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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]

Acute superior mesenteric artery embolism is a life-threatening disease, and the prognosis is very poor. Few reports described the application of percutaneous mechanical thrombectomy in acute superior mesenteric artery embolism. In this report, we showed a series of cases treated by percutaneous mechanical thrombectomy and shared our experience. Our case series included a total of twelve patients with acute superior mesenteric artery embolism treated by AngioJet Ultra Thrombectomy System from November 2019 to June 2021 in Hwa Mei Hospital, University of Chinese Academy of Sciences. Based on the kinds of literature, we summarized the diagnosis, treatment, and surgical experience of acute superior mesenteric artery embolism. Percutaneous mechanical thrombectomy was successfully achieved in all patients. A total of nine patients' symptoms were significantly relieved and smoothly discharged from the hospital. After operation, three patients still complained of abdominal pain, and one patient underwent exploratory laparotomy and the superior mesenteric artery pseudoaneurysm resection; the other two elderly patients did not undergo the exploratory laparotomy. During the follow-up, ten patients were free of any clinical symptoms or signs, one patient who refused laparotomy died 2 days later from septic shock, and the other patient was lost to follow-up. Percutaneous mechanical thrombectomy using an AngioJet Ultra (Boston Scientific®, USA) Thrombectomy System is a safe, effective, and minimally invasive method in the initial stage of acute superior mesenteric artery embolism. We believe that percutaneous mechanical thrombectomy could be a promising alternative in select cases. Furthermore, large sample data and long-term follow-up are needed to verify its effect. [ABSTRACT FROM AUTHOR]

Objective: To compare the therapeutic effects of ultrasound-guided and non-guided catheter-directed thrombolysis in the treatment of deep venous thrombosis of lower extremity.Methods: From August 2015 to April 2016, 60 patients with lower extremity deep venous thrombosis were randomly divided into two groups ( n = 30 for each) to receive catheter-directed thrombolysis. Group A was treated under the ultrasound guidance, while Group B was treated without guidance.Results: Catheter-directed thrombolysis was successfully performed by only one intubate in Group A but by 5.9 intubates in Group B. It took 15.4 ± 3.2 min in Group A, significantly less than that in Group B (30.8 ± 6.6 min, p < 0.05). The incidences of hematoma were also remarkably different between the two groups (3.33% vs. 26.67%, p = 0.026). No pseudoaneurysm or arteriovenous fistula was found in Group A, but there were two cases of pseudoaneurysm and two cases of arteriovenous fistula in Group B (both 6.67%, p = 0.492). The circumference differences of the affected limb between before and after thrombolysis were 49.47 ± 2.484 mm in Group A, significantly higher than that in Group B (28.40 ± 2.856 mm, p < 0.001). After treatment, the venous unobstructed improvement rates and deep vein patency rate were both better than those in Group B (77 + 2.603% vs. 57.23 + 1.828% and 80% vs. 46.67%, respectively; p < 0.001). There were only three cases of PTS in Group A (10%, 3/30), but there were 11 cases in Group B (36.67%, 11/30).Conclusion: Ultrasound-guided catheter-directed thrombolysis has advantages, with improvement of venous patency and decrease of the incidence of PTS. [ABSTRACT FROM AUTHOR]

Patient, a 59-year-old male coming from an undeveloped area of Sichuan Province, China, was admitted because of chest pain for one month. Compute tomography angiography showed descending aorta pseudoaneurysm at the level of the 6th thoracic vertebra (T6). History of bone tuberculosis and tuberculosis DNA test had confirmed diagnosis of tuberculosis. Interventional surgery was performed 3 days after admission. A covered stent (Medtronic TF 3030C200EE) was deployed slowly and accurately. Digital subtraction angiography showed that the pseudoaneurysm was isolated successfully and completely. The chest pain syndrome was relieved considerably. On the day after surgery, the patient was discharged. Fourteen months later, a recent CT revealed that the stent was in the right place and fluent and no infective clue was detected. The patient did not have any discomfort. Interventional therapy for infective pseudoaneurysm still has long promising prognosis. At the same time, anti-infection therapy is also essential. [ABSTRACT FROM AUTHOR]

Background: Central venous catheter placement is an important aspect of patient care for the administration of fluids and medications and for monitoring purposes. However, it is still associated with significant morbidity and mortality. Case presentation: We report a case of iatrogenic inferior thyroid artery pseudoaneurysm during the central line placement due to internal jugular vein puncture. This is a rare complication of central venous cannulation. Fortunately the pseudoaneurysm was monitored closely, diagnosed promptly and obliterated by using radiological intervention. We discuss the risk factors and management of the unintended artery puncture. Conclusion: The pathway of the management post arterial puncture depends on the size of the needle or catheter, which is direct related to the consequence of arterial injuries. Identifying risk factors is very important to avoid the complications. However, the use of ultrasound guided venipuncture is the most important method to avoid mechanical complications. [ABSTRACT FROM AUTHOR]