Objective To analyze the clinical characteristics of deep venous thrombosis (DVT) of lower extremity in the elderly.Methods One hundred and eighty elderly inpatients with DVT and one hundred and forty-four non-elderly DVT inpatients were recruited in the study.The prevalence situation, risk factors, complications and curative effect were analyzed.Rcsulls The prevalence of DVT in patients aged 60-69 years was the highest(50.5%), followed by the patients aged 70-79 years(40.5 %), The five major risk factors were post-operation (27.8 %), malignant tumor (15.0 %), traumatic fracture ( 7.8 %), sequelae of cerebrovascular disease (7.2 %) and long-term bedridden(5.0%).49.4% of the elderly had Cockett's syndrome, including 14.0% of them with common iliac vein (CIV) occlusion(n=6), 48.8% of them with >50% stenosis of the CIV (n= 21) and 37.2% of them with <50% stenosis (n= 16).In acute stage of DVT, the curative effect of thrombectomy was superior to that of thrombolysis, while there were no statistically significant differences in curative effect between the two methods in non-acute phase.The curative effect between elderly group and non-elderly group did not show significant difference.Conclusions The elderly are easy to suffer from DVT, and malignant tumor and sequelae of cerebrovascular disease are the risk factors for DVT in the elderly.The curative effect of thrombectomy is better than that of thrombolysis in elderly patients with acute DVT.

0.05). ConclusionsWhen varicose veins of the lower extremity with deep vein insufficiency exists, patients should undergo high ligation and stripping of the great saphenous vein, additional correction of the deep vein reflux provides no further effect.

Objective To evaluate the complicatio ns after thrombectomy for deep vein thrombosis (DVT) of the lower extremity. Methods Thrombectomy was under taken for 143 patients using Fogarty catheter, then local thrombolysis and antic oagulation was undertaken by a indwelling catheter in the great saphenous vein. Results The total recurren ce rate of DVT was 12.6%(18/143), whereas the early recurrence rate without loc al thrombolysis and anticoagulation was 29.8%(14/47). The recurrence rate was 1 8.9%(14/74) against the background of Cockett syndrome, and 5.8%(4/69) withou t Cockett syndrome. Other complications included lymphatic fistula in 4 cases (2 .8%), pulmonary embolism, vena cava thrombosis, massive haemorrhage, and incisi onal infection in one each, death ensued in 3 (2.1%). ConclusionsThe recurrence rate of DVT could be low ered by management of the stenosis or occlusion of common iliac vein and local thrombolysis and anticoagulation. Thrombectomy should be the first choice of the rapy for DVT.

Objective To study the effect of thoracoscopic sympathectomy and/or chemical lumbar sympa- thectomy performed on patients with Raynaud disease. Methods Five patients, 1 male,4 females, aged from 30 to 65(mean 45. 3 ). Raynaud phenomenon appeared only on both hands in one patient, only on feet with a toe gangrene in another one , the other 3 cases on all limbs. Thoracoscopic symathectomy was performed for those whose hands were af- fected and chemical lumbar sympathectomy(12-3 ) was pererformed for those whose feet were affected. Results All patients were followed up from 12 to 48 months(mean 24 months). All experinced improvement with hands warm and satisfactory results after thoracoscopic sympathectomy. However, the original symptoms reccurred in two patients after postoperatire six months. All 4 patients performed chemical lumbar sympathectomy experienced improved symptoms with feet warm and satisfactory results and the symptoms did not recur up to now. The sympathectomy showed different results for hands and for feet. Conclusions Thoracoscopic sympathectomy for hands affected by Raynaud disease has efficiency temporarily, but is not satisfactory. The chemical lumbar sympathectomy for the feet affected by Raynaud disease has dramatically disappearence of symptoms and the results are very good

Objective To investigate the therapeatic effects of chemical thoracic sympathectomy (CTS) for Raynaud disease. Methods A niddle was injected into the first or second thoraic vertebra from back. A X-ray examination was performed to definite the position of the niddle tip. One millilitre of urographine was injected to determine if it was infused into thoracic cavity. If not, 2 ml of 5% phenol was injected and the niddle was removed. Results Within 10 minutes both pairs of the hands of the two patients with Raynaud's disease turned into flushing and warm from pallor and cool after CTS. Ice-water test changed to negative. Conclusions CTS is of simple, microinvasive and low cost procedure for Raynaud's disease.

Objective To report an improved method, color-ultrasonography-guided inferior vena cava (IVC) filter placement, for preventing the pulmonary embolism (PE) caused by the deep venous thrombosis (DVT). Methods Color-ultrasonography-guided IVC filter insertion was performed in 9 patients with DVT of lower limb, 1 of which also had PE accompanied with at the time of admission. Out of the 9 patients, 5 patients underwent embolectomy immediately after the filter placement while the other 4 patients were treated conservatively. Results The placements were all completed successfully. Follow-up observations for 1～7 months (mean 2 months) found no complications or occurrence of PE. No recurrence of PE was found in the patient already with PE. Conclusions The color-ultrasonography-guided IVC filter placement can effectively prevent PE caused by DVT. The method is suitable for severe, immovable patients, as well as patients with renal insufficiency and being allergic to intravenous contrast, and is safe, convenient, cheap and prone to popularization.

Objective To study the causes, prevention and treatment of secondary thrombosis after vena cava filter placement. Methods We summarized the clinical experience regarding 7 cases of secondary thrombosis of the inferior vena cava from December 2001 to June 2004 in this hospital. Results Two patients underwent thrombectomy, 1 patient received interventional thrombolytic therapy, and the rest of 4 patients received conservative treatment. All the treatment had obtained good results. No pulmonary embolism took place in the study. Conclusions Thrombosis secondary to filtration can be completely prevented by adhering strictly to the indications of filter placement and conducting supplementary anticoagulation therapy. Interventional therapy is the first choice for the treatment of secondary thrombosis after filter placement.

Objective To assess long-term outcomes of electrocoagulation for treating varicose veins of the lower extremities. Methods A retrospective review was made on clinical data of 426 cases of varicose veins of the lower extremities treatd by electrocoagulation from October 1996 to October 2001.Postoperative follow-ups were carried out with clinic checkups or questionnaires.Results Of the 426 cases,follow-ups for 4~9 years(mean,5.8 years) were completed in 364 cases(500 limbs) and a loss to follow-up was encountered in 62 cases,the follow-up rate being 85.4%.The cumulative rate of recurrent varicose veins was 10.4%(52/500),in which the recurrent varicose veins were cured with sclerosing agents in 50 limbs and with re-operations in 2 limbs.The relief rate of sensation of heaviness and tension was 95.1%(309/325).Accompanying venous ulcers in 20 limbs healed up within 2~8 weeks.The incidences of subcutaneous hematoma and saphenous nerve injury were 0.8%(5/594) and 1.2%((7/594),) respectively.Skin burns happened in 5 limbs(0.8%,5/594). Conclusions Electrocoagulation for varicose veins of the lower extremities is proved to be a novel minimally invasive method,with advantages of safety,effectiveness,low costs,and short hospital stay.

Objective To summarize the experience of fluoroscopy-guided chemical thoracic sympathectomy(CTS) for the treatment of Raynaud's phenomenon.Methods A series of 73 cases of Raynaud's phenomenon(141 upper limbs) treated with CTS from March 2001 to September 2005 in this hospital was chronologically divided into two groups: the Group A between March 2001 and December 2002 and the Group B between January 2003 and September 2005.In the Group A,under the guidance of X-ray fluoroscopy,a needle was punctured through the back skin to the second or the third thoracic sympathetic ganglion beside the thoracic vertebrae and 2 ml of 5% phenol was injected.In the Group B,when the needlepoint reached the rear edge of target thoracic vertebra,2~3 ml of anesthetic was injected.Then the needle was advanced sequentially untill the needlepoint reached the sympathetic ganglion.Other manipulation was the same with the Group A. Results The incidence of pneumothorax in the Group A(28.4%,19/67) exceeded greatly that in the Group B(4.1%,3/74)(?~2=15.773,P=0.000).The effective rate in the Group A(77.6%,52/67) was much lower than that in the Group B(97.3%,72/74)(?~2=12.851,P=0.000).Between the two groups,differences of the incidence of axilla pain(Group A,2 limbs;Group B,5 limbs)(?~2=0.411,P=0.521),bradycardia(Group A,1 case;Group B,nil)(?~2=0.002,P=0.967),and Horner's syndrome(Group A,1 case;Group B,1 case)(?~2=0.000,P=1.000) were not statistically significant.Conclusions Pneumothorax is a common complication of chemical thoracic sympathectomy.Improvement of procedure can reduce the incidence of pneumothorax and increase the effective rate.

Objective To observe pathological changes of varicose veins after electrocoagulation and endovenous laser treatment(EVLT) and to compare the efficacy between electrocoagulation and EVLT for the treatment of varicose veins of the lower extremity.Methods Twenty patients with varicose veins of the lower extremity were treated with either electrocoagulation(n=10) or EVLT(n=10).Histopathological changes of varicose veins were observed.Eight dogs were randomly divided into 2 groups and treated with electrocoagulation or EVLT.The treated veins were taken out at 0,7,and 14 days after operation,for histopathological examinations.Results After electrocoagulation or EVLT,the endothelial cells of varicose veins were absent,the structure of smooth muscle cells was indistinct,broken collagenous fibers and elastic fibers were observed,and thrombosis leading to occlusion was observed in the lumen.Incomplete thrombus organization and conglutination with the walls were observed 7 days after operation.Mild recanalization was found in both groups.On the 14th postoperative day,the hyperplasia of smooth muscle cells,collagenous fibers,and elastic fibers was detected.Complete thrombus organization was seen,and recanalization presented no obvious changes.ConclusionsBoth electrocoagulation and EVLT can lead to the occlusion of varicose veins,being effective therapeutic alternatives for varicose veins of the lower extremity.