1.Clinical comparison of percutaneous transluminal angioplasty and surgical resection for Cimino-Brescia arteriovenous fistula stenosis in hemodialysis patients
ting Yan YU ; hui Zhan GAO ; bing Liu ZHAO ; juan Lei XIAO ; bo Zhi ZHENG ; zhang Run ZHU ; ying Hong WANG ; jun Xian L(U) ; xi Da JI
Journal of Medical Postgraduates 2017;30(12):1305-1308
Objeetive As to the high incidence of arteriovenous fistula(AVF) stenosis,surgical operation will result in the exhaustion of vascular resources in patients,while percutaneous transluminal angioplasty(PTA) can maintain vascular resources for ostomy.However,there is still no clear definition between the choices of PTA and surgical resection.The aim of this study was to compare the efficacy of PTA and surgical resection followed by reconstruction for the treatment of arteriovenous fistula stenosis in order to find appropriate treatment.Methods Retrospective analysis had been done on 46 hemodialysis patients with arteriovenous fistula stenosis in Nanjing BenQ hospital from January 2015 to March 2017,which included 22 cases treated with PTA (PTA group) and 24 cases treated with surgical operation (operation group).Comparison was made in general clinical situation,patency rate at six months after surgery,over patency time and adverse reactions to surgery between the two groups.Results The number of stenoses in PTA group was bigger than that in operation group and the difference was of statistic significance (2.78±1.43 vs 1.67±0.71,P<0.05).There was no significant difference in patency rate between the two groups (P =0.828).There were 57 venous stenoses in PTA group,among which 12 stenoses were anastomotic (21.05%) with 79.3% average stenosis degree and 43 stenoses were at venous outflow tract of fistula (75.44%) with 84.26 average stenosis degree.In PTA group,3 patients had hematoma brachial puncture position and recovered by self-absorption without special treatment.In operation group,1 patient had mild blood oozing and recovered after treatment;4 patients recovered gradually from mild swelling on the back of the hand of the operation side.No difference was found in adverse reactions between two groups (P>0.05).Conclusion PTA treatment is preferred for multiple stenoses(n ≥ 3),which ensures better preservation of vascular resources at a comparable patency rate.
2.Efficacy of stents coated with antibody against CD105 on preventing restenosis and thrombosis in minipigs
Song CUI ; Shu-Zheng L(U) ; Yun-Dai CHEN ; Guo-Xiang HE ; Hong-Bing YAN ; Li-Jun MENG ; Hong LIU ; Xian-Tao SONG ; Ze-Ning JIN ; Chang-Jiang GE
Chinese Journal of Cardiology 2010;38(7):648-651
Objective Novel stents loaded with antibody against CD105 were analyzed for their potential to limit coronary neointima formation and to accelerate endothelialization by attracting activated endothelial cell. Methods Thirty Stents coated with antibody against CD105, thirty unloaded polymer, and thirty bare metal stents were deployed in 90 coronary arteries of 30 minipigs. Oral aspirin (300 mg before operation and 100 mg post operation) and clopidogrel (300 mg before operation and 75 mg post operation) were orally administrated. Coronary artery quantitative analysis was completed by coronary arteriography,the vascular endothelium changes were observed under scanning electron microscope and the vascular morphological changes were observed under light microscope 7 and 14 days after operation. Results Complete procedural and angiographic success was achieved in all 30 minipigs. There were no major adverse cardiac and cerebrovascular events. At 7 days, there was no difference for mean neointimal area and percent rea stenosis among various groups. At 14 days, endothelialization scores were significantly higher in the CD10S antibody-loaded stents and bare metal stents group than in sirolimus-eluting stents group (1.78 ± 0.49, 1. 50±0. 67 vs. 1. 08±0. 29, all P < 0. 05 ), mean percent area stenosis in the CD105 antibody-loaded stents, sirolimus-eluting stents group were less than that in bare metal stents group [ (23. 8± 4) % , (24. 2±2)% vs. (38.0 ±3)% , all P <0.05] ,mean angiographic late luminal loss in the CD105 antibody-loaded stents, sirolimus-eluting stents group were less than that in bare metal stents group [ (0. 29±0. 28) mm, (0. 28±0. 02) mm vs. (0.41±0. 01) mm, all P < 0. 05 ]. There was no difference for mean percent area stenosis in the CD105 antibody-loaded stents and sirolimus-eluting stents group. The mean neointimal area in the CD105 antibody-loaded stents,and sirolimus-elutingstents group were less than that in bare metal stents group [(0.88±0.08) mm2, (0. 89 ±0. 12mm)2 vs. ( 1. 00 ±0. 14) mm2 , all P<0.05] and there was no difference for the mean neointimal area in the CD105 antibody-loaded stents and sirolimus-eluting stents group. At 7 and 14 days, there was no difference for the injury score and the inflammation score among various groups, scanning electron microscopy evidenced enhanced endothelial coverage on CD105 antibody-loaded stents compared to sirolimus-eluting stents group. Conclusion Stent coated with antibody against CD105 could effectively reduce in-stent restenosis and accelerate endothelialization in th eminipigs.