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Objective To discuss the risk factors of iliaofemoral vein restenosis after percutaneous recanalization of post-thrombotic occlusion.Method From March 2006 to December 2014,44 limbs in 41 patients with chronic post-thrombotic iliaofemoral vein occlusion underwent endovascular treatment in our hospital.Post-operative patency was evaluated by ultrasonography and anterograde veinography.Results Initial technical success was 90.2％ (37/41).During the follow-up,5 cases of reobstruction were determined,2 were caused by insufficient stent extension into the inferior vena cave.Failure in two cases of intra-stent thrombosis were found due to arbitrary discontinuity of oral anticoagulative therapy.Moreover,2 of 9 cases with venous ulcers in lower extremities were exacerbated after failure of endovascular treatment,we therefore performed surgical ligation and endovenous laser treatment of circumambient perforating veins.Conclusion Insufficient lesion cover,not enough extension to interior vena cave and unreasonable post-operative anticoagulation discontinuity are major causes of intra-stent reobstruction in iliaofemoral venous occlusion.
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Objective To discuss the therapeutic effect in the treatment of the acute limb arterial critical ischemia.Methods Collect thirty-nine cases of acute limb arterial critical ischemia in Renji Hospital from Janary 2014 to July 2016.According to the patients' manifestation,these operations were porfermed including thrombectomy,cathetery-directed thrombolysis,mechanical suction bolt,percutaneous angioplasty and stenting.The effect and complications were observed.Results The eighteen patients in 39 cases (46.2％) were dead,including 5 cases without operation,13 operation.The eight cases were amputated during 34 cases of operations.In the 21 out-patients safely,2 cases were not followed up.The time of follow-up was from 3 to 27 months,on average 14.3 months.During the 21 patients,5 cases died from heart cerebrovascular or tumor diseases,3 cases with footdrop,2 cases with toe amputations,3 cases with distal leg and foot anesthesias.Conclusions The patiens with acute limb arteries critical ischemia must be treated as early as,and reinforced the management of multiple organ function,which may improve the diseases' therapeutic effect.
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Objective To investigate the relationship between carotid artery plaque formation and blood pressure(BP),pulse pressure(PP),mean blood pressure(MBP) in elderly men.Methods A total of 1461elderly men were divided into carotid artery plaque group(n =1012)and non-carotid artery plaque group(n =449) according to vascular ultrasound examination.Systolic blood pressure(SBP) and diastolic blood pressure(DBP) were recorded by 24-hour ambulatory blood pressure monitoring(ABPM),at the same time pulse pressure (PP)and mean arterial blood pressure(MBP)were calculated.The relationship between carotid artery plaque formation and SBP,DBP,PP,MBP were analyzed.Results The age in carotid artery plaque group was significantly higher than that in non-carotid artery plaque group[(80.5±5.4) years old vs(77.3±5.9) years old,t =-4.233,P ＜ 0.01];The levels of SBP,PP and M BP in artery plaque group were significantly higher than those in non-carotid artery plaque group[SBP:(132.2±17.0) mm Hg vs(127.5±16.0) mm Hg,t =-4.893,P ＜ 0.001; PP:(60.8±13.4) mm Hg vs(55.9±12.5) mm Hg,t =-5.021,P ＜0.001) ;MBP:(92.6±10.3)mm Hg vs(91.0±9.9)mm Hg,t =-3.897,P ＜ 0.01].The incidence of carotid artery plaque was closely related to age(OR =1.061,P =0.0001),myocardial infarction(OR =1.896,P =0.0135),hypertension grades(OR =1.177,P =0.0019),high cholesterol(OR =1.353,P =0.0335),reduced systolic function(OR =2.466,P =0.0001),lower extremity arterial plaque(OR =5.453,P =0.0001).Conclusion In elderly men,formation of the carotid artery plaque is closely related to increased SBP,PP and MBP,but independent to DBP.
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Objective , To investigate the influence of blood pressure variability on cerebral infarction in older men. Methods Ambulatory blood pressure was measured in 1527 elderly men ( older than 65 yrs) with atherosclerosis. All cases were divided into 2 groups: Six hundred and seven patients with cerebral infarction ( group A)and 920 patients without cerebral infarction ( group B). Smooth curve method was used to analyze each patient's ambulatory blood pressure data and the trend of each patient's blood pressure curve was portrayed. The differences between the actual blood pressure and the blood pressure on the curve was defined as blood pressure variability,and the blood pressure variability between the 2 groups was compared. Results The systolic blood pressure variability in 24 hours in group A was significantly higher than that in group B( [8.4'±2. 2]mm Hg vs [ 8.0 ± 2. 0 ] mm Hg, P ＜ 0. 01 ), especially for the systolic blood pressure variability in daytime( [ 8. 2 ± 2. 2 ] mm Hg vs [ 7. 8 ± 2. 1 ] mm Hg, P ＜ 0. 01 ). However, the systolic blood pressure variability at night was not significantly different between the 2 groups( [ 8.9 ± 3. 9 ] mm Hg vs [ 8. 7 ± 3.7 ] mm Hg,P ＞ 0. 05 ). There were no significant difference between the diastolic blood pressure of 24 hours( [5. 5 ± 3.8 ] mm Hg vs [5.5 ± 1.5 ]mm Hg,P ＞0. 05),during daytime([5.4 ± 1.5]mm Hg vs [5.3 ± 1.4] mm Hg,P ＞0.05)and nighttime ( [ 6. 1 ± 2.7 ] mm Hg vs [ 6. 1 ± 2. 6 ] mm Hg, P ＞ 0. 05 ). Conclusion In elderly men with atherosclerosis,cerebral infarction was closely related to systolic blood pressure variability,but independent of nighttime systolic blood pressure and diastolic blood pressure variability.
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Objective To explore the relationship between pulse pressure (PP) and artery atherosclerosis in elders. Methods Totally 2358 eiders( > 60y) with the risk factors of artery atherosclerosis from Yangpu District DOI:10.3760/cma.j.issn.1008-6315.2009.09.006Central Hospital and 11 Community Health Service Centers were enrolled . The basic information includes age, sex, height,body mass, history of smoking, blood pressure, heart rate, history of coronary heart disease, ischemic stoke, chronic kidney diseases and diabetes,etc. The fasting blood sugar(FBS) ,blood lipid( total cholesterel,triglyceride, low-density lipreprotein, high-deusity liproprotein), serum creatinine, serum uric acid, serum alanine aminotransferase were measured. The elders were divided into two groups according to the PP( PP <60 mm Hg and PP≥60 mm Hg) to analyse the relationship between PP and age, BMI, SBP, DBP, HR, FBS, TC, TG, LDL-C, HDL-C, Cr, Ccr, UA, AST and history of coronary heart disease,ischemic stoke,chronic renal disease, and diabetes. Results Serum levels of FBS,TC,TG, LDL-C, UA in the group with PP less than 60 nun Hg were ( 5.6±1.7 ) mmol/L, (4.3±1.3 ) mmol/L, ( 1.5±1.2) mmol/L, ( 2.5±1.1 ) mmol/L, UA ( 246.8±131.2 ) μmol/L, that in the group with PP over or equal to 60 mm Hg group were (6.3±2.6) mmol/L, (4.8±1.2) mmol/L, ( 1.9±1.1 ) mmol/L, (2.9±1.2) mmol/L, (291.4±133.6) μmol/L, Serum levels of FBS, TC, TG, LDL-C, UA in the group with PP over 60 mm Hg were obviously elevated as compared with that in the group with PP lower than 60 ram Hg(P <0.01 ) ; The preven-lence rates of coronary heart disease ischemic stoke,chronic,renal disease, diabetes in the group with PP less than 60 mm Hg were 10.8% ,26.0%, 12.4%, 17.6%, that in the group with PP over or equal to 60 mm Hg group were 17.8% 、31.7% ,16.9% ,23.8% (P <0.01 ). The preveulence of coronary heart disease ischemic stoke,chronic re-nal disease, diabetes were significandy increased in the group with PP over or equal to 60 mm Hg group. Logistic re-gression analysis showed PP was closely related to FBS, BMI, age, LDL-C, UA, HDL-C ( β = 0.103,0.093.0.097, 0.089 ,0.076 , - 0.057, P < 0.05 ). Conclusions For those elders with the basis of artery atherosclerosis, high PP can inhance the development of artery atheresclerosis and also inhance the occurance and development of cardio-ce-rebrovascular and renal diseases.
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Objective To investigate the relationship between type-2 diabetes mellitus and artery atherosclerosis(AS) in the elderly. MethodsThe clinical data of 277 elders,who were admitted in hospital between April 2005 and September 2007, were retrospectively analyzed. These elders were divided into four groups: type 2 diabetes with carotid atherosclerosis (CAS) group (group A, n=119), type 2 diabetes without CAS group (group B, n= 30), non-diabetic with CAS group (group C, n=32), non-diabetic without CAS group (group D, n=96). The correlation between carotid artery plaque and related factors were studied. Results① Compared with group C,fasting blood glucose[(7.14±2.49) mmol/L vs. (5.21±0.87) mmol/L], triglycefide [(1.41±0.78) mmol/L vs. (0.95±0.39) mmol/L],left and right common carotid artery IMT [(0.85±0.11) nun vs. (0.79±0.08) mm, (0.85±0.11)mm vs. (0.78±0.09)mm] and PI [(1.37±1.16) vs. (0.50±0.80)] of group A were significantly increased, while high density lipoprotein [(1.29±0.32) mmol/L vs. (1.58±0.45) mmol/L] is significantly decreased(P=0.01). ②Compared with group B, left and right common carotid artery IMT [(0.85±0.11) mm vs. (0.80±0.11)mm,(0.85±0.11)mm vs. (0.80±0.12)mm,PI[(1.37±1.16) vs. (0.00±0.00)]and incidence of stroke 34.5% (41/119) vs. 13.3% (4/30) of group A are significantly increased (P<0.05 or P<0.01). ③Carotid artery plaque was positively correlated with history of diabetes(r=0.051, P<0.01),hypertension(r= 0.169,P<0.01),coronary heart disease (r=0.109,P<0.05),stroke(r=0.136,P<0.05),fatty liver(r= 0.340,P<0.01),FBG(r=0.339,P<0.01),TG(r=0.195,P<0.01),APOB (r=0.152,P<0.05),but negatively correlated with HDL-C (r=-0.143, P<0.05). Conclusion The risk of AS is higher in elderly patients with type 2 diabetes than that of non-diabetes. The incidence of stroke is higher in type 2 diabetes with AS than those of type 2 diabetes without AS. Carotid artery plaque is positively correlated with diabetes, hypertension, history of coronary heart disease, history of stroke, fatty liver, FBG, TG, ApoB, but negatively correlated with HDL-C.