ABSTRACT
Objective To evaluate the short-term effect of drug-coated balloon (DCB) with paclitaxel in treating in-stent restenosis (ISR) of femoral popliteal artery.Methods A total of 18 patients with femoral popliteal artery ISR,who were admitted to authors' hospital during the period from June 2016 to December 2016 to receive paclitaxel DCB treatment,were enrolled in this study.The patients included 15 males and 3 females,with a mean age of (72.7±9.8) years old.According to Fontaine classification,grade Ⅱ B was seen in 9 patients,grade Ⅲ in 8 patients,and grade Ⅳ in one patient.Preoperative CT angiography showed that ISR could be confirmed in 3 patients and complete occlusion of the stent in 15 patients.After the diseased artery was re-opened,pre-dilatation with common balloon was conducted,which was followed by dilatation with paclitaxel DCB;remedial stent implantation was carried out when the restrictive dissection was observed or if the residual stenosis was beyond 50％.Angiography was performed immediately after the procedure to check the vascular patency.On the third day afterthe treatment,the ankle-brachial index (ABI) of diseased lower extremity was determined to assess the improvement of ischemia.Three month after the treatment,the patients were followed up to detemine the incidence of restenosis,the clinically-driven target lesion revascularization (TLR) rate,and the occurrence of serious clinical events within 3 months.Results Successful re-opening of the diseased artery was achieved in all 18 patients,the technical success rate was 100％.At 3 months after the treatment,the restenosis rate and TLR rate were 10％ (1/10) and 6.67％ (1/15) respectively.No procedure-related complications occurred in all patients.Conclusion For the treatment of femoral popliteal artery ISR,the use of paclitaxel DCB is safe and effective.
ABSTRACT
Objective To evaluate the TriVex system in the treatment of varicose veins of lower extremities,focusing on postoperative complications and management.Methods Clinical data of 108 patients (146 legs) of varicose veins of the lower extremity undergoing TriVex procedure were retrospectively analyzed.Deep veinons patency was verified in all patients by preoperative sonography.Above knee stripping of the great saphenous vein was done first when necessary.The below knee phlebectomy of the side branches was done with the new system (Trivex System/Smith and Nephew).Postoperative patients were followed-up,and results were evaluated.Results Procedure was successful in all cases.98 cases were followed up for 1 ～ 24 months.The mean operation time per leg was (34±8) minutes.Complications were as following:26 legs (17.8%) developed postoperative hematoma which was healed by conservative therapy including two cases in which the tension seroma,which was successfully managed by puncture aspiration.Transien skin numbness or paraesthesia developed in 13.0% (19/146).Subcutaneous induration in 11.6%(17/146) cases.Residual varicose and recurrence in 3.4% (5/146).Incision related complications developed in 4.8% (7/149) cases.Conclusion Transilluminated powered phlebectomy (TriVex) is a safe and effective cosmetic procedure for less invasive varicose vein surgery.