杨宁介入医学网

标准的血管造影设备 Angio suite 持续的心电监护仪，检测心动过缓 Continuous ECG monitoring bradycardia 病人不需要镇静 Pt not sedated 同侧手Squeaky toy in the controlateral hand...

计划中的颈动脉支撑架的植入包括 颈动脉 分叉部位 的颈动脉支撑架 和 非颈动脉分叉部位 的颈动脉支撑架的植入。 颈动脉分叉部位的支撑架植入需要回答究竟什么时候进行干预治疗？是进行颈动脉剥脱还是颈动脉支撑架？这两者关系究竟是竞争性的，还是互为补充的...

Peri-operative (stenting) treatment Platelet activation and frequent post-op emboli following carotid stenting No large trials of optimal approaches largely based on cardiology Most widely recommended regimen clopidogrel (300-600mg loading...

抵克立得（Ticlopidine）500 mg/d或 波立维Clopidogrel 75 mg/d 一共4周 低分子肝素（Low-molecular weight heparin）0.8 ml/d 共4周 阿司匹林（Aspirin）无期限服用（ indefinitely）...

病例：Lower Pole Selection 脾50% 萎缩 究竟栓塞多少脾？ Zhu K 2009 Dig Liver Dis To insure a sustained and long-term increase in platelet and leucocyte counts, the splenic infarction rate needs to be greater than 50% Madoff 2012 JVIR Traditi...

Summary PSE useful and reasonably safe Much work needs to be done to refine and define optimal technique...

脾动脉栓塞并发症发生相关因素 并发症 vs 部分脾栓塞% 门静脉高压脾亢：回顾性评价17例患者脾栓塞的结果 Petermann et al Diagn Interv Imaging 93(1): 30-36 17 患者：部分脾栓塞＞70%，并发症发生率50% 部分脾栓塞＜70%，并发症发生率＜70%。...

62 pts 1- to 2-mm gelfoam particles suspended in gentamicin Follow-up - 5 years 分组 A B C 梗死% 70% 50-70% 50% 患者数 12 34 16 严重并发症 50% 8.8% 0% 中位住院时间(天) 16 9 5 Zhu - 2009 Dig Liver Dis 41:411（朱康顺） ....

主脾动脉栓塞 vs 部分脾动脉栓塞 （Main Splenic Art Embo vs PSE） 61 pts with hypersplenism caused by cirrhosis Non-randomized prospective trial TSAE embo of main splenic art with coils PSE peripheral splenic embo with gelfoam or PVA TSAE PS...

Catheter Position Proximal vs Distal 主脾动脉栓塞（Main splenic artery） - Quicker - Can be done without micro-catheters 选择性末段脾动脉分支栓塞 Sub-selecting distal splenic branches - 花更多的操作时间； （ Takes more time） - 需要微导管...