Imaging Features of Symptomatic Radiation-induced Cervical Artery Stenosis

Recently,the survival rate of head and neck cancer patients has increased with the improvement of radiotherapy （RT） technology and comprehensive treatment.Cancer survivors after RT are at increased risk for cerebrovascular events. Radiation-induced cervical artery stenosis （RICAS） has its own characteristics compared with those lesions without a history of RT.

Percutaneous cervical carotid artery access with stenting of the left internal carotid artery in an elderly patient

To describe the successful endovascular treatment in a nonagenarian with symptomatic internal carotid artery stenosis using direct carotid artery access. An independent 98 year-old man was admitted to our hospital for symptoms of progressive weakness with disorientation and dysphasia. Carotid Duplex ultrasonography was performed which revealed a totally occluded right internal carotid artery and high grade stenosis of the left internal carotid artery by velocities of 608/240 cm/sec. The patient refused surgical endarterectomy and thus he was referred for carotid artery stenting. Using the femoral artery approach and multiple catheter techniques, access to the common carotid artery could not be accomplished safely. The procedure was aborted and he was therefore brought back to the catheterization laboratory the following day for direct carotid access. Carotid artery stenting was accomplished by using of a 6F sheath percutaneously in the left common carotid, cerebral protection device (CPD) and a Nitinol stent. The patient was discharged the following day without complications. At 14 months follow-up the patient is functional and independent without recurrence of symptoms. Carotid artery stenting via direct access can be accomplished in patients when the femoral artery approach is anatomically prohibitive. In this case of advanced age and the patient’s refusal for surgery, direct carotid access was his only option.

Clinical Efficacy of Acupuncture Combined with Massage on Cervical Spondylopathy of Vertebral Artery Type and Its Effect on Hemodynamics of Patients

Objective:To investigate the clinical efficacy of acupuncture combined with massage on cervical spondylopathy of vertebral artery type and its effect on hemodynamics of patients.Methods:Sixty patients with vertebral artery type cervical spondylosis treated in our hospital from July 2017 to October 2019 were selected as the research subjects and randomly divided into 2 groups of 30 cases each.The control group was treated with acupuncture,and the observation group was treated with acupuncture combined with massage,and the clinical efficacy and hemodynamic index of the two groups were compared after 1 month of treatment[peak systolic blood velocity(PSV),pulsatile index(PI),time mean flow velocity(TMFV)].Results:There was no statistical difference in the PSV,PI,and TMFV between the two groups before treatment(P>0.05).After treatment,the observation group had a higher treatment efficacy than the control group with PSV and TMFV increasing and PI decreasing in both groups,and the change in the observation group was greater than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Acupuncture combined with massage on cervical spondylopathy of vertebral artery type can improve the clinical efficacy and improve the hemodynamic index of patients,which is worthy of clinical application.

Acupuncture-based treatments on cervical spondylosis of vertebral artery type

Cervical spondylosis of vertebral artery type is one of the chief patterns of cervical spondylosis.It is often described as neck pain accompanied with radiating pain and neurologic symptoms,such as sudden dizziness,blurred vision,tinnitus,nausea,vomiting,memory loss,and sudden fainting.The incidence of cervical spondylosis increases and patients with cervical spondylosis become progressively younger.Acupuncture in the cervical spondylosis of vertebral artery type treatment has a local positive reaction“Liuhe point”,in order to dredge the local Qi and blood.More and more evidences into the effectiveness and safety of cervical spine acupuncture for cervical spondylosis,specific neck pain,cervical radiculopathy,etc.This article summarizes the recent literature on acupuncture and acupuncture combined with other therapies for cervical spondylosis of vertebral artery type treatment and provides a comprehensive review from the perspectives of acupuncture therapy,warm needle moxibustion therapy,electroacupuncture,and acupuncture combined with other therapies,in order to provide reference and reference for clinical treatment.

All roads lead to Rome——Direct cervical carotid artery access in carotid artery intervention

Carotid artery stenting (CAS) is an alternative treatment for patients with severe carotid artery stenosis, especially those with prohibitively high surgical risks.……

MULTI-CENTER RANDOMIZED CONTROLLED TRIALS OF COMBINED TREATMENT OF VERTEBRAL ARTERY TYPE CERVICAL SPONDYLOSIS WITH ACUPUNCTURE AND MASSAGE

Objective.To evaluate the clinical value of synthetical therapy of acupuncture and massage for treating vertebral artery type cervical spondylosis （VACS）. Methods： In the present study, triple-center, single-blind, randomized and control methods were adopted. Qualified subjects were randomly assigned to three groups： acupuncture-massage （acu-mas） group, acupuncture group, and massage group （60 subjects in each group）. Bilateral Fengchi （风池 GB 20）, Jiaji （夹脊 EX-B 2, C4-7） and Baihui （百会 GV 20） ware punctured in combination with massage at the neck-shoulder and back region. The treatment was conducted once daily, 14 times altogether. Results. After treatment, of the 60 cases in each of acu-mas, acupuncture and massage groups, 28, 11 and 13 were cured, 13, 20 and 17 markedly effective, 12, 14 and 16 effective, and 7, 15 and 14 ineffective, with the total effective rates being 88.3%, 75.0% and 76.7% respectively. The therapeutic effect of acu-mas group was significantly superior to that of simple acupuncture and massage groups （P〈 0.05）. The scores of clinical symptoms and signs in 3 groups all declined significantly after treatment （ P〈 0.01 ）, and the score of symptoms of acu-mas was markedly lower than those of acupuncture and massage groups （P〈 0.05）. No significant differences were found among 3 groups in the score of clinical signs and between acupuncture and massage groups in the score of clinical symptoms （P〉0.05）. The time for producing therapeutic effects in acu-mas group was significantly shorter than those of acupuncture and massage groups （P〈0.01, 0.05）, meanng a faster of aou-mas group in producing clinical effect. No adverse events ware found in all the 3 groups. Conclusion： Acupuncture and massage are effective and safe in the treatment of VACS, and the therapeutic effect of acupuncture combined with massage is superior to that of simple acupuncture and simple massage therapy.

TREATMENT OF VERTEBRAL－ARTERY TYPE CERVICAL SPONDYLOPATHY WITH NEEDLE－KNIFE THERAPY

In the present paper, 62 cases of vertebral artery type cervical spondylopathy were treated with needle knife therapy (acupotomy). After 2-6 sessions of treatment, 23 cases (37.1%) were cured, 19 (30.7%) showed marked improvement, 15 (24.2%) had some improvement and 5 (8.1%) failed in the treatment. The total effective rate was 91.9%. It indicates that acupotomy therapy is a highly effective remedy for treating vertebral artery type cervical spndylopathy.

OBSERVATION ON THE THERAPEUTIC EFFECT OF ACPUNCTURE COMBINED WITH MASSAGE FOR CERVICAL SPONDYLOSIS OF VERTEBRAL ARTERIAL TYPE BY USING TRANCRANIAL DOPPLYER ULTRASONOGRAPHY

To observe the effect of acupuncture combined with massage on blood flow velocity of the vertebro-basilar artery in cervical spondylosis of vertebral arterial type （CSVAT） patients. Methods： In the present study, methods of evidence-based medicine, triple-centers, single-blindness, randomization and control were used. A total of 100 cases of CSVAT patients were randomized into acupuncture plus massage （acu-massage） group （n = 38）, acupuncture group （n = 32） and massage group （n = 30）. Acupoints used were Fengchi （风池, GB 20）, cervical Jiaji （颈夹脊 EX-B 2）, Baihui （百会 GV 20）, and the methods of massage used were kneading-rolling, adhesion-separating and acupoint-digital pressing, topical digital pressing and rubbing, traction-extending and mild palm-rubbing. The treatment was conducted once daily, with 7 sessions being a therapeutic course and continuously for 2 courses. Changes of peak velocity （Vp）, end-diastolic velocity （Vd）, mean velocity （Vm） of blood flow of the vertebral artery （VA） and basilar artery （BA）, etc were detected before and after the treatment by using transcranial Doppler （TCD） ultrasonography. Resuits： After the treatment, the abnormally low Vp of both VA and BA in acu-massage, acupuncture and massage groups, Vm of VA in acu-massage and acupuncture groups, Vm of BA in acu-massage and massage groups, and Vd of VA and BA in the 3 groups all increased significantly in comparison with their own pretreatment（ P 〈 0.05, 0.01）, and the therapeutic effects of acu-massage group in the 3 indexes were significantly superior to those of acupuncture group and/or massage group （P 〈0.05, 0.01 ）. The abnormally increased Vp of VA in acu-massage and acupuncture groups, Vm of VA in the 3 groups, and Vd of VA in acu-massage and massage groups decreased obviously after the treatment in comparison with their own pretreatment （P 〈 0.05, 0.01）, and the therapeutic effects of acu-massage group were significantly superior to those of acupuncture and/or massage group in the 3 indexes of VA （P〈0.05, 0.01）. In addition, the abnormally increased Vp, Vm and Vd of BA in the 3 groups showed a similar tendency. No significant differences between acupuncture and massage groups in 3 indexes （ P 〉0.05）. Conclusion： The therapeutic effects of acupuncture plus massage is significantly superior to those of simple acupuncture and simple massage therapies in improving abnormal blood dynamics of vertebral and basilar arteries in CSVAT patients.

Cervical Spondylopathy Involving the Vertebral Arteries Treated by Body-Acupuncture Combined with Scalp-Acupuncture in 72 Cases

Among various types of cervical spondylopathy, the one involving the vertebral arteries is frequently encountered in the middle-aged and the old people. It is often accompanied with arteriosclerosis and high blood viscosity, and clinically it is difficult to be treated. From March 1996 to December 2000, the authors hadtreated 72 cases of cervical spondylopathy of this type and achieved satisfactory therapeutic effects shown by clinical symptoms and indicated by the trans-cranial Doppler ultrasonic examination (TCD). This is reported as follows. ……

Efficacy observation on cervical spondylosis of vertebral artery type treated with warm needling and rehabilitation physiotherapy therapy

Objective To compare the differences in the efficacy on cervical spondylosis of the vertebral artery type （CSA） treated with the warm needling therapy combined with the rehabilitation physiotherapy, the simple warm needling therapy and the simple rehabilitation physiotherapy separately and observe the impacts of them on the vertebral basilar artery （VBA） in hemodynamics. Methods Ninety cases of CSA patients were randomized divided into an acupuncture plus rehabilitation group, a warm needling group and a rehabilitation group, 30 cases in each. In the acupuncture ＋ rehabilitation group, the warm needling therapy was used at Jiájǐ （夹脊 EX-B 2） from C3 to C7 in combination with the rehabilitation physiotherapy such as traction and magnetic therapy. In the warm needling group, the simple warm needling therapy was applied. In the rehabilitation group, the simple rehabilitation physiotherapy was adopted. The VBA hemodynamic parameters, Vp, Vd, Vm and PI values were detected under the transcranial Doppler and taken as the indexes for the efficacy assessment of the groups. The efficacy of each group was assessed in association with the clinical curative rate. Results After treatment, the VBA hemodynamic parameters, Vp, Vd, Vm and PI values were all remarkably improved as compared with those before treatment in the three groups （P〈0.01, P〈0.05）. The improvement of the indexes in the acupuncture plus rehabilitation group were more significant as compared with either of the other two groups （all P〈0.01）. The clinical curative rate was 70.0% （21/30） in the acupuncture plus rehabilitation group, which was superior to 53.3% （16/30） in the warm needling group and 53.3% （16/30） in the rehabilitation group （all P〈0.01）. Conclusion The warm needling in combination with the rehabilitation physiotherapy significantly improves in VBA hemodynamic parameters for CSA and its clinical efficacy is superior to either the simple warm needling or the rehabilitation physiotherapy. Hence, this combined therapy was highly deserved to be promoted in clinical practice.

The filiform fire needling therapy for cervical spondylosis of vertebral artery type:120 cases report

Objective To verify the clinical efficacy of the filiform-fire needling therapy on cervical spondylosis of vertebral artery type（CSA）.Methods One hundred and twenty cases of CSA were treated with the filiform-fire needling therapy.The acupoints were Bǎihuì（百会 GV 20）,Fēngchí（风池 GB 20）,Nǎohù（脑户 GV 17）,Jìngbǎiláo（颈百劳 EX-HN 15）,etc.The needles were inserted rapidly and retained for 20 min.The treatment was given once a day.7 treatments made 1 session.The efficacy was assessed after 1 session of treatment.Results Eighty-eight cases were effective markedly,accounting for 73.3%.Twenty-seven cases were effective,accounting for 22.4%.Five cases were failed,accounting for 4.2%.The total effective rate was 95.8%.Conclusion The filiform-fire needling therapy achieves the significant efficacy on CSA.