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Objective To investigate the effect of periulcerous suturing on the healing of skin ulceration in patients with chronic deep venous thrombosis. Methods Thirty-two patients were divided into two groups: control group treated with drugs and compression therapy; suturing group treated with drugs, compression therapy and skin suturing around the ulceration. The clinical data of these cases were retrospectively studied. Result In the suturing group, perforator veins (1.0±0.8) decreased, oxygen saturation of venous blood (39±7) mm Hg and transeutaneous oxygen monitoring (tcPO_2) (71±12)mm Hg were elevated, the number of mitochondrion increased and white cell infiltration decreased, the figure of rough surfaced endoplasmic reticulum recovered, ulcer healing (12±6) d quickened and recrudescence (12.5%) lessened after treatment. All differences were statistically significant when compared with those in the control group (P<0.05). Conclusion Suturing around the ulceration can lighten blood stagnation and inflammatory cell infiltration, improve dystrophy and oxygen supply of the tissue, shorten the period of ulcer healing. It is a simple, good therapeutic and economical method to cure ulcer and can decrease the recurrent rate with physiotherapy.
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Objective To evaluate the effect of ultrasound ablation transluminally(USATL) for deep venous thrombosis(DVT) of lower extremities. Methods The clinical features of 47 patients with DVT of lower extremities treated by USATL were retrospectively analyzed. Results 5 cases were changed to surger because of a long disease course(4 months~4 years) or chronic inflammation.42 cases had satisfactory results with USATL.Among them,36 cases restored to complete return venous flow;6 had partial return flow. The symptoms and signs of 42 cases were alleviated apparently compared with pretreatment.1 case died of the rectal cancer metastasis 2 months after the treatment.Conclusions USATL can ablate DVT safely ,effectively, and conveniently.Some other transluminal angioplasties are necessary to improve the therapeutic result.
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Objective To study the factors influencing outcome of acute arterial embolism in extremity.Method From Aug 1997 to Nov 2001, we have accomplished treatment in 41 cases of acute arterial embolism in extremity with Fogarty catheter.Result Among 41 cases,26 cases were succeeded in leg salvage,8 cases were subject to amputation and 7 cases were dead finally.Conclusions Durationand degree of ischemia in extremity,embolectomy completeness in the case of introoperation,reperfusive injury and myonephropathic-metabolic syndrome,Primary diseases and general conditions are main influencing factors in treatment of acute arterial embolism.
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Objective To analyse postoperative co mp lications of ultrasonic ablation and transluminal therapy in patients of deep v enous thrombosis(DVT) in the lower extremities. Meth ods In this study, 205 DVT patients with a history fro m 6h to 90d were treated by a combination of ultersonic ablation、Fogarty ca theter thrombectomy、balloon dilatation and stent placement. Results Major complications developed in 37 cases (18.05%) including vein perforation, thrombosis, bleeding and anaphylaxis to contrast medium, except for minor complications such as lymph exudation. The re was no mortality in this series. Conclusions This procedure is safe, miniinvasive and effective therap y for DVT patients.
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Objective:To summarize experience of 8 lower limb deep venous thrombosis(DVT) patients who used OptEase recyclable vesa cava filter(VCF) during in operations.Methods:Through collecting the clinical data of 8 patients who used OptEase recyclable vena cava filter(VCF) ,analyzing the method of recycling and releted complications.Results:No pulmonary embolism happened during and after operations,when recycle VCF implanted,vena cava graphy shows:inperfection thrombous near the filter in 1 case and vena iliaca thromb of uninjure side in 1 case too,reclaiming successfully in 5 cases,3 cases turn to permanent placement.FolIowing-up observation for 3-8 months,recurrence of limbs vena thrombosis never happened.Conclusion:The recyclable vena cava lilter could prevent plamonary embolism effectively in lower limb deep venous thrombosis patients.
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Objective To investigate the protection effect of inferior vena cava filter on pulmonary embolism in patients with deep venous thrombosis(DVT) of lower extremities. Methods Inferior vena cava filters were placed in 55 patients with DVT. Simon Nitiol filter(SNF) was used in 25 cases,Trap Ease filter(TEF) in 13 cases and Antheor Temporal filter(ATF) in 17 cases.10 patients with DVT were treated by non operation therapy,45 patients by operation and transluminal angioplasties.Whether patients occurred pulmonary embolism was observed clinically,and the form and site of SNF and TEF were monitored by periodic fluoroscopy . Results Inferior vena cava filter was placed successfully in all patients.Symptoms and signs of DVT disappeared in all the patients after treatment . None of the putients occurred pulmonary embolism in this series. One case occurred inferior vena cava thrombolism in 16 months after SNF placement. Thrombus attached to ATF after the ATF taking off from inferior vena cava was found in 17 cases.Conclusions Inferior vena cava filter placement is a simple, safe and efficient method to prevent pulmonary embolism in a short period.But its long term complications should be considered and investigated.
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Objective To study methods of salvage therapy for acute lower extremity(ALEI) ischemia.(Methods) A restrospectively analyzsis was made on the clinical data of 96 patients with consecutive 106 ALEI limbs.In which Fogarty catheter embolectomy was used as the initial treatment for ALEI in a regular(operating) room or in an intervention therapy room under DSA monitoring,and graft bypass after embolectomy was performed on 8 cases(12 limbs).Results In 70 cases(75 limbs) successful embolectomy of the(iliac),femoral,popliteal and tibial artery was achieved.In 11 cases(12 limbs) embolectomy at distal to the popliteal artery was unsuccessful.Eight cases(12 limbs) with obstruction proximal to the femoral artery were treated by axillofemoral bypass in 4 cases,and femorofemoral bypass in 4 cases.One case of thoracoabdominal aortic dissection aneurysm and lower extremity ischemia had fenestration of the abdominal aoric dissection.Proximal embolectomy and distal amputation was performed in 6 cases.Fimally,76(79.2%) cases had(salvaged) limbs,11(11.4%) patients had amputated limbs,and 9(9.4%) patients died.Seventy-six(patients)(85 limbs) were followed up for 1 to 38 months,7 cases(7 limbs) were reoperated on because of recurrent embolism.Conclusions Embolectomy is the effective treatment method for ALEI.Embolectomy(under) DSA monitoring can improve therapeutic results.The prognosis lies on the duration and extent of(ischemia),and management of complications.
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Objective To explore the effects of overexpression of hypoxia inducible factor 1? (HIF 1?) mRNA on vascular endothelial growth factor (VEGF) and novoendotheliasis in venous autografts Methods Wistar rats were randomly divided into two groups with 28 rats in each group A rat experimental model of autogenous vein graft was established by transplanting the right external jugular vein into between the interrupted right common carotid artery The transplanted vein in the experimental group was first immersed into a solution containing recombinant adeno associated virus (rAAV) HIF 1? for 45 minutes Vein grafts and blood simples were taken at 7 or 14 days after transplantation RT PCR, ELISA, immunohistochemistry were used to detected HIF 1? mRNA and VEGF expression Results HIF 1? mRNA and VEGF protein remarkably increased in experimental group, and serum level of E selectin significantly decraesed at day 14 The novoendotheliasis and myo endothelium junction in vein grafts were remodeled at day 14 in the experimental group Conclusion Re establishment of the structure and function of the autograft vein graft endothelium was accelerated by overexpressed HIF 1? mRNA
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ObjectiveTo investigate the causes of groin lymphatic fistula after transluminal ultrason ic angioplasty (TUA) in the treatment of deep vein thrombosis(DVT) of lower extremity through groin incision. Methods A retrospective anal ysis of the causes of groin lymphatic fistula(GLF) in 72 patients with DVT after treatment of ultrasonic ablation was made. ResultsTUA and thr ombectomy using Forgaty balloon catheter for DVT of lower extremity achieved successful recanalization in all the 72 cases (100%). Of the 72 cases,51 had i liac vein stenosis,the venous stenosis disappeared after balloon dilation;amo ng the 51 cases ,6 cases received stent placement. GLF occurred postoperati vely in 60 cases. No death occurred in this series. ConclusionsTUA is an effective method in the treatment of DVT of lower extremity,but t he incidence of postoperative GLF is high.The causes of GLF may be related to the injury of lymphatic vessels, increase of quantity of lymph flow induced by increased venous pressure, infection, surgical technique factors and postop erative medicine therapy etc.
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Objective To assess temporary filter in the inferior vena cava (IVC) for trapping thrombus and preventing pulmonary embolism in patients with deep vein thrombosis. Methods In 58 cases of deep vein thrombus in single lower extremity, Antheor temporary filter (ATF) was introduced into IVC prior to anticoagulation and/or vascular intraluminal procedures. Results All IVC filters were successfully introduced. No symptomatic pulmonary embolism was documented. ATF was removed after a mean of 12.0?2.0 days. Thrombus was trapped in 46 cases (79.3%). Thrombus more than 1 cm in size was trapped in 2 cases. Conclusion Temporary filter was safe and effective in prevention of pulmonary embolism.
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0.05).Conclusions The intraluminal ultrasonic ablation angioplasty can be safely used to treat human venous thrombosis.