Endovascular treatment of aortic saddle embolism through percutaneous mechanical Thrombectomy via Straub Rotarex catheter.

BACKGROUND: To summarize our experience of endovascular treatment for abdominal aorta saddle embolism (ASE) through percutaneous mechanical thrombectomy (PMT). METHODS: Clinical data of three ASE patients treated with an endovascular approach using percutaneous mechanical thrombectomy (PMT) were reviewed and analyzed. RESULTS: After PMT, blood flow of limbs was restored in all of the three patients. However, two patients died from sudden cardiac arrest caused by hyperkalemia several hours after the procedure. The other one patient survived through continuous renal replacement therapy, which was initialized shortly after the surgical procedure. CONCLUSION: Endovascular treatment through PMT can quickly restore blood flow in the ASE patients. Blood purification through renal replacement therapy is crucial to reduce mortality after restoring blood flow of the limbs.

Endovascular therapy for floating thrombus in the inferior vena cava.

OBJECTIVE: We aimed to summarize the clinical characteristics of floating thrombus in the inferior vena cava (IVC). METHODS: From January 2014 to June 2019, four patients with floating thrombus in the IVC were admitted to our hospital and underwent intracavitary therapy. Diagnosis, therapy, and clinical characteristics of floating thrombus were summarized. RESULTS: Three patients presented with pulmonary embolism. Three of the patients had a floating thrombus discovered by inferior venacavography and one was found by contrast-enhanced computed tomography. Two patients had deep venous thrombosis in the lower extremities. One patient had a double IVC, one had left iliac vein compression syndrome, and one had right renal phlebothrombosis. The four patients underwent implantation of a temporary IVC filter and were treated with anti-coagulation, debulking, and thrombolysis. All four patients achieved satisfactory results. CONCLUSIONS: Floating thrombus in the IVC is often caused by spread of branch vein thrombosis, and is more likely to lead to pulmonary embolism. Anti-coagulant therapy and debulking under the protection of filters can achieve satisfactory clinical results.

[High-fat diet induces pulmonary fibrosis in rats and inhibitory effects of N-acetylcysteine].

OBJECTIVE: To explore the relation between high-fat diet and pulmonary fibrosis and the inhibition of N-acetylcysteine (NAC) on lung tissue in rats. METHODS: Thirty Sprague Dawley (SD) male rats were randomly divided into control group (n = 10) on a quantitative control Lieber-DeCarli liquid diet, a high-fat diet group (n = 10) on a high fat-diet Lieber-DeCarli liquid diet and NAC group (n = 10) on NAC 300 mg×kg(-1)×d(-1). All rats were sacrificed 8 weeks later. The morphological changes and collagen deposition in lung tissue were observed by hematoxylin & eosin and Masson staining while the contents of glutathione (GSH) and hyaluronic acid (HA) measured through colorimetry and enzyme-linked immunosorbent assay. And the expression of transforming growth factor-ß1 (TGF-ß1) expression in lung tissue was detected through immunohistochemistry. RESULTS: There were variable degree of alveolar and alveolar septal infiltration of inflammatory cells. And more deposition of collagen fibers appeared at intervals of alveolar in high fat group. Similar pathological changes were found in NAC group, but the degree was lower than that of high-fat group. Compared to the control and NAC groups, the lung tissue content of GSH decreased (GSH: 0.11 ± 0.05 vs 0.19 ± 0.11, 0.22 ± 0.14 mg/g, both P < 0.05) while HA and TGF-ß1 increased in high-fat diet group (HA: 0.57 ± 0.06 vs 0.46 ± 0.04, 0.41 ± 0.04 mg/g; TGF-ß1: 24.6 ± 3.4 vs 16.8 ± 2.6, 11.7 ± 1.5, all P < 0.05). CONCLUSION: High-fat diet may induce pulmonary fibrosis in rats and NAC has inhibitory effects.