1.Therapeutic effect of continuous arterial catheter directed thrombolysis on lower limb arterial ischemic disease
Jie FANG ; Yongbao ZHANG ; Han LI ; Chengjia QU ; Lequn TENG ; Chenyang SHEN
International Journal of Surgery 2019;46(7):477-480
Objective To investigate the clinical efficacy of continuous arterial catheter directed thrombolysis for ischemia disease of lower extremity.Methods Retrospective analysis of clinical data of 29 patients undergoing continuous arterial catheter directed thrombolysis from June 2016 to June 2018 in Department of Aortic and Vascular Surgery Center,Fuwai Hospital,CAMS&PUMC was conducted.There were 25 males and 4 females,aged (65.3 ± 11.2) years,with an age range of 51-81 years.The patients were diagnosed after admission and received continuous arterial thrombolysis.After thrombolytic therapy,estimate was conducted whether to place the stent further based on the result of angiographit.The patients' pain symptom relief,embolism,bleeding and other complications were observed in the 6 months,12 months and 24 months by telephone follow-up or outpatient review.Meanwhile,the patients improved the color Doppler ultrasound examination.Results The 21 patients were markedly effective,7 patients were effective,and 1 patient was ineffective in all the 29 patients who accepted the continuous arterial catheter directed thrombolysis therapy.Two of the patients developed distal toe arterial embilization during thrombolysis and improved after drug treatment.The total effective rate was 96.5% (28/29).Stents implant rate was 20.7% (6/29).The follow-up rate was 86.2% (25/29).No symptom relapse was observed.Conclusion Continuous arterial catheter directed thrombosis for ischemia disease of lower extremity is minimally invasive,safe and effective.
2.Paclitaxel coated balloon in the treatment of femoral popliteal artery disease
Yongbao ZHANG ; Lequn TENG ; Jie FANG ; Xinnong LIU ; Chengjia QU ; Chenyang SHEN
Chinese Journal of General Surgery 2022;37(3):184-188
Objective:To summarize the clinical efficiency of paclitaxel drug coated balloon (DCB) in femoral popliteal artery disease.Methods:Retrospective analysis was made on 125 patients (141 limbs) admitted from Jun 2016 to Jul 2019 for femoral popliteal disease treated with DCB.Results:Median follow-up time was 19 months. The average lesion length was (138±78) mm, with an overall cumulative primary patency rate of 81.4% and 60.8% at 12 and 24 months postoperatively and f-TLR rates of 90.1% and 83.0%, respectively. In a total of 109 primary lesions, subgroup analysis showed that among the TASC C/D primary lesions, the primary patency rate was significantly lower in those with combined severe calcification and the f-TLR rate in those with popliteal involved lesions. TASC grade C/D lesions, severe calcified lesions were independent risk factors for patency, while hypertension was an independent protective factor.In-stent restenosis (ISR) target lesions involving the popliteal segment had a significantly worse prognosis than ISR of the superficial femoral artery.Conclusion:DCB in the treatment of lower femoral popliteal artery lesions can achieve a satisfactory medium-term patency outcome, while the efficacy for complex lesions still needs further improvement.