Objective:To summarize the nursing treatment of patients who underwent implantation of a blood flow diverter to treat complex intracranial aneurysms.Methods:Data from 22 patients with complex aneurysms,diagnosed at an...Objective:To summarize the nursing treatment of patients who underwent implantation of a blood flow diverter to treat complex intracranial aneurysms.Methods:Data from 22 patients with complex aneurysms,diagnosed at an interventional center for blood flow diverter implantation between February 2015 and February 2016,treated in the Henan Provincial People’s Hospital(Zhengzhou,China),were retrospectively analyzed.Nursing methods,including preoperative,intraoperative,and postoperative care,were analyzed.Results:All 22 patients underwent successful surgery,with no related complications or hospital mortality,and were cured in hospital.Conclusion:Interventional flow diverter therapy for patients with complex intracranial aneurysms is a new technology,and involves intensive care by nursing staff and appears to be a promising new treatment method.展开更多
False aneurysm occurring after replacement of ascending aorta by a vascular prosthesis is a rare, but life-threatening complication. In spite of advances in endovascular techniques, surgery remains the treatment of ch...False aneurysm occurring after replacement of ascending aorta by a vascular prosthesis is a rare, but life-threatening complication. In spite of advances in endovascular techniques, surgery remains the treatment of choice in the majority of cases. We report the case of a huge pseudoaneurysm caused by late dehiscence of the right coronary ostium-aortic tubular graft anastomosis, occurred 30 years after replacement of aortic valve and ascending aorta by classical Bentall operation. A fistula originating from the aneurysmal sac extended across the sternum into the thoracic subcutaneous soft tissues and gave rise to a pulsatile mass well appreciable on the anterior chest wall. The surgical treatment, consisting of partial resection of the aortic tubular graft and sternal reconstruction was effective and uneventful.展开更多
Visceral artery aneurysms(VAA) include splanchnic and renal artery aneurysms. They represent a rare clinical entity, although their detection is rising due to an increased use of cross-sectional imaging. Rupture is th...Visceral artery aneurysms(VAA) include splanchnic and renal artery aneurysms. They represent a rare clinical entity, although their detection is rising due to an increased use of cross-sectional imaging. Rupture is the most devastating complication, and is associated with a high morbidity and mortality. In addition, increased percutaneous endovascular interventions have raised the incidence of iatrogenic visceral artery pseudoaneurysms(VAPAs). For this reason, elective repair is preferable in the appropriately chosen patient. Controversy still exists regarding their treatment. Over the past decade, there has been steady increase in the utilization of minimally invasive, non-operative interventions, for vascular aneurysmal disease. All VAAs and VAPAs can technically be fixed by endovascular techniques but that does not mean they should. These catheter-based techniques constitute an excellent approach in the elective setting. However, in the emergent setting it may carry a higher morbidity and mortality. The decision for intervention has to take into account the size and the natural history of the lesion, the risk of rupture, which is high during pregnancy, and the relative risk of surgical or radiological intervention. For splanchnic artery aneurysms, we should recognize that we are not, in reality, well informed about their natural history. For most asymptomatic aneurysms, expectant treatment is acceptable. For large, symptomatic or aneurysms with a high risk of rupture, endovascular treatment has become the firstline therapy. Treatment of VAPAs is always mandatory because of the high risk of rupture. We present our point of view on interventional radiology in the splanchnic arteries, focusing on what has been achieved and the remaining challenges.展开更多
We report a rare case of postoperative pseudoaneurysm of the gastroduodenal artery following radical gastrectomy.Surgical trauma to the gastroduodenal artery during regional lymphadenectomy was considered as the cause...We report a rare case of postoperative pseudoaneurysm of the gastroduodenal artery following radical gastrectomy.Surgical trauma to the gastroduodenal artery during regional lymphadenectomy was considered as the cause of the postoperative pseudoaneurysm. The pseudoaneurysm was successfully managed by ligating the bleeding vessel. We should consider the possibility of pseudoaneurysm formation in a patient with gastrointestinal bleeding in the postoperative period following radical gastrectomy with regional lymph node and perivascular lymphatic dissection.展开更多
Background: The purpose of AAA screening is to prevent rupture and mortality. Screening for life-threatening diseases is a double-edged sword. The aim of this study is to describe 65-year-old men’s experiences of hea...Background: The purpose of AAA screening is to prevent rupture and mortality. Screening for life-threatening diseases is a double-edged sword. The aim of this study is to describe 65-year-old men’s experiences of health related quality of life and anxiety after screening for Abdominal Aortic Aneurysm, and experiences of information and reasons for not participating. Methods: 368 men answered Short Form 36 (SF-36), and anxiety and depression scale (HAD). 72 telephone interviews were conducted with the participants and 77 with those who declined to take part in the screening programme. Results: The SF-36 domains of Physical Function and Role limitations due to emotional health problems were significantly better for men who had undergone screening compared to a matched population. Compared to non-smokers, smokers had lower values in the SF-36 domains of general health perceptions, social functioning, role limitations due to emotional health problems and mental health. 80% of patients did not experience any form of anxiety/panic in connection with the screening invitation. Of the men who did not participate, 56% stated that they would like to be screened or had already undergone the examination. Conclusion: The men who underwent the investigation were healthier in some of the SF-36 domains than the general population. The participants did not experience any great anxiety before the screening and despite the short duration of the examination.展开更多
BACKGROUND Ureteroscopic lithotripsy(URSL) is a common surgical treatment for ureteral stones.Although flexible ureteroscopy can be used to treat ureteral and renal stones in a single procedure,rigid ureteroscopy can ...BACKGROUND Ureteroscopic lithotripsy(URSL) is a common surgical treatment for ureteral stones.Although flexible ureteroscopy can be used to treat ureteral and renal stones in a single procedure,rigid ureteroscopy can only be used to treat ureteral stones;nonetheless,rigid ureteroscopy remains mainstream in Taiwan owing to its late introduction and flexible ureteroscopy is not covered by national health insurance.Hematuria is a common complication that occurs when the scope passes through stricture sites or when mucosal damage occurs during lithotripsy,but this is usually self-limited.Prolonged hematuria requiring intervention is termed persistent hematuria.Persistent hematuria is less common and few studies have reported the development and etiology of renal pseudoaneurysm after flexible ureteroscopy for renal stones.Herein,we present the first reported case of renal pseudoaneurysm after rigid URSL for ureteral stone.CASE SUMMARY The patient was a 57-year-old man who developed renal pseudoaneurysm with active bleeding after rigid ureteroscopy.He presented with gross hematuria and intolerable left flank pain after left URSL.Severe anemia was noted(hemoglobin level,6.8 g/d L).Contrast enhanced computed tomography revealed one pseudoaneurysm each in the upper and lower renal cortex.He was managed via transcatheter arterial embolization with microcoils,which relieved the symptoms.CONCLUSION To the best of our knowledge,ours is the first case report on renal pseudoaneurysm after rigid URSL.Because renal pseudoaneurysms are difficult to access,underlying hypertension,clinical signs such as refractory flank pain,and gross hematuria should be carefully monitored following similar endourological procedures.展开更多
Anastomotic false aneurysm (AFA) of the aorta is a potentially lethal complication after prosthetic grafting. Nineteen aneurysms were encountered in 18 patients within a 30-year period (1960-1991). There were 10 men a...Anastomotic false aneurysm (AFA) of the aorta is a potentially lethal complication after prosthetic grafting. Nineteen aneurysms were encountered in 18 patients within a 30-year period (1960-1991). There were 10 men and 8 women, aged 27?0 years (mean 58 years). In 14 patients, the prostheses were made of silk, in 2 were PTFE, and in 1 each Dacron or silk-Dacron cross-weaved. Patients with an intact AFA had a pulsatile abdominal mass, abdominal pain, an oc culuded graft and peripheral emboli. Five patients were asymptomatic. Clinical onset of AFA varied from 2 weeks to 12 years (mean 5 years). The accurate rate of diagnosis of single plane angiography was 75% (3 of 4), and computed tomography 100% (ten of ten). Ultrasound was used only once and suggested an AFA. Four AFAs were less than 5cm in diameter. Five patients refused operation and died in 2 years from rupture. Operative mortality was 11% (1 of 9). Treatment was resection of AFA and replacement with a new graft. Life-ong follow-p is required for patients with an aortic aneurysm. All ratroperitoneal AFAs should be resected, since the outcome of rupture is poor.展开更多
Background Abdominal aortic aneurysm （AAA） is a severe aortic disease with a high death rate. AAA resection and artificial vessel replacement is the main surgical treatments. Nursing of the elderly patients are more...Background Abdominal aortic aneurysm （AAA） is a severe aortic disease with a high death rate. AAA resection and artificial vessel replacement is the main surgical treatments. Nursing of the elderly patients are more difficult as they are usually accompanied by some other diseases. The perioperative nursing experience is summarized in this article. Methods A retrospective study was carded out in 24 elderly patients （over 60 years old） who were diagnosed with infrarenal AAA and received AAA resection and artificial vessel replacement between Jan, 2009 and Jan, 2012 in our hospital. Results All the 24 patients fully recovered and there was no death before discharge. Severe complications were observed in 8 patients： one （4.2%） developed thrombosis of the femoral artery and received embolectomy of the femoral artery; 2 （8.3%） developed respiratory dysfunction; 3 （12.5%） suffered renal dysfunction; 2 （8.3%） suffered incomplete intestinal obstruction. Conclusions It is of great value for improvement of surgical outcome and the patient＇s postoperative recovery to perform good observation and perioperative nursing in time.展开更多
Objective The aim of this study is to estimate the incidence and describe the diagnosis,treatment and nursing care of Kawasaki Disease among children in Guilin city,Guangxi Province,China.The study is also designed to...Objective The aim of this study is to estimate the incidence and describe the diagnosis,treatment and nursing care of Kawasaki Disease among children in Guilin city,Guangxi Province,China.The study is also designed to assess clinical aspects of retrospection,management and outcome,specifically in relation to cardiac disease.Methods To retrospectively collected the clinical data of pediatric patients with Kawasaki's disease at the Affiliated Hospital of Guilin Medical University in China,which covered a two-year period from 2015 to 2016.Results During the two-year study period,a total of 25 cases of Kawasaki disease were reported in the hospitals,comprising of 11 boys and 14 girls(male-female ratio was 1∶1.27).The seasonal distribution showed a slightly higher incidence in spring and summer.The patients’mean age of onset was 2.78 years old.The average hospitalization days of patients were 8.08(range from 5 to18days).16 Kawasaki patients were diagnosed as bronchial pneumonia.Coronary arterial abnormalities were detected during follow up by UCG in 5 cases,but no coronary artery aneurysm was found.All 25 patients recovered and were discharged from the hospital.Conclusion Early treatment and proper nursing management are key issues to prevent the occurrence of coronary artery aneurysm in Kawasaki Disease patients.展开更多
Dynamic hip screw fixation is a com- monly performed procedure for internal fixation of intertro- chanteric femoral fractures. Arterial injury following the operative fixation is a rare but serious event. We present a...Dynamic hip screw fixation is a com- monly performed procedure for internal fixation of intertro- chanteric femoral fractures. Arterial injury following the operative fixation is a rare but serious event. We present a patient who developed pseudoaneurysm ofprofunda femo- ris artery after internal fixation of intertrochanteric fracture with a dynamic hip screw. The diagnosis was confirmed by angiographic study and it was successfully treated by coil embolization.展开更多
False aneurysm of the femoral artery is a rare complication of intertrochanteric fracture. Most of these situations are due to iatrogenic trauma or the trauma itself and are rarely caused by dislocated bone fragments....False aneurysm of the femoral artery is a rare complication of intertrochanteric fracture. Most of these situations are due to iatrogenic trauma or the trauma itself and are rarely caused by dislocated bone fragments. Here we report a case of a 72-year-old man who presented acutely with a pseudoaneurysm of the superficial femoral artery from the spike of a lesser trochanter fragment. Percutaneous endovascular treatment of the pseudoaneurysm with a covered stent was undertaken on an urgent basis. Five days later, the patient was operated upon and the lesser trochanter fragment was excised through an anterior incision and the intertrochanteric fracture was fixed using dynamic hip screws. The fracture was united at 10 weeks. At one-year＇s follow-up, there were no graft-related complications. This case illustrates that an intertrochanteric fracture with a dis- placed lesser trochanter fragment can present acutely with bleeding and a pseudoaneurysm of the femoral artery.展开更多
The transcatheter closure of perimembranous ventricular septal defect （pmVSD） has become a promising treatment modality. However, transcatheter closure of multiple pmVSDs with giant aneurysm is still very challengin...The transcatheter closure of perimembranous ventricular septal defect （pmVSD） has become a promising treatment modality. However, transcatheter closure of multiple pmVSDs with giant aneurysm is still very challenging. We present our preliminary experiences.展开更多
基金National Natural Science Foundation of China(81601583).
文摘Objective:To summarize the nursing treatment of patients who underwent implantation of a blood flow diverter to treat complex intracranial aneurysms.Methods:Data from 22 patients with complex aneurysms,diagnosed at an interventional center for blood flow diverter implantation between February 2015 and February 2016,treated in the Henan Provincial People’s Hospital(Zhengzhou,China),were retrospectively analyzed.Nursing methods,including preoperative,intraoperative,and postoperative care,were analyzed.Results:All 22 patients underwent successful surgery,with no related complications or hospital mortality,and were cured in hospital.Conclusion:Interventional flow diverter therapy for patients with complex intracranial aneurysms is a new technology,and involves intensive care by nursing staff and appears to be a promising new treatment method.
文摘False aneurysm occurring after replacement of ascending aorta by a vascular prosthesis is a rare, but life-threatening complication. In spite of advances in endovascular techniques, surgery remains the treatment of choice in the majority of cases. We report the case of a huge pseudoaneurysm caused by late dehiscence of the right coronary ostium-aortic tubular graft anastomosis, occurred 30 years after replacement of aortic valve and ascending aorta by classical Bentall operation. A fistula originating from the aneurysmal sac extended across the sternum into the thoracic subcutaneous soft tissues and gave rise to a pulsatile mass well appreciable on the anterior chest wall. The surgical treatment, consisting of partial resection of the aortic tubular graft and sternal reconstruction was effective and uneventful.
文摘Visceral artery aneurysms(VAA) include splanchnic and renal artery aneurysms. They represent a rare clinical entity, although their detection is rising due to an increased use of cross-sectional imaging. Rupture is the most devastating complication, and is associated with a high morbidity and mortality. In addition, increased percutaneous endovascular interventions have raised the incidence of iatrogenic visceral artery pseudoaneurysms(VAPAs). For this reason, elective repair is preferable in the appropriately chosen patient. Controversy still exists regarding their treatment. Over the past decade, there has been steady increase in the utilization of minimally invasive, non-operative interventions, for vascular aneurysmal disease. All VAAs and VAPAs can technically be fixed by endovascular techniques but that does not mean they should. These catheter-based techniques constitute an excellent approach in the elective setting. However, in the emergent setting it may carry a higher morbidity and mortality. The decision for intervention has to take into account the size and the natural history of the lesion, the risk of rupture, which is high during pregnancy, and the relative risk of surgical or radiological intervention. For splanchnic artery aneurysms, we should recognize that we are not, in reality, well informed about their natural history. For most asymptomatic aneurysms, expectant treatment is acceptable. For large, symptomatic or aneurysms with a high risk of rupture, endovascular treatment has become the firstline therapy. Treatment of VAPAs is always mandatory because of the high risk of rupture. We present our point of view on interventional radiology in the splanchnic arteries, focusing on what has been achieved and the remaining challenges.
文摘We report a rare case of postoperative pseudoaneurysm of the gastroduodenal artery following radical gastrectomy.Surgical trauma to the gastroduodenal artery during regional lymphadenectomy was considered as the cause of the postoperative pseudoaneurysm. The pseudoaneurysm was successfully managed by ligating the bleeding vessel. We should consider the possibility of pseudoaneurysm formation in a patient with gastrointestinal bleeding in the postoperative period following radical gastrectomy with regional lymph node and perivascular lymphatic dissection.
文摘Background: The purpose of AAA screening is to prevent rupture and mortality. Screening for life-threatening diseases is a double-edged sword. The aim of this study is to describe 65-year-old men’s experiences of health related quality of life and anxiety after screening for Abdominal Aortic Aneurysm, and experiences of information and reasons for not participating. Methods: 368 men answered Short Form 36 (SF-36), and anxiety and depression scale (HAD). 72 telephone interviews were conducted with the participants and 77 with those who declined to take part in the screening programme. Results: The SF-36 domains of Physical Function and Role limitations due to emotional health problems were significantly better for men who had undergone screening compared to a matched population. Compared to non-smokers, smokers had lower values in the SF-36 domains of general health perceptions, social functioning, role limitations due to emotional health problems and mental health. 80% of patients did not experience any form of anxiety/panic in connection with the screening invitation. Of the men who did not participate, 56% stated that they would like to be screened or had already undergone the examination. Conclusion: The men who underwent the investigation were healthier in some of the SF-36 domains than the general population. The participants did not experience any great anxiety before the screening and despite the short duration of the examination.
文摘BACKGROUND Ureteroscopic lithotripsy(URSL) is a common surgical treatment for ureteral stones.Although flexible ureteroscopy can be used to treat ureteral and renal stones in a single procedure,rigid ureteroscopy can only be used to treat ureteral stones;nonetheless,rigid ureteroscopy remains mainstream in Taiwan owing to its late introduction and flexible ureteroscopy is not covered by national health insurance.Hematuria is a common complication that occurs when the scope passes through stricture sites or when mucosal damage occurs during lithotripsy,but this is usually self-limited.Prolonged hematuria requiring intervention is termed persistent hematuria.Persistent hematuria is less common and few studies have reported the development and etiology of renal pseudoaneurysm after flexible ureteroscopy for renal stones.Herein,we present the first reported case of renal pseudoaneurysm after rigid URSL for ureteral stone.CASE SUMMARY The patient was a 57-year-old man who developed renal pseudoaneurysm with active bleeding after rigid ureteroscopy.He presented with gross hematuria and intolerable left flank pain after left URSL.Severe anemia was noted(hemoglobin level,6.8 g/d L).Contrast enhanced computed tomography revealed one pseudoaneurysm each in the upper and lower renal cortex.He was managed via transcatheter arterial embolization with microcoils,which relieved the symptoms.CONCLUSION To the best of our knowledge,ours is the first case report on renal pseudoaneurysm after rigid URSL.Because renal pseudoaneurysms are difficult to access,underlying hypertension,clinical signs such as refractory flank pain,and gross hematuria should be carefully monitored following similar endourological procedures.
文摘Anastomotic false aneurysm (AFA) of the aorta is a potentially lethal complication after prosthetic grafting. Nineteen aneurysms were encountered in 18 patients within a 30-year period (1960-1991). There were 10 men and 8 women, aged 27?0 years (mean 58 years). In 14 patients, the prostheses were made of silk, in 2 were PTFE, and in 1 each Dacron or silk-Dacron cross-weaved. Patients with an intact AFA had a pulsatile abdominal mass, abdominal pain, an oc culuded graft and peripheral emboli. Five patients were asymptomatic. Clinical onset of AFA varied from 2 weeks to 12 years (mean 5 years). The accurate rate of diagnosis of single plane angiography was 75% (3 of 4), and computed tomography 100% (ten of ten). Ultrasound was used only once and suggested an AFA. Four AFAs were less than 5cm in diameter. Five patients refused operation and died in 2 years from rupture. Operative mortality was 11% (1 of 9). Treatment was resection of AFA and replacement with a new graft. Life-ong follow-p is required for patients with an aortic aneurysm. All ratroperitoneal AFAs should be resected, since the outcome of rupture is poor.
基金supported by Science and Technology Planning Project of Guangdong Province(No.2012A030400056)
文摘Background Abdominal aortic aneurysm （AAA） is a severe aortic disease with a high death rate. AAA resection and artificial vessel replacement is the main surgical treatments. Nursing of the elderly patients are more difficult as they are usually accompanied by some other diseases. The perioperative nursing experience is summarized in this article. Methods A retrospective study was carded out in 24 elderly patients （over 60 years old） who were diagnosed with infrarenal AAA and received AAA resection and artificial vessel replacement between Jan, 2009 and Jan, 2012 in our hospital. Results All the 24 patients fully recovered and there was no death before discharge. Severe complications were observed in 8 patients： one （4.2%） developed thrombosis of the femoral artery and received embolectomy of the femoral artery; 2 （8.3%） developed respiratory dysfunction; 3 （12.5%） suffered renal dysfunction; 2 （8.3%） suffered incomplete intestinal obstruction. Conclusions It is of great value for improvement of surgical outcome and the patient＇s postoperative recovery to perform good observation and perioperative nursing in time.
基金Guangxi Zhuang Autonomous Region Education Department Science Research Project(KY2016LX234)
文摘Objective The aim of this study is to estimate the incidence and describe the diagnosis,treatment and nursing care of Kawasaki Disease among children in Guilin city,Guangxi Province,China.The study is also designed to assess clinical aspects of retrospection,management and outcome,specifically in relation to cardiac disease.Methods To retrospectively collected the clinical data of pediatric patients with Kawasaki's disease at the Affiliated Hospital of Guilin Medical University in China,which covered a two-year period from 2015 to 2016.Results During the two-year study period,a total of 25 cases of Kawasaki disease were reported in the hospitals,comprising of 11 boys and 14 girls(male-female ratio was 1∶1.27).The seasonal distribution showed a slightly higher incidence in spring and summer.The patients’mean age of onset was 2.78 years old.The average hospitalization days of patients were 8.08(range from 5 to18days).16 Kawasaki patients were diagnosed as bronchial pneumonia.Coronary arterial abnormalities were detected during follow up by UCG in 5 cases,but no coronary artery aneurysm was found.All 25 patients recovered and were discharged from the hospital.Conclusion Early treatment and proper nursing management are key issues to prevent the occurrence of coronary artery aneurysm in Kawasaki Disease patients.
文摘Dynamic hip screw fixation is a com- monly performed procedure for internal fixation of intertro- chanteric femoral fractures. Arterial injury following the operative fixation is a rare but serious event. We present a patient who developed pseudoaneurysm ofprofunda femo- ris artery after internal fixation of intertrochanteric fracture with a dynamic hip screw. The diagnosis was confirmed by angiographic study and it was successfully treated by coil embolization.
文摘False aneurysm of the femoral artery is a rare complication of intertrochanteric fracture. Most of these situations are due to iatrogenic trauma or the trauma itself and are rarely caused by dislocated bone fragments. Here we report a case of a 72-year-old man who presented acutely with a pseudoaneurysm of the superficial femoral artery from the spike of a lesser trochanter fragment. Percutaneous endovascular treatment of the pseudoaneurysm with a covered stent was undertaken on an urgent basis. Five days later, the patient was operated upon and the lesser trochanter fragment was excised through an anterior incision and the intertrochanteric fracture was fixed using dynamic hip screws. The fracture was united at 10 weeks. At one-year＇s follow-up, there were no graft-related complications. This case illustrates that an intertrochanteric fracture with a dis- placed lesser trochanter fragment can present acutely with bleeding and a pseudoaneurysm of the femoral artery.
基金This work was Supported by the grant from the Natural Science Foundation of Shandong Province （No. ZR2012HM073）.
文摘The transcatheter closure of perimembranous ventricular septal defect （pmVSD） has become a promising treatment modality. However, transcatheter closure of multiple pmVSDs with giant aneurysm is still very challenging. We present our preliminary experiences.
