Percutaneous Transluminal Embolization with Coils-Treatmentof Pulmonary Arteriovenous Malformations

The clinical values of coils em boliztion in the treatm ent of pulm onary arteriovenous m alformations (PAVM ) and related complications were investigated.Eleven patients with PAVMs verified by pulm onary arterial angiography were treated by transcatheter coils em boliza- tion.Chest X- ray(11cases) ,com puter tomography(7cases) and/ or magnetic resonance im aging (2 cases) were performed before embolization.Blood- gas analysis was done in5 cases before and after em bolization.The follow- up materials of8patients were collected to evaluate the effect of em bolization with coils.The clinical m anifestations included cerebral em bolus,hem optysis and de- creased oxygenation in 9patients and the remaining 2 had no sym ptoms.9/ 11cases were found by chest X- ray and 8were diagnosed definitely.7/ 7,2 / 2 cases were diagnosed by CT or MR and di- agnosis was m ade in all cases.Embolization was perform ed in 2 9vessels.Partial pressure of oxy- gen in arterial blood of5 cases changed significantly before and after embolization.Slight com pli- cations occurred in 6 patients,such as low fever,chest pain,pleurisy.The follow- up results showed that7cases were cured effectively.No primary and secondary device migration,and no m edical paradoxical em bolization occurred.It was concluded thatcoils em boliztion is a well- estab- lished m ethod for treating PAVMs.It is a m inimally invasive lung preserving treatment with high efficiency and less com plication.

STENT TREATMENT FOR COMPLICATED CORONARY ABTERIOLESIONS

41 cases of corouary artarioleaion admitted duringDeceuber,1995-Dacember 1997 were treated with otent andanalyzed of which 40 cases,36 hale and 4 fanalesuffered from complicated coronary arterioloaion.Stable angina pectoile 11 cues,unstable anginapactoriar 11 cases,cardiac infarction:10 casesSingle vasoleaion: 13 cases,double:21 cases,triple:6 cases Forty-two atants ware implanted in fortytwo lesioned vessals Vasolasion olassification inaccordance With ACC/AHA acors:Type Bl 4 locationa B2locations,C 16 locations.Clinical rate.of auccsasvithout complications was reach in 38 cases(95%)and two failed. Moan residuo atanonin rated -1.8%Follow-up visits aftar two years found no death oroccurrence of cardiac infarction 22 cases were raliovedcoapletely of thair angina pactoris and 17 casesware relived to diffarant degrese,and only onecase with his angina pactoris aggravated a Follow-upfour cases found none half aftar PTCA restanceierated 20%. The obtained ranults auggect that atenttreatmant is satisfactory for treating conplicatedcoronary artary dissases.

Psychological characteristics and quality of life in patients with aortic dissection and coronary heart disease undergoing interventional therapy

Background Aortic dissection(AD)is one of the serious diseases that threaten human life. Endovascular aortic ancurysm repair(EVAR),as a first-line treatment of type B AD,has the advantages of short operation time,little trauma,and rapid recovery. Previous studies have paid more attention to the clinical prognosis and imaging changes after endovascular repair of AD,with few focus on the quality of life after operation. The prevalence of coronary heart disease(CHD)has dramatically risen during the past few decades. Percutaneous coronary intervention(PCI)is considered one of the primary approaches for CHD treatment. Anxiety and depression are commonly associated with coronary heart disease(CHD). Psychological problems may be related with occurrence of unhealthy lifestyles and non-adherence to treatment. This study was to explore psychological characteristics and the quality of life and their influencing factors after interventional therapy of AD and CHD.Methods Respectively 100 AD and 100 CHD patients undergoing interventional therapy were investigated with SF-36,self-rating anxiety scale(SAS),self-rating depression scale(SDS)and social support scale. The values of SF-36,SAS,SDS between the AD and CHD group were analyzed. The influencing factors of quality of life were evaluated. Results There was no significant difference in SF-36 score between AD patients after endovascular repair and CHD patients after percutaneous coronary intervention. However,the scores in the dimensions of role-physical(54.00±41.54 vs. 65.25±34.43,P=0.038)and social functioning(74.00±20.69 vs.81.00±20.35,P=0.020)were lower in AD patients than in CHD patients. Multiple linear regression analysis showed that age,occupational status,postoperative time,anxiety,depression,and social support were the influencing factors of life quality in aortic dissection patients. Conclusion Compared with CHD patients receiving percutaneous coronary intervention,quality of life in AD patients after endovascular repair should be paid attention to. It is necessary that a multidisciplinary team including psychological medical staff should be established to manage AD patients.[S Chin J Cardiol 2019;20(3):174-181]

Relationship of vascular remodeling and restenosis after interventional therapy:an experimental study on rabbit atherosclerotic iliac artery model

Objective To evaluate the relative contribution of every part of vascul ar wall to lumen area loss after angioplasty.Methods Angioplasty was performed on rabbits iliac atherosclerosis mode l. Histomorphometric results of histological cross sectional areas from target vessels of animals killed immediately after angioplasty (acute group, n=20) were compared with those of the same areas from animals killed 4 weeks after the proc edure (chronic group, n=23), when restenosis occurred in this model. If taking 3 0% diameter decrease as restenosis criteria, the chronic group was further divid ed into two subgroups (nonrestenosis subgroup and restenosis subgro up )and their histomorphometric results were also compared.Results The lumen area decreased by 0.48 mm 2 from acute group to chro nic group (acute group 0.86±0.23?mm 2 vs chronic group 0.38±0.20?mm 2, P< 0.001). Over the same period intimal area increased by 0.12 mm 2 and the area circumscribed by inner elastic lamina (IEL area) decreased by 0.36 mm 2. Intimal hyperplasia could only explain 25% of the later lumen area loss. We further found a more significant IEL area decrease in RS subgroup than in NRS s ubgro up (0.68±0.35?mm 2 vs 0.94±0.14?mm 2, P<0.05), despite the sam e intimal area (0.39±0.16?mm 2 vs 0.41± 0.31?mm 2, P=NS). T he d ifferent lumen area between RS subgroup and NRS subgroup (0.27±0.10?mm 2 vs 0 .55±0.10?mm 2, P<0.001) was predominantly due to the greater IEL shrinking in RS subgroup.Conclusion Our data indicate that later lumen area loss after angiopla sty results from both intimal hyperplasia and arterial shrinking (remodeling ), but the latter plays a much greater role.