ABSTRACT
Objective:To compare the perioperative complications of carotid endarterectomy with patch angioplasty or primary closure.Methods:The clinical data of 492 carotid endarterectomy patients at the Vascular Surgery Department of Anzhen Hospital from Mar 2003 to Dec 2016 was analyzed retrospectively.Results:There were 364 cases (74%) in the patch angioplasty group and 128 cases (26%) in the primary closure group. The incidence of perioperative ischemic stroke was significantly lower in the patch angioplasty group than that in the primary closure group (0.8% vs. 3.9%, P=0.031), and there was no difference in the incidence of the remaining perioperative complications. By subgroup analysis, the incidence of perioperative ischemic stroke was significantly lower in the patch angioplasty group than in the primary closure group when the diameter of the internal carotid artery was <5 mm (0.7% vs. 6.0%, P=0.001), whereas there was no difference between the two groups when the diameter of the internal carotid artery was ≥5 mm. Conclusions:Carotid endarterectomy with patch angioplasty can reduce the incidence of perioperative cerebral infarction, especially in cases with an internal carotid artery diameter <5 mm.
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Objective To investigate the clinical value of pharyngeal protection tube in endoscopic therapy for patients with liver cirrhosis and esophagogastric varices. Methods The clinical data of 120 patients from January 2013 to October 2016, suffered from liver cirrhosis and esophagogastric varices, and accepted the endoscopic therapy were analyzed retrospectively. 60 patients underwent endoscopic therapy and were meanwhile applied pharyngeal protection tube; 60 cases were treated with the assistance of routine endoscopy. The completion rate of treatment and the incidence of complications were observed and compared between the two groups. Results Pharyngeal protection tube group: The completion rate of endoscopic treatment in the pharynx protective tube group was 98.3%, without complications. In the control group, the completion rate of the treatment under endoscopy was 88.3%, and there were 7 cases of aspiration, asphyxia and inhalation pneumonia. Conclusions Using pharyngeal protection tube to protect airway can improve the safety and completion rate of endoscopic treatment of esophageal and gastric varices, reduce the incidence of complications, and the pharyngeal protection tube is simple and cost-effective, which is worthy of clinical application.
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Objective To evaluate retrograde transpopliteal access for femoral-popliteal artery total occlusion with blind puncture.Methods Clinical data of 22 cases admitted from Sep 2014 to June 2016 undergoing endovascular treatment of the femoral-politeal artery occlusion with transpopliteal artery retrograde access by blind puncture were analyzed.Results A total of 22 patients underwent retrograde popliteal access with blind puncture after antegrade attempts failed.Puncture above the knee was performed in 18 cases and below the knee in 4 cases.The average increase of ABI was 0.57.Hematoma of puncture site was observed in 2 patients,other complications included pneumonia in 1 case and renal insufficiency in 2 cases.The mean follow-up time was (13 ± 5)months.Restenosis occurred in 8 patiens(36.4％)during the follow-up time.The primary patency was (86.4 ± 0.07) ％ at 6 months and (70.7-± 0.12) ％ at 12 months.There was no major amputation rate and mortality during the follow-up.Conclusions Retrograde transpopliteal access for femoral-popliteal artery occlusion with blind puncture is safe and effective.