1.Interventional treatment for Buddi-Chiari syndrome with occlusive hepatic veins
Jianjie RONG ; Xiaoqiang LI ; Aimin QIAN ; Hongfei SANG
Chinese Journal of General Surgery 2012;27(5):392-394
ObjectiveTo evaluate interventional therapy for Buddi-Chiari syndrome with occlusive hepatic veins.MethodsIn this study,37 Budd-Chiari syndrome cases with occlusive hepatic vein undergoing abdominal ultrasonography, CT scan, and liver vascular reconstruction before operation.Interventional procedures included recanalization of occlusive hepatic veins through transjugular,transfemoral vein or both. ResultsProcedures were successful in 34 patients (success rate 34/37,92% ),with 38 hepatic veins opened. After hepatic vein was opened,nine patients were treated with PTA alone.27 stents were placed in 25 patients,with 2 cases receiving stent placement in both the right hepatic vein and accessory hepatic vein.7 home-made Z-stent were placed after the opening of occluded inferior vena cara.After the procedures hepatic vein pressure dropped from ( 36.0 ± 3.4) cm to ( 21.0 ± 2.3 ) cm H20.Recurrence of stenosis or oclusion was found in 4 out of 9 receiving PTA only after a follow-up of (23.0 ± 2.0) months.In the other 23 patients with stent implantation there were 6 eases of restenosis or occlusion (6/23,26% ). ConclusionsAccording to the hepatic vein and intrahepatic collateral venous occlusion conditions,correct selection of interventional methods can significantly decrease the hepatic and portal vein pressure,improve clinical symptoms.
2.Comparison of surgical thrombectomy and catheter-directed thrombolysis for acute deep vein thrombosis of the low extremity caused by Cockett syndrome
Yeqing ZHANG ; Xiaoqiang LI ; Qingyou MENG ; Pengfei DUAN ; Jianjie RONG
Chinese Journal of General Surgery 2013;(4):284-287
Objective To study the short-and long-term results for Cockett syndrome caused acute deep vein thrombosis (DVT) of the lower extremity by surgical thrombectomy or catheter-directed thrombolysis.Methods One hundred and two Cockett syndrome caused acute DVT cases were treated by surgical thrombectomy or catheter-directed thrombolysis (CDT) from Jan 2006 to Dec 2011.There were 52 patients treated by CDT (group A),and 50 cases by surgical thrombectomy (group B).All patients received warfarin treatment after operation.Results There were no significant differences in general clinical characteristics between the two groups.The limb edema reduction rates between the two groups were of no significant difference(83% ± 6% vs.82% ± 8% P > 0.05).The venous patency were basically the same (64.6% ± 6.7% vs.65.3% ± 7.2%,P > 0.05).The mean time required was shorter in group A than in group B[(30.5 ±6.7) min vs.(97.5 ±23.6) min,P <0.01].The average hospital stay was shorter [(9.8±5.4) d vs.(17.7 ±8.2) d,P<0.01],and morbidity was less[13.4% vs.42%,P<0.01].Eighty six patients were followed up.The circunference difference of thigh,the score of vein patency between the two groups were of no significant difference (P > 0.05).Conclusions Compared with surgical group,patients in CDT group have shorter hospital stay,less complication and similar long and shortterm results.
3.Surgical and interventional therapy in patients with acute superior mesenteric vein thrombosis
Pengfei DUAN ; Xiaoqiang LI ; Aimin QIAN ; Hongfei SANG ; Jianjie RONG
Chinese Journal of General Surgery 2013;28(7):504-506
Objective To evaluate the surgical and interventional therapy in patients with acute superior mesenteric vein thrombosis.Methods In this series,31 acute superior mesenteric vein thrombosis(SMVT) cases were reviewed from Oct 2006 to Feb 2012.According to varied clinical presence,patients received superior mesenteric vein thrombectomy with necrotic bowel resection or indirected catheter thrombolysis through superior mesenteric artery.Results 6 of 9 cases undergoing surgery were cured and other 3 still complained abdominal distension when discharged for not being able to bear anticoagulation and thrombolysis after operation due to alimentary tract hemorrhage,and residual thrombus was shown in superior veins by venography.17 of 22 treated by interventional therapy gained obvious relief within 72 hours after intervention,others gained symptomatic relief in 5-7 days.Indirected catheter thrombolysis were interrupted in 2 due to alimentary tract hemorrhage.One patient was shifted to surgery 48 hours after catheter thrombolysis due to deterioration.Mean duration of follow-up after hospital discharge was (19 ± 5) months in 25 cases,20 had no abdominal distension and pain,3 with postcibal abdominal distension.Conclusions Indirected thrombolytic therapy by way of the superior mesenteric artery is a technically simple,safe and effective therapy for patients with acute SMVT.
4.Establishing a rapid monitoring method of common pathogens of frozen embryo and sperm in mice
Weichao XU ; Sujing QIANG ; Jianjie GU ; Rong GE ; Lijun LIU ; Ping XU ; Rong RUI
Chinese Journal of Comparative Medicine 2016;26(9):69-75
Objective To establish a rapid monitoring method of the three common bacteria in mice frozen resources, such as embryo, sperm, etc. Methods To extract DNA of the three positive bacteria( Staphylococcus auerus, Klebsiella?pneumoniae and β?hemolyticstreptococcus) , and establish PCR monitoring method of the three positive strains through designing primer and refining PCR condition. Then extract total DNA of the frozen resources, detect the DNA according to the PCR condition of the three positive bacteria, some samples were detect by fluorescence quantitative PCR at the same time. Results ①successfully establish a PCR detection method of the three positive bacteria, the minimum detectable concentration of Staphylococcus auerus, Klebsiella pneumoniae and β?hemolytic streptococcus is 4?19 × 10 -5 ng/μL, 1?98 × 10 -5 ng/μL and 1?07 × 10 -3 ng/μL. ②Proved that the three bacteria doesn ’ t exist in the sample by normal PCR and fluorescence quantitative PCR methods. Conclusions Establising a rapid monitoring method of common pathogens of frozen embryo and sperm in mice.
5.Mensurement and analysis of biological characteristics of C57BL/6J mice and their offsprings after frozen-thawed embryo transfer of C57BL/6J mice
Weichao XU ; Jianjie GU ; Rong GE ; Lijun LIU ; Ping XU ; Rong RUI
Chinese Journal of Comparative Medicine 2017;27(4):69-74
Objective To investigate the changes of average body weight gain and serum biochemical indexes of C57BL/6J mice (B6 mouse) and their offspings after frozen-thawed embryo transfer of B6 mice.Methods The mice were divided into three groups in this study.In the experimental group I (E-I,30 males and 20 females),2-cell embryos after in-vitro fertilization were collected,and cryopreserved by EFS method,then obtained the offsprings after transplantation of the recovered embryos to oviduct of recipient mice (ICR mouse).In the experimental group II (E-II,26 males and 17 females),when the mice from E-I grew to maturity,the offsprings were obtained from natural mating of mice from E-I.In the control group (20 males and 20 females),the offsprings came from conventional feeding and natural mating.The three groups of mice were raised to 16 weeks old,weighing the body weight at a regular time intervals,and the serum biochemical indexes were obtained from 16-week-old mice.Then the changes of average body weight and serum biochemical indexes of the mice were analyzed.Results The average body weight of E-I mice was significantly higher than that of control group at each week-age (P<0.01).The average body weight of E-II female mice was significantly higher than that of the control group in 12-16-week old mice (P<0.01),but the average body weight of E-II male mice showed no significant differences compared with the control group except for few weeks.The serum biochemical indexes of E-I and E-II mice were changed in all items except for AST,TP and Ca.Conclusions There are some effects on the average body weight gain and serum biochemical indexes of C57BL/6J mice and their offspings after frozen-thawed embryo transfer.
6.Value of deep vein ascending venography in the diagnosis of iliac vein compression syndrome
Tiejun ZHAO ; Xiaoqiang LI ; Aimin QIAN ; Fengrui LEI ; Jianjie RONG ; Chenglong LI ; Wendong LI
Chinese Journal of General Surgery 2014;29(4):269-271
Objective To evaluate ascending venography in the diagnosis of iliac vein compression syndrome.Methods From April 2011 to April 2013,we have had 556 patients with varicose veins suspected of Cockett syndrome.The degree of varicose veins by the International Union of Venous Clinical Classification (CEAP classification) was as following[1]:shallow varicose veins of lower limb (C2) in 190;varicose veins with limb swelling (C3) in 149 cases ; with body skin changes,such as pigmentation,eczema or lipid hard skin disease (C4) in 130; with healed ulcers (C5) in 17; with active ulcer(C6) in 70.Deep vein anterograde contrast and femoral venous cannula angiography were performed on 760 times.Results Iliac vein compression syndrome (Cockett) was detected by ascending venography in 154 patients,the diagnosis was established by following femoral venous cannula angiography.In the other 48 patients in whom Cockett syndrome was suspected by ascending venography,final diagnosis was reached by femoral venous cannula angiography.Altogether there were 202 iliac vein compression syndrome cases,with a positive rate 38.19% (202/529).The narrowness was larger than 50% in 173 cases.In 145 cases there were visible collateral vessels.Conclusions Deep vein ascending angiography is a useful screening method in the diagnosis and treatment of Cockett syndrome.
7.Midterm rusults of endovascular treatment for ilio-femoral venous postthrombotic syndrome
Aimin QIAN ; Jianjie RONG ; Hongfei SANG ; Qingyou MENG ; Liwei ZHU ; Xiaobin YU ; Xiaoqiang LI
Chinese Journal of General Surgery 2016;31(4):281-284
Objective To evaluate clinical outcome of patients treated with endovascular dilation and stent placement for ilio-femoral venous postthrombotic syndrome (PTS).Methods 42 PTS cases were enrolled in our group from June 2003 to December 2011.Dilation and stent placement in stenosis/ occlusion of ilio-femoral veins were performed in all cases,temporary femoral arteriovenous fistula was established in 24 cases.Results These were not severe perioperative complications.All patients were followed up for 8-75 months.Preoperative limb ulcers in 5 cases were healed.Early thrombosis in stents found in 3 cases was cleared by catheter directed thrombolysis (CDT).Severe in-stent restenosis (> 50%)was found in 10 cases,treated with dialation or re-stenting.Primary patency,assisted primary patency and secondary patency rates were 75%,78%,80.1%;64.1%,67.1%,69.6%;63.8%,65.3%,66%;61.7%,65%,65.2%,respectively,at 6 months,12 months,24 months and 36 months.Postoperative Venous Clinical Severrity Score (VCSS) decreased (P =0.000).There was statistical significant improvement in every dimension evaluated by the MOS item short from health survey(SF-36) after operation (P =0.000).Conclusion Ilio-femoral venous stenting is a safe and effective treatment for PTS and with good clinical midterm results.
8.Endovascular intervention for infrapopliteal arterial ischemia
Qingyou MENG ; Xiaoqiang LI ; Aimin QIAN ; Hongfei SANG ; Pengfei DUAN ; Liwei ZHU ; Jianjie RONG ; Xiaobin YU
Chinese Journal of General Surgery 2008;23(9):699-701
Objective To evaluate the efficacy of endovascular interventional treatment for infrapopliteal arterial ischemic diseases. Methods Sixty patients(65 limbs)of infrapopliteal arterial isehernia of the lower extremities received pereutancotm transluminal angioplasty(PTA)and/or stents implantation from November 2004 to July 2007.The symptoms,changes of ankle/brachial index(ABI),limb salvage rate and immediate patent rate were observed. Results PTA/stenting procedure was successful in 51 out of 60 patients(65 limbs)with the technical success rate of 83.3%.Symptoms were improved in 53 cases(88.3%)including complete symptom remission in 40 cases(66.7%),partial remission in 13 patients(21.7%).The procedure failed in 7 cases(11.6%).In successful cases,AB1 increased from preoperative 0.40±0.18 to postoperative 0.91±0.22(P<0.01).The amputation below knee was performed in two cases and toe apodizers in four cases.The limb salvage rate was 91% during the same hospitalization.Discharged 54 cases were followed up with 14.5±1.2 months,during this period amputation above knee was performed in 2 cases,amputation below knee in 2 cases,and toe apodizers in 2 cases,with a limb salvage rate of 88.9%(48/54).Symptoms were recurrent in five cases,with recurrence rate of 9.2%.Vascular reocclusion or restenosis were found in 10 cases.the patent rate was 81.5% and the cumulative patent rate was 57.3% in one year. Conclusions Endovascular interventional treatment for infrapopliteal arterial ischemic disease is safe and effective.
9.Iliac vein intervention with arteriovenous fistula in treatment of lower extremity postthrombotic syndrome
Pengfei DUAN ; Haorong WU ; Xiaoqiang LI ; Aimin QIAN ; Jianjie RONG ; Xiaobin YU
Chinese Journal of General Surgery 2009;24(11):926-929
Objective To discuss a new method of interventional and surgical therapy for the lower extremity postthrombotic syndrome (PTS). Methods 35 PTS cases were enrolled in our group. Dilation and stent placement in stenosis of iliac veins were performed in all cases, then temporary femoral arteriovenous fistula was established. After two weeks, 15 cases with varicosity underwent high ligation of the great saphenous vein and stripping, 5 cases with leg ulcers (ulcers diameter>3 cm) underwent skingrafting. After operation, patients took warfarin orally for 6 months and wear elastic compression stockings. Results Procedures were successful in all cases. Thrombectomy extracted only a few old thrombus. Before discharge, limb swelling subsided in 26 cases while 4 remain light swelling and 5 had no obviously relief. Twenty-six cases were followed-up for 3~24 monthes. Limb swelling subsided in 22 cases but still exist in 4. Limb ulcers were healed in 11 cases and the area of pigmentation were diminished. Limb ulcer recurred 12 months after skingrafting and healed finaly after perforator veins clipping with second skingrafting. Color Doppler was used in follow-up to check the potency of affected deep veins, good outcome was found in 20 cases and rough intima with stenosis of iliac veins was found in 2, no flow signal in 4. Conclusions Stenosis of iliac veins in PTS are common, the pathological changes could be treated by interveional method combined with temporary arteriovenous fistula. The degree of recanalization of femoral-popliteal veins determined the results.
10.Perioperative complications of interventional therapy for lower extremity arteriosclerosis obliterans
Pengfei DUAN ; Xiaoqiang LI ; Haorong WU ; Xiaobin YU ; Hongfei SANG ; Aimin QIAN ; Jianjie RONG
Chinese Journal of General Surgery 2009;24(6):466-469
Objective To evaluate the prevention and management for the complications in interventional therapy for the lower extremity arteriosclerosis obliterans (ASO). Methods In this study 207 ASO cases received interventional therapy. The relationship between complication rates and different TASC type and the influence of diabetes mellitus (DM) with coronary heart disease (CHD) on critical organs complication rates was analyzed. Results The intervention succeeded in 190 cases. There was 17 failures, including 13 procedure failures and 4 deaths due to postoperative critical organ complications. Among the complications there were puncture site hemorrhage in 12, pseudoaneurysm in 4, alimentary tract hemorrhage in 2, arteriorrhexis in 6, cerebral infarction in 8, acute heart failure in 9, respiratory failure in 13, renal failure in 6, thrombosis in 5 and blue-toe syndrome in 1. The intraoperative complication rate of femoral-political type (39.84%, 51/128) was high than that of aorta-iliac type (18.99%, 15/79) (P< 0.05). Those critical organ complication rates of patients with DM and patients with DM&CHD were 27.66% (13/47)and 24.49% (12/49)respectively, they were higher than that of patients without (5%, 2/40) (P<0.05). Conclusions The high complication rates during interventional therapy of ASO were because of misoperation and complicated pathological type and together with DM and CHD. These rates could be decreased when we treated DM and CHD before operation and chosen a reasonable method and shorten the duration of operation.