Background: To compare distal transradial access (dTRA) in the anatomic snuffbox and conventional transradial access (cTRA) for coronary angiography. Methods: Eighty cases that underwent coronary angiography were selected at The 903 Hospital of PLA in China from April 2017 to March 2018. Patients in the dTRA group underwent distal transradial access, and patients in the cTRA group received conventional transradial access. Puncture success rate, fluoroscopy time, and hemostasis time were determined. Results: The puncture success ratio was 85% in the dTRA group and 100% in the cTRA group (P < .05). The fluoroscopy time was 36 minutes and 19 min minutes in the dTRA group and cTRA group (P < .05), respectively. The compression hemostasis time after operation was 120 minutes and 240 minutes in the dTRA group and cTRA group (P < .05), respectively. The complication rate in the cTRA group was 7.5%, while there was no complication in the dTRA group. In addition, there also was no significant difference between the two groups in the rate of complications (cTRA = 7.5%, dTRA = 0.0%, P > .05). Conclusion: Distal transradial access in the anatomical snuffbox for coronary angiogram is a potential alternative to conventional radial arterial access.

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Background In this study, we sought to evaluate the feasibility of improved transcatheter aortic valve implantation (TAVI) in noncalcified aortic valve by using the novel concept of double-layer ChenValve prosthesis. TAVI was initially considered as an alternative treatment for high-risk patients with aortic stenosis. However, non noncalcified aortic valve disease was considered as a contraindication to TAVI. Methods ChenValve prosthesis, which consisted of a self-expanding Nitinol ring, a balloon-expandable cobalt-chromium alloy stent and a biological valve, was implanted at the desired position under fluoroscopic guidance in a transapical approach through a 20F sheath in 10 goats. Aortic angiography was performed to measure the diameter of the aotic annulus and assess the performance of the artificial valve. The ultrasound was used to evaluate the regurgitation or paravalvular leakage and trans-prosthetic vascular flow velocity postoperatively. The aortogram and transthoracic echocardiography were applied to observe whether the valve stent was implanted at the desired position. Results ChenValve prosthesis was successfully transppical implanted in all animals. The aortogram and transthoracic echocardiography performed immediately after implantation revealed that the valve stent was implanted at the desired position. There was no significant paravalvular leakage, obstruction of coronary artery ostia, stent malpositioning or dislodgement occurred. Conclusions This preliminary trial with the novel double-layer ChenValve prosthesis demonstrated the feasibility of improved TAVI in noncalcified aortic valve. The mechanism of Nitinol ring-guided locating the aortic sinus enables us to anatomically correct position the artifact valve. This improved strategy seems to make the TAVI process more safe and repeatable in noncalcified aortic valve.

Aiming at the difficulties of lumbar vertebrae segmentation in computed tomography (CT) images, we propose an automatic lumbar vertebrae segmentation method based on deep learning. The method mainly includes two parts: lumbar vertebra positioning and lumbar vertebrae segmentation. First of all, we propose a lumbar spine localization network of Unet network, which can directly locate the lumbar spine part in the image. Then, we propose a three-dimensional XUnet lumbar vertebrae segmentation method to achieve automatic lumbar vertebrae segmentation. The method proposed in this paper was validated on the lumbar spine CT images on the public dataset VerSe 2020 and our hospital dataset. Through qualitative comparison and quantitative analysis, the experimental results show that the method proposed in this paper can obtain good lumbar vertebrae segmentation performance, which can be further applied to detection of spinal anomalies and surgical treatment.