ABSTRACT
Objective To evaluate the efficacy difference of different embolization agents in transcatheter embolization for treating massive hemoptysis caused by systemic pulmonary circulation shunt(SPS). Methods The clinical and imaging data in 98 patients with hemoptysis complicating SPS,including bronchodilator in 72 cases,pulmonary tuberculosis in 18 cases and lung carcinoma in 8 cases. All cases were treated with bronchial arterial embolization (BAE). According to different used embolization agents, the cases were divided into the gelfoam group and polyvinyl alcohol(PVA)grains embolization group. All cases were followed up at postoperative 1 d,1,3,6 months as well as 1,2 years. The data were analyzed by using Ridit test. Results Ninety-eight cases of massive hemoptysis were confirmed by DSA,among them,84 cases were complicating pulmonary artery fistula, 18 cases were pulmonary venous fistula and 2 cases were mixed fistula; 32 cases were simple BPS, 62 cases were pulmonary circulation fistula existed in the bronchial arteries and non-bronchial artery and 4 cases were simple non-BPS. The two groups had no complications such as embolism,paraplegia,esophagus-trachea fistula and skin ischemic necrosis. The follow up on postoperative 1 d, at postoperative 1, 3,6 months and at postoperative 1,2 years indicated that among 48 cases in the gelfoam group, 20 cases were cured, 18 cases were significantly effective,6 cases were effective and 4 cases were ineffective,the effective rate was 91.7 % ;among 50 cases in the PVA grain embolization group, 38 cases were cured, 8 cases were significantly effective,4 cases were effective and O case was ineffective, the effective rate was 100%. Moreove no severe complications such as ectopic embolism, paraplegia, esophagus-trachea fistula and skin ischemic necrosis occurred. The difference between the two groups had statistical significance by Ridit analysis. Conclusion Transcatheter embolization for treating massive hemoptysis caused by SPS is safe and reliable,has small trauma, using PVA grains embolization can reduce the long term recurrence rate of hemoptysis.
ABSTRACT
Objective To evaluate the value of PLD associated with O 3 injection for the treatment of lumbar disc heniation.Methods Lateral decubitus position on healthy side under the direction of DSA, a working pipe was inserted from the back lateral way to damage the disc contents through multiple angles followed by extirpation of the nucleus pulposus and then injecting O 2-O 3 10 ml into the lumbar disc space and near by area of the inter vertebral foramina. As for patients with L4-5 and L5-S1 protrusions the main lumbar discs can be treated in the same way, but for another minor one, the injection of O 2-O 3 10 ml into the lumbar disc and the nearby intervertebral foramina and ethanol through a 21G needle would be properly promising. Results Puncture and technical opertaion were performed successfully in all the patients with excellent results in 63, good in 27, and poor in 10. 120 cases with injection of O 2-O 3 into the lumbar discs showed the figure of lumbar space displaying clear in 37 cases, less clear in 35 cases, only gas entering lumbar disc at the needling point with lumbar space displaying unclear in 30 cases and lots of gas entering the front space of canalis vertebralis cavitas epiduralis in 18 cases. Conclusions PLD associated with O 3 injection is the advantageous supplement mutually posscessing safety and efficancy.