The mouse model of multiple cerebral infarctions,established by injecting fluorescent microspheres into the common carotid artery,is a recent development in animal models of cerebral ischemia.To investigate its effect...The mouse model of multiple cerebral infarctions,established by injecting fluorescent microspheres into the common carotid artery,is a recent development in animal models of cerebral ischemia.To investigate its effectiveness,mouse models of cerebral infarction were created by injecting fluorescent microspheres,45–53μm in diameter,into the common carotid artery.Six hours after modeling,fluorescent microspheres were observed directly through a fluorescence stereomicroscope,both on the brain surface and in brain sections.Changes in blood vessels,neurons and glial cells associated with microinfarcts were examined using fluorescence histochemistry and immunohistochemistry.The microspheres were distributed mainly in the cerebral cortex,striatum and hippocampus ipsilateral to the side of injection.Microinfarcts were found in the brain regions where the fluorescent microspheres were present.Here the lodged microspheres induced vascular and neuronal injury and the activation of astroglia and microglia.These histopathological changes indicate that this animal model of multiple cerebral infarctions effectively simulates the changes of various cell types observed in multifocal microinfarcts.This model is an effective,additional tool to study the pathogenesis of ischemic stroke and could be used to evaluate therapeutic interventions.This study was approved by the Animal Ethics Committee of the Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences(approval No.D2021-03-16-1)on March 16,2021.展开更多
A 26-year-old woman with ulcerative colitis was transferred to our hospital with left hemiparesis due to cerebral infarction. Cervical ultrasonography and magnetic resonance imaging angiography revealed thrombosis at ...A 26-year-old woman with ulcerative colitis was transferred to our hospital with left hemiparesis due to cerebral infarction. Cervical ultrasonography and magnetic resonance imaging angiography revealed thrombosis at the right common carotid artery and the right internal carotid artery. Antithrombotic and anticoagulant therapies were commenced. After about 2 wk of the treatment, the frequency of her diarrhea increased. She underwent emergency subtotal colectomy, but 10 d later an abundant hemorrhage from the remnant rectum occurred, so the remnant rectum was resected and an ileal pouch anal anastomosis was performed. Antithrombotic and anticoagulant therapies were continued, but neither her neurological status nor magnetic resonance imaging angiography findings showed subsequent changes. She was discharged 3 mon after operation. This is a rare case of common carotid arterial thrombosis occurring as a complication of ulcerative colitis, in which antithrombotic and anticoagulant therapies are considered to provoke a deterioration of the patient’s bowel disease.展开更多
BACKGROUND: The purpose of this study was to identify the consistency of invasive dynamic blood pressure(BP) monitoring between the superior mesenteric artery(SMA) and the common carotid artery(CCA).METHODS: Eight mal...BACKGROUND: The purpose of this study was to identify the consistency of invasive dynamic blood pressure(BP) monitoring between the superior mesenteric artery(SMA) and the common carotid artery(CCA).METHODS: Eight male Sprague-Dawley rats were cannulated in SMA and CCA simultaneously for BP monitoring, respectively.The abdominal aorta was prepared for the induction of BP change through clamping/de-clamping by a microvascular clip.The dynamic BP monitoring was performed by a polygraph system.Systolic blood pressure(SBP), diastolic blood pressure(DBP), and mean arterial pressure(MAP) values would be recorded during different time periods: the baseline(T1), the increasing period after clamping(T2), the platform period during clamping(T3), the decreasing period after de-clamping(T4), and the final platform period(T5).Three trials were performed on each rat with 15-minute intervals between consecutive monitoring.RESULTS: Systolic BP showed no significant differences between SMA and CCA.However, significant difference was found in diastolic blood pressure except at T5(P=0.534).Mean arterial pressure of two arteries were significantly different only at T1(P=0.015).The strength of association was significantly high between BP measurements through SMA and CCA(P<0.001).The BlandAltman analyses showed that mean bias of MAP changed no more than 5 mmHg and standard deviation less than 8 mmHg during T2 and T4, respectively.CONCLUSION: The study indicates SMA might be an alternative site for invasive BP monitoring during abdominal aorta occlusion and release, especially in cerebrovascular-related research.展开更多
Absence of the common carotid artery(CCA) and/or internal carotid artery (ICA ) is a kind of rare congenital anomaly. This paper reports one patient with bilateral absence of the CCA and ICA who suffered from cerebral...Absence of the common carotid artery(CCA) and/or internal carotid artery (ICA ) is a kind of rare congenital anomaly. This paper reports one patient with bilateral absence of the CCA and ICA who suffered from cerebral infarction. And the relative literatures of the possible cause and collateral circulation were reviewed.展开更多
Objective:Objective To explore the first aid and nursing of patients with anastomotic fistula after radical resection of esophagus carcinoma complicated with major carotid hemorrhage.Methods:The clinical data of anast...Objective:Objective To explore the first aid and nursing of patients with anastomotic fistula after radical resection of esophagus carcinoma complicated with major carotid hemorrhage.Methods:The clinical data of anastomotic fistula complicated with carotid artery rupture and massive hemorrhage after radical resection of typical esophageal carcinoma were analyzed and summarized.Results:Through the close cooperation of medical care,the rescue was successful.Conclusion:Earlier prevention observation,raising first aid consciousness and actively cooperating with doctors can improve the success rate of rescue.展开更多
BACKGROUND We report a rare case of numbness in the right hand,finally diagnosed as bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome and ...BACKGROUND We report a rare case of numbness in the right hand,finally diagnosed as bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome and explain the cause of these diseases.CASE SUMMARY The patient was a 65-year-old woman.She complained of dizziness,numbness and weakness of the right hand for 6 mo.She was diagnosed with bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome by ultrasound,enhanced computed tomography,computed tomography angiography and other examinations.Considering the surgical risks,the patient refused the aberrant right subclavian artery stent implantation and was discharged.We hypothesize that these two kinds of deformity and right subclavian steal syndrome may not occur by accident and result from multiple malformations.CONCLUSION Bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome is rare.This case reminds interventional radiologists of the possibility of these abnormalities before surgery.展开更多
Occlusion of the common carotid artery(CCA) is rare. CCA occlusion(CCAO) can present as drowsiness and right hemiplegia related to emboli after total arch replacement. Although we selected a follow-up at first because...Occlusion of the common carotid artery(CCA) is rare. CCA occlusion(CCAO) can present as drowsiness and right hemiplegia related to emboli after total arch replacement. Although we selected a follow-up at first because color duplex sonography showed retrograde flow from the left external carotid artery to the internal carotid artery, this patient had epilepsy and single-photon emission computed tomography(SPECT) acquired quantitative results of actual brain perfusion and showed insufficient collateral blood flow. To improve brain perfusion, we performed a bypass of the left subclavian artery to left CCA bypass. Postoperatively, the patient did not have epilepsy and drowsiness. Also, right hemiplegia improved enough for him to walk with support. SPECT showed increased left cerebral flow(the asymmetry ratio was 71% to 81%). Evaluation of the carotid artery with color duplex sonography alone was insufficient when CCAO showed retrograde or collateral flow. We should have performed quantitative evaluation with SPECT at the same time.展开更多
Common carotid artery (CCA) dissection is a rare emergency condition. Early diagnosis of these cases is important to prevent the ischemic emergencies. We presented a CCA dissection case, who was admitted to the hosp...Common carotid artery (CCA) dissection is a rare emergency condition. Early diagnosis of these cases is important to prevent the ischemic emergencies. We presented a CCA dissection case, who was admitted to the hospital after taken out from under rubble with satisfactory outcome.展开更多
Neck, being not protected by skeleton, is vulnerable to external trauma and injury which involves blood vessels, trachea, esophagus and other endocrine and nervous system organs. Vascular injuries can not only cause p...Neck, being not protected by skeleton, is vulnerable to external trauma and injury which involves blood vessels, trachea, esophagus and other endocrine and nervous system organs. Vascular injuries can not only cause potentially, life-threatening hemorrhage but also need profound surgical expertise in man- agement. Development of collateral circulation in neck is well known: however, there is scarcity of literature on the role of collateral formation in neck trauma. Here, we present a unique case of pene- trating gunshot injury to neck with right common carotid and right subclavian artery injury with hemorrhagic shock managed with ligation of these vessels as a life-saving procedure. The patient pre- sented ~ith no neurological or motor de~,cits in immediate postoperative period owing to the collateral circulation between right vertebral artery and right common carotid and right subclavian artery.展开更多
BACKGROUND Kommerell’s diverticulum(KD)with aberrant left subclavian artery is a rare congenital deformity and also has very little research literature about it(35%of case study).There are three types of aortic arch ...BACKGROUND Kommerell’s diverticulum(KD)with aberrant left subclavian artery is a rare congenital deformity and also has very little research literature about it(35%of case study).There are three types of aortic arch diverticulum.Even literature concerning the treatment options are limited.CASE SUMMARY We present a case report of a 50-year-old male with KD in the right aortic arch with aberrant left subclavian artery.We conducted a total endovascular repair procedure,which is innovative and will spread more light in the medical world.Our patient has no past medical history and is a non-smoker and non-alcoholic.Patient presented with shortness of breath,chest pain and dizziness for six months.Blood tests were done and computerized tomography(CT)angiogram of the chest confirmed the diagnosis,illustrating showed a 3.9 cm KD.On Day 1,the CT angiogram showed mild dilatation of the thoracic aorta,adjacent esophagus,trachea was compressed and displaced.Surgery was planned as the treatment modality.Carotid-Subclavian artery bypass and endovascular aortic repair was conducted.We used prolene 5-0 C1 sutures to precisely anastomose a 6-mm Dacron graft to the left subclavian artery.Haemostasis was secured and wounds were closed.Protamine was administered and patient was shifted to intensive care unit.Post-operative,patient responded favorably and was discharged.Regular follow-up is done.CONCLUSION The procedure we performed is novel.This will help the cardio-thoracic surgeons a better insight about the full procedures we conducted,thereby bringing more light and better treatment options in managing KD with aberrant subclavian artery.展开更多
Objective: To evaluate the long-term effect of endovascular occlusion with microcoils on traumatic pseudoaneurysms (TPAs) in the common carotid artery in rabbits.Methods: TPAs in the right common carotid artery were s...Objective: To evaluate the long-term effect of endovascular occlusion with microcoils on traumatic pseudoaneurysms (TPAs) in the common carotid artery in rabbits.Methods: TPAs in the right common carotid artery were surgically made in 16 rabbits. At 3-4 weeks after operation, the survived 12 models were randomly divided into a control group (n=3) with no treatment and an experimental group (n=9), in which TPAs were intraluminally embolized with microcoils and corresponding therapy was given. Three months after embolization, the TPAs were examined with digital subtraction angiography and pathology. Results: The 3 rabbits in the control group all died of rupture of TPA. Among the 9 TPAs occluded with microcoils, 4 were completely occluded, 4 were partially occluded, and 1 was excluded due to the microcoils migrating into the parent artery. Three months after embolization, the 4 TPAs which were completely occluded remained obliterated as determined by digital subtraction angiographic findings. The parent artery remained unobstructed and the structure of the TPAs were replaced by a mass of scar tissues. The 4 TPAs which were partially occluded remained unruptured and the microcoils were compressed.Conclusions: The lumen in TPA can be completely occluded by microcoils and the parent artery is unblocked. Partial occlusion of the lumen can also prevent the rupture of TPA.展开更多
Injury to the supraaortic artery is a rare event, with poor prognosis and high mortality.1 Improvement of the outcome may lie on the combination of several aspects, including better pre-hospital care, use of emergency...Injury to the supraaortic artery is a rare event, with poor prognosis and high mortality.1 Improvement of the outcome may lie on the combination of several aspects, including better pre-hospital care, use of emergency cardiopulmonary bypass (CPB), improved surgical techniques and facilities, and advanced postoperative intensive care. Some researchers emphasized the importance of emergency CPB in the treatment and thought that it was responsible mainly for the improved outcome.2-6 However, there exists controversies about it.7-9 In this article, we reported that a patient with life-threatening hemorrhage due to traumatic transection of the left common carotid artery, who was admitted to our hospital in July 2003, was treated successfully with operations with help of emergency CPB and systemic hypothermia.展开更多
目的探讨颈总动脉交感神经网剥脱术对混合型脑性瘫痪儿童临床疗效及血清炎性细胞因子的影响。方法对50例混合型脑性瘫痪儿童行颈总动脉交感神经网剥脱术,比较手术前后白细胞介素(interleukin,IL)-6、IL-10、肿瘤坏死因子-α(tumor necro...目的探讨颈总动脉交感神经网剥脱术对混合型脑性瘫痪儿童临床疗效及血清炎性细胞因子的影响。方法对50例混合型脑性瘫痪儿童行颈总动脉交感神经网剥脱术,比较手术前后白细胞介素(interleukin,IL)-6、IL-10、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平及改良Ashworth痉挛评分、教师流涎(teacher drooling scale,TDS)分级和粗大运动功能分类系统(gross motor function classification system,GMFCS)改善情况。结果50例混合型脑性瘫痪儿童术后IL-6、TNF-α水平较术前降低,差异有统计学意义(P<0.05);术后IL-10水平较术前差异无统计学意义(P>0.05)。术后改良Ashworth痉挛评分及TDS分级较术前改善,差异有统计学意义(P<0.05);术后GMFCS程度较术前无改善,差异无统计学意义(P>0.05)。手术前后TNF-α水平与改良Ashworth痉挛评分及TDS分级均呈正相关,手术前后TNF-α水平与GMFCS程度无相关性;手术前后IL-6、IL-10水平与改良Ashworth痉挛评分、TDS分级、GMFCS程度均无相关性。结论IL-6、IL-10、TNF-α参与了混合型脑性瘫痪的发病过程,而颈总动脉外膜交感神经网剥脱术可通过降低IL-6、TNF-α水平达到改善临床症状的效果,值得推广应用。展开更多
The optimal velocity encoding of phase-contrast magnetic resonance angiography (PC MRA) in measuring cerebral blood flow volume (BFV) ranges from 60 to 80 cm/s. To verify the accuracy of two-dimensional (2D) PC ...The optimal velocity encoding of phase-contrast magnetic resonance angiography (PC MRA) in measuring cerebral blood flow volume (BFV) ranges from 60 to 80 cm/s. To verify the accuracy of two-dimensional (2D) PC MRA, the present study localized the region of interest at blood vessels of the neck using PC MRA based on three-dimensional time-of-flight sequences, and the velocity encoding was set to 80 cm/s. Results of the measurements showed that the error rate was 7.0±6.0% in the estimation of BFV in the internal carotid artery, the external carotid artery and the ipsilateral common carotid artery. There was no significant difference, and a significant correlation in BFV between internal carotid artery + external carotid artery and ipsilateral common carotid artery. In addition, the BFV of the common carotid artery was correlated with that of the ipsilateral internal carotid artery. The main error was attributed to the external carotid artery and its branches. Therefore, after selecting the appropriate scanning parameters and protocols, 2D PC MRA is more accurate in the determination of BFV in the carotid arteries.展开更多
基金supported by the Project of National Key R&D Program of China,No.2019YFC1709103(to WZB)the National Natural Science Foundation of China,Nos.81774211(to WZB),81873040(to MJY),81774432(to JJC),81801561(to DSX),82004492(to JW)。
文摘The mouse model of multiple cerebral infarctions,established by injecting fluorescent microspheres into the common carotid artery,is a recent development in animal models of cerebral ischemia.To investigate its effectiveness,mouse models of cerebral infarction were created by injecting fluorescent microspheres,45–53μm in diameter,into the common carotid artery.Six hours after modeling,fluorescent microspheres were observed directly through a fluorescence stereomicroscope,both on the brain surface and in brain sections.Changes in blood vessels,neurons and glial cells associated with microinfarcts were examined using fluorescence histochemistry and immunohistochemistry.The microspheres were distributed mainly in the cerebral cortex,striatum and hippocampus ipsilateral to the side of injection.Microinfarcts were found in the brain regions where the fluorescent microspheres were present.Here the lodged microspheres induced vascular and neuronal injury and the activation of astroglia and microglia.These histopathological changes indicate that this animal model of multiple cerebral infarctions effectively simulates the changes of various cell types observed in multifocal microinfarcts.This model is an effective,additional tool to study the pathogenesis of ischemic stroke and could be used to evaluate therapeutic interventions.This study was approved by the Animal Ethics Committee of the Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences(approval No.D2021-03-16-1)on March 16,2021.
文摘A 26-year-old woman with ulcerative colitis was transferred to our hospital with left hemiparesis due to cerebral infarction. Cervical ultrasonography and magnetic resonance imaging angiography revealed thrombosis at the right common carotid artery and the right internal carotid artery. Antithrombotic and anticoagulant therapies were commenced. After about 2 wk of the treatment, the frequency of her diarrhea increased. She underwent emergency subtotal colectomy, but 10 d later an abundant hemorrhage from the remnant rectum occurred, so the remnant rectum was resected and an ileal pouch anal anastomosis was performed. Antithrombotic and anticoagulant therapies were continued, but neither her neurological status nor magnetic resonance imaging angiography findings showed subsequent changes. She was discharged 3 mon after operation. This is a rare case of common carotid arterial thrombosis occurring as a complication of ulcerative colitis, in which antithrombotic and anticoagulant therapies are considered to provoke a deterioration of the patient’s bowel disease.
基金supported by Zhongnan Hospital of Wuhan University Science,Technology and Innovation Seed Fund,Project(cxpy2017039)
文摘BACKGROUND: The purpose of this study was to identify the consistency of invasive dynamic blood pressure(BP) monitoring between the superior mesenteric artery(SMA) and the common carotid artery(CCA).METHODS: Eight male Sprague-Dawley rats were cannulated in SMA and CCA simultaneously for BP monitoring, respectively.The abdominal aorta was prepared for the induction of BP change through clamping/de-clamping by a microvascular clip.The dynamic BP monitoring was performed by a polygraph system.Systolic blood pressure(SBP), diastolic blood pressure(DBP), and mean arterial pressure(MAP) values would be recorded during different time periods: the baseline(T1), the increasing period after clamping(T2), the platform period during clamping(T3), the decreasing period after de-clamping(T4), and the final platform period(T5).Three trials were performed on each rat with 15-minute intervals between consecutive monitoring.RESULTS: Systolic BP showed no significant differences between SMA and CCA.However, significant difference was found in diastolic blood pressure except at T5(P=0.534).Mean arterial pressure of two arteries were significantly different only at T1(P=0.015).The strength of association was significantly high between BP measurements through SMA and CCA(P<0.001).The BlandAltman analyses showed that mean bias of MAP changed no more than 5 mmHg and standard deviation less than 8 mmHg during T2 and T4, respectively.CONCLUSION: The study indicates SMA might be an alternative site for invasive BP monitoring during abdominal aorta occlusion and release, especially in cerebrovascular-related research.
文摘Absence of the common carotid artery(CCA) and/or internal carotid artery (ICA ) is a kind of rare congenital anomaly. This paper reports one patient with bilateral absence of the CCA and ICA who suffered from cerebral infarction. And the relative literatures of the possible cause and collateral circulation were reviewed.
文摘Objective:Objective To explore the first aid and nursing of patients with anastomotic fistula after radical resection of esophagus carcinoma complicated with major carotid hemorrhage.Methods:The clinical data of anastomotic fistula complicated with carotid artery rupture and massive hemorrhage after radical resection of typical esophageal carcinoma were analyzed and summarized.Results:Through the close cooperation of medical care,the rescue was successful.Conclusion:Earlier prevention observation,raising first aid consciousness and actively cooperating with doctors can improve the success rate of rescue.
基金Supported by Fujian Province Medical Innovation Project,No.2016-CXB-13
文摘BACKGROUND We report a rare case of numbness in the right hand,finally diagnosed as bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome and explain the cause of these diseases.CASE SUMMARY The patient was a 65-year-old woman.She complained of dizziness,numbness and weakness of the right hand for 6 mo.She was diagnosed with bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome by ultrasound,enhanced computed tomography,computed tomography angiography and other examinations.Considering the surgical risks,the patient refused the aberrant right subclavian artery stent implantation and was discharged.We hypothesize that these two kinds of deformity and right subclavian steal syndrome may not occur by accident and result from multiple malformations.CONCLUSION Bilateral common carotid artery common trunk with aberrant right subclavian artery combined with right subclavian steal syndrome is rare.This case reminds interventional radiologists of the possibility of these abnormalities before surgery.
文摘Occlusion of the common carotid artery(CCA) is rare. CCA occlusion(CCAO) can present as drowsiness and right hemiplegia related to emboli after total arch replacement. Although we selected a follow-up at first because color duplex sonography showed retrograde flow from the left external carotid artery to the internal carotid artery, this patient had epilepsy and single-photon emission computed tomography(SPECT) acquired quantitative results of actual brain perfusion and showed insufficient collateral blood flow. To improve brain perfusion, we performed a bypass of the left subclavian artery to left CCA bypass. Postoperatively, the patient did not have epilepsy and drowsiness. Also, right hemiplegia improved enough for him to walk with support. SPECT showed increased left cerebral flow(the asymmetry ratio was 71% to 81%). Evaluation of the carotid artery with color duplex sonography alone was insufficient when CCAO showed retrograde or collateral flow. We should have performed quantitative evaluation with SPECT at the same time.
文摘Common carotid artery (CCA) dissection is a rare emergency condition. Early diagnosis of these cases is important to prevent the ischemic emergencies. We presented a CCA dissection case, who was admitted to the hospital after taken out from under rubble with satisfactory outcome.
文摘Neck, being not protected by skeleton, is vulnerable to external trauma and injury which involves blood vessels, trachea, esophagus and other endocrine and nervous system organs. Vascular injuries can not only cause potentially, life-threatening hemorrhage but also need profound surgical expertise in man- agement. Development of collateral circulation in neck is well known: however, there is scarcity of literature on the role of collateral formation in neck trauma. Here, we present a unique case of pene- trating gunshot injury to neck with right common carotid and right subclavian artery injury with hemorrhagic shock managed with ligation of these vessels as a life-saving procedure. The patient pre- sented ~ith no neurological or motor de~,cits in immediate postoperative period owing to the collateral circulation between right vertebral artery and right common carotid and right subclavian artery.
文摘BACKGROUND Kommerell’s diverticulum(KD)with aberrant left subclavian artery is a rare congenital deformity and also has very little research literature about it(35%of case study).There are three types of aortic arch diverticulum.Even literature concerning the treatment options are limited.CASE SUMMARY We present a case report of a 50-year-old male with KD in the right aortic arch with aberrant left subclavian artery.We conducted a total endovascular repair procedure,which is innovative and will spread more light in the medical world.Our patient has no past medical history and is a non-smoker and non-alcoholic.Patient presented with shortness of breath,chest pain and dizziness for six months.Blood tests were done and computerized tomography(CT)angiogram of the chest confirmed the diagnosis,illustrating showed a 3.9 cm KD.On Day 1,the CT angiogram showed mild dilatation of the thoracic aorta,adjacent esophagus,trachea was compressed and displaced.Surgery was planned as the treatment modality.Carotid-Subclavian artery bypass and endovascular aortic repair was conducted.We used prolene 5-0 C1 sutures to precisely anastomose a 6-mm Dacron graft to the left subclavian artery.Haemostasis was secured and wounds were closed.Protamine was administered and patient was shifted to intensive care unit.Post-operative,patient responded favorably and was discharged.Regular follow-up is done.CONCLUSION The procedure we performed is novel.This will help the cardio-thoracic surgeons a better insight about the full procedures we conducted,thereby bringing more light and better treatment options in managing KD with aberrant subclavian artery.
文摘Objective: To evaluate the long-term effect of endovascular occlusion with microcoils on traumatic pseudoaneurysms (TPAs) in the common carotid artery in rabbits.Methods: TPAs in the right common carotid artery were surgically made in 16 rabbits. At 3-4 weeks after operation, the survived 12 models were randomly divided into a control group (n=3) with no treatment and an experimental group (n=9), in which TPAs were intraluminally embolized with microcoils and corresponding therapy was given. Three months after embolization, the TPAs were examined with digital subtraction angiography and pathology. Results: The 3 rabbits in the control group all died of rupture of TPA. Among the 9 TPAs occluded with microcoils, 4 were completely occluded, 4 were partially occluded, and 1 was excluded due to the microcoils migrating into the parent artery. Three months after embolization, the 4 TPAs which were completely occluded remained obliterated as determined by digital subtraction angiographic findings. The parent artery remained unobstructed and the structure of the TPAs were replaced by a mass of scar tissues. The 4 TPAs which were partially occluded remained unruptured and the microcoils were compressed.Conclusions: The lumen in TPA can be completely occluded by microcoils and the parent artery is unblocked. Partial occlusion of the lumen can also prevent the rupture of TPA.
文摘Injury to the supraaortic artery is a rare event, with poor prognosis and high mortality.1 Improvement of the outcome may lie on the combination of several aspects, including better pre-hospital care, use of emergency cardiopulmonary bypass (CPB), improved surgical techniques and facilities, and advanced postoperative intensive care. Some researchers emphasized the importance of emergency CPB in the treatment and thought that it was responsible mainly for the improved outcome.2-6 However, there exists controversies about it.7-9 In this article, we reported that a patient with life-threatening hemorrhage due to traumatic transection of the left common carotid artery, who was admitted to our hospital in July 2003, was treated successfully with operations with help of emergency CPB and systemic hypothermia.
文摘目的探讨颈总动脉交感神经网剥脱术对混合型脑性瘫痪儿童临床疗效及血清炎性细胞因子的影响。方法对50例混合型脑性瘫痪儿童行颈总动脉交感神经网剥脱术,比较手术前后白细胞介素(interleukin,IL)-6、IL-10、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平及改良Ashworth痉挛评分、教师流涎(teacher drooling scale,TDS)分级和粗大运动功能分类系统(gross motor function classification system,GMFCS)改善情况。结果50例混合型脑性瘫痪儿童术后IL-6、TNF-α水平较术前降低,差异有统计学意义(P<0.05);术后IL-10水平较术前差异无统计学意义(P>0.05)。术后改良Ashworth痉挛评分及TDS分级较术前改善,差异有统计学意义(P<0.05);术后GMFCS程度较术前无改善,差异无统计学意义(P>0.05)。手术前后TNF-α水平与改良Ashworth痉挛评分及TDS分级均呈正相关,手术前后TNF-α水平与GMFCS程度无相关性;手术前后IL-6、IL-10水平与改良Ashworth痉挛评分、TDS分级、GMFCS程度均无相关性。结论IL-6、IL-10、TNF-α参与了混合型脑性瘫痪的发病过程,而颈总动脉外膜交感神经网剥脱术可通过降低IL-6、TNF-α水平达到改善临床症状的效果,值得推广应用。
基金the Medical Program of Scientific & Technical Foundation in Xiamen in 2008, No. 3502Z20084028
文摘The optimal velocity encoding of phase-contrast magnetic resonance angiography (PC MRA) in measuring cerebral blood flow volume (BFV) ranges from 60 to 80 cm/s. To verify the accuracy of two-dimensional (2D) PC MRA, the present study localized the region of interest at blood vessels of the neck using PC MRA based on three-dimensional time-of-flight sequences, and the velocity encoding was set to 80 cm/s. Results of the measurements showed that the error rate was 7.0±6.0% in the estimation of BFV in the internal carotid artery, the external carotid artery and the ipsilateral common carotid artery. There was no significant difference, and a significant correlation in BFV between internal carotid artery + external carotid artery and ipsilateral common carotid artery. In addition, the BFV of the common carotid artery was correlated with that of the ipsilateral internal carotid artery. The main error was attributed to the external carotid artery and its branches. Therefore, after selecting the appropriate scanning parameters and protocols, 2D PC MRA is more accurate in the determination of BFV in the carotid arteries.