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Objectives To compare Doppler noninvasive vascular testing and computed tomographic angiography(CTA) with vascular angiography in the assessment of arteriosclerotic occlusion of the lower limbs. Methods In this study 97 lower extremities in 64 patients suffering from arteriosclerotic occlusion underwent both Doppler and CTA plus angiography. Angiogram results were taken as golden standard.The sensitivity and specificity of Doppler was calculated,the diagnostic accuracy of Doppler scanning and CTA plus angiography was calculated and compared.The statistic analysis was performed using x2 test in SPSS 16.0 format. Results Compared with CTA,Doppler scanning is equally accurate at the segments of iliac artery,common femoral artery,superficial femoral artery,dorsal pedis artery and posterior tibial artery (P ＞ 0.05).At segment of popliteal artery,Doppler scanning yields more accurate results (P ＜0.05 ). Conclusions Being noninvasive convenient and of good accuracy,Doppler examination has a role for the diagnosis of arteriosclerotic occlusion of the lower limbs.
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ObjectiveTo evaluate endovascular stenting for TASC TASC Ⅱ C/D femoropopliteal arterial disease.MethodsBetween January 2008 and June 2011,Endovascular treatments of 51 limbs TASC Ⅱ C/D femoropopliteal artery occlusions in 46 patients(27 male and 19 female) were retrospectively reviewed.Mean age was (70 ± 8 ) years ( range,52 years to 88 years).Severe intermittent claudication,rest pain,minor tissue defect and foot ulceration or gangrene were in 29 limbs,12 limbs,6 limbs and 4 limbs,respectively. Technical success rate,ankle brachial index (ABI),complication rate, and cumulative primary patency rate were evaluated. ResultsTechnical success rate was 90.2％.93 stents were placed in 46 limbs of the 42 patients.Postoperative ABI was increased in all patients.42 patients(46 lower limbs) were followed up for a mean period of 14.6 months.Primary,assisted-primary,and cumulative patency rates at 6 months were 81.0％,88.1％ and 90.5％.Primary,assisted-primary,and cumulative patency rates at 12 months were 66.7％,71.8％ and 79.5％ respectively. ConclusionsEndovascular treatment of TASC Ⅱ C/D femoropopliteal arterial lesions is microinvasive,safe and effective.
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Objectives To evaluate the safety and efficacy of endovascular angioplasty for extracranial vertebral artery ( VA ) stenosis caused by atherosclerosis. Methods We analyzed retrospectively data of the 24 patients with extracranial vertebral artery stenosis who had been placed endovascular angioplasty from April 2006 to March 2010. According to Mori classification, there were 21 type A and 3 type B among all cases.The artery stenosis rate was 60％ -95％ , the average was 79％ ± 10％. Results Twenty-four balloon mounted stents were placed, the successful rate was 100％. Postoperatively the stenosis rate decreased to 4％ ± 6％. Patients were followed up from 3 to 36 months, the average was 22 months. Symptomes disappeared in 15 out of 17 patients. Postoperative restenosis on the treatment site with transient brain ischemia occurred in one patient. The symptoms in another patient of multiple cerebral infarction with ataxia and episodic vertigo were not relieved, although the patient didn't suffer from apoplectic seizure after the intervention. Postoperative color Doppler ultrasound revealed an over 50％ residual stenosis in 5 patients. The postoperative restenosis rate was 20. 8％. According to Malek scoring, 22 patients were scored 1 point, 1 patient scored 2 and one scored 4. Conclusions Endovascular angioplasty with stent placement is a safe and effective treatment. The restenosis rate could be futher reduced by technology improvement.
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Objective To evaluate the safety and efficacy of endovascular intervention to revise peripheral bypass problems through prosthetic approach.Methods Among 17 cases undergoing graft bypass anastomotic stenosis and graft thrombosis was identifled in 16 cases(inflow or outflow obstructive lesions in 10),inflow obstructive lessions in 1(without anastomotic and graft thrombosis).All revision procedures were taken under local anesthesia,16 patients were treated by means of surgical thrombectomy followed by endovascular intervention through prosthesis itself in addition to one who had no thrombectomy.The graft patency and clinical outcome were observed.Resuits Thirteen stents were implanted in 13patients with distal anastomotic stenosis and 1 with proximal anastomotic stenosis including 10 stentings/PTAs in iliac popliteal,posterior tibial or anterior tibial arteries.One stent was implanted in 1 patient with common femoral stenosis.Stenting were not used(abandoned)in 2 patients,of which one underwent a foot amputation and calf gangrene occurred a week later,and the other had a redo of grafting.Follow-up time is 1-35 months.with an average of 12±4 months.One had a below-knee amputation two months after intervention,the other had symptoms recurred and treated with a redo 3 months afterwards.the third died of myocardial infarction six months later.Grafts remained patent in the rest 13 patients at follow-up.Conclusions Endovascular intervention through prosthesis is a safe and effective method,which offers an alternative means to treat anastomotic stenosis.inflow or outflow obstructive lesions.
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Objective To study the effect of rosiglitazone, a ligand of peroxisome proliferator-activated receptor gamma (PPAR?), on the expression of PPAR? in hepatic stellate cells (HSCs) and its effect on the biological characters of HSCs. Methods The activated HSCs were devided into three groups:control, 3??mol/L rosiglitazone group, and 10??mol/L rosiglitazone group. The expression of PPAR?, ?-smooth muscle actin(?-SMA), and type Ⅰ and Ⅲ collagen was detected by means of RT-PCR, Western blot and immunocytochemistry respectively. The cell proliferation was determined with MTT colorimetric assay. The cell apoptosis was demonstrated with flow cytometry. Results The expression of PPAR? at mRNA and protein level markedly increased in HSCs of 10??mol/L rosiglitazone group(t≥4.627, P