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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 determine the incidence and clinical features of headache after carotid endarterectomy (CEA).Methods A retrospective analysis was made on the data of patients undergoing CEA in the Department of Vascular Surgery,Peking Union Medical College Hospital from Jan 2014 to Jan 2015.There were 119 males and 24 females,including 97 cases of symptomatic carotid stenosis and 110 cases of severe carotid stenosis.Results The incidence of newly emergent headache after surgery was 44％ (63/143).The earliest time of headache was 30 minutes after surgery and the latest was 6 days after surgery.95％ of headache occurred within 48 hours after surgery (60/63).79.4％ (50/63) of the headache lay ipsilaterally with CEA,and bilateral headache accounted for 20.6％ (13/63).Severe headache accounted for 4.8％ (3/63),all were ipsilaterally frontal and temporal headache,complicating central nervous system symptoms.Conclusions After CEA headache is a common clinical symptom.Most were mild to moderate and unilateral,which can be relieved spontaneously.Cerebral hemodynamics need to be further examined to differentiate the different pathological states of severe headache on the operative side after CEA because of the high risk of developing hyperperfusion syndrome or cerebral infarction.History of TIA or stroke is the risk factor of post-CEA headache.
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Objective To investigate the distribution of anxiety and depression disorders in patients of carotid artery stenosis (CAS),and the relationship between symptoms of cerebral infarction and the severity of anxiety and depression.Methods We used Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale(SDS) created by William W.K.Zung to evaluate the anxiety and depression disorders associated with CAS in 93 patients hospitalized at the Department of Vascular Surgery,and 146 hospitalized varicose veins patients as acontrols.Results The scales of CAS are significantly higher than the control group(SAS:32 ± 8 vs 29 ± 7,P ＜ 0.001 ; SDS:42 ± 14 vs 35 ± 11,P ＜ 0.001),within-group analysis of CAS shows that there is no statistical difference between symptomatic group and non-symptomatic group (SAS:32 ±8 vs 32 ± 7,P =0.780; SDS:41 ± 14 vs 42 ± 14,P =0.830),or between infarction group and non-infaction group (SAS:31 ± 8 vs 33 ± 8,P =0.147; SDS:39 ± 14 vs 43 ± 13,P =0.241).Conclusions CAS can cause anxiety and depression disorders,and the disorders are not related to symptoms of cerebral ischemia and cerebral infarction.