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Objective@#To investigate the correlation between the stenosis degree of superior mesenteric artery (SMA) and each artery within the scope of aorto-iliac artery in patients with lower extremity atherosclerotic occlusive disease (LEAOD).@*Methods@#Images of 70 patients who had undergone the aorta-iliac-femoral arteries CT angiography (CTA) examination and had a definite diagnosis of LEAOD due to intermittent claudication or resting pain admitted to Tianjin Hospital from January to December in 2017 were enrolled. The arteries in the aorta as well as iliac were surface-reconstructed, which were analyzed by advanced vascular analysis (AVA) combined with the original images, including SMA trunk, abdominal aorta (AA), left and right common iliac artery (LCIA, RCIA), left and right internal iliac artery (LIIA, RIIA), left and right external iliac artery (LEIA, REIA). The normal reference plane and the maximal stenosis plane were selected, and the stenosis rate of each artery in the reconstruction range was automatically calculated with software. The patient's imaging data were divided into groups with two methods: ① according to the degree of SMA stenosis, the patients were divided into group Ⅰ (stenosis degree ≤70%) and groupⅡ (stenosis degree > 70%); ② LEAOD patients with different gender were respectively divided into three groups: middle-aged group (45-59 years old), pre-elderly group (60-74 years old) and elderly group (75-89 years old). The comparison between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery was analyzed with Pearson simple correlation analysis.@*Results@#The incidence of SMA stenosis in all LEAOD patients was 100%. Correlation analysis showed that there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in group Ⅰ (n = 64) and group Ⅱ (n = 6), respectively (r value was -0.021, 0.023, 0.023, -0.137, 0.182, -0.113, 0.141, respectively, in group Ⅰ, and it was 0.020, -0.560, 0.010, 0.306, -0.204, -0.381, 0.393, respectively, in group Ⅱ, all P > 0.05). In 52 male patients, there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in middle-aged group (n = 16), pre-elderly group (n = 27) and elderly group (n = 9), respectively (r value was -0.032, 0.024, 0.324, 0.146, 0.312, 0.008, 0.344, respectively, in middle-aged group, it was -0.108, -0.116, -0.040, -0.249, -0.082, -0.052, 0.096, respectively, in pre-elderly group, and it was 0.182, 0.311, 0.400, 0.360, 0.688, 0.498, 0.406, respectively, in elderly group, all P > 0.05). In 18 female patients, there was also no correlation between the stenosis degree of SMA and above each artery within the scope of aorto-iliac artery in pre-elderly group (n = 11) and elderly group (n = 6), respectively (the r value was -0.170, 0.040, -0.019, 0.152, 0.508, 0.042, 0.456, respectively, in pre-elderly group, and it was -0.660, 0.008, -0.055, -0.056, -0.213, 0.344, 0.011, respectively, in elderly group, all P > 0.05). The correlation in middle-aged group was not analyzed because there was only 1 patient.@*Conclusions@#Although the atherosclerotic changes in LEAOD patients can affect SMA and aorto-iliac artery at the same time, there was no correlation between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery which may due to the differences in the histological structure and hemodynamics among different arteries. SMA atherosclerotic stenosis and occlusion is a relatively independent disease process for LEAOD.
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OBJECTIVE:To investigate the effects of fluvastatin combined with aspirin on the related indicators of patients with diabetic lower extremity arteriosclerosis occlusive desease(LEAOD). METHODS:80 patients with diabetic LEAOD were ran-domly divided into control group(40 cases)and observation group(40 cases). Based on convertional treatment,control group was given Rosuvastatin calcium tablet 5 mg+Aspirin enteric-coated tablet 100 mg every evening;observation group was given Fluvas-tatin sodium capsule 40 mg+Aspirin enteric-coated tablet 100 mg. They were treated for 3 months. Fibrinogen,plasma D-dimer, blood viscosity, cholesterol (TC), triglyceride (TG), glycosylated hemoglobin (HbAlc), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), carotid intima-media thickness, compliance situation of TC, TG, HbAlc,LDL-C and HDL-C,cases of carotid intima thickening,plaque formation,stenosis and occlusion before and after treat-ment were observed,and the incidence of adverse reactions was recorded. RESULTS:After treatment,fibrinogen,plasma D-di-mer,blood viscosity,TC,TG,HbAlc,LDL-C and carotid intima-media thickness in 2 groups were significantly lower than before treatment,and observation group was significantly lower than control group;HDL-C in 2 groups was significantly higher than be-fore,and observation group was significantly higher than control group,with statistical significance (P0.05). CONCLUSIONS:Fluvastatin combined with aspirin can significantly improve the pa-tients 'blood viscosity,blood lipid,vascular endothelial function in the treatment of diabetic LEAOD,it can reduce the thrombotic disease risk,and does not increase the incidence of adverse reactions.
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The infrapopliteal arteriosclerosis occlusive disease mainly involves the anterior tibial artery,posterior tibial artery and fibular artery.For the arteriosclerosis occlusive disease of larger arteries of lower extremity,such as iliac artery,femoral artery,etc.,the interventional therapy pattern has been already very mature.However,as the infrapopliteal artery is fine in diameter and the lesion is usually wide with extensive calcification,it is hard to effectively treat the infrapopliteal arteriosclerosis occlusive disease with routine interventional therapy.The therapeutic methods of infrapopliteal arteriosclerosis occlusive disease mainly include surgical treatment,endovascular treatment,drug therapy,and the autologous stem cell transplantation therapy that is still in the research stage at present.This paper aims to introduce the latest progress in interventional therapy for the treatment of infrapopliteal arteriosclerosis occlusive disease in recent years,and to make a prospect for clinical practice in future.
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Objective To discuss the value of CE-MRA of lower extremity angiography in diagnosing Arteriosclerotic occlusive disease. Methods CE-MRA was performed on 25 patients with symptom of arteriosclerotic occlusive disease. CT angiograms were produced using maximal intensity projection. Results 24 examinations of CE-MRA were successful with 2 cases of straitness in right ailiaca communist, 2cases of straitness and 2 cases of occlusion in aorta abdominal, 4 cases of straitness and 2 cases occlusion in artery of femoral, 3 cases of straitness and 4 cases of occlusion in artery of crus. One case was failed for the patient himself. Conclusion CE-MRA of lower extremity angiography can monitor multiple arteries of Arteriosclerosis occlusive disease of lower limbs and observe the extent and range of lesions. It has high diagnostic accuracy in patients with lower extremity artery diseases, and it is a safe, no-trauma and effective method in lower extremity artery.