We treated 33 cases of Budd-Chiari syndrome caused by locallized occlusive lesions of the inferior vena cava（IVC）with balloon dilatation and stent deployment. Of the 33,21 were male and 12 female.Complete“membranou...We treated 33 cases of Budd-Chiari syndrome caused by locallized occlusive lesions of the inferior vena cava（IVC）with balloon dilatation and stent deployment. Of the 33,21 were male and 12 female.Complete“membranous occhislon was found in 18，incomplete"membrane" in 6.and locallized stenosis in 9.展开更多
The effects of final kissing balloon dilatation （FKBD） have not been systemically evaluated in patients with coronary bifurcation lesions treated with 1-stent strategy. A meta-analysis was performed to in- tegrate t...The effects of final kissing balloon dilatation （FKBD） have not been systemically evaluated in patients with coronary bifurcation lesions treated with 1-stent strategy. A meta-analysis was performed to in- tegrate the results of independent studies to provide a more precise estimate of the treatment effect. Methods A systematic literature search was carried out for all the relevant articles up till March 2012. Only studies with adequate data reporting major adverse cardiac events （MACE） and target lesion revascularization （TLR）, and follow-up of at least 6 months were included. The endpoints analyzed in this meta-analysis were stent throm- bosis （ST）, all-cause death, myocardial infarction （MI）, MACE and TLR. Result Four studies were found to be eligible for inclusion in the meta-analysis. There were also no significant differences with the occurrence of MI （1.7% vs. 1.5%, OR 1.14, 95% CI 0.38 to 3.44, P = 0.81）, all-cause death （1.1% vs. 1.1%, P = 0.84, OR 0.91, 95% CI 0.35 to 2.35） and stent thrombosis （0.9% vs. 0.8%, OR 1.03, 95% CI 0.35 to 3.09, P = 0.95） in patients with FKBD or No FKBD. However, FKBD was associated with a higher risk of MACE （8.0% vs. 5.3%, OR 1.56, 95% CI, 1.02-2.39, P = 0.04）, primarily as a result of an increased risk of TLR （6.4% vs. 3.4%, OR 2.12, 95% CI 1.30 to 3.48 P = 0.003）. Conclusions In patients with coronary bifurca- tion lesions treated with 1-stent technique, FKBD may be associated with adverse outcomes mainly because of a higher rate of TLR.展开更多
A 78-year-old male was admitted to our hospital because of choledocholithiasis.ERC demonstrated choledocholithiases with a maximum diameter of 13 mm, and we performed endoscopic papillary large balloon dilation(EPLBD)...A 78-year-old male was admitted to our hospital because of choledocholithiasis.ERC demonstrated choledocholithiases with a maximum diameter of 13 mm, and we performed endoscopic papillary large balloon dilation(EPLBD) with a size of 15 mm.Immediately following the balloon deflation, spurting hemorrhage occurred from the orifice of the duodenal papilla.Although we performed endoscopic hemostasis by compressing the bleeding point with the large balloon catheter, we could not achieve hemostasis.Therefore, we placed a 10 mm fully covered selfexpandable metallic stent(SEMS) across the duodenal papilla, and the hemorrhage stopped immediately.After 1 wk of SEMS placement, duodenal endoscopy revealed ulcerative lesions in both the orifice of the duodenal papilla and the lower bile duct.A direct peroral cholangioscopy using an ultra-slim upper endoscope revealed a visible vessel with a longitudinal mucosal tear in the ulceration of the lower bile duct.We believe that the mucosal tear and subsequent ruptured vessel were caused by the EPLBD procedure.展开更多
AIM: To evaluate a new balloon-expandable stainless steel stent (Cordis stent) in a transjugular intrahepatic portosystemic shunt (TIPS) porcine model and compared with Wallstent. METHODS: TIPS was performed in 26 nor...AIM: To evaluate a new balloon-expandable stainless steel stent (Cordis stent) in a transjugular intrahepatic portosystemic shunt (TIPS) porcine model and compared with Wallstent. METHODS: TIPS was performed in 26 normal domestic pigs weighing 20 kg-30 kg using a Cordis stent or Wallstent (13 pigs in each stent). All pigs were sacrificed at the 14th day after TIPS. The stent deployment delivery system, stent patency, and stent recoil after placement were evaluated.Proliferative response in representative histological sections from the center,hepatic and portal regions of the two stent designs were quantified. RESULTS: The shunt was widely patent in 4 pigs in the Cordis stent group (4/12, premature dead in 1 pig), and in 5 pigs in the Wallstent group (5/13). All remaining stents of both designs were occluded or stenotic. The mean quantified proliferation including thickness of the proliferation and the ratio of proliferation: total area in three assayed regions in Cordis stent and Wallstent was 2.18 mm:2.00 mm, and 59.18 mm2:51.66 mm2, respectively (P 】 0.05). The delivery system and mechanical properties of the Cordis stent functioned well. CONCLUSION: The new Cordis stent is appropriate for TIPS procedure.展开更多
BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ...BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ingesting an enzyme-based chemical detergent,resulting in a serious pulmonary infection and severe malnutrition.Upper gastrointestinal imaging showed that he had an ETF,and endoscopy showed that he had extreme and severe esophageal stricture.This case was complex and difficult to treat.According to the domestic and foreign lite-rature,there is no universal treatment that is low-risk.CASE SUMMARY A patient came to our hospital with extreme ES,an ETF,and severe malnutrition complicated with pulmonary tuberculosis 1 mo after the consumption of an enzy-me-based detergent.The ES was serious,and the endoscope was unable to pass through the esophagus.We treated him by endoscopic incision method(EIM),esophageal stent placement(ESP),and endoscopic balloon dilation(EBD)by using the bronchoscope and gastroscope.This treatment not only closed the ETF,but also expanded the esophagus,with minimal trauma,greatly reducing the pain of the patient.According to the literature,there are no similar reported cases.CONCLUSION We report,for the first time,a patient with extreme CES complicated with ETF,where the endoscope could not be passed through his esophagus but he could be examined by bronchoscopy and treated by EIM,ESP,and EBD.展开更多
目的分析颅内大脑动脉闭塞型脑梗死患者急诊取栓术后补救性支架植入或者球囊扩张成形术对患者预后的影响。方法回顾性选取2020年10月—2023年10月临沂市中医医院收治的83例颅内大脑动脉闭塞型脑梗死取栓患者的临床资料。根据不同的治疗...目的分析颅内大脑动脉闭塞型脑梗死患者急诊取栓术后补救性支架植入或者球囊扩张成形术对患者预后的影响。方法回顾性选取2020年10月—2023年10月临沂市中医医院收治的83例颅内大脑动脉闭塞型脑梗死取栓患者的临床资料。根据不同的治疗方法分为两组,球囊扩张组49例、支架组34例,比较两组患者的动脉狭窄程度、预后情况、死亡率和生活质量。结果术后1周,支架组的动脉狭窄程度为(22.73±3.56)%,低于球囊扩张组的(31.84±4.67)%,差异有统计学意义(t=9.597,P<0.05)。术前,两组的美国国立卫生院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分比较,差异无统计学意义(P>0.05);术后3个月,支架组的NIHSS评分低于球囊扩张组,差异有统计学意义(P<0.05)。两组的预后情况和死亡率比较,差异无统计学意义(P均>0.05)。术后3个月,两组患者的Barthel指数评分较术前升高,差异有统计学意义(P均<0.05),但术后两组的Barthel指数评分比较,差异无统计学意义(P>0.05)。结论临床中针对颅内大脑动脉闭塞型脑梗死患者急诊取栓术后的进行支架植入可以有效改善患者的动脉狭窄程度和神经功能。支架植入和球囊扩张在患者预后和生活质量方面没有差异,临床中可以根据患者的不同情况选择不同的方法进行治疗。展开更多
文摘We treated 33 cases of Budd-Chiari syndrome caused by locallized occlusive lesions of the inferior vena cava（IVC）with balloon dilatation and stent deployment. Of the 33,21 were male and 12 female.Complete“membranous occhislon was found in 18，incomplete"membrane" in 6.and locallized stenosis in 9.
文摘The effects of final kissing balloon dilatation （FKBD） have not been systemically evaluated in patients with coronary bifurcation lesions treated with 1-stent strategy. A meta-analysis was performed to in- tegrate the results of independent studies to provide a more precise estimate of the treatment effect. Methods A systematic literature search was carried out for all the relevant articles up till March 2012. Only studies with adequate data reporting major adverse cardiac events （MACE） and target lesion revascularization （TLR）, and follow-up of at least 6 months were included. The endpoints analyzed in this meta-analysis were stent throm- bosis （ST）, all-cause death, myocardial infarction （MI）, MACE and TLR. Result Four studies were found to be eligible for inclusion in the meta-analysis. There were also no significant differences with the occurrence of MI （1.7% vs. 1.5%, OR 1.14, 95% CI 0.38 to 3.44, P = 0.81）, all-cause death （1.1% vs. 1.1%, P = 0.84, OR 0.91, 95% CI 0.35 to 2.35） and stent thrombosis （0.9% vs. 0.8%, OR 1.03, 95% CI 0.35 to 3.09, P = 0.95） in patients with FKBD or No FKBD. However, FKBD was associated with a higher risk of MACE （8.0% vs. 5.3%, OR 1.56, 95% CI, 1.02-2.39, P = 0.04）, primarily as a result of an increased risk of TLR （6.4% vs. 3.4%, OR 2.12, 95% CI 1.30 to 3.48 P = 0.003）. Conclusions In patients with coronary bifurca- tion lesions treated with 1-stent technique, FKBD may be associated with adverse outcomes mainly because of a higher rate of TLR.
文摘A 78-year-old male was admitted to our hospital because of choledocholithiasis.ERC demonstrated choledocholithiases with a maximum diameter of 13 mm, and we performed endoscopic papillary large balloon dilation(EPLBD) with a size of 15 mm.Immediately following the balloon deflation, spurting hemorrhage occurred from the orifice of the duodenal papilla.Although we performed endoscopic hemostasis by compressing the bleeding point with the large balloon catheter, we could not achieve hemostasis.Therefore, we placed a 10 mm fully covered selfexpandable metallic stent(SEMS) across the duodenal papilla, and the hemorrhage stopped immediately.After 1 wk of SEMS placement, duodenal endoscopy revealed ulcerative lesions in both the orifice of the duodenal papilla and the lower bile duct.A direct peroral cholangioscopy using an ultra-slim upper endoscope revealed a visible vessel with a longitudinal mucosal tear in the ulceration of the lower bile duct.We believe that the mucosal tear and subsequent ruptured vessel were caused by the EPLBD procedure.
文摘AIM: To evaluate a new balloon-expandable stainless steel stent (Cordis stent) in a transjugular intrahepatic portosystemic shunt (TIPS) porcine model and compared with Wallstent. METHODS: TIPS was performed in 26 normal domestic pigs weighing 20 kg-30 kg using a Cordis stent or Wallstent (13 pigs in each stent). All pigs were sacrificed at the 14th day after TIPS. The stent deployment delivery system, stent patency, and stent recoil after placement were evaluated.Proliferative response in representative histological sections from the center,hepatic and portal regions of the two stent designs were quantified. RESULTS: The shunt was widely patent in 4 pigs in the Cordis stent group (4/12, premature dead in 1 pig), and in 5 pigs in the Wallstent group (5/13). All remaining stents of both designs were occluded or stenotic. The mean quantified proliferation including thickness of the proliferation and the ratio of proliferation: total area in three assayed regions in Cordis stent and Wallstent was 2.18 mm:2.00 mm, and 59.18 mm2:51.66 mm2, respectively (P 】 0.05). The delivery system and mechanical properties of the Cordis stent functioned well. CONCLUSION: The new Cordis stent is appropriate for TIPS procedure.
文摘BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ingesting an enzyme-based chemical detergent,resulting in a serious pulmonary infection and severe malnutrition.Upper gastrointestinal imaging showed that he had an ETF,and endoscopy showed that he had extreme and severe esophageal stricture.This case was complex and difficult to treat.According to the domestic and foreign lite-rature,there is no universal treatment that is low-risk.CASE SUMMARY A patient came to our hospital with extreme ES,an ETF,and severe malnutrition complicated with pulmonary tuberculosis 1 mo after the consumption of an enzy-me-based detergent.The ES was serious,and the endoscope was unable to pass through the esophagus.We treated him by endoscopic incision method(EIM),esophageal stent placement(ESP),and endoscopic balloon dilation(EBD)by using the bronchoscope and gastroscope.This treatment not only closed the ETF,but also expanded the esophagus,with minimal trauma,greatly reducing the pain of the patient.According to the literature,there are no similar reported cases.CONCLUSION We report,for the first time,a patient with extreme CES complicated with ETF,where the endoscope could not be passed through his esophagus but he could be examined by bronchoscopy and treated by EIM,ESP,and EBD.
文摘目的分析颅内大脑动脉闭塞型脑梗死患者急诊取栓术后补救性支架植入或者球囊扩张成形术对患者预后的影响。方法回顾性选取2020年10月—2023年10月临沂市中医医院收治的83例颅内大脑动脉闭塞型脑梗死取栓患者的临床资料。根据不同的治疗方法分为两组,球囊扩张组49例、支架组34例,比较两组患者的动脉狭窄程度、预后情况、死亡率和生活质量。结果术后1周,支架组的动脉狭窄程度为(22.73±3.56)%,低于球囊扩张组的(31.84±4.67)%,差异有统计学意义(t=9.597,P<0.05)。术前,两组的美国国立卫生院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分比较,差异无统计学意义(P>0.05);术后3个月,支架组的NIHSS评分低于球囊扩张组,差异有统计学意义(P<0.05)。两组的预后情况和死亡率比较,差异无统计学意义(P均>0.05)。术后3个月,两组患者的Barthel指数评分较术前升高,差异有统计学意义(P均<0.05),但术后两组的Barthel指数评分比较,差异无统计学意义(P>0.05)。结论临床中针对颅内大脑动脉闭塞型脑梗死患者急诊取栓术后的进行支架植入可以有效改善患者的动脉狭窄程度和神经功能。支架植入和球囊扩张在患者预后和生活质量方面没有差异,临床中可以根据患者的不同情况选择不同的方法进行治疗。
