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This paper summarized professor ZHANG Boli's experience in treating stubborn bi （痹） with the herbal pair of Ruxiang （Olibanum）- Moyao （Myrrha）. The basic pathogenesis of stubborn bi is channel and collateral stasis and obstruction. Ruxiang and Moyao are thus used in mutual reinforcement to rectify qi and diffuse bi， activate blood and relieve pain， thereby removing static and obstructed qi and blood， unblocking the obstructed channels and colla-terals， which is especially suitable for stubborn bi caused by channel and collateral obstruction. In clinical practice， the herbal pair of Ruxiang-Moyao is used together with qi-moving and blood-activating medicinals to treat chest bi by expelling stasis and diffusing stagnation， dissipating cold and unblocking vessels. To treat long-term wither and weakness in late stage of stroke， the medicinals of boosting qi and invigorating blood， unblocking channels and venting collaterals can be added to the herbal pair so as to soothe and drain vessels and collaterals， harmonize and regulate qi and blood. Simiao Yongan Decoction （四妙勇安汤） can be integrated in the treatment of vessel bi by moving qi and dissolving stasis， and for the long-term stubborn vessel bi， integrated internal and external treatment is suggested by external use of Ruxiang-Moyao to vent bi with aromatics. Moreover， it is emphasized to use the herbal pair of Ruxiang-Moyao in accordance with indications and cautions.
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<p><b>OBJECTIVE</b>To calculate the volume embolization ratio of densely packing experimental aneurysms by three dimensional digital subtraction angiography (3D-DSA).</p><p><b>METHODS</b>Six experimental crotch aneurysms were created microsurgically in the common carotid artery of white rabbits. Two weeks later, each aneurysm's volume was measured with 3D-DSA surface shaded display(SSD) and the correction of lacteprene balloon calibration method. In the same time, the aneurysms were densely packed with electric detachable coils. The volume of coils that were used in each aneurysm was calculated separately. The ratio of coils volume and aneurysm volume was the volume embolization ratio (VER).</p><p><b>RESULTS</b>The aneurysms volumes measured by 3D DSA SSD ranged from 0.037 to 0.087 ml. The VER ranged from 23.5% to 32.5% (average 27.4%).</p><p><b>CONCLUSION</b>The minimum VER of densely packing experimental crotch aneurysms with electronic detachable coils was 23.5%.</p>
Subject(s)
Animals , Rabbits , Angiography, Digital Subtraction , Embolization, Therapeutic , Methods , Intracranial Aneurysm , Diagnostic Imaging , TherapeuticsABSTRACT
Objective To study the vascular architecture and the indication of endovascular embolization of intramedullary AVMs and evaluate the therapeutic effect. Methods 15 patients (male 9 and female 6 , 9 to 43 years old) with acute or progressive paralysis were undergone DSA and endovascular embolization. The embolic material was PVA particles and silk suture segments. Lidocaine test was performed before embolization if it was necessary. Results There were 3 glomus AVMs and 12 juvenile AVMs among the 15 cases. The glomus AVM was usually fed by single artery, the juvenile AVM was fed by two or more arteries. Among 15 patients, 2 were cured, 3 had excellent effect, 6 had good effect, 4 showed no changed and no one became worsening. After 6 months to 5 years follow up, 7 patients with recurrency were re embolized,another 2 patients were lost of follow up. Conclusions Endovascular embolization is a mild invasive, safety and effective therapeutic method for curing AVMs by avascularizing the rudus and decreasing the drainage vein pressure and bleeding.
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Objective:To improve the CT and MRI diagnostic accuracy of intracranial atypical cavernous angiomas(ACA).Methods:We retrospectively analyzed CT and MRI appearances,operative and pathological findings of 12 cases with ACA.Of them,11 cases were seanned by CT,10 cases by MRI and 9 by both CT and MRI.Results:Of 12 cases:One case as located at the sella ,1 case was at the fourth ventricle,5 cases were located at the cerebral hemisphere,4 cases were located at the middle cranial fossa and 1 case was at the posterior cranial fossa.There was edema in 3 cases,1 case had cystic component and 4 cases had cerebral hemorrhage.The localized rate of ACA by CT and MRI was 100%,but 11 cases were misdiagnosis and 1 case did not made the qualitative diagnosis. Conclusion:The qualitative diagnosis of ACA have some difficulty,so that the emphasis should be on the analysis of the combination imagiology and clinic.
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Objective To evaluate the size of the liver tissue necrosis at different power and energy, to search the size of liver tissue necrosis at ideal power and energy, and to provide dependable data for semiconductor laser-therapy in malignant hepatic tumor. Methods Ten rabbits were included, and the rabbit liver tissue was fired using semiconductor laser at 1 W, 2 W, and 3 W with the energy of 200 J, 400 J, 600 J, 800 J, and 1 000 J. The diameters of the necrosis and charring in the target area were measured. Results The diameter of the liver tissue necrosis and charring was from 4.3 mm and 7.8 mm at 1 W to 10.4 mm and 21.9 mm at 2 W in 1 000 J. From 2 W to 3 W, the diameter of the liver tissue necrosis and charring remained unchanged. At the power of 2 W, the diameter of liver tissue necrosis and charring was proportional to the energy, and the areas of necrosis were correlated with that of charring. Conclusion Semiconductor laser photocoagulation is safe and feasible. This experiment supplies valuable laboratorial data for further clinical study.
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Objective To evaluate the value of DSA in the diagnosis of staging moyamoya disease (MMD).Methods DSA of 31 patients with MMD were reviewed retrospectively. Results The stenosis or occlusion with different extents of the supracranial internal carotid arteries and the collateral circulations were shown in DSA of the all patients. MMD lesions of 57 cerebral hemispheres shown in the DSA of 31 patients were diagnosed by staging according to the description of Suzuki: Stage Ⅰ in 4 cerebral hemispheres; Ⅱ,10;Ⅲ17;Ⅳ12;Ⅴ6 and Ⅵ,8. Conclusions DSA could show clearly the stenotic degree, occlusive site and collateral circulation of the MMD and simultaneously with the staging of the disease; and thus guiding the choice for early surgical teatment.
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Objective To determine whether preoperative embolization is a valuable adjunct to surgical excision of hemangioblastoma. Methods Eleven cases of hemangioblastoma, involving 8 of cerebellum , 1 of medulla oblongata and 2 of spinal cord shown by CT, MR and DSA were embolized preoperatively. The feeding arteries were catheterized with microcatheter and devascularized with polyvinyl alchol particles. Results The blood supplies of the tumor in 6 cases were completely eliminated, and partial occlusion through embolization were undergone for the other 5 cases. Surgical operation was undergone 1-7 days later with all, the 11 tumors totally resected acompanied by minimal blood loss and shortening of the operation time. In addition, manipulation and removal of these embolized tumors were actually easier than expected. No complications occurred during the procedures of embolization and operation. Conclusions Preoperative embolization of hemangioblastoma is a useful and relatively safe to surgical complete resection of this hypervascular tumor with significant reduction of blood loss and operation time.
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Objective To evaluate the clinical application of intraluminal stent angioplasty(PTRAS) in the treatment of renal arterial stenoses. Methods A retrospective study was done in 28 patients with renal arterial stenoses. Primary renal artery stenting was performed in 28 consecutive patients (36 renal arteries). Blood pressure, serum creatine, the number of anti hypertensive medications were recorded at 1,6,12 month post stent angioplasty respectively. Arterial angiography was also taken 1 year later to evaluate the incidence of restenosis. Results Technical success rate was 100% achiving in all patients without serious complications. Primary successful patenty rate reached 82% (renal artery 86%), secondary successful rate was 89% (renal artery 90%). Systolic and diastolic blood pressure were reduced significantly ( P
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Transjugular intrahepatic portosystemic shunts (TIPS) were done on 5 patients between November 1993 and April 1994 for treatment of variceal bleeding. The pro- cedure was succeeded in 4 but failed in 1. Portal vein pressure was reduced from 35.5?3.3 cm. H_2O to 24.3?4.5cm. H_2O and Portosystemic venogradient dropped to 8.4?0.7cm. H_2O right after TIPS. Variceal bleeding recurred in 1 case due to shunt stenosis. Patency was reestablished by placement of another Wallstent in the pre-existed Z-stent canalization. Post- procedural transient hepatoencephalopathy developed in the another and was easily managed by medical therapy. Postprocedural Barium meal study one month later showed alleviation of all the esophageal varices. The authors concluded that TIPS creation is an effective and reliable means of lowering portal vein pressure. And the Wallstent may have the further capability to prevent the postprocedural shunt stenosis.
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Six spinal cord AVMs underwent intravascular embolization in our hospital between January 1993 and August 1994 were reported.All cases diagnosed by selective digital substract angiography.There were one cervical two thoracic intramedullar AVMs,and three lumbodorsal intradural perimedullary AVFs,Five cases received complete occlusion and one intramedullary AVM was partially embolized.Three perimedullary AVFs recovered markedly and partial improvement was also seen in three intramedullary AVMs during the follow-up period from 2 to 20 months.We concluded that intravascular embolization therapy is an alternative and effective manner in treating intramedullary AVM and type Ⅱ type Ⅲ perimedullary AVF.
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Objective To investigate the diagnostic and therapeutic methods of dural arteriovenuoe fistula in carotid cavernous sinus region.Methods Twenty five cases of clinical diagnosis of dural arteriovenous fistula of carotid cavernous sinus region were identified by whole cerebral angiography with seldingers technique.Among them 13 cases underwent endovascular embolized therapy due to large amount of shunt,and another 12 cases were undertaken conservative method of compressing carotid artery of affected side on basis of lesser amount of shunt with a few number of feeding arteries.Results Conditions of the 25 cases revealed by DSA were selected for the proper indications and then underwent the formentioned therapy with all successful achievement.Conclusion Diagnosis of dural arteriovenous fistula of carotid cavernous sinus region is not difficult.Emdovascular embolization is very effective,but the conservative compressing method of carotid artery of the affected side is also an efficient therapy.(J Intervent Radiol,2006,15:195-197)