Haemorrhagic shock, which arises as a complication of pelvic fracture subsequent to severe trauma, represents a perilous state. The utilization of interventional endovascular haemostasis assumes a pivotal role in the management of patients with vascular injury following pelvic fracture. This article reports the treatment of a patient with pelvic fracture caused by a serious work-related vehicle accident. Despite the implementation of timely blood and fluid transfusion to combat shock, the application of aortic balloon obstruction, and interventional iliac artery embolization for haemostasis, the patient\'s condition failed to display any discernible improvement. Repeat angiography further revealed a displacement of the interventional embolization material, and the patient subsequently died of multiple organ failure. The occurrence of spring coil displacement is infrequent, but the consequences thereof are considered grave, necessitating meticulous discernment in the selection of haemostatic materials for this type of patient. The diagnostic and therapeutic processes encompassing the particular case described here were analysed and are discussed with the objective of augmenting the efficacy and success rate of treatment modalities for patients in similar circumstances.

Acute carbon monoxide poisoning can cause hypoxic injury to multiple organs. Neurological impairment and cardiac dysfunction are common manifestations of severe poisoning patients, but hemorrhagic complications are rare in clinic. The clinical diagnosis and treatment of a case of massive intrathecal hematoma of the rectus abdominis secondary to acute severe carbon monoxide poisoning was reported. The pathophysiological mechanism and treatment strategy of rectus sheath hematoma secondary to acute severe carbon monoxide poisoning was analyzed, in order to improve the understanding of hemorrhagic complications of carbon monoxide poisoning. This case suggests that for patients with a history of cardiovascular disease and taking anticoagulants, clinicians should be alert for the risk of bleeding when making medical decisions.
急性一氧化碳中毒可造成全身多脏器缺氧性损伤，神经功能损害和心脏功能障碍是重症中毒患者常见表现，但出血性并发症在临床上较为少见。本文报道1例急性重度一氧化碳中毒继发腹直肌鞘内巨大血肿患者的临床诊治经过，分析急性重度一氧化碳中毒继发腹直肌鞘内血肿的病理生理机制及救治策略，以提高对一氧化碳中毒出血性并发症的认识。该病例提示，对于既往已存在心血管系统疾病史及服用抗凝药物的患者，临床医生在制定治疗方案时，需警惕出血的风险。.

This study aimed to assess the safety and efficacy of interventional embolization in cirrhotic patients with refractory hepatic encephalopathy (HE) associated with large spontaneous portosystemic shunts (SPSS). Inverse probability of treatment weighting (IPTW) was employed to minimize potential bias. A total of 123 patients were included in this study (34 in the embolization group and 89 in the control group). In the unadjusted cohort, the embolization group demonstrated significantly better liver function, a larger total area of SPSS, and a higher percentage of patients with serum ammonia levels > 60 µmol/L and the presence of hepatocellular carcinoma (HCC) (all P < 0.05). In the IPTW cohort, baseline characteristics were comparable between the two groups (all P > 0.05). Patients in the embolization group exhibited significantly longer HE-free survival compared to the control group in both the unadjusted and IPTW cohorts (both P < 0.05). Subsequent subgroup analyses indicated that patients with serum ammonia level > 60 μmol/L, hepatopetal flow within the portal trunk, the presence of solitary SPSS, a baseline HE grade of II, and the absence of HCC at baseline showed statistically significant benefit from embolization treatment (all P < 0.05). No early procedural complications were observed in the embolization group. The incidence of long-term postoperative complications was comparable to that in the control group (all P > 0.05). Hence, interventional embolization appears to be a safe and effective treatment modality for cirrhotic patients with refractory HE associated with large SPSS. However, the benefits of embolization were discernible only in a specific subset of patients.

BACKGROUND: Vascular malformations (VMs) arise as a result of errors in the process of angiogenesis and are usually present at birth, but may not become apparent until after birth. However, giant VMs of the head and face are uncommon, with few reported cases, and the prognosis for their surgical intervention is unclear.
METHODS: A 12-year-old girl was admitted to the hospital with findings of an enlarged right temporal scalp. After admission, computed tomography (CT) angiography of cerebral ateries showed a right occlusal gap and a right temporal artery venous malformation. Furthermore, cerebral angiography showed a right temporal lobe VM with multiple vessels supplying blood. The patient underwent surgery to remove the malformed vessels and the eroded skull. Two hours after the surgery, the patient\'s right pupil was dilated, and an urgent CT scan of the skull showed a right subdural haematoma under the incision, which was urgently removed by a second operation. After surgery, we gave continuous antibiotic anti-infection treatment, and the patient recovered well and was discharged two weeks later.
CONCLUSIONS: Surgical removal of giant haemangiomas is risky and adequate preoperative (including interventional embolisation) and intraoperative preparations should be made.

BACKGROUND: The amount of midline shift (MLS) considered safe for middle meningeal artery embolization (MMAE) in patients with chronic subdural hematoma (CSDH) has not been established. Whether MMAE could be used as upfront treatment for unilateral large CSDH patients with significant MLS (>1 cm) has not been reported.
OBJECTIVE: To investigate the efficacy and safety of MMAE in unilateral large CSDH patients with MLS > 1 cm.
METHODS: Eleven carefully selected CSDH patients with mild or moderate symptoms and significant MLS > 1 cm from 1 May 2021 to 31 August 2022 were included in the study. All patients were treated with MMAE using polyvinyl alcohol (PVA) particles. Outcomes were assessed clinically and with interval imaging studies at follow-up.
RESULTS: All 19 MMAs (unilateral embolization in three patients and bilateral embolization in eight patients) were successfully embolized. All 11 patients were followed for subsequent months, and there was no recurrence and enlargement of CSDH. Procedural adverse events, mortality, or complications were not observed. The average time to achieve a 50% reduction in MLS was approximately four weeks, while it took approximately eight weeks to achieve a 50% reduction in maximal volume. All 11 patients showed improvement in their neurological symptoms at three days post-operation, including four hemiplegic patients.
CONCLUSIONS: MMAE may demonstrate safety in carefully selected CSDH patients with significant midline shift (MLS > 1 cm), particularly in those who are not suitable for surgery, thus providing a potential alternative approach.

先天性肝内门体分流是一种极为罕见的血管畸形，其异常分流道连接肝内门静脉与肝静脉或下腔静脉，导致部分血液绕过肝脏直接进入体循环从而引发高氨血症、高半乳糖血症等，严重者并发肝肺综合征、肺动脉高压、肝性脑病，治疗较为棘手。现报道1例以肝肺综合征为首发表现的先天性肝内门体分流V型患儿，应用Amplatzer血管塞Ⅱ型成功介入栓塞的案例，术后1d复查血氨降至正常，术后6个月患儿缺氧症状消失，临床指标改善。以期加深对该病的认识，提示介入治疗可作为部分患儿的首选治疗方案。.

UNASSIGNED: To analyzes the changes in serum levels of matrix metalloproteinase-9 (MMP-9), neuroenolase (NSE), myeloperoxidase (MPO) and prognostic factors in patients with intracranial aneurysm (IA) undergoing interventional embolization at different treatment times.
UNASSIGNED: A retrospective analysis was made of 200 IA patients admitted to our department from January 2018 to June 2021 was performed. All patients underwent interventional embolization. According to the timing of surgery, the patients were divided into an early group (n=120, onset to surgery ≤72 h) and a delayed group (n=80, onset to surgery >72 h). The effect of embolization, complications and neurological deficit scale (NDS) scores were compared between the two groups. Serum MMP-9, NSE and MPO levels were compared before and after surgery, and the prognosis of all patients within 2 years after surgery was assessed by the Glasgow outcome scale (GOS) and divided accordingly into the good prognosis group (n=147) and the poor prognosis group (n=53) accordingly, and the prognostic factors influencing the patients were analyzed univariately and multifactorially.
UNASSIGNED: Cilj je bio da se analiziraju promene u serumskim nivoima matriks metaloproteinaze-9 (MMP-9), neuroenolaze (NSE), mijeloperoksidaze (MPO) i prognostičkih faktora kod pacijenata sa intrakranijalnom aneurizmom (IA) koji su podvrgnuti interventnoj embolizaciji u različitim vremenima lečenja.
UNASSIGNED: Urađena je retrospektivna analiza 200 pacijenata sa IA koji su primljeni na naše odeljenje od januara 2018. do juna 2021. godine. Svi pacijenti su podvrgnuti interventnoj embolizaciji. Prema vremenu operacije, pacijenti su podeljeni u ranu grupu (n=120, početak operacije ≤72 h) i odloženu grupu (n=80, početak operacije >72 h). Efekat embolizacije, komplikacije i rezultati skale neurološkog deficita (NDS) su upoređeni između dve grupe. Nivoi MMP-9, NSE i MPO u serumu su upoređeni pre i posle operacije, a prognoza svih pacijenata u roku od 2 godine nakon operacije procenjena je Glasgov skalom ishoda (GOS) i prema tome podeljena u grupu sa dobrom prognozom (n=147) i grupa sa lošom prognozom (n=53) shodno tome, a prognostički faktori koji utiču na pacijente analizirani su univarijantno i multifaktorski.
UNASSIGNED: Nakon operacije, stopa potpune embolije bila je veća u ranoj grupi nego u odloženoj grupi (P<0,05). Nakon operacije, nije bilo statističke značajnosti u poređenju pojedinačnih stopa komplikacija u obe grupe (P>0,05). U 3d, 1 mesec i 6 meseci nakon operacije, rezultati NDS pacijenata u obe grupe su bili niži od onih pre operacije, a poređenje NDS rezultata pacijenata u obe grupe u različitim vremenskim tačkama je bilo statistički značajno ( P<0,05). Posle operacije, nivoi MMP-9, NSE i MPO u serumu su bili niži u obe grupe nego pre operacije, a bili su niži u ranoj grupi nego u odloženoj grupi (P<0,05). Rezultati GOS-a su pokazali da je u roku od 2 godine nakon operacije bilo 97 i 23 slučaja sa dobrom i lošom prognozom u ranoj grupi i 54 i 26 slučajeva sa dobrom i lošom prognozom u odloženoj grupi, respektivno, a stopa dobre prognoze u ranoj grupi grupa je bila veća od one u odloženoj grupi (P<0,05). Multifaktorska analiza je pokazala da su odložena operacija, aneurizma u zadnjoj cirkulaciji, širina vrata aneurizme >4,5 mm, stepen III-IV po Fisheru, stepen III-IV Hunt-Hess i hipertenzija nezavisni faktori rizika za lošu prognozu nakon interventne embolizacije IA (P <0,05).
UNASSIGNED: Rana interventna embolizacija kod pacijenata sa IA može poboljšati njihovu potpunu stopu embolizacije i smanjiti nivoe MMP-9, NSE i MPO u serumu; odložena operacija, aneurizma u zadnjoj cirkulaciji, širina vrata aneurizme >4,5 mm, Fisher stepen III-IV, Hunt-Hess stepen III-IV i hipertenzija su snažno povezani sa lošom prognozom nakon interventne embolizacije kod pacijenata sa IA.

UNASSIGNED: This study explores the clinical application value of medical adhesive in endovascular embolization treatment of peripheral pseudoaneurysm.
UNASSIGNED: This was a retrospective review on 31 patients with peripheral pseudoaneurysm treated with medical adhesive endovascular embolization at the First Affiliated Hospital of Shihezi University from July 2021 to July 2023. Follow-up for 3-6 months was to observe the clinical efficacy and postoperative complications of medical adhesive embolization treatment.
UNASSIGNED: A total of 32 pseudoaneurysms were embolized in 31 patients with peripheral pseudoaneurysms. All pseudoaneurysms originated from visceral arteries. Among them, 29 pseudoaneurysms were embolized with medical adhesive alone, and three pseudoaneurysms were embolized with coil-assisted medical adhesive. After endovascular embolization with medical adhesive, all pseudoaneurysms were successfully embolized. Technical success was 100%. All patients experienced cessation of bleeding after endovascular embolization with medical adhesive, and there were no serious post-operative complications. Clinical success was 100%. During the follow-up period, two patients experienced recurrent bleeding but no pseudoaneurysm recurrence was observed.
UNASSIGNED: Endovascular medical adhesive embolization is a safe and effective method for treating pseudoaneurysm, with high hemostatic efficiency and permanent occlusion of the pseudoaneurysm after embolization, which is worthy of clinical promotion and application.

UNASSIGNED: To investigate the clinical efficacy and safety of interventional embolization in the treatment of anterior circulation aneurysms.
UNASSIGNED: Eighty patients with anterior circulation aneurysms admitted to People\'s Hospital of Leshan from June 2019 to December 2021 were retrospectively analyzed. According to the different surgical methods, they were divided into two groups: the observation group and the control group. Patients in the observation group were given interventional embolization, while those in the control group were given craniotomy clipping. The surgical efficacy, postoperative neurological function and quality of life, surgical prognosis and surgical complications of the two groups were compared.
UNASSIGNED: The intraoperative blood loss and hospitalization time in the observation group were lower than those in the control group (p<0.05). The scores of the Hunt-Hess and modified Rankin scale in the observation group were significantly lower than those in the control group three months after surgery (p<0.05). The good prognosis rate of the observation group was higher than that of the control group (p<0.05). Moreover, the complication rate of the observation group was 12.50%, which was significantly lower than 32.50% in the control group (p<0.05).
UNASSIGNED: Interventional embolization shows the advantages of minimally invasive procedures such as shorter operative times and shorter hospital stays. It has better clinical safety because it can significantly improve the neurological function and quality of life of patients, improve the prognosis of patients, and reduce the incidence of complications.

UNASSIGNED: Interventional embolization schedules based on absolute ethanol are usually used for peripheral arteriovenous malformations (PAVMs), and clinicians often choose the scheme according to the classification.
UNASSIGNED: To evaluate different interventional embolization schedules based on absolute ethanol for PAVMs.
UNASSIGNED: A retrospective study was performed of 165 patients with PAVMs treated with interventional embolization based on absolute ethanol in Henan Provincial People\'s Hospital from January 2018 to May 2021. PAVMs were classified as type II (n = 67), type III (n = 81) and type IV (n = 17) according to the Yakes classification system, including 123 maxillofacial, 13 trunk and 29 limbs. Effectiveness of embolization was based on PAVM devascularization on angiography: 100% (total), 90%~99% (near-total), 70%~90% (substantial), 30%~70% (partial) and 0%~30% (failure).
UNASSIGNED: PAVMs were classified as type II (n = 67), type III (n = 81) and type IV (n = 17) according to the Yakes classification system, including 123 maxillofacial (74.55%), 13 trunk (7.88%) and 29 limbs (17.58%). There are statistical differences in the angiographic outcomes among different Yakes classification and between different methods (P < 0.05), and there was a statistical difference in the failure rates among different Yakes classification (P < 0.05).
UNASSIGNED: PAVMs occur maxillofacial usually, and Type II can achieve better effect by spring coil and absolute ethanol, while Type III and Type IV have no ideal effect by Pingyangmycin + iodized oil + PVA + absolute ethanol and spring coil + absolute ethanol, respectively. Both the two happen to be complications, and wound accounts the highest.