Objective To preliminarily evaluate the feasibility and safety of percutaneous sharp recanalization of the superior vena cava (SVC) with puncture instruments assistance followed by catheter placement in hemodialysis patients with exhausted central venous access resources. Methods A retrospective analysis was conducted on clinical data of hemodialysis patients who underwent RUPS-100-assisted sharp recanalization at West China Hospital, Sichuan University between March 2019 and August 2024. All patients were diagnosed with SVC occlusion via digital subtraction angiography or computed tomographic angiography and conventional guidewires and catheters failed to traverse the occlusive lesions as judged by operators. The technical success rate, perioperative complications, post-procedure blood flow volume, and catheter patency rate were recorded. Results A total of 17 patients were enrolled, among whom sharp recanalization was successfully performed in 14 cases, corresponding to a technical success rate of 82.4%. The mean length of recanalized occlusive segment was (2.2±0.5) cm, and the mean procedural time was (73.4±9.5) minutes. One patient developed intraoperative hemopericardium (Society of Interventional Radiology adverse event grade C), which improved under close monitoring and conservative management without progression to cardiac tamponade. The post-procedure blood flow was maintained above 240 mL/min in all successfully recanalized patients. The primary patency rates at 6 months and 12 months were 92.9% and 66.7%, respectively. Conclusions RUPS-100-assisted sharp recanalization is an effective and acceptably safe salvage procedure for the treatment of SVC occlusion in hemodialysis patients, offering a novel therapeutic option for patients with refractory vascular access dysfunction. Given the limitations of its retrospective, single-center and small-sample design, further large-scale studies are required to validate these findings.
Objective To observe the effect of cationic liposomal ceftazidime (CLC) combined with nano-hydroxyapatite/β-tricalcium phosphate (n-HA/β-TCP) in the treatment of chronic osteomyelitis of rabbits. Methods Thirty healthy New Zealand white rabbits (4-6 months old; weighing, 2-3 kg) were selected to prepare the chronic osteomyelitis models. After 4 weeks, the gross observation, X-ray examination, and bacteriological and histopathological examinations were done; the models were made successfully in 27 rabbits. Of 27 rabbits, 24 were randomly divided into 4 groups (n=6): only debridement was performed in group A; ceftazidime was given (90 mg/kg), twice a day for 8 weeks after debridement in group B; ceftazidime and n-HA/β-TC were implanted after debridement in group C; and CLC and n-HA/β-TCP were implanted after debridement in group D. Before and after treatments, X-ray examination was done, and Norden score was recorded. At 8 weeks after treatment, the specimens were harvested for gross observation and for gross bone pathological score (GBPS) using Rissing standard; half of the specimens was used for histological observation and Smeltzer scoring, the other half for bacteriological examination and calculation of the positive rate of bacteria culture. Results At 8 weeks after treatment, Norden score of group D was significantly lower than that of groups A, B, and C (P lt; 0.05), but no significant difference was found among groups A, B, and C (P gt; 0.05). At 8 weeks after treatment, sinus healed in groups C and D, but sinus was observed in groups A and B; the GBPS scores of groups C and D were significantly lower than those of groups A and B (P lt; 0.05). The Smeltzer scores of groups C and D were significantly lower than those of groups A and B (P lt; 0.05). The positive rates of bacteria culture of groups C (0) and D (0) were significantly lower than those of group A (25.0%) and group B (16.7%) (P lt; 0.05). Conclusion CLC combined with n-HA/β-TCP has good effect in treating chronic osteomyelitis of rabbits, and it has better effect in treating chronic osteomyelitis of rabbits than ceftazidime with n-HA/β-TCP.