ABSTRACT
【Objective】 To observe the safety and effectiveness of endovascular treatment for mild stroke patients with acute anterior circulation large vessel occlusion. 【Methods】 The retrospective study enrolled 38 mild stroke patients with anterior circulation large vessel occlusion who received endovascular thrombectomy (EVT) at The First Affiliated Hospital of Xi’an Jiaotong University between January 2018 and August 2021. Vascular recanalization rate after endovascular treatment (mTICI≥2b), procedural complications, NIHSS score at discharge, and the rate of good modified Rankin Score (mRS≤2) at 90d were observed. 【Results】 The average age of the 38 patients was 62.89±12.41 years, and there were 21 males (55.3%). The vascular recanalization rate post EVT was 100%, while with three cases of thrombosis escape (7.9%) and one case (2.6%) of sICH of 24 h post EVT. The average NIHSS at discharge was 1 (0-1) point, which significantly decreased compared to the average baseline NIHSS 4 (4-5) points (P<0.01). The 90 d followed-up rate was 89.47%, and among all the followed-up patients, 91.2% of them had mRS≤2. Imaging follow-up showed good vascular flow and no in-stent restenosis. 【Conclusion】 Endovascular treatment for acute anterior circulation large vessel occlusion in mild stroke is safe and effective.
ABSTRACT
In order to improve the cure rate of critically ill patients in Wuhan epidemic area and reduce the fatality rate, the state have dispatched medical staffs from the whole country to support Wuhan and treat critically ill patients in dedicated facilities. A medical team from the First Affiliated Hospital of Xi’an Jiaotong University, consisting of 133 medical staffs major in critical care medicine, respiralogy, infection, cardiology, and general surgery, entirely took over the critical care unit of the East Hospital of the Renmin Hospital of Wuhan University, and formed a multidisciplinary collaboration team with local medical staffs to treat patients together. Up to March 13th in 2020, the author′s medical team has admitted a total of 109 patients, of which 48 had been discharged up on recovery. Critically ill patients with Corona Virus Disease 2019 mainly have elder age, comorbidities, complicated conditions, and difficult diagnosis and treatment. The author and the author′s team combined with clinical practice, share experience and strategies of general surgery related issues in the treatment of critically ill patients, providing reference for collegues in general surgery.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the therapeutic effect of cranial-cervical aneurysms with stent-graft.</p><p><b>METHODS</b>Clinical data of 20 patients with cranial-cervical aneurysm treated with stent-graft in Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University from November 2006 to November 2015 were retrospectively analyzed. There were 15 male and 5 female patients with a mean age of 40 years (ranging from 22 to 67 years). There were 10 spontaneous cases, 5 trauma history cases and 5 surgery history cases. Postoperative follow-up were made by telephone, CT angiography or digital subtraction angiography, evaluating therapeutic effect.</p><p><b>RESULTS</b>Twenty-four stent-grafts placement were carried out in 20 patients and all of them were successfully deployed in the parent artery. Intraoperative stent malapposition induced endoleak occurred in 3 cases, incomplete coverage of distal stent segment in 2 cases, acute thrombosis in 1 case and vessel lesion in 1 case. Eighteen cases were radiographically cured while the other 2 cases improved through additional stent placement, coil embolization or artery thrombolysis. Clinical symptoms of post-operative patients were improved to varying degrees. Follow-up of 1 to 96 months (average of 19 months) were accomplished. Delayed parent artery occlusion were encountered in 2 cases while endoleak still existed in 1 case.</p><p><b>CONCLUSION</b>Application of stent-graft for cranial-cervical aneurysms is safe and effective and the short-term follow-up results are satisfied.</p>