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Objective To explore the safety and efficacy of rivaroxaban after interventional treatment of pulmonary embolism.Methods Patients with acute pulmonary embolism undergoing pulmonary indwelling catheter thrombolysis at Chifeng Municipal Hospital from Jun 2016 to Jun 2017 were divided into a group of 23 patients,who afterwards receiving rivaroxaban as a long-term anticoagulant,and that of 45 patients treated with traditional anticoagulant therapy (low molecular weight heparin bridged warfarin).Results The short and mid-term follow-up for the cure rate in the rivaroxaban group was higher than that in the traditional anticoagulation group (60.9％ vs.35.6％,P ＜0.05,and 73.9％ vs.44.4％,P ＜0.05).The incidence of adverse reactions such as bleeding (4.3％) was significantly lower than that of the heparin warfarin group (28.9％),there was no recurrence of venous thromboembolism (VTE) in the rivaroxaban group,and 3 cases in the traditional anticoagulant group;there was no death in either group.Conclusions In the interventional treatment of acute pulmonary embolism,single-agent oral rivaroxaban is equivalent to low-molecular-weight heparin-bridged warfarin;rivaroxaban can effectively reduce pulmonary embolism and the occurrence of bleeding complications after endovascular intervention.
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Objective Pulmonary embolism is a common cardiovascular emergency with the characteristics of high incidence,high mortality.This study compared pulmonary artery catheter thrombolysis with peripheral intravenous thrombolysis for acute pulmonary embolism in the mid-term clinical efficacy.Methods From June 2011 to September 2015,68 patients were given pulmonary artery interventional therapy,54 cases received peripheral intravenous thrombolysis;discharged patients were followed up for 3-12 months to evaluate the curative rate,effective rate,recurrence rate and the incidence of complications.Results Follow up rate was 79.5％.The cure rate of the treatment group was higher than that of the control group (47.3 ％ vs 23.8 ％,P ＜ 0.05);The significant effective rate of the treatment group was higher than that of the control group (81.8％ vs 52.4％,P ＜ 0.05);The incidence of Chronic pulmonary hypertension (1.8％) was lower than that of the control group (16.7％);There was no significant difference in improvement rate,recurrence rate and mortality.Conclusion The medium-term efficacy of pulmonary artery catheter directed thrombolysis is superior to that of peripheral intravenous thrombolysis;it can effectively reduce the incidence of chronic thromboembolic pulmonary hypertension.
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Objective To evaluate indwelling intrapulmonary artery catheter thromolysis for acute pulmonary embolism.Methods From June 2011 to June 2013 56 cases of acute pulmonary embolism were diagnosed by multi-row spiral CT and admitted at the Department of Vascular Surgery.The average age was (56 ± 11) years.Inferior vena cava filter was implanted and pulmonary angiography,catheter thrombectomy,indwelling pulmonary intraarterial thrombolytic therapy was performed.Postoperatively low molecular weight heparin and warfarin was given,dosage adjusted by prothrombin international normalized ratio at 2-3.Results Mean pulmonary arterial pressure (mPAP) decreased from (43 ± 7) mmHg to (22 ± 6) mmHg (P ＜ 0.05),arterial partial pressure of oxygen (PO2) rose from (49 ± 8) mmHg to (83 ± 9) mmHg (P ＜ 0.05).Clinical symptoms significantly relieved in 51 out of the 56 cases (91％).45 patients were followed up for an average of (15 ± 4) months,with one recurrence.There was no filter migration,vena cava thrombosis,chronic obstructive pulmonary disease and other complications.Conclusions Emergency pulmonary artery indwelling catheter thrombolysis is safe and effective therapy for acute pulmonary thromboembolism.
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Objective To summarize the therapeutic efficacy of electrocoagulation for varicose veins of the lower extremities.Methods Totally 168 cases(238 limbs)of varicose veins of the lower extremities were treated with electrocoagulation in our department from April 2000 to April 2007.Through a small ankle incision,electrocoagulation probe was inserted ascendingly into the groin via the great saphenous vein.After high ligation of the great saphenous vein,the varicose veins and great saphenous trunk were electrocoagulated.Results The patients were discharged from hospital in one to two days after the operation.None of them had incisional infection.The ulcers at the ankle were healed in four weeks.Postoperative complications in this series,included Ⅰ degree burn injury in one limb,Ⅱ degree burn injury in one limb,superficial phlebitic pain in two limbs(two cases);and numbness around the ankle in 14 limbs(10 cases).Totally 148 cases with 208 limbs were followed up for 2 to 9 years with a mean of 6.6 years.During the period,the rate of recurrent varicosity was 3.4%(7/208);and healing rates of ache,dermatitis and eczema,ankle pigment,swelling around the calf and ankle were 95.3%(162/170),85.7%(12/14),41.7%(15/36)and 36.4%(16/44)respectively.Conclusion Electrocoagulation is a minimally invasive and effective method for the treatment of varicose veins of the lower extremities,with quick recovery and low rate of recurrence.