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Objective To report deep venous thrombosis (DVT) after greater saphenous vein ligation and stripping and to evaluate diagnosis,treatment and prophylaxis. Methods The clinical characteristics, diagnosis and treatment of 12 inpatients with postoperative DVT were analyzed retrospectively. Results Of these 12 cases there were 7 cases of central type DVT,2 cases of peripheral DVT,and 3 cases of mixed type DVT.Secondary pulmonary embolism was complicated in 2 cases.Clinical symptoms in these 10 cases of proximal DVT were all severe.Catheter-directed thrombolysis(CDT) through the ipsilateral popliteal vein with protective(IV)CF was applied for these 10 cases.Of 10 cases,femoral vein was found ligated in 1 case,which was repaired under open surgery. Residual greater saphenous vein thrombus extending into deep vein was proved and managed by successful thrombolectomy in one case.Cockett syndrome were found as the causes in the other 8 cases,6 cases were treated with balloon dilatation angioplasty and endovascular stenting of the iliac vein.The 2 cases of with distal DVT were treated by anticoagulation therapy.All patients were cured. Conclusions Cockett syndrome,femoral vein injury and too long residual greater saphenous vein are common causes of DVT after greater saphenous vein ligation and tripping.Careful selection of cases,correct diagnosis,standard operative manipulation,early ambulation were all important in the prevention of DVT after great saphenous vein varix procedure.
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Objective To evaluate the endovascular treatment of diffuse aortoiliac occlusive diseases. Methods Thirty-two patients underwent endovascular treatment in which rest pain was found in 84.38%, foot local gangrene in 15.62%. Mean age was 69.7 years (range, 52 years to 81 years) and 71.9% was male. Trans Atlantic Inter-Society Consensus C and D disease was respectively in 40.6% and 59.4% patients. Mean length of vasculopathy was (14.6 ± 1.2) cm (range, 4.5 cm to 19.5 cm) All patients had prohibitive risk for open revascularization. With the approach from femoral artery or brachial artery, combined techniques, such as recanahzation, balloon dilation, stent placement and concomitant common femoral endarterectomy were used. Results Technical success was achieved in twenty-nine patients(90.63%). The complication rate was 3.45%. Clinical status was markedly improved in eight cases (27.59%) and moderately improved in twenty-one cases(72.41%). Mean postoperative ABI was 0.73 ± 0.12, mean preoperative ABI was 0.32 ± 0.09. Significant differences were seen between postoperative ABI and preoperative ABI(P<0.05). Mean time of follow-up was (13.9±6.2) months. At 6 months, primary patency was 81.82% and secondary patency was 89.09%. At 12 months, primary patency was 63.64% and secondary patency was 80.18%. Conclusion Combined multiple endovascular technique is a safe and effective method in the treatment of poor risk diffuse aortoiliac occlusive diseases.
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Objective To study the treatment of multilevel atherosclerotic occlusive disease of the lower(extremity).Methods From March 2004 to January 2006,intraoperative iliac balloon angioplasty and stenting combined with simultaneous vascular bypass and profundoplasty were performed on 24 limbs in 21 patients(suffering) from lower extremity multilevel atherosclerotic occlusive disease.In 24 limbs iliac balloon angioplasty and stent placement were performed with simultaneous profundoplasty in 12 limbs and femoro-popliteal bypass in 14 limbs.Results Surgical procedures were technically successful in all patients.There were no severe postoperative morbidity or mortality.Before-operative vs postoperative ABI was 0.24?0.13 vs 0.63?(0.18)(P
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ObjectiveTo evaluate the effect of varicose vein of lower limbs treated by intravenous laser treatment .MethodIntravenous laser apparatus combin ation with operation was used to treat the varicose vein of the lower extremi ties in 98 patients(all 118 legs).The change of symptoms and signs were recorded and compared before and after operation by using venous ultrasonagraphy and pa thological examination to evaluate the treatment effect.ResultsIn the 84 followed up patieats (104 compromised legs),dull,heaviness were rel ieved completely after operation in 87 legs(83.7%),decreased in 11 legs(10.6%); skin pigmentation obviously decreased in 37 of 44 legs(84.1%);superficial varic ose vein disappeared in all the patients.No blood flow signal was detected in 10 1 legs(97.1%) and slow blood flow in 3 legs(2.9%) were detected by ultrasounogr aphy.Pathological examination revealed various degeneration and necrosis in ful l layers of the vessels;and smooth muscle cells were disrupted,cell nucleus bec ame pyknotic, the internal and external elastic laminar were ruptured and no inflammatory cell infiltration in the lumen and wall of the vessels were seen .ConclusionsIntravenous laser treatment is an ideal method in the treatment of varicose vein of lower extremities .