[en] Objective: To investigate the significance of renal arterial embolization nephrectomy for treating post-transplanted renal failure. Methods: 15 cases of post-transplanted renal failure received renal arterial embolization. The post-procedural efficacies were followed up for about 6 months to 4 years. Results: Among the 15 cases, 11 showed blood pressure decreasing to normal level, 3 with reduction of the drug dose for anti-hypertension and 1 of no response. In addition, 12 suffered from postprocedural anuria, and 3 with obvious hypourocrinia associated with significant decrease of proteinuia; 5 with positive lymphcytic population response antigen (PRA > 20%), but turning negative with 3 of them after 3 weeks. All the transplanted kidneys revealed different degrees of atrophy but 4 of them obtained chances of successful retransplantation 3- 6 months after the procedure, 3 of them with follow up of 1-3 years were being well. Conclusions: Renal arterial embolization is a safe, efficient measure for treating post-transplanted renal failure with obvious decrease of correlative clinical symptoms and providing conditions for renal retransplantation. (authors)

[en] Objective: To study the efficacy, safety and correlative characteristics of Chinese herb as a vascular embolization agent. Methods: Vascular embolization agent combined from several kinds of Chinese herb was manufactured and served as anticarcinogen and coagulant according to the chinese Pharmacopoeia. The characteristics of the combination embolization agent through embolizing the hepatic arteries in eight pigs were studied. Results: The combination agent was a non-homogenous suspension, easily to be injected through 5-F catheter with hyper attenuation under fluoroscopy; simultaneously with good histocompatibility and hemo-compatibility and without feverish response and toxicity. The combination agent mainly embolized the peripheral arteries with maintaining occlusion for 5 weeks and without formation of collateral circulation. Slight injuries of normal hepatic tissues with hepatic cytonecrosis and endochyloma focal necrosis were found through optical and electronic microscopy. Conclusions: The Chinese herb combination agent is safe and effective in experimental application with good angioembolic function and a potential peripheral embolization agent. (authors)

[en] The article of interventional therapy of hepatocellular carcinoma were reviewed including the method, basic research and the questions remained to be solved. All interventional therapies consisted of transcatheter arterial chemoembolism, transcatheter arterial heat infusion, transcatheter arterial heat embolism, Chinese medicinal herb, percutaneous ethanol injection, radiofrequency ablation, percutaneous microwave coagulation and cryosurgery had their insufficiencies. The combined therapy, such as double chemoembolism, TACE combined with ablation, TACE combined with gene therapy could further promote the therapeutic effect. The research of the biological behavior of the residue after TACE was just at the beginning with problems still to be acknowledged. With the emerging of anti-oncogene therapy(P 53)and oncolytic virus therapy represented the gene therapy, together with anti-angiogenesis therapy, now the interventional therapy for hepatocellular carcinoma steps in a new stage. The treatment of during and perioperative periods possesses a great correlative influence with the therapeutic effect and complications and should be further standardized. (authors)

[en] Objective: To study effects of S-adenosy-methionine (SAMe) for acute hepatic functional damage after transcatheter chemoembolization in the treatment of primary large HCC. Methods: The clinical data of 51 cases of liver neoplasm after TACE from May 2003 to October 2005 were analyzed retrospectively, including SAMe 1000 mg intravenous drip after TACE daily of the treatment group and diammonium glycyrrhizinate 30 ml intravenous drip after TACE daily of the control group. The two groups were separately assessed the hepatic function on 1st day preoperatively and the 2nd, 4th d and 8th day, postoperatively, and together with the hamilton depression rating scale for derpression (HRSD)and the clinical general impression estimation for the evaluation of the clinical efficiency. Results: All the hepatic functional labels changed markedly after TACE with ALT, AST, TBIL and DBIL rising to a certain extent on the 2nd day postoperatively (P<0.05). The labels began to decrease on the 4th day. There were no significant statistical differences of ALT, AST, TBIL and DBIL between 1st day preoperatively and 8th day postoperatively in the treatment group (P>0.05). There were significant differences of the labels during the same period in the control group (P< 0.05). γ-GT changed irregularly in the two groups. There were also no significant differences of TP and A between 1st d preoperatively and 8th d, postoperatively in the two groups. In the treatment group, 15 patients (60%) showed relief of chief complaints of fatigue, hypodynamia, anxiety, insomnia. The total scores of HRSD also decreased revealing the better cooperation of the patients with treatment. Conclusions: SAMe provides hepatic functional protection for large primary HCC patients after TACE especially for the satisfactory short-term efficiency in acute liver damage with simultaneous anti-depression and enhancing TACE effects, and promoting life quality. (authors)

[en] The aim of this study is to evaluate the diagnostic performance of multidetector CT angiography (CTA) in depicting bronchial and non-bronchial systemic arteries in patients with haemoptysis and to assess whether this modality helps determine the feasibility of angiographic embolisation. Fifty-two patients with haemoptysis between January 2010 and July 2011 underwent both preoperative multidetector CTA and digital subtraction angiography (DSA) imaging. Diagnostic performance of CTA in depicting arteries causing haemoptysis was assessed on a per-patient and a per-artery basis. The feasibility of the endovascular treatment evaluated by CTA was analysed. Sensitivity, specificity, and positive and negative predictive values for those analyses were determined. Fifty patients were included in the artery-presence-number analysis. In the per-patient analysis, neither CTA (P=0.25) nor DSA (P=1.00) showed statistical difference in the detection of arteries causing haemoptysis. The sensitivity, specificity, and positive and negative predictive values were 94%, 100%, 100%, and 40%, respectively, for the presence of pathologic arteries evaluated by CTA, and 98%, 100%, 100%, and 67%, respectively, for DSA. On the per-artery basis, CTA correctly identified 97% (107/110). Fifty-two patients were included in the feasibility analysis. The performance of CTA in predicting the feasibility of angiographic embolisation was not statistically different from the treatment performed (P=1.00). The sensitivity, specificity, and positive and negative predictive values were 96%, 80%, 98% and 67%, respectively, for CTA. Multidetector CTA is an accurate imaging method in depicting the presence and number of arteries causing haemoptysis. This modality is also useful for determining the feasibility of angiographic embolisation for haemoptysis.

[en] Objective: To evaluate the interventional management in treating hemorrhage from abdominal viscera. Methods: During the period from June 2009 to June 2011, a total of 36 patients with abdominal visceral hemorrhage were admitted to authors, hospital. Emergency interventional embolization or endovascular stent-graft exclusion was carried out in all patients. The lesions included hepatic pseudoaneurysm (n = 10), gastric ulcer with bleeding (n = 3), intestinal pseudoaneurysm (n = 3), renal pseudoaneurysm (n = 12), renal vascular malformation (n = 5) and abdominal bleeding due to scar pregnancy (n = 3). The results were analyzed. Results: Interventional embolization of the responsible artery and its branches or endovascular stent-graft exclusion procedure was carried out in all 36 patients, with the success rate of hemostasis being 100%. No complications such as severe functional impairment of abdominal organs, etc. occurred. Conclusion: Interventional treatment is quite safe and effective for abdominal visceral hemorrhage. For a given patient with abdominal bleeding from solid or hollow organ, individualized employment of interventional technique and embolic agents should be recommended. (authors)

[en] Objective: To investigate the clinical value of 64-section CT angiography (CTA) in detecting the origin of dorsal pancreatic artery (DPA). Methods: Ninety-seven consecutive patients with diabetes received transcatheter infusion of autologous bone marrow-derived stem cell transplantation into DPA. Abdominal CTA was performed in 42 patients before angiography. Celiac trunk, splenic, common hepatic and superior mesenteric arteries were reconstructed in order to locate the origin and traveling course of DPA. A routine angiography of both celiac and superior mesenteric arteries was performed for the demonstration of DPA. Further angiography of splenic and gastroduodenal arteries was carried out if necessary. Taking DSA images as the reference standard, the sensitivity, specificity and accuracy of CTA for DPA detection were calculated. Results: DPA was the main supply artery of pancreas in 85.7% patients (36/42). CTA demonstrated the origin of DPA in 35 cases, although one of which was confirmed to be misjudged (false positive). In seven cases CTA could not demonstrate DPA, and DSA proved that 2 of them was misjudged (false negative). The sensitivity,specificity and accuracy of CTA for DPA detection were 94.4%, 83.3% and 92.9%, respectively. Conclusion: 64-section CTA can accurately detect the origin of main supply artery of pancreas, which is of great value in guiding the interventional procedure for pancreatic diseases. (authors)

[en] Purpose: To investigate the diagnostic performance of 64-section CTA in the detection of dorsal pancreatic artery before interventional therapy for patients with diabetes. Materials and methods: The study was approved by the institutional ethics committee; written informed consent was obtained. Forty-two consecutive patients with diabetes received an experimental treatment of autologous bone marrow-derived stem cell transplantation by means of infusion into the dorsal pancreatic artery. All cases underwent abdominal CTA before angiography of pancreatic arteries in order to locate the origin and course of dorsal pancreatic artery. Angiography of coeliac artery, splenic artery, common hepatic artery and superior mesenteric artery were performed both in CTA and DSA. Superselective catheterization of dorsal pancreatic artery was carried out for the infusion of stem cell. Sensitivity, specificity and accuracy for the detection of dorsal pancreatic artery with CTA were calculated using DSA images as the reference standard. Results: Thirty-five and thirty-six dorsal pancreatic arteries were detected by CTA and DSA respectively. Dorsal pancreatic artery was not visualized in either CTA or DSA in 5 patients. The sensitivity, specificity and accuracy for CTA were 94.4%, 83.3% and 92.9%. Conclusion: 64-section CTA is accurate for the detection of dorsal pancreatic artery. It may be useful for the facilitation of superselective arterial infusion of stem cells to pancreas.