Central Retinal Artery Occlusion (CRAO) represents one of the most critical ophthalmic emergencies, often associated with the poorest visual prognosis. Its primary manifestation is acute, monocular vision loss or impairment. In the absence of intervention, the natural course of the condition allows only 17.7%–20.0% of CRAO patients to regain functional vision. Consequently, patients in the acute phase necessitate not only timely treatment but also meticulous perioperative management. Within China, although CRAO has been incorporated into the "Guidelines for the Prevention and Treatment of Stroke in China (2021 Edition)," standardized guidelines specifically addressing perioperative nursing management for CRAO interventional therapy are currently lacking.To further standardize the perioperative management of patients undergoing CRAO treatment, thereby aiming to salvage vision and enhance patient quality of life, the Interventional Nurse Branch of the Guangdong Nursing Association and the Interventional Physician Branch of the Guangdong Medical Association jointly spearheaded an initiative. They convened medical and nursing experts from relevant fields across China. This document, the "Expert Consensus on Perioperative Nursing for Interventional Therapy of Central Retinal Artery Occlusion," was compiled by the authors based on domestic and international evidence-based medicine. Its development involved an extensive review of numerous national and international guidelines and literature, integrated with insights drawn from clinical practice and research concerning CRAO interventional therapy in China. The consensus was refined through extensive expert discussions and revisions.The primary objective of this consensus is to standardize the perioperative management protocols for CRAO interventional therapy, providing a standardized, consistent, and evidence-based reference and guidance for clinical diagnosis, treatment, and nursing practice.

To investigate the safety and efficacy of treatment with standalone flow diverter (FD) placement for unruptured large basilar trunk aneurysms (LBTAs).

Patients with unruptured LBTAs (maximum diameter ≥ 10 mm) who underwent standalone FD placement in the First Hospital of Harbin Medical University from January 2015 to August 2023 were retrospectively included. The occurrence of postoperative complications and follow-up imaging results were evaluated. The modified Rankin Scale (mRS) score was used to assess the clinical outcomes of patients; the O'Kelly-Marotta (OKM) grading was used to evaluate the aneurysm occlusion status during imaging follow-up.

A total of 14 patients (14 aneurysms) with unruptured LBTAs who received FD treatment were included, with a surgical success rate of 100%. The average maximum diameter of the aneurysms was 18.0±8.9 mm. All patients were treated with standalone FD placement without coil embolization. A total of 20 stents were used to treat 14 aneurysms, among which 3 stents were overlappingly placed in 2 patients and 2 stents were overlappingly placed in another 2 patients. Postoperatively, neurological complications occurred in 5 patients (35.7%), of which 4 (28.6%) first appeared during the perioperative period and 1 (7.1%) first appeared during the follow-up period. A total of 3 patients died, with a mortality rate of 21.4%. The first appearance of complications in all 5 patients with complications was ischemic complications, and 2 (14.3%) patients had combined hemorrhagic complications. The average last clinical follow-up time for all patients was 25.5±12.3 months. The rates of favorable outcome (mRS score > 2) at discharge and the last follow-up were 85.7% (12/14) and 71.4% (10/14), respectively. Imaging follow-up was obtained in 9 patients, with a median follow-up time of 6 (6, 8) months, and among them, 5 patients (55.5%) had complete aneurysm occlusion (OKM grade D) during follow-up.

The treatment of unruptured LBTAs with standalone FD placement has a high surgical success rate and acceptable safety and efficacy. However, clinicians should still be vigilant against the occurrence of fatal or disabling ischemic complications after surgery.

To explore the safety and efficacy of small-sized stents in the treatment of unruptured distal anterior cerebral aneurysms.

A retrospective analysis was conducted on 29 patients with 29 aneurysms who were admitted to our center and treated with low-profile stents from January 2018 to December 2023. Among them, 15 aneurysms were located in the A2 segment and 14 aneurysms were located in the A3 segment. After the procedure, the Raymond-Roy grading standard was used to judge the degree of occlusion of the aneurysm, and the modified Rankin scale (mRS) was used to evaluate the clinical prognosis.

A total of 29 stents were placed in 29 patients (29 aneurysms), and the success rate of stent placement was 100%. The immediate postoperative aneurysm occlusion results indicated class Ⅰ in 17 cases (58.6%), class Ⅱ in 11 cases (37.9%), and class Ⅲ in 1 case (3.5%) based on R-R classification. Among 29 patients, 3 patients (10.3%) had complications during the perioperative period, all of which were ischemic complications. After thrombolysis or tirofiban treatment, the thrombus dissolved, of which only one patient had postoperative right-sided muscle strength grade 3, review of cranial MR suggested a small frontal lobe cerebral infarction, and the patient's symptoms improved before discharge, and right-sided muscle strength was grade 4 at 6-month postoperative follow-up. There were no hemorrhagic complications in any of the patients. A total of 22 patients underwent digital subtraction angiography (DSA) examination, which indicated class Ⅰ in 20 cases (90.9%), class Ⅱ in 1 case (4.5%), class Ⅲ in 1 case (4.5%), and 1 patient had aneurysm recurrence. At 6 months postoperatively, 29 patients had mRS score ≤ 2.

For treatment of unruptured distal anterior cerebral aneurysms, small-sized stents-assisted embolization is safe and effective. Braided stents tend to have better long-term embolization but can lead to intraoperative thrombosis.

To evaluate the clinical efficacy and feasibility of irreversible electroporation (IRE) combined with chemotherapy in patients with stage Ⅳ pancreatic cancer.

A retrospective analysis was conducted on 42 patients with stage Ⅳ pancreatic cancer treated at the General Hospital of Tianjin Medical University between September 2021 and March 2024. Twenty-two patients received IRE in combination with chemotherapy, and 20 received chemotherapy alone. Data collected included tumor location, tumor size, and pre- and postoperative chemotherapy regimens. Patients were followed regularly to document IRE-related adverse events and assess overall survival (OS).

The median OS was longer in the IRE group than in the chemotherapy group (P=0.283). Median progression-free survival (PFS) was also slightly longer in the IRE group (P=0.167). The mean length of hospital stay for the IRE group was 5.9±0.75 days. Serious IRE-related adverse events occurred in five patients: pyloric edema (n=1), obstructive jaundice (n=1), pancreatitis (n=2), and intraoperative bleeding (n=1). Postoperative pain scores were significantly reduced compared with preoperative scores (P<0.05).

IRE combined with chemotherapy may be a feasible and clinically beneficial option for stage Ⅳ pancreatic cancer, offering modest survival benefits, reduction in local pain symptoms, fewer adverse effects, and shorter hospitalization time.

To evaluate the safety and the short-term effect of TACE in treating hepatic malignant tumor via TRA and TFA.

This retrospective study analyzed 43 patients with hepatic malignancies treated at the authors' institutions between October 2021 and December 2023. All patients underwent TRA TACE following prior TFA TACE. The primary endpoints were the technical success, the complications and the adverse events. The secondary endpoints were the short-term effect and the dose-related indexes.

Radial artery and target vessel catheterization were successfully performed in 42 cases in the TRA group, of which the technical success rate was 97.7%. The technical success rate of the TFA group was 100%, and the difference between the two group was not significant (P>0.05). The incidence of the complications and the adverse events in the TRA group and the TFA group were 2.3%vs.9.3% and 79.1%vs.74.4%, respectively, with no significant difference (P>0.05). The fluoroscopy time, the accumulative dose, and the dose area product in the TRA group and the TFA group were 12(10, 15) min vs. 10(8, 12) min; 567(412, 760) mGy vs. 481(390, 670) mGy; 191(152, 288) Gy×cm²vs. 188(141, 220) Gy×cm², respectively. The difference of the fluoroscopy time between the two groups was significant(P<0.001). The short-term effect of the two groups was comparable, with no significant difference(P>0.05).

The safety and the short-term effect of TRA TACE in treating hepatic malignant tumor are comparable to TFA TACE. Although TRA TACE may increase the fluoroscopy time, it may not increase the radiation dose.

To explore whether it is feasible to shorten the delayed film time of ultra-liquefied lipiodol hysterosalpingography.

After hysterosalpingography with ultra-liquefied lipiodol, pelvic delay films were taken at 3 hours,6 hours and 24 hours after operation to observe the residual lipiodol in the fallopian tube and judge the patency and function of the fallopian tube. Chi-square test was used to compare the differences in the degree of tubal patency diagnosed by taking delayed films at 3 h, 6 h, and 24 h after hysterosalpingography.

Chi-square test results showed that there was a statistically significant difference in the diagnostic results of delayed films at 3 hours, 6 hours, and 24 hours (P=0.002). There was no significant difference in the diagnostic results of delayed films between the two groups at the 3rd hour and the 6th hour (P=0.807). There were statistically significant differences in the diagnostic results between the delayed films taken at the 3rd or 6th hour and the delayed films taken at the 24th hour (P=0.001, P=0.006). In the case of tubal patency, there was no significant difference in diagnostic results between the delayed films taken at 3 hours, 6 hours and 24 hours (P=0.787). However, in the case of unobstructed fallopian tubes, delayed filming at 3 and 6 hours showed that some lipiodol residues in the fallopian tubes or local accumulation of lipiodol around the umbrella end indicated poor peristalsis, and delayed films at 24 hours miss fallopian tube function information (P=0.001, P=0.001). In the case of hydrosalpinx, the difference between the delayed film taken at the 3rd hour and the 6th hour and the delayed film taken at the 24th hour was statistically significant (P=0.010, P=0.015). In the case of fallopian tube obstruction, there was a statistically significant difference in the delay film between the 3rd hour and the 24th hour (P=0.003).

In the case of fallopian tube patency, the delayed film taken at the third hour can meet the diagnostic requirements and evaluate the fallopian tube function. In the case of hydrosalpinx and fallopian tube obstruction, it is more valuable to take a delayed film at 24 hours.

This study aims to investigate the spatial relationship, puncture path distance, and plane overlap between hepatic veins and portal vein in simulated transjugular intrahepatic portosystemic shunt (TIPS) procedures based on CT images, in order to improve the success rate of puncture procedure during TIPS.

This retrospective study was conducted from December 2023 and April 2024 in patients with cirrhosis, who underwent abdominal contrast-enhanced CT. A Right-Anterior-Superior three-dimensional spatial coordinate system was established to analysis the spatial relationship and distance between middle or right hepatic vein (points A) and right portal trunk (point B). The spatial positions, puncture path distance between the hepatic vein puncture point (point A) and the portal vein puncture point (point B) during TIPS, as well as the plane overlap between point A and the right portal vein branch, were statistically analyzed.

A total of 84 cirrhotic patients were analyzed retrospectively. Point B was more frequently located posterior to point A when the middle hepatic vein was chosen as point A compared to the right hepatic vein (P<0.05). When choosing middle hepatic vein as point A, the puncture path distance path would be shorter (P<0.05). Additionally, the plane overlap was greater when the middle hepatic vein was selected as point A than when the right hepatic vein was chosen (P<0.05).

Based on CT images of cirrhotic patients, puncturing the origin of the right portal vein branch via the middle hepatic vein results in a shorter puncture path and higher plane overlap compared to using the right hepatic vein. These findings have the potential to improve the success rate of puncture techniques during TIPS procedures and reduce puncture-related complications.

To evaluate the prognostic differences and influencing factors of transjugular intrahepatic portosystemic shunt (TIPS) in decompensated cirrhosis caused by autoimmune liver disease (AILD) versus hepatitis B virus (HBV).

A retrospective analysis was conducted on 470 patients who received TIPS treatment at the First Affiliated Hospital of Nanjing Medical University from January 2018 to June 2023. Patients were divided into the AILD group (n=47) and the HBV group (n=102). Baseline data, preoperative and postoperative portal pressure, surgical conditions, postoperative upper gastrointestinal rebleeding, stent dysfunction, hepatic encephalopathy, and survival prognosis were collected and analyzed.

The median follow-up time was 614 days for the AILD group and 854 days for the HBV group. The 3-month, 6-month, and 1-year mortality rates in the AILD group were 6.38%, 21.27%, and 21.27%, respectively, compared to 2.94%, 3.92%, and 7.84% in the HBV group. The survival rate in the AILD group was significantly lower than that in the HBV group (P=0.029). Univariate and multivariate analyses identified etiology (HR=2.211, 95% CI: 1.111~4.401, P=0.024) and MELD score (HR=1.009, 95% CI: 1.021~1.184, P=0.012) as risk factors for mortality. No significant differences were found between the two groups in terms of rebleeding and hepatic encephalopathy rates, but stent dysfunction was more common in the AILD group (P=0.056). Serum creatinine level was an independent risk factor for overt hepatic encephalopathy (HR=1.004, 95% CI: 1.000~1.007, P=0.038).

TIPS can effectively reduce portal pressure and improve clinical symptoms in patients with decompensated cirrhosis caused by both AILD and HBV. However, AILD patients have a shorter survival period compared to HBV patients, although there are no significant differences in postoperative rebleeding and overt hepatic encephalopathy between the two groups.

This study aimed to evaluate the safety and efficacy of local sclerosant injection in the treatment of pyogenic granuloma.

A retrospective analysis was performed on patients with pyogenic granuloma admitted to the Interventional Vascular Anomalies Department of our hospital from February 2022 to December 2024. Based on the appearance of the lesion and its basal dimensions, patients were classified into broad-stalk and narrow-stalk types. The broad-stalk type was treated with a combination of ligation using silk thread and injection of a sclerosant, whereas the narrow-stalk type received only the sclerosant injection. Treatment outcomes, incidence of complications, number of treatment sessions, and recurrence rates were analyzed to assess the clinical effectiveness of the treatment.

Among the 15 patients included, 9 with the narrow-stalk type underwent sclerosant injection, and 6 with the broad-stalk type received the combined treatment of silk thread ligation and injection of a sclerosant (either 1% polidocanol or Lauromacrogol). Complete resolution of the lesions was achieved within 8 weeks following treatment. Only 1 patient required 2 sessions of local injection, while the remaining patients were successfully treated with a single session. All patients tolerated the treatment well, and no adverse reactions such as allergic responses or skin necrosis were observed. During a follow-up period ranging from 2 to 24 months, no recurrences were noted, and no post-healing pigment deposition or scar formation was observed.

Local sclerosant injection is a highly effective and safe treatment modality for pyogenic granuloma. For broad-stalk lesions, the addition of ligation may further enhance therapeutic outcomes.

Pulmonary embolism (PE) is a respiratory disease in which emboli fall off in the systemic circulation, leading to obstruction of pulmonary arteries and branches, causing pulmonary circulation dysfunction. The most common is pulmonary thromboembolism, commonly known as pulmonary embolism, which refers to pulmonary thromboembolism. Pulmonary embolism is the third most common cardiovascular disease in China with a high incidence, but its clinical symptoms are often non-specific, and the diagnosis requires unconventional examination methods. Therefore, it often leads to high mortality due to misdiagnosis, missed diagnosis or untimely diagnosis. If not treated in time, the total mortality rate of pulmonary embolism is 18%-30%, while the mortality rate after anticoagulant therapy is 2%-11%. Therefore, early diagnosis and treatment are very important for patients with pulmonary embolism. This article mainly summarizes the research progress of the diagnosis and treatment of pulmonary embolism based on evidence-based medical evidence at home and abroad.

Artificial intelligence is based on computer algorithms and simulates human intelligence to analyze large amounts of data to verify the sensitivity and specificity of algorithms and continuously optimize itself to achieve the goal of completing designated tasks. In recent years, the application of artificial intelligence technology in the medical field has become increasingly widespread, especially in interventional radiology. Artificial intelligence can use image recognition and analysis technology to help doctors quickly and accurately diagnose and treat diseases. In interventional treatment, artificial intelligence can assist doctors in performing angiography, tumor ablation, and vascular interventions, improving the precision and safety of the operation. At the same time, artificial intelligence can also utilize big data analysis to analyze the imaging data of patients and provide personalized treatment plans for doctors, and combine robotic technology to perform minimally invasive surgery to reduce surgical risks and the recovery time of patients. However, artificial intelligence-assisted interventional treatment also faces a series of challenges, such as privacy protection and data security.