1.Ultrasound guided thrombin injection for treatment of iatrogenic femoral pseudoaneurysms
International Journal of Surgery 2015;42(6):396-398
Objective To evaluate the effect and safety of ultrasound-guided pereutaneous thrombin injection for the treatment of iatrogenic femoral arterial pseudoaneurysm.Methods Thirty patients [6 male,24 female,age range 45-82 years,mean (63 ± 10) years] were found to have pseudoaneurysms confirmed by ultrasound between 1 and 7 days following femoral arterial puncture from July 2011 through July 2014.Results All patient had pseudoaneurysm thrombosis after the first procedure.Thrombin 200-1000 U (50 U/mL)was injected into the pseudoaneurysm under ultrasound-guidance,performed.One patient showed acute allergy 5 min after thrombin injection,which was relieved by anti-allergic therapy.No thromboembolic complications or infections occurred.Conclusions Ultrasound-guided pereutaneous thrombin injection is a safe and effective noninvasive method for the treatment of iatrogenic femoral pseudoaneurysm and should be considered as first-line therapy.
2.Anticoagulants: a review of its history and newly use
International Journal of Surgery 2011;38(12):828-832
Anticoagulants is the drugs which prevent blood clotting process by affecting coagulation factor.They can be used for prevention of thromboembolic disease and stroke.As we stand on the threshold of a new era of anticoagulants,it is time to take an overview of the different types of anticoagulants and how to use them in the management of some specific conditions,including pregnancy,renal impairment,heparininduced thrombocytopenia and cancer.
3.Changes of serum enzymes in acute mesenteric vasculopathy
Chinese Journal of General Surgery 2014;29(4):285-288
Objective To study changes of serum enzymes among acute mesenteric vasculopathy (AMV) and several surgical acute abdomens for early diagnosis of acute mesenteric vasculopathy.Methods Rabbit models were established for acute mesenteric artery ischemia,acute mesenteric venous ischemia,acute mechanical ileus,acute strangulated intestinal obstruction,acute gastric perforation,acute pancreatitis,sham group,blank control group.Serum enzymes were tested after 0,1,3,6,9 h.Result Compared with blank control,acute mesenteric vasculopathy experienced significantly alterations of the serum enzymes.ALT (alanine aminotransferase),ALP (alkaline phosphatase),r-GT (glutamyl transferthe enzyme) were significantly higher after mesenteric veins blocked 3 hours,LDH (lactate dehydrogenase) was significantly higher after mesenteric venous blocked 6 hours (P < 0.05).ALT was significantly higher after mesenteric artery blocked 6 hours (P < 0.05).Elevated ALT were statistically different in acute mesenteric vasculopathy compared with blank control,sham group,gastric perforation,mechanical ileus,and strangulated intestinal obstruction (all P < 0.05) ; r-GT level was statistically different between acute mesenteric artery ischemia and acute mesenteric venous ischemia.Conclusions Mesurements of serum enzymes level are helpful to make early diagnosis of acute mesenteric vasculopathy.
4.Analysis the risk factors associated with symptomatic pulmonary embolism in patients with deep venous thrombosis
Luyuan NIU ; Huan ZHANG ; Fuxian ZHANG
Chinese Journal of General Surgery 2017;32(5):415-417
Objective To evaluate the predicting risk factors for fatal pulmonary embolism (PE) in patients with acute deep venous thrombosis of the lower limbs.Methods 182 consecutive patients with acute deep vein thrombosis in the lower limbs were retrieved from our hospital between January 2011 and May 2015.Collected clinical data for all patients included,demographic,body mass index,Wells score.The possible risk factors in patients with PE were retrospectively analyzed.Results The total incidence rate of symptomatic PE in 182 patients was 14.28%.Through muhivariate logistic regression analysis,we found that Wells score,location of thrombosis,inpatient days,bone fracture was significantly associated with symptomatic PE (P < 0.05).Conclusion Higher Wells score,Proximal thrombosis and fracture are the high risk factors related with symptomatic PE.
5.Application of cerebral protection devices in carotid artery stenting
Huan ZHANG ; Fuxian ZHANG ; Zhijun WENG
International Journal of Surgery 2009;36(2):119-122
Carotid artery stenosis is one of the most important reasons for stroke. Carotid artery stenting possesses more advantages with less damage and pain for patients, which has becaome the most effective treatment for carotid artery stensis, and the use of review the issues related to te carotid artery stenting under cerebral protection. With the accomplishment of many successful large scale clinical trials carried out by multiple centers, it is believed that carotid artery stenting with cerebral protection plays important orle in the prevevtion and treatment of cerebral stroke initiated by carotid artery stenosis.
6.Management of aorto-iliac occlusive disease by kissing-stents technique
Fuxian ZHANG ; Huan ZHANG ; Gangzhu LIANG
Chinese Journal of General Surgery 2010;25(7):546-548
Objective To evaluate the place of kissing-stents technique in the management of aorto-iliac occlusive disease. Method Clinical data of 15 patients with aorto-iliac occlusive disease treated from Apr 2007 to Apr 2009 in our hospital were retrospectively analyzed. There were 9 males, and 6 females with a mean age of 66 years ( range 45-77 years). All 15 patients had significant symptoms of extremity ischemia. Claudication was complained in 11 (73% ) patients with an average distance of 88 meters. Four (27% ) patients had rest pain, gangrene of the toes was found in 2 patients ( 13% ). There were occlusive aorto- bilateral iliac artery with stenosis at superficial artery in 2 patients, occlusion at bilateral common iliac artery in 3 patients, occlusive disease at left common iliac artery with stenosis at bilateral superficial artery in 2 patients, occlusion at right common iliac artery in 8 patients, with stenosis or occlusion at superficial artery in 4 patients. In these 15 patients ABI was from 0.0 to 0.6, with an average of 0.36 ±0.3. Result Kissing-stents technique was successfully used in all 15 patients. 40 stents was released in bilateral common iliac arteries including 15 self-expanding stents and 25 balloon expandable stents. Residual stenosis was less than 30% and mean pressure gradient was 5 mm Hg. ABI increased from 0. 5 to 1.0 averaging at 0. 8 ±0. 2. The average hospitalization time was 7 days. Primary and secondary patency was 87% and 94% respectively as shown by a follow-up of 2 years. Conclusions Endovascular management of aorto-iliac occlusive disease by Kissing- stents technique is safe and effective and can raise the endovascular operation success rate and lower the complications.
7.The prevention and management of complications in vena caval filter placement
Fuxian ZHANG ; Lu HU ; Changming ZHANG
Chinese Journal of General Surgery 2001;0(09):-
Objective To explore the complication s and management of the placement of vena caval filter in patients suffering from deep venous thrombosis (DVT). Methods From 1998 to 2005, 80 DVT patients were treated by vena caval filte r placement. Before the placement 46 cases received CTA, 27 cases did radionucli de imaging(LPS), 16 cases did color Doppler ultrasonography, 5 cases underwen t venography. Result The p rocedure was successful in all 80 cases. New DVT developed in contralateral fem oral vein in 2 patients and vena caval obliteration developed in 3 patients afte r one year. Conclusion The complications of vena caval filter placement could be prevented by correctly de fine indication and good expertise.
8.An experimental study on the prevention of spinal ischemia caused by cross-clamp of thoracoabdominal aorta
Fuxian ZHANG ; Changming ZHANG ; Lu HU
Chinese Journal of General Surgery 1997;0(04):-
Objective To prevent and manage spinal ischemia caused by cross-clamping the thoracoabdominal aorta often undertaken in clinical surgical practice. Methods Forty-five rabbits were divided for 3 experiments. A variety of vasoactive agents were used to manage spinal ischemia; The effect of cerebrospinal fluid drainage was evaluated; Hypothermia was used to alleviate the spinal ischemia injury. Results Among the above three experiments neuron degeneration was the mildest in hypothermia group though prostaglandin and cerebrospinal fluid drainage do have some positive effects. Conclusion It was suggested that administration of hypothermia and prostaglandin are the most effective for the prevention of spinal ischemic injury during major thoracoabdominal aorta surgery.
9.Role of hydrogen sulfide in the cardiovascular diseases
Bingbing MA ; Fuxian ZHANG ; Gangzhu LIANG
International Journal of Surgery 2010;37(3):196-199
Endogenous hydrogen sulfide (H_2S) is to third found gaseous transmitter.In cardiovascular system, H_2S is produced endogenously by cystathionine γ-lyase (CSE)and plays an important role in the regulation of cardiovascular physiologic function and patho physiological processes.The CSE/H_2S system has a variety of biological effects in the cardiovascular system, such as inducing vasorelaxation,decreases blood pressure,inhibiting vascular smooth muscle cell proliferation and inducing anti-oxidant.It is also concerned with variety of cardiovascular diseases such as hypertension, hyperlipemia, atherosclerosis,coronary artery disease and so on.We summarize the biochemical characteristics and the physiological functions of endogenous H_2S and its patho physiological effects in cardiovascular diseases.
10.Recent progress in application of local drug delivery for preventing restenosis after peripheral arterial revascularization.
Mingyi ZHANG ; Fuxian ZHANG ; Huan ZHANG ; Gangzhu LIANG
Chinese Journal of Surgery 2015;53(3):237-240
Restenosis following vascular revascularization remains an important clinical problem. Local drug delivery which can provide enough drug concentration in the lesion location without causing adverse systemic effect is an excellent solution for this question. We conducted a systematic literatory search on PubMed and CKNI through May 2014. After reviewing all related papers, we provided a comprehensive overview of the available drugs and techniques for local drug delivery that have been developed to prevent restenosis after peripheral vascular interventions, including innovations that have been tested only in animals as well as those already approved for clinical use. In brief, anti-proliferative drugs such as paclitaxel and sirolimus are the most used and suitable drugs for local delivery system. Additionally, some promising drugs including anti-inflammatory drugs, antioxidant drugs and drugs inhibiting cell proliferation and migration are already being tested in pre-clinical trials or animal models. At the same time, intraluminal and extraluminal delivery devices have also got a rapid development during the past decades. The efficacy of drug-eluting stent, drug-eluting balloon, porous and microporous balloon and the most recent drug-eluting bioresobable scaffold for preventing of restenosis in peripheral vessels have been demonstrated in humans or in animals, some of them even have received the CE mark in Europe. Endovascular microinfusion catheter and drug-loaded perivascular wraps have only been tested in animal models, more researches are needed. With the development of pharmacology and bioengineering, great strides will be made in the prevention of restenosis in the near future.
Animals
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Anti-Inflammatory Agents
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administration & dosage
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Antibiotics, Antineoplastic
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administration & dosage
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Arteries
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Coronary Restenosis
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prevention & control
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Drug Delivery Systems
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Drug-Eluting Stents
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Humans
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Myocardial Revascularization
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Paclitaxel
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Sirolimus