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Objective To evaluate the relationship between asymptomatic carotid stenosis (ACS)and lower limb arteriosclerosis obliterans (ASO).Methods 200 patients with lower extremities arteriosclerosis obliterans who were admitted in our hospital between Oct 2013 and Oct 2015 were retrospectively reviewed.Patients were divided into severe ACS (stenosis ≥ 70％)and moderate ACS (stenosis ＜ 70％).Results Compared with moderate ACS,the severe ACS patients were elder,heavier cigarette-smoker and alcohol drinker,higher hypertriglyceride and fibrinogen level (all P ＜ 0.05).The incidence rate of severe ACS increased as lower limb ASO gets more significant (x2 =28.2,P ＜ 0.05).It also increased with age (x2 =7.78,P ＜ 0.05).Multi-factor logistic regression showed advanced age (OR:1.079,95％ CI:1.055-1.104,P ＜ 0.05) and hypertriglyceride (OR:2.013,95％ CI:1.076-3.325,P ＜ 0.05) were risk factors for severe ACS.Conclusions The incidence of severe ACS increased with the increasing of age and severity of lower limb ASO.Advanced age and hypertriglyceride were potential risk factors for severe ACS.
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Objective To compare the postoperative follow-up indexes of femoral popliteal artery bypass grafts and evaluate the sensitivity of vessel function test methods for the early detection of grafts restenosis.Methods 84 cases were followed-up after femoral popliteal graft bypass,using ankle brachial index (ABI),ABI decrease amplitude,and Duplex ultrasound to detect peak systolic velocity (PSV) and peak systolic velocity ratio (PSVR).All patients were divided into mild stenosis group (0-49％),moderate stenosis group (50％-74％) and severe stenosis group (75％-99％).Results ABI was 0.88 ±0.12,0.81 ± 0.10 and 0.52 ± 0.13;ABI decrease amplitude was 0.13 ± 0.06,0.12 ± 0.06 and 0.36±0.06;PSV(m/s) was 0.89 ±0.23,0.91 ±0.31 and 1.70 ±0.85,respectively.There was remarkable difference for ABI,ABI decrease amplitude and PSV between severe stenosis and mild to moderate stenosis group (P ＜0.05).PSVR was 1.00 ±0.08,2.14 ±0.31 and 3.58 ±0.31 respectively,in the three groups (P ＜ 0.05).Conclusion PSVR was more sensitive to detect grafts restenosis early than ABI,ABI decrease amplitude and PSV.
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Objective To explore the clinical value of the duplex ultrasonography (duplex US) for evaluating the re-stenosis after peripheral arterial bypass grafting. Methods Eighty prosthetic grafts of sixty-three patients with femoral-pop-liteal arterial bypass grafting were follow-up regularly by duplex US. They were divided into non significant stenosis group (n=56), the significant stenosis group (n=15) and occlusion group (n=9) according to the tube diameter and arterial blood flow-ing parameters, which changed postoperatively. The diagnostic results were compared and analyzed between duplex US and digital subtraction angiography (DSA). The peak flow velocity of middle grafts (MG) to 40 cm/s was defined to evaluate risk of graft occlusion. Results The diagnostic coincidence rate of duplex US and DSA for grafts stenosis classification was 90%. The diagnostic sensitivity of duplex US to grafts stenosis was 91.7%, and the specificity was 92.9%. The positive pre-dictive value was 84.6%for grafts stenosis, and the negative predictive value was 96.3%, the false positive rate was 16.7%, and the false negative rate was 8.3%. The grafts occlusion rate was higher in MG<40 cm/s group than that of MG≥40 cm/s group. Conclusion There was a good consistency with Duplex US and DSA for the diagnosis of peripheral artery bypass graft restenosis. Duplex US showed characteristics of non-invasive, simple and easily accepted by patients.
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Objective To evaluate the incidence of asymptomatic carotid stenosis (ACS) in patients with peripheral arterial occlusive disease (PAOD) who was admitted for revascularization.Methods 229 PAOD patients were evaluated by carotid ultrasound preoperatively and divided into severe ACS group (ACS ≥ 70％) and non severe ACS group (ACS ＜ 70％).The clinical characteristics and associated risk factors of the two groups were analyzed.Results The incidence of severe ACS was 19.7％,age,blood pressure,total cholesterol and fibrinogen levels in severe ACS group were significantly higher than those in non-severe ACS group (P ＜ 0.05),the more severe the symptoms of PAOD are,the higher is the incidence of severe ACS.Age,hypertension and hypercholesterolemia were all predictors of severe ACS.Conclusions The severity of PAOD is positively correlated with the incidence of severe ACS.Age,hypertension and hypercholesterolemia are independent risk factors for severe ACS.
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<p><b>OBJECTIVE</b>To summarize our experience in surgical treatment of traumatic lower limb pseudoaneurysm.</p><p><b>METHODS</b>Twenty patients with traumatic lower limb pseudoaneurysm were surgically treated in our department from January 2007 to January 2012. The treatment protocols included interventional covered-stent placement (10 cases), spring coil embolization (2 cases), and surgical operation (8 cases). Surgical operations included pseudoaneurysm repair (2 cases), autologous-vein transplantation (1 case), and artificial-vessel bypass graft (5 cases).</p><p><b>RESULTS</b>All the patients were successfully treated without aggravating lower limb ischemia. Pseudoaneurysm disappeared after treatment. A surgical operation is suitable to most pseudoaneurysms, but its damage is relatively obvious and usually leads to more bleeding. It also requires a longer operating time. Compared to a surgical operation, interventional therapy is less traumatic and patients usually have a quicker recovery (P<0.05). All patients were followed up once per month for 12-36 months by color Doppler ultrasound examination. There were no cases of pseudoaneurysm recurrence.</p><p><b>CONCLUSION</b>Both surgical operation and interventional therapy are safe and effective in the treatment of pseudoaneurysm.</p>