6 research outputs found
Systematic review and network meta-analysis of pre-emptive embolization of the aneurysm sac side branches and aneurysm sac coil embolization to improve the outcomes of endovascular aneurysm repair
ObjectivePrevious reports have revealed a high incidence of type II endoleak (T2EL) after endovascular aneurysm repair (EVAR). The incidence of T2EL after EVAR is reduced by pre-emptive embolization of aneurysm sac side branches (ASSB) and aneurysm sac coil embolization (ASCE). This study aimed to investigate whether different preventive interventions for T2EL were correlated with suppression of aneurysm sac expansion and reduction of the re-intervention rate.MethodsThe PubMed, Web of Science, MEDLINE and Embase databases, and conference proceedings were searched to identify articles on EVAR with or without embolization. The study was developed in line with the Participants, Interventions, Comparisons, Outcomes, and Study design principles and was conducted and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. We used network meta-analysis based on multivariate random-effects meta-analysis to indirectly compare outcomes of different strategies for embolization during EVAR.ResultsA total of 31 studies met all inclusion criteria and were included in the qualitative and quantitative syntheses. The included studies were published between 2001 and 2022 and analyzed a total of 18,542 patients, including 1,882 patients who received prophylactic embolization treatment during EVAR (experimental group) and 16,660 who did not receive prophylactic embolization during EVAR (control group). The effect of pre-emptive embolization of the inferior mesenteric artery (IMA) (IMA-ASSB) in preventing T2EL was similar (relative risk [RR] 1.01, 95% confidence interval [CI] 0.38–2.63) to the effects of non-selective embolization of ASSB (NS-ASSB) and ASCE (RR 0.88, 95% CI 0.40–1.96). IMA-ASSB showed a better clinical effect in suppressing the aneurysm sac expansion (RR 0.27, 95% CI 0.09–2.25 compared with NS-ASSB; RR 0.93, 95% CI 0.16–5.56 compared with ASCE) and reducing the re-intervention rate (RR 0.34, 95% CI 0.08–1.53 compared with NS-ASSB; RR 0.66, 95% CI 0.19–2.22 compared with ASCE). All prophylactic embolization strategies improved the clinical outcomes of EVAR.ConclusionProphylactic embolization during EVAR effectively prevents T2EL, suppresses the aneurysm sac expansion, and reduces the re-intervention rate. IMA embolization demonstrated benefits in achieving long-term aneurysm sac stability and lowering the risk of secondary surgery. NS-ASSB more effectively reduces the incidence of T2EL, while IMA embolization alone or in combination with ASCE enhances the clinical benefits of EVAR. In addition, as network meta-analysis is still an indirect method based on a refinement of existing data, more studies and evidence are still needed in the future to establish more credible conclusions
Adsorption of Berberine Hydrochloride, Ligustrazine Hydrochloride, Colchicine, and Matrine Alkaloids on Macroporous Resins
This research aims at identifying
suitable resin adsorbents for
efficient separation and purification of alkaloids from plant materials.
The adsorption properties (equilibrium, kinetics, and column breakthrough)
of four alkaloid model compounds (berberine hydrochloride, ligustrazine
hydrochloride, colchicine, and matrine) on selected macroporous resins
were studied. The adsorption equilibrium capacities and desorption
ratios of the four model compounds on nine different macroporous resins
were measured and compared. It was observed that the resins with a
low polarity and high surface area offered a high adsorption capacity
for all alkaloids. The pseudo-second-order adsorption rate equation
fit well all the kinetic data, and the Langmuir and Freundlich isotherm
equations correlate well the adsorption isotherms on the four resins.
Among the nine resins studied in this work, the HPD300 resin was identified
as the most promising adsorbent for alkaloids separation and purification
because of its excellent adsorption and desorption properties for
all four alkaloid compounds. The adsorption breakthrough experiment
on the HPD300 resin using a mixture solution containing all four model
compounds further confirmed the effective separation of alkaloids
on the HPD300 resin