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Objective:To compare drug-coated balloon (DCB) and standard angioplasty balloon (SAB) in the treatment of postoperative in-stent restenosis (ISR) in patients with arteriosclerosis obliterans (ASO) of the lower extremity.Methods:From Jan 2017 to Dec 2018, 43 ISR patients after percutaneous transluminal angioplasty for ASO of the lower extremity at our hospital were enrolled.Patients were divided into 2 groups with 18 patients treated by DCB and 25 by SAB. The patients were followed up for 6~12 months.Results:There was no significant difference in the incidence of complications between DCB group and SAB group ( P>0.05).Compared with that in SAB group, the plasma level of ET-1 in DCB group was lower while NO was higher at 6, 24 h and 2 weeks after surgery ( P<0.05), there was no significant difference in P-selectin ( P>0.05). The ABI values in both groups increased, and that in DCB group were higher than SAB group at 6 and 12 months after surgery ( P<0.05). The lumen loss in DCB group at 6 and 12 months after surgery was significantly lower ( P<0.05). At 6 and 12 months, the primary patency of target lesions in the DCB group was 100.00% and 88.89%, which was higher than the 72.00% and 52.00% in the SAB group ( P<0.05); the CD-TLR rate in the DCB group was 11.11%, which was lower than 48.00% in the SAB group ( P<0.05). Conclusion:DCB comes with lower postoperative ISR in ASO patients of the lower extremity.
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Objective To investigate the application value of CT venography(CTV) in the diagnosis and treatment of Budd‐Chiari syndrome(BCS) .Methods 58 patients with BBCS in our hospital from January 2012 to January 2014 were performed the CTV examination .The inferior vena cava ,hepatic vein ,portal vein and collateral vessels were performed the reconstruction analysis . Results All the patients were definitely diagnosed as BCS after completing CTV examination ,including :19 cases of inferior vena cava(IVC) diaphragm type ,15 cases of short IVC segment occlusion ,8 cases of long IVC segment occlusion ,9 cases of hepatic vein stenosis or occlusion ,7 cases complicated by fresh thrombosis .In addition ,the different degrees of compensatory expansion of col‐lateral vesse ,intuition and comprehensiveness ,can display the position ,character and length of lesion vessel ,also observes the de‐grees of collateral vessels expansion and liver cirrhosis .
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Objective To explore the clinical significance of interventional treatment of iliac vein compression syndrome(IVCS). Methods Percutaneous transluminal angioplasty(PTA) was performed in 40 cases. Thirty three cases underwent endovascular stent implantation and 27 cases underwent second stage left saphenous vein ligation and stripping and the valves of left femoral veins narrowing. Thirty one cases were followed up postoperatively and the duration was 6～66 months (mean 28 months). Results The dilation of iliac veins was successful in 36 cases and there were good efficacy in all patients when they discharged from hospital. Followed up during post operation, all the limbs ulcers were cured and varicose veins disappeared. The skin pigmentation disappeared in 17 of 19 cases and markedly relieved in 2 cases. Left lower limb swelling disappeared in 15 of 17 cases and relieved in 2cases. Conclusion There is good efficacy in the interventional treatment of left iliac vein lesions, but second stage procedures should be performed in secondary lesions of saphenous veins and valves of femoral veins.
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Objective To evaluate interventional therapy for Budd-Chiari syndrome. Methods IVC venography was first carried out, the obliteration or stenosis in the IVC was opened or dilated with the hard tip of guid wire or puncture needle and balloon, then a stent was implanted. Results The procedure was successful in 271 out of 312 cases including IVC intervention in 260 cases, and hepatic vein intervention in 11 cases. IVC stent was used in 195 cases and hepatic vein stent in 1 case. There was no pulmonary embolism happened, acute renal failure occurred in 6 cases, hepatic coma in 1 case and acute heart failure in 21 cases. One patient died in this group and 2 were complicated with acute IVC thrombosis. Follow up of 6 to 104 mos was made in 203 cases with recurrence found in 21 cases. Conclusion Interventional therapy is indicated for most types of BCS with safe and effective results.
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Objective To explore the appropriate method for mechanical thrombectomy, selection of vena cava filter and its duration in place. Method Fifty-five cases of severe acute deep vein thrombosis of the lower limbs were enrolled. Vena cava filter was first placed, then thrombectomy was performed with Amplatz thrombectomy device (ATD). The iliac vein lesions were dilated by balloon followed by temporary arterivenous fistula construction. Result Procedures were all successful in 52 cases, iliac vein stenosis was found in 47 cases and dilated by balloon. Permanent vena cava filters were placed in 20 cases while temporary in 32 cases. Fifty cases were followed-up for 3～30 monthes. Tumefaction disappeared in 46 cases leaving no after thrombosis syndrome. Conclusion This comprehensive modality is effective, less traumatic and of quick recovery. During the procedure, possible residual thrombi should always be under close attention and stenosis in iliac veins be confirmed by repeated venography. In most cases, placing a temporary vena cava filter was the best choice.
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Objective To evaluate the role of temporary arteriovenous fistula(AVF) in the treatment of acute deep venous thrombosis(DVT) with Amplatz thrombectomy device(ATD). Method Seventy-six cases of acute DVT underwent mechanical thrombolysis with ATD, in which 50 cases received a temporary AVF after interventional therapy. Result One case died of pulmonary embolism. Ipsilateral limbs swelling subsided and pain alleviated in the remaining 72 cases since first post-operative day. Secondary contralateral DVT developed in 2 cases on the 7th post-operative day. The patency of temporary AVF was 86%(43/50). Sixty-eight cases (90.7%) were followed-up for 10~42 months post-operatively with limbs swelling completely subsided in 59 cases and ameliorated in 6 cases. Secondary inferior vena cava thrombosis developed in one case and 2 cases died of unrelated diseases. Conclusion Temporary AVF increases blood flow volume and blood velocity in the thrombectomized vein segment to improve the vein patency, hence is a valuable auxiliary means of ATD.
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Objective To evaluate the effects of Amplatz thrombectomy device (ATD), thrombolysis (TL), and surgical thrombectomy (TX) on venous wall morphology complicated with acute femoral vein thrombosis in dogs. Methods The femoral venous thrombosis model was induced in 36 adult mongrel dogs. The thrombosed veins were treated with ATD ( n =12), TL ( n =12), and TX ( n =12), respectively. Results Clearance of thrombus was successful in all cases. One week after treatment, the rate of venous patency in ATD, TL, and TX group was 75%, 33%, and 25%, respectively ( P
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Objective To evaluate the effect of endovascular stenting combined with external constriction valvuloplasty of superficial femoral vein for the treatment of Cockett syndrome. MethodsForty two cases of Cockett syndrome with femoral veins reflux were treated with iliac vein stent implantation or venoplasty, and superficial femoral veins were constricted with ePTFE graft patch at the level of the first valves. ResultsThe iliac veins were all patent after stent implantation. A follow up of 8 to 45 months revealed that limb swelling disappeared in 38 cases with no varicose. Slight limb swelling was left over in 3 cases. Stent thrombosis developing in one case two months later subsided after a successful thrombolysis. ConclusionThe procedure is mini invasive, safe and effective for the treatment of Cockett syndrome.