Résumé
Objective To observe the curative effect of catheter thrombolysis in the treatment of subacute lower limb arterial occlusion.Methods Eighty-five patients with subacute lower limb arterial occlusion (98 limbs) and treated with catheter thrombolysis were enrolled and the removal of thrombus and patency of vessels were evaluated by angiography.Then,balloon dilatation or stent implantation was performed according to the angiographic findings after thrombolysis. Results After catheter thrombolysis, the degree and length of occlusion were significantly improved (P < 0.01). To judge the curative effect: significantly effective in 5 limbs (5.1%), effective in 85 limbs (86.7%), ineffective in 8 limbs(8.2%),total effective rate was 91.8%.Catheter thrombolysis combined with balloon dilatation and stent implantation were performed according the vascular occlusion status and all the occluded segments were open, the postoperative angiography showed no distal vascular occlusion. No bleeding occurred. Conclusions Catheter thrombolysis is effective and safe in the treatment of lower extremity arterial occlusion in subacute stage.Endovascular treatment combined with endovascular treatment can achieve good results.
Résumé
Objective To investigate the effect on the miemvnscular density(MVD)and the expression of vascular endothelial growth factor(VEGF)in VX2 tumor after transcatheter arterial chemoembolization(TACE)combined with endostatin.Methods The VX2 tumor model wag established.The rabbits bearing tunlor were randomly divided into three groups as the control group.TACE group and TACE combined with endostatin group.with 10 rabbits in each group.In the control group,normal saline was administered via the hepatic artery.In the TACE group,lipiodol(0.2 ml/kg)and ADM(2.g/kg)were administered.Lipiodol(0.2 ml/kg),ADM(2 mg/kg)and endostatin(2 mg/kg)were administered for each rabbit in the TACE combined with endostatin group.Seven days after operation,the rabbits were sacrificed and the tumors were removed.Immunohistochemistry wag performed to demonstrate the expression of VEGF and the MVD wag caleulated.The ANOVA wag used for statistics.Results The average absorbance values of VEGF were 0.130±0.038.0.200±0.049 and 0.120±0.047 respectively for the 3 groups.There was signiflcant difference among the three groups(F=9.42,P＜0.01).rnle expression of VEGF in the TACE group was the hiShest among the 3 groups.Compared with the otIler two groups,there had signifieant differences(q=4.93,5.63,P＜0.01).The average absorbance value of the TACE combined with endostatin group was lower than that of control group,but there was no significant difference between them(q=0.70,P＞0.05).The values of MVD were(80±17),(84±16)and(57±13)/HPF for the 3 groups respectivelv.There wag significant difference among them(F=8.70,P＜0.01).111e value of MVD in the TACE combined with endestatin group was the lowest, and there were significant differences when compared with the control group (q=4.63, P＜0.01) and the TACE group (q =5.48, P＜0.01).There was no significant difference between the control group and the TACE group (q = 0.85, P ＞ 0.05) in MVD.Conclusion Compared with chemoembolization only, ehemoembolization combined with endostatin can significantly depress the expression of VEGF and decrease the angiogenesis of the tumor.The combined method has a beneficial effect on prognosis of hepatic tumor.