目的探讨机械取栓治疗大脑前动脉闭塞的疗效和结局。方法回顾性分析2018-01—2020-06在徐州医科大学附属医院采用机械取栓治疗的7例急性大脑前动脉闭塞患者的临床资料,主要终点定义为在脑梗死溶栓治疗后血流分级(TICI)≥2b为血管再通,...目的探讨机械取栓治疗大脑前动脉闭塞的疗效和结局。方法回顾性分析2018-01—2020-06在徐州医科大学附属医院采用机械取栓治疗的7例急性大脑前动脉闭塞患者的临床资料,主要终点定义为在脑梗死溶栓治疗后血流分级(TICI)≥2b为血管再通,次要终点包括90 d改良的Rankin量表(mRS)评分和有无症状性颅内出血。结果本组患者中7例中4例为原发性栓塞,3例继发于介入治疗;平均发病年龄55.9岁(34~70岁),发病时NIHSS评分13.4分(8~18分);5例(71.4%)合并同侧大脑中动脉或对侧大脑前动脉闭塞;7例(100%)实现再通(TICI≥2b),发病到靶血管开通时间平均271.4 min(185~325 min);6例(85.7%)出现同侧大脑前动脉支配区的梗死灶;4例(57.1%)90 d m RS评分≤2分,3例(42.9%)90 d m RS评分≥3分,其中1例(14.3%)mRS评分6分;1例(14.3%)出现脑血管痉挛,1例(14.3%)患者发生颅内出血。结论尽管可以在急性大脑前动脉闭塞患者中考虑机械取栓治疗,但需要进一步的临床试验确定机械取栓对急性大脑前动脉闭塞的疗效。展开更多
Objective： The aim of the study was to analyze the tumor recurrence factors in patients of primary hepatocellular carcinoma （PHC） with postoperative transcatheter arterial chemoembolization （TACE）. Methods： A to...Objective： The aim of the study was to analyze the tumor recurrence factors in patients of primary hepatocellular carcinoma （PHC） with postoperative transcatheter arterial chemoembolization （TACE）. Methods： A total of 121 cases of PHC by TACE after 1-2 months of surgery was retrospectively analyzed, followed up and analyzed the free survival time and the factors related to tumor-free survival. Results： In all 121 cases, 1-, 2-, and 3-year tumor-free survival rates were 72.73%, 46.21% and 26.93%, respectively. Gender, age, HBV infection, tumor size, capsule is complete, degree of differentiation and the presence of vascular thrombosis were put into the COX proportional hazards model of survival time to select the influential variables. In the clinical data of all variables entering COX proportional hazards model, tumor size, tumor differentiation and the presence of vascular thrombosis were statistically significant contributions to the model. In the tumor diameter less than or equal 10 cm [P = 0.040, Exp （B） = 2.210], vascular thrombosis [P = 0.039, Exp （B） = 2.922] and the lower degree of tumor differentiation [P = 0.035, Exp （B） = 3.038], the risk of tumor recent recurrence increased. Conclusion： Tumor size, differentiation, and the presence of vascular thrombosis are the independent risk factors affecting the prognosis of PHC after TACE.展开更多
Objective: Rupture of hepatocellular carcinoma (HCC) following transarterial embolization/chemoembolization (TAE/TACE) is a rare but life-threatening complication. The aim of the study was to explore the incidence, ri...Objective: Rupture of hepatocellular carcinoma (HCC) following transarterial embolization/chemoembolization (TAE/TACE) is a rare but life-threatening complication. The aim of the study was to explore the incidence, risk factors, clinical characteristics, treatment, and outcomes of this complication. Methods: We described two cases and reviewed all cases of ruptured HCC after TAE/TACE reported in the literature. Results: Our search yielded 32 cases of ruptured HCC after TAE/TACE. The overall incidences were 0.45% per patient and 0.21% per session. The mean age of the patients was 57.4 years (range 28-90 years, n=26, No. of cases with available information). Males accounted for 81% of cases (21/26). The 50% of the cases had histories of primary hypertension, diabetes or peripheral artery disease (6/12). Mean diameter of the tumors was 11.4 cm (range 3-20 cm, n=27). The 100% of cases had superficial or exophytic tumors (23/23). Portal vein thrombosis was presented in 61.5% of patients (8/13). The median interval between TAE/TACE and rupture was 2 days (range 0 hour-30 days, n=31). Management choices included emergency TAE, surgery, and conservative treatment. The overall median survival time was 7 days (n=19). Conclusion: Rupture of HCC following TAE/TACE is relatively rare but potentially life-threatening. The management is difficult and prognosis is poor. Large tumor size, superficial or exophytic tumors as well as portal vein thrombosis and comorbidities such as primary hypertension, diabetes or peripheral artery disease may be predisposing factors for rupture.展开更多
Objective: This study evaluated the therapeutic effect of external beam radiotherapy (RT) combined with trans- catheter arterial chemoembolization (TACE) on the patients with unresectable hepatocellular carcinoma (HCC...Objective: This study evaluated the therapeutic effect of external beam radiotherapy (RT) combined with trans- catheter arterial chemoembolization (TACE) on the patients with unresectable hepatocellular carcinoma (HCC). Methods: From June 1994 to April 2002, 114 patients with unresectable HCC were nonrandomized prospectively stepped into our study. All patients received TACE as initial therapy, except 54 also received combination therapy with external beam therapy. Sur- vival failure patterns were analyzed and compared between the two groups. Results: Overall survival rates in the patients in the radiotherapy group were 65%, 47%, 38% at 1, 2, 3 years, respectively, improved over the non-radiotherapy group rates of 54%, 36.5%, 18% at 1, 2, 3 years, respectively. There was significant difference between two groups (P < 0.05). The survival rates correlated with tumor size, number of tumors, and portal vein embolus. Conclusion: TACE combined with RT is a more effective treatment than TACE alone in patients with unresectable HCC.展开更多
文摘目的探讨机械取栓治疗大脑前动脉闭塞的疗效和结局。方法回顾性分析2018-01—2020-06在徐州医科大学附属医院采用机械取栓治疗的7例急性大脑前动脉闭塞患者的临床资料,主要终点定义为在脑梗死溶栓治疗后血流分级(TICI)≥2b为血管再通,次要终点包括90 d改良的Rankin量表(mRS)评分和有无症状性颅内出血。结果本组患者中7例中4例为原发性栓塞,3例继发于介入治疗;平均发病年龄55.9岁(34~70岁),发病时NIHSS评分13.4分(8~18分);5例(71.4%)合并同侧大脑中动脉或对侧大脑前动脉闭塞;7例(100%)实现再通(TICI≥2b),发病到靶血管开通时间平均271.4 min(185~325 min);6例(85.7%)出现同侧大脑前动脉支配区的梗死灶;4例(57.1%)90 d m RS评分≤2分,3例(42.9%)90 d m RS评分≥3分,其中1例(14.3%)mRS评分6分;1例(14.3%)出现脑血管痉挛,1例(14.3%)患者发生颅内出血。结论尽管可以在急性大脑前动脉闭塞患者中考虑机械取栓治疗,但需要进一步的临床试验确定机械取栓对急性大脑前动脉闭塞的疗效。
文摘Objective： The aim of the study was to analyze the tumor recurrence factors in patients of primary hepatocellular carcinoma （PHC） with postoperative transcatheter arterial chemoembolization （TACE）. Methods： A total of 121 cases of PHC by TACE after 1-2 months of surgery was retrospectively analyzed, followed up and analyzed the free survival time and the factors related to tumor-free survival. Results： In all 121 cases, 1-, 2-, and 3-year tumor-free survival rates were 72.73%, 46.21% and 26.93%, respectively. Gender, age, HBV infection, tumor size, capsule is complete, degree of differentiation and the presence of vascular thrombosis were put into the COX proportional hazards model of survival time to select the influential variables. In the clinical data of all variables entering COX proportional hazards model, tumor size, tumor differentiation and the presence of vascular thrombosis were statistically significant contributions to the model. In the tumor diameter less than or equal 10 cm [P = 0.040, Exp （B） = 2.210], vascular thrombosis [P = 0.039, Exp （B） = 2.922] and the lower degree of tumor differentiation [P = 0.035, Exp （B） = 3.038], the risk of tumor recent recurrence increased. Conclusion： Tumor size, differentiation, and the presence of vascular thrombosis are the independent risk factors affecting the prognosis of PHC after TACE.
文摘Objective: Rupture of hepatocellular carcinoma (HCC) following transarterial embolization/chemoembolization (TAE/TACE) is a rare but life-threatening complication. The aim of the study was to explore the incidence, risk factors, clinical characteristics, treatment, and outcomes of this complication. Methods: We described two cases and reviewed all cases of ruptured HCC after TAE/TACE reported in the literature. Results: Our search yielded 32 cases of ruptured HCC after TAE/TACE. The overall incidences were 0.45% per patient and 0.21% per session. The mean age of the patients was 57.4 years (range 28-90 years, n=26, No. of cases with available information). Males accounted for 81% of cases (21/26). The 50% of the cases had histories of primary hypertension, diabetes or peripheral artery disease (6/12). Mean diameter of the tumors was 11.4 cm (range 3-20 cm, n=27). The 100% of cases had superficial or exophytic tumors (23/23). Portal vein thrombosis was presented in 61.5% of patients (8/13). The median interval between TAE/TACE and rupture was 2 days (range 0 hour-30 days, n=31). Management choices included emergency TAE, surgery, and conservative treatment. The overall median survival time was 7 days (n=19). Conclusion: Rupture of HCC following TAE/TACE is relatively rare but potentially life-threatening. The management is difficult and prognosis is poor. Large tumor size, superficial or exophytic tumors as well as portal vein thrombosis and comorbidities such as primary hypertension, diabetes or peripheral artery disease may be predisposing factors for rupture.
文摘Objective: This study evaluated the therapeutic effect of external beam radiotherapy (RT) combined with trans- catheter arterial chemoembolization (TACE) on the patients with unresectable hepatocellular carcinoma (HCC). Methods: From June 1994 to April 2002, 114 patients with unresectable HCC were nonrandomized prospectively stepped into our study. All patients received TACE as initial therapy, except 54 also received combination therapy with external beam therapy. Sur- vival failure patterns were analyzed and compared between the two groups. Results: Overall survival rates in the patients in the radiotherapy group were 65%, 47%, 38% at 1, 2, 3 years, respectively, improved over the non-radiotherapy group rates of 54%, 36.5%, 18% at 1, 2, 3 years, respectively. There was significant difference between two groups (P < 0.05). The survival rates correlated with tumor size, number of tumors, and portal vein embolus. Conclusion: TACE combined with RT is a more effective treatment than TACE alone in patients with unresectable HCC.
