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Lower extremity arteriosclerosis obliterans is a clinical manifestation of atherosclerosis in the lower extremities.At present, the main treatment methods include stent implantation, balloon angioplasty.However the incidence of restenosis after interventional surgery is high, which seriously affects the effect of surgical treatment and the prognosis of patients.This article reviews the mechanism, influencing factors and the latest progress in the prevention and treatment of vascular restenosis after arteriosclerosis obliterans of the lower extremity orteriosclerosis obliterans intervention, which is of important clinical significance to the early prevention and treatment of instent restenosis.
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OBJECTIVE@#To evaluate the effectiveness and safety of Rotarex catheter system in treating femoropopliteal artery stenosis accompanied with thrombosis.@*METHODS@#From Jun. 2017 to Dec. 2019, the clinical data of 32 femoropopliteal artery stenosis accompanied with thrombosis cases treated with Rotarex catheter system were retrospectively analyzed. There were 23 males and 9 females aged from 50 to 89 years and the mean age was (70.7±10.3) years. Six cases had acute course of disease (≤2 weeks), 17 cases had subacute course of disease (>2 weeks, ≤3 months), and 9 cases had chronic course of disease (>3 months). Mean lesion length was (23.4±13.7) cm, mean occlusion length was (19.9±13.3) cm, and in-stent occlusion 7 cases. The superficial femoral artery (SFA) was involved in 13 cases, the popliteal artery (PA) was involved in 8 cases, and both SFA and PA were involved in the other 11 cases. All the cases were treated with Rotarex catheter system. When necessary, suction with large lumen catheter was enabled. Residual stenosis was treated with percutaneous transluminal angioplasty (PTA). Drug-coated balloon (DCB) was only used in patients with financial status, and stent was used only when it was necessary. Heparin was used for 24 h after procedures, and after that, antiplatelet agents were used. Doppler ultrasonography was taken during the followed-up.@*RESULTS@#Technical success was 100%, and mean procedure time was (107.4±21.5) min. 8F (1F≈0.33 mm) and 6F Rotarex catheter were used in 27 and 5 cases respectively. In 27 cases, forward flow was obtained immediately after debulking with Rotarex catheter, and in the other 5 cases, suction with large lumen catheters were used. PTA was used in all 32 cases. DCB were used in 8 cases, of which 4 were used in in-stent stenosis. Twelve cases were implanted stents. There were no perioperative deaths. The only one procedure related complication was distal embolism. We took out the thrombus with guiding catheter. In all cases, mean hospital stay were (4.6±1.5) d. The ankle brachial index increased from 0.32±0.15 to 0.86±0.10 after treatment (t=-16.847, P < 0.001). The Rutherford stages decreased significantly (Z=-4.518, P < 0.001). All the patients were followed up for 6.0-36.0 months, and the median time was 16.0 months. 2 cases stopped antiplatelet agents, which resulted in acute thrombosis. Another percutaneous mechanical thrombectomy and PTA were taken in one of them. Two cases died of cardiovascular disease during the follow-up, and no amputation was observed. Target lesion restenosis occurred in 7 cases during the follow-up, and target lesion revascularization (TLR) was taken in two of them.@*CONCLUSION@#In treating femoropopliteal artery stenosis accompanied with thrombosis, Rotarex catheter can remove thrombus effectively, and that can expose underlying lesions and reduce stent use and complications rates. It is a safe and effective method.
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Male , Female , Humans , Middle Aged , Aged , Aged, 80 and over , Femoral Artery/surgery , Retrospective Studies , Constriction, Pathologic , Platelet Aggregation Inhibitors , Treatment Outcome , Thrombosis , CathetersABSTRACT
Objective:To analyze the clinical effect of thin-walled low-chronic outward force (COF) stent in the treatment of femoral popliteal artery occlusive disease.Methods:Retrospective analysis was made on the clinical data of 76 consecutive patients with femoral popliteal artery occlusive disease (76 limbs) of lower extremities admitted to Renji Hospital affiliated to Shanghai Jiaotong University Medical College from June 2018 to May 2019, all of whom underwent Pulsar-18 stent(Biotronic, Germany) implantation. The clinical symptoms and stent patency rate were analyzed.Results:All 76 patients were successfully implanted with stents, and the Rutherford grade of postoperative clinical symptoms was significantly decreased, while the ankle brachial index (ABI) was significantly increased ( P<0.05). After 24 months of follow-up, the patency rates of femoral popliteal artery stents in phase Ⅰ at 3, 6, 12 and 24 months were 97.0%(64/66), 95.4%(62/65), 82.8%(53/64) and 79.4%(50/63), respectively. The patency rates of femoral popliteal artery stents in phase Ⅱ at 6, 12 and 24 months were 100%(65/65), 95.3%(61/64) and 90.5%(57/63), respectively. The stent patency rate was lower in complex femoral popliteal artery occlusion. Conclusions:The thin-walled and low-COF stent has good clinical results and patency in treatment of femoral popliteal artery occlusive disease. Good vessel prepare and drug-coated balloon may lower the in-stent restenosis.
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Objective:To explore the predictive value of ankle brachial index (ABI), HEART and thrombolysis in myocardial infarction (TIMI)scores for restenosis in patients with lower extremity arteriosclerosis obliterans (LEASO) after stent implantation.Methods:A retrospective study of 100 patients who were admitted to the Heyuan City People′s Hospital for stent implantation for LEASO from January 2015 to January 2020 and met the inclusion criteria were collected, and the patients were divided into restenosis group ( n=28) and patency group ( n=72) according to whether they were restenosis after operation. The clinical data of the two groups of patients were compared, including gender, age, disease course, history of cardiovascular and cerebrovascular diseases, smoking history, regular medication after surgery, number of stents, total length, bilateral lesions, total occlusion of lower extremities, length of vascular lesions, high-sensitivity C-reactive protein (hs-CRP), fasting blood glucose, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol, fibrinogen, hemoglobin, platelet count and red blood cell count, and ABI, HEART, TIMI scores were compared, the relationship between ABI, HEART and TIMI scores and postoperative restenosis was further analyzed. Measurement data were expressed as mean±standard deviation ( ± s), and two independent samples t-test was used for comparison between groups; enumeration data were compared between groups by Chi-square test. Based on independent risk factors in multivariate Logistic regression analysis, a nomogram prediction model was constructed using R 3.3.2 software and software package rms. Correlations were analyzed using bivariate Pearson linear correlation analysis. The receiver operating characteristic curve (ROC) was used to evaluate the predictive value of each score and nomogram model for postoperative restenosis, and the results were expressed as the area under the curve (AUC) and the 95% confidence interval (95% CI) of the area. Results:Patients in the restenosis group and the patency group had a history of smoking, the proportion of irregular postoperative medications, the number of implanted stents, the total length of implanted stents, hs-CRP, fibrinogen, total cholesterol, red blood cell count levels, and ABI, HEART, TIMI scores were significantly different ( P<0.05). Pearson correlation analysis showed that ABI score ( r=-0.527, P=0.001) was negatively correlated with postoperative restenosis, and the HEART score ( r=0.604, P=0.010) and TIMI score ( r=0.719, P=0.005) were positively correlated with postoperative restenosis. A history of smoking, irregular medication after surgery, number of implanted stents>2, total length of implanted stent>212 mm, hs-CRP>2 mg/L, fibrinogen>3.7 g/L, ABI score ≤0.58, HEART score>6.30, and TIMI score>4.30 were independent risk factors for postoperative restenosis. The ABI, HEART, and TIMI scores predict the AUC of the ROC curve for postoperative restenosis of 0.813, 0.789, and 0.798, cutoff points were 0.58, 6.30 and 4.30 score, sensitivities were 95.64%, 91.17% and 92.51%, specificities were 64.18%, 55.43% and 58.62%, respectively. The consistency index (C-index) and ROC curve AUC of the nomogram prediction model were 0.811 (95% CI: 0.721-0.901) and 0.818 (95% CI: 0.732-0.904), respectively, indicating a good degree of discrimination. Conclusions:ABI, HEART and TIMI scores are independent risk factors for restenosis after stent implantation in LEASO patients. ABI, HEART and TIMI scores can effectively predict the risk of restenosis after stent implantation in patients.
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Objective:To investigate the short-term and long-term efficacy of endovascular stent therapy for lower extremity atherosclerotic occlusive disease.Methods:Eighty patients with lower extremity atherosclerotic occlusive disease who received treatment in Lishui Central People's Hospital from January 2020 to January 2021 were included in this study. They were randomly divided into control and observation groups, with 40 patients in each group. The control group received lower extremity artery bypass grafting, and the observation group received endovascular stent therapy. Clinical efficacy, ankle-brachial index, claudication distance, blood flow dynamics of dorsalis artery, nerve conduction velocity of the lower extremities, and postoperative complications were compared between the two groups in the short-term and 1-year follow-ups.Results:Total response rate in the observation group was 87.5% (35/40), which was significantly higher than 67.5% (27/40) in the control group ( Z = 2.00, P < 0.05). At 1-year follow-up, total response rate in the observation group was 70.0% (28/40), which was slightly, but not significantly, higher than 47.5% (19/40) in the control group ( Z = 1.77, P > 0.05). After treatment, the ankle-brachial index and claudication distance in the observation group were significantly higher than those in the control group ( t = 3.34, 8.30, both P < 0.001). The diameter, peak velocity and blood flow of dorsal foot artery in the observation group were significantly superior to those in the control group ( t = 6.98, 4.46, 5.95, all P < 0.001). Lower extremity nerve conduction velocity in the observation group was significantly higher than that in the control group ( t = 3.01, 3.70, both P < 0.05). The incidence of postoperative complications in the observation group was slightly, but not significantly, lower than that in the control group [5.0% (2/40) vs. 15.0% (6/40), P > 0.05]. Conclusion:Compared with lower extremity artery bypass grafting, endovascular stent therapy has good short-term and long-term efficacy in the treatment of lower extremity atherosclerotic occlusive disease. Endovascular stent therapy can increase ankle-brachial index and claudication distance, improve the hemodynamic indexes of dorsalis pedis artery, increase lower extremity nerve conduction velocity and has a few complications.
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A 74-year-old man having a right refractory foot ulcer was referred to our hospital with a diagnosis of arteriosclerosis obliterans. Angiography of the lower extremities showed occlusive lesions in the middle popliteal artery and lower-leg arteries. Preoperative examination revealed decreased cardiac function and severe stenosis of the left and right coronary arteries. Therefore, we first performed coronary artery bypass grafting, followed by revascularization of the lower limbs at a later date. Owing to the lack of suitable autologous vein grafts, our procedure of choice was popliteal endarterectomy via a posterior approach with short saphenous vein angioplasty. The patient's foot ulcer healed completely following surgery. His postoperative course was uneventful, and he remained symptom-free during a 1-year follow-up.
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Objective: To study the effectiveness of tibial transverse transport combined with the antibiotics embedded bone cement in the treatment of chronic infection of foot and ankle with lower extremity ischemic diseases. Methods: A retrospective analysis was performed on 28 patients with ischemic diseases of lower extremities associated with chronic foot and ankle infection who were treated with tibial transverse transport combined with antibiotic bone cement between August 2015 and October 2019. There were 22 males and 6 females, with an average age of 65.6 years (range, 41-86 years). There were 25 cases of diabetic foot, 2 cases of arteriosclerosis obliterans, and 1 case of thromboangiitis obliterans. The course of infection ranged from 1 to 27 years, with an average of 14.9 years. The healing condition and time of foot and ankle in all patients were recorded and compared, and the Wagner grading and WIFi (W: lower extremity wound classification; I: ischemic classification; Fi: foot infection classification) grading were compared before and at last follow-up. Results: The wound surface of 1 diabetic foot patient improved at 111 days after operation, without purulent secretion, and lost follow-up. The remaining 27 cases were followed up 5 to 21 months (mean, 8.4 months). There was no necrosis in the tibial osteotomy incision and the local flap. After operation, 21 cases showed needle reaction of external fixator, but the needle infection gradually improved after the corresponding treatment. Among the 24 patients with diabetic foot, 1 died of multiple organ failure due to pulmonary infection. Acute lower extremity vascular embolism occurred in 1 case, and the foot was amputated due to acute gangrene. In the remaining 22 cases, the wound healing time of foot and ankle was 2.5-11.0 months (mean, 4.6 months). At last follow-up, Wagner grading and WIFi grading of the patients were significantly improved when compared with those before operation ( P<0.05). One patient with thromboangiitis obliterans had foot and ankle healing at 6 months after operation. Two patients with lower extremity arteriosclerosis obliterans had foot and ankle healing at 16 and 18 months after operation, respectively. Conclusion: Tibial transverse transport combined with the antibiotics embedded bone cement is effective in treating chronic infection of foot and ankle with lower extremity ischemic diseases.
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This paper systematically summarized related literature on the treatment of atherlsclerotic occlusive disease of the lower extremities (ASO-LE) in recent years from three aspects, including internal treatment, external treatment , internal and external treatment, which shows that TCM treats ASO-LE mainly by activating blood circulation to dissipate stasis, warming Yang, smoothing meridian. TCM treatment could improve clinical symptoms and quality of life of ASO-LE patients. Futurestudies should pay attention to TCM advantage of "Preventing Diseases" and explore the effective ways of integrating prevention and treatment.
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Complex femoropopliteal artery lesions (CFPAL) is a clinical difficulty. Dug-coated balloon (DCB) can carry the drug directly to the lesion site for release, so that the drug can accumulate at the target site in a high concentration and inhibit intimal hyperplasia. Directional atherectomy (DA) can make the drug carried by DCB penetrate into the vascular wall better by removing the vascular plaque, and improve the clinical therapeutic effect. The application advances of DCB or/and DA in treatment of CFPAL were reviewed in this paper.
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Objective: To observe the effect of Turbohawk atherectomy combined with percutaneous transluminal angioplasty (PTA) using drug-coated balloon (DCB) for treatment of in-stent restenosis (ISR) after femoropopliteal artery stent implantation. Methods: Clinical data of 63 ISR patients after femoropopliteal artery stent implantation were retrospectively analyzed. The patients were divided into 2 groups, those in observation group (n=28) were treated with atherectomy combined with DCB, while in control group (n=35) were treated with DCB alone. The therapeutic effect and prognosis were compared between 2 groups. Results: All 63 patients were successfully treated without death nor amputation. There was no significant difference of ankle brachial index (ABI) before procedure, 7 days and 6 months after procedure between 2 groups. The difference of minimum lumen diameter (MLD) before procedure, immediately and 6 months after procedure were not statistically significant (all P> 0.05). ABI and MLD in the observation group were higher than those in control group 12 months after procedure, while the rate of late lumen loss (LLL) was lower than that in control group (both P 0.05), while primary patency rate of observation group was higher than that of control group 12 months after procedure (P=0.028). Conclusion: Atherectomy combined with DCB is effective in treatment of femoropopliteal artery ISR, especially in the near and middle terms.
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Objective: To observe the value of MR diffusion tensor imaging (DTI) for dynamic evaluation on morphological and functional changes of ischemic skeletal muscle in hind limbs of rabbit models of peripheral arterial occlusive disease (PAOD). Methods: PAOD models were established through excision of the full length and branches of right femoral artery with 32 New Zealand rabbits. DTI scanning of bilateral hind-limbs were conducted on the 3rd, 14th, 21st and 28th day after operation (each n=8), and rabbits were sacrificed after DTI, and the skeletal muscles were harvested for pathological examinations. ADC and fractional anisotropy (FA) values were measured and compared, and the pathological manifestations were observed. Results: DWI showed that the operated calf muscles of PAOD rabbits were oedematous and expanded on the 3rd and 14th day after operation, the corresponding area appeared as hyper-intense on ADC maps and reddish on chromatic FA map, the operated side had higher ADC value and lower FA value than contralateral side, especially on the 3rd day after operation (all P0.05). Pathological examinations showed ligated striated muscles swelling, hemorrhage and necrosis on the 3rd and 14th day after operation, especially on the 3rd day. On the 21st day after operation, atrophy of individual striated muscles, hyperplastic and angiectatic interfascicular thick-walled vessels, as well as proliferation of small intermuscular vessels were observed. On the 28th day after operation, swelling cells basically recovered, most of fibroblasts/myofibroblasts were obviously hyperplastic and intercellular space slightly widened. Conclusion: DTI can dynamically and quantitatively evaluate the damage and repair process of ischemia skeletal muscle of hind limbs in PAOD rabbits over time.
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Objective@#To explore whether individualized exercise prescription can improve the walking ability of patients with lower extremity arteriosclerosis occlusion (ASO).@*Methods@#A total of 64 ASO patients with ankle brachial index (ABI) between 0.6 and 0.9 were randomly divided into the observation group (32 cases) and the control group (32 cases), Patients in the control group received routine nursing intervention, and patients in the observation group received nursing intervention based on individualized exercise prescription, ABI and walking impaired questionnaire (WIQ) scales were measured at admission and 12 weeks after intervention.@*Results@#There was no statistically significant difference in ABI values before and after the intervention of the control group (P > 0.05), and ABI values before and after the intervention of the observation group were 0.72 + 0.15 and 0.77 + 0.13 respectively (t=2.254, P < 0.05). There was no statistically significant difference in walking distance and walking speed before intervention (P > 0.05) in the two groups; the walking distance and walking speed after intervention in the observation group were (498.38±77.11) m and (50.44±11.27); the control group was (461.72±64.64) m and (44.02±9.86), and the differences were statistically significant (t=2.06, 2.43, P < 0.05).@*Conclusions@#Individualized exercise prescription can improve the degree of ischemia of the affected limb, improve the walking distance and walking speed of the patients, and it is convenient to implement and worthy of clinical promotion.
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Objective: To explore the therapeutic effect of SilverHawk atherectomy in the treatment of atherosclerotic occlusion of infrapopliteal arteries. Methods: SilverHawk atherectomy was used to treat 34 patients (39 limbs) with atherosclerotic occlusion of infrapopliteal arteries. Then the therapeutic results and follow-up results were observed. Results: There was no death during the perioperative period of SilverHawk atherectomy. Totally 31 limbs (28 cases) were treated antegradely, while 8 limbs (6 cases) were punctured retrogradely. The procedural success rate was 100% (39/39), and the technical success rate was 92.31% (36/39). One week after atherectomy, the claudication distance, toe brachial index (TBI) and ankle brachial index (ABI) were all higher than those before atherectomy (all P<0.05). All patients were followed up for 2 to 46 months (mean [23.63±9.71] months), the ulcer healing rate was 90.00% (9/10), and 1 of 4 gangrenous limbs underwent amputation below the knee. The primary patency rate at 6, 12, 24 months was 87.18% (34/39), 82.05% (32/39) and 71.79% (28/39), respectively, while the secondary patency rate was 94.87% (37/39), 92.31% (36/39) and 84.62% (33/39), respectively. Conclusion: SilverHawk atherectomy is effective in treatment of atherosclerotic occlusion of infrapopliteal artery.
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With the aging of population, the prevalence of peripheral arterial disease (PAD) shows a trend of rising. Lower limb arteriosclerosis occlusion disorder (ASO) is the most common disease of PAD. Endovascular therapy is the preferred treatment for ASO in lower extremity. As the characteristic of lower limb ASO, vascular calcification has an important impact on the efficacy and prognosis of interventional therapy, which is closely related to the rates of amputation and all-cause mortality. The correct understanding and active intervention of vascular calcification are helpful for the treatment and prognosis. The advancements of lower limb arterial calcification and vascular calcification affecting endovascular therapy of ASO in lower extremity were mainly reviewed in this article.
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Objective: To observe effect of percutaneous transluminal angioplasty (PTA) with drug coated balloon for treatment of lower extremity atherosclerotic occlusive disease (LEAOD). Methods: Totally 43 LEAOD patients (43 lower limbs) were randomly divided into study group (n=21) and control group (n=22). Patients in study group were treated with drug-coated balloon PTA, and those in control group with general balloon. Fontaine stages before and 7 days after PTA were counted in both groups. The internal diameter, restenosis rate and ankle-brachial index (ABI) of the target artery segment of superficial femoral artery were calculated before PTA and 1, 3, 6 months after PTA, while stenosis rate of the target artery segment of superficial femoral artery was counted at 6 months after PTA. Results: Fontaine stage 7 days after PTA were lower in both groups than that before PTA (both P50% in 3 cases (no 100%) while in control group were 50% in 10 cases (100% in 2 cases) (P<0.01). Conclusion: PTA with drug coated balloon is safe and effective in treatment of LEAOD, which can reduce the rate of restenosis, and the short-term effect is better than that PTA with ordinary balloon.
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Objective To evaluate the efficacy of excimer laser atherectomy (ELA) combined with drug-coated balloon (DCB) in the treatment of lower limb arteriosclerosis obliterans.Methods From Sep 2016 to Dec 2018 42 patients (42 limbs) underwent ELA combined with DCB therapy.Results There were 27 males and 15 females.The mean age was (65.7 ±9.7) years.The average lesion length was (14.3 ±7.5) cm.The technical success rate was 100％ and the remission rate of clinical symptoms was 92.9％.Ankle-brachial index was significantly improved from (0.45 ± 0.15) pre-operation to (0.85 ± 0.13) postoperation (P =0.001).The mean follow-up was 10.9 months.At 3,6,and 12 months follow-up,the primary patency rate was 95.2％,92.8％ and 84.9％.The 1-year limb salvage rate was 95.2％.Conclusion ELA combined with DCB has a good 1-year results as our data reveal.
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Objective To explore whether individualized exercise prescription can improve the walking ability of patients with lower extremity arteriosclerosis occlusion (ASO). Methods A total of 64 ASO patients with ankle brachial index (ABI) between 0.6 and 0.9 were randomly divided into the observation group (32 cases) and the control group (32 cases), Patients in the control group received routine nursing intervention, and patients in the observation group received nursing intervention based on individualized exercise prescription, ABI and walking impaired questionnaire (WIQ) scales were measured at admission and 12 weeks after intervention. Results There was no statistically significant difference in ABI values before and after the intervention of the control group (P>0.05), and ABI values before and after the intervention of the observation group were 0.72+0.15 and 0.77+0.13 respectively (t=2.254 , P<0.05). There was no statistically significant difference in walking distance and walking speed before intervention (P>0.05) in the two groups; the walking distance and walking speed after intervention in the observation group were (498.38 ± 77.11) m and (50.44 ± 11.27); the control group was (461.72 ± 64.64) m and (44.02 ± 9.86), and the differences were statistically significant (t=2.06, 2.43, P < 0.05). Conclusions Individualized exercise prescription can improve the degree of ischemia of the affected limb, improve the walking distance and walking speed of the patients, and it is convenient to implement and worthy of clinical promotion.
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Objective To evaluate the effect of Huayu-Tongbi decoction combined with sarpogrelate in the treatment of senile diabetes mellitus complicated with arteriosclerosis obliterans (ASO) of lower extremities. Methods A total of 105 ASO patients who met the inclusion criteria were divided into control group (52 cases) and observation group (53 cases) by random number table method. The control group was treated with oral sarpogrelate. The observation group was treated with Huayu-Tongbi decoction on the basis of the control group. Both groups were treated for 2 months. The level of FPG, HbA1c, TC, HDL-C and LDL-C were detected by automatic biochemical analyzer. The arteriosclerosis index (AI), ankle brachial index (ABI) and intima-media thickness (IMT) were calculated. The internal diameter of posterior tibial artery and dorsal pedal artery, peak velocity and blood flow were measured by ultrasound detector before and after treatment in two groups. The clinical effect was evaluated. Results The total effective rate was 94.3% (50/53) in the observation group and 76.9% (40/52) in the control group. There was a significant difference between the two groups (χ2=6.502, P=0.011). After treatment, the level of FPG, HbA1c, TC and LDL-C in the observation group was significantly lower than those in the control group (t were 5.201, 6.716, 5.878 and 10.293, respectively, all Ps<0.01). internal diameter of posterior tibial artery and dorsal pedal artery, peak velocity and blood flow in the observation group were significantly larger than those in the control group (t were 4.295, 6.639, 8.310, 5.045, 5.393 and 9.672, respectively, all Ps<0.01). After treatment, the AI (4.23 ± 0.65 vs. 4.81 ± 0.83, t=3.991), IMT (0.95 ± 0.10 mm vs. 1.11 ± 0.13 mm, t=4.829) in the observation group were significantly lower than those in the control group ( P<0.01), while the ABI (1.10 ± 0.19 vs. 0.93 ± 0.17, t=7.077) was significantly higher than those in the control group (P<0.01). Conclusions The Huayu-Tongbi decoction combined with sarpogrelate can regulate the disorder of glucose and lipid metabolism in elderly diabetic patients with ASO, improve the blood circulation of posterior tibial artery and dorsal pedal artery, in order to improve the clinical effect.
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Objective To understand the status of Knowledge-Attitude-Practice(KAP) and analyze the affecting factors in postoperative patients with arteriosclerosis obliterans (ASO) of lower extremity. Methods The clinical data of 169 postoperative patients with ASO from October 2017 to March 2018 were analyzed. The patients′ knowledge, behavior, attitude and compliance of four dimensions as the dependent variable, general data and disease data as independent variables through single factor analysis of variance. Multivariate statistical analysis was carried out with statistical significance to analysis the status of KAP and influencing factors of ASO patients. Results ASO patients′ four dimensions of knowledge, behavior, attitude and compliance were (6.33 ± 3.33), (58.80 ± 6.36), (14.39 ± 4.22) and (10.67 ± 2.49) points, respectively. Univariate analysis of variance showed that place of residence, education level, family economic level, diabetes, course of disease, social support, self-assessment of depression, self-assessment of anxiety and self-efficacy of symptom management were all risk factors in ASO patients. Conclusions Strengthen the health management of ASO postoperative patients, so that patients get continuous health guidance, thereby improving their quality of life and long-term patency rate.
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Femoropopliteal arteriosclerosis obliteration has been a common disease affecting human health. Currently, endovascular treatment has become the mainstream of operation, but the postoprative restenosis rate is still very high. Directional atherectomy (DA) can improve blood vessel compliance by removing plaque, but it has no obvious effect in reducing the restenosis rate. The emergence of drug-coated balloon (DCB) has brought the dawn to solve this problem. Through the entry of its loaded drug into the vascular wall to prevent the proliferation of endothelial cells and smooth muscle cells, DCB exerts its long-term anti-intimal hyperplasia effect. A number of studies have shown that DCB can reduce the late lumen loss and the restenosis rate, thus decrease the re-operation rate. Combination use of DA and DCB can improve the uptake of drugs, then, better results can be expected. However, the present research results are not sufficient to support the above theoretical speculation, and large sample and more multicenter randomized controlled studies need to be done before it can be validated.