Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2018-01-25 Cooperative journals: 《南方医科大学学报》
Abstract： Objective To evaluate the safety and short-term efficacy of Willis covered stent for treatment of blood blister-like aneurysms (BBA). Methods Eight patients with BBA were treated with Willis covered stent system during the period from December 2014 to February 2016. The guiding catheter was placed as high as possible to facilitate the delivery of the covered stent system. Results Nine covered stents were implanted in the aneurysms of 8 patients (8 aneurysms), and 8 stents were released successfully in the parent arteries. In 6 patients, angiography immediately after stent release showed complete disappearance of the aneurysm and the parent arteries remained patent. One patient experienced a minor endoleak after stent implantation, and another stent was implanted to eliminate the endoleak. Iatrogeniccarotid-cavernous fistula occurred in 1 patient due to tortuosity of the parent artery, for which superficial temporal artery-to-middle cerebral artery bypass combined with parent artery occlusion was performed instead; the patient recovered smoothly and the bypass remained patent at 6 months after the operation. No other periprocedural complications occurred in these patients. Follow-up study showed no new-onset neurological deficits in these 8 patients, who had mRS score of 0 in 6 patients and of 1 in 2 patients. Digital subtractive angiography at 6 months after the operation demonstrated no aneurysm in these patients, and only one patient showed mild stenosis in the parent artery. Conclusion Willis covered stents are effective for treatment of BBAwith good safety andshort-termoutcomes.
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2017-12-27 Cooperative journals: 《南方医科大学学报》
Abstract： Objective To compare the efficacy, clinical characteristics, safety, injection time and radiation exposure of Onyx embolization using a long-distance injection method and routine injection method for management of dural arteriovenous fistula (DAVF). Methods The clinical data were retrospectively analyzed in 59 patients with DAVF treated with Onyx embolization using long-distance injection method (28 patients) and routine injection method (31 patients). The efficacy, safety, injection time and radiation exposure during Onyx embolization were compared between the two injections methods. Results The average radiation dose exposure to the surgeon per procedure was significantly lower in the long-distance injection group than in the routine group. The injection time (P=0.53), injection volume (P=0.78), number of supply arteries (P=0.80), Cognard types (P=0.67), and effect of embolization (P=0.88) were all similar between the two groups. Conclusion Endovaseular treatment of intracranial DAVF with Onyx embolization using the long-distance injection method is feasible, safe and effective and can reduce the radiation exposure to the surgeon.
Subjects: Medicine, Pharmacy >> Preclinical Medicine submitted time 2017-12-07 Cooperative journals: 《分子影像学杂志》
Abstract： Objective To investigate the clinical features, diagnosis, therapeutic strategy and prognosis of primary intracranial choriocarcinoma. Methods A retrospective review of three rare cases with primary intracranial non-pineal region choriocarcinoma diagnosed histopathologically was performed. Results One case was intrasellar region choriocacinoma with right cavernous sinus invaded and internal carotid artery wrapped. It was misdiagnosed with nonfunctional pituitary adenoma preoperatively. Tumor apoplexy was occurred one day before surgery. Panhypopituitarism developed after emergency opertation. The patient refused to receive any other tumor treatment and died one month later. Tumor of case 2 was located in suprasellar region and third ventricle. Serum卜-HCG was 2300 mIU/mL. Radiotherapy and chemotherapy was performed after tumor resection. The patient died ten months after being discharged. Case 3 was right basal ganglion lesion with serum卜-HCG 25 mIU/mL on admission. Choriocarcinoma was diagnosed after stereotactic biopsy. The patient was receiving chemotherapy and still in follow-up. Conclusion Most of the primary intracranial choriocarcinomas are located in pineal region, only extremely rare cases occur in sellar and basal ganglion region. Male predominate in pineal and basal ganglion region tumors but female predominate in sellar region tumors. Choriocarcinoma is a highly malignant tumor which often progresses rapidly and has poor prognosis.卜-HCG is a reliable marker of choriocarcinoma. Recently chemotherapy combined with operation is the primary treatment for it, and some clinical practices have proved their effect.
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