简介：Tileterm‘percutaneouscoronaryintervention'(PCI)isusedtodescribevariousproceduresthatcanbeusedtomechanicallyimprovemyocardialperfusionwithoutresortingtosurgery.Themostcommonprocedureispercutaneoustransluminalcoronaryangioplasty(PTCA),usuallywithimplantationofanintracoronarystent.Othermethodsmaybeappropriateinsmallsubsetsofpatients.Morethan1millionPCIprocedureswereperformedworldwidein2000.

简介：AbstractIatrogenic femoral artery pseudoaneurysm is a common complication of the endovascular procedures. Manual compression and thrombin injection are the conventional techniques to occlude the pseudoaneurysms. However, there are still some failed cases that applied these treatment options. The aim of the study is to seek a potential and alternative method with ProGlide system to close the pseudoaneurysm. During April 2018 to February 2019, 2 patients with iatrogenic pseudoaneurysm of the superficial femoral were treated with the suture-base closure device-ProGlide. After punctured the pseudoaneurysm and placed a 6-F sheath, the guide wire was placed in the right femoral artery via the access of the pseudoaneurysm neck. Then the pseudoaneurysm neck was sutured by ProGlide to occlude the blood supply to the pseudoaneurysm. These 2 patients were cured with no complications and complaints, which revealed that percutaneous suture technique with ProGlide at the neck level of pseudoaneurysm provides a novel method for the management of vascular access pseudoaneurysm, especially in those with a wide and short neck.

简介：AlatticeBoltzmannnumericalmodelingmethodwasdevelopedtopredictskinconcentrationaftertopicalapplicationofadrugontheskin.ThemethodisbasedonD2Q9latticespacesassociatedwiththeBhatnagar-Gross-Krook(BGK)collisiontermtosolvetheconvection-diffusionequation(CDE).Asimulationwascarriedoutindifferentrangesofthevalueofbound,whichisrelatedtoskincapillaryclearanceandthevolumeofdiffusionduringapercutaneousabsorptionprocess.Whenatypicaldrugisusedontheskin,thevalueofcorrespondstotheamountofdrugabsorbedbythebloodandtheabsorptionofthedrugaddedtotheskin.Theeffectofwasstudiedforwhentheregionofskincontactisalinesegmentontheskinsurface.

简介：BackgroundShort-termhospitalreadmissionsafterpercutaneouscoronaryintervention(PCI)accountforhighermedicalcostsandpoorprognosisofpatientswithcoronaryarterydisease(CAD).However,patientsathighriskforreadmissionarenotyetidentified.MethodsAtotalof1416patientssuccessfullytreatedwithPCIwereincluded.Dataofage,sex,presentationtypeofCAD,cardiacfunction,coexistentdiseases,contrastdose,numbersoflesionsandstentsimplanted,procedurecomplication,out-of-hospitalmedicationwerecollected.Coxregressionmodelwasemployedtoanalyzethemultiplefactorsinfluencingreadmission.Results75.8%ofallreadmissionswereduetoCADandtheaveragereadmissiontimewas422days.UnivariateanalysisandmultivariateCoxregressionmodeleventuallyshowedthatpatientswithanyprocedurecomplicationsand/ormorelesionsinnumberwereathigherriskforreadmissionwhileolderage,smoke,urgentPCIandmorestentsimplantedpreventedthemfromreadmitting.ConclusionThemajorcauseofreadmissionafterPCIisstillCADitself.DuringtheindexhospitalizationofPCI,patientswithmulti-vesseldiseaseneedcarefultreatmentandprocedurecomplicationsshouldbepreventedinordertoextendtheintervalofreadmission.

简介：BACKGROUND:Theclinicaltreatmentofneuropathicpainisverytroublesome,andthephysicalmethodofradiofrequencythermocoagulationisagoodchoiceforitstreatment.OBJECTIVE:Toobservethecurativeeffactofpercutaneousradiofrequencythermocoagulationonneuropathicneuralgia.DESIGN:Acasefollow-upanalysis.SETTING:MinimallyInvasiveSurgeryRoom,DepartmentofNeurosurgery,UrumqiGeneralHospitalofLanzhouMilitaryAreaCommandofChinesePLA.PARTICIPANTS:Totally131patientswereselectedfromtheDepartmentofNeurosurgery,UrumqiGeneralHospitalofLanzhouMilitaryAreaCommandofChinesePLAfromDecember2000toJune2006,including73malesand58females,aging37-72yearsold,ANDthediseasecoursewas2-15years.①Drugtreatmentfailedtoalleviatethepainorinducedobvioussidethepainorinducedobvioussideeffects;②Withthesamepathologicalchangesaspainandeffectiveinthenerveblocktest;Hadsignedtheinformedconsentsbeforetreatment.Distributionoftheneuropathicpain:①Trigeminalneuralgia,whichwerelightingattack,locatedatV2in28cases,V3in46cases,V1+V2in3cases,V2+V3in28cases,andV1+V2+V3in1cases;②Migrainelocatedat(exceptthefrontalbranchoftrigeminalnerve)greaterandlesseroccipitalnervesin6cases,auriculotemporalnervein3cases,temporalandzygomaticnervesin3cases;③UnilateralneuralgiaofC2andC3followingherpeszosterin1case,andchestintercostalsneuralgiain2cases;④Lastingburningpainintheoperativeareaafterthoracotomywasin1caseoflungcancer.METHODS:①Alltheenrolledpatientsweretreatedwithpercutaneouspunctureattrigeminalganglionorperipheralnerve,thennerveblockwasperformedfirstlyforanesthesia,andthepaindisappearedimmediatelyatthismoment,therewashypoesthesiaornumbnessintheareaofinnervation,whichmanifestedthepunctureappositionwascorrect.thenelectrostimulationof50Hzwiththecurrentof0.1-0.5Vwasgivenforfurtherfunctionallocalization.②TheRFG-3Cradio

简介：Cardiaccatheterizationandpercutaneouscoronaryinterventionplayanimportantroleinthemanagementofcoronaryarterydisease.Althoughthetransfemoralapproachhasbeenthetraditionallydominantmethod,therehasbeenanincreasedutilizationofthetransradialapproach.Multipleobservationalstudiesandrandomizedclinicaltrialshaveshownfewerbleedingcomplications,reducedmorbidityandmortality,improvedqualityoflife,andbettereconomicoutcomeswhenthetransradialapproachisutilizedwhencomparedtothetransfemoralapproach.Despiteitsmanybenefits,utilizationofthisapproachincertaincountriesincludingtheUnitedStateshasbeenlessthanoptimalduetoaloweradoptionratesmostlydrivenbylackoftrainingopportunitiesanddecreasedawarenessofclinicalbenefitsofthetransradialapproach.Inthisreview,thehistory,observationaltrends,efficacy,andtechnicalaspectsoftransradialcardiaccatheterizationandpercutaneouscoronaryinterventionarediscussed.

简介：Commonpracticedictatestheperformanceofpercutaneouscoronaryinterventionunderconventionalangiographicguidance.Withstudiessuggestingthehighincidenceofintraobservervariability,especiallyinangiographicborderlinelesions,newmodalitiessuchasintravascularultrasound(IVUS)guidanceduringpercutaneouscoronaryinterventionhavesurfaced.MultiplestudieshaveshownimprovedoutcomeswithIVUSguidance,mainlydrivenbyadecreaseinischemia-driventargetlesionrevascularization.Inthepasttwodecades,amultitudeofstudieshaveinvestigatedtheusesandclinicaloutcomesassociatedwiththistechnology.Inthisreview,wehighlighttheutility,advantages,economicimplications,andclinicaloutcomesofIVUSguidanceoverstandardangiographicguidance,withemphasisondataastheypertaintoIVUS-guidedstentimplantation.

简介：BackgroundLargepercutaneouscoronaryintervention(PCI)centershaveshownstatisticallybetterprognosiswithtransradialapproach(TRA)comparedwithtransfemoralapproach(TFA).SowetriedtocomparetheoutcomesbetweenTRAandTFAinonehighvolumePCIcenterinST-segmentelevationmyocardialinfarction(STEMI)patientsundergoingprimaryPCI.MethodSixhundredandsixtytwoSTEMIpatientswhounderwentprimaryPCIwithstentsimplantationwereretrospectivelyincludedfromJune1,2006toApril30,2011inourhospitalandprospectivelyfollowedforoneyear.Theprimaryendpointwasdefinedasin-hospitalnetadverseclinicalevents(NACE)whichincludeddeath,myocardialinfarction(MI),stroke,targetvesselrevascularization(TVR)andmajorbleeding.Thesecondaryendpointwasdefinedas1yearmajoradversecardiovascularevents(MACE)whichincludeddeath,MIandTVR.ResultsTheoccurrenceratesofNACE(8.0%vs.17.0%,P=0.0018),accesssitecomplications(4.0%vs.10.7%P=0.0027)andaccesssite-relatedmajorbleeding(2.4%vs.6.3%,P=0.0254)wereallhigherintheTFAgroupthanintheTRAgroup.Theincidencerateof1yearMACEwassimilarbetweenTRAandTFA(8.5%vs.13.2%,P=0.0932).TheinverseprobabilitiesweightingmatchedmultivariableCoxregressionanalysisshowedTRAwasanindependentpredictoroflowerratesofin-hospitalNACE(HR:0.58,95%CI:0.34-0.99,P=0.0477),in-hospitaldeath(HR:0.31,95%CI:0.10-0.73,P=0.0499)andaccesssitecomplications(HR:0.37,95%CI:0.19-0.73,P=0.0040).ConclusionsTRAshowedgreatefficacyandsafetyforSTEMIpatientsundergoingprimaryPCIinhighvolumePCIcenters.Itshouldberecommendedasroutinepracticeinfuture,andespeciallyinthosepatientswithhighriskofbleeding.

简介：无

简介：Toprovidetheoreticalbasisforeffectandmechanismofpercutaneouslumbardiscectomyinclinic.Methods:Atotalof180patientswithlumbarintervertebraldischerniationwereevaluatedbyCTonthefifthdaybeforeandafteroperation.Meanwhile,CTvaluewasmeasuredinthedeterminedlevelandregion.Results:Afteroperation,CTvalueofthecentralandposteriordeterminedpointofherniatedintervertebraldiscwaslowersignificantlythanthatbeforeoperation(P<0.01),butCTvalueoftheanteriordeterminedpointwasdifferentinsignificantly.Theexcellentandgoodresultsofthepatientstogetherwere83%postoperatively.Conclusions:Thecurativeeffectofpercutaneouslumbardiscectomyisachievedthroughreductionoflumbarintradiscalpressure.

简介：瞄准：估计联合transcatheter的效果动脉的chemoembolization(不作声)并且在有大hepatocellular癌(HCC)的病人的经皮的乙醇脱离(豌豆)。方法：有unresectable的63个病人的一个总数大HCC被对待与不作声由豌豆列在后面。肿瘤的最大的尺寸从5.3厘米到17.8厘米。幸存率，尖锐效果，毒性和预示的因素被分析。结果：在1，3和5年的累积幸存率是59.4%，28.4%和15.8%，分别地(27.7瞬间的中部的幸存)。肿瘤区域被超过50%在30减少(47.6%)盒子。在有增加的-fetoprotein(法新社)的56种情况中珍视，法新社水平被超过75%拒绝。联合治疗很好通常被容忍。仅仅二个病人从variceal流血死了与治疗联系了。比例的危险建模的艇长证明肿瘤，肿瘤边缘和乙醇剂量的数字是独立预示的因素。结论：联合不作声并且豌豆治疗是为unresectable的一条有希望的途径大HCC。

简介：ObjectivesToassessfive-yearresultsaftersuccessfulpercutaneousmechanicalmitralcommissurotomy(PMMC).MethodsThirty-fourselectedpatientswithrheumaticmitralstenosisunderwentPMMCsuccessfullyinGuangdongcardiovascularinstitutebetweenFebruary2001andAugust2002.Serialechocardiogramswereperformedinallpatientsatbaseline,dischargeandannuallythereafter.ResultsFive-yearfollow-upratewas97.1%.Five-yearsurvivalratewas100%.BeforeandafterPMMCandatfollow-up,meanmitralvalveareabytwo-dimensionalechocardiographywas(0.87±0.15)cm2,(2.11±0.38)cm2and(1.81±0.36)cm2,respectively(P<0.01).Five-yearmitralrestenosisratewas6.1%.ConclusionPMMCcanachieveexcellentandsustainedlong-termresultsinselectedpatientswithmitralechocardiographicscoreexceedingorbeingequalto9.

简介：ObjectivesToevaluatethefeasibilityandsafetyofdistalprotectiondevice(PercuSurge)duringpercutaneouscoronaryintervention(PCI)inpatientswithacutecoronarysyndrome.MethodsFromOctober2004toAugust2007,40patientswithhighriskacutecoronarysyndromewhoreceivedprimarycoronaryinterventionwereincludedinthisstudy.PatientsweredividedintotwogroupsaccordingtowhetherPercuSurgewasattemptedduringPCI.Thebasicclinicalcharacteristics,angiographicresults,andfollow-updatabeforedischargewerecompared.Coronaryarteriesbloodflowthrombolysisinmyocardialinfarction(TIMI)grade,TIMImyocardialperfusion(TMP)gradeandtherateofno-reflowwereperformedinallcasesafterPCI.ResultsTherewasnosignificantdifferencebetweenthetwogroupsinbasicclinicalcharacteristicsandangiographybeforePCI(P>0.05).AllpatientsunderwentPCIsuccessfullyinbothgroups.InthePercuSurgegroup,PCIwithPercuSurgeguardwireprotectionwasperformedsuccessfullyin18patients.TherewassignificantdifferencebetweenthetwogroupsinTIMI3flowsgainedintargetvesselsafterPCI.BetterpercentageofTMPgrade3oftargetvesselswasachievedinPercuSurgegroup.Lessno-reflowwerefoundinPercuSurgegroup.TherewerelowerpeaktroponinIandserumMBisoenzymeofcreatinekinaselevels,higherleftventricularejectionfractionandsmallerleftventricularend-diastolicdimensioninthePercuSurgegroupafterPCIatthedatebeforedischarge(P<0.05).TherewasnomajoradversecardiaceventsinPercuSurgegroup,onlyonepatientdiedinthecontrolgroup.ConclusionsThisstudydemonstratesthatusingthePercuSurgeGuardwiresystemduringPCIinhighriskacutecoronarysyndromepatientstopreventno-reflowisfeasibilityandsafety.

简介：肱骨的客观Supracondylar破裂在小儿科的肘附近说明60%所有破裂，甚至在发达国家，18%病人在医院里经历外科48小时或更长的列在后面表示。管理指南还不为谁的这些病人是清楚的在场迟了。这未来的研究的目的是评估跟随关上的减小并且在损害以后介绍12个小时或更多的肱骨的广泛地代替的supracondylar破裂的经皮的卡住的临床、放射学、功能的结果。我们考察了关上的减小并且与代替的扩展的在40个病人的用穿过的K电线的经皮的卡住的功能、放射学的结果的方法在表示与超过12个小时的延期打肱骨(Gartland类型III)的supracondylar骨折。病人的平均年龄是4.5年，在表示的吝啬的延期是17.55个小时。结果关上了减小，经皮的卡住在90%病人是成功的。平均数在时期上面列在后面是15个月。Baumann的角度在所有病人在未受影响的方面的4度以内被恢复。在有严重胀大的病人的一个小中间的切口的使用帮助了我们避免尺骨的神经损害。用弗林的标准，38个病人(95%)有优秀结果。二个病人有温和肌炎，两个有差的结果。任何一个都没病人开发肘脉内翻足。结论关上了减小并且交叉在孩子肱骨的代替的supracondylar破裂卡住甚至与推迟的表示是一个安全、有效的方法。

简介：无

简介：Objective:Toobservetheclinicaleffectofradiofrequencyablation(RFA)combinedwithtranscatheterarterialchemoembolization(TACE)foradvancedhepatocellularcarcinoma(HCC).Methods:Atotalof92casesofadvancedprimarylivercancerunderwentTACEandRFAtreatmentfromJune2005to2011attheDepartmentofHepatobiliarySurgery,theFirstAffiliatedHospitalofBengbuMedicalCollege.Atotalof88caseswithcompleteclinicaltreatmentandfollow-updataweredividedintotwogroups:43patientstreatedwithTACE(TACEgroup)and45patientsthatreceivedTACEcombinedwithRFAtreatment(TACE+RFAgroup).Afterclinicaldataassessment,tumorsizeandsurvivalstatuswerenotsignificantlydifferentbetweenthegroupsasdeterminedbystratifiedanalysis.Results:Beforeandaftersurgery,spiralCTradiographyandcolorcomparisonobservedablationconditions.Thetumornecrosisratesaftertreatment(CR+PR)were67.4%(29/43)and91.1%(41/45)fortheTACEandcombinedtreatmentgroups,respectively,andthedifferencewasstatisticallysignificant(P<0.05).ThequalityoflifewassignificantlyimprovedforpatientsundergoingTACE+RFAcomparedwiththecontrolgroup.SurvivaldurationwasnotsignificantlydifferentinpatientsundergoingTACE+RFAcomparedwiththecontrolgroup.Conclusions:Inthisstudy,theeffectofRFAcombinedwithTACEtreatmentwasbetterthanTACEaloneintreatingadvancedHCC.

简介：Percutaneouscoronaryintervention(PCI)improvessymptomsandprognosisinischemia-inducing,functionallysignificant,coronarylesions.Useoffractionalflowreserveallowsphysicianstoinvestigatetheischemia-inducingpotentialofaspecificlesionandcanbeusedtoguidecoronaryrevascularization,especiallyinmultivesselcoronaryarterydisease.Fractionalflowreserve-guidedPCIhasbeenextensivelyinvestigated.Resultsshowthatdeferralofstentinginnon-significantlesionsissafe,whereasdeferralofstentinginfunctionallysignificantlesionsworsensoutcome.FFR-guidedPCIimprovesoutcomeinmultivesseldiseaseoverangiography-guidedPCI.Untilrecently,therewaslittleknownaboutthelong-termoutcomeofFFR-guidedrevascularizationanditsvalidityinacutecoronarysyndromes.Thisreviewaimstoaddressthenewevidenceregardinglong-termappropriatenessofFFR-guidedPCI,theneedforhyperemiatoevaluatefunctionalseverity,andtheuseofFFRinacutecoronarysyndromes.

简介：ObjectivesTounderstandtheeffectofcarvedilolonthecoronaryvascularendothelialfunctionofthepatientswithcoronaryheartdiseaseafterpercutaneoustransluminalcoronaryangioplasty(PTCA).Methods51cases,havingoneormorethantwobranchesnarrow(≥70%),werediagnosedbycoronaryangiography.Thesepatientsweredividedrandomlyintocarvedilolgroup(n=28)andcontrolgroup(n=23)whodidnottakecarvedilol.Endothelin(ET)andnitrodioxide(NO)levelsofperipheralbloodweremeasuredbeforeandafterPTCA,beforeandaftertwoweeksbytakingcarvedilol.ResuitsComparedwiththeETandNOlevelsbeforePTCA,ETweremarkedlyincreasedandNOweredecreasedafterPTCA(p<0.05);comparedwiththeETandNOlevelsbeforetakingcarvedilol,ETweredecreasedandNOwereincreasedaftertwoweek(p<0.05),buttheETandNOlevelsofthecontrolgroupdidnotchangeintheperiodoftwoweeksobservation(p>0.05).ConclusionsCarvedilolmayimprovethecoronaryvascularendothelialfunctionafterPTCA.

简介：BackgroundAfterpercutaneouscoronaryintervention(PCI),somepatientsmaysufferfromrestenosisandstentthrombosis.Manystudiessuggestthatendothelialprogenitorcell(EPC)hasanimportantroleinpreventingrestenosisandstentthrombosis.AnovelstentwhichcanattractEPChasbeendesignedtoprovideabetteroutcomefortheseproblems.MethodThedataofthepresentreviewwasobtainedbysearchingPUBMEDandotherdatabases(1994-2011)usingthekeytermsof'endothelialprogenitorcell','reendothelialization','restenosis','stentthrombosis',and'percutaneouscoronaryintervention'.ResultRapidreendothelializationisessentialinpreventingrestenosisandstentthrombosis.EPCcandifferentiateintoendothelialcellandacceleratethereendothelialization.Afternumerouspreclinicalandclinicalresearches,thecorrelationbetweencirculatingEPCstorestenosisstillremainspoorlyunderstood.However,manystudieshaveshowntheimportantroleofEPCindiminishingtheriskofthrombosisfollowingstentimplantation.Somepharmacologicalagentshavebeenreportedcanincreasethenumberand/orfunctionsofEPC.Recently,CD34+antibodycoatedstenthasbeendevelopedtoattractEPCtothehealingendothelium,andhasshowedfavorableresults.ConclusionEPChasimportantroleinrapidreendothelializationaftervascularinjury.EPCcanpreventstentthrombosisafterPCI,howevertheeffectsofEPCinpreventingrestenosisneedfurtherinvestigations.ThecapturingCD34+stentissafeandsignificantlydecreasesstentthrombosis.

简介：AbstractBackground:The development of the technique has improved the success rate of percutaneous coronary intervention (PCI) for instent chronic total occlusion (IS-CTO). However, long-term outcomes remain unclear. The present study sought to investigate long-term outcomes of PCI for IS-CTO.Methods:A total of 474 IS-CTO patients were enrolled at two cardiac centers from 2015 to 2018 retrospectively. These patients were allocated into either successful or failed IS-CTO PCI groups. The primary endpoint (major adverse cardiac events [MACE]) consisted of recurrent angina pectoris (RAP), target-vessel myocardial infarction (MI), heart failure, cardiac death, or ischemia-driven target-vessel revascularization (TVR) at follow-up. Multivariable Cox regression analysis was used to investigate the association between treatment appropriateness and clinical outcomes.Results:A total of 367 patients were successfully treated with IS-CTO PCI while 107 patients had failed recanalization. After a median follow-up of 30 months (interquartile range: 17-42 months), no significant difference was observed between the two groups for the following parameters: cardiac death (successful PCI vs. failed PCI: 0.9% vs. 2.7%; adjusted hazard ratio [HR]: 1.442; 95% confidence interval [CI]: 0.21-9.887; P = 0.709), RAP (successful PCI vs. failed PCI: 40.8% vs. 40.0%; adjusted HR: 1.025; 95% CI: 0.683-1.538; P = 0.905), heart failure (successful PCI vs. failed PCI: 6.1% vs. 2.7%; adjusted HR: 0.281; 95% CI: 0.065-1.206; P = 0.088), target-vessel related MI (successful PCI vs. failed PCI: 1.5% vs. 2.7%; adjusted HR: 1.150; 95% CI: 0.221-5.995; P = 0.868), MACE (successful PCI vs. failed PCI: 44.2% vs. 45.3%; adjusted HR: 1.052; 95% CI: 0.717-1.543; P = 0.797). More patients were free of angina in the successful IS-CTO PCI group compared with failed PCI in the first (80.4% vs. 60%, P < 0.01) and second years (73.3% vs. 60.0%, P = 0.02) following up. Successful IS-CTO PCI had a lower incidence of MACE in the first and second years (20.2% vs. 40.0%, P < 0.01; 27.9% vs. 41.3%, P = 0.023) compared with failed PCI. After a median follow-up of 30 months, the reocclusion rate was 28.5% and TVR was 26.1% in the successful IS-CTO PCI group. Receiving >18 months of dual antiplatelet therapy (DAPT) was an independent predictor of decreased risk of TVR (HR: 2.682; 95% CI: 1.295-5.578; P = 0.008) or MACE (without TVR) (HR: 1.898; 95% CI: 1.036-3.479; P = 0.038) in successful IS-CTO PCI.Conclusions:After a median follow-up of 30 months, the successful IS-CTO PCI group had MACE similar to that of the failed PCI group. However, the successful IS-CTO PCI group had improved angina symptoms and were free from requiring coronary artery bypass grafting in the first or second years. To decrease MACE, DAPT was found to be essential and recommended for at least 18 months for IS-CTO PCI.