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To investigate the safety and efficacy of the combination of radiofrequency ablation (RFA) and vertebroplasty versus single vertebroplasty in treating spinal metastases.The data of 35 patients with vertebral neoplastic lesions who received RFA combined with vertebroplasty (group A, 15 patients with 17 lesions) or single vertebroplasty (group B, 20 patients with 24 lesions) from March 2016 to June 2019 were retrospectively compared. The data of patients' Visual Analogue Scale (VAS) scores prior to the treatments, 1 week, 1 month, 3 months, and 6 months after the treatments, injected cement volume, ratios of cement leakage were compared between the two groups.All procedures were successfully done without severe complications. The VAS scores in group A were decreased more rapidly 1 week after the treatments and remained more stable at 6 months than that in group B (P 0.05). The cement injected in group A (5.95 ± 1.45 mL, range 4-9.5 mL) was significantly more than that in group B (4.09 ± 0.55 mL, range 3.1-5.5 mL) (P 0.05). The ratio of vascular cement leakage in group A was significantly lower than that in group B (P 0.05), while no statistical difference was found in the non-vascular cement leakage (P 0.05).Our study shows that the combination of RFA and vertebroplasty has a better analgesic effect with more injected cement and lower rates of venous cement leakage than single vertebroplasty.

Coronavirus disease 2019 or most commonly known as COVID-19 is a trending global infectious disease which a few months ago was affirmed as a global health emergency or a pandemic by the WHO Emergency Committee. The common symptoms manifested in this pandemic disease are high grade fever, cough, fatigue, shortness of breath and flu like symptom which can evolve into severe respiratory disorders such as pneumonia, acute respiratory distress syndrome (ARDS) and/or end-organ failure. Factors that contribute to the severity or high mortality rate in COVID-19 include old age, comorbidities like hypertension, diabetes, hyperlipidaemia, neutrophilia, and organ and coagulation dysfunction. Disseminated intravascular coagulation and other various coagulopathies including Venous thromboembolism have known to become a major contributing factor to high mortality rate. Venous thromboembolism is a disease which is a combination of deep vein thrombosis and pulmonary embolism. Prophylactic anticoagulation in patients prone to or with a pre-existing history of venous thromboembolism is associated with decreased mortality in severe COVID-19 pneumonia. This review article focuses upon COVID-19 and increased incidence of venous thromboembolism in patients infected by COVID-19 along with the role it has in high mortality rate in COVID-19 patients.

To evaluate the age of caval thrombus that experimentally induced in swine by use of magnetic resonance imaging (MRI). Caval thrombus was experimentally created in 15 swine by autologous clot injection assisted with caval net knitting. Serial high-resolution MR images were obtained using magnetic resonance venography (MRV) and T1 high-resolution isotropic volume examination (THRIVE) sequences in a 3.0-T MR system at 1, 7, 14, 21, and 28 days post model creation. At each time point, three pigs were sacrificed and the thrombotic vena cava was processed for histopathological examinations respectively. Caval thrombus was successfully induced in 15 pigs in group A. The signal intensity (SI) change of caval thrombus on THRIVE was age-dependent, with a typical sign of circle or semi-circle hyper-intensity at 7-day-old model while SI of thrombus was lower than that of muscle from day 14 throughout day 28. The histo-pathological findings revealed that RBCs-rich thrombus at day 1 without blue-stained particles, RBCs layers with infiltration of inflammatory cells and sporadically distributed blue-stained particles at 7-day-old thrombus. At day 14, 21 and 28, blue-stained particles became richer, coupled with formation of granulation tissue and fibrous tissue. The swine model in the study is good for age evaluation of venous thrombosis. The peripheral circle or semi-circle hyperintensity on THRIVE indicates the young age of caval thrombus in swine.

The distinction of radiation-induced brain necrosis (RBN) and recurrent glioblastoma multiform (rGBM) remains a diagnostic challenge due to their similarly on routine follow-up imaging studies and also their clinical manifestations. Our purpose of this review article is to evaluate the role of advanced MR imaging techniques such as Perfusion-weighted imaging (PWI), Diffusion-weighted imaging (DWI) and Magnetic resonance spectroscopy (MRS) in the differentiation of RBN and rGBM and their complications together with our experience and knowledge gained during our neuroimaging practice.

Objective This study aimed to report a single centre management experience and mid term outcomes for symptomatic spontaneous isolated superior mesenteric artery dissection (SISMAD). Methods This was a retrospective observational study. Between 1 August 2012, and 30 June 2018, consecutive patients with symptomatic SISMAD were included. Patient demographics, clinical symptoms, comorbidities, risk factors, and dissection characteristics were obtained. The treatment regimens and clinical and follow up outcomes were reviewed and analysed. A chi square test, Fisher's exact test, or one way analysis of variance was used to compare variables between the groups. Binary logistic regression was used to determine predictive factors for failed conservative treatment. The cumulative rate of complete dissection remodelling was calculated using a Kaplan–Meier curve. Results Sixty-two patients (mean age, 56.0 ± 9.3 years) were included. Patients at risk of intestinal ischaemia or dissecting aneurysm rupture were considered to be high risk patients (Group 1, n = 16) and received primary endovascular treatment. The remaining patients were considered low risk (Group 2, n = 46) and received primary conservative treatment. Symptom relief was observed in 82.6% of patients in Group 2. Finally, failed conservative treatment was observed in 50% of the low risk patients. Dissection length ≥50 mm was an independent risk factor for failed conservative treatment (p = .019; OR 4.68, 95% CI 1.29–16.98). During a median follow up of 30.5 months (interquartile range, 17.5, 58.3), patients with stents had a higher complete dissection remodelling rate than those without stents. Conclusion This study found that conservative treatment showed satisfactory symptom resolution for low risk SISMAD patients. Endovascular stenting was associated with a high technical success and dissection remodelling rate. This treatment modality might be reserved for patients with high risk SISMAD or failed conservative treatment. In addition, a dissection length ≥50 mm was a risk factor for failed conservative treatment.

The management of acute massive pulmonary embolism (PE) patients who did not respond to systemic thrombolysis (ST) has not been well established. The present study aimed to investigate the safety and effectiveness of catheter-based therapies (CDT) in this condition. We conducted a retrospective study of PE patients after unsuccessful ST (UST) between January 2012 and January 2018. Massive PE was identified in 408 patients and treated with full-dose ST therapy. Thrombolysis at 36 h was judged to be unsuccessful in 52 patients. Four ineligible patients were excluded, and the remaining 48 patients underwent rescue CDT: 30 patients underwent thrombus fragmentation with a rotating pigtail catheter; 8 patients underwent Straub rotational thrombectomy; and 10 patients underwent AngioJet rheolytic thrombectomy. In total, 42 patients subsequently underwent CDT relative to reduced-dose thrombolysis. Pooled clinical success was achieved in 45 patients, and the time-to-clinical instability relief for CDT was short (i.e., 48 h). Clinical findings significantly improved with oxygen saturation and the shock index (p

Objectives: To investigate the safety and efficacy of a stent combined with a linear strand of 125I seeds to treat malignant cancer–associated venous obstruction. Methods: We retrospectively analyzed the data of 57 patients with malignant cancer–associated venous obstruction. Nineteen patients underwent the placement of a stent combined with a linear strand of 125I seeds (group A), and 38 patients underwent the placement of a bare stent (group B). The following parameters were compared between the 2 groups of patients: symptom relief rate, duration of venous patency, survival time, quality of life, and adverse events. Results: A total of 34 stents and 527 seeds were implanted in group A, while a total of 57 stents were implanted in group B. The surgery success rate was 96.5%, and no serious complication related to the surgery was reported. Symptoms of venous obstruction improved significantly after surgery. The score of group A decreased from 14.74 ± 0.562 points before surgery to 2.79 ± 1.357 points after surgery( P < .001), and the score of group B decreased from 13.79 ± 1.398 points before surgery to 5.55 ± 3.674 points after surgery ( P < .001). The patency rate of group A was significantly higher than that of group B at 1 to 6 months after surgery (100%, 84.2%, 68.4%, 63.2%, 36.8%, 21.1% vs 68.4%, 23.7%, 18.4%, 7.9%, 5.3%, 2.6%, respectively; P < .05). Before treatment, there was no statistically significant difference in the Karnofsky Performance Status (KPS) score between the groups ( P = .791). After 1 to 6 months of treatment, the KPS score was significantly higher in group A than in group B ( P = .013). The median patency duration in groups A and B was 125 days (95% CI: 80.018-169.982) and 35 days (95% CI: 20.501-49.499), respectively ( P < .001). The median survival time of group A was 155 days (95% CI: 110.406-199.594), and that of group B was 98 days (95% CI: 55.712-140.288; P = .325). Multivariate analysis showed that the implantation of a stent combined with a linear strand of 125I seeds and the KPS score (≥80 points) were independent factors of long-term patency after stent placement. Conclusions: The placement of a stent combined with a linear strand of 125I seeds is a safe and effective treatment for venous obstruction caused by malignant tumors. This treatment provides prolonged patency compared with the placement of bare stent, and while it does not significantly improve the survival time of patients, it can improve their quality of life.

Purpose The present study aimed to investigate the preliminary safety and efficacy of rheolytic thrombectomy (RT) using AngioJet ZelanteDVT catheter or Solent Omni catheter for acute proximal deep vein thrombosis (DVT).Material and Methods We conducted a retrospective review of 40 patients who treated by AngioJet RT divided into ZelanteDVT group (n=17) and Solent group (n=23) from January 2019 to January 2021. Data of demographics, clinical characteristic, technical success, clinical success, complications, and early follow-up were analysed.Results No significant differences regarding demographics were detected (all p >.05). The technical success rates were both 100%. ZelanteDVT group had a shorter duration time of RT and a higher primary RT success than those of Solent group (all p significantly lower than that was 79.3% in Solent group (p =.010). The successful outcome for ZelanteDVT group and Solent group were 100% (17/17) and 95.7% (22/23), both high in the two groups (p >.05). Except for transient macroscopic hemoglobinuria occurred in all patients at the first 24 hours post-RT, none suffered other procedure-related adverse events or major complications in both groups. Minor complications presented as bleeding events occurred in 21.7% (5/23) patients of Solent group, and one (5.9%) patient in Zelante DVT group (p >.05). At 6-month, the frequency of PTS was 5.9% (1/17) in ZelanteDVT group compared with 17.4% (4/ 23) in Solent group (p >.05).Conclusion Both catheters are safe and effective for the management of patients with proximal DVT, leading to improved clinical outcomes with low complication. Zelante-DVT catheter offered more powerful thrombectomy over Solent catheter, allowing for faster extraction of the DVT with shorter run time and lower adjunctive CDT.

Background: The objective of this study is to establish a minimally invasive technique to create a stable carotid artery stenosis rabbit model. This article summarizes the specific methods and key points of this technology.Methods: The experiment studied a rabbit that was anesthetized through the vein. After the femoral artery was exposed, a minimally invasive needle was used to puncture the femoral artery, then the sheath was placed into the artery. We primarily put a catheter in the ascending aorta for angiography and then used a PT2 guidewire for super-selection. The PT2 guidewire was retained, and a balloon was placed in the right common carotid artery (CCA) through a guidewire to inflate it three times. Six rabbits in the 2- (2W) and 4-week (4W) groups were examined at 14 and 28 days, respectively. The rabbits in the control group received angiography at the beginning and 28 days later but without balloon injury. After angiography assessment, specimens of right CCA were dissected. Pathological and immunohistochemical examinations were performed on the collected specimens, and iFlow analysis was performed as well.Results: All the 18 animals which survived were observed. The rabbits in the 2W and 4W groups showed stenosis of the right CCA. Digital subtraction angiography showed the diameter was lower than that in the control group (1.04 ± 0.1, 0.71 ± 0.12, and 1.83 ± 0.08 mm in 2W, 4W, and control group, P < 0.05). Pathology also suggested carotid stenosis and obvious intimal hyperplasia. The results of immunohistochemistry showed that α-smooth muscle actin was highly expressed in the 2W and 4W groups, and the integrated optical density (IOD) value was higher than that in the control group (14,807.11 ± 1,822.3, 22,245.96 ± 1,212.82, and 6,537.16 ± 1,186.62 in the 2W, 4W, and control group, P < 0.05). Meanwhile, a cluster of differentiation 31 (CD31) was low expressed in the 2W and 4W groups, and the IOD value was lower than that in the control group (519.14 ± 44.4, 1,029.64 ± 98.48, and 1,502.05 ± 88.79 in the 2W, 4W, and control group, P < 0.05), which suggested endothelial damage and partial repair. The analysis by iFlow showed that the time-to-peak after balloon strain in the 2W and 4W groups were longer than that in the control group.Conclusion: We established a minimally invasive, effective, and safe method to establish a carotid artery stenosis rabbit model. The highlights of this technology were the application of minimally invasive methods, reducing surgical bleeding, infection, and related complications. This technology avoided the influence of tissue around CCA in the traditional carotid artery balloon injury model, which might lead to more accurate treatment outcomes.

The incidence of central nervous system tuberculosis is a rare entity that accounts about 1% of all tuberculosis and remains a major health problem in developing countries. We report a case of 1-year-old baby boy who presented with a three-week history of vomiting, seizure and progressive right-sided weakness. Brain magnetic resonance imaging performed on the admission day revealed a large lesion measuring (4.3*3.5cm) involving the left thalamus with extensive perilesional edema producing enfacement of third ventricle, midline shifting and obstructive hydrocephalus.

The aim of this study was to assess factors associated with conservative management failure in patients with symptomatic isolated mesenteric artery dissection.Patients with symptomatic isolated mesenteric artery dissection who underwent conservative therapy as first line treatment between February 2010 and May 2018 were included in this retrospective study. Conservative management failure was defined as the persistence or aggravation of symptoms and signs, increasing aneurysmal dilation, or new appearance of a dissecting aneurysm after conservative management. Univariable and multivariable analyses were performed to identify risk factors for failure of conservative management.A total of 123 patients (115 men, 8 women, mean age, 53.7 ± 6.1 years) were included in this study. Conservative management was successful in 89 (72.4%) patients but failed in the remaining 34 (27.6%) patients. Of the 89 for whom conservative management was successful, all of the symptoms were eliminated (n = 81) or relieved (n = 8) within 3.8 ± 0.7 days after conservative management. All of the 34 patients in whom conservative management failed underwent successful endovascular stenting. Failure of conservative management was associated with type II IMADs as defined by the Sakamoto classification (meaning that there is an entry tear, but no re-entry, and still no thrombosis of false lumen, odds ratio: 33.76; 95% confidence interval 8.65-131.85; p .001) and with ≥90% luminal stenosis (odds ratio 40.70; 95% confidence interval: 3.76-440.07; p .01).Conservative management can be used successfully in most patients with symptomatic isolated mesenteric artery dissection. Risk factors for failed conservative treatment were type II IMADs and degree of luminal stenosis ≥90%.

Objective To evaluate perfusion alterations in skeletal muscle in a canine hind limb ischemia model using color-coded digital subtraction angiography (CC-DSA). Methods Twelve beagles underwent embolization at the branch of their left deep femoral artery. Right hind limbs were used as the control group. Angiography was performed before and immediately after embolization. Upon CC-DSA analysis, time to peak (TTP) was measured before embolization in both sides of the beagles' hind limbs at the middle iliac artery, and the distant, middle and proximal femoral artery. Regions of interest (ROI) peak and ROI peak time were symmetrically computed in proximal and distal thigh muscles before and immediately after embolization. The data were analyzed and compared using the Wilcoxon signed rank test. Results Before embolization, ROI peak in the proximal thigh was lower than in the ipsilateral distal thigh, whereas ROI peak time in the proximal thigh was longer than in the distal thigh. In the iliac femoral artery, there was no significant difference in ROI peak, ROI peak time, or TTP between right and left sides. After embolization, ROI peaks in proximal and distal skeletal muscles of the left hind limb were significantly lower than on the contralateral side. ROI peak time was significantly longer in the left proximal and left distal thigh compared to the contralateral side. There were no significant changes in ROI peak or ROI peak time in the right proximal and right distal thigh compared to pre-embolization values. Changes in ROI peak and ROI peak time were larger in the left proximal than in the left distal thigh. Conclusion CC-DSA provided real-time measurement of changes in vascular hemodynamics and skeletal muscle perfusion without increasing X-ray usage or contrast agent dose.

Given the substantial resource use and emissions generated from the building sector, China is seeking a more sustainable and greener mode of building construction. To grasp the characteristics of the embodied energy use of the building sector across provinces in China, a multidimensional framework is developed to examine the spatial and sectoral distributions through the whole supply chain using a multiregional input-output (MRIO) analysis and structural path analysis (SPA) as the underlying methods. The results show that from a regional perspective, Liaoning, Shandong, and Guangdong are identified as top contributors, while from a sectoral perspective, the manufacture of nonmetallic mineral products, smelting and pressing of metals, and transportation, storage, posts, and telecommunications are the largest energy suppliers. The upstream examination indicates that self-digestion is an obvious and dominant energy use behavior for most regions, while the relative importance of sectoral suppliers changes regularly with the increase in upstream stages. The energy capture that occurred in the cross-regional energy transfers indicates that Zhejiang and Hebei are the national leading net importer and net exporter of energy use in China's building sector, respectively.

BACKGROUND Arteriovenous fistulas (AVFs) are used to provide vascular access for hemodialysis in patients with end-stage renal failure. However, stenosis and thrombosis can compromise long-term AVF patency. The objective of this study was to evaluate catheter thrombolysis with percutaneous transluminal angioplasty (PTA), using a trans-brachial approach, for acutely thrombosed AVFs. MATERIAL AND METHODS This retrospective study examined 30 cases of AVF thrombosis treated between January 1, 2015 and January 1, 2017. All patients received transcatheter thrombolysis with PTA using a trans-brachial approach. AVF patency was assessed after 6 months. RESULTS Thrombolysis with PTA was performed at 2 to 72 h after diagnosis of AVF occlusion due to acute thrombosis, and AVF patency was restored in all patients. After 6 months, the primary and secondary patency rates were 76.7% and 93.3%, respectively. For type I stenosis, primary patency was achieved in 10 of 16 patients (62.5%) and secondary patency was achieved in 14 of 16 patients (87.5%). For type II stenosis, primary patency was achieved in 13 of 14 patients (92.9%) and secondary patency was achieved in 14 of 14 patients (100%). Comparing type I and II stenosis, a significant difference was detected in the rates of primary patency (odds ratio=0.909, 95% confidence interval 0.754-1.096, P=0.049), but not secondary patency (P=0.178), after 6 months. CONCLUSIONS Our study provides preliminary evidence that catheter-directed thrombolysis with PTA using a trans-brachial approach can achieve high patency rates when used to treat acutely thrombosed AVFs.

Background: Several paclitaxel-coated balloons have been proved to provide better efficacy results than uncoated balloons in femoropopliteal lesions. But the efficacy and safety of FREEWAY balloons have not been investigated in Chinese patients. This study aimed to evaluate the efficacy and safety performance of FREEWAY paclitaxel-coated balloons vs. uncoated balloons in Chinese femoropopliteal artery lesions.Methods: In this prospective multi-center randomized controlled FREEWAY-CHINA study, 311 patients with symptomatic lower limb ischemia (Rutherford category 2–5) and femoropopliteal lesions of 14 Chinese centers were randomly assigned in a 1:1 ratio to endovascular treatment with either FREEWAY paclitaxel-coated balloons or uncoated balloons (control). The primary endpoint was the 6-month clinically-driven target lesion revascularization (CD-TLR) rate. Secondary endpoints included the device and technical success rate, the ankle-brachial indexes (ABIs), Rutherford category change, the 6-month primary and secondary patency rates, severe adverse effects, and the 12-month CD-TLR rate.Results: The two groups were comparable in terms of their demographic and lesion characteristics. Patients' mean age was 70 years, and 70% were men. The mean lesion length was 71 mm. The 6-month CD-TLR rate was 2.6% in the FREEWAY group and 11.7% in the control group (P = 0.001). The 12-month CD-TLR rate was 2.7% in the FREEWAY group and 13.2% in the control group (P = 0.0005). Other endpoints, including patency rates, major adverse events, and ABI or Rutherford change, did not differ between the two groups.Conclusion: The FREEWAY balloon resulted in an effective decrease in CD-TLR rates and had similar safety results compared to the uncoated balloon in Chinese femoropopliteal artery patients at the 12-month follow-up appointment.

BackgroundMechanical thrombectomy is the standard treatment for acute ischemic stroke (AIS) with large vessel occlusion (LVO) in the anterior circulation. This trial aimed to indicate whether Skyflow, a new thrombectomy device, could achieve the same safety and efficacy as Solitaire FR in the treatment of AIS.MethodsThis study was a prospective, multicenter, randomized, single blind, parallel, positive controlled, non-inferiority clinical trial. Patients with intracranial anterior circulation LVO within 8 hours from onset were included to receive thrombectomy treatment with either the Skyflow or Solitaire FR stent retriever. The primary endpoint was the rate of successful reperfusion (modified Treatment In Cerebral Infarction (mTICI) ≥2b) after the operation. The safety endpoints were the rate of symptomatic intracranial hemorrhage (sICH) and subarachnoid hemorrhage (SAH) at 24 hours after operation.ResultsA total of 95 and 97 patients were involved in the Skyflow group and Solitaire FR group, respectively. A successful reperfusion (mTICI ≥2b) was finally achieved in 84 (88.4%) patients in the Skyflow group and 80 (82.5%) patients in the Solitaire FR group. Skyflow was non-inferior to Solitaire FR in regard to the primary outcome, with the criterion of a non-inferiority margin of 12.5% (p=0.0002) after being adjusted for the combined center effect and the National Institutes of Health Stroke Scale (NIHSS) score. The rate of periprocedural sICH and SAH did not differ significantly between the two groups.ConclusionEndovascular thrombectomy with the Skyflow stent retriever was non-inferior to Solitaire FR with regard to successful reperfusion in AIS due to LVO (with a pre-specified non-inferiority margin of 12.5%).

Background Acute limb ischemia (ALI) is an important clinical event threatening both life and the affected limbs, but the optimal treatment for ALI remains undefined. The aim of this study was to compare the safety and effectiveness of thrombectomy approaches via either catheter-based thrombectomy (CBT) or catheter-directed thrombolysis (CDT). Methods A total of 98 patients (mean age 69.7 years, 60 male) who underwent endovascular intervention for ALI from January 2015 to July 2019 were included. Of these, 57 were treated with primary CBT via a large-bore catheter, an AngioJet catheter or Rotarex catheter, and/or underwent low-dose CDT, and 41 were treated with primary CDT. The safety and effectiveness of CBT compared to conventional CDT and other various endovascular techniques were evaluated. Results More Rutherford IIb patients were treated with primary CBT (68.4%) than CDT (26.8%; P P P P P > .05). Clinical success was estimated to be achieved in 98.2% of patients who underwent CBT, which is similar to the 97.6% estimated in those who underwent primary CDT (P = 1.000), and this finding was similar among the CBT subgroups. Patients who underwent CBT had a higher procedure-related distal embolization rate and economic cost than those who underwent primary CDT (P P = .059), especially minor complications (P = .036). The freedom from amputation at 6 and 12 months for CBT and CDT was assessed (93.0% vs 90.2% respectively, P = .625; 89.5% vs 82.9%, respectively, P = .34,). Comparable limb salvage was found for different techniques of large bore catheters, AngioJet catheters and Rotarex catheters. The Kaplan-Meier table analysis also showed similar limb salvage rates between groups. Conclusions Endovascular treatment of ALI with the use of catheter-based therapies is an effective modality that can reduce the requirement for thrombolysis, with expected reductions in hemorrhagic complications, but at the risk of remediable distal emboli and increased economic cost. It has a similar clinical outcome to conventional CDT alone. Different CBT techniques have comparable efficacy but different adverse event profiles.

To evaluate the diagnostic accuracy of a contrast-free multimodal magnetic resonance (MR) protocol (including M2DIPEAR, THRIVE, BTFE-SPAIR, and FLAIR sequences) in the detection of iliac vein obstruction with or without thrombosis. From May 1st, 2015, to May 1st, 2016, a total of 73 patients (aged 51.33 ± 4.21 years) who received both digital subtraction angiography (DSA) and the multimodal MR imaging were included. The protocol of the multimodal MR included M2DIPEAR and BTFE-SPAIR for presenting iliac vein obstruction, and THRIVE and FLAIR for revealing the co-existed thrombosis. Three observers who were blinded to clinical and DSA results independently analyzed all multimodal MR datasets. Per-patient evaluations on presence or absence of iliac vein obstruction were performed to calculate the diagnostic performance of MR imaging (DSA regarded as gold reference) in terms of overall accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Capability to display the co-existing venous thrombus was also evaluated per-MR sequence using a 3-point scale system. Iliac vein obstruction was depicted with DSA in 64 patients. In per-patient evaluation, the multimodal MR imaging yielded accuracy of 95.9% (70/73), sensitivity of 96.9% (62/64), specificity of 88.9% (8/9), positive predictive value of 98.4% (62/63), and negative predictive value of 80% (8/10), respectively. In the multimodal MR sequences, balanced turbo field echo—spectral attenuated inversion recovery (BTFE-SPAIR) sequence was superior to other sequences in depicting the iliac vein configuration, but fluid attenuated inversion recovery (FLAIR) and T1 high-resolution isovolumetric examination (THRIVE) seemed superior in detecting co-existing venous thrombosis. M2DIPEAR and BTFE-SPAIR sequence can reveal iliac vein obstruction while THRIVE and FLAIR can detect the co-existed thrombosis. The proposed multimodal MR protocol can accurately depict the iliac vein obstruction and accurately detect the co-existing venous thrombosis comparable with that of DSA.

Objective The aim was to evaluate the outcomes of endovascular treatment with bare stents alone versus stent assisted coiling in isolated mesenteric artery dissection (IMAD) aneurysms. Methods Patients with an IMAD aneurysm who underwent endovascular stenting between February 2010 and February 2017 at one of three institutions were included in this study. Data regarding technical success, procedure time, symptom resolution, complications, changes in IMAD aneurysm, and stent patency were recorded. Results A total of 38 patients (35 men) were included, 27 treated with bare stents alone and 11 treated with stent assisted coiling. Technical success was achieved in 100% of patients treated with bare stents and in 81.8% of those treated with stent assisted coiling (p = 0.078). The mean procedure times were 62.6 ± 5.3 min for treatment with bare stents and 116.4 ± 8.4 min for stent assisted coiling (p Conclusions Bare stents alone and stent assisted coiling have high technical success rates and demonstrate good intermediate patency in patients with an IMAD aneurysm. Bare stents alone may serve as an alternative to stent assisted coiling for the management of IMAD aneurysm

Background:The efficacy and safety of transcatheter arterial embolization (TAE) using the N-butyl-2 cyanoacrylate (NBCA) Glubran2 in the treatment of acute renal hemorrhage (RH) under coagulopathic conditionsarestill no consensus.Methods: Between February 2014 and June 2019, 8 patients underwent TAE with the NBCA Glubran2 for acute RH under coagulopathic conditions. Coagulopathy was defined as abnormal values of prothrombin time and activated partial thromboplastin time and/or a reduced platelet count.Angiograms and medical records were retrospectively reviewed to determine technical/clinical success, complications and recurrent hemorrhage after TAE, and follow-up outcomes were assessed.Results: Of note, one patient presented with severe coagulopathy, and three presented with severe RH and hemodynamic instability. The NBCA Glubran2 was employed as a sole embolic material in sixpatients. In the remaining two patients, it was employed for secondary embolization.Under coagulopathic conditions, due to the use of the NBCA Glubran2, both technical success and clinical success for acute RH were achieved in all patients. Duringa mean follow-up time of 30.1 months (range, 3-84 months), neither persistent nor recurrent active hemorrhage required repeat endovascular or surgical treatment for hemostasis. No Glubran2related complications occurred mid-TAE pro-cedure. In addition, renal function information was available for all patients, and there was no significant difference between the serum creatinine levels [(83.8 ± 15.5) vs (85.8 ± 32.2) μmol/L] before and one week after Glubran2 embolization (p=0.89; CI, -34.5 to 30.5).Conclusions: The present findings suggest that TAE with the NBCA Glubran2 may be a safe alternative treatment for the management of RH under coagulopathic conditions. In particular, this method appears to be a potentially attractive alternative when con-ventional embolic materials fail in patients with ongoing hemodynamic instability or even under severe coagulopathic conditions.

Purpose To review preliminary efficacy and safety outcomes of mechanical thrombectomy using the Solitaire AB device combined with thromboaspiration for treatment of acute embolic occlusion of the superior mesenteric artery (SMA). Materials and Methods Between October 2015 and October 2017, 9 patients (average age, 77 y; range, 62–84 y) presenting with acute mesenteric ischemia attributable to embolic occlusion at the stem of the SMA were retrospectively evaluated for mechanical thrombectomy using the Solitaire AB device combined with manual thromboaspiration. Adjunctive stent implantation was performed to correct pre-existing atherosclerotic stenosis or as a rapid recanalization solution after unsuccessful thrombectomy. Technical success was defined as successful deployment of the Solitaire device across the thrombus and successful retrieval of the device. Clinical success was defined as successful embolus retrieval and SMA recanalization. Adjunctive procedures and periprocedural complications were noted. Technical success, clinical success, and follow-up outcomes were assessed. Results Technical success was achieved in all patients. Clinical success was achieved in 7 (78%) patients. An adjunctive stent was required in 3 (33%) patients, including 1 unsuccessful thrombectomy. All patients had notable relief from abdominal pain after the procedure. No device-related complications or distal embolization events were noted during the procedures. Bowel resection was prevented in all patients. In-hospital mortality was 11% (1/9). During median follow-up of 6 months (range, 3–12 months), all surviving patients remained symptom-free, and stent patency was achieved in all patients. Conclusions Preliminary outcomes suggest that mechanical thrombectomy using the Solitaire AB device with manual thromboaspiration is associated with rapid, effective, and safe recanalization for acute embolic occlusion at the stem of the SMA.

This study was performed to assess the probability of post-thrombotic syndrome (PTS) after treatment of lower extremity deep venous thrombosis (LEDVT). Patients with LEDVT undergoing their first treatments in Nanjing First Hospital from January 2013 to December 2014 were enrolled in this study (156 patients were enrolled in the training cohort, and 135 patients were enrolled in the validation cohort). 51 and 45 patients developed PTS in the two cohorts, respectively. Independent risk factors for PTS were investigated in the training cohort, and these independent risk factors were employed to develop the APTSD scoring system with which to predict the probability of PTS. Four independent risk factors for PTS were identified: iliac vein compression syndrome, residual iliac-femoral vein thrombosis, residual femoral-popliteal vein thrombosis and insufficient anticoagulation. Patients in the training cohort were divided into 2 groups according to the APTSD score of ≤7.0 and >7.0 points regarding the probability of PTS (median PTS-free time, 21.82 vs. 18.84 months; P 7.0 points may have an increased probability of developing PTS.

The purpose of this study was to compare the efficacy and safety associated with catheter-directed thrombolysis (CDT) using either recombinant tissue plasminogen activator (rt-PA) or urokinase (UK) for subacute deep venous thrombosis (DVT). From January 2014 to December 2016, we conducted a retrospective analysis on a total of 49 patients who underwent consistent CDT with either rt-PA (rt-PA-CDT group) or UK (UK-CDT group) treatment. The thrombolytic rate of the rt-PA-CDT group was significantly higher than that of the UK-CDT group (87.5% vs 60%, respectively; χ2 = 4.751; P = .029). The rt-PA-CDT group exhibited an improved grade III thrombolytic rate (9 patients vs 3 patients; χ2 = 5.144; P = .023). The time for the rt-PA-CDT group to achieve a grade III thrombolytic rate was shorter than that of the UK-CDT group (5.01 ± 1.09 days vs 6.43 ± 1.69 days, respectively; t = −2.187; P = .044). No severe complications were seen in either group and mild complications rates were 16.7% and 20.0% (χ2 = .091; P = .763). The clinical efficacy rates at discharge were 91.7% and 76.0%, respectively (χ2 = 2.200; P = .138). In conclusion, CDT with a continuous infusion of low-dose rt-PA resulted in safe and effective thrombolysis in the great majority of patients with proximal DVT in the subacute phase. Furthermore, rt-PA was significantly better than UK in terms of the thrombolytic rate. In our study, rt-PA-CDT improved the thrombolytic rate of grade III thrombus and achieved a grade III thrombolytic rate in a shorter time than UK-CDT.

Background A permanently indwelling filter in the inferior vena cava (IVC) may induce caval thrombosis, which could develop and evolve from an acute to a chronic phase. The differential diagnosis of acute and chronic thromboses determines the treatment strategy. The role of computed tomography (CT) in diagnosing acute and chronic intra-filter and IVC thromboses has not been well established. This retrospective study summarizes the CT signs that indicate acute and chronic phases of intra-filter and IVC thromboses. Methods This study included eight patients who developed a lower-extremity deep venous thrombosis (DVT) and were treated with intracaval filter placement as an alternative to anticoagulation and thrombolysis. During the follow-up, all patients developed an intra-filter thrombosis in the IVC confirmed by CT and/or CT venography (CTV). Demographic and CT data of all patients during the follow-up period were collected for analysis. Results All patients had normal-appearing IVCs prior to filter placement, as shown on trans-femoral venography. Eight filters (five TrapEase, three OptEase) were placed in the eight IVCs, respectively. Subsequently, IVC-CT or CTV revealed acute intra-filter or IVC thrombosis in all eight patients, manifesting as an intracaval filling defect and thickened IVC wall. Filter protrusion and secondary caval atrophy seen on CT indicated a chronically occluded IVC. Conclusions IVC thrombosis may result from filter placement. The chronicity of caval thrombotic occlusion is likely to be associated with filter protrusion and secondary IVC atrophy revealed on CT scans.

To review the clinical evidence for ultrasound-accelerated catheter-directed thrombolysis (UACDT) using the EKOS system in the treatment of deep vein thrombosis (DVT) in terms of case selection, procedural outcomes, clinical outcomes and safety outcomes. A systematic literature search strategy was used to identify the use of the EKOS system in the treatment of DVT using the following electronic databases: MEDLINE, EMBASE, the Cochrane databases and the Web of Science. The references in the relevant literature were also screened. Our literature search identified a total of 16 unique clinical studies. Twelve of the sixteen studies were retrospective case series studies. To date, only one randomised controlled trial (RCT) is available. Overall, UACDT using the EKOS system was performed 548 times in 512 patients. Among all cases, 77-100% achieved substantial lysis (> 50%) based on the different definitions of the individual studies. This treatment modality appears to be safe, as there were no reported procedure-related pulmonary embolisms (PE) and only one procedure-related death was reported. Bleeding events were reported in 14 of the 16 studies, and 3.9% (20/512) of the cases of bleeding were considered major. During the follow-up, post-thrombotic syndrome was observed in 17.1% (20/117) of cases. UACDT using the EKOS system is an effective, safe and promising treatment modality for DVT, but the existing clinical evidence is inadequate to make UACDT using the EKOS system the first-line choice for DVT. Additional prospective large-sample RCTs with long-term follow-ups are warranted to define the role of UACDT using the EKOS system in the treatment of DVT.

PURPOSE: We aimed to evaluate skeletal muscle perfusion in a canine hind limb ischemia model using computed tomography (CT) perfusion imaging. METHODS: Twelve beagles underwent embolization at the branch of the left deep femoral artery. The right hind limbs were used as controls. CT perfusion imaging was performed immediately after embolization. The perfusion parameters of the regions of interest (ROI), including blood volume (BV), blood flow (BF), mean transit time (MTT) and permeability (PMB), were obtained in both the lateral and posterior hind limb muscle groups. RESULTS: After embolization, the BV, BF, and PMB values in the lateral muscles of the left hind limbs were significantly lower than those in the right hind limbs (P > 0.05), and the MTT was significantly prolonged (P > 0.05). The values for BV, BF, MTT, and PMB in the posterior muscles of the left hind limbs were not significantly different from those in the right hind limbs (P > 0.05). The values for BV, BF, and PMB in the lateral muscles of the left hind limbs were significantly lower than those in the posterior muscles of the left hind limbs (P > 0.05). CONCLUSION: CT perfusion imaging could be used to evaluate skeletal muscle perfusion in a canine model, which may have clinical relevance in lower limb ischemia and vascular reconstruction.

The study aimed to compare the tumor response to and complications of doxorubicin-eluting CalliSphere bead-transarterial chemoembolization (DEB-TACE) using small- and medium-sized beads in patients with hepatocellular carcinoma (HCC) who underwent multiple rounds of oncology therapies. Sixty patients with intermediate stage HCC who had previously received multiple oncology therapies underwent DEB-TACE with CalliSpheres of 100–300 μm (small bead group, n = 34) or 300–500 μm (medium bead group, n = 26) in diameter between October 2016 and December 2018. Adverse events and the response rate of the index tumor based on the modified Response Evaluation Criteria in Solid Tumors at 3 months post-TACE were compared between the groups. The rates of complete response, partial response, stable disease, and progressive disease were 35.4%, 29.4%, 17.6%, and 17.6%, respectively, for the small bead group and 33.1%, 23.1%, 20.8%, and 23.0%, respectively, for the medium bead group, showing no significant between-group differences (P > 0.05). Common Terminology Criteria for Adverse Events version 4.0 grade 3/4 adverse events were reported in 8 patients in the small bead group and in no patients in the medium bead group, showing a significant group difference (P

This paper investigates the relationship between the community of shared future, extra-role behavior, and innovation performance. This paper conducts an empirical study based on 334 valid sample data items of 53 technology-based small to medium enterprises (SMEs) in China. The data were subjected to structural equation analysis using SPSS 20.0 software. The results show that the community of shared future positively affects the extra-role behavior of employees and their innovation performance and has a positive impact on knowledge sharing behavior, voice behavior, and helping behavior. Knowledge sharing behavior, voice behavior, and helping behavior all play a mediating role between the community of shared future and employees&rsquo, innovation performance.

The aim of the present study was to investigate whether the rescue of thrombolysis with the recombinant tissue plasminogen activator (rt-PA) alteplase was an effective and safe therapeutic option in patients who did not respond to urokinase. Between February 2016 and February 2017, 26 patients with deep venous thrombosis (DVT) underwent rescue thrombolysis with alteplase. Unsuccessful thrombolysis with urokinase was defined as a lack of improvement in the degree of thrombotic removal with a lysis rate 3 million units of total urokinase, or >7 days infusion duration. The thrombus score, lysis rate and post-thrombolysis safety of alteplase, following unsuccessful urokinase thrombolysis were all evaluated. At the end of the unsuccessful urokinase thrombolytic therapy, the mean duration of the perfusion was 6.09±1.60 days, and the mean total dose was (362.5±90.0) ×10(4) units. No significant difference was detected in the total thrombus score before (7.85±2.40) and at the completion (6.19±2.33) of urokinase thrombolysis (P>0.05). The mean duration of perfusion was 3.36±1.69 days, and the mean total infusion dose was 44.8±22.6 mg for the rescue thrombolysis with alteplase. The mean thrombus score decreased to 1.19±2.10 at the completion of rescue thrombolysis. The alteplase post-thrombolysis scores were significantly decreased compared with those of urokinase thrombolysis (P0.05). No symptomatic pulmonary embolism or major bleeding occurred during rescue thrombolysis, but minor bleeding complications occurred in 4 cases (15.4%). In conclusion, rescue thrombolysis with alteplase led to an effective and safe outcome in patients with DVT who did not respond to initial thrombolysis with urokinase, and may be a valid and easy alternative treatment option.

In this article, we presented the detailed measurements and comparisons of skeletal muscle perfusion parameters in a canine hind limb ischemia model. Data presented here is related to and supportive to the research article “Evaluation of skeletal muscle perfusion in canine hind limb ischemia model using color-coded digital subtraction angiography” [1], where interpretation of the research data presented here is available.

Most of the literature has analyzed the accessibility value of landscapes based on flat terrain. However, the spatial interactions between the built and natural environments have changed with the transformation of urbanization from horizontal to vertical development. Therefore, this paper aims to redefine the amenity value of urban landscapes in terms of accessibility and visibility, considering topographical undulations and building occlusions, and to further analyze the spatial and temporal variances and spillovers of the value of urban landscapes in a three-dimensional system. Taking the famous ‘Mountain City’ Chongqing as the case study, the findings show that the topography of the mountain largely reduces walking accessibility, resulting in the accessibility of the mountain being less attractive in the three dimensional system. The visibility of rivers and parks is affected by house occlusion and a wavy terrain, and the landscape visibility of individual houses lacks a spatial spillover effect. Theoretically, the research contributes a new vertical perspective to the value of urban landscapes within the concept of the harmonious coexistence of humans and nature and empirically provides recommendations for improving functional facilities and optimizing spatial layouts to highlight the unique charm of a three dimensional city.

To analyze factors potentially associated with the occurrence of distal edge stenosis after stent placement for isolated superior mesenteric artery dissection (ISMAD). Cases of consecutive patients who were diagnosed with spontaneous ISMAD between February 2010 and July 2018 were retrospectively identified. Of the 123 cases identified, 45 patients (42 men; three women) underwent endovascular stent placement and were included in the study. Univariate and multivariate analyses were used to assess factors potentially associated with distal edge stenosis. The technical success rate among study patients was 100%. During 26.7 ± 17.3 months of follow-up, CT angiography demonstrated good distal edge patency in 25 patients (55.6%) and evidence of distal edge stenosis in 20 patients (44.4%). In univariate analysis, stent length (odds radio [OR] 1.03; 95% confidence interval [CI] 1.01, 1.06; P = .02), stent-to-vessel (S/V) diameter ratio (OR 2.27; 95% CI 1.35, 3.82; P

Cancer-associated vein obstruction (CAVO) is a common complication in oncological patients, but the effective therapeutic options are scant. We report a patient with reiterative recurrent CAVO who was successfully treated with intraluminal brachytherapy using a self-expandable stent loaded with linear radioactive iodine-125 seeds (RIS) strand. During follow-up, her clinical symptoms were well improved. Three-month imaging follow-up revealed satisfactory patency of the iliofemoral vein, and the stents combined with RIS strands performed well. No serious complications associated with the implantation of stent and RIS strands were documented in any of the sessions. Intraluminal brachytherapy using a self-expandable stent loaded with linear RIS may be a safe and effective option for CAVO as long as it includes not only blood flow restoration but also brachytherapy administration for cancer.

Purpose The purpose of this study was to evaluate mid-term patency of iliac vein following endovascular treatment for iliac vein compression syndrome (IVCS) with or without deep venous thrombosis (DVT). Materials and methods The authors’ institutional review board approved the study. Two hundred and thirty-three consecutive patients with IVCS were treated with endovascular treatment and followed up. The therapeutic strategies and complications were recorded. Cumulative patency was assessed with Kaplan–Meier curves. Independent predictors of in-stent obstruction were calculated with the Cox regression model. Results Endovascular treatment was technically successful in 225 of the 233 patients (96.6%). All of 225 patients were treated with percutaneous transluminal angioplasty and stent placement. No severe procedure-related complications occurred. The cumulative 1-, 3- and 5-year primary patency rates over a median follow-up time of 34 months (range, 0.3–82 months) were 93.2%, 84.3% and 74.5%, respectively. Independent predictors for in-stent obstruction included use of multiple stents and irregular stocking wearing. The cumulative 1-, 3-, 5-year secondary patency rates were 100%, 93.3% and 92%, respectively. Conclusions Endovascular treatment could achieve favorable mid-term patency in patients with IVCS with or without DVT.

This study aimed to evaluate the efficacy and safety of endovascular repair using detachable Solitaire AB stents for acute ischemic dissection of “S”-shaped carotid arteries. From May 2015 to December 2016, a total of 127 patients with acute ischemic stroke (AIS) underwent endovascular treatment in our center. Among them, five AISs were due to acute dissection of an “S”-shaped carotid artery. Coexisting carotid embolism was identified in all five patients, who first underwent successful Solitaire AB stent-based retrieval of the embolism. All patients then underwent Solitaire AB stenting to reopen the occluded carotid arteries, all of which were successfully recanalized. There were no procedure-related complications, except for minor hemorrhage transformation in one patient. The mean NIHSS scores were 12 ± 3.7 and 3.8 ± 3.4 at admission and 90 days after stenting, respectively (P = 0.018). The median modified Rankin Scale score at 90 days was 2.0 ± 1.4. Follow-up computed tomography angiography demonstrated in-stent patency in four of the five patients. Dissection of an “S”-shaped carotid artery infrequently leads to AIS. Such dissected arteries can be safely and reliably repaired by this stenting, ensuring successful reconstruction of the carotid arterial circulation.

Due to the complexity of stakeholder relationships, social conflicts related to unbalanced benefit distribution hinder the implementation of urban renewal. Based on game theory, this study investigates the bargaining process between developers and residents concerning benefit distribution and considers the government's role in achieving through various regulatory strategies the goals of either fairness or efficiency. The fairness-efficiency solution for both stakeholders in the model is the symmetric Nash bargaining solution with equal information. Urban renewal in China is gradually changing from being efficiency oriented to being fairness oriented, while the issues of vague property boundaries and defective articles remain. To promote cooperation and reduce negotiation costs, the simplification of administration procedures, the establishment of information sharing mechanisms and the introduction of third-party agencies to ensure harmony between developers and residents is recommended.

China is currently in the fast track of urbanization and industrialization. This poses a series of challenges pertaining to environmental issues given the resultant boom in energy consumption and carbon emissions. To tackle these problems, this study explores the effects of economic agglomerations and geographic attributes on energy transmission patterns using multi-regional input-output model, complex network analysis, and exploratory spatial data analysis. The results show that Shandong, Jiangsu, and Zhejiang are the three leading regions with regard embodied energy consumption; they have distinct energy utilization models but can also provide instructive lessons for energy conservation at the provincial level. Energy interactions represent self-organizing agglomerative patterns, and the physical geographic clusters are highly consistent with the virtual administrative division of agglomeration economies. The in-depth investigation of major agglomerations has revealed that infrastructure construction remains a vital driver of local economies in developing areas, whereas more developed agglomeration economies have more balanced and service-oriented development. Bilateral connections in current major agglomeration economies have been enhanced, but multilateral connections are still rare. The findings of this study provide a bottom-up insight into the spatiotemporal effect on embodied energy system of China.

The objective of this study was to evaluate the clinical value of combination of diagnostic computed tomography (CT) and somatostatin receptor imaging with (99m)Tc-octreotide acetate SPECT/CT in differentiation of benign pulmonary nodules from cancers.This was a retrospective study, 29 patients with suspected pulmonary neoplasm underwent diagnostic CT and (99m)Tc-octreotide SPECT/CT scans, and the tumor-to-normal tissue tracer value (T/N) for (99m)Tc-octreotide was measured. Diagnosis was confirmed by histological analysis.Eighteen of the 29 patients included in this study had lung cancer: 2 with small cell lung cancer and 16 with nonsmall cell lung cancer. The other 11 patients had benign lung lesions: 5 with tuberculosis, 4 with nontuberculosis infection, 1 with hematoma, and 1 with fibroma. (99m)Tc-octreotide uptake (expressed as mean T/N±SD) was significantly higher in lung cancers (2.58±0.91) than benign lesions (1.38±0.79) (p=0.002). Specificity for pulmonary malignant nodule diagnosis was 63.6% for diagnostic CT, 72.7% for somatostatin receptor SPECT/CT imaging, and 81.8% for the combined use of diagnostic CT and somatostatin receptor SPECT/CT imaging.Somatostatin receptor imaging with (99m)Tc-octreotide SPECT/CT is useful for the differentiation of benign pulmonary nodules from lung cancers, the combination of diagnostic CT and (99m)Tc-octreotide SPECT/CT further increases the specificity of malignant pulmonary nodule detection.

Bayesian approaches can be used to improve ill-posed image reconstruction by regularizing the inverse solution using spacial or temporal neighborhood information. This paper proposes a prior with adaptively binary neighborhood (ABN prior) for statistical tomographic reconstruction. With binary weight map adapted to local image features, the proposed prior can lead to improved reconstruction by including relevant pixels belonging to similar structures and excluding those not. A two-step algorithm is also put forward for tomographic reconstruction using the proposed prior. Experiments using both simulated and clinical computerized tomography (CT) data are performed to validate the reconstructions with the proposed ABN prior.

Typical iliac vein compression syndrome (IVCS) is characterized by compression of left common iliac vein (LCIV) by the overlying right common iliac artery (RCIA). We described an underestimated type of IVCS with dual compression by right and left common iliac arteries (LCIA) simultaneously. Thirty-one patients with IVCS were retrospectively included. All patients received trans-catheter venography and computed tomography (CT) examinations for diagnosing and evaluating IVCS. Late venography and reconstructed CT were used for evaluating the anatomical relationship among LCIV, RCIA and LCIA. Imaging manifestations as well as demographic data were collected and evaluated by two experienced radiologists. Sole and dual compression were found in 32.3% (n = 10) and 67.7% (n = 21) of 31 patients respectively. No statistical differences existed between them in terms of age, gender, LCIV diameter at the maximum compression point, pressure gradient across stenosis, and the percentage of compression level. On CT and venography, sole compression was commonly presented with a longitudinal compression at the orifice of LCIV while dual compression was usually presented as two types: one had a lengthy stenosis along the upper side of LCIV and the other was manifested by a longitudinal compression near to the orifice of external iliac vein. The presence of dual compression seemed significantly correlated with the tortuous LCIA (p = 0.006). Left common iliac vein can be presented by dual compression. This type of compression has typical manifestations on late venography and CT.

Mass data generated from in-service radiographic product contain assignable information on Image Quality (IQ). Analyzing data from routine work might supplement the time-consuming Image Quality Assurance Test Procedure (IQATP) to evaluate IQ and to know product type performance on site, which can also locate risks and give manufacturer directions for the further actions as well. This article illustrates methodologies of extracting IQ information from mass data and visual quality track, analysis, control, and risk mitigation in Big Data environments.

Fat-suppression technology of magnetic resonance is very important in clinical practice. This article is written to interpret the principle, advantages/disadvantages and clinical applications of some regular fat-suppression sequences in the diagnosis of Bone-Joint Disease, including: 1) frequency-selective saturation (FS); 2) short-TI inversion recovery (STIR); 3) frequency selective inversion pulse; 4) fat suppression water or fat selective excitation technique; 5) Dixon technology and 6) magnetization transfer contrast (MTI).

Microvascular lesion in diabetic peripheral arterial disease (PAD) still cannot be resolved by current surgical and interventional technique. Endothelial cells have the therapeutic potential to cure microvascular lesion. To evaluate the efficacy and immune-regulatory impact of intra-arterial infusion of autologous CD133+cells, we recruited 53 patients with diabetic PAD (27 of CD133+group and 26 of control group). CD133+cells enriched from patients’ PB-MNCs were reinfused intra-arterially. The ulcer healing followed up till 18 months was 100% (3/3) in CD133+group and 60% (3/5) in control group. The amputation rate was 0 (0/27) in CD133+group and 11.54% (3/26) in control group. Compared with the control group, TcPO2and ABI showed obvious improvement at 18 months and significant increasing VEGF and decreasing IL-6 level in the CD133+group within 4 weeks. A reducing trend of proangiogenesis and anti-inflammatory regulation function at 4 weeks after the cells infusion was also found. These results indicated that autologous CD133+cell treatment can effectively improve the perfusion of morbid limb and exert proangiogenesis and anti-inflammatory immune-regulatory impacts by paracrine on tissue microenvironment. The CD133+progenitor cell therapy may be repeated at a fixed interval according to cell life span and immune-regulatory function.

To evaluate the feasibility of a swine model of thrombotic inferior vena cava (IVC) occlusion (IVCO) created by autologous thrombus injection with assistance of intra-caval net knitting. Sixteen pigs were included and divided into two groups: Group A (n = 10), IVCO model created by knitting a caval net followed by autologous thrombus injection; Group B (n = 6), control model created by knitting a net and normal saline injection. Venography was performed to assess each model and the associated thrombotic occlusion. The vessels were examined histologically to analyse the pathological changes postoperatively. IVCO model was successfully created in 10 animals in Group A (100%). Immediate venography showed extensive clot burden in the IVC. Postoperative venography revealed partial caval occlusion at 7 days and complete occlusion coupled with collateral vessels at 14 days. Histologically, Group A animals had significantly greater venous wall thickening, with CD163-positive and CD3-positive cell infiltration. Recanalization channels were observed at the margins of the thrombus. By contrast, no thrombotic occlusion of the IVC was observed in Group B. The thrombotic IVCO model can be reliably established in swine. The inflammatory reaction may contribute to the caval thrombus propagation following occlusion.

Endoleaks constitute the main concern regarding the use of covered stents in the treatment of intracranial aneurysms. We investigated immediate/late endoleaks after stent-graft placement for the treatment of experimentally created carotid fusiform aneurysm (FA) in a canine model.Eighteen carotid FAs in nine dogs receiving covered stents were followed. Their procedural and angiographic data were collected immediately and six months after stenting. Univariate analysis and multivariate logistic regression analysis were performed to determine the factors predictive of immediate/late endoleaks. Receiver operating characteristic curve analysis was performed to determine the best cutoff values of the independent factors.All carotid FAs were successfully treated with Willis covered stents and received a six-month follow-up. The rate of immediate and late endoleaks after stenting was 38.89% and 16.67%, respectively. Anchoring length was identified as independent predictor of immediate endoleaks (P =0.037) and its best cutoff value was 3.06 mm (95% confidence interval: 2.39-3.72). No parameters were identified to be independent predictors of late endoleaks.Treating carotid FAs with Willis covered stents is technically feasible. Most endoleaks heal spontaneously and significantly correlate with anchoring length.

The present study aimed to examine the feasibility of catheter-directed thrombolysis (CDT) using continuous infusion of low-dose urokinase in combination with low molecular weight heparin (LMWH) for acute iliofemoral venous thrombosis. This retrospective analysis included patients with symptomatic acute iliofemoral venous thrombosis who received CDT using continuous infusion of low-dose urokinase in combination with LMWH within the past four years. Urokinase was administered at 1×104 U/h and 2×104 U/h in patients at high-risk and low-risk of bleeding, respectively. Measurements included urokinase dosage, duration, clinical outcomes and CDT-related complications. A total of 46 patients were included (high-risk, n=17; low-risk, n=29). In the high-risk patients, 64.7% experienced dissolution of ≥50% thrombi after a median CDT duration of 8 days (range, 6-10 days) and median total urokinase dose of 1.92×106 units (range, 1.44-2.4×106 units). In the low-risk patients, 82.8% achieved dissolution of ≥50% thrombi after a median CDT duration of 7 days (range, 4-10 days) and a median total urokinase dose of 3.36×106 units (range, 1.92-4.80×106 units). Remission of clinical symptoms after CDT was achieved in 15 (88.2%) and 28 (96.6%) cases in high-risk and low-risk patients, respectively. No treatment-associated pulmonary embolism or major bleeding was observed. Three (6.5%) subjects (high-risk, n=1; low-risk, n=2) experienced minor bleeding. In conclusion, continuous infusion of low-dose urokinase via CDT in combination with LMWH is effective and safe for acute iliofemoral venous thrombosis in patients with one or more risk factor for bleeding.

Objectives In the present study, we establish two swine models of iliac vein occlusion (IVO) with spontaneous thrombosis to understand the mechanisms linking IVO and thrombosis. Methods Two IVO models were established in 12 swine either by ligating the common iliac vein (CIVO) or both the common and external iliac veins (CEIVO). Venography was performed to assess each model and the associated thrombosis. Invasive blood pressure was also measured, and the vessels were examined histologically to analyse the pathological changes after ligation. Results On venography, the CIVO model showed common iliac vein (CIV) occlusion and reflux in the collateral veins whereas the CEIVO model showed occlusion in the CIV and external iliac vein (EIV), stasis in the EIV, and decreased collateral vasculature on venography. Thrombosis was only observed in the CEIVO model, which was with significantly higher venous blood pressure in the EIV and with significantly more thickened venous wall with lymphocytic infiltration histologically. Conclusions Two IVO models can be feasibly and reliably established in swine. The CEIVO model had a higher prevalence of thrombosis than the CIVO model. This CEIVO model produces comparatively less collateral drainage and greater inflammation that can contribute to the thrombosis prone to this type of model.

A novel and numerically efficient treatment of electromagnetic modes localized at defects in two-dimension (2D) photonic crystals is presented in this paper. The method represents the fields in terms of scattered fields by each column of the photonic crystals. With the method, the field distributions in two photonic crystal structures are calculated with satisfying results.