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Objective:To evaluate the safety and efficacy at 1-year follow-up of the use of drug-coated balloon (DCB) for the treatment of femoropopliteal in-stent restenosis (ISR).Methods:This study enrolled 252 patients undergoing Orchid DCB angioplasty for peripheral arterial disease in the femoral-popliteal segment. The clinical data were retrospectively analyzed.Results:Forty-nine patients were eligible, including 29 (59.2%) chronic total occlusions belonging to TransAtlantic Inter-Society Consensus-Ⅱ(TASC Ⅱ) D, 7 (14.3%) thrombosis, and 14 (28.6%) moderate to severe calcifications. The mean lesion length was (215.9±97.1) mm. 69.4% were of occlusive lesions (Tosaka Ⅲ category). Only 1 provisional stent was implanted. 98% patients had severe claudication or even worse. Of these cases, 34 (73.9%) showed improvements in Rutherford category, while 11 (23.9%) did not change and 1 (2.2%) case deteriorated. The average value of ABI was 0.478±0.264 before surgery and 0.907±0.207 at the end of follow-up. The improvement in Rutherford category ( P<0.01) and ABI ( P<0.005) were both significant. The primary patency (PP) was 80.4%, and the freedom from clinically driven TLR was 84.8% at 1 year. During the follow-up period, there was no all-cause death and major limb amputation. Conclusion:This multicenter study demonstrated the effectiveness of DCB as a treatment for complicated and extensive ISR lesions within 12 months.
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Objective To investigate the effect of catheter-based peripheral sympathetic denervation (CPSD) on peripheral artery sympathetic tone of New Zealand rabbits.Methods Twenty New Zealand rabbits were randomly divided into CPSD group and control group (each n =10).Endovascular radiofrequency ablation above the bifurcation of the abdominal aorta was performed on the rabbits in CPSD group.Norepinephrine was infused with continuous trans-arterial pumping in both two groups.And laser Doppler flowmetry was used to measure the peripheral microperfusion and temperature of right hindlimb of rabbits.The changes of the peripheral microperfusion and temperature before (resting state) and after norepinephrine infused (norepinephrine load state) were compared between the two groups.Results Eight rabbits completed the procedure in each group.The change of peripheral microperfusion between resting and norepinephrine load states in CSPD group was lower than that in control group ([-37.19±22.56]％ vs [-57.02％±10.12]％,P=0.04),whereas the change of temperature was not significantly different between the two groups ([0.35±0.50]℃ vs [-0.21± 1.83]℃,P=0.43),while significant difference was noticed when two rabbits with abnormal temperature change in control group were neglected ([0.34± 0.50] ℃ vs [-1.14 ±0.72] ℃,P＜0.01).Conclusion CPSD can be used to decrease the peripheral artery sympathetic tone of New Zealand rabbits,and may play an important role in relieving symptoms of critical limb ischemia.
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Objective To investigate the effectiveness of endovascular technique in treatment of acute arterial hemorrhage of abdominal organs.Methods Totally 159 cases (145 patients) acute arterial hemorrhage of abdominal organs were enrolled.All patients underwent emergency transarterial angiography.Endovascular treatment by spring coil,gelatin sponge,or covered stent were in 40 cases.The success rate of immediate and long-term hemostasis was judged by the postoperative radiography,symptoms and the changes of vital signs and laboratory results.Results The positive signs in angiography were observed in 47 among the total 159 cases (47/159,29.56％).Seventy-seven postoperative hemorrhage cases underwent angiography and 29 cases (29/77,37.66 ％) were positive,82 non-operative hemorrhage cases underwent angiography and 18 cases (18/82,21.95％) were positive.The difference was statistical significant (P＜0.05).Endovascular treat ment were performed in 40 cases (33 by spring coils,4 by gelatin sponge and 3 by covered stent).Hemorrhages were con trolled immediately in all the 40 cases after embolization and the success rate were 100％.Conclusion Endovascular tech nique is minimal invasive,and it is an effective method for treatment of acute arterial hemorrhage in abdominal organs.
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Objective To understand effects of hyperthyroidism on glucose metabolism and its clinical significance.Methods 65 patients admitted in Xixi Street Community Health Center were divided into 3 groups according to their accompanying disease:group A,22 cases of hyperthyroidism accompanying with diabetes mellitus,group B,23 cases of diabetes,and group C,20 cases of hyperthyroidism.Group A and B were treated with intensive insulin therapy.Group B patients took oral methimazole or propylthiouracil.Group C patients were treated with conventional treatment of hyperthyroidism.All patients were treated for three weeks.Fasting plasma glucose (FPG) and postprandial 2h plasma glucose (2hBG),heart rate,serum triiodothyronine three (TT3),serum total thyroxine (TT4)and other indicators were recorded before and after treatment.Results After intensive insulin therapy,FPG and 2h BG of patients in group A and B were controlled in ideal range.After treatment,TT3 and TT4 decreased significantly faster than before treatment(P ＜ 0.05).Patients in group A needed more insulin than in group B to bring the blood glucose to the normal level(P ＜0.05),but after three weeks,patients in group A and group B needed similar dose of insulin.Patients in group A needed more time than patients in group B to bring down the blood glucose level.(P ＜ 0.05).In addition,change of heart rate in group A before and after treatment were greater than the other two groups,and patients' heart rate in group A returned to normal after three weeks of treatment.(P ＜ 0.05).Conclusions Thyroid hormones affects glucose metabolism.Diabetes complicated with hyperthyroidism mainly caused by patient's abnormal glucose metabolism and insulin resistance.Intensive insulin therapy for these patients can improve β cell function,lower blood glucose rapidly.Compared with diabetes patient without complication of hyperthyroidism,early intensive insulin therapy should be considered.