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Objective To compare and analyze the clinical outcomes of endovascular treatment of anterior circulation large vessel occlusion (ac-LVO) caused by large artery atherosclerosis (LAA) and simple arterial embolization. Methods From August 2020 to September 2022, 87 patients with ac - LVO hospitalized in The Second Affiliated Hospital of Bengbu Medical University were enrolled. All patients were treated with endovascular treatment, including intravenous thrombolysis, stent thrombectomy, aspiration thrombectomy or angioplasty (balloon dilatation or stent implantation). According to intraoperative findings (etiology), they were divided into LAA group (n = 32) and simple arterial embolization group (embolization group, n = 55). The primary outcome was the 90 d modified Rankin Scale (mRS) score, and the secondary outcomes were postoperative vascular recanalization rate [modified Thrombolysis Cerebral Infarction (mTICI)] and incidence of symptomatic cerebral hemorrhage 1 d after surgery. Results The proportions of patients with atrial fibrillation (χ² = 17.672, P = 0.000) and thrombus retrieval ≥ 3 times (χ² = 10.606, P = 0.001) in the embolization group were higher than those in the LAA group, the proportion of intravenous thrombolysis in the embolization group was less than that in the LAA group (χ² = 5.403, P = 0.020). However, the time from onset to operation (Z = 1.111, P = 0.267), the time from admission to operation (Z = 0.149, P = 0.882), preferred surgical approach for endovascular treatment (Fisher's exact probability: P = 0.153), as well as the rate of good prognosis (mRS score ≤ 2; χ² = 0.004, P = 0.950) and mortality (χ² = 0.035, P = 0.851) at 90 d after surgery, the rate of postoperative vascular recanalization (mTICI grade ≥ IIb; χ² = 0.033, P = 0.856) and symptomatic cerebral hemorrhage rate 1 d after surgery (χ² = 0.345, P = 0.557) for the secondary outcome were observed in both groups, the above differences were not statistically significant. Conclusions The efficacy and prognosis of endovascular treatment of ac-LVO caused by LAA and simple arterial embolization has the same effect and clinical prognosis. [ABSTRACT FROM AUTHOR]

Objective To explore the application value of transnasal endoscopy combined with endovascular treatment in the operation of skull base tumors. Methods A retrospective analysis was conducted on the clinical data of 9 patients who underwent endoscopic transnasal resection of skull base tumors and received endovascular treatment at Tianjin Huanhu Hospital from January 2017 to July 2022. To observe the tumor resection and evaluate the postoperative efficacy of nasopharyngeal carcinoma according to the World Health Organization (WHO) solid tumor measurement standards. During the follow- up period, Glasgow Outcome Scale (GOS) was used to assess postoperative neurological function recovery, and record tumor recurrence or progression. Complications related to endovascular treatment, such as pseudoaneurysm, spontaneous cerebral hemorrhage and cerebral infarction, were also recorded. Results Among 9 patients, there were 4 patients confirmed donor artery or internal carotid artery (ICA) rupture by DSA before operation, one case underwent spring coil embolization before operation, one case had a carotid catheter sheath inserted in advance during operation, one case had successful hemostasis with spring coil embolization during operation, one case had successful hemostasis with covered stent implantation during operation, 4 cases had ICA rupture confirmed by DSA during operation, and one case had successful hemostasis with spring coil embolization after DSA confirmation of ICA rupture. The total resection rate was 8/9. During a follow - up of 32.00 (25.00, 48.50) months, all patients did not experience tumor recurrence or progression. At the last follow -up, the GOS scores were 4-5, indicating good recovery of neurological function. A patient with recurrent nasopharyngeal carcinoma who underwent immunotherapy had a recurrent pseudoaneurysm at the distal end of the ICA covered with a stent implanted in the petrous segment. Three months after the stent implantation, the patient underwent external carotid artery - radial artery - middle cerebral artery bypass surgery to successfully stop the bleeding without any postoperative complications. The remaining 8 patients did not experience complications such as spontaneous cerebral hemorrhage or pseudoaneurysm. All patients did not experience complications such as cerebral infarction. Conclusions Evdovascular treatment is helpful in evaluating the relationship between skull base tumors and surrounding blood vessels before endoscopic transnasal resection of skull base tumors. It can effectively block the donor artery, reduce the probability of intraoperative bleeding, effectively treat the rupture of large blood vessels, and reduce the occurrence of serious complications. The efficacy and safety are both high. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prognosis and the influencing factors of restenosis after endovascular intervention in diabetes patients with lower extremity arteriosclerosis obliterans. Methods: 100 patients with diabetes complicated with arteriosclerosis obliterans of lower extremities admitted to our hospital from January 2022 to December 2022 were selected. All patients were treated with endovascular intervention, and the treatment conditions were analyzed. Then, the patients were followed up, and the number of patients with restenosis was recorded, A logistic regression model was established to analyze the independent influencing factors of short-term prognosis (good prognosis=0, poor prognosis=1) and occurrence of restenosis (non restenosis=0, restenosis=1) as dependent variables. Results: 100 diabetic patients with lower extremity arteriosclerosis occlusion were treated by endovascular intervention, the length of hospital stay was (13.43±2.42) d, the cost of treatment is RMB (73453.43±1253.64）, the total response rate was 80.00%, The incidence of cardiovascular and cerebrovascular events was 5.00%, the amputation rate was 4.00%, the incidence of restenosis at 1-year follow-up was 25.00%; Significant difference between poor prognosis group and good prognosis group: age, duration of lower extremity arterioscle rosis occlusion, ankle-brachial index, fibrinogen, total cholesterol, smoking history, and combined hyperlipidemia (P＜0.05）,Fasting blood glucose, fibrinogen, total cholesterol, glycated hemoglobin, smoking history, hyperlipidemia, and chronic renal insufficiency between restenosis and non-restenosis patients (P＜0.05); The factors affecting poor prognosis were age, ankle brachial index, fibrinogen, total cholesterol, and hyperlipidemia (P＜0.05); the factors influencing treatment restenosis were fibrinogen, hemoglobin A 1 c, smoking history, hyperlipidemia, with chronic renal insufficiency (P＜0.05). Conclusion: The total effective rate of endovascular intervention for diabetes patients with lower extremity arteriosclerosis obliterans is 80.00%, and the incidence of restenosis is 25.00%. Fibrinogen and hyperlipidemia are the common influencing factors for poor prognosis and restenosis, among which age, ankle brachial index, total cholesterol are also the influencing factors for poor prognosis, and the influencing factors for restenosis include glycosylated hemoglobin, smoking history, and chronic renal insufficiency. [ABSTRACT FROM AUTHOR]

Objective: To investigate the safety and effectiveness of endovascular intervention in the treatment of intracranial aneurysm (IA) complicated with ischemic cerebrovascular disease. Methods: The clinical data of 32 patients with IA complicated with ischemic cerebrovascular disease treated by endovascular intervention from January 2018 to December 2020 were retrospectively analyzed. Results: A total of 35 IA and 37 stenoses were found in 32 patients. The average size of IA was (5.17.3.12)mm Among them, 26 aneurysms (74%) were located in the internal carotid artery, 9 aneurysms (26%) were located in the vertebrobasilar artery, and 7 patients (22%) were found to have two intracranial aneurysms before operation. Among 37 stenosis, 9 (24%) were located in the vertebrobasilar artery, 8 (22%) were located in the extracranial segment, and the remaining 20 (54%) were located in the internal carotid artery. The average stenosis rate was 75.7% before operation. 31 aneurysms (89%) were completely occluded and 4 aneurysms (11%) remained in the neck. Among 37 stenoses, the average stenosis rate after operation was 8.8%, and the distal cerebral vessels of all patients were unobstructed after operation. During the treatment, there was 1 case of in-stent restenosis and 1 case of cerebral vasospasm. The modified Rankin scale (mRS) was less than 2 in all patients at discharge. All the 32 patients were followed up by digital subtract angiography (DSA) for 6 to 18 months (average 8.8 months). During the follow-up, 1 case had in-stent restenosis. Conclusions: Endovascular intervention is safe and effective in the treatment of IA complicated with ischemic cerebrovascular diseases, which is worthy of clinical reference. [ABSTRACT FROM AUTHOR]

Iatrogenic injury of the vertebral artery during cervical spine surgery though uncommon is critical. With advances in interventional endovascular techniques, the therapeutic approach for vertebral artery injuries has changed. Nonetheless, an established strategy for their management is lacking. We report a case of pseudoaneurysm due to vertebral artery injury, during cervical spine surgery for a tumor, that was treated successfully with endovascular coiling in a plug-and-patch fashion after triple stenting failed. [ABSTRACT FROM AUTHOR]

Purpose Practical challenges are encountered in percutaneous intravascular procedures when applied to markedly angulated branching vessels. Herein, we introduced a folded-loop guidewire remodeling technique-the guidewire-shaping technique-to overcome difficult catheterization. Materials and Methods First, the tip of a 0.014-inch micro-guidewire was manually shaped like a pigtail loop. Second, the shaped guidewire was introduced into the microcatheter and was preloaded into the hollow metal introducer for suitability with the microcatheter hub. Gentle rotation of the guidewire after release from the microcatheter can create the preshaped pigtail loop configuration. On pulling back, the loop loosened, the configuration was changed to a small U-shaped tip, and the guidewire tip was easily introduced into the target artery. Results Between December 2019 and January 2022, the described technique was used in 64 patients (male/female, 49/15; mean age, 66.8 ± 9.5 years) for selective arterial embolization, after failed attempts with the conventional selection technique. The technique was successful in 63/64 patients (98%). The indications of embolization include transcatheter arterial chemoembolization, gastrointestinal bleeding, hemoptysis, trauma-induced bleeding, and tumor bleeding. Conclusion The folded-loop guidewire remodeling technique facilitates the catheterization of markedly angulated branching arteries; when usual catheterization method fails. [ABSTRACT FROM AUTHOR]

Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To analyze the effectivity and safety of stent thrombectomy and direct aspiration thrombectomy in the treatment of ischemic stroke caused by acute middle cerebral artery (MCA) M2 segment occlusion. Methods A total of 44 patients with ischemic stroke caused by acute MCA M2 segment occlusion who received endovascular therapy in Wuhan No.1 Hospital from March 2016 to March 2021 were selected, including 22 patients with stent thrombectomy and 22 patients with direct aspiration thrombectomy. Time from onset to the end of surgery, postoperative immediate recanalization rate [modified Thrombolysis in Cerebral Infarction Score (mTICI) ≥ 2b], postoperative 90-day good prognosis rate [modified Rankin Scale(mRS)≤ 2], mortality, rate of symptomatic intracranial hemorrhage (sICH) and asymptomatic intracranial hemorrhage (asICH) were recorded. Results The postoperative recanalization rate in the total 44 patients was 77.27% (34/44), while 68.18% (15/22) in the stent group and 86.36% (19/22) in the aspiration group. Five patients in the aspiration group had poor result with aspiration and were remedied with stent thrombectomy. There was no statistic difference in the time from puncture to the end of the surgery (t = 0.978, P = 0.334), recanalization rate (χ² = 2.071, P = 0.150), postoperaitve 90-day good prognosis rate (χ² = 0.364, P = 0.546), mortality (χ² = 0.193, P = 0.660), incidence of sICH (χ² = 0.524, P = 0.469) and asICH (χ² = 0.275, P = 0.600). Conclusions This preliminary study showed that stent thrombectomy and direct aspiration thrombectomy in patients with ischemic stroke caused by acute MCA M2 segment occlusion are safe and effective, but further exploration of multicentre, large - sample randomised controlled trials is needed. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy and safety of emergent carotid artery stenting (CAS) after intracranial artery mechanical thrombectomy for acute internal carotid artery (ICA) stenosis related tandem lesions. Methods A total of 79 patients with acute ICA stenosis related tandem lesions admitted to the Advanced Stroke Center of Zhangzhou Hospital affiliated to Fujian Medical University from January 2015 to December 2019 were selected. All patients underwent urgent endovascular therapy with "half" anterograde approach with or without usage of embolic prevention device (EPD) technology, and divided into CAS group (n = 47) and non-CAS group (n = 32) according to whether CAS was performed in emergency. Compared and analysed the 2 groups of surgical related indexes [including the preoperative Alberta Stroke Program Early CT Score (ASPECTS), the occlusion site of tandem lesions, the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology Collateral Flow Grading System (ASITN/SIR ACG), puncture-to-reperfusion time, leakage on C-arm CT, incidence of distal embolism], and the clinical prognostic indicators [including the incidence of symptomatic intracranial hemorrhage (sICH), culprit artery reocclusion rate, postoperative 90-d favorable outcome rate and mortality]. Univariate and multivariate forward Logistic regression were used to analysis the influencing factors of postoperative 90-d poor prognosis in acute ICA stenosis related tanchem lesions. Results All 79 patients had immediate postoperative mTICI grading ≥ 2b, the vascular recanalization rate was 100%. There was no statistically significant differences in the preoperative ASPECTS (t = -0.170, P = 0.865), the occlusion site of tandem lesions (Z = 5.907, P = 0.091), the ASITN/SIR ACG (t = -0.900, P = 0.368), puncture-to-reperfusion time (t = 0.182, P = 0.856), leakage on C-arm CT (Z = -0.171, P = 0.864), incidence of distal embolism (χ² = 0.872, P = 0.350), the incidence of sICH (χ² = 1.670, P = 0.434), the culprit artery re-occlusion rate (χ² = 0.000, P = 1.000), postoperative 90-d favorable outcome rate (χ² = 2.149, P =0.143) and the mortality (χ² = 0.150, P = 0.699) between CAS group and non-CAS group. Logistic regression analysis showed that increasing age (OR = 1.078, 95%CI: 1.011-1.148; P = 0.021), leakage on C-arm CT (OR = 5.163, 95%CI: 1.633-16.326; P = 0.005) were risk factors for postoperaive 90-d poor outcomes of the patients with acute carotid atherosclerotic stenosis related tandem lesions. Conclusions For patients with acute ICA stenosis related tandem lesions used "half" anterograde approach with or without usage of EPD technology, the decision of emergent CAS after mechanical thrombectomy was made according to the stenosis degree of ICA and leakage on C-arm CT. This strategy is safe and feasible, and has the potential of clinical promotion. [ABSTRACT FROM AUTHOR]

Background DSA is an irreplaceable diagnostic method for cerebral vascular disease. It is sensitive to intracranial macrovascular disease, but not to distal blood perfusion. In order to quantitatively assess the perfusion area of the feeding artery, this study is the first to propose an imaging method of the internal carotid artery (ICA) perfusion area relying on deconvolution algorithm and cross - correlation (CC) algorithm. Methods Four patients with cerebral vascular disease and 2 healthy subjects who underwent DSA examination in Luwan Branch of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from June 2020 to May 2021 were enrolled. The arterial input function (AIF) of the ICA was extracted, and a deconvolution algorithm was used to calculate the time to peak (Tmax) for each pixel. Then the CC algorithm was used to obtain the CC map related to the perfusion of the ICA at each pixel point of the whole brain. Area of interest (ROI) of AIF were randomly selected for 2 healthy subjects, calculated the root mean square error (RMSE) of the CC map for reliability analysis. The CC map was drawn for 4 patients with cerebral vascular disease for validity analysis. Results Reliability analysis showed that the RMSE values of Towne's and lateral views of the CC map and Tmax map of the left and right ICA in a healthy subject were 0.008 ±0.011, 0.022 ± 0.002, 0.015 ±0.007, 0.004 ±0.008, and (0.108 ± 0.181) s, (0.181 ± 0.214) s, (0.301 ± 0.230) s, (0.035 ± 0.092) s; another healthy subject were 0.015 ± 0.023, 0.007 ±0.011, 0.007 ±0.011, 0.005 ±0.012, and (0.172±0.275) s, (0.092 ± 0.174) s, (0.087±0.156) s, (0.079± 0.153) s. The averaged RMSE value of Tmax map was lower than the temporal resolution of DSA, indicating that the reliability of the CC map of the AIF value box in different ROIs of the ICA was high. Validity analysis showed that the CC map and Tmax map of the patient with acute ischemic stroke treated by intravenous thrombolysis bridging to mechanical thrombectomy can fully display the perfusion changes of the ICA after successful thrombectomy. Postoperative DSA in the patient with subacute ischemic stroke after endovascular therapy showed recanalization of the occluded artery, while the CC map showed no significant change in the perfusion of the ICA. The DSA of the patient with middle cerebral artery (MCA) stenosis without related ischemic events showed severe MCA stenosis, but the CC map showed that the ICA was well perfused, and no endovascular treatment was required. The DSA of the patient with acute ischemic stroke without MCA stenosis showed no MCA stenosis, but only sparse ICA-related perfusion was seen on the CC map. Conclusions The CC map and Tmax map based on DSA images have good reliability in different ROIs of AIF. The CC map can provide quantitative information on the perfusion area of the feeding arteries, which is helpful for accurate diagnosis and appropriate treatment decisions. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy and safety of combined anticoagulants with endovascular treatment for subacute and chronic cerebral venous sinus thrombosis (CVST) under the assistance of high resolution magnetic resonance black-blood thrombus imaging (MRBTI). Methods and Results A retrospective study was performed on the patients with CVST who were treated at Department of Neurosurgery of Tianjin Huanhu Hospital from January 2019 to January 2021. Preoperative high resolution MRBTI confirmed 15 patients with subacute and chronic CVST, and endovascular treatment was performed on the basis of systemic anticoagulant therapy. The results showed that 10 cases were in subacute stage and 5 cases were in chronic stage. After treatment, the venous sinus was completely recanalized in 4 cases and partially recanalized in 11 cases. Complications occurred in 2 cases (intracranial hematoma enlarged in one case, microguide wire penetrated straight sinus wall during surgery in one case), contact thrombolytic therapy was continued after the condition stabilized. The mean indwelling time of microcatheter in straight sinus was (6.27 ± 0.21) d and the mean length of hospital stay was (11.53 ± 1.30) d. The degree of impairment of consciousness [Glasgow Coma Scale (GCS) score] was improved at discharge [at discharge (13.67 ± 2.02) score vs. at admission (11.67 ± 2.13) score; t = 9.165, P = 0.000], the degree of neurological impairment [modified Rankin Scale (mRS) score] was improved 6 months after surgery [at 6 months after surgery 1 (0, 2) score vs. at admission 3 (2, 4) score; Z = - 3.624, P = 0.000]. Conclusions High resolution MRBTI is an effective technique to identify subacute and chronic CVST patients. For these patients, the combination of systemic anticoagulation and endovascular treatment can reduce venous sinus thrombosis load and improve symptoms in a short time, which is a safe, effective and preferred treatment. [ABSTRACT FROM AUTHOR]

Cerebral venous sinus thrombosis (CVST) is a special type of stroke. At present, anticoagulant therapy is the main treatment, but the mortality rate is higher in severe patients with ineffective anticoagulant therapy, and endovascular treatment can improve the prognosis of these patients. However, there is a lack of large randomized controlled trials to verify the endovascular treatment of CVST currently, so the effectiveness and safety of endovascular treatment is questionable. This article is to analyze the current status and problems of endovascular treatment for CVST in recent years, in order to guide clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To study the prognostic value of neutrophil/lymphocyte ratio（NLR） combined with heart-type fatty acid-binding protein（H-FABP） for prognosis of patients undergoing Stanford Type B thoracic endovascular aneurysm repair（TEVAR）.Methods: The clinical data of 172 patients with Stanford type B aortic dissection who received TEVAR in our hospital from June 2017 to September 2020 were analyzed retrospectively. Baseline data, NLR and H-FABP levels at admission and related laboratory indicators were collected. Patients’ prognosis was followed up. According to the difference in prognosis, patients were divided into poor prognosis group and good prognosis group. The above data and indicators were compared between the two groups, and the influencing factors of prognosis were analyzed by multivariate Logistic regression. Receiver operating characteristic（ROC） curve was used to analyze the prognostic value of NLR combined with H-FABP. Results: Systolic blood pressure and diastolic blood pressure in the poor prognosis group were higher than those in the good prognosis group（P<0.05）. The NLR, H-FABP and white blood cell count（WBC） levels in the poor prognosis group were higher than those in the good prognosis group, while the platelet count（PLT） level was lower than that in the good prognosis group（P<0.05）. Multivariate Logistic regression analysis showed that systolic blood pressure, diastolic blood pressure,NLR, H-FABP and WBC levels were all influencing factors for poor prognosis after TEVAR in Stanford type B aortic dissection patients（P <0.05）. ROC curve analysis showed that the area under curve of NLR combined with H-FABP in predicting the postoperative prognosis of TEVAR in Stanford type B aortic dissection patients were 0.876 which higher than those predicted by the above two indexes alone 0.626 and 0.712, respectively. Conclusion: NLR combined with H-FABP has a high prognostic value for TEVAR in Stanford type B aortic dissection patients. [ABSTRACT FROM AUTHOR]

Objective To summarize the clinical features of cerebral hyperperfusion syndrome (CHS) after cerebrovascular reconstruction for moyamoya disease (MMD), and to screen its related predictive factors. Methods The clinical data of 50 patients with MMD who underwent cerebrovascular reconstruction in the Second Affiliated Hospital of Nanchang University from June 2017 to December 2018 were collected, including sex, age, history of hypertension, disease type, preoperative Suzuki stage, surgery side, mean arterial pressure (MAP) before and after surgery, time from surgery to onset of CHS, clinical manifestations, duration of symptoms, and postoperative hospital stay. Univariate and multivariate Logistic regression analysis were used to screen the related predictors of CHS after cerebrovascular reconstruction for MM D. Spearman rank correlation analysis to explore the correlation between time from surgery to symptom onset and duration of symptoms. Results Among the 50 patients, 13 patients (26%) developed CHS after surgery. Logistic regression analysis showed that over age (OR = 0.867, 95%CI: 0.790-0.953; P = 0.003) and left-side surgery (OR = 0.158, 95%CI: 0.029-0.863; P = 0.033) was predictor of postoperative CHS in patients with MMD. Spearman rank correlation analysis showed that the time from surgery to symptom onset was negatively correlated with duration of symptom in patients with CHS (rs = -0.925, P = 0.000). Conclusions CHS is a self-limiting complication after cerebrovascular reconstruction for MMD. Higher age and left-sided surgery are clinical predictive factors of postoperative CHS. [ABSTRACT FROM AUTHOR]

Copyright of Imaging Science & Photochemistry is the property of Imaging Science & Photochemistry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the indications, therapeutic effects and safety of thoracic endovascular aortic repair for treatment of thoracic penetrating aortic ulcer. Methods We retrospectively analyzed clinical data of the patients diagnosed with penetrating thoracic aortic ulcer, who underwent thoracic endovascular aortic repair in our department between October, 2018 and May, 2019. The patients' age, lesion location and type, comorbidities, surgical methods, operation time, intraoperative blood loss, length of hospital stay, perioperative complications and follow-up data were analyzed. Results We analyzed the clinical data for 7 patients with a mean age of 70.29±7.54 years, including 3 patients with penetrating ulcers in the aortic arch and 4 with ulcers in the descending thoracic aorta. The mean depth of the penetrating aortic ulcers was 6.00±2.02 mm with a mean width of 12.07±5.26 mm and a mean length of 14.71±9.05 mm. The opration were completed smoothly in all the patients with a mean operation time of 90.00±32.53 min. A chimney stent was placed in the left subclavian artery in 3 cases. The patients were followed up for 1 to 7 months, during which the penetrating thoracic aortic ulcers were found to be effectively repaired in all the cases; endoleaks of any types or other complications occurred in none of the cases during the follow-up. Conclusion Thoracic endovascular aortic repair is safe and effective for treatment of penetrating thoracic aortic ulcer, and can be safely performed in elderly patients and patients with comorbidities.

Objective Summarize the clinical characteristics and treatment plan of 2 cases of abnormal anastomosis at the origin of the posterior inferior cerebellar artery (PICA) complicated with aneurysm. Methods and Results Two cases of abnormal anastomosis of the PICA complicated with aneurysms all showed spontaneous subarachnoid hemorrhage (SAH). MRI showed abnormal anastomosis of the PICA, accompanied by multiple small aneurysms at the anastomotic vessel or anastomotic site. All patients underwent occipital artery (OA) -PICA bypass graft and electrocoagulation of the aneurysms at the same time. Use "PICA anastomosis" as the key words to search PubMed (January 1, 2000 to June 30, 2021) 8 articles in English, 8 patients, combined with 2 cases in this article cases, a total of 10 patients with abnormal anastomosis at the origin of the PICA complicated with aneurysm. All cases occurred as spontaneous SAH; 8 cases of aneurysms occurred at the anastomosis site, one case occurred at the distal end of the PICA, and one case occurred in a branch of the original artery. Five cases underwent craniotomy, 3 cases of OA-PICA bypass surgery and concurrent electrocoagulation (2 cases) or clipping (one case) of the aneurysms, one case of simple aneurysm clipping, and one case of aneurysm clipping combined with cutting off anastomotic artery, and there were no clear complications after surgery; 4 cases underwent endovascular interventional treatment, 2 cases of coil embolization of aneurysms, 2 cases of Glubran glue embolization of aneurysms, of which 3 cases had postoperative complications, manifested as mild brainstem infarction (2 cases) or disturbance of consciousness (one case). Conclusions Abnormal anastomosis at the origin of the PICA complicated with aneurysm is rare, and the risk of rupture and hemorrhage is high. OA-PICA bypass and electrocoagulation or clipping of the aneurysm can be used as a treatment option. [ABSTRACT FROM AUTHOR]

Objective To assess the efficacy of occipital artery (OA)-posterior inferior cerebellar artery (PICA) bypass for the treatment of vertebral aneurysms involving PICA. Methods and Results A total of 6 patients with vertebral aneurysms involving PICA treated by OA-PICA bypass in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2016 to December 2020 were retrospectively reviewed. Complications were recorded and outcomes were assessed by modified Rankin Scale (mRS). OA-PICA bypass was successfully performed in 6 patients and bypass patency was confirmed by intraoperative indocyanine green angiography (ICGA). OA-PICA bypass and surgical trapping were performed in the same session in one patient (Case 4). Elective endovascular trapping was applied after bypass in 3 cases (Case 1, Case 3, Case 5). Elective stent implantation was conducted in one patient (Case 2) after the bypass surgery. One patient (Case 6) died of aneurysm rehemorrhage 10 h after OA-PICA bypass. No complications were observed during the hospitalization in the remaining 5 patients. Bypass patency was achieved in a mean follow-up time of 37 months and outcome was favorable (mRS was 1, for all) one year after the final surgery. Conclusions OA-PICA bypass is an effective method for the treatment of PICA-involved vertebral aneurysms. [ABSTRACT FROM AUTHOR]

Objective: To explore the application value of cross lesion pressure gradient testing in the endovascular therapy for lower extremity arterial occlusive disease. Methods: A total of 73 patients with lower extremity arterial occlusive disease who were hospitalized and underwent endovascular therapy in chang sha first hospital from January 2018 to June 2019 were selected. The lumen lesions were confirmed by angiography, and the stenosis degree was recorded by true diameter measurement of lumen. After the guidewire was passed through the lesion, the lumen pressure before and after the lesion was measured and the pressure gradient before intervention was recorded. Balloon dilation and/or stent implantation intervention were determined based on the patient's clinical presentation, preoperative imaging examination of the lesion, and pressure gradient. Again after completing all intervention for nearly - distal pressure lesions, and pressure gradient value after intervention were recorded. The correlation between TLPG and Fontaine stage, ankle brachial index (ABI ) and pain score were analyzed. The correlation between TLPG and the degree of lumen stenosis were analyzed. The correlation between the pressure gradient value difference, ABI index difference and pain score difference before and after intervention were analyzed. Results: Spearman correlation analysis showed that TLPG was positively correlated with Fontaine stage, ABI index and pain score before intervention(P<0.05). There was no significant correlation between TLPG and degree of lumen stenosis(P>0.05). There was a positive correlation between the pressure gradient value differenc and ABI index difference before and after intervention (P<0.05). There was no significant correlation with the pain score difference (P>0.05). Conclusion: TLPG measurement in the process of endovascular treatment may be an objective and accurate index to guide the evaluation of arteriosclerosis of lower extremity, may be helpful to grasp the indication of intervention of critical lesions, may be helpful to objectively evaluate the immediate effect of intervention, so as to provide some guidance and help for the standardized endovascular therapy for lower extremity arterial occlusive disease. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of zero defect nursing in interventional catheter room on adverse events and operation time in patients with abdominal aortic aneurysm (AAA). Methods 94 AAA patients who were treated in the interventional catheter room of Affiliated Hospital of Xuzhou Medical University from June 2019 to June 2020 were randomly divided into a control group and an observation group. The control group received routine nursing and the observation group adopted zero defect nursing on the basis of routine nursing. The relative conditions of operation, the incidence of adverse events and the quality of nursing were compared. Results The operation time, blood loss and hospitalization time in the observation group with significantly lower than those in the control group (all P <0. 05). The incidence of adverse events in the observation group was significantly lower than that of the control group (P <0. 05). The subitem scores and total scores of nursing quality in the observation group were significantly higher than those in the control group (all P <0. 05). Conclusion The zero defect nursing for AAA patients undergoing endovascular surgery can significantly improve the quality of nursing and effectively promote postoperative rehabilitation. [ABSTRACT FROM AUTHOR]

Objective To investigate the availability and safety of distal mechanical embolization combined with simultaneous carotid stenting for acute ischemic stroke due to anterior circulation tandem occlusion of large intracranial vessels and carotid artery. Methods Ten patients with anterior circulation intracranial artery occlusion combined with severe stenosis or occlusion at the beginning of ipsilateral internal carotid artery were selected in Department of Neurosurgery, the First Affiliated Hospital of Harbin Medical University from January to December 2019. All patients were treated with balloon dilation for the lesion at the beginning of the artery. The distal end of the catheter was removed through the guide catheter, and then the carotid stent implantation was performed. Immediately after surgery, modified Thrombolytic in Cerebral Infarction (mTICI) was used to evaluate vascular recanalization. The National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological deficit 24 h after surgery, and the modified Rankin Scale (mRS) was used to evaluate the prognosis of 90 d after surgery, and recorded symptomatic intracranial hemorrhage, non-symptomatic intracranial hemorrhage, and surgical complications. Results All patients completed the surgery. The immediate postoperative intracranial vessel mTICI was 2b grade in 5 cases, 3 grade in 3 cases, 2a grade in one case, and 0 grade in one case. The revascularization rate was 8/10. Of the 8 patients with successful revascularization, one patient (12.50%) occurred reocclusion the extracranial segment of the internal carotid artery at 7 d after surgery, but the clinical symptoms were not worsen. Six patients had a NIHSS score ≥ 4 points which were lower than baseline 24 h after surgery, and their symptoms improved significantly; 90 d postoperative mRS score was 0 in 2 cases, 1 in one case, 2 in one case, 3 in 4 cases, 4 in one case, and 6 in one case (died). The rate of good was 4/10. Four cases presented non - symptomatic intracranial hemorrhage. No symptomatic intracranial hemorrhage and other complications occurred. Conclusions Distal embolization combined with simultaneous carotid stenting is a feasible strategy for acute ischemic stroke due to anterior circulation tandem occlusion. [ABSTRACT FROM AUTHOR]

Objective: To investigate the application value of Interlock detachable coils for the endovascular treatment of splenic aneurysms. Methods: The clinical data of 36 patients with splenic aneurysms treated with Interlock detachable coils from February 2016 to February 2019 were retrospectively analyzed, including 10 cases of male, 26 cases of female, 31 cases of true aneurysms. 5 cases of pseudo splenic aneurysm were diagnosed by ultrasound or CTA preoperation. An angiogram was performed immediately after embolization to determine the technical success rate. The blood routine, pancreatic amylase and aortic CTA were monitored during the perioperative period and at 2 weeks, 3 months and 6 months after surgery to observe the incidence of complications. Results: 6 patients underwent embolization of the aneurysm at the proximal end and the tumor cavity, and the rest only embolized the spleen aneurysm tumor cavity. Intraoperative DSA angiography showed that the occlusion rate of the splenic aneurysm was higher than 97%. A total of 128 Interlock coils were used during the operation, of which 104 were diamond-shaped and 24 were ordinary 2D. The average diameter of the coils is 6.3± 4.2(2-12)mm, the average length is 16± 13.5(3-32)mm, and the average size of the tumoris 40.6± 12.5(15-70)mm. No complications occurred during the perioperative period. The average follow-up was 10.0± 3.2(6-15) months. After 1 month, 2 cases had spleen infarction, 7 cases had mild abdominal pain and low fever. In all cases, no tumor cavity recanalization and tumor enlargement were observed. Conclusion: Interlock can release the coils safely and effectively for the treatment of splenic aneurysms. It has a wide application prospect and its long-term efficacy needs long-term follow-up observation. [ABSTRACT FROM AUTHOR]

Objective To summarize the experiences and perioperative complications of endovascular recanalization in chronic carotid artery occlusion (CCAO). Methods A total of 12 patients with CCAO were included from August 2018 to July 2019, who were all treated with endovascular recanalization. The occlusive site, occlusive segment, occlusive proximal stump morphology and the nature of the lesion were evaluated by multimode imaging, and perioperative complications were recorded. Results Ten patients were successfully operated, the success rate of vascular recanalization was 83.33%. Two patients had failed in surgery, including one patient with long segment artery dissection above the petrous bone segment and one patient with blunt stump. Perioperative complications occurred in 6 patients, including 3 cases of intraoperative embolus shedding, one case of intraoperative vasospasm, one case of postoperative cerebral hyperperfusion syndrome (CHS), and one case of postoperative severe hypotension. Conclusions The long segment lesion above the petrous bone segment, the shape of the stump and the nature of lesion may affect the success rate of vascular recanalization. Embolus detachment, vasospasm, CHS and hypotension are the main perioperative complications. [ABSTRACT FROM AUTHOR]

Objective To explore the feasibility, effectiveness and safety of recanalization of symptomatic non - acute intracranial artery occlusion (SNIAO). Methods A total of 61 patients with SNIAO from December 2008 to August 2019 were enrolled. All patients underwent recanalization. The cerebral infarction thrombolytic blood flow classification (TICI) was used to evaluate the recanalization rate and record perioperative complications. For complications during surgery, the prognosis was evaluated by modified Rankin Scale (mRS). The arterial restenosis was observed by DSA. Results Fifty-three of 61 patients (86.89% ) had successful recanalization, 8 (13.11% ) had failed recanalization. Among the 8 patients, 4 cases failed to pass through the occluded segment with the microwire gave up the operation, one case died of branch artery bleeding caused by puncture of micro-wire and was ruptured, and 3 cases died of intracranial hemorrhage (ICH) caused by postoperative cerebral hyperperfusion syndrome. Fifty - three patients with successful recanalization had improved postoperative clinical symptoms and completed 6-24 months of follow-up. Forty-four patients had a good prognosis, 6 had a moderate prognosis, and 3 had a poor prognosis. Arterial restenosis occurred in 4 patients with no clinical symptoms. Conclusions Vascular recanalization treatment for SNIAO is technically feasible, and the efficacy is positive. The long-term prognosis is good, but the requirements for neurointerventional technology are high. The surgeon must have some technical reserve and clinical experience. During the peroperative period the doctor must have the ability to manage and street the complications cooperate between the treatment team and the nursing team. [ABSTRACT FROM AUTHOR]

Objective To explore whether occlusion site affects success rate, methods of recanalization, perioperative complications, and prognosis of the recanalization in chronic internal carotid artery occlusion (CICAO). Methods Thirty - nine patients diagnosed as CICAO from January 2017 to January 2020, and treated by endovascular recanalization were retrospectively reviewed. Baseline information, endovascular procedures, complications, clinical and angiographic prognosis were collected. Effects of occlusion site were analyzed. Results Thirty patients (76.92% ) achieved successful endovascular recanalization. Successful recanalization rates varied among groups with different occlusion sites of extracranial short segment (CI, CI-C2 or CI-C3), medium segment (CI-C4), long segment (CI-C5 or CI-C6) and intracranial short segment (C6 or C6-C7), were 9/11, 8/10, 9/14 and 4/4, respectively. Sole angioplasty with balloon was applied in 7 patients (23.33%), sole stenting in 15 (50%), angioplasty with balloon and stents in 8 (26.67%). Among different occlusion sites of extracranial short, medium, long segment, and intracranial short segment, sole angioplasty with balloon was applied in 0/9, 1/8, 3/9 and 3/4, respectively; while sole stenting was applied in 9/9, 4/8, 1/9 and 1/4, showing a gradually increasing trend. Procedure-related complications were not related with occlusion site. One patient (33.33%) died, while 29 surviving patients during a median clinical follow-up of 16 (4, 27) months with successful recanalization, but one (3.45%) developed ipsilateral minor stroke due to restenosis. With a median angiographic follow-up of 5.50 (3.50, 8.00) months, 2 restenosis and 3 reoclusion were found in 21 patients, all of which came from medium and long segment occlusion. Conclusions Endovascular recanalization is feasible and effective in CICAO with relatively low procedure - related complications. However, success rate of recanalization decreases in groups of long segment occlusion. Application of angioplasty methods differs in groups with varying occlusion sites. Procedure - related complications seems relatively low. While, restenosis and re-occlusion are mostly found in long segment occlusion site. [ABSTRACT FROM AUTHOR]

Objective To explore the application value of high - resolution magnetic resonance imaging vascular wall imaging (HR-VWl) in the interventional opening treatment of chronic internal carotid artery occlusion (CICAO). Methods A total of 11 patients with symptomatic CICAO were treated by recanalization from March 2018 to September 2019. The start - stop parts position of occlusions, and occlusion segments with or without residual lumen, intracavitary thrombosis and arterial dissection was shown according to preoperative HR - VWI. Type I occlusion (ophthalmic segment occlusion), type II occlusion [occlusion of the internal carotid artery (ICA) bulb to the clinoid process and its proximal intracranial segment] and type III occlusion (occlusion of the ICA bulb to the ophthalmic segment and beyond), and type A occlusion (with residual lumen but without thrombosis or arterial dissection), type B occlusion (residual lumen, thrombus and arterial dissection in residual lumen), type C occlusion (no residual lumen and no thrombus and arterial dissection) and type D occlusion (no residual lumen but with intracavitary thrombosis and arterial dissection) were recorded. Compared with preoperative and intraoperative DSA, vascular recanalization rate, perioperative complications and prognosis were recorded. Results Before the operative HR-VWI classification: type I occlusion in 2 cases, type II occlusion in 7 cases and type III occlusion in 2 cases, and type A occlusion in 4 cases, type B occlusion in 2 cases, type C occlusion in 1 cases and type D occlusion in 2 cases. Compared with intraoperative DSA, the positive detection rate of HR -VWI for residual lumen, intracavitary thrombosis and arterial dissection was 10/11 cases. One case (1/11) preoperative HR-VWI classification is type III occlusion patients, confirmed by intraoperative DSA real type classification is II occlusion. A total of 10 patients (10/11) for recanalization, one failure cases for HR-VWI classification type III - C. Perioperative complications occurred in 2 patients (2/11). Six and 7 patients improved in the first and third month after surgery, and 5 and 4 patients were stable, one patient developed in-stent restenosis the sixth months after the operation. Conclusions Preoperative HR-VWI showed that residual lumen in occlusion segment indicated higher success rate of recanalization and higher surgical safety, thrombosis in the residual lumen increased the risk of perioperative complications, but did not reduce the success rate and prognosis of recanalization. [ABSTRACT FROM AUTHOR]

Objective To assess the feasibility, safety, and short-term outcomes of angioplasty and stenting for patients with symptomatic non-acute middle cerebral artery occlusion (SNMCAO). Methods Eight SNMCAO patients who failed in medical treatment and under - went surgical recanalization, were collected from January to December 2019. The success rate, perioperative complications, prognosis and stent restenosis were summarized. Results In 8 cases, 7 cases succeeded adn 1 case failed. Four cases occurred perioperative complications, including symptomatic intracranial hemorrhage (2 cases), fransient cerebral ischemic attact (1 case) and stent thrombosis (1 case). Seven to thirty days after operation the modifical Rankin Scale (mRS) 0-2 score were seen in 6 cases, 3 in one case and 4 in one. Four months after operation one case occurred restenosis in the stent. Conclusions For patients with SNMCAO, if medical treatment is not effective, endovascular recanalization can be considered, but the recanalization technique is complicated and the incidence of complications is still high. Therefore, the safety and necessity of endovascular recanalization need to be strictly evaluated. [ABSTRACT FROM AUTHOR]

Objective To explore the efficacy and safety of endovascular treatment (EVT) for acute ischemic stroke with large vessel occlusion (AIS-LVO) caused by carotid artery dissection (CAD). Methods From July 2018 to July 2019, 19 patients with AIS-LVO caused by CAD, including 11 cases of internal carotid artery (ICA) dissection and 8 cases of vertebral artery (VA) dissection, were treated with EVT (including thrombus aspiration, stent thrombectomy, balloon dilatation and stent implantation). Modified Thrombdy in Cerebral Infarction (mTICI) was to evaluate vascular recanalization, modified Rankin Scale (mRS) was to evaluate the prognosis. Results The forward blood flow of 15 patients recovered to mTICI grade 3 (complete recanalization), and 4 patients recovered to mTICI grade 2b (partial recanalization). Patients with postoperative complications were: one case of death caused by cerebral hernia, one case of cerebral edema due to a large cerebral infarction, one case had a small amount of cerebral hemorrhage, one case of subarachnoid hemorrhage. Seventeen patients had good prognosis at discharge (mRS score ≤ 2), one case had a poor prognosis (mRS score 4), and one case died. Conclusions Patients with AIS-LVO caused by CAD were assessed and treated with EVT, and the effect of recanalization of occlusive vessels is obvious, and the clinical prognosis is good. [ABSTRACT FROM AUTHOR]

Objective To evaluate the efficacy and safety of endovascular treatment (EVT) for acute tandem occlusion of proximal internal carotid artery (ICA) and intracranial large artery. Methods Five patients presented with acute tandem occlusion of proximal and intracranial ICA and middle cerebral artery (MCA) presented from August to November 2018 were included. Every patient was treated with proximal ICA stenting first and then intracranial artery sent thrombectomy. The result of revascularization was recorded with Thrombolysis in Cerebral Infarction (TICI) at the end of procedure. The outcome at 3 d, 90 d and one year postprocedure was evaluated with modified Rankin Scale (mRS). Results Proximal ICA stenting was successful and intracranial artery sent thrombectomy was performed in all patients. TICI grade 2b-3 was achieved in 4 patients and TICI grade 2a in one patient immidiately after surgery vascular recanalization rate was 4/5. There was no intracranial hemorrhage and more infarction. All patients had improved significantly. At 90 d after discharge, 2 patients had a mRS score 0, 2 patients had a mRS score 2, one patient had a mRS score 3. After one year, all patients remained a favorable clinical outcome (mRS score 0-1). Conclusions For patients presented with acute tandem occlusion of proximal ICA and intracranial large artery, antegrade recanalization with proximal ICA stenting and intracranial sent thrombectomy are safe and efficacious. [ABSTRACT FROM AUTHOR]

Objective To evaluate whether patients with acute basilar artery occlusion (BAO) tandem lesion could affect the clinical outcome after receiving endovascular treatment (EVT) in a high-volume stroke center. Methods A total of 187 consecutive patients with acute BAO receiving EVT from January 2012 to July 2018 were recruited in this study. The patients were categorized into 2 groups with (25 cases) or without (162 cases) tandem lesion. Preoperative Posterior Circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) and Pons-Midbrairn Index (PMI) were used to evaluate the cerebral infarction range, and Post-Traffic Score and American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) grading were used to evaluate the posterior circulation collateral compensation after actue BAO. The main prognostic indicators were immediate postoperative vascular recanalization rate, functional independence and prognosis 90 d after treatment, and the main safety endpoints were intracranial hemorrhage (ICH) and symptomatic intracranial hemorrhage (sICH) incidence 7 d after surgery and mortality 90 d after treatment. Results In tandem group, the lesions were mainly located at the beginning of the basilar artery (including the intracranial segment of the vertebral artery) and at the distal end (P = 0.000), and the proportion of intracranial arterial stenosis was lower (P = 0.000). Among the 25 patients with tandem lesion, 21 took the Dirty-road route and 4 took the Clean-road route. The proportion of stent thrombectomy (P = 0.030) and intraoperative intravenous injection of tirofibana (P = 0.028) was lower, the proportion of stent implantation was higher (P = 0.005), the proportion of vascular recanalization after treatment was lower (P = 0.001), and the mortality rate was higher 90 d after treatment (P = 0.002). Univariate and multivariate Logistic regression analysis showed that acute BAO tandem lesion had a lower immediate vascular recanalization rate (OR = 0.050, 95%CI: 0.010-0.530; P = 0.012) and a higher mortality 90 d after treatment (OR = 17.320, 95%CI: 2.700-111.040; P = 0.003). Conclusions Tandem lesion seems to be associated with low rate of recanalization and high rate of mortality in patients with acute BAO. [ABSTRACT FROM AUTHOR]

Objective To screen the risk factors related to unfavorable prognosis and evaluate the predictive effect of four imaging scoring systems on the unfavorable prognosis in the patients with acute basilar artery occlusion (BAO) after endovascular thrombectomy. Methods From March 2012 to August 2018, a total of 57 patients with acute BAO were treated with endovascular thrombectomy, preoperative DWI Posterior Circulation Alberta Stroke Program Early CT Score (pc-ASPECTS), DWI Brain Stem Score (BSS), Posterior Circulation CTA (pc-CTA) and Basilar Artery CTA (BATMAN) were used. Thrombolysis in Cerebral Infarction (TICI) was used to evaluate the incidence of vascular recanalization. The incidence of symptomatic intracranial hemorrhage (sICH) was recorded within 36 h. The prognosis was evaluated by modified Rankin Scale (mRS) at 3 months. Univariate and multivariate backward Logistic regression analysis were used to screen the risk factors related to the unfavoriable prognosis in the patients with acute BAO after endovascular thrombectomy. Receiver operating characteristic curve (ROC) was used to calculate the area under the curve (AUC), and evaluate the predictive value of DWI pc-ASPECTS, DWI BSS, pc-CTA and BATMAN scores for prognosis. Results In 57 patients, 53 patients (92.98%) had successful recanalization, 2 (3.51%) had partial recanalization, 2 (3.51%) had no recanalization, 3 (5.26%) had sICH, 22 (38.60%) had good prognosis, 35 (61.40%) had poor prognosis, and 14 (24.56%) died. After univariate and multivariate backward Logistic regression analysis, higher NIHSS score on admission (OR = 0.879, 95%CI: 0.783-0.986; P = 0.028), higher DWI BSS score (OR = 0.348, 95%CI: 0.177-0.683; P = 0.002) and lower BATMAN score (OR = 1.549, 95% CI: 1.019-2.353; P = 0.040) were risk factors for unfavorable prognosis of patients with acute BAO after endovascular thrombectomy. ROC analysis of the four radiographic scoring systems showed that the AUC of DWI pc-ASPECTS, DWI BSS, pc-CTA and BATMAN score were 0.787 (95%CI: 0.658-0.884, P = 0.000), 0.861 (95%CI: 0.744-0.938, P = 0.000), 0.634 (95% CI: 0.496-0.757, P = 0.091) and 0.698 (95% CI: 0.562-0.813, P = 0.012), respectively. Conclusions Higher NIHSS score on admission, higher DWI BSS score and lower BATMAN score are risk factors for unfavorable prognosis of acute BAO treated with endovascular thrombectomy. [ABSTRACT FROM AUTHOR]

Five randomized control clinical trials of N Engl J Med showed the efficacy of endovascular treatment (EVT) of acute ischemic stroke with large vessel occlusion (AIS-LVO) of anterior circulation. The "spring" of mechanical thrombectomy is coming. The international guideline changed and the treatment of AIS-LVO have been entering a new era. Mechanical thrombectomy became the one of milestones in the treatment of ischemic cerebrovascular events. The year of 2020 is the five years' anniversary since the "spring" of thrombectomy. What have we learned and where are we heading? To mark this anniversary year, this review takes you through the evolution of EVT from its tough beginnings to a way through the dark. [ABSTRACT FROM AUTHOR]

Objective: To increase the awareness of perimedullary arteriovenous fistulas (PMAVF) by investigating the clinical and imaging characteristics as well as treatment options of the disease. Methods: The diagnosis and treatment of a patient with PMAVF were reported. A summary of the clinical and imaging characteristics as well as treatment modalities of the disease was made based on literatures. Methods: One patient presented with progressive lower limb numbness accompanied by weakness, and gradually developed incontinence. MRI of thoracic and lumbar segments showed obvious tortuosity and dilatation of perimedullary artery near the ninth thoracic vertebrae level. The examination of spinal angiography (DSA) showed that the anterior spinal artery from the right thoracic 9 intercostal artery at the level of the thoracic 12 vertebra supplied an abnormal drainage venous mass at the right side of the spine. The patient underwent curative embolization of draining veins and fistula with OnyxR. glue embolization. Muscle strengths of the lower limbs recovered to scale 4 one year post-operation. Conclusion: Most of the early clinical manifestations of PMAVF are not specific and then progressive myelopathy gradually appears. Spinal MRI plays an important role in the diagnosis of PMAVF. CT angiography and contrast-enhanced MR angiography (ceMRA) of the spinal cord are helpful to determine the location of fistula before operation. Digital subtraction angiography (DSA) is still the gold standard for the diagnosis of the disease. Surgical resection and endovascular therapy are two main modalities to treat this disease. [ABSTRACT FROM AUTHOR]

Objective To investigate the influence of endovascular embolization and surgical clipping on long - term prognosis, quality of life and postoperative complications of patients with anterior circulation intracranial aneurysms. Methods A total of 128 patients with anterior circulation intracranial aneurysms were chosen from January 2016 to October 2017 and randomly divided into 2 groups including group A (N = 64) treated with endovascular embolization and group B (N = 64) treated with surgical clipping. The hospitalization time, total treatment cost, laboratory indexes before and after operation including S-100B protein (S - 100B), matrix metalloproteinase - 9 (MMP - 9) and interleukin - 6 (IL - 6), postoperative neurological function [Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS)], life quality [Medical Outcomes Study 36 - item Short - Form Health Survey (SF - 36) and Activities of Daily Living (ADL)J and postoperative complications incidence of both groups were compared and analyzed. Results Compared with group B, group A had shorter hospitalization time (t = 4.712, P = 0.000), significantly lower levels of S - 100B (F = 4.276, P = 0.000), MMP-9 (F =3.576, P = 0.000) and iL-6 (F =3.897, P = 0.000), better SF-36 (t = 4.673, P = 0.000) and ADL (t = 3.816, P = 0.000) scores, better GOS (χ² = 4.726, P = 0.019) and mRS (t = 3.816, P = 0.000) scores 6 months after operation. However, the total treatment cost of group A was significantly higher than group B (t = 5.046, P = 0.000). The evaluation of postoperative complications incidence 30 d after operation showed group A had significantly lower infection incidence (x2 = 9.195, P = 0.002) than group B, while there was no significant difference in the incidence of aneurysm rupture, cerebral ischemia, and vasospasm incidence between 2 groups (P > 0.05, for all). Conclusions Endovascular embolization in the treatment of anterior circulation intracranial aneurysms can efficiently shorten hospitalization time, improve long-term prognosis, reduce the levels of S- 100B, MMP-9 and IL-6, improve patients' quality of life and be helpful to prevent the infection risk. Surgical clipping has the advantage of reducing the economic burden of patients. [ABSTRACT FROM AUTHOR]

The treatment of aortic disease previously used conventional open surgery to replace the aorta with artificial vascular prosthesis after resecting the lesioned segment. The recently developed technique of endovascular aneurysm repair (EVAR) uses a stent graft to reinforce the diseased aortic wall while allowing blood low continuity and preventing further aortic expansion, dissection and aortic rupture. Taiwan's National Health Insurance now covers payment for authorized EVAR procedures, making treatments safer for patients who are elderly, have congestive heart failure, have multiple comorbidities, or have other high-risk factors. EVAR is gradually replacing previous methods to become the primary treatment approach for aortic disease. This article discusses the development of EVAR, indications, operative procedures, complications, postoperative risk factors, and clinical nursing problems. We hope that this article provides new information on nursing care for patients undergoing endovascular aneurysm repair surgery. [ABSTRACT FROM AUTHOR]

Objective To investigate methods and results of endovascular treatment in TASC (II) D-type femoral artery occlusion. Methods From January 2012 to May 2013, 26 cases (26 branches) of superficial femoral artery occlusion with endovascular treatment of TASC (II) D-type superficial femoral artery occlusion were retrospectively reviewed. The efficacy was evaluated through ABI, CTA, DSA and symptoms improved. Results 26 branches were treated with endovascular methods. Technical success rate was 80.7% (21/26), including 13 branche with stent implantation, 6 branches with Silverhawk atherectomy and 2 branches with Viabahn stent implantation.All patients were followed up for a mean period of (10.3±1.2) months, primary patency rates at 6 months were 69.2% in stent group, 66.7% in Silverhawk atherectomy group and 100% in Viabahn stent group. Conclusion Endovascular treatment of TASC (II) D-type femoral artery occlusion can lead to satisfactory short term patency rates, and Viabahn stent is the latest treatment. [ABSTRACT FROM AUTHOR]

The history of vascular surgery in new China could be divided into the following three stages: the first stage, since the early 1980s, the technique of endovascular surgery was introduced in China, developed in some major hospitals, and gradually popularized to some basic hospitals conditionally. Vascular surgery had gradually developed into an independent discipline in China by the late 1980s. The second stage, since the late 1980s, vascular diagnosis and treatment technology, vascular equipment, and related research modification had been improving continuously in China, and achieved certain success, especially since the establishment of the department of vascular surgery affiliated to the Chinese Medical Association in 1993, vascular surgery in China representing its period of primary development. The third stage, since the beginning of the 21st century, the innovation of the technique of endovascular surgery and hybridization technology, and the development of materials technology had contributed to the second leaping forward of vascular surgery in China. Since then, vascular surgery enters a new era of minimally invasive surgery and opens a period of rapid development.