Endovascular therapy for complex subclavian artery occlusive diseases / 介入放射学杂志

Objective To discuss the key points of endovascular therapy for complex subclavian artery occlusive diseases. Methods During the period from January 2012 to December 2013, a total of 92 patients with complex subclavian artery occlusive disease were admitted to Xuanwu Hospital of Capital Medical University, Beijing, China. The clinical data were retrospectively analyzed. The features of the lesions, the success rate of endovascular therapy, the use of combined approaches, the relief of symptoms after treatment, etc. were evaluated. Results The complex subclavian artery occlusive diseases could be divided into three types. Type Ⅰ: long segment of the left subclavian artery was occluded; type Ⅱ: ostial stenosis or occlusion of the right subclavian artery; and type Ⅲ: subclavian artery stenosis or occlusion was associated with the ostial disorder of the vertebral artery, or the opening of vertebral artery was affected by the subclavian artery stenosis or occlusion. The technical success rate was 82.6%. Combination use of femoral artery and brachial artery approach was employed in 27.2% of patients, which had improved the technical success rate. After the treatment the symptom improvement rate was 81.6%. Conclusion Upper limb artery approach can improve the re-canalization rate of left subclavian artery with long segment occlusion, and can ensure the accurate positioning of stent at the site of right subclavian artery opening. During the procedure of endovascular intervention for subclavian artery occlusion disease, attention should be paid to the protection of the vertebral artery.

Diabetic inferior genicular artery occlusion balloon and Department of internal medicine treatment control of Deep / 中国医师杂志

Objective Diabetic infrapopliteal artery occlusive disease Deep balloon angioplasty ( percutaneoustransluminal an-gioplasty, PTA) near the middle of the treatment effect and the Department of internal medicine ,conservative treatment .Methods Sixty patients with type II diabetes mellitus complicated with severe infrapopliteal arterial occlusive patients , divided into treatment group (41 cases) and Department of internal medicine treatment group (19 cases),all patients had CTA or MRA or DSA imaging;in-terventional treatment group using Deep balloonPTA ,3 days before operation and postoperative long-term Plavix and culture as anti platelet , blood glucose controltherapy;Department of internal medicine treatment group with control of blood glucose ,precedent in im-proving microcirculation ,debridement dressing and anti infection;observed in 2 week,1 month,3 months,6 months ,1 year,2 years,3 years, two groups were compared after treatment of clinical symptoms and changes signs ,ankle brachial index (ABI),the dorsal artery of foot diameter and blood flow velocity ,evaluation and the total efficiency of 6 months,1 year,2 years,3 years and cut rate .Results Interventional arterial blood flow improved significantly after operation in treatment group ,the clinical symptoms,signs were improved obviously, ankle brachial index improved significantly ,compared with the Department of internal medicine treatment group statistical significance ( P <0.05 ) ,and the total efficiency of 3 years the rate of limb salvage and Department of internal medicine therapy group with significant difference ( P <0.05).Conclusions Deep balloon PTA treating diabetic infrapopliteal artery occlusive disease cura-tive effect,can significantly improve the rate of limb salvage;Department of internal medicine treatment forelderly ,important organ dys-function patients .

Intraoperative Balloon Angioplasty in Diabetic Foot with Peripheral Artery Occlusive Disease During Amputation: Two Case Reports / 대한정형외과학회잡지

Amputation should be considered for the patients with limb necrosis or infection due to major vessel obstruction combined with diabetes. Patients with peripheral artery occlusive disease combined with diabetes have a higher risk of amputation and a higher possibility of reoperation than those patients without diabetes because of complications that include hematoma, infection and necrosis of the stump. We report here on 2 cases for which balloon angioplasty was used to promote wound healing on the stump site during amputation, and the patients had peripheral artery occlusive disease with a diabetic foot. The wounds healed early without complication in both cases.

Coronary Angiographic Findings and Risk Factors for Coronary Artery Occlusive Disease in Renal Transplant Patients with Clinically Suspected Ischemic Heart Disease / 대한이식학회지

PURPOSE: Cardiovascular disease is a substantial health problem in renal transplant patients, and ischemic heart disease is a leading cause of death in these patients. Renal transplant patients have many conventional risk factors for atherosclerotic coronary artery diaese, including hypertension, hyperlipidemia, and posttransplant diabetes mellitus. This study were to evaluate the prevalence of angiographically-determined coronary artery occlusive disease (CAOD) in renal transplant patients, and to identify the risk factors for significant coronary artery disease. METHODS: The retrospective study were performed in 36 patients with renal transplantation who underwent coronary angiography to diagnose ischemic heart disease. RESULTS: A total of 36 recipients (27 males, 9 females) were studied and the mean age was 51.5 years. Significant CAOD was identified in 69% of patients (1-vessel: 19%, 2: 25, 3: 25). By univariate and multivariate logistic regression analysis, the association of clinical variables with CAOD was assessed. The interval between the diagnosis of end-stage renl disease and renaltransplantation was an independent risk factor (P<0.05). The variables such as old age, acute rejection episodes, cholesterol level, as well as the presence of obesity, and D.M,. were not associated. CONCLUSION: The prevalence of angiographically-determined CAOD in renal transplant recipients is 69%. The risk of CAOD seems to be increased in recipients with long duration of dialysis before transplantation. The early or preemptive transplantation could be recommended for preventing CAOD in renal transplantation candidates.