Objective To evaluate the efficacy and safety of interventional therapy for left iliac vein compression syndrome (LICS). Methods A total of 27 patients with LICS that were diagnosed by colour Doppler or venography,were included in this study. Among the cases,the disease course was shorter than 3 weeks in 13 patients,who presented with acute iliac-femoral vein thrombosis; in the other 14 patients,the disease course was longer than 3 weeks,showing the symptoms of chronic venous thrombosis. Venous puncture was performed via the contralateral femoral vein in 13 cases,and through the ipsilateral popliteal vein in 14. Venous filter was placed in 11 cases before thrombolysis,while in the other 16 cases,no filter was used. All of the patients received catheter-directed thrombolysis,afterwards,7 of them underwent percutaneous transluminal angioplasty,and the other 20 received angioplasty plus stent placement. Results In the 13 patients,who received venous puncture via the contralateral femoral approach,the guide wire could advance through the stenosis successfully in 8 patients but failed in 5. Ipsilateral popliteal vein puncture were then employed and succeeded in all the patients. Ipsilateral popliteal puncture were performed successfully in 14 patients. In 11 patients,inferior vena cava filter was placed before the procedure. In this series,the thrombolysis time was (85?16) h with a dose of (3000?320) thousand units urokinase. The thrombosis was dissolved completely in 13 acute patients and partial dissolution was attained in 14 patients in whom blood flow signal were detected color Doppler. After the operation,venogram showed complete patent iliac veins in all of the 27 cases. The patients were followed up for 6 to 26 months (mean,11 months). During the period,19 patients obtained patent iliac-femoral vein with the symptoms disappeared; 8 patients met the standard of improvement. Conclusions Interventional technique can be the first-line treatment for left iliac vein compression syndrome because of its favorable result and minimal invasion.

Objective To assess the different methods and their outcomes of interventional therapy for stenosis or occlusion in superior vena cava and its branches. Methods Sixty patients with stenosis or occlusion of SVC and its branches were retrospectively analyzed after interventional therapy. Among them, 38 were males and 22 were females, with age range from 15 to 72 years old(mean age 58). Seventeen patients were treated by thrombolysis, and the rest 43 patients accepted percutaneous angioplasty and stenting. Before and after that, the pressures within the vein were measured at the inflow side. The paired-t test was used for statistical analysis. Results After treatment, the pressure at the inflow side dropped from (24.8±2.3)mm Hg to (7.1±1.5)mm Hg(1 mm Hg=0.133 kPa), with a significant difference(t=3.232,P＜0.01). The clinical outcomes included complete relief in 27 patients, partial relief in 28 patients and non-relief in 5 patients. No major complications occurred. During 6 months follow up, restenosis occurred in 10 patients, among whom 6 received repeat intervention with good results. The other 4 patients turned to surgery .Conclusion Interventional therapy for stenosis or occlusion in SVC and its branches could recanalize the vessels, restore the blood flow and relief the clinical symptoms.

Objective: To summarize the characteristics of arrhythmia with the relevant factors affecting its prognosis in patients of apical hypertrophic cardiomyopathy (AHCM). Methods: A total 283 AHCM patients with echocardiography or cardiac magnetic resonance (CMR) conifrmed diagnosis in our hospital from 2005-01 to 2012-08 were summarized. The patients were divided into 2 groups: With arrhythmia group, n=103 and Without arrhythmia group,n=180. The endpoint event was followed-up by clinical and telephone visits in both groups and the relevant risk factors affecting AHCM prognosis were investigated by Cox regression analysis. Results: There were 269 patients ifnished the follow-up investigation, 98 in With arrhythmia group, 171 in Without arrhythmia group, and the death rate was 4.08% vs 1.17%, the occurrence of endpoint event was 18.37% vs 5.58%respectively. Cox regression analysis indicated that age (HR=23.051, 95% CI 1.08-1.068,P<0.005), left atrial diameter (HR=4.113, 95%CI 1.002-1.119,P=0.043) and NT-proBNP (HR= 18.653, 95% CI 3.433-26.650,P<0.005) were the independent risk factors affecting prognosis in AHCM patients. Conclusion: Arrhythmia is one of the common presentations of AHCM, it does not have much impact on survival, while it may cause ventricular ifbrillation and increase the occurrence of cardiovascular events.

Objective: To assess the effect of percutaneous transluminal septal myocardial ablation (PTSMA) on mid- to long-term left ventricular diastolic function in patients with hypertrophic obstructive cardiomyopathy (HOCM) by real-time three-dimensional echocardiography (RT-3DE). Methods: A total of 46 HOCM patients who received 2DE and RT-3DE examination before and after (with the mean of 18.8 months) PTSMA were studied. The ratios of E/A and E/Ea were analyzed, RT-3DE was conducted to collect the images, to obtain 17-segmant volume-time curve and to calculate the parameters of rEDV, rESV, rSV and rPFR respectively. Results: The follow-up echocardiography in all 46 patients indicated that the ratio of E/Ea decreased after the operation (12.04 ± 3.29) vs (15.70 ± 5.68),P<0.001, the rSV of left ventricular anterior wall middle segment and anterior septal middle segment decreased after the operation,P<0.05, while the rPFR of anterior septal middle segment, rear septal middle segment and apical segment increased,P<0.05. Conclusion: PTSMA may improve local left ventricular diastolic function in HOCM patients, RT-3DE provides a new method and viewing angle for HOCM evaluation.

Objective To analyze the correlation between septal branch characteristics and the prognosis of alcohol septal ablation ( ASA ) in patients with hypertrophic obstructive cardiomyopathy . Methods The clinical , echocardiographic , angiographic and procedural characteristics were analyzed retrospectively in 55 patients.Good prognosis was defined as left ventricular outflow tract gradient decreased by 50%at long term follow-up.The characteristics of septal branch were analyzed in terms of QCA .Results There were no differences in the length of the ablated septal branch , sizes of the adjacent branches , distances between the septal branch and the ostia of the coronary arteries and the volume of alcoholo consumed ( all P>0.05).Compared with poor prognosis group (n =27), the diameter of the ablated septal branches were significantly larger in the good prognosis group ( n=28 ) [ ( 1.75 ±0.36 ) mm vs.( 1.48 ±0.41 ) mm, P=0.012].The distance between the ablated branch and its adjacent branch was farer in the good prognosis group [(18.80 ±10.20)mm vs.(13.04 ±6.65)mm, P=0.020].In multivariate analysis, the diameter of the ablated branch (OR 9.258,95%CI 1.427-60.069, P=0.020)and the distance between the ablated septal branch and its adjacent septal branch (OR 1.102,95% CI 1.002-1.213, P =0.046) were found to be independent risk factors for good prognosis of ASA .Conclusions The diameter of the ablated septal branch and the distance between its adjacent septal branch are associated with better prognosis of ASA .

Objective: To explore the changing features of plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) level in patients with hypertrophic obstructive cardiomyopathy (HCM) after alcohol septal ablation (ASA). Methods: A total of 82 HCM patients treated by ASA in our hospital were studied. According to plasmalevel of NT-proBNP, the patients were divided into 2 groups: High NT-proBNP group and Low NT-proBNP group,n=41 in each group. Plasma NT-proBNP was examined by ELISA; ventricular septal thickness (VST), left ventricular posterior wall thickness (LVPWT), maximal ventricular wall thickness (MLVWT) and left atrial diameter (LAD) were measured by echocardiography. There were 50 patients ifnished 1 year clinical or in-hospital follow-up, their NT-proBNP level and echocardiography were detected at 2 days and 1 year post-operation.The relationship between echocardiography parameter and NT-proBNP level was assessed; NT-proBNP was compared between pre- and 2 days, 1 year post-operation. Results:①In all 82 patients: compared with Low NT-proBNP group, High NT-proBNP group had increased VST (23.66±6.46) mm vs (20.79±4.56) mm,P=0.035, LVPWT (12.79±2.99) mm vs (11.50±2.35) mm,P=0.048, MLVWT (28.03±5.66) mm vs (25.18±4.81) mm,P=0.027 and LAD (40.73±4.86) mm vs (38.08±6.17) mm,P=0.049.②In 50 patients who ifnished 1 year follow-up study: compared with pre-operation, NT-proBNP level was slightly increased at 2 days post-operation (1841.79±1310.88) fmol/ml vs (1552.15±951.57) fmol/ml,P=0.066, while decreased at 1 year post-operation (1038.46±714.03) fmol/ml vs (1552.15±951.57) fmol/ml,P=0.000. Conclusion: Plasma NT-proBNP level was affected by atrial size and ventricular thickness in HCM patients, it may obviously decrease during long-term follow-up period.

Objective To explore the status,developing demands and directions of the education and training of military medical equipment.Methods The main problems of the PLA's medical equipment education and training were analyzed via being compared with those of foreign armies.According to the requirements on the campaign mode changing in the future war,the innovating mode under information-based military training,and the research and exploration of novel equipment and new technology,the developing directions in the future were ascertained.Results The interface was enhanced between new medical equipment development and educational training,and specifications were prepared for medical equipment application and maintenance.Conclutsion Exploring the pivot choke points and the developing directions will provide strategy guidance on the rapid and highly efficient elevation of military medical equipment supporting capacity.

Objective: To investigate the efficacy of bare metal stent for treating focal coronary artery aneurysm complicating with severe stenosisin single coronary artery. Methods: This retrospective analysis was performed in 7 patients who were diagnosed as local coronary artery aneurysm complicating with severe stenosis(≥70%) in single coronary artery and treated with bare metal stent during the period from December 2012 to June 2015 in Fuwai Hospital. All 7 patients were male with age of (62±11) years old. During the interventional operation, the narrow parts were pre-expanded,and all patients received bare metal stents implantation to cover aneurysms.The clinical and imaging data of patients immediately post procedure and at postoperative follow-up were collected to evaluate the clinical efficacy. Results: There were 5 cases of left anterior descending aneurysms and 2 cases of right coronary artery aneurysms. The diameter of aneurysm was (5.21±1.28)mm, and the length was (13.71±3.88)mm. There was intracranial vortex in coronary arteriography immediately after intervention.Proximalstenosis of coronary artery aneurysm was disappeared,and the distal blood flow was TIMI class 3.There were no signs of aortic dissection and thrombus formation.During 6(6 16) months follow-up, the aneurysms were disappeared,and there were no major adverse cardiovascular events which including myocardial ischemia, acute myocardial infarction, revascularization,bleeding,and death for all patients. Conclusion Initial experience shows that double-layer bare metal stents implantation for patients with localized coronary artery aneurysm complicating with severe stenosis in single vessel is safe and effective.

Objective To observe the long-term prognosis and related outcome predictors for hypertrophic obstructive cadiomyopathy (HOCM) patients underwent alcohol septal ablation (ASA).Methods A total of 227 consecutive patients (age:(47.8 ± 11.7) years) treated by ASA from September 2005 to December 2013 in our hospital were included and followed-up for 4.42 years(range:(1.17-9.93) years).Follow up rate is 97.4％ (221/227).General information,medical history,data of ASA and complications during hospitalization were obtained through access to medical records of patients.The patients were followed up by telephone or outpatient visit.Results During hospitalization period,one patient died due to retroperitoneal hemorrhage,two ventricular fibrillation events and two sustained ventricular tachycardia events occurred and all patients were successfully recovered after electrical cardioversion (defibrillation).Four cardiac tamponade events occurred,35.7％ (81/227) patients experienced temporary three degree atrioventricular block.Five delayed three degree atrioventricular block evens occurred.During follow up,the percent of NYHA Ⅲ/Ⅳclass was significantly reduced (10.1％ (23/227) vs.74.9％ (170/227),P =0.000).The incidence of syncope and amaurosis fugax was also reduced(2.6％ (6/227) vs.39.2％ (89/227),P =0.035).A total of six patients died (4 cardiac death),one patient complicating atrial fibrillation died of cerebral embolism,one patient died of rectal cancer.One cerebral hemorrhage occurred.Six patients developed-new onset atrial fibrillation.One patient received permanent pacemaker implantation.Eight patients received surgical myocardial resection.Three patients underwent repeated ASA.Survival free of all-cause mortality at 1,5,9 year was 100％,96％,96％,respectively.Survival free of cardiac death and NYHA Ⅲ/Ⅳclass at 1,5,9 year was 100％,86％,70％,respectively.Cox-regression analysis showed that residual left ventricular outflow tract gradient after ablation(HR =1.027,95 ％ CI 1.006-1.048,P =0.010),less volume of injected ethanol (HR =0.596,95 ％ CI 0.398-0.892,P =0.012),presence of temporary complete atrioventricular block (HR =0.332,95％ CI 0.124-0.886,P =0.028) were independent predictors of cardiac death and NYHA Ⅲ/Ⅳ.Conclusion Our study results suggest that ASA could significantly improve symptoms and outcome in patients with HOCM.Residual left ventricular outflow tract gradient after ablation,less volume of injected ethanol,presence of temporary complete atrioventricular block during ASA are independent predictors of cardiac death and NYHA Ⅲ/Ⅳ.

Objectives:To analyze the efficacy and safety of drug coated balloon for coronary de novo lesions in real world. Methods:We enrolled consecutive patients with coronary de novo lesions treated with drug coated balloons from January 2020 to June 2021 in Fuwai Hospital.The baseline data,procedure data and in-hospital cardiac events were collected through case query.All patients were followed up by clinical visit or telephone call.Major adverse cardiac events(MACE)were defined as the composite of the cardiac death,acute myocardial infarction,target lesion revascularization.According to the diameter of the blood vessels,the patients are divided into the large vessel lesion group(vessel diameter≥2.75 mm,n=337),and the small vessel lesion group(vessel diameter<2.75 mm,n=575). Results:There were 940 coronary de novo lesions in 912 patients.A total of 974 drug balloons were used,average diameter was(2.6±0.8)mm,average length was(21.0±6.0)mm,average pressure was(10.0±3.8)atm.Among the 940 primary coronary artery lesions,343 lesions had a diameter≥2.75 mm,and 597 lesions had a diameter<2.75 mm.During hospitalization,two patients with acute ST-segment elevation myocardial infarction died of cardiac rupture after emergency coronary interventional treatment,acute vessel closure because of coronary hematoma occurred in 1 patient and bailout drug-eluting stent was used in this patient,five patients received salvage stent treatment due to type C dissection immediately after drug coated balloon treatment.During follow-up,Target lesion revascularization(TLR)occurred in 15(1.6%)patients(including coronary artery bypass grafting in 1 patient).Nonfatal acute myocardial infarction occurred in 1 patient,cardiac death occurred in 1 patient,2 patients died of cerebral hemorrhage,1 patient died of cerebral infarction,MACE rate was 1.9%(17/912).MACE rate during follow-up was similar between large vessels group and small vessels group(1.8%vs.1.9%,P>0.05). Conclusions:Our study indicates that drug coated balloon for coronary de novo lesion is safe and effective.There is no difference of MACE rate between large vessel group and small vessel group.