Objective To evaluate the perioperative management of blood pressure in patients with bilateral carotid artery severe stenosis underwent staging carotid endarterectomy (CEA).Methods This retrospective study included 31 patients with bilateral carotid stenosis who underwent bilateral revascularizations in our department from April 2012 to November 2015.Patients were recorded with general information,and the changes of blood pressure in preoperative,intraoperative and postoperative were observed,respectively.Regulation and control of blood pressure were performed according to individual patient's condition.Results Thirty one patients underwent a total of 62 consecutive procedures successfully.Postoperative symptoms disappeared or significantly reduced.Twenty three cases (74.2％) had high perfusion symptoms in the ipsilateral CEA,and 5 cases (16.1％) with high perfusion syndrome in the contralateral surgery.Patients were improved after strict control of blood pressure and dehydration reduced intracranial pressure.The high peffusion symptoms in patients were significantly improved or disappeared after 1 week.Doppler ultrasound was used to evaluate the carotid artery before discharge.Conclusions For patients with bilateral carotid stenosis,staging purposes CEA is safe and effective.However,perioperative blood pressure management is very important.Individual control of blood pressure can significantly reduce the risk of postoperative high perfusion and cerebral infarction.Blood pressure control is recommended after 1 week in about 85％ of preoperative blood pressure.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.