Value of computed tomographic venography in the diagnosis of iliac vein stenosis or occlusion / 中华普通外科杂志

Objective To evaluate computed tomography venography (CTV) in diagnosis of iliac vein stenosis or occlusion.Methods From Jun 2015 to Jun 2017,168 CVD patients with CEAP clinically graded at 4 to 6 underwent evaluation with digital subtraction angiography (DSA) CTV and colour Doppler ultrasound.Taking DSA as standard,the diagnostic value of CTV and colour Doppler ultrasound were analyzed and compared.Results DSA established diagnosis of 95 cases,compared with DSA,CTV's and colour Doppler ultrasound's sensitivity,specificity,positive likelihood ratio and negative likelihood ratio was 87.4％ and 64.2％,94.5％ and 98.6％,15.89 and 45.86 and 0.13 and 0.36.Compared with colour Doppler ultrasound,CTV's sensitivity was significantly higher (P ＜ 0.05,the 95 ％ confidence intervals were 0.764-14.257),and there was no significant difference between them in aspect of specificity (P =0.375,the 95％ confidence intervals were 0.943-0.986),Kappa value was 0.809(P ＜0.05,the 95％ confidence intervals were 0.714-0.893),0.597 (P ＜ 0.05,the 95％ confidence intervals were 0.464-0.717).Conclusion In the diagnosis of CVD combined with iliac and femoral venous stenosis,CTV has outstanding sensitivity,specificity,and good conformancy with that of DSA.

Effect of rivaroxaban on HIF-α, P-selectin and TNF-αin patients with lower extremity venous thrombosis / 中国生化药物杂志

Objective To investigate the effect of rivaroxaban on HIF-α, P-selectin and TNF-αin patients with lower extremity venous thrombosis.Methods 41 cases from May 2014 to February 2015 were selected and randomly divided into two groups, 21 cases in the control group were treated by routine treatment, 20 cases in the experiment group were treated on the base of the control group with ivaroxaban.Serum HIF-α, P-selectin and TNF-αwere detected before and after the treatment.ResuIts Compared with the control group, the clinical effect were higher ( P0.05).HIF-α, P-selectin and TNF-αwere lower(P<0.05),HIF-αwas positively correlated with TNF-α(r =-0.468,P<0.05), and was not correlated with P-selectin, P-selectin was not associated with TNF-α.ConcIusion Rivaroxaban can effectively improve the lower limb venous thrombosis in patients with clinical symptoms, reduce serum HIF-α, P-selectin and TNF-αexpression, has better clinical curative effect, for clinical treatment of lower limb venous thrombosis has important significance.

Catheter directed thrombolysis treatment of acute lower extremity deep venous thrombosis of the clinical problem analysis / 中国医师进修杂志

Objective To discuss and analyze the issue in the catheter directed thrombolysis(CDT) treatment of acute lower extremity deep venous thrombosis.Methods The clinical data of 182 cases of acute lower extremity deep venous thrombosis from January 2011 to January 2013 which were treated by CDT were retrospectively analyzed,and the issues in these treatment were discussed and analyzed.Results The effect were classified into three degrees.Thrombosis clearance exceed 95 percent belonged to the first degree,among 50 percent and 95 percent belonged to the second degree,and below 50 percent belonged to the third degree.In this study,the respective number of each degree were 93/68/21.Sixty-one cases combined iliac venous compression syndrome were treated by stent.Twenty-two cases were treated with inferior vena cava filter.All the patients were followed up 10 months,148 cases of them maintained patency.Conclusions The effect of CDT treatment to acute lower extremity deep venous thrombosis is remarkable,meanwhile the patency is improved and the deep vein thrombosis were decreased through this method.But the issues of access,filter and iliac venous compression syndrome should also be considered.