Multidisciplinary transluminal intervention for the treatment of acute deep venous thrombosis of the lower extremities / 中华普通外科杂志

Objective To evaluate a combination of open surgery and multiple interventional methods in the treatment of DVT of the lower extremities. Methods 521 cases (521 limbs,356 male and 165 female) were studied in this group. Age ranged from 16 to 86 years with the mean age of (46 ±9)years. All 521 cases with DVT were treated by Fogarty embolectomy catheter. Among them,348 cases underwent percutaneous transluminal angioplasty (PTA), 135 cases received PTA and ultrasound ablation,stent-grafts were implanted in 108 cases. Results Based on angiography during operation, the obstructed iliofemoral vein received complete recanalization in 511 cases. Among them, the postoperative luminal diameter was more than 90% in 38 cases after Fogarty embolectomy, the average stenosis rate was reduced from 90% ±5% to 24% ±5% in 365 cases after PTA and stent-grafts were implanted in 108 cases with the stenosis rate still over 50% after PTA. Only partial recanalization was achieved in the entrance of common iliac vein to inferior vena cava in 10 cases. Of the 521 cases,472 cases were followed-up with mean time of (53 ± 26) months, ranging from 8 to 108 months and 462 cases reported satisfactory results with normal life,the unsuccessful 10 cases still felt swelling pain especially in erect position. Complications occurred in 33 cases. Conclusions Open surgery combining with multiple interventional methods is a safe and effective method in the treatment of DVT.

Minimally invasive treatment of acute deep venous thrombosis in lower extremities caused by mili-tary training / 中华创伤杂志

Objective To evaluate the effect of combined multiple interventional methods in treatment of acute deep venous thrombi (DVT) in lower extremities caused by military training. Meth-ods All 25 patients with DVT were treated with embolectomy by using Fogarty catheter. Of all, three pa-tients were treated only with embolectomy, six underwent embolectomy plus percutaneous transluminal an-gioplasty (PTA), 11 received PTA plus ultrasound ablation and five were implanted with stent-grafts. The clinical results were analyzed retrospectively. Results Based on angiography during operation, the ob-structed iliofemoral vein received complete recanalization in 24 patients, with the perioperative luminal di-ameter ≥71%. Partial recanalization of the entrance of common iliac vein to inferior vena cava was failed in one patient. All 25 patients were followed up for an average 34 months after operation, which showed that 24 patients received satisfactory results with normal military training and that the other one with failed recanalization of vena iliaca still felt swelling pain in lower extremity after training. Conclusion Com-bined multiple interventional methods can remarkably improve the therapeutic effect for DVT caused by military training.

Interventional Treatment for Acute Deep Venous Thrombosis in the Lower Extremities Caused by Military Training Injuries / 中国微创外科杂志

50% of the diameter in 5(after receiving balloon dilation for vascular stenosis).In one patient,the opening of the left common iliac vein was still obstructed.Follow-up was achieved for 2 to 70 months(mean,34)in the patients,during which the symptoms and signs disappeared in 21 patients.In 3 cases,the perimeter of the disease limb was thicker than the opposite one by 0.5 to 1.0 cm.The situation was improved by conservative therapies.The patient who had obstructive left common iliac vein after the treatment,still complained of swelling of the limbs.Conclusions Multiple interventional methods can remarkably improve the therapeutic effectiveness for DVT caused by military training injuries.

Clinical analysis of staged arteriovenous shunts for the treatment of arterial occlusive disease of the limbs / 中国普通外科杂志

Objective To evaluate the result of staged arteriovenous shunts for the treatment of thromboangiitis obliterans(TAO) and arterial sclerosis obstruction (ASO). MethodsData of 176 cases undergoing this procedure were retrospectively reviewed. ResultsIn this group, 147 cases (83 5%) were followed up with a median of 9 8 years. Pain and/or claudication disappeared in 86 out of 90 cases (95 5%) treated by low positioned shunt one week postoperatively, with a limb salvage rate of 100%. Among 57 cases treated by high positioned shunts of the lower limbs, pain and claudication disappeared in 43 cases (75 4%) 2~3 weeks postoperatively. Postoperative amputation has to be performed in 5 cases with a limb salvation rate of 91%. ConclusionsThe clinical result of this staged arteriovenous shunts is satisfactory for the treatment of thromboangiitis obliterans(TAO) and arterial sclerosis obstruction (ASO).