Randomized controlled trial of endovenous N-butylcyanoacrylate endovenous nonthermal ablation and radiofrequency endovenous thermal ablation for incompetent great saphenous veins / 中华普通外科杂志

Objective:To evaluate the safety and efficacy of n-butyl cyanoacrylate (NBCA) in treating great saphenous vein(GSV) incompetence.Methods:60 patients (60 limbs) with GSV incompetence were randomly divided into NBCA glue group (30 cases) and radiofrequency ablation(RFA) group in 30 cases. The clinical outcomes, venous clinical severity score(VCSS), and quality of life using the Aberdeen varicose vein questionnaire(AVVQ) were evaluated. The primary endpoint is the occlusion rate of GSV at 3 months after surgery.Results:For the two groups, the occlusion rate of GSV was 100% immediately after surgery and at 3 months follow-up. AVVQ and VCSS were improved in the two groups( P<0.05). In terms of complications, the NBCA group had scleroma in 3 cases, pain and skin redness in 1 case respectively, but no ecchymosis and numbness. In the RFA group, numbness occurred in 1 case, skin redness in 2 cases, scleroma in 3 cases, ecchymosis and pain in 4 cases respectively. The incidence of ecchymosis and total complications in the NBCA group was significantly lower than that in the RFA group( P<0.05). No DVT or other adverse event occurred in both groups. Conclusion:NBCA and RFA have the same short-term closure rate. Furthermore, the NBCA treatment requires less equipment, no use of tumescent anesthetic, and has lower incidence in terms of complications than that of RFA.

Observation and clinical study of left lower limb great saphenous vein double backbone variations / 局解手术学杂志

Objective To observe the left lower limb great saphenous vein double backbone variations and then conclude correlated var -iation with articles and essays which can offer basic data reference for correlational research and treatment .Methods A male adult corpse fixed by 10%formalin was dissected , and the aberrant vessels were measured by digital caliper and Digimizer .Collected essays and articles about variation of great saphenous vein and its tributary on CNKI from January 1,2000 to May 1,2016.Results There were two major vein of left lower limb great saphenous vein from feet to foramen of saphenous vein of this corpse .The common variations of great saphenous vein and its tributary included variation of quantity and position .Conclusion The variations of great saphenous vein and its tributary do not exist alone.There are usually several variants exist together .So,taking an imaging examination before the operation of great saphenous varicose veins is the key of preventing vessels from injury and reducing the happening of complication .

The experience in treatment of thirty-two cases of brachial artery trauma associated with humeral super-middle fracture / 中国基层医药

Objective To explore the treatment methods for brachial artery trauma associated with humeral super-middle fracture.Methods Thirty-two patients of brachial artery trauma associated with humeral super-middle fracture were treated in our department from March 2001 to April 2005 with in tramedallary expanded self-locking nail (IESN) combined with autotransplantation of great saphenous vein to repair brachial artery.Results All patients were followed up for 12 to 18 months,13.6 months on the average.No stenosis occurred at the anastomosed veins according to color Doppler ultrasound.All fractures achieyed clinical healing and the limbs survived well.Conclusion The IESN combined with autotransplantation of great saphenous vein to repair brachial artery is an effective method to treat brachial artery traumaassociated with humeral super-middle fracture,having the advantage of reasonable operation procedure.stabile immobilization and satisfactory functional recovery.

Autogenous vein grafting for the treatment of atherosclerotic occlusion of the lower limbs / 中国普通外科杂志

Objective To evaluate the clinical effects of autogenous vein grafting for the treatment of atherosclerotic occlusion of the lower limbs. Methods Ninety cases of segemental atherosclerotic occlusion of the lower limbs underwent autogenous vein graft bridging procedures from Jan 2002 to Feb 2005 in our hospital. The immediate surgical results were compared with symptoms of pre-operation, and the long-term patency rate was evaluated. Results Total symptom relief was achieved in 87 cases, with the limbs pain disappearing, skin temperature going up, and the refractory ulcer tending to heal. There was a significant difference in ABI, perioperatively increasing from 0. 38?0. 11 to 0. 85?0. 18(P

Acetylcholine-Induced Endothelium-Dependent Responses in the Internal Mammary Artery and Grafted Saphenous Vein in Humans(in Vivo)

BACKGROUND: Coronary artery bypass grafts obtained from internal mammary artery(IMA) have a greater patency rate than do saphenous vein grafts(SVG). The release or production of endothelium-derived relaxing factor(EDRF), which regulates blood flow and inhibits platelets function, may contribute to the higher patency rate of IMA. In order to evaluate the difference between endothelium dependent relaxation in IMA and in grafted saphenous veins, we observed acetylcholine responses of IMAs and SVGs in humans. METHOD: Incremental dose if acetylcholine(Ach:A1-20, A2-50, A3-100microg) or single dose if acetylcholine(A3) were infused into the non-grafted IMA in 16 patients with different clinical presentation of coronary artery disease(3 with stable angina, 2 with acute myocardial infarction 4 with variant angina and atypical chest pain syndrome in 7). After the dose-response to Ach was completed nitroglycerine 200microg was injected into the IMA. Graded dose of Ach (A1, A2, A3) was also infused in 13 grafted saphenous veins(SVG). RESULTS: The overall vascular effects of Ach into the IMA were dilatory responses regardless of different clinical presentation. Two or 3 minutes after Ach injection, the diameter of IMA increased by 9.2%(A1) and 16. 7%(A3) respectively(p<0.01). Maximal dilatory response after A3 was comparable to that after nitroglycerin injection. Angiographically normal segements of SVGs also increased its diameter 2 minutes after Ach injection (7.2% with A1, 6.9% with A2 and 8.5% with A3). Thus the degree of relaxation of IMA was more prominent than that of SVGs. Angiographically dicreased segments of SVGs had no response after Ach injection. The overall responses of native coronary artery to Ach was dose dependant constriction. CONCLUSION: Injection of Ach to IMA and angiographically normal segments of SVGs caused vascular dilatation probably due to EDRF response. However the degree of relaxation was more prominent in IMA than in SVG. Angiographically diseased segments of SVGs had no response to Ach injection, suggesting that diseased SVG does not produce EDRF. However the finding of a consistent Ach-induced EDRF relaxation in the SVGs despite of constrictive response in the majority of native coronary arteries might suggest that the regenerated endothelial cell in the SVGs were probably of saphenous vein origin rather than derived from the coronary arterial endothelium.