In order to standardize the perioperative nursing for endovascular treatment of splenic artery aneurysms， improve nursing quality， and promote the rapid recovery of patients， this consensus is specifically developed.Based on existing domestic and international clinical practice and literature research，and through expert demonstration， this consensus comprehensively elaborates on the classification of splenic artery aneurysms， endovascular treatment methods， indications， preoperative nursing and postoperative nursing.This consensus is highly practical and provides guidance for clinical practice.

Objective

To investigate the safety and efficacy of direct thrombectomy versus bridging therapy for patients with acute ischemic stroke caused by arteriosclerotic basilar artery occlusion （BAO）within the intravenous thrombolysis time window.

Methods

This study conducted a retrospective analysis of clinical data from patients with arteriosclerotic basilar artery occlusion （BAO）， who initiated treatment within 4.5 hours of symptom onset， from January 2018 to October 2023， across four stroke centers.The primary evaluation metrics included the rate of favorable prognosis at 90 days， as well as preoperative clinical characteristics， number of thrombectomy attempts， successful reperfusion rates， incidence of symptomatic intracranial hemorrhage， and mortality rates among both patient groups.Efficacy of the two treatment modalities was compared using multivariate logistic regression analysis.

Results

A total of 63 BAO patients were included in the study， with 25 undergoing direct mechanical thrombectomy and 38 receiving bridging therapy.There were no statistically significant differences in preoperative baseline data between the two groups.In terms of the adjusted 90-day good prognosis rate and functional independence rate， the bridging therapy group outperformed the direct thrombectomy group （P=0.026 and P=0.011）， and also required fewer thrombectomy attempts （P=0.032）.No significant differences were observed between the two groups in terms of successful reperfusion rates， incidence of symptomatic intracranial hemorrhage， and mortality rates（P＞0.05）.

Conclusion

For arteriosclerotic BAO patients treated within 4.5 hours， bridging therapy provides a better prognosis compared to direct mechanical thrombectomy， with fewer thrombectomy attempts required.

Objective

To explore the clinical efficacy and safety of microwave ablation （MWA）combined with synchronous transarterial chemoembolization （TACE） and targeted immunotherapy in unresectable liver cancer.

Methods

We conducted a retrospective analysis of patient records from January 2021 to September 2024， involving 17 patients with large hepatocellular carcinoma who received MWA combined with synchronous TACE and targeted and immunotherapeutic drugs in our hospital， with Child-Pugh class A or B liver function.The study involved performing MWA under CT guidance， immediately followed by TACE， and initiating a combination of targeted therapy and immunotherapy within one week post-procedure.The primary endpoints included Disease Control Rate （DCR）， Objective Response Rate （ORR）， Progression-Free Survival（PFS）， Overall Survival （OS）， and safety.Statistical analysis was conducted using the Kaplan-Meier method to construct survival curves， the Log-rank test to compare patient survival rates， and Cox regression for multivariate analysis.Efficacy and safety were evaluated during follow-up.

Results

This technique was successfully applied in all patients.Among the 17 patients， 3 cases （17.6%） achieved complete remission （CR）， 11 cases （64.7%）achieved partial remission （PR）， 1 case （5.8%） presented with stable disease （SD）， while 2 cases （11.8%） had progressive disease （PD）.The objective response rate （ORR）， calculated as the sum of complete response（CR） and partial response （PR）， reached 82.3%.The disease control rate （DCR） was 88.2%.Moreover， the median progression-free survival （PFS） was not reached.The median OS was not reached.The survival rates at 6 months， 12 months， and 24 months were 100%， 93.8%， and 66.8%， respectively.Among the 10 patients with BCLC stage C， the median overall survival （OS） was 20 months.There were no bleeding or other related complications.In the safety assessment during the treatment with targeted and immunotherapeutic drugs， the overall incidence of adverse events was 100.0%.Among them， 3 cases （17.6%） had grade 3 adverse events， and grade 1-3 adverse events could be relieved after symptomatic treatment.

Conclusion

MWA combined with synchronous TACE and targeted immunotherapy is safe and effective for the treatment of large hepatocellular carcinoma.This offers new approaches and options for the clinical treatment of large hepatocellular carcinoma，improving the prognosis for patients with large liver cancer.

Objective

To evaluate the safety and efficacy of transarterial chemoembolization （TACE）combined with lenvatinib and immune checkpoint inhibitors （TACE-L-ICIs） for uHCC.

Methods

Between June 2019 and March 2024， 75 patients were included in the retrospective analysis； 37 patients received TACE-L-ICIs treatment， and 38 received TACE combined with lenvatinib （TACE-L）.Overall survival （OS），progression-free survival （PFS）， adverse events （AEs）， and tumor response rates were compared between the two groups.

Results

The median OS in the TACE-L-ICIs group and the TACE-L group was 27.1 months and 18.2 months， respectively （P=0.147， HR=0.67， 95%CI=0.39-1.15）.However， Landmark survival analysis revealed a statistically significant difference in OS （P=0.020）.The median PFS was 14.3 months in the TACE-L-ICIs group compared to 7.6 months in the TACE-L group （P=0.023， HR=0.57， 95%CI=0.34-0.64）.The objective response rates （ORR） in the two groups were 67.3% and 42.1% （P=0.037）， respectively.The incidence rates of grade 3/4 adverse reactions in the TACE-L-ICIs group and the TACE-L group were 18.4%and 13.2% （P=0.754）， respectively.

Conclusion

Compared with TACE combined with lenvatinib， TACE combined with lenvatinib and immune checkpoint inhibitors for uHCC provides improved clinical benefits and acceptable safety.

Objective

To assess the clinical outcome of balloon dilatation or stent placement for the treatment of venous outflow tract obstruction after ex vivo liver resection and autotransplantation （ELRA）for hepatic vesicular echinococcosis.

Methods

Eighteen patients admitted to our interventional radiology department from January 2020 to April 2024 after ELRA for hepatic encapsulation due to stenosis or occlusion of the inferior vena cava and hepatic vein were retrospectively analyzed.Patients were monitored for intraoperative changes in inferior vena cava and hepatic vein pressures， postoperative liver function （AST， ALT，bilirubin， albumin， etc.）， lower extremity edema， and peritoneal effusion.

Results

Eighteen patients （12 males and 6 females） underwent endovascular treatment.Ten cases underwent simple balloon dilatation and achieved good efficacy； eight cases who were poorly treated with balloon dilatation and opted for stenting achieved better efficacy after the operation.Eighteen patients underwent a total of 36 interventions， with a technical success rate of 100% （36/36）.The pressure gradient of the hepatic venous outflow tract was reduced from 25.43±3.96 to 15.24±5.37 mmHg （P＜0.001）； inferior vena cava pressure decreased from 20.67±5.54 to 12.00±4.58 mmHg（P＜0.001）.The changes in hepatic vein and inferior vena cava pressure before and after balloon dilatation or stent placement were statistically significant.There was no statistically significant difference in the liver function indexes such as AST， ALT， bilirubin， and albumin compared with the preoperative period.All patients' clinical symptoms have improved after one or more interventions.

Conclusion

Balloon dilatation or stent placement for the treatment of postoperative venous outflow tract obstruction after ELRA is simple and efficacious.It would be the preferred treatment option for postoperative venous outflow tract obstruction after ELRA.

Objective

To evaluate the safety and efficacy of Shockwave intravascular lithotripsy（IVL） in the interventional treatment of acute coronary syndrome （ACS） with severe coronary calcified lesions.

Methods

A total of 36 patients with ACS who underwent interventional treatment of coronary artery IVL at the Fifth Affiliated Hospital of Sun Yat-sen University from September 2022 to December 2023 were enrolled in this study.Baseline data， procedural data， coronary imaging， and major cardiovascular events during follow-up through December 2024 were collected to evaluate the safety and efficacy of IVL in the treatment of ACS with severe coronary calcified lesions.

Results

Among the 36 patients， 27 were males and 9 were females； the mean age was 66.08±8.36.There were 26 cases （72.2%） with unstable angina，8 cases （22.2%） with NSTEMI， and 2 cases （5.6%） with STEMI.Among target vessels treated with IVL，3 cases （8.3%） involved the left main coronary artery， 26 cases （72.2%） were in the left anterior descending artery， 1 case （2.8%） was in the circumflex artery， and 6 cases （16.7%） were in the right coronary artery.All cases underwent intravascular imaging evaluation.All target vessels demonstrated severe calcification， with 14 cases （38.9%） exhibiting grade Ⅲ and 22 cases （61.1%） grade Ⅳ calcified lesions.Shockwave balloon was utilized alone in 14 cases （38.9%） and combined with cutting balloon in 22 cases （61.1%）.Successful deployment of drug-eluting stents （DES） or drug-coated balloons （DCB） was achieved in all cases， with postprocedural outcomes demonstrating residual stenosis ＜40%， TIMI flow grade 3， minimum lumen area （MLA）of 8.59±2.38 mm²， and procedural success rate of 100%.No complications， including slow-flow/no-reflow phenomenon， coronary perforation， significant dissection， or acute thrombosis， were observed.Postoperative coronary imaging follow-up performed in 16 cases （44.4%） at a median interval of 12 months （IQR 5.5-12.5）demonstrated no target vessel lesion progression.During the median follow-up of 20 months （IQR 13-21）， no target vessel-related rehospitalizations were documented.

Conclusion

The new technique of IVL is safe and effective in the treatment of coronary artery calcification lesions.

Objective

Evidence has shown that the combination of a ¹²⁵I seed strip and selfexpanding metal stents （SEMS） placement may prolong both survival and stent patency times in patients with malignant biliary obstruction （MBO）.However， no research has been published on the application of ¹²⁵I seed strips combined with double SEMS placement for the treatment of Bismuth type Ⅲ-Ⅳ hilar MBO.Therefore， we conducted a retrospective analysis to evaluate the effectiveness and safety of this combination in treating Bismuth type Ⅲ-Ⅳ hilar MBO.

Methods

A total of 215 patients with MBO received ¹²⁵I seed strip combined with SEMS placement treatment； among these， 26 patients with type Ⅲ-Ⅳ hilar MBO received the ¹²⁵I seed strip combined with double SEMS placement.We analyzed the patients' characteristics， SEMS placement methods， technical success rate， clinical success rate， overall survival time， stent patency time， and complications.

Results

Among the 26 patients， there were 7 cases of type Ⅲ hilar MBO and 19 cases of typeⅣ hilar MBO.Four types of stent placement techniques were used： X-type， T-type， Y-type， and tandem type.X-type stent placement technique accounted for 11.5% （3/26）； T-type for 23.1% （6/26）； Y-type for 38.5% （10/26）；and tandem type for 26.9% （7/26）.The technical success rate was 96.2%， and the clinical success rate was 100%.The median survival time was 208.0±14.5 days （95% confidence interval： 179.6-236.4）， and the median stent patency time was 178.0±21.1 days （95% confidence interval： 136.7-219.3）.No serious complications were observed.

Conclusion

The results of this study indicate that the combination of ¹²⁵I seed strips with double SEMS placement is safe and effective in managing patients with Bismuth type Ⅲ-Ⅳ hilar MBO.

Objective

To investigate the impacts of miR-545-3p mediated by ultrasound microbubbles on the proliferation， apoptosis， and invasion of colorectal cancer （CRC） cells by regulating HOXA3.

Methods

Real-time fluorescence quantitative polymerase chain reaction （qRT-PCR） was used to detect the mRNA expression levels of miR-545-3p and homeobox gene A3 （HOXA3） in SW620，SW480， LoVo， CACO-2， and the normal colon epithelial cell line NCM460； SW480 cells with good growth were divided into blank group， microbubble group， miR group， overexpression miR-545-3p group，microbubble+miR group， microbubble+overexpression miR-545-3p group， microbubble+overexpression miR-545-3p+empty vector （pcDNA6.2/nLumio-DEST， pcDNA） group， and microbubble+overexpression miR-545-3p+HOXA3 group.qRT-PCR was used to detect the expression of miR-545-3p and HOXA3 in each group， MTT was used to detect cell proliferation， flow cytometry was used to detect cell apoptosis，Transwell assay was used to detect cell invasion， and Western blotting was used to detect HOXA3 and proliferating cell nuclear antigen （PCNA）.Gene expression levels of PCNA， matrix metalloproteinase 9（MMP-9）， and Bcl-2-associated X protein （Bax） were measured.

Results

The expression of miR-545-3p was down-regulated and HOXA3 mRNA expression was up-regulated in CRC cells （P＜0.05）， and the changes were most significant in SW480 cells， which were selected for follow-up research.The luciferase activity of miR-545-3p co-transfected with HOXA3-WT was lower than that of miR NC co-transfected with HOXA3-WT （P＜0.05）.Overexpression of miR-545-3p can upregulate miR-545-3p expression，downregulate HOXA3 expression， inhibit cell proliferation， invasion and expression of PCNA and MMP-9 proteins， and promote cell apoptosis and Bax protein expression （P＜0.05）.Overexpression of miR-545-3p in the microbubble+miR-545-3p group upregulates miR-545-3p expression， downregulates HOXA3 expression， inhibits cell proliferation， invasion， and expression of PCNA and MMP-9 proteins， and promotes cell apoptosis and Bax protein expression more effectively than overexpression of miR-545-3p alone（P＜0.05）.The tumor weight of the miR-545-3p microbubble group in nude mice was significantly lower than that of the control group， microbubble group， and miR microbubble group （P＜0.05）.

Conclusion

miR-545-3p mediated by ultrasound microbubbles can inhibit the proliferation and invasion of CRC cells and induce their apoptosis by down-regulating HOXA3， providing a new drug delivery method and potential target for clinical treatment of CRC， and providing a basis for molecular targeted therapy of CRC.

Objective

To explore the hotspots and future trends of research related to TIPS and hepatic encephalopathy through bibliometrics for academic research in this field.

Methods

The Web of Science database was searched for literature related to TIPS and hepatic encephalopathy published between 2014 and 2023， and the data were counted and analyzed using VOSviewer， Bibliometrix， and CiteSpace software.

Results

A total of 454 articles were included in the search， and there was a general upward trend in the number of articles published in the past 10 years.China had the highest number of publications； the Fourth Military Medical University of China was the most prolific institution， and Guohong Han， Bin Xiong，and Lei Wang from China were the authors with the most publications.Risk factor analysis， myasthenia gravis， and dystrophy are the current research hotspots in this field.

Conclusion

China's contribution to the research field of TIPS and hepatic encephalopathy is outstanding， but the number of high-quality studies needs to be improved.In the future， attention should be paid to studies related to risk factors and predictive models of hepatic encephalopathy after TIPS， especially myasthenia gravis and malnutrition， as the current research hotspots in this field deserve further attention.

Prostatic artery embolization （PAE） has the advantage of safety and efficacy compared to the transurethral resection of the prostate （TURP） in the treatment of lower urinary tract symptoms （LUTS）caused by benign prostatic hyperplasia （BPH）.However， due to various operational challenges and difficulties that remain to be discussed and resolved with this treatment approach， PAE does not hold a high priority in treatment options.Numerous scholars have conducted extensive research to solve these problems of PAE and improve clinical benefits.By extensively reviewing relevant literature reports on PAE for BPH， this paper comprehensively discusses and summarizes the difficulties encountered during PAE procedures， post-surgery，and in long-term follow-ups.

Acute mesenteric ischemia （AMI） is a severe abdominal emergency， with superior mesenteric artery embolism being the most common cause.With the advancement of interventional treatment techniques in recent years， it has gradually become an alternative to surgical treatment.Current endovascular treatment methods include assisted stent implantation， mechanical thrombectomy， and other interventional techniques， as well as combinations of multiple strategies.This article discusses the application of interventional therapy in superior mesenteric artery embolism， aiming to rapidly restore blood flow， alleviate symptoms， and effectively reduce the incidence of complications.

Objective

To explore the application effect of the Six Sigma management method in the efficiency of interventional surgical table work.

Methods

Using a before-and-after comparison method， 218 patients who underwent interventional surgery in the composite operating room of Hunan Provincial People's Hospital from April to June 2021 before the improvement were selected as the control group， and 230 patients who underwent interventional surgery in the composite operating room of Hunan Provincial People's Hospital from August to October 2022 after the improvement were selected as the observation group.The five links of definition， measurement， analysis， improvement， and control in the Six Sigma management method were used to carry out the work in sequence， collect the existing problems in surgical reception work， analyze the reasons affecting the efficiency of reception work， take targeted measures， and conduct quality monitoring.Compare the on-time opening rate， preoperative preparation time， incidence of adverse events， and patient nursing satisfaction of the first surgery in two groups before and after improvement.

Result

The on-time opening rate of the first surgery in the observation group （98.0%） was higher than that in the control group （82.0%），and the difference was statistically significant （P＜0.05）； the preoperative preparation time of the observation group was shorter than that of the control group， and the difference was statistically significant （P＜0.001）； the incidence of adverse events in the observation group （0.4%） was lower than that in the control group （2.8%），and the difference was statistically significant （P＜0.05）； the nursing satisfaction score of the observation group was 92.00 （90.00， 96.00）， higher than that of the control group （82.00， 79.00， 86.00）， and the difference was statistically significant （P＜0.001）.

Conclusion

The application of the Six Sigma management method can optimize the surgical docking workflow and improve the efficiency of interventional surgical docking work.

Objective

To investigate the effect of research-type quality control circle （QCC） activity in constructing the "3E" teaching model of prevention and treatment nursing of venous thromboembolism（VTE）.

Methods

A QCC was established and led by the VTE preventive nursing group of the First Affiliated Hospital of Naval Medical University.Through the implementation of QCC management steps， the changes in various indicators before and after the implementation of QCC activities were compared and the application effectiveness was analyzed.

Results

The excellence rate of knowledge in theory related to VTE prevention and treatment in nurses increased from 71.43% to 95.71%， the excellence rate of skills in practice and operation related to VTE prevention and treatment in nurses increased from 70.00% to 97.14%， the standard implementation rate of VTE prevention and treatment measures in nurses increased from 55.71% to 88.57%，and the patients' satisfaction rate of the standard implementation of VTE prevention and treatment measures in nurses increased from 72.86% to 94.29% （all P＜0.05）.After the activity， the intangible results also improved，such as skill application of members in QCC and the ability of solving problems.

Conclusion

Through research-type QCC， the construction of the “3E” teaching model of prevention and treatment nursing of venous thromboembolism can standardize the teaching and evaluation， which will enhance the nurses' knowledge in theory and skills in practice and operation， and improve the nursing practice.