bjective To study the effectiveness of subfascial endoscopic communicating branch vein ablation in treating communicating branch vein insufficiency.MethodsFiftyseven cases of primary lower extremity vein valve insufficiency complicated by communicating vein insufficiency diagnosed by venography and color duplex were treated with subfascial endoscopic communicating branch vein ablation, and their information was analyzed retrospectively.ResultsSwelling was observed in leg of 7 cases after operation, and disappeared within one week spontaneously. Incision infection occurred in 2 cases and skin ambustion happened in 2 cases. Superficial vein varicosis disappeared in all case, skin pigmentatin declined significantly and ulcers healed in 2-3 weeks.Conclusion Subfascial endoscopic communicating branch vein ablation is an excellent choice in treating communicating branch vein insufficiency.
ObjectiveTo probe plasma calcitonin gene related peptide (CGRP) levels during thrombolytic therapy in patients with iliofemoral venous thrombosis in order to investigate its regularity of the alteration and its clinical significance.MethodsFifty patients with acute iliofemoral venous thrombosis and 30 patients with chronic iliofemoral venous thrombosis were given urokinase and prostaglandin E1 from veins for 15 days. The CGRP levels were determined by radioimmunoassay before treatment and on the 6th hour, 1st day, 3rd day, 7th day, 14th day, 30th day after treatment.ResultsThe plasma CGRP levels were increased in patients with acute iliofemoral venous thrombosis compared with the contrast ones. The CGRP levels in serious group was lower than those in mild group. However, the CGRP levels of 30 chronic patients and 12 patients who received the second course of thrombolysis as on effective were not different from those of contrast ones. The plasma CGRP levels were increased at the 6th hour,reached the peak at the 3th day and returned to normal at the 14th day after thrombolytic therapy in acute group which just consistent with the therapeutic effectiveness.ConclusionIt is helpful to judge whether the thrombolytic therapy is effective and the illness has come to chronic stage according to the levels of plasma CGRP in patients with iliofemoral venous thrombosis.
【Abstract】 Objective To explore the feasibility and safety of the femoral vein as a vascular graft material. Methods A total of 114 specimens of lower limbs were harvested from 60 adult cadavers; the lower extremity femoral veins, popliteal vein, deep femoral vein, and the communicating branch were dissected and observed; the length of the available femoral vein, from the point at which deep femoral vein and femoral vein joint to the lower edge of abductor hiatus, and squash vein diameter were measured. Computed tomography venography (CTV) data from 120 patients with lower extremity femoral vein thrombosis were analysed, and the venous reflux pathway of the lower extremity was observed. Results The average height of male was 158.3 cm, and the available length of femoral vein was (18.8 ± 2.3) cm (relative length, 0.118 ± 0.013), and squash vein diameter was (15.8 ± 0.8) mm. The average height of female was 149.2 cm, and the available length of femoral vein was (15.1 ± 1.5) cm (relative length, 0.101 ± 0.010), and squash vein diameter was (14.0 ± 1.1) mm. There were significant differences in the length of the available femoral vein (t=6.354, P=0.000) and squash vein diameter (t=5.555, P=0.000) between male and female. Positive correlation was found between the length of the available femoral vein and height (r=0.964, P=0.000). Low correlation was found between squash vein diameter and height (r=0.382, P=0.003). Double femoral veins were found in 16 limbs (14.0%), a femoral-popliteal vein communicating branch in 48 limbs (42.1%), a deep femoral-popliteal vein communicating branch in 38 limbs (33.3%). CTV showed that great saphenous vein, femoral-popliteal, or deep femoral-popliteal vein communicating branches had compensative capacity in patients with femoral vein thrombosis. Conclusion It is reliable and safe to harvest femoral vein as a vascular graft because of the existence of the great saphenous vein and communicating branches between the popliteal vein and femoral vein or deep femoral vein.
Objective To study the effectiveness of substitute valve at the popliteal vein in treatment of deep venous valve insufficiency of lower extremities. Methods From January 1996 to August 2002, 27 patients were diagnosed having deep venous valve insufficiency of lower extremities by color Doppler and radiography with an average disease course of 17.4 years.All 27 patients had varicose vein, 25 pain, 22 swelling,25 pigmentation in ankle area and 19 chronic ulcerations.Two cases had been treated with great saphenous vein ligation and striping.Averagevein pressure in resting position was (11.00±0.73)kPa,and the ambulatory venous pressure was (9.14±0.68)kPa.All patients were treated with substitute valve at the popliteal vein,and great saphenous vein ligation and stripping, some were treated with subfascial endoscopic perforating veins ablation. Results The average ambulatory venous pressure after operation was (5.94±0.82)kPa,were significantly different from that before operation(P＜0.01). The curative results were satisfactory,and all symptom and physical sign disappeared.After a mean follow-up period of2-6 years,21 cases had satifactory results. Conclusion Substitute valve at the popliteal vein have the value of widespread application.
Objective To evaluate the effect and safety of infantile femoral vein blood sampling with vacuum versus disposable needle. Methods Such databases as VIP, CNKI, CBM, Google Academic and Wanfang data were searched to collect the randomized controlled trials (RCTs) about infantile femoral vein blood sampling with vacuum versus disposable needle published from January 2000 to July 2010. The studies were screened according to the inclusive and exclusive criteria, the data were extracted, the methodology quality was assessed, and meta-analysis was conducted by using RevMan 5.0 software. Results A total of 15 RCTs were included. Of 3 490 patients in all, 1 770 were in the treatment group and 1 726 were in the control group. The baseline conditions were reported in 14 studies, and the random methods were mentioned in 11 RCTs. All studies didn’t report the allocation concealment and blind method. Only 2 RCTs reported separately that, the degree of neonatal pain was lower in the treatment group (Plt;0.01), and the satisfaction of parents was higher in the treatment group (Plt;0.01). Four RCTs compared the sampling time between the two groups without meta-analysis mentioned due to the disunity of standard, only the descriptive outcomes showed a shorter time in the treatment group. The meta-analysis showed that, compared with the control group, the reject rate of sample quality was lower (RR=0.20, 95%CI 0.15 to 0.26), the success rate of one time sampling was higher (RR=1.20, 95%CI 1.16 to 1.24), the injury of local tissue was slighter (RR=0.62, 95%CI 0.45 to 0.86), and the iatrogenic contamination was lower (RR=0.62, 95%CI 0.45 to 0.86) in the treatment group. Conclusion This review shows that the vacuum sampling is superior to the disposable needle sampling for domestic infantile femoral vein blood collection. Due to the low quality of the included studies with high possibility of bias, this conclusion needs to be further verified by performing more high-quality studies.
Objective To evaluate the clinical effect of staging endovascular angioplasty in treatment for iliofemoral venous post-thrombotic syndrome （PTS）. Methods The clinical data of 45 patients with iliofemoral venous PTS from May 2008 to October 2011 in this hospital were analyzed retrospectively. After the identification of the stenosis or occlusion by angiography via femoral vein by percutaneous puncture or incision puncture， recanalization of the occlusion was done by guide wire. Then the percutaneous transluminal angioplasty （PTA） was performed. Results A total of 45 cases （45 legs） had been undergone PTA. The procedures were technically successful in all the patients. No serious complications such as lumen rupture happened. Follow-up time was 6-30 months with （18.06±3.12） months， the symptoms of the affected limb were obviously relieved in 31 cases， partly relieved in 10 cases， not relieved in 4 cases. Reexamination of venous angiography， 9 cases were cured， 18 cases were excellent， 14 cases were improved， 4 cases were ineffective. The total effective rate was 91.11% （41/45）. Conclusion PTA is a safe and effective method in treatment for iliofemoral venous PTS.
目的 分析股动静脉插管在体外膜肺氧合（extracorporeal membrane oxygenation，ECMO）抢救治疗中的临床应用。方法 回顾性分析笔者所在医院2002 年6 月至2010年7 月期间因重症心肺功能衰竭而施行股动静脉插管并进行静脉-动脉转流体外膜肺氧合（VA-ECMO）抢救的47例患者的临床资料。结果 本组47例患者均顺利施行ECMO支持，37例患者经过治疗后治愈出院，10例死亡。插管并发症有出血、肢体缺血等，均经相应处理后治愈。结论 ECMO对急性心肺衰竭是理想的支持方法，股动静脉为急救插管的首选通道。
Objective To investigate the clinical effect of percutaneous endovascular interventional treatment for bilateral iliofemoral venous thrombosis. Methods From November 2012 to February 2016, the clinical data of 18 patients with bilateral iliofemoral venous thrombosis were retrospectively analyzed. All patients including 7 males and 11 females, aged from 51 to 86 years with an average of (66.2±7.8) years old. All patients underwent interventional treatment, and mechanical aspiration thrombectomy was performed under the protection of inferior vena cava filter at the acute or subacute phase; those whose venography showed iliac vein stenosis received balloon dilatation and self-expandable stents immediately. Iliac vein stenosis received balloon dilatation and self-expandable stents immediately at the chronic phase. Results The treatment was successful in all patients. The circumference difference of thigh and calf was (7.3±2.1) and (4.6±2.7) cm respectively before and after treatment. Thirteen patients with stenosis or occlusion of the iliac vein were treated with adjunctive balloon dilatation and stent placement, and 20 self-expandable stents were inserted successfully. All the patients were followed up for 12–34 months with an average of (21.5±7.3) months; stenosis or occlusion of the stent were seen in 1 patient after 9 months; post thrombotic syndrome was observed in 1 patient after 12 months. The 12-month primary patency rate and secondary patency rate was 88.9% (16/18) and 100.0% (18/18), respectively. Conclusion Endovascular interventional therapy of bilateral iliofemoral venous thrombosis is a safe and effective method.