Objective:To evaluate the efficacy of drug-coated balloons (DCB) in hemodialysis patients with peripheral artery disease (PAD) involving infrapopliteal lesions.Methods:A retrospective analysis was conducted on 53 hemodialysis patients (56 limbs, 66 lesions) with infrapopliteal PAD who underwent DCB treatment between Dec 2018 and Dec 2021. The primary outcome was improvement in Rutherford classification, while secondary outcomes included target lesion revascularization (TLR) and wound healing rate. Safety endpoints were all-cause mortality, amputation-free survival, and amputation rate.Results:The mean lesion length was (145.2±78.4) mm, and 87.5% of patients were of Rutherford grade ≥4. The median follow-up period was 14 months. Rutherford classification significantly improved at 3 and 12 months ( P< 0.001). At 12 months, TLR was 16.6%, wound healing rate was 68.6%, amputation-free survival was 73.2%, all-cause mortality was 19.8%, and amputation rate was 8.9%. Multivariate Cox regression indicated that high WIfI risk ( HR=3.936, 95% CI: 1.079-14.355, P=0.038) was an independent predictor of amputation-free survival. Conclusion:DCB is effective and safe for hemodialysis patients with infrapopliteal artery disease, while high WIfI risk predicts poor prognosis.

Objective:To evaluate the efficacy of drug-coated balloons (DCB) in hemodialysis patients with peripheral artery disease (PAD) involving infrapopliteal lesions.Methods:A retrospective analysis was conducted on 53 hemodialysis patients (56 limbs, 66 lesions) with infrapopliteal PAD who underwent DCB treatment between Dec 2018 and Dec 2021. The primary outcome was improvement in Rutherford classification, while secondary outcomes included target lesion revascularization (TLR) and wound healing rate. Safety endpoints were all-cause mortality, amputation-free survival, and amputation rate.Results:The mean lesion length was (145.2±78.4) mm, and 87.5% of patients were of Rutherford grade ≥4. The median follow-up period was 14 months. Rutherford classification significantly improved at 3 and 12 months ( P< 0.001). At 12 months, TLR was 16.6%, wound healing rate was 68.6%, amputation-free survival was 73.2%, all-cause mortality was 19.8%, and amputation rate was 8.9%. Multivariate Cox regression indicated that high WIfI risk ( HR=3.936, 95% CI: 1.079-14.355, P=0.038) was an independent predictor of amputation-free survival. Conclusion:DCB is effective and safe for hemodialysis patients with infrapopliteal artery disease, while high WIfI risk predicts poor prognosis.

A total of 280 patients with varicose veins of lower extremities who were prescribed stretch socks as pressure therapy in the outpatient clinic of Beijing Chaoyang Hospital from September 2019 to November 2019 were included in the study. Among 280 patients 208 were followed up for one year(74.3%), 139 cases (66.8%) gave up wearing stretch socks and 69 cases (33.2%) insisted to wear. The main reasons for giving up wearing were feeling too tight (23.1%), too much troubles (17.7%), symptom improvement (15.1%), poor effect (10.8%) and so on. The compliance of wearing stretch socks as pressure therapy in outpatients with varicose veins of lower extremities is poor with a variety of reasons, the data may provide a reference for improving clinical compliance in the future.

Objective:To evaluate the safety and efficacy of a combination of percutaneous mechanical thrombectomy (PMT) and drug coated balloon(DCB)for the treatment of in-stent restenosis(ISR) and arterial thrombosis of the lower extremity.Methods:The clinical data of 53 patients treated with PMT + DCB were analyzed retrospectively, including 38 cases of ISR and 15 cases of arterial thrombosis. 33 patients were males and the others were females , the mean age was (68.6±9.4) years . Patients were followed at 30 days, 6 months, and 12 months concerning clinical symptoms, calculation of ABIs and duplex ultrasonography.Results:Procedural success was achieved in all 53 patients. One patient died of cardiovascular event perioperatively. 6 operation-related complications occurred including 5 cases of distal embolism during the PMT managed by using 5 F angiography catheter suction and one case of artery perforation during PMT procedure, a balloon was used to cover it. 47 (88.6%) patients completed 12-month follow-up, the TLR was 10.6% (5/47). One patient had the amputation 4 months later; There were 7 cases with arterial restenosis.PMT+ DCB were performed again in 4 cases, 1 case received stent implantation and 2 cases treated by medication.Conclusion:The use of combination of PMT and DCB is a safe and effective method to treat ISR and arterial thrombosis of the lower extremity.

Objective To explore the role and clinical efficacy of catheter induced thrombolysis (CDT) debulking method in the treatment of aorto-iliac artery occlusion.Methods A total of 59 patients with aorto-iliac artery occlusion who underwent endovascular treatment between June 2015 and June 2017 were enrolled.Patients were divided into PTA group and CDT group according to the treatment methods received.The PTA group received a balloon-expandable stent placement,and the CDT group underwent thrombolytic therapy for 48 to 72 hours before angiographic evaluation and further PTA treatment.Results In the CDT group,7 cases were still unable to place the stent after thrombolysis,and 20 patients successfully received stenting including 1-stent-placement in 16 patient and 2-stents-placement in 4.In PTA group 32 patients were treated with stents placement including 1-stent-placement in 19 patients,2-stents in 12,3-stents in 1.Follow-up rate was 86.3％ within 1 year,the patency rate was 84.21％ in the PTA group,and 76.92％ in the CDT group.Conclusions CDT is effective method for occlusion of the aortoiliac artery.TASC classification of aorto-iliac arterial occlusion degrades after CDT treatment,thus reducing the use of stenting.

Arteriosclerotic occlussive disease of the lower extremeties has become a common disease of aging society.Interventional technique is the main method of treating this disease,however,in-stent restenosis various and will degenerate itstherapeutic effect significantly and bring big trouble to clinicians.In the last decade,prevention and treatment techniques have emerged on the underlying mechanismofin-stent restenosis.Particularly,great improvement has been made,because of the development of related devices,such as drug coated balloons,cutting balloons,viabahn stentand bioresorbable stent,all of which could reduce the incidence of in-stent restenosisto varying degrees.In this paper,the latest progress of clinical research on the mechanism and treatment of in-stent restenosis is reviewed,particularly,the clinical effects of these newdevices are analyzed and summarized.

Objective To study the frequency of 9 bp sequence deletion of mithochondrial DNA in three ethnic nationalities of Guizhou Province .Methods A total of 183 male blood samples were randomly extracted from Miao nationality (69 cases) in Leishan County ,Shui nationality (44 cases) and Buyi nationality (70 cases) in Libo County .Polymerase chain reaction(PCR) and di-rect sequencing were used to detect the mithochondrial DNA 9 bp sequence deletion .Results The standard type ,deleting type and 3 type were found in the samples of 3 ethnic nationalities in Guizhou Province ,the highest deletion frequency was Shui nationality (40 .91% ) in Libo County ,1 cases of 3 type was detected in Miao nationality of Leishan County ,and the mtDNA 9 bp deletion fre-quency had no statistical difference among 3 ethnic nationalities(P>0 .05) .Conclusion The frequency of mtDNA 9 bp deletion is different among three native minorities ,the genetic variation in Shui nationality is larger ,compared with Miao nationality genetic re-lationship ,Shui nationality has a relatively closer affinity with Buyi nationality .

Objective To investigate the association between HLA-DP gene polymorphism and the susceptibility to hepatitis B virus (HBV) infection in people in Buyi,Miao and Shui ethnic groups in Guizhou.Methods A total of 256 patients with HBV infection,142 HBV self-cleared patients and 135 controls were recruited from 3 ethnic groups for this case-control study.Genotypes of rs3077 and rs9277535 were determined by using real-time PCR with a TaqMan-MGB probe.Results Compared with healthy subjects and self-cleared subjects,the allele distribution of rs9277535 was significantly associated with chronic HBV infection (P＜0.05),no significant differences in rs3077 allele and genotype distributions were found among 3 groups (P＞0.05).Compared with the rs9277535 GG genotype,the AA and AG genotypes were protective factors against HBV infection in dominant model after adjustment for age and sex (OR=0.645,95％CI:0.421-0.988),and no significant difference in rs3077 locus was found in the same analysis (P＞0.05).For men,the rs3077 locus CC and CT genotypes were also protective factors against HBV infection (OR=0.493,95％CI:0.266-0.916),and there was no significant difference in rs9277535 locus compared the genotype distributions among 3 groups in dominant mode.Comparison of allele and genotype distribution in 3 ethnic groups showed that HLA-DP gene rs3077 genotype distributions had significant difference between the HBV infection group and the healthy control group in Buyi ethnic group (x2=6.726,P=0.036).Conclusions The presence of rs9277535A allele at HLA-DP gene polymorphisms might decrease the risk for HBV infection,the rs3077 C allele at HLA-DP gene polymorphisms might also confer protective effect against HBV infection in women.No significant correlation between HLA-DP gene rs3077 and rs9277535 locus polymorphism and HBV clearance was found in this study.The HLA-DP gene rs3077 genotype distribution of HBV-infected patients had significant differences among different ethnic groups.

Vascular access is the dialysis patient's lifeline. Lower extremity arteriovenous accesses are a potential vascular access option in hemodialysis patients who have exhausted all upper-limb sites.The lower extremity options are including autogenous and prosthetic arteriovenous accesses.Numerous challenges including patency rates and complications are encountered in the lower extremities that are not seen in the upper extremities.In this review,we focus on the advances in lower extremity accesses.

Objective To evaluate hybrid therapy in patients with complex arteriosclerosis obliterans.Methods From Sep 2006 to Oct 2011,66 patients with complex arteriosclerosis obliterans were treated by hybrid therapy.A retrospective review was performed in all cases.Primary patency rate analyses were performed using Kaplan-Meier life tables.Results The technical success rate was 100％,and no patients died in perioperative period.12.1％ patients improved 3 levels,22.7％ patients improved 2 levels,and 65.2％ patients improved 1 level in Fontaine grade after procedures.The average ABI before and after procedures were 0.38 and 0.67 (P ＜ 0.05).2 patients died and other 64 patients completed 24 months follow-up.The primary patency rates and second patency rates were 75.0％ and 92.2％ at 24 months respectively.Primary patency rates of Fontaine Ⅱ patients were better than Fontaine Ⅲ and Ⅳ patients (P ＜ 0.05),and primary patency rates of Fontaine Ⅲ patients were better than Fontaine Ⅳ patients (P ＜ 0.05).Conclusions Hybrid therapy procedures provide an effective treatment in complex arteriosclerosis obliterans patients.