[Application of iliac vein molding and stent implantation through the ipsilateral great saphenous vein approach in daytime treatment mode].

OBJECTIVE: To explore the feasibility and recent efficacy of iliac vein molding and stenting in daytime treatment mode in patients with iliac vein stenosis. METHODS: Medical records of iliac vein molding and stenting performed in the ipsilateral great saphenous vein approach conducted from February 2017 to March 2022 were retrospective reviewed. There were 21 cases, 6 males and 15 females. Age ranged from 37 to 79 years [(62.5 ± 10.2) years]. The stenosis in the 21 limbs simply involved the common iliac veins in 16 patients, 2 patients had the simple and external iliac veins, and both the total and external iliac veins in 3 patients. Both iliac vein molding and iliac vein stenting were performed through the ipsilateral great saphenous vein approach. The patients with simple iliac vein stenosis with great saphenous vein valve insufficiency also underwent radiofrequency closure of great saphenous vein and flexural vein sclerosis therapy simultaneously. Regular postoperative direct oral anticoagulants therapy and stress therapy were followed. All the patients were hospitalized for less than 24 h. RESULTS: All the 21 patients operations were successful (the success rate was 100%), without any intraoperative complications. Immediate postoperative complications were puncture point bleeding in 1 case. The bandage gauze was completely wet. The bleeding was stopped after 5min of recompression. All the patients were hospitalized for less than 24 h. Follow-up results: The 3-month follow-up rate after operation was 100%. Absolute effective 18 cases (18/21, 85.7%). Relatively effective(postmentation still after surgery, but with less extent) in 3 cases (3/21, 14.3%). The iliac vein stents were unobstructed, and the trunk of the great saphenous vein was well closed in the patients with great saphenous vein radiofrequency treatment. The 6-month follow-up rate after operation was 71.4%(15/21). Of these, 14 cases (14/15, 93.3%) were absolutely effective. Relatively effective(postmentation still after surgery, but with less extent) in 1 case (1/15, 6.7%). The iliac vein stents were no restenosis or obstruction, and the trunk of the great saphenous vein was well closed in the patients with great saphenous vein radiofrequency treatment. CONCLUSION: The interventional treatment technique of iliac vein stenosis is feasible in the daytime treatment mode, with clear advantages and satisfactory recent efficacy.

High-efficiency broadband tunable green laser operation of direct diode-pumped holmium-doped fiber.

Green laser sources have become increasingly important for the application in scientific research and industry. Although several laser approaches have been investigated, the development of green lasers with the necessary efficiency and spectral characteristics required for practical deployment continues to attract immense interest. In this study, the efficient green laser operation of a Ho3+-doped fluoride fiber directly pumped by a commercial blue laser diode (LD) is experimentally investigated at various active fiber lengths. In the free-running laser, the slope efficiency was optimized up to 59.3% with 543.9 nm lasing, with respect to the launched pump power, using a 20-cm long active fiber. This is the maximum slope efficiency reported to date for a green fiber laser. A maximum output power of 376 mW at 543.5 nm was achieved by using a 17-cm long active fiber pumped at a maximum available launched pump power of 996 mW. Moreover, broadband tuning operation was demonstrated by employing a range of active fiber lengths, together with an intracavity bandpass filter. The operating wavelength was tunable from 536.3 nm to 549.3 nm. A maximum tuning power achieved was 118 mW at 543.4 nm for a 17-cm long active fiber. Moderate Ho3+-doped fiber length is shown to be effective in producing a high performance of a green fiber laser. The short-length of the active fiber considerably extends the green short wavelength operation due to limited reabsorption of the signal below 540 nm.

One-year outcomes of radiofrequency ablation of incompetent perforator veins using the radiofrequency stylet device: Cohort study from East Asia.

OBJECTIVES: The present study was designed to assess outcomes of patients undergone radiofrequency ablation (RFA) for their incompetent perforator veins (IPVs) with ClosureFast stylets. METHODS: Data of 165 IPVs in 138 limbs of 117 consecutive patients between July 2017 to Nov. 2019 were retrospectively reviewed. Primary endpoints (technical success rate, complications) and secondary endpoints (VCSS) were analyzed. RESULTS: The immediate technical success rate was 100%. There were no major complications. The rate of ecchymosis and induration was 5.8%. 129/165 IPVs in 79.5% (93/117) patients had achieved sonographic evaluation at 1 year followed-up, in which 3 perforators were recanalized. VCSS scores at pre-operation and 1-year follow-up were 5.77 ± 1.88 and 2.70 ± 1.39, respectively (t= 29.644, P= .000). CONCLUSIONS: In conclusion, RFA is safe and effective for the treatment of IPVs. At the 1-year follow-up, the RFA of IPVs showed a low recanalization rate and had a satisfactory improvement on VCSS.

[Relative factors of type II endoleak after endovascular aneurysm repair].

OBJECTIVE: To study the relative factors of type II endoleak after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms. METHODS: Twenty-eight cases of abdominal aortic aneurysms treated by EVAR were retrospectively analyzed. The characteristics of the inferior mesentery arteries (IMA), the arc Riolan and the lumbar arteries of the cases with or without type II endoleak were analyzed. RESULTS: Type II endoleak was found in 8 (28.6%) cases, of which, 2 were type IIa and 6 were type IIb. The diameter of the IMA originating part of the cases with type II endoleak [(4.03 ± 1.00) mm] was significantly bigger than that without endoleak [(2.89 ± 0.50) mm, P=0.007]. The number of the lumbar arteries originating from the aneurysm sac in cases with type II endoleak (3.4 ± 0.8) was significantly more than that without endoleak (1.9 ± 1.5, P=0.017). However, type II endoleak was irrelevant to the diameter of originating part of the lumbar arteries and the form of the arc Riolan. After the average 14.5 months follow-up, the aneurysm sac was found with shrinkage in 1 case, no change in 2 cases, and augment in 5 cases. Secondary transarterial embolization was performed for only 1 case. CONCLUSION: Type II endoleak was much easily found in cases with bigger diameter of originating part of the IMA, or in cases with more lumbar arteries originating from the aneurysm sac.

[Comparison of curative effect and thrombolysis time between r-tPA application and urokinase in the interventional thrombectomy and thrombolysis for acute and severe pulmonary embolism].

OBJECTIVE: To study the influence of r-tPA and urokinase in curative effect and thrombolysis time on patients with acute and severe pulmonary embolism after interventional thrombectomy. METHODS: After reviewing and analyzing the clinical data of 19 acute and severe pulmonary embolism patients, we classified them into two groups in accordance with the application of r-tPA and urokinase to compare the changes of their heart rate, blood pressure, pulmonary arterial pressure, arterial partial pressure of oxygen and hemachrome before and after thrombolysis, as well as the thrombolysis effect time the two groups took. RESULTS: The heart rate, blood pressure, pulmonary arterial pressure, arterial partial pressure of oxygen of the patients in both groups gained remarkable improvement after operation (P<0.05); the pulmonary arterial pressure of the r-tPA patient group dropped but not significantly compared with that before operation (P>0.05); the pulmonary arterial pressure of the urokinase patient group dropped significantly compared with that study before operation (P<0.05); the hemachrome of both patient groups did not significantly drop after operation (P>0.05); the thrombolysis effect time by adopting r-tPA was remarkably shorter than that caused in thrombolysis by adopting urokinase (P<0.05). CONCLUSION: Both r-tPA and urokinase are effective in interventional thrombolysis for acute and severe pulmonary embolism. However, r-tPA could significantly shorten the time caused in thrombolysis without increasing any bleeding risk.

[Successful endovascular repair of isolated iliac aneurysm and reserving the internal iliac artery with fenestrated covered stent].

Isolated iliac aneurysm is rare and difficult for surgery repair because it locates in the deep pelvis. Endovascular repair is preferred currently, and internal iliac artery is generally embolized in order to avoid the endoleak. Embolization of the internal iliac artery can lead to the complications such as buttock claudication, colon ischaemia and erectile dysfunction. Therefore, the antegrade flow of internal iliac artery should be reserved. One seventy-seven-year-old male patient with isolated left common iliac aneurysm, 30 mm in diameter, was successful endovascular repaired using fenestrated covered stent. At 1-month follow up, the patient was asymptomatic. Computed tomography scan shows the iliac aneurysm was completely excluded, and the antegrade flow of the left common, internal and external iliac arteries were normal.