Curative Effect of Interventional Therapy and Neurological Changes in Ischemic Stroke of Posterior Circulation Evaluated by Magnetic Resonance Imaging under Genetic Algorithm

Objective. This study aimed to evaluate the improvement and neurological function changes of patients with ischemic stroke in the posterior circulation before and after interventional therapy using magnetic resonance imaging (MRI) under genetic algorithm and compressed sensing algorithm. Methods. Thirty-six patients with posterior circulation ischemia who visited the interventional cerebrovascular disease area were included in this study. The treatment effect was observed through abnormal signal changes in the lesion area on each sequence of MRI images before and after treatment. The National Institutes of Health Stroke Scale (NIHSS) was used for the evaluation of the changes in neurological function. Results. The real data experiment results suggested that the peak signal-to-noise ratio (PSNR) = 39.33 and structure similarity (SSIM) = 0.96 in the algorithm reconstructed image, which showed no significant difference with the simulation experiment results of PSNR = 35.19 and SSIM = 0.96 ( P < 0.05 ). In addition, the stenosis rate after interventional treatment (13.89%) was substantially lower than that before treatment (91.67%) ( P < 0.05 ). Cerebral blood flow (CBF) of the bilateral occipital lobes and cerebellum after six months of treatment was higher than that before treatment ( P < 0.05 ), and the incidence of postoperative restenosis was 11.11% (4/36). Conclusion. The combination of genetic algorithm and compressed sensing algorithm had a good effect on MRI image processing. The posterior circulation ischemia interventional stent implantation can effectively improve the stenosis of the vertebral artery and vertebral basilar artery as well as the cerebral tissue perfusion in the ischemic area, which improved the clinical symptoms substantially and reduced the probability of restenosis.

Remote Vascular Interventional Surgery Robotics: A Literature Review

Interventional doctors are exposed to radiation hazards during the operation and endure high work intensity. Remote vascular interventional surgery robotics is a hot research field that can not only protect the health of interventional doctors, but also improve accuracy and efficiency of surgeries. However, the current vascular interventional robots still have many shortcomings to be improved. This article introduces the mechanical structure characteristics of various fields of vascular interventional therapy surgical robots, discusses the current key features of vascular interventional surgical robotics in force sensing, haptic feedback, and control methods, summarizes current frontiers about autonomous surgery, long geographic distances remote surgery and MRI-compatible structures. Finally, combined with the current research status of vascular interventional surgery robots, this article analyzes the development directions and puts forward a vision for the future vascular interventional surgery robots.

Surgery and Catheter Ablation for Atrial Fibrillation: History, Current Practice, and Future Directions

Atrial fibrillation (AF) is the most common of all cardiac arrhythmias, affecting roughly 1% of the general population in the Western world. The incidence of AF is predicted to double by 2050. Most patients with AF are treated with oral medications and only approximately 4% of AF patients are treated with interventional techniques, including catheter ablation and surgical ablation. The increasing prevalence and the morbidity/mortality associated with AF warrants a more aggressive approach to its treatment. It is the purpose of this invited editorial to describe the past, present, and anticipated future directions of the interventional therapy of AF, and to crystallize the problems that remain.

Short-term results of percutaneous closure of patent foramen ovale guided by transoesophageal echocardiography in patients with cryptogenic stroke: A retrospective study

Background: This study aimed to assess the short-term (12 months) results of PFO occlusion guided by transoesophageal echocardiography (TEE) and the results of regular transthoracic ultrasound foaming test (UFT). Methods: Data of 75 patients who underwent interventional therapy for PFO and CS were retrospectively analysed. The patients were grouped according to their preoperative UFT results: group A, small volume of right-to-left shunts; group B, moderate volume of right-to-left shunts; and group C, large volume of right-to-left shunts. All patients were treated with an Amplatzer occluder under TEE guidance. UFT follow-up was conducted regularly until 12 months after surgery. Results: No remarkable differences in preoperative data, length of hospital stay, or operative time were noted between the groups. Length of the PFO and diameter of the occluder differed between the groups: group A=group Bp<0.001). One patient in group C developed recurrent stroke 11 months postoperatively. Two patients in group C developed atrial arrhythmia, which improved after 3 months of antiarrhythmic treatment. However, 19 patients still had positive UFT results 12 months postoperatively. Furthermore, the positive UFT rate 12 months postoperatively differed between the groups: group A=group Bp<0.05). Conclusions: In patients with PFO and CS, interventional therapy guided by TEE could lead to satisfactory short-term (12 months) outcomes. A longer PFO and preoperative large-volume shunt were negatively associated with a negative UFT rate 12 months postoperatively. Further studies are required to clarify the relationship between positive UFT results postoperatively and stroke recurrence.

Remote Vascular Interventional Surgery Robotics: A Review

Interventional doctors are exposed to radiation hazards during the operation and endure high work intensity. Remote vascular interventional surgery robotics is a hot research field that can not only protect the health of interventional doctors, but also improve accuracy and efficiency of surgeries. However, the current vascular interventional robots still have many shortcomings to be improved. This article introduces the mechanical structure characteristics of various fields of vascular interventional therapy surgical robots, discusses the current key features of vascular interventional surgical robotics in force sensing, haptic feedback, and control methods, summarizes current frontiers about autonomous surgery, long geographic distances remote surgery and MRI-compatible structures. Finally, combined with the current research status of vascular interventional surgery robots, this article analyzes the development directions and puts forward a vision for the future vascular interventional surgery robots.

Computed Tomography Image Characteristics before and after Interventional Treatment of Children’s Lymphangioma under Artificial Intelligence Algorithm

The artificial intelligence algorithm was used to analyze the characteristics of computed tomography (CT) images before and after interventional treatment of children’s lymphangioma. Retrospective analysis was performed, and 30 children with lymphangioma from the hospital were recruited as the study subjects. The ultrasound-guided bleomycin interventional therapy was adopted and applied to CT scanning through convolutional neural network (CNN). The CT imaging-related indicators before and after interventional therapy were detected, and feature analysis was performed. In addition, the CNN algorithm was adopted to segment the image of the tumor was clearer and more accurate. At the same time, the Dice similarity coefficient (DSC) of the CNN algorithm was 0.9, which had a higher degree of agreement. In terms of clinical symptoms, the cured children’s lesions disappeared, the skin surface returned to normal color, and the treatment was smooth. In the two cases with effective treatment, the cystic mass at the lesion site was significantly smaller, and the nodules disappeared. CT images before interventional therapy showed that lymphangiomas in children were more common in the neck. The cystic masses at all lesion sites varied in diameter and size, and most of them were similar to round and irregular, with uniform density distribution. The boundary was clear, the cyst was solid, and there were different degrees of compression and spread to the surrounding structure. Most of them were polycystic, and a few of them were single cystic. After interventional treatment, CT images showed that 27 cases of cured children’s lymphangioma completely disappeared. Lymphangioma was significantly reduced in two children with effective treatment. Edema around the tumor also decreased significantly. Patients who did not respond to the treatment received interventional treatment again, and the tumors disappeared completely on CT imaging. No recurrence or new occurrence was found in three-month follow-up. The total effective rate of interventional therapy for lymphangioma in children was 96.67%. The CNN algorithm can effectively compare the CT image features before and after interventional treatment for children’s lymphangioma. It was suggested that the artificial intelligence algorithm-aided CT imaging examination was helpful to guide physicians in the accurate treatment of children’s lymphangioma.

Effect of Early Protective Lung Ventilation on Mortality and Hemodynamics in Patients With Acute Myocardial Infarction Complicated With Cardiogenic Shock and Pulmonary Edema Undergoing Emergency Interventional Therapy

Background: To investigate the effect of early protective lung ventilation (EPLV) on mortality and hemodynamic parameters in patients with acute myocardial infarction complicated with cardiogenic shock (CS) and pulmonary edema undergoing emergency percutaneous coronary intervention (PCI).Methods: From January 2015 to June 2017, patients with acute myocardial infarction complicated with CS and pulmonary edema were admitted to the Tianjin chest Hospital. Based on the use of a mechanical ventilator, patients were divided into the EPLV and Non-invasive ventilation (NIV) groups. Hemodynamic indexes and in-hospital mortality of patients between the two groups was analyzed.Results: The EPLV group consisted of 51 patients and the NIV group consisted of 38 patients. The difference in mortality rates was statistically significant between the EPLV and NIV groups (P=0.01). Central venous pressure, pulmonary artery pressure, and pulmonary capillary wedge pressure after emergency PCI in the EPLV group were lower compared to patients in the NIV group ((P<0.05). Man arterial pressure in patients in the EPLV group was higher compared to NIV patients (P<0.05). Logistic regression analysis showed that EPLV did not increase the risk of mortality (P=0.37, OR=2.16, 95% CI (0.31, 9.52)).Conclusion: EPLV resulted in lower mortality and improved hemodynamic function in patients with acute myocardial infarction complicated with CS and pulmonary edema undergoing emergency PCI.

Endoscopic negative pressure therapy as stand-alone treatment for perforated duodenal diverticulum: presentation of two cases

Background Endoscopic negative pressure therapy is a novel and successful treatment method for a variety of gastrointestinal leaks. This therapy mode has been frequently described for rectal and esophageal leakages. Duodenal diverticular perforations are rare but life-threatening events. The early diagnosis of duodenal diverticular perforation is often complicated by inconclusive symptoms. This is the first report about endoscopic negative pressure therapy in patients with perforated duodenal diverticula. Case presentation We present two cases of duodenal diverticula perforations treated with endoscopic negative pressure therapy as stand-alone treatment. Start of symptoms varied from one to three days before hospital admission. Early sectional imaging led to the diagnosis of duodenal diverticular perforation. Both patients were treated with endoluminal endoscopic negative pressure therapy with simultaneous feeding option. Three respective changes of the suction device were performed. Both patients were treated with antibiotics and antimycotics during their hospital stay and be discharged from hospital after 20 days. Conclusions This is the first description of successful stand-alone treatment by endoscopic negative pressure therapy in two patients with perforated duodenal diverticulum. We thus strongly recommend to attempt interventional therapy with endoluminal endoscopic negative pressure therapy in patients with duodenal diverticular perforations upfront to surgery.