiakou 075061Hebei ProvinceChina

BACKGROUND Treatment decision making is strictly associated with the outcomes in patients with ischemic stroke who show a large core infarct.Medical care alone may result in suboptimal treatment efficacy,and endovascular treatment may be accompanied by safety issues.Whether endovascular treatment is superior to medical care is not well investigated in the clinical studies.AIM To investigate the efficacy of endovascular treatment and drug therapy alone in mild ischemic stroke patients with large infarct cores.METHODS Fifty patients with mild ischemic stroke and 50 patients with acute ischemic stroke caused by anterior large vessel occlusion were selected at the First Affiliated Hospital of Hebei North University between January 2021 and December 2021.Patients were divided into an endovascular therapy group and a drug therapy group according to different treatment methods.In the endovascular therapy group,there were 28 patients with minor stroke and 22 patients with large infarct cores.The drug therapy group had 22 patients with minor stroke and 28 patients with large infarct cores.The National Institutes of Health Stroke Scale(NIHSS) scores were collected and compared between the two groups immediately after the operation and 24 h and 7 d after the operation.The modified Rankin scale(m RS) and/or activity of daily living were assessed at hospital discharge.RESULTS There was no significant difference in NIHSS scores between the two groups before the operation(P > 0.05).NIHSS scores were lower in the endovascular therapy group than in the drug therapy group at 24 h and 7 d after the operation and at hospital discharge(all P endovascular therapy group than in the drug therapy group(P endovascular treatment group than in the drug therapy group,and the activity of daily living score was better in the endovascular treatment group than in the drug therapy group(all P < 0.05)

关键词： Ischemic stroke Large infarct cores endovascular therapy Drug therapy Efficacy

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Analysis on endovascular therapy for Acute Ischemic Stroke with Large Vessel Occlusion and Large-Scaled Core Infarct Volume in the Time Window

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World Journal of Neuroscience 2022年第4期12卷 181-186页

作者： Gang Yang Shaojun Yang Yaojie Cai Department of Neurosurgery Zhuji Affiliated Hospital of Shaoxing University Shaoxing China Department of Neurology Zhuji Affiliated Hospital of Shaoxing University Shaoxing China

Patients who received endovascular therapy (EVT) for acute ischemic stroke with large vessel occlusion (AIS-LVO) and large-scaled core infarct volume in the time window were analyzed. Literature data were reviewed. Results showed that although EVT is the first choice to AIS-LVO, patients often have poor prognosis. Alberta stroke program early CT score (ASPECTS) based on computerized tomography angiography source image (CTA-SI) can reflect the real cerebral perfusion more truly, and it can assess the size of core infarct more quickly and accurately, thus enabling to judge prognosis.

关键词： Acute Ischemic Stroke with Large Vessel Occlusion endovascular therapy

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Willis covered stent in the treatment of a recurrent blood blister-like aneurysm after pipeline implementation:A case report

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Journal of Interventional Medicine 2023年第2期6卷 96-98页

作者： Yu Fu Feng Fan Jing Li Sheng Guan Department of Neurointervention Radiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina Henan Neurointerventional Engineering Research Center China

Blood blister-like aneurysms(BBAs)are fragile and difficult to treat.However,the optimal treatment has yet to be determined.Pipeline embolization devices and Willis covered stent implementation are still controversial strategies for treating BBA.Herein,we report a case of recurrent BBA successfully treated with a Willis covered stent.A long-term follow-up angiography after the procedure indicated complete occlusion of the aneurysm.This case demonstrates the safety and efficacy of applying the Wills cover stent in the treatment of recurrent BBA after Pipeline implantation.

关键词： Blood blister-like aneurysm endovascular therapy Pipeline embolization device Willis covered stent

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Onyx embolization of a spinal epidural hemorrhage caused by thoracic spinal epidural arteriovenous fistula:A case report and literature review

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Journal of Interventional Medicine 2022年第2期5卷 111-115页

作者： Xi Chen Liang Ge Hailin Wan Lei Huang Yeqing Jiang Gang Lu Xiaolong Zhang Department of Radiology Huashan HospitalFudan UniversityShanghai200040.China

Spinal epidural hemorrhages(SEDH)caused by spinal epidural arteriovenous fistulas(SEAVFs)are rare;thus,their specific pathogenesis has not been explained.Furthermore,the standard treatment for SEAVFs has not yet been defined.Here we report the case of a 36-year-old Chinese man who experienced acute onset chest pain and tightness.His symptoms rapidly aggravated until the lower limbs were unable to support him.Spinal magnetic resonance angiography(MRA)revealed a localized SEAVF and a secondary spinal cord lesion at the T4 level.Digital subtraction angiography(DSA)confirmed the presence of the SEDH/SEAVF at the T3–4 level with the left radicular artery feeding the fistula.Based on DSA and MRA findings,SEDH,local spinal cord infarction,and spinal venous reflux disorder were conditionally diagnosed.Using the arterial route,Onyx-34 was injected into the fistula to embolize the feeding arteries and the venous system.Angiography was performed after the microcatheter was withdrawn,and no residual fistula or anterior spinal artery was observed.The six-week follow-up MRI showed acceptable healing of the SEAVF,and the patient improved neurologically.This case suggests that endovascular treatment with Onyx-34 embolization should be considered a promising treatment strategy for this type of complicated SEAVF.

关键词： endovascular therapy Spinal epidural arteriovenous fistula Spinal epidural hemorrhage

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Management of Acute Lower Extremity Thrombosis Associated with Bilateral Popliteal Aneurysms Using Combined Thrombolytic therapy and Stent Graft Repair

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Chinese Medical Journal 2015年第4期128卷 564-566页

作者： Bao-Lei Guo Wei-Guo Fu Zhen-Yu Shi Li-Xin Wang Da-Qiao Guo Department of Vascular Surgery Zhongshan Hospital Fudan University Institute of Vascular Surgery Shanghai 200032 China

To the Editor：This is a brief clinical report on different endovascular procedures in the treatment of popliteal artery aneurysms （PAAs）.A 75-year-old man presented at the vascular clinic with progressive left lower limb pain at rest associated with coolness,pain,and paresthesia.His medical history was significant for hypertension and hyperlipidemia.The femoral and popliteal pulsations were only felt in the left limb.Coldness,pallor,paresthesia,delayed capillary refilling,and color changes were noted in the left limb together with rest pain.Duplex ultrasound was performed and an embolization （Rutherford Grade 2b） and bilateral PAAs were found,which on computed tomography angiogram （CTA） measured 62 mm and 82 mm with the maximum diameters in the right and left popliteal artery,respectively.Thrombus was found in both aneurysm sacs [Figure 1 a and b].Thromboembolism from the left PAA could be seen in the distal arteries.Other potentially associated aneurysms were excluded by magnetic resonance angiography.The erythrocyte sedimentation rate and C-reactive protein were moderately elevated,and thrombophilia profile was negative,and history for any orogenital ulcers was negative.

关键词： Popliteal Artery Aneurysms endovascular therapy Stent Grafts

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Loss of bifurcation patency after cross-over stenting of ostial lesions in superficial femoral artery： possible causes, prevention and reintervention

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Chinese Medical Journal 2014年第18期127卷 3291-3295页

作者： Jiang Junhao Chen Bin Dong Zhihui Shi Yun Li Weimiao Yue Jianing Department of Vascular Surgery Zhongshan Hospital FudanUniversity Shanghai 200032 China

Background Crossover stenting across the origin of the profunda femoral artery （PFA） and occasionally into the common femoral artery （CFA） is commonly used after suboptimal balloon angioplasty of ostial occlusive lesions of the superficial femoral artery （SFA） involving the bifurcation. Late stent occlusion at the bifurcation is not rare and results in severe lower extremity ischemia. Therefore, we tried to assess its possible causes, prevention and reintervention. Methods Using a prospectively maintained single-center database, 12-month femoral bifurcation patency was retrospectively compared and lesion and procedural predictors of stent occlusion were determined among 63 patients （64 lesions） who between July 2011 and February 2013 underwent crossover （36 non-jailed and 15 jailed SFA, and 12 distal and 1 complete CFA） stenting of de novo ostial SFA lesions. Results Twelve-month overall patency rate at the femoral bifurcation was 88%, with no significant difference between jailed-ostial SFA （80%） and distal CFA （67%） stenting （P=0.731）, and significant differences between either and non-jailed ostial stenting （100%,P=0.035 and 0.002）. When PFA ostium was jailed by the stent, patients with preexisting CFA or PFA lesions had a 12-month bifurcation patency rate of 20%, significantly lower than those with simple ostial SFA lesions （83%, P=0.015）. Stent induced intimal hyperplasia caused bifurcation occlusion in 6 surgical reintervention cases. Conclusions In crossover stenting of ostial lesions in SFA, bifurcation patency loss was significantly higher in distal CFA and jailed ostial SFA stenting than non-jailed ostial SFA stenting. Preexisting CFA or PFA lesion is a significant risk factor for bifurcation patency loss when PFA ostium is jailed by crossover stenting.

关键词： peripheral arterial disease endovascular therapy femoral bifurcation perioperative outcomes

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A novel cerebrovascular drug-coated balloon catheter for treating symptomatic intracranial atherosclerotic stenosis lesions:Study protocol for a prospective,multicenter,single-arm,target-value clinical trial

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Journal of Interventional Medicine 2023年第4期6卷 179-185页

作者： Qianhao Ding Wenbo Liu Jingge Zhao Dehua Guo Yao Tang Tengfei Zhou Yanyan He Ferdinand K.Hui Yonghong Ding Liangfu Zhu Zilang Wang Yingkun He Tianxiao Li Department of Cerebrovascular Disease and Neurosurgery Zhengzhou University People's HospitalHenan University People's HospitalHenan Provincial People's HospitalHenan Provincial Neurointerventional Engineering Research CenterHenan International Joint Laboratory of Cerebrovascular Disease and Henan Engineering Research Center of Cerebrovascular InterventionZhengzhou450003China Clinical Research Center Zhengzhou University People's HospitalHenan Provincial People's HospitalZhengzhou450003China Neuroscience Institute Queen's Medical CenterUniversity of HawaiiHonoluluHIUSA Department of Radiology Mayo ClinicRochesterMNUSA

Background:Previous single-center studies have demonstrated that drug-coated balloons(DCBs)may reduce restenosis rates,which is an important factor affecting the prognosis for intracranial interventional therapy.However,currently available cardiac DCBs are not always suitable for the treatment of intracranial atherosclerotic stenosis(ICAS).This study aimed to evaluate the safety and efficacy of a novel DCB catheter designed for patients with severely symptomatic ICAS.Methods:This prospective,multicenter,single-arm,target-value clinical trial was conducted in 9 Chinese stroke centers to evaluate the safety and efficacy of a novel DCB catheter for treating symptomatic severe ICAS.Primary metrics and other indicators were collected and analyzed using SAS version 9.4(SAS Institute,Cary,NC,USA).Results:A total of 155 patients were enrolled in this study.The preliminary collection of follow-up data has been completed,while data quality control is ongoing.Conclusion:Results of this study demonstrated the patency rate,safety,and effectiveness of a novel on-label paclitaxel DCB designed for the treatment of ICAS.Ethics and dissemination:This study,involving human participants,was reviewed and approved by the Ethics Committee of Drugs(Devices)Clinical Experiment at Henan Provincial People’s Hospital(reference number:2020-145-03)and other research centers participating in the clinical trial.The results of this study will be presented at international conferences and sent to peer-reviewed journals for publication.Standard protocol items:The Recommendations for Interventional Trials checklist was used when drafting the study protocol.Trial registration number:Registered with the Chinese Clinical Trial Registry on June 11,2021(Chi CTR2100047223).

关键词： Intracranial arterial stenosis Drug-coated balloon Ischemic stroke Transient ischemic attack endovascular therapy

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颅骨修补术后癫痫发作的相关因素Logistic分析

颅骨修补术后癫痫发作的相关因素Logistic分析

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2020年浙江省神经外科学学术大会

作者：王耿焕褚正民沈建国褚闻来朱坤灿嘉兴学院附属第二医院

目的 :探索颅骨修补术后癫痫发作的相关因素。方法:回顾性分析2009年1 月至2019年12 月我院神经外科收治的470例颅骨修补术患者的临床资料,术后随访0.5-2.5年,按术后癫痫发作情况,分为癫痫发作组和无癫痫发作组,比较两组患者各种因素的... 详细信息

目的 :探索颅骨修补术后癫痫发作的相关因素。方法:回顾性分析2009年1 月至2019年12 月我院神经外科收治的470例颅骨修补术患者的临床资料,术后随访0.5-2.5年,按术后癫痫发作情况,分为癫痫发作组和无癫痫发作组,比较两组患者各种因素的差异,以探寻癫痫发作的影响因素。结果:470例患者中颅骨修补术后出现癫痫发作76例(16.2%)。单因素分析显示,皮瓣凹陷,大骨瓣,术前昏迷,双侧修补,围手术期使用抗癫痫药物有统计学意义 (均P<0.05)。多因素Logistic分析显示皮瓣凹陷,大骨瓣,围手术期使用抗癫痫药物有统计学差异(均P<0.05)。

关键词： Traumatic pseudoaneurysm endovascular therapy Internal maxillary artery Superficial temporal artery Occipital artery External carotid artery

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Traumatic pseudoaneurysms of external carotid artery branch: case series, and treatment considerations

Traumatic pseudoaneurysms of external carotid artery branch:...

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2020年浙江省神经外科学学术大会

作者：王耿焕褚正民沈建国周海航嘉兴学院附属第二医院

Aim To explore the diagnosis and treatment of traumatic external carotid branch pseudoaneurysms.Material and Methods Eleven cases of traumatic external carotid artery branch pseudoaneurysms were admitted in our hospital.Digital subtraction angiography (DSA) was performed in all patients.It revealed the pseudoaneurysms originated from the internal maxillary artery in 5 cases,superficial temporal artery in 5 cases and occipital artery in 1 case.Five cases of internal maxillary artery pseudoaneurysms and 2 cases of superficial temporal artery pseudoaneurysms were treated by embolization,the other 3 cases were surgically resected.Results Complete cessation of nasal bleeding was achieved in all the 5 pseudoaneurysms of internal maxillary artery after the endovascular therapies.Scalp Bleeding stopped and scalp defect healed up in 2 patients with superficial temporal artery pseudoaneurysms treated by interventional therapy.All patients were followed up for 0.5-2 year without recurrence of nosebleed and scalp lump.Conclusion For patients with repeated severe epistaxis after craniocerebral injury,DSA should be performed as soon as possible to confirm traumatic pseudoaneurysm.endovascular therapy is an effective method for traumatic internal maxillary artery pseudoaneurysms.For patients with scalp injuries and pulsatile lumps,further examinations including DSA should be performed to conform the diagnosis.Surgical treatment or endovascular therapy for scalp traumatic pseudoaneurysm is effective.

关键词： Traumatic pseudoaneurysm endovascular therapy Internal maxillary artery Superficial temporal artery Occipital artery External carotid artery

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