[en] Interventional radiology possesses the character of tiny wound and conforms to the modem tide of medical development with wide prospect. There are different developmental modes appearing in these years, no matter what they are, but we persist in the opinion that interventional radiology is a new developing clinical subject, neither a purely medical technology nor an adjunct for clinical subjects. Specialization, standardization and clinicalization are the inevitable key developmental way for interventional radiology. Interventional department of the people's hospital of Henan Province gives a successful mode and prospect for all colleagues to refer and think over. (authors)

[en] During the past decades, interventional neuroradiology has become one of the most important modalities for treatment of cerebral vascular diseases. Chinese doctors have made great progress in this field, and their diagnosis and treament have also reached the international level in some territories. Following the need of specialized development for interventional neuroradiology, more and more problems have arisen and even caused argument in this field. To resolve the issue and promote the healthy and fast development of interventional neuroradiology, it is time for us to formulate the standard training and certification system for interventional neuroradiologist. (authors)

[en] Objective: To discuss the key points of nursing cooperation with the performance of Solitaire stenting removal of thrombus for the treatment of acute ischemic stroke. Methods: A total of 30 cases with acute ischemic stroke underwent emergency interventional operation. Solitaire stenting removal of thrombus was carried out in all patients. The experience of nursing cooperation was retrospectively summarized. Results: Emergency Solitaire stenting to remove the thrombus was successfully performed in 30 patients with acute ischemic stroke. The vascular re-canalization rate was 93.3%. In performing the operation, the nurses and technicians cooperated with the operator well. The monitoring of vital physical signs was well manipulated and recorded. No mis-delivering medical instruments occurred. Intact imaging data were successfully obtained. Conclusion: Careful preoperative preparation by instrument nurses and skilled cooperation with the surgical performance are the key points to ensure a successful emergency interventional procedure. The whole-course EKG monitoring also plays an important role in accomplishing the operation. (authors)

[en] The prognosis of acute severe ischemic stroke treated by conservative therapy is very poor. Endovascular treatment can promptly recanalize acutely-obstructed large intracranial vessel and thus effectively improve stroke outcomes. For recent years, stent retrievers, represented by SolitaireAB/FR stent, have overcome the shortages of thrombolytic therapy as well as the mechanical insufficiency of some initially-developed thrombectomy devices such as MERCI retriever, Penumbra system, etc. and these stent retrievers have brought about the combination of instant flow-restoration and reliable thrombectomy, benefited by which the therapeutic window for ischemic stroke is greatly prolonged, and the recanalization rate is markedly increased, which enables the patient to obtain a favorable outcome. This paper is intended to make a comprehensive review about recent progress in stent retrievers used for acute severe ischemic stroke. (authors)

[en] Objective: To investigate and evaluate the feasibility and middle, long-term efficacies of percutaneous transhepatic recanalization and angioplasty of hepatic veins (PTRAHV)in the treatment of Budd- Chiari syndrome(BCS)with occlusion of hepatic veins. Methods: From September 1996 to October 2006, 101 Budd-Chiari syndrome patients with occlusion of hepatic veins or accompanied by occlusion of inferior vena cava were recruited for the clinical study,including 65 males and 46 females (average age 42.47 years). Free hepatic vein pressure (FHVP)were measured through catheterization pre and post-angioplasty. Periprocedural complications, portal venous indexes including vessel diameter, mean flow rate and the direction, and venous patency ratio were evaluated and compared by Color Doppler during follow-up. Results: The successful ratio was 91% (92/101). During perioperative procedure, 3 patients with acute hepatic vein thrombosis, 2 with liver puncture tract bleeding, 1 with subcapsular hematoma and 1 ease with pulmonary embolism occurred but with no mortality after systemic conservative treatment. Follow-up of 6 months after PRTAHV were collected in 74 cases with portal venous indexes improvement over that of pre-procedure (P<0.05), the primary patency ratios of involved hepatic veins was 83.78%(62/74), 78.38%(58/74)and 76.47%(39/51)at 6 months, 1 and 2 years after operation respectively, and the assisted patency ratios was 94.59% (70/74), 91.89% (68/74)and 84.31% (43/51), respectively. Conclusions: PTRAHV is safe and effective option for treatment of Budd-Chiari syndrome with membraneous and segmental hepatic lesions. The middle and long-term efficacies are promising. (authors)

[en] Objective: To investigate the value of comprehensive preoperative imaging evaluation in determining indication of intervention for patients with symptomatic intracranial artery stenosis. Methods: DSA, high-resolution MRI of plaque and computed tomography perfusion (CTP) or perfusion weighted imaging (PWI) were performed in 26 patients with symptomatic intracranial artery stenosis and the intracranial artery cavity, artery wall and cerebral perfusion were evaluated. For patients with atherosclerotic plaque, the plaque characterization was analyzed according to high-resolution MRI findings, and intervention was used for those with unstable plaque. However, medicine was used for patients with arteritis. All patients were followed up after therapy. Results: Combining with DSA, the stenosis in 18 cases was thought to be associated with atherosclerotic plaque, which showed eccentric stenosis with mild or no enhancement on MRI; 13 of them had symptomatic unstable plaques, 1 case showed stable plaque but cerebral perfusion damaged severely, all of them were treated with interventional therapy; the other 4 cases had stable plaques and treated with medicine. The stenosis in 8 patients, which showed concentric hypertrophy of local endangium on MRI, was caused by arteritis and treated with medicine. No ischemic events occurred during the following 1-8 months [average (5.2±3.1) months] after therapy. Conclusion: Comprehensive preoperative imaging evaluation for patients with symptomatic intracranial artery stenosis is of great value in guiding the therapy. (authors)

[en] Objective: To explore the role of endovascular techniques in treatment for arterial injuries of skull base. Methods: A total of 53 consecutive cases suffered from skull base arterial injuries were enrolled in our hospital from Oct 2004 to May 2007, including 44 male and 9 female cases with average age of 23.3 years. Thirty-nine cases presented with pulsatile exophthalmos and intracranial vascular murmur, cerchnus and dysphagia in another 9, epistaxis in the remaining 5 cases. Diagnosis of 39 carotid cavernous fistulae (CCF)and 14 carotid pseudoaneurysm were performed by angiography (DSA). Alternative endovascular procedures were performed depending on lesions characteristics and follow-up was done by telephone and outpatient work up. Results: Procedures were performed involving 56 carotid arteries in all 53 cases including 34 CCF with embolization of detachable balloon(33 cases), 3 with balloon and coils, and 3 by stent-graft placement. 8 carotid pseudoaneurysms were cured by parent artery occlusion with balloon, 2 experienced endovascular isolation with balloon and coils, and 4 with stent-graft. Follow-up for mean 9.5 months (range from 2 to 25 months) revealed that the chief symptoms of 45 cases (85%) were relieved within 6 months after the procedure but ocular movement and visual disorder remained in 8 cases (15%)till 12 months. Six pseudoaneurysms and 3 residual leak were found in reexamination, of which 2 cases underwent intervention again 2 and 3 months later due to dural arterial-venous fistula in cavernous sinus, respectively. Conclusions: Endovascular treatment is safe and effective therapeutic option with minimal invasion for skull base arterial injuries. Detachable balloon embolization is the first choice for CCF and carotid pseudoaneurysm. Spring coil packing and stent-graft implantation should be in alternation as combination for special cases. (authors)

[en] Objective: To design the mushroom covered stent and study the primary application for gastroesophageal anastomosis-thoracic cavity fistula. Methods: On the base of the peculiar anatomic structure and the pathological changes of gastroesophageal anastomosis-thoracic cavity fistula, authors designed the mushroom covered stent. Under the fluoroscopic guidance, 6 mushroom covered stents were placed in 5 patients. Results: The fistula oral of the patients with post-operative perforation were closed with the mushroom covered stent, the food intake ability and nurturer of all patients were improved. Conclusions: The structure of the mushroom covered stents is reasonable, which is effective and safe for treating the patient with gastroesophageal anastomosis-thoracic cavity fistula

[en] Purpose: To treat the esophagotracheal fistula that was the main cause of death in patients with esophageal carcinoma, the placement of the stent was studied. Materials and methods: Under the fluoroscopic guidance, 28 stents (5 stents made in USA and 23 in China) were successfully implanted in all the 28 patients with esophagotracheal fistula. Results: The aphagia of the patients was greatly improved and a normal diet could be swallowed at once after the placement of the stents. The 27 cases of inhalation pneumonia that caused by the fistula was recovered. Conclusion: The result indicated that the treatment with the placement of the covered self-expanding stent is simple, safe, and effective for most patients with aphagia and pneumonia due to esophagotracheal fistula

[en] Objective: To determine the anatomic factors that could help to predict the degree of primary endovascular occlusion of cerebral aneurysms by 3D-DSA and to use a simple scoring system to predict the difficulty of achieving complete occlusion of cerebral aneurysm. Methods: 119 patients with 129 intracranial aneurysms underwent 3D-DSA and were subsequently treated by endovascular packing with coils. All patients underwent 2D-DSA after the primary embolization so that we could assess the degree of aneurysmal occlusion. The following aneurysm-related anatomic parameters were measured on 3D-DSA including the largest diameter, neck size, dome-to-neck ratio and shape. The relationship between each parameter and the rate of successful treatment was determined in order to reveal the anatomic factors and a score used to demonstrate difficulty of attaining occlusion was developed on the basis of the identified predictors of successful treatment. Subsequently, we assessed the correlation between the score and the rate of successful occlusion. Results: Three anatomic parameters influenced significantly the rate of successful occlusion: neck size (P=0.02), shape (P<0.01) and dome-to-neck ratio (P=0.04). The difficult score based on the three parameters (neck size, shape, dome-to-neck ratio) was significantly correlated with the occlusion rate (P<0.01). Conclusions: Several anatomic parameters (neck size, shape, dome-to-neck ratio) of aneurysms are correlated with the immediate outcome of aneurysmal occlusion. The difficult score based on 3D-DSA findings provides useful information for predicting successful endovascular treatment of intracranial aneurysms. (authors)