Objective:This study aimed to explore the incidence of abnormal catheter positioning and the effectiveness and safety of intravascular adjustment or removal of abnormally positioned catheters through percutaneous punc...Objective:This study aimed to explore the incidence of abnormal catheter positioning and the effectiveness and safety of intravascular adjustment or removal of abnormally positioned catheters through percutaneous punctures.Materials and methods:A retrospective analysis was conducted on 58 patients with abnormal catheter positioning,treated between January 2009 and June 2019.Intravascular adjustment of the migrated catheters and removal of the fractured catheters were performed through percutaneous puncture using a pigtail catheter,cobra catheter,and gooseneck snare.Results:Of the 58 cases,there were 23 cases of catheter migration and 35 cases of catheter fracture.The incidence of abnormal catheter positioning was 3.0%,corresponding to 1.2%migrations and 1.8%fractures.Among the 23cases of migration,1 case did not require adjustment and another underwent unsuccessful adjustment.The rate of successful adjustment of migrated catheters was 91.3%,whereas the rate of successful removal of fractured catheters was 100%.No surgery-related complications were observed either immediately or during the 1-month follow-up period.Conclusions:This study showed that the incidence of abnormal catheter positioning is low.Intravascular techniques used for the adjustment or removal of abnormally placed catheters are safe,efficient,and minimally invasive.展开更多
Objective:Transarterial and transvenous embolization methods are considered effective and safe approaches for the treatment of cavernous sinus dural arteriovenous fistula(CSDAVF).Here.,we report the angioarchitectural...Objective:Transarterial and transvenous embolization methods are considered effective and safe approaches for the treatment of cavernous sinus dural arteriovenous fistula(CSDAVF).Here.,we report the angioarchitectural features and clinical outcomes of CSDAVF in patients treated with either the inferior arterial approach(IAA) or the inferior petrosal sinus approach(IPSA).Methods:The clinical data of 32 patients with CSDAVF treated at our institution from May 2008 to May 2014 were retrospectively analyzed.All patients underwent routine diagnostic digital subtraction angiography(DSA) before surgery.Embolization was performed using the IPSA through the internal jugular vein or IAA,based on angioarchitectural features.Results:Of the 32 patients with CSDAVF,24 underwent embolization treatment through the internal jugular veinIPSA and 8 patients underwent treatment through IAA.Nineteen patients in the IPSA group experienced mild headache,which improved after specific treatment.The immediate postembolization angiographic results revealed complete occlusion in 26 cases(18 IPSA and 8 IAA) and almost complete occlusion in 6 cases(IPSA).Complications that occurred during the procedure included abducens nerve palsy(n=1,IPSA) and prosopoplegia(n=1,IAA).One patient developed tinnitus,which was diagnosed as anterior cranial fossa new-onset dural arteriovenous fistula on DSA,whereas the symptoms of other patients all improved with no recurrence.Conclusions:On the basis of the angioarchitectural features of CSDAVF,IAA can be considered the primary treatment when the blood-supplying artery and fistula are relatively singular,and when the microcatheter can easily reach the fistula through the artery.The venous approach should be selected as the primary approach when the fistula is indistinguishable and blood is supplied by multiple arteries through small plexiform vessels.Choosing the optimal surgical approach may increase the success rate of intravascular CSDAVF surgery and may help avoid complications.展开更多
文摘Objective:This study aimed to explore the incidence of abnormal catheter positioning and the effectiveness and safety of intravascular adjustment or removal of abnormally positioned catheters through percutaneous punctures.Materials and methods:A retrospective analysis was conducted on 58 patients with abnormal catheter positioning,treated between January 2009 and June 2019.Intravascular adjustment of the migrated catheters and removal of the fractured catheters were performed through percutaneous puncture using a pigtail catheter,cobra catheter,and gooseneck snare.Results:Of the 58 cases,there were 23 cases of catheter migration and 35 cases of catheter fracture.The incidence of abnormal catheter positioning was 3.0%,corresponding to 1.2%migrations and 1.8%fractures.Among the 23cases of migration,1 case did not require adjustment and another underwent unsuccessful adjustment.The rate of successful adjustment of migrated catheters was 91.3%,whereas the rate of successful removal of fractured catheters was 100%.No surgery-related complications were observed either immediately or during the 1-month follow-up period.Conclusions:This study showed that the incidence of abnormal catheter positioning is low.Intravascular techniques used for the adjustment or removal of abnormally placed catheters are safe,efficient,and minimally invasive.
文摘Objective:Transarterial and transvenous embolization methods are considered effective and safe approaches for the treatment of cavernous sinus dural arteriovenous fistula(CSDAVF).Here.,we report the angioarchitectural features and clinical outcomes of CSDAVF in patients treated with either the inferior arterial approach(IAA) or the inferior petrosal sinus approach(IPSA).Methods:The clinical data of 32 patients with CSDAVF treated at our institution from May 2008 to May 2014 were retrospectively analyzed.All patients underwent routine diagnostic digital subtraction angiography(DSA) before surgery.Embolization was performed using the IPSA through the internal jugular vein or IAA,based on angioarchitectural features.Results:Of the 32 patients with CSDAVF,24 underwent embolization treatment through the internal jugular veinIPSA and 8 patients underwent treatment through IAA.Nineteen patients in the IPSA group experienced mild headache,which improved after specific treatment.The immediate postembolization angiographic results revealed complete occlusion in 26 cases(18 IPSA and 8 IAA) and almost complete occlusion in 6 cases(IPSA).Complications that occurred during the procedure included abducens nerve palsy(n=1,IPSA) and prosopoplegia(n=1,IAA).One patient developed tinnitus,which was diagnosed as anterior cranial fossa new-onset dural arteriovenous fistula on DSA,whereas the symptoms of other patients all improved with no recurrence.Conclusions:On the basis of the angioarchitectural features of CSDAVF,IAA can be considered the primary treatment when the blood-supplying artery and fistula are relatively singular,and when the microcatheter can easily reach the fistula through the artery.The venous approach should be selected as the primary approach when the fistula is indistinguishable and blood is supplied by multiple arteries through small plexiform vessels.Choosing the optimal surgical approach may increase the success rate of intravascular CSDAVF surgery and may help avoid complications.
