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Objective:To evaluate the diagnostic evaluation process and the effectiveness and safety of intracavitary therapy for pelvic congestion syndrome (PCS).Methods:A retrospective analysis was conducted on 38 patients admitted to Beijing Shijitan Hospital affiliated to Capital Medical University from March 2019 to February 2022. Combined with the patient′s symptoms, PCS was diagnosed by color Doppler ultrasound, computed tomography venography (CTV), and venography. The ovarian vein was embolized with controllable spring coil and polydocanol foam sclerosing agent. The patients were followed up 1, 3 and 6 months after operation.Results:The total surgical success rate of 38 patients was 100%, and the incidence of complications was 5.3%(2/38); Spring coils (2.8±0.3)per person; The dosage of hardener was (7.0±2.1)ml/person. The improvement rate of patient symptoms was 97.4%(37/38); After 1, 3, and 6 months of surgery, color Doppler ultrasound was reexamined and no recanalization was observed in the embolized ovarian veins; The diameter of the parauterine vein was (2.8±0.5)mm, which was significantly lower than the preoperative (7.5±1.9)mm ( P<0.05); The Visual Analogue Scale (VAS) score was significantly lower than the preoperative score [(2.12±1.87)points vs (7.58±0.82)points, P<0.001]. Conclusions:Process based assessment is helpful in identifying and diagnosing PCS patients who urgently need treatment; Endovascular treatment based on embolization of ovarian vein with controllable spring coil and foam sclerosing agent is minimally invasive, safe and effective.
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Objective:To evaluate the role of Angiojet thrombus clearance device in the treatment of dialysis access thrombosis.Methods:The clinical data of 37 patients with Angiojet thrombus clearance due to hemodialysis thrombosis from May 2019 to May 2021 were retrospectively analyzed.Results:The clinical success rate was 100%, the mean operation time was (42±21) minutes. The time of aspiration was (35±18) s, and the average length of occlusion was (8±5) cm. All patients were treated with balloon dilation after aspiration. The average postoperative dialysis flow was (270±15) ml/min. The mean length of stay was (2.0±1.5) days. There were no surgically related deaths, no vascular rupture or bleeding, no major complications. Dilated local pseudoaneurysm formation was observed in 5 patients after dilation by angiography without special treatment. The mean follow-up time was 11 months. The primary patency rate was 85% and the secondary patency rate was 87% at 6 months post operatively.Conclusion:Angiojet thrombus removal device has the advantages of minimally invasive, short operation time and repeatability.
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Objective:To observe the clinical effect of TurboHawk plaque excision system combined with drug-coated balloon in the treatment of femoral popliteal artery in-stent restenosis.Methods:The clinical and follow-up data of 13 patients with femoral popliteal artery in-stent restenosis were retrospectively analyzed, ankle-brachial index (ABI) and lower extremity artery CTA before and after surgery were recorded.Results:Surgery was successful in all the 13 patients.There was perioperative death, no major complications. One patient underwent salvage stent implantation due to residual stenosis of more than 30% in the proximal end of the stent after rotary cutting and expansion . The average postoperative ABI was (0.90±0.08), significantly higher than that before the operation ( P<0.05). All patients were followed-up for mean 16.4 months, One patient died of acute heart failure after 13 months, one of the lower extremity vascular CTA confirmed in-stent restenosis was treated by drug-coated balloon. The primary patency rate was 84.6% at one year. Conclusion:The mid-term results of directional atherectomy system combined with drug-coated balloon in the treatment of femoral artery in-stent restenosis is satisfactory.
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Objective To prospectively study the changes of venous blood before and after travel by high speed train.Method From December 2013 to August 2015,following the appropriate inclusion and exclusion criteria,50 volunteers and 20 high speed rail crew member were recruited.Blood samples were collected,and lower extremity venous ultrasound was performed in general information,and recorded activities (including walking distance,number of steps,etc.) and drinking water volume,before and after travel.Results After 5 hours in the train,in all the participants venous blood coagulation indicators were on the rise.Doppler ultrasound examination showed:the lower extremity venous diameter increased,the venous return slowed down,the leg circumference diameter increased (all P ＜ 0.05).High speed rail crew had increased leg circumference (P ＜ 0.05).Conclusion 5 hours high-speed train travelling increases the likelihood of economy class syndrome.High speed rail crew working 10 hrs are with increased circumference of the lower extremity veins.
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Objective To evaluate the predicting risk factors for fatal pulmonary embolism (PE) in patients with acute deep venous thrombosis of the lower limbs.Methods 182 consecutive patients with acute deep vein thrombosis in the lower limbs were retrieved from our hospital between January 2011 and May 2015.Collected clinical data for all patients included,demographic,body mass index,Wells score.The possible risk factors in patients with PE were retrospectively analyzed.Results The total incidence rate of symptomatic PE in 182 patients was 14.28％.Through muhivariate logistic regression analysis,we found that Wells score,location of thrombosis,inpatient days,bone fracture was significantly associated with symptomatic PE (P ＜ 0.05).Conclusion Higher Wells score,Proximal thrombosis and fracture are the high risk factors related with symptomatic PE.
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Objective To evaluate the safety and efficacy of preparatory catheter-directed thrombolysis together with assisted endovascular angioplasty in treating chronic occlusive arterial disorders of lower extrenities under the second time window principle for thrombolysis.Methods From Jan 2001 to Dec 2014,preparatory catheter-directed thrombolysis together with assisted endovascular angioplasty was performed in 206 patients with chronic occlusive arterial disorders of lower extremities.All the patients had a history of chronic ischemia of lower limb for an average of (20 ± 9) months (3-60 months).Anklebrachial index (ABI) was 0.00-0.65 with a mean of (0.33 ± 0.22).Results The mean time of thrombolysis was 72 hours (within a range of 24-120 h).The D-dimer level multiplied next day after thrombolysis.The occluded length of the diseased arteries before the treatment was 60-180 mm,with a mean of (90 ± 27) mm.After catheter-directed thrombolysis,the occluded length decreased to 20-60 mm [mean of (40 ± 15) mm].Thrombolysis was effective in 192 patients (92％).Endovascular angioplasty was successfully completed in all patients after thrombolysis therapy.Postoperative ABI was 0.64-1.0 [mean of (0.86 ± 0.11)].During the perioperative period no complications nor death occurred.Conclusions Under the guidance of the second time window principle for thrombolysis,preparatory catheterdirected thrombolysis together with assisted endovascular angioplasty is an effective and safe treatment for chronic occlusive arterial disorders of the lower extremities.
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Objective To prospectively study the changes of venous blood before and after travel by high speed train.Method From December 2013 to August 2015,following the appropriate inclusion and exclusion criteria,50 volunteers and 20 high speed rail crew member were recruited.Blood samples were collected,and lower extremity venous ultrasound was performed in general information,and recorded activities (including walking distance,number of steps,etc.) and drinking water volume,before and after travel.Results After 5 hours in the train,in all the participants venous blood coagulation indicators were on the rise.Doppler ultrasound examination showed:the lower extremity venous diameter increased,the venous return slowed down,the leg circumference diameter increased (all P ＜ 0.05).High speed rail crew had increased leg circumference (P ＜ 0.05).Conclusion 5 hours high-speed train travelling increases the likelihood of economy class syndrome.High speed rail crew working 10 hrs are with increased circumference of the lower extremity veins.
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Objective To analyze the risk factors of restenosis after renal artery endovascular treatment in patients with Takayasu arteritis.Methods In this study,39 patients with Takayasu arteritis underwent endovascular therapy from January 2003 to March 2014.Univariate and multivariate logistic regression analysis were used to analyze the risk factors relating to restenosis.Results There were 13 males and 26 females.The mean age was (27 ± 11) years.Seventeen unilateral and 22 bilateral renal artery stenosis were treated.A total of 54 endovascular procedures were successfully performed including 23 cases of unilateral percutaneous transluminal angioplasty (PTA),14 cases of unilateral stent implantation,12 cases of bilateral PTA,and 5 cases of bilateral stent implantation.The mean follow-up was (48 ±34) months,the restenosis rate was 38.9％ (21.54) and the mean time of restenosis was (11.5 ± 2.3) months.Elevated erythrocyte sedimentation rate (ESR) (OR =6.624,95 ％ CI:1.222-35.902) was independent risk factors for restenosis.Antiplatelet therapy (OR =0.158,95％ CI:0.028-0.887) and glucocorticoids or i mmunosuppressive therapy (OR =0.035,95 ％ CI:0.003-0.349) were protection factors against renal artery restenosis.Conclusion The elevated ESR increases the risk of restenosis after endovascular treatment in Takayasu arteritis associated renal artery stenosis.Antiplatelet therapy and glucocorticoids or immunosuppressive therapy were protection factors for renal artery restenosis.
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Restenosis following vascular revascularization remains an important clinical problem. Local drug delivery which can provide enough drug concentration in the lesion location without causing adverse systemic effect is an excellent solution for this question. We conducted a systematic literatory search on PubMed and CKNI through May 2014. After reviewing all related papers, we provided a comprehensive overview of the available drugs and techniques for local drug delivery that have been developed to prevent restenosis after peripheral vascular interventions, including innovations that have been tested only in animals as well as those already approved for clinical use. In brief, anti-proliferative drugs such as paclitaxel and sirolimus are the most used and suitable drugs for local delivery system. Additionally, some promising drugs including anti-inflammatory drugs, antioxidant drugs and drugs inhibiting cell proliferation and migration are already being tested in pre-clinical trials or animal models. At the same time, intraluminal and extraluminal delivery devices have also got a rapid development during the past decades. The efficacy of drug-eluting stent, drug-eluting balloon, porous and microporous balloon and the most recent drug-eluting bioresobable scaffold for preventing of restenosis in peripheral vessels have been demonstrated in humans or in animals, some of them even have received the CE mark in Europe. Endovascular microinfusion catheter and drug-loaded perivascular wraps have only been tested in animal models, more researches are needed. With the development of pharmacology and bioengineering, great strides will be made in the prevention of restenosis in the near future.
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Animals , Humans , Anti-Inflammatory Agents , Antibiotics, Antineoplastic , Arteries , Coronary Restenosis , Drug Delivery Systems , Drug-Eluting Stents , Myocardial Revascularization , Paclitaxel , SirolimusABSTRACT
<p><b>OBJECTIVE</b>To identify the risk factors associated with the severity of pulmonary embolism among patients with deep venous thrombosis of lower extremities.</p><p><b>METHODS</b>This prospective study enrolled 208 patients with acute deep venous thrombosis to screen for pulmonary embolism between July 2010 and July 2012 in Beijing Shijitan Hospital. There were 101 male and 107 female patients, with a mean age of (59 ± 16) years. Gender, age, extension, side of lower extremities of deep venous thrombosis was analyzed by χ² test. Ordinal Logistic regression was used to determine risk factors associated with severity of pulmonary embolism.</p><p><b>RESULTS</b>There were 83 patients with iliofemoral deep venous thrombosis, 102 patients with femoropopliteal and 23 patients with calf deep venous thrombosis. Pulmonary embolism was detected in 70 patients with the incidence of 33.7%. Pulmonary embolism was significantly correlated with extension (χ² = 17.286, P = 0.004) and sides (χ² = 15.602, P = 0.008) of deep venous thrombosis, not with age (χ² = 7.099, P = 0.260), gender (χ² = 7.014, P = 0.067), thrombotic risk factors (χ² = 3.335, P = 0.345) in univariate analysis. Results of multivariate ordinal logistic regression showed that iliofemoral vein thrombosis (OR = 6.172, 95% CI: 1.590 to 23.975, P = 0.009) and bilateral venous thrombosis (OR = 7.140, 95% CI: 2.406 to 24.730, P = 0.001) are associated with more serious pulmonary embolism.</p><p><b>CONCLUSIONS</b>Incidence of pulmonary embolism is still high in patients with deep venous thrombosis. Extensive iliofemoral and bilateral vein thrombosis may increase risk of severity of pulmonary embolism. Clinicians should pay more attention to these high-risk patients.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Acute Disease , Incidence , Logistic Models , Lower Extremity , Pathology , Prospective Studies , Pulmonary Embolism , Diagnosis , Pathology , Risk Factors , Veins , Pathology , Venous Thrombosis , Diagnosis , PathologyABSTRACT
Objective The purpose of the experiment is to research the effects of different kind of anti-platelet drugs and their combinations in prevention of vascular restenosis after ballon-injury, and to evaluate the best way of clinical utility of anti-platelet drugs.Methods Fifty-six male New Zealand White Rabbits were randomly assigned to 3 groups: the control group (ML) , the model group (M) , the experimental group.The experimental group was divided to 5 subgroups, the aspirin group (A), the cilostazol group (B) , the clopidogrel group (C), the aspirin plus cilostazol group (A + B) , and the aspirin plus colopidogrel group (A + C).Femoral artery stenosis model was induced by halloon injury except the control group.The rabbits were fed different drugs 3 days before operation except the normal group and the model group.On the 14th day after operation, the rabbits were sacrificed and the iliofemoral arteries were removed and made to the pathological section.We measured the internal elastic lamina, external elastic lamiua and luminal areas measured.Then calculate the area of intima, media and the ratio of intima vs.media.Results ①There is no endothelium hyperplasia in control group.Compared with the control group, we observed endothelium hyperplasia in both model group and the experimental groups.Compared with the model group, endothelium hyperplasia in all experimental groups is in a lower degree;② Cilostazol alone works better than aspirin alone and clopidogrel alone in prevention of vascular restenosis after ballon-injury.Clopidogrel combined with aspirin and cilostazol combined with aspirin both work better than aspirin alone in prevention of vascular restenosis after ballon-injury.There is no apparent difference between the effect of clopidogrel combined with aspirin and cilostazol combined with aspirin.Conclusions ① Different anti-platelet drugs and different combinations of them can prevent the happening of vascular restenosis after ballon-injury.② Cilostazol works better than aspirin and clopidogrel in prevention the happening of vascular restenosis after ballon-injury, and combination of anti-platelet drugs which contains cilostazol works better than other way of combination of anti-platelet drugs.③ Cilostazol and combination of anti-platelet drugs which contains cilostazol is potential useful in clinical uses to prevent restenosis after PTA.
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Objective To investigate the distribution of femoro-popliteal artery chronic totally occlusions (CTO) and to analyze the influence of different risk factors on the distribution of lesions. Methods A total of 47 patients with CTA and DSA proved femoro-popliteal artery CTO, who were admitted to the Affiliated Beijing Shijitan Hospital of Capital Medical University during the period from January 2013 and May 2015, were enrolled in this study. In order to make a clear description about the distribution characteristics of the lesions, the superficial femoral artery was averagely divided into three segments (F1-F3), and the popliteal artery was also divided into three segments (P1-P3) according to the bony landmarks. Based on the CTA images (including 3D reconstruction images) and DSA images, the distribution of CTO lesions was determined. The factors that might influence the distribution of CTO lesions were collected, and the results were analyzed using multivariable logistic regression analysis. Results A total of 59 femoro-popliteal artery CTO lesions detected in 47 patients were included in this study. The average length of lesion segment was (12.91 ± 10.13) cm. According to the 6-section division method of femoro-popliteal artery, the lesions involved F1 (n=23), F2(n=34), F3(n=48), P1(n=18), P2(n=6) as well as P3(n=5) segments. Multivariable logistic regression analysis reveals that F1 segment was most prone to be affected by CTO lesions in patients with hypertension (RR=3.21) and in patients who had cigarette smoking habit (RR=1.76). In male patients, P1segment was more easil y involved by CTO lesions (RR=1.98). In patients with diabetes mellitus, the RR value was gradually increased from the proximal to the distal end of the blood vessel, indicating that the lesion was more likely to involve distal vessels. Conclusion The distributions of femoro-popliteal artery CTO lesions have certain characteristics, which are closely associated with femoro-popliteal artery hemodynamics and atherosclerosis risk factors.
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Objective To evaluate the effect and safety of ultrasound-guided pereutaneous thrombin injection for the treatment of iatrogenic femoral arterial pseudoaneurysm.Methods Thirty patients [6 male,24 female,age range 45-82 years,mean (63 ± 10) years] were found to have pseudoaneurysms confirmed by ultrasound between 1 and 7 days following femoral arterial puncture from July 2011 through July 2014.Results All patient had pseudoaneurysm thrombosis after the first procedure.Thrombin 200-1000 U (50 U/mL)was injected into the pseudoaneurysm under ultrasound-guidance,performed.One patient showed acute allergy 5 min after thrombin injection,which was relieved by anti-allergic therapy.No thromboembolic complications or infections occurred.Conclusions Ultrasound-guided pereutaneous thrombin injection is a safe and effective noninvasive method for the treatment of iatrogenic femoral pseudoaneurysm and should be considered as first-line therapy.
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<p><b>OBJECTIVE</b>To evaluate the corresponding influence on pulmonary embolism incidence between immobilization and exercise in different stage of thrombus after acute deep vein thrombosis in rabbits.</p><p><b>METHODS</b>Forty-eight New Zealand rabbits were randomly divided into three groups depending on the different organized stage of thrombus: the early, medium and later stage group.Each group was subdivided into two sub groups: the immobile and mobile subgroup. Rabbit modeling of deep vein thrombosis was made by ligating the right femoral vein. Among the early-stage group, rabbits of the immobile subgroup were fixed for 3 days, while that of the mobile subgroup were free to move for 3 days, then each was euthanized to extract the lungs for pathological examination. Among the medium-stage group, each of the immobile subgroup were fixed for 7 days, while the mobile subgroup ones were fixed for 3 days, then released free-moving for 4 days following the pathological extraction. Among the later-stage group, animals in the immobile subgroup were fixed for 14 days comparing the mobile subgroup fixed for 7 days and next free-moving for 7 days, then each was euthanized.</p><p><b>RESULTS</b>Among the early-stage group, pulmonary embolism incidence (PEI) of the immobile and mobile subgroup was 4/8 vs.3/8, the pulmonary lobe embolism incidence (PLEI) was 17.5% (7/40) vs. 15.0% (6/40). Among the medium-stage group, PEI of the immobile and mobile subgroup was 3/8 vs. 2/8, PLEI was 37.5% (7/40) vs. 25.0% (10/40). Among the later-stage group, PEI of the immobile and mobile subgroup was 3/8 vs. 3/8, PLEI was 12.5% (5/40) vs. 15.0% (6/40). There was no statistical difference between immobilization subgroup and mobilization subgroup among different stage group.</p><p><b>CONCLUSION</b>On the premise of given anticoagulation treatment, early ambulation do not significantly increase pulmonary embolism incidence after acute deep vein thrombosis of lower extremity in rabbits.</p>
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Animals , Rabbits , Disease Models, Animal , Immobilization , Lung , Pathology , Motor Activity , Pulmonary Embolism , Time Factors , Venous ThrombosisABSTRACT
Objective To evaluate glycemic control,complication and influence factors of glycosylated hemoglobin(HbA1c) in type 2 diabetic(T2DM) patients with hypertension in retired and veteran of military communities in Kunming.Methods Cross-sectional study was conducted and 216 T2DM patients with hypertension were enrolled in current study.A self-made questionnaire was used to collected information including age,course of the disease,complication,hypoglycemic agents and status of glucose controlling.The levels of HbA1 c,fasting blood-glucose (FBG),2h postprandial blood glucose (2hPBG),total cholesterol (TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol (LDL-C),Blood urea nitrogen(BUN),creatinine(Cr) and uric acid(UA) were measured.Relative factors of HbA1c were analyzed.Patients were divided into the standard (HbA1c ＜ 7％) and substandard groups (HbA1c ≥ 7％) according to the level of HbA1c,and divided into the oral-medication,insulin-treatment and oral medication combined insulin groups according to therapeutic regimens.Results The goal attainment rate of HbA1c(HbA1c ＜7％) in retired and veteran of military communities in Kunming was 44.9％ (97/216).The levels of FBG,postprandial plasma glucose(PPBS) and TG in standard group were (6.1 ± 1.2) mmol/L,(9.4 ± 1.8) mmol/L and (1.9 ± 1.3) mmol/L,significant different from those in substandard groups [(7.8 ± 1.6) mmol/L,(11.5 ±2.2) mmol/L and (2.4 ± 1.3) mmol/L],and the differences were significant (t =11.6,9.1,2.2; P ＜ 0.05 or P ＜ 0.01).Meanwhile,the rate of cardiovascular disease,cerebrovascular disease,proteinuria,peripheral neuropathy and retinopathy were 69.8％,34.5 ％,20.5％,20.5％,29.6％,respectively,significantly different between the standard and substandard groups (P ＜ 0.05).HbA1 c level was linear correlated with FBG (r =0.76,P ＜ 0.01),PBG (r =0.61,P ＜ 0.01),TG (r =0.24,P ＜ 0.05) and the frequency of glucose monitoring (r =-0.55,P ＜ 0.01).As the increasing of the stage of diabetes,the selected therapeutic regimen were oral anti-diabetic agents,followed by insulin and insulin combined oral antidiabetic agents.The levels of PBG and serum creatinine in patients with insulin monotherapy were higher than those in other groups (P ＜0.05).Conclusion The level of glucose controlling of retired and veteran of military communities in Kunming is better.The prevalence of diabetic chronic complications is higher in patients with poor glucose controlling.HbA1c level is correlated with FBG,PBG,TG and the frequency of glucose monitoring.Oral antidiabetic agents is the primary therapeutic regimen.
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Objective To explore the change of monocyte chemotactic factor-1 protein(MCP-1)and matrix metalloproteinase-9( MMP-9)of patients with coronary artery disease( CAD)following percutaneous coronary interventional( PCI). Methods Fifty patients underwent PCI procedures for CAD compromising a single coronary artery were selected as PCI group and 30 healthy individuals with normal findings by coronary angiography were selected as the control group. Plasma MCP-1 and MMP-9 were measured in all the subjects. Results The plasma MCP-1 level of patients with CAD after PCI was(19. 87 ± 5. 31)ng/ L,higher than that before operation((15. 71 ± 5. 23)ng/ L,t = 3. 95,P < 0. 01). Whereas in the control group,the MCP-1 level after coronary angiography was(13. 78 ± 5. 58)ng/ L,which was as same as that before operation (12. 42 ± 5. 39 ng/ L,P = 0. 34). Plasma MMP-9 level in the CAD patients after PCI procedures was(22. 69 ± 5. 97)mg/ L,higher than that before operation((19. 52 ± 5. 72)mg/ L,t = 2. 71,P < 0. 01). There was no significant difference in term of plasma MMP-9 level in control group befor and after operation((17. 53 ± 5. 51) mg/ L vs.(16. 69 ± 5. 42)mg/ L,P = 0. 55). Conclusion Plasma MCP-1 and MMP-9 increase in CAD patients following PCI procedures. But their roles in the vascular restenosis following the procedures need further investigation.
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Objective To study changes of serum enzymes among acute mesenteric vasculopathy (AMV) and several surgical acute abdomens for early diagnosis of acute mesenteric vasculopathy.Methods Rabbit models were established for acute mesenteric artery ischemia,acute mesenteric venous ischemia,acute mechanical ileus,acute strangulated intestinal obstruction,acute gastric perforation,acute pancreatitis,sham group,blank control group.Serum enzymes were tested after 0,1,3,6,9 h.Result Compared with blank control,acute mesenteric vasculopathy experienced significantly alterations of the serum enzymes.ALT (alanine aminotransferase),ALP (alkaline phosphatase),r-GT (glutamyl transferthe enzyme) were significantly higher after mesenteric veins blocked 3 hours,LDH (lactate dehydrogenase) was significantly higher after mesenteric venous blocked 6 hours (P ＜ 0.05).ALT was significantly higher after mesenteric artery blocked 6 hours (P ＜ 0.05).Elevated ALT were statistically different in acute mesenteric vasculopathy compared with blank control,sham group,gastric perforation,mechanical ileus,and strangulated intestinal obstruction (all P ＜ 0.05) ; r-GT level was statistically different between acute mesenteric artery ischemia and acute mesenteric venous ischemia.Conclusions Mesurements of serum enzymes level are helpful to make early diagnosis of acute mesenteric vasculopathy.
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Objectives To assess outcomes of endovascular treatment for critical limb ischemia in patients with TASC C and D femoropopliteal lesions.Methods Between January 2009 and January 2012,patients with critical limb ischemia for TASC Ⅱ C or D lesions underwent endovascular treatment.Patients demographic,pre-and post- procedure ABI,primary patency rate,limb salvage at 1,3,6,12,24 months were reviewed.Results There were 58 males,38 females, mean age was (76 ± 10 ) years,with Rutherford Ⅳ in 68 limbs,Ⅴ in 23 limbs,Ⅵ in 5 limbs.Successful rate of procedure for target lesions was 94.80％,angioplasty alone was performed in 13 limbs,stent in 80 patients,thromblysis assisted angioplasty and stent in 8 limbs.Stents of popliteal artery were implanted in 47 limbs.Major complication rate was 19.80％,two patients died within 30 days.Mean ABIs were 0.25 ±0.17 and 0.76 ±0.23 before and after procedure.Mean time of follow up was (12 ± 6) months.Primary patency rates and limbs salvage rate were 94.79％ and 95.83％,93.73％ and 95.83％,88.01％ and 93.42％,78.34％ and 93.42％,68.38％ and 83.04％ on 1,3,6,12,24 months respectively.Conclusions Patients with critical limb ischemia caused by TASC C/D lesions often suffer from significant comorbid medical conditions.Endovascular procedure has a high risk of morbidity and restenosis,but short term limb salvage rate is satisfactory.
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Anticoagulants is the drugs which prevent blood clotting process by affecting coagulation factor.They can be used for prevention of thromboembolic disease and stroke.As we stand on the threshold of a new era of anticoagulants,it is time to take an overview of the different types of anticoagulants and how to use them in the management of some specific conditions,including pregnancy,renal impairment,heparininduced thrombocytopenia and cancer.
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Endogenous hydrogen sulfide (H_2S) is to third found gaseous transmitter.In cardiovascular system, H_2S is produced endogenously by cystathionine γ-lyase (CSE)and plays an important role in the regulation of cardiovascular physiologic function and patho physiological processes.The CSE/H_2S system has a variety of biological effects in the cardiovascular system, such as inducing vasorelaxation,decreases blood pressure,inhibiting vascular smooth muscle cell proliferation and inducing anti-oxidant.It is also concerned with variety of cardiovascular diseases such as hypertension, hyperlipemia, atherosclerosis,coronary artery disease and so on.We summarize the biochemical characteristics and the physiological functions of endogenous H_2S and its patho physiological effects in cardiovascular diseases.