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Biliary stent combined with iodine-125 seed strand implantation in malignant obstructive jaundice

World Journal of Clinical Cases 2021年第4期9卷 801-811页

作者： Hui-Wen Wang Xiao-Jing Li Shi-Jie Li Jun-Rong Lu Dong-Feng He department of interventional Harbin Medical University Cancer HospitalHarbin 150081Heilongjiang ProvinceChina

BACKGROUND Malignant obstructive jaundice is mainly caused by *** a few patients are indicated for surgical resection,and the 3-year survival rate is<50%.For patients who are not eligible for surgery,biliary stent placement can relieve biliary obstruction and improve liver function and quality of ***,restenosis after biliary stents has a poor prognosis and is a clinical *** stent combined with iodine-125(125I)seed implantation can prolong stent patency and improve *** To evaluate the safety and efficacy of biliary stent combined with 125I seed strand implantation in malignant obstructive *** We enrolled 67 patients between January 2016 and June 2018 with malignant obstructive jaundice and randomized them into a biliary stent combined with 125I seed strand treatment(combined)group(n=32)and biliary stent(control)group(n=35).All patients underwent enhanced computed tomography and magnetic resonance imaging and were tested for biochemical and cancer *** patients underwent pathological examination before *** patients were followed up by telephone or clinical *** liver function improvement,postoperative complications,stent patency time,and survival time were compared between the two *** risk factors were *** Technical success was achieved in all patients in both *** liver function improved significantly in all patients(total bilirubin,direct bilirubin,alanine aminotransferase,and aspartate aminotransferase decreased significantly in all patients,the P values were less than 0.05).There was no significant difference in preoperative or postoperative indexes between the two groups for changes in total bilirubin(P=0.147),direct bilirubin(P=0.448),alanine aminotransferase(P=0.120),and aspartate aminotransferase(P=0.387)between the two *** median stent patency time of the combined group was 9.0±1.4 mo[95%confidence interval(CI):6

关键词： Biliary stent 125I Obstructive jaundice Malignant tumor Clinical research Surgery

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Prolonged high-pressure balloon angioplasty of femoropopliteal lesions：Impact on stent implantation rate and mid-term outcome

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Journal of Geriatric Cardiology 2014年第2期11卷 126-130页

作者： Gianluca Rigatelli Mariano Palena Paolo Cardaioli Fabio dell'Avvocata Massimo Giordan Dobrin Vassilev Marco Manzi Cardiovascular Diagnosis and Endoluminal Interventions Rovigo General Hospital Rovigo Italy interventional Radiology Unit Abano Terme General Hospital Padova Italy interventional Cardiology department National Heart Institute Sofia Bulgaria

Objectives To assess the impact on stent implantation rate and mid-term outcomes of prolonged high pressure angioplasty of femoropopliteal lesions. Methods We retrospectively enrolled 620 consecutive patients from January 2011 to December 2011 （75.6 ±12.3 years, 355 males, 76.5%in Rutherford class 5-6）, referred for critical limb ischemia and submitted to prolonged high-pressure angioplasty of femoropopliteal lesions. The definition of prolonged high-pressure angioplasty includes dilation to at least 18 atm for at least 120 s. Proce-dural data, and clinical and instrumental follow-up were analyzed to assess stent implantation rate and mid-term outcomes. Results The preferred approach was ipsilateral femoral antegrade in 433/620 patients （69.7%） and contralateral cross-over in 164/620 （26.4%） and pop-liteal retrograde＋femoral antegrade in 23/620 （3.7%）. Techniques included subintimal angioplasty in 427/620 patients （68.8%） and endolu-minal angioplasty in 193/620 patients （31.2%）. The prolonged high pressure balloon angioplasty procedure was successful in 86.2%（minor intra-procedural complications rate 15.7%）, stent implantation was performed in 74 patients （11.9%）, with a significant improvement of ankle-brachial index （0.29 ±0.6 vs. 0.88 ±0.3, P〈0.01） and Rutherford class （5.3 ±0.8 vs. 0.7 ±1.9, P〈0.01）, a primary patency rate of 86.7%, restenosis of 18.6%on Doppler ultrasound and a target lesion revascularization of 14.8%at a mean follow-up of 18.1 ±6.4 months （range 1-24 months）. Secondary patency rate was 87.7%. Conclusions Prolonged high pressure angioplasty of femoropopliteal lesions appears to be safe and effective allowing for an acceptable patency and restenosis rates on mid-term.

关键词： Peripheral artery disease Angioplasty Balloon Stent

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Novel imaging biomarkers of response to transcatheter arterial chemoembolization in hepatocellular carcinoma patients

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Chinese Journal of Cancer Research 2015年第6期27卷 611-616页

作者： Sylvain Favelier Louis Estivalet Pierre Pottecher Romaric Loffroy department of Vascular Oncologic and Interventional Radiology University of Dijon School of Medicine Bocage Teaching Hospital

Hepatocellular carcinoma common cause of cancer death （HCC） is the third most worldwide （1）. Most patients present with intermediate or advanced disease that is not amenable to curative treatment, and the median survival in this group is 6-8 months （2）. Several studies and well- designed randomized trials have shown a positive effect of transcatheter arterial chemoembolization （TACE） on patient outcome and survival （3-8）. As nicely described in the present article from Wring et al., assessment of tumor response is of extreme importance in patients undergoing locoregional treatments of liver cancer （9）. Early assessment of the effectiveness of TACE and monitoring of tumor response are paramount to the identification of treatment failure, guidance of future therapy, and determination of the interval for repeat treatment.

关键词： TACE Novel imaging biomarkers of response to transcatheter arterial chemoembolization in hepatocellular carcinoma patients HCC CBCT

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Portal stent with endovascular brachytherapy improves the efficacy of TACE for hepatocellular carcinoma with main portal vein tumor thrombus

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Hepatobiliary & Pancreatic Diseases International 2020年第2期19卷 187-190页

作者： Tian Li Chong Liu Jin-Tong He Kai-Da Sui Zhou-Bo Zhang Duo Hong Hong-Ying Su Hai-Bo Shao department of interventional Radiology the First Hospital of China Medical UniversityShenyang 110001China

Hepatocellular carcinoma(HCC)with portal vein tumor throm-bus(PVTT)yields poor prognosis with a median overall survival(OS)of 2.7–4 months[1].Once PVTT develops in the main portal vein,the sudden appearance of portal hypertension often leads to fatal complications,including esophagogastric variceal hemorrhage,refractory ascites,and liver *** chemoemboliza-tion(TACE)has been recommended for advanced HCC patients by China Liver Cancer Group due to its benefit of OS compared with using sorafenib alone[2].For the treatment of PVTT,portal stent with endovascular iodine-125 brachytherapy(PSEIB)was re-cently reported to be effective because it relieved portal hyper-tension rapidly and controlled PVTT effectively with an improved OS of 9.3–12.5 months[3,4].The combination of PSEIB and TACE had been applied in some studies[3,4].Nevertheless,these studies failed to demonstrate the effect of PSEIB on TACE *** we aimed to present a case how PSEIB improves the efficacy of TACE for HCC patients with main PVTT.

关键词： portal Portal alone

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Sorafenib Combined with Cryoablation to Treat Unresectable Hepatocellular Carcinoma

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Chinese Journal of Cancer Research 2011年第3期23卷 188-193页

作者： Hong Ni Mao Yang Zhi Guo Ti Zhang department of interventional Therapy Tianjin 300060China department of Hepatobiliary Disease Cancer Institute ＆ HospitalTianjin Medical UniversityTianjin 300060China

Objective：To evaluate the efficacy and tolerability of sorafenib combined with cryoablation in treating unresectable hepatocellular carcinoma （HCC）.Methods：Patients with unresectable advanced HCC received cryoablation and sorafenib at a dose of 400 mg twice daily in 4-week cycles on the same day of the *** response,median overall survival and the median time to radiological progression were calculated and the toxicity was ***：Seventy-eight patients with unresectable HCC were involved in this *** median age was 52 years （range,22-81 years）.The Eastern Cooperative Oncology Group （ECOG） performance status scores were 0 （39.7%）,1 （55.1%）,and 2 （5.1%）.Nine （11.5%） patients were at Barcelona clinic liver cancer （BCLC） stage A,twenty-four （30.8%） patients were at stage B and 45 （57.7%） patients were at stage *** （6.4%） achieved partial responses,and 34 （43.6%） achieved stable *** median time to progression （TTP） for all enrolled patients was 6.6 months and the median overall survival （OS） was 12.2 ***：Cryoablation combined with sorafenib demonstrates good efficacy and acceptable tolerability in treating unresectable advanced HCC patients.

关键词： Hepatocellular carcinoma Sorafenib Cryoablation Unresectable

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Combined therapy with transcatheter arterial chemoembolization and percutaneous microwave coagulation for small hepatocellular carcinoma

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World Journal of Gastroenterology 2009年第6期15卷 748-752页

作者： Wei-Zhu Yang Na Jiang Ning Huang Jing-Yao Huang Qu-Bin Zheng Quan Shen interventional Radiology department Union Hospital Fujian Medical University Fuzhou 350001 Fujian Province China

AIM:To assess the efficacy of combined transcatheter arterial chemoembolization(TACE)and percutaneous microwave coagulation therapy(PMCT)for small hepatocellular carcinoma(HCC). METHODS:Thirty-five patients with a total of 41 HCC nodules(≤3 cm in diameter)were treated with TACE followed by computed tomograghy(CT)-guided percutaneous microwave coagulation therapy(PMCT) within 1-3 wk. RESULTS:By biopsies and enhanced CT scans, complete necrosis of the tumor and 3-5 mm of the surrounding non-cancerous area were observed in 34 *** seven foci,incomplete necrosis of the surrounding parenchyma was *** alpha- fetoprotein(AFP)levels returned to normal 10 d after treatment in 25 patients who originally had high serum AFP *** follow-up period was 6-31 mo,and all patients remained *** patient had a recurrence in the subsegments of the liver,and another patient had a recurrence near the original lesion. CONCLUSION:Combined therapy with TACE and PMCT is a safe and effective treatment without severe complications for small HCC.

关键词： Liver neoplasms Therapy Hepatocellular carcinoma Transcatheter arterial chemoembolization Microwave coagulation therapy Percutaneous local treatment

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A temporary self-expanding metallic stent for malignant colorectal obstruction

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World Journal of Gastroenterology 2013年第7期19卷 1119-1123页

作者： Xiao-Li Ding Yong-Dong Li Rui-Min Yang Fen-Bao Li Ming-Qiu Zhang department of Imaging and interventional Center The First Affiliated Hospital of Xinxiang Medical College Institute of Diagnostic and interventional Radiology The Sixth Affiliated People's HospitalShanghai Jiao Tong University

AIM:To investigate the clinical safety and efficacy of a temporary self-expanding metallic stent(SEMS) for malignant colorectal ***:From September 2007 to June 2012,33 patients with malignant colorectal obstruction were treated with a temporary *** stent had a tubular configuration with a retrieval lasso attached inside the proximal end of the stent to facilitate its *** SEMS was removed one week after *** examination,abdominal X-ray and a contrast study were prospectively performed and both initial and follow-up data before and at 1 d,1 wk,and 1 mo,3 mo,6 mo and 12 mo after stent placement were *** collected on the technical and clinical success of the procedures,complications,need for reinsertion and survival were ***:Stent placement and removal were technically successful in all patients with no procedurerelated ***-procedural complications included stent migration(n = 2) and anal pain(n = 2).Clinical success was achieved in 31(93.9%) of 33 patients with resolution of bowel obstruction within 3 d of stent *** of the 33 patients died 73.81 ± 23.66 d(range 42-121 d) after removal of the stent without colonic *** success was achieved in another 8 patients without symptoms of obstruction during the follow-up *** of the stent was performed in the remaining 12 patients with re-obstruction after 84.33 ± 51.80 d of *** mean and median periods of relief of obstructive symptoms were 97.25 ± 9.56 d and 105 ± 17.43 d,respectively,using Kaplan-Meier ***:Temporary SEMS is a safe and effective approach in patients with malignant colorectal obstruction due to low complication rates and good medium-term outcomes.

关键词： Self-expanding metallic stents Colorectum Malignant obstruction Complications

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Stent fracture after transjugular intrahepatic portosystemic shunt placement using the bare metal stent/stent-graft combination technique

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World Journal of Gastrointestinal Surgery 2023年第10期15卷 2133-2141页

作者： Qi-Jia Liu Xiao-Feng Cao Yun Pei Xuan Li Guo-Xiang Dong Chang-Ming Wang department of interventional Radiology and Vascular Surgery Peking University Third HospitalBeijing 100191China department of interventional Therapy Yangquan First People’s HospitalYangquan 045000Shanxi ProvinceChina

BACKGROUND A transjugular intrahepatic portosystemic shunt(TIPS)is widely placed to treat portal *** the Viatorr®stent(*** and Associates,Flagstaff,AZ,United States)is not available in all hospitals in China,the bare metal stent(BMS)/stent-graft combination technique is still popular for TIPS *** fracture is a complication after TIPS placement using this technique,with limited available literature focusing on *** To assess the incidence of stent fracture after TIPS placement using the BMS/stent-graft combination technique and to identify the risk factors for stent *** proposed technique modifications to improve the clinical results of TIPS placement with the BMS/stent-graft combination *** We retrospectively analyzed the computed tomography(CT)data of all patients with portal hypertension who underwent the TIPS procedure between June 2011 and December 2021 in a single *** implanted with the BMS/stent graft and had follow-up imaging data available were *** identified patients with stent fracture and analyzed their *** logistic regression was applied to identify the potential predictors of stent *** Of the 68 included patients,stent fracture occurred in seven(10.3%)*** on CT images,the stent fractures were categorized into three *** study consisted of four(57.1%)type I fractures,one(14.3%)type II fracture,one(14.3%)type IIIa fracture,and one(14.3%)type IIIb *** adjusting for covariates,multivariable logistic regression revealed that the risk factors for stent fracture were the implantation of a greater number of stents[adjusted odds ratio(aOR)=22.2,95%confidence interval(CI):1.2-415.4,P=0.038]and a larger proximal sagittal stent bending angle(aOR=1.1,95%CI:1.0-1.3,P=0.020).CONCLUSION Stent fracture occurred in approximately 10%of patients with portal hypertension who underwent TIPS with the BMS/stent-graft combination tec

关键词： Portal hypertension Transjugular intrahepatic portosystemic shunt Stent fracture Bare metal stent/stent-graft combination Risk factor Fracture types

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Hepatic venous pressure gradient: Inaccurately estimates portal venous pressure gradient in alcoholic cirrhosis and portal hypertension

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World Journal of Gastrointestinal Surgery 2023年第11期15卷 2490-2499页

作者： Dan Zhang Tao Wang Zhen-Dong Yue Lei Wang Zhen-Hua Fan Yi-Fan Wu Fu-Quan Liu department of interventional Therapy Beijing Shijitan HospitalCapital Medical UniversityBeijing 100038China department of interventional Therapy Yantai Yuhuangding Hospital of Qingdao UniversityYantai 264099Shandong ProvinceChina

BACKGROUND Portal hypertension(PHT)in patients with alcoholic cirrhosis causes a range of clinical symptoms,including gastroesophageal varices and *** hepatic venous pressure gradient(HVPG),which is easier to measure,has replaced the portal venous pressure gradient(PPG)as the gold standard for diagnosing PHT in clinical ***,attention should be paid to the correlation between HVPG and *** Between January 2017 and June 2020,134 patients with alcoholic cirrhosis and PHT who met the inclusion criteria underwent various pressure measurements during transjugular intrahepatic portosystemic shunt *** were assessed using Pearson’s correlation coefficient to estimate the correlation coefficient(r)and determination coefficient(R^(2)).Bland-Altman plots were constructed to further analyze the agreement between the *** were analyzed using paired t tests,and P values<0.05 were considered statistically *** In this study,the correlation coefficient(r)and determination coefficient(R2)between HVPG and PPG were 0.201 and 0.040,respectively(P=0.020).In the 108 patients with no collateral branch,the average wedged hepatic venous pressure was lower than the average portal venous pressure(30.65±8.17 vs.33.25±6.60 mmHg,P=0.002).Hepatic collaterals were identified in 26 cases with balloon occlusion hepatic venography(19.4%),while the average PPG was significantly higher than the average HVPG(25.94±7.42 mmHg vs 9.86±7.44 mmHg;P<0.001).The differences between HVPG and PPG<5 mmHg in the collateral vs no collateral branch groups were three cases(11.54%)and 44 cases(40.74%),*** In most patients,HVPG cannot accurately represent *** formation of hepatic collaterals is a vital reason for the strong underestimation of HVPG.

关键词： Portal hypertension Portal venous pressure gradient Hepatic venous pressure gradient Alcoholic cirrhosis Hepatic collateral

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Endovascular revascularisation of acute tandem vertebrobasilar artery occlusion:seven case series with literature reviews

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Stroke & Vascular Neurology 2018年第1期3卷 17-21页

作者： Haihua Yang Ning Ma Shiyong Zhang Xiaochuan Huo Feng Gao Xuan Sun Dapeng Mo Zhongrong Miao department of interventional Neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina department of Neurology Beijing Daxing HospitalCapital Medical UniversityBeijingChina department of interventional Neurology Beijing Fengtai Youanmen HospitalBeijingChina

background The outcome of acute ischaemic stroke due to tandem vertebrobasilar artery occlusion was *** revascularisation may be a positive approach for acute basilar artery occlusion combined with vertebral ostium stenosis or *** reported seven patients with acute vertebrobasilar tandem occlusion by using angioplasty or stenting for proximal lesion and thrombectomy for distal *** and methods Consecutive patients with acute tandem vertebrobasilar artery occlusion at two centres were included in this *** retrospectively analysed the clinical,technical and functional outcomes of the *** From March 2016 to March 2017,seven patients were *** mean age and National Institute of Health Stroke Scale score at admission was 57 years and 22,respectively.A reverse approach was used in five *** Thrombolysis in Cerebral Infarction score 2b-3 was acquired in all *** were no procedural *** modified Rankin Scale score was 1-2 for three patients and 4 for one patient at 3 *** patients died at 3 months of *** Endovascular revascularisation may be feasible for acute tandem vertebrobasilar artery occlusion,and more researches are needed.

关键词： occlusion acute vertebrobasilar

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