Objective To investigate the effect of arterilization of veins in treatment of extensive arterial oblitery ischemia of limbs . Methods Eighteen lower limbs and six upper limbs with symptoms of chronic ischemia were diagnosed as having extensive occlusion of the major arteries by color Doppler Ultrasonic Scanning and DSA. According to the level of occlusion, the involved limbs were treated by arterilization of veins in one stage. Results During hospitalization, one lower limb was amputated. Seventeen lower limbs and six upper limbs were followed up for 3 to 26 months. Among them, one lower limb was amputated for necrosis of toes after 3 months; the outcomes of the others were satisfactory. By Doppler scanning, the arterial blood flow was observed after operation. Conclusion Arterilization of veins in extensive arterial oblitery ischemia of limbs is a simple and effective treatment with good result.
目的 评价盐酸沙格雷酯治疗慢性下肢动脉闭塞症的有效性和安全性。方法 对根据临床症状、下肢三维血管重建（CTA）或血管造影检查诊断为慢性下肢动脉硬化闭塞症的32例患者，采用盐酸沙格雷酯（100 mg/片）治疗，1片/次，3次/d，餐后口服，连续4周。用药24个月后观察患者临床症状的改善情况，分析盐酸沙格雷酯的治疗效果。结果 用药24个月期间，失访3例，获访29例。综合疗效显效6例，良好15例，改善5例，无效3例，总有效率为89.7% （26/29）。治疗前后患者的凝血系统和临床生化各指标比较差异均无统计学意义（P＞0.05）。用药后3例（10.3%）患者出现轻度恶心和胃部不适，2例（6.9%）患者出现轻度皮疹，其余患者均无不良反应出现。安全性评价安全没问题24例，稍有问题5例。结论 盐酸沙格雷酯可以改善慢性下肢动脉硬化闭塞症患者的临床症状。
ObjectiveTo discuss the diagnosis, treatment and clinical characteristics of open vascular injuries in the lower extremities and summarize our experiences. Methods To review the records of patients sustained an open injuries to the lower extremities vessel between 1999 and 2001 retrospectively. The clinical, operative findings and prognosis were collected and studied.ResultsAll 25 patients received emergency surgical treatment to repair the vascular injuries. It included 18 with isolated arterial injuries and 7 with combined arteriovenous injuries. Saphenous vein grafts were placed in 5 patients and vascular prostheses were placed in 5 patients with arterial injuries.Twentyfour patients were cured (96%), and 1 graft obstruction occurred (could not be contacted 40 days after operation). ConclusionOpen vascular injuries in the lower extremities should be diagnosed and treated as early as possible. The aim of the operation is to repair or reconstruct the injured vessel and to lower the mortality and morbidity rate.
Objective To establish the three diamension-model and to observe the contribution of endothelial progenitor cell (EPC) in the angiogenesis and its biological features. MethodsEPC was obtained from the rats’ peripheral blood. Its cultivation and amplification in vitro were observed, and the function of the cultural EPC in vitro was detected. The three diamension-model was established and analyzed. ResultsEPC was obtained from the peripheral blood successfully. The proliferation of the EPC which induced with VEGF(experimental group) was better than that without VEGF （control group） at every different phase (P＜0.01). It was found that EPC grew into collagen-material from up and down in the three diamension-model, and its pullulation and infiltration into the collagen were seen on day 1 after cultivation. With the time flying, there were branch-like constructions which were vertical to the undersurface of collagen and interlaced to net each other. It showed that in experimental group the EPC grew fast, its infiltration and pullulation also were fast, the branch-like construction was thick. But in control group, the EPC grew slowly, infiltration and pullulation were slow, the branch-like construction was tiny and the depth of infiltration into collagen was superficial. The number of new vessels in experimental group was larger than that in the control group at every different phase (P＜0.01). ConclusionRat tail collagen can induce EPC involved in immigration, proliferation and pullulation in angiogenesis. The three-diamension model of EPC can be used to angiogenesis research. VEGF can mobilize and induce EPC to promote the angiogenesis.
ObjectiveTo compare the clinical efficacy of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in the treatment of patients with carotid artery stenosis, and to provide a more abundant evidence-based medicine for the treatment of CEA and CAS in patients with carotid artery stenosis. MethodsForty patients with carotid artery stenosis were randomly divided into CEA group and CAS group based on the operative indication. Patients in CEA group were given carotid endarterectomy treatment and those in CAS group were given carotid artery stenting treatment. Then clinical efficacy of the two groups were observed and compared. ResultsIn terms of the occurring rate of perioperative complications, cardiovascular events in 3 months after operation, and some major end events such as stroke, death and so on, the comparative difference between the two groups was of no statistical significance (P > 0.05). Through the followed-up visits of 12 months, the comparative difference between the two groups was also of no statistical significance (P > 0.05) in terms of the occurring rate of carotid artery restenosis and disabling or fatal stroke. ConclusionsFor patients with severe extracranial carotid stenosis under indication of operation treatment, carotid endarterectomy and carotid artery stenting are of equivalent clinical efficacy, and both of them are of high security, although further study with large-amount and evidence-based medical data in long term from multiple centers is still in need.