OBJECTIVES: In recent years, the role of remnant cholesterol (RC) in the development and progression of cardiovascular diseases has gained increasing attention. However, evidence on the association between RC and subclinical atherosclerosis is limited. This study aims to examine the relationship between RC and atherosclerotic plaques in single and multiple vascular territories. METHODS: This retrospective cross-sectional study used baseline data from participants enrolled between October 2022 and May 2024 in the National Key Research Program "Study on the Prevention and Control System of Risk Factors for Panvascular Diseases". Color Doppler ultrasonography was performed to detect plaques in 4 vascular territories: Bilateral carotid arteries, bilateral subclavian arteries, abdominal aorta, and iliac-femoral arteries. RC was calculated as total cholesterol minus the sum of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). Participants were categorized into quartiles (Q1-Q4) according to RC levels. The proportions of participants with ≥2 plaques in a single vascular territory and with plaques in ≥2 vascular territories were compared across RC quartiles. Multivariate ordinal Logistic regression was used to assess the association between RC and the number of plaques in a single vascular territory, as well as the risk of multiple vascular territory involvement. Additionally, the effects of LDL-C/RC concordance on plaque distribution were analyzed. RESULTS: A total of 3 539 participants were included, of whom 2 169 (61.29%) were male, with a age of (51.94±9.22) years. From Q1 to Q4, the proportion of participants with ≥2 plaques in a single vascular territory (bilateral carotid, subclavian, abdominal aorta, and iliac-femoral arteries), as well as those with plaques in ≥2 vascular territories, increased progressively. Compared with Q1, both Q3 and Q4 were significantly associated with higher plaque numbers in a single vascular territory (both P<0.05). When treated as a continuous variable, higher RC levels were associated with an increased risk of greater plaque numbers within a single vascular territory (all P<0.05). RC levels were also significantly associated with multiple vascular territory involvement: Compared with Q1, Q4 had a 1.015-fold higher risk [odds ratio (OR)=2.015, 95% confidence interval (CI) 1.669 to 2.433], and each 1 mmol/L increase in RC corresponded to a 0.160-fold increased risk (OR=1.160, 95% CI 1.073 to 1.271). In LDL-C/RC coordination analysis, compared with the low LDL-C/low RC group, the low LDL-C/high RC group was significantly associated with multiple vascular territory involvement (OR=1.576, 95% CI 1.220 to 2.036). CONCLUSIONS Elevated RC levels are closely associated with atherosclerotic plaques in both single and multiple vascular territories, even among individuals with normal LDL-C, suggesting that RC should be considered in clinical risk assessment and management of atherosclerosis.
Humans ; Plaque, Atherosclerotic/diagnostic imaging* ; Male ; Female ; Cross-Sectional Studies ; Middle Aged ; Retrospective Studies ; Cholesterol/blood* ; Cholesterol, LDL/blood* ; Aged ; Cholesterol, HDL/blood* ; Risk Factors ; Atherosclerosis ; Ultrasonography, Doppler, Color ; Femoral Artery/diagnostic imaging*

Acute arterial occlusion is a rare complication following total knee arthroplasty (TKA). The incidence as reported previously is from 0.03% to 0.17%; however, the sequelae can be disastrous because of its potential threat to limb loss.We report a case of acute arterial occlusion in the midpiece of femoral artery following TKA occurred 40 min postoperatively. The occlusion site existed at the midpiece of femoral artery is uncommon. Arterial circulation of the lower limb could not be restored by the thrombolysis and thrombectomy treatments performed within 11 h after TKA. In the end, amputation had to be carried out. In the treatment of acute arterial occlusion following TKA with a tourniquet, it is important to fully consider that arteriosclerosis may induce atheromatous plaque disruption, which might be the reason for acute arterial occlusion.
Amputation ; methods ; Angiography ; methods ; Arterial Occlusive Diseases ; etiology ; surgery ; Arthroplasty, Replacement, Knee ; adverse effects ; methods ; Disease Progression ; Female ; Femoral Artery ; diagnostic imaging ; surgery ; Follow-Up Studies ; Humans ; Middle Aged ; Osteoarthritis, Knee ; diagnostic imaging ; surgery ; Postoperative Complications ; diagnosis ; surgery ; Severity of Illness Index ; Thrombectomy ; methods ; Thrombosis ; diagnostic imaging ; etiology ; surgery

OBJECTIVETo evaluate the value of three preoperative imaging methods in the anterolateral thigh flap (ALT) transplantation.

METHODSAccording to preoperative imaging, patients who underwent the ALT flap transplantation were divided into three groups: computed tomography angiography (CTA) group, digital subtract angiography ( DSA) group and magnetic resonance angiography (MRA) group. There were fifteen cases in each group. We compared the imaging quality of the ALT artery among these groups and recorded the parameters of lateral femoral circumflex artery, descending branches and perforators including type, course and size. The results from images were compared with intraoperative findings. The success rate and complications were also recorded.

RESULTSThe preoperative imaging accuracy of the types of the lateral femoral circumflex artery and descending branch was more than 92.3%, with no significant different between any two of three groups (P > 0.05). The difference in diameters of descending branches and perforators from preoperative measurement and from intraoperative measurement was also not significant between any two of the three groups; the success rate and complications were not also obviously different (P > 0.05 , P > 0.05, respectively).

CONCLUSIONSPreoperative mapping using CTA, DSA and MRA is a feasible and reliable method for the flap design in ALT transplantation. As a preoperative evaluation means, CTA and MRA may replace DSA in the ALT transplantation.

Angiography, Digital Subtraction ; methods ; Feasibility Studies ; Femoral Artery ; anatomy & histology ; diagnostic imaging ; Humans ; Magnetic Resonance Angiography ; Preoperative Care ; Surgical Flaps ; transplantation ; Thigh ; Tomography, X-Ray Computed

Dynamic hip screw fixation is a commonly performed procedure for internal fixation of intertrochanteric femoral fractures. Arterial injury following the operative fixation is a rare but serious event. We present a patient who developed pseudoaneurysm of profunda femoris artery after internal fixation of intertrochanteric fracture with a dynamic hip screw. The diagnosis was confirmed by angiographic study and it was successfully treated by coil embolization.
Accidental Falls ; Aged ; Aneurysm, False ; diagnostic imaging ; etiology ; therapy ; Angiography ; Bone Screws ; Embolization, Therapeutic ; Female ; Femoral Artery ; Femoral Fractures ; surgery ; Fracture Fixation, Internal ; methods ; Hip Fractures ; surgery ; Humans ; Postoperative Complications ; diagnosis ; etiology ; therapy

Anti-Bacterial Agents ; therapeutic use ; Child, Preschool ; Female ; Femoral Artery ; diagnostic imaging ; surgery ; Humans ; Lower Extremity ; blood supply ; Lung ; diagnostic imaging ; pathology ; Male ; Mycoplasma pneumoniae ; Pneumonia, Mycoplasma ; complications ; microbiology ; therapy ; Thrombolytic Therapy ; methods ; Thrombosis ; etiology ; microbiology ; therapy ; Tomography, X-Ray Computed

OBJECTIVETo assess the value of echo-tracking technology in evaluating endothelial function of the femoral artery in patients with Grave's disease.

METHODSThirty-four patients with Grave's disease patients and 30 normal adults as controls were recruited in this study. The intima-media thickness (IMT), arterial stiffness (β), pressure strain elastic modulus (Ep), arterial compliance (AC), pulse wave conducting velocity (PWVβ) and augmentation index (AI) parameters were examined using echo-tracking technology for evaluating the right femoral arterial elasticity.

RESULTSCompared with the control subjects, the patients with Grave's disease showed significantly increased β, Ep, and PWVβ and significantly decreased AC (P<0.05), but the argumentation index were similar between the two groups (P>0.05). In patients with Grave's disease, β and Ep were positively correlated with FT3, FT4, TT3, TT4, and PWVβ was positively correlated with FT3 and FT4.

CONCLUSIONSEcho-tracking technology can provide more accurate quantitative evidences for early diagnosis of femoral artery endothelial dysfunction in patients with Grave's disease, but the influence of procedural factors on the measurement accuracy should be considered in the evaluation.

Adult ; Case-Control Studies ; Female ; Femoral Artery ; diagnostic imaging ; Graves Disease ; complications ; diagnostic imaging ; physiopathology ; Humans ; Male ; Middle Aged ; Thyrotoxicosis ; complications ; diagnostic imaging ; physiopathology ; Ultrasonography

OBJECTIVESTo summarize the clinical experience of stented elephant trunk with femoral artery bypass grafting procedure to treat severe aneurysmal dilation of Stanford A aortic dissection or aortic aneurysm. To study the surgical indication and surgical strategy of chronic Stanford A aortic dissection and aneurysmal dilation, also to summarize the early follow-up results.

METHODSFrom February 2006 to November 2011, 19 patients with Stanford A aortic dissection or aortic aneurysm with extented aneurysmal dilation (megaaorta) received stented elephant trunk with femoral artery bypass grafting procedure. There were 3 acute cases and 16 chronic cases with 14 male patients and 5 female patients. Average age of this group was (42 ± 8) years and average body weight was (70 ± 15) kg. One patient was aortic aneurysm and all the other were Stanford A aortic dissection. Eight patients were Mafan's syndrome. Ascending aorta replacement or Bentall's operation was done first and total arch replacement and stented elephant trunk operation was done under deep hypothermia and circulatory arrest. After the patient was weaned from cardiopulmonary bypass, bypass from ascending aorta to femoral artery was done subcutaneously using the 10 mm graft in the same femoral incision.

RESULTSThere was no operative mortality. One patient had chylothorax which recovered with medical treatment and one patient got paraplegia after surgery. The cardiopulmonary bypass time was (176 ± 42) minutes, aortic cross clamping time was (88 ± 25) minutes and deep hypothermia and low flow rate time was (23 ± 8) minutes. The blood pressure of the lower extremities were normal after operation. Follow-up time was (22 ± 19) months. All patients survived. False lumen closure rate at the stent level was 100%. CT scan at 3 to 6 months after operation showed no obvious dilation of the descending aorta. Two patient successfully received second stage operation of total (subtotal) thoracoabdominal aorta replacement.

CONCLUSIONSStented elephant trunk and aorta to femoral artery bypass is a safe procedure to treat aortic dissection or aortic aneurysm with extended aneurysmal dilation. This procedure can effectively increase the blood supply of the lower extremities due to small true lumen of the descending aorta, and may decrease the speed of dilation of the false lumen. It is also a practical procedure to lay the foundation for the second stage operation of normothemia thoracoabdominal aorta replacement.

Adult ; Aneurysm, Dissecting ; diagnostic imaging ; surgery ; Aortic Aneurysm ; diagnostic imaging ; surgery ; Blood Vessel Prosthesis Implantation ; methods ; Female ; Femoral Artery ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVETo assess the efficacy and safety of two arterial closure devices, Angioseal and Perclose, in patients undergoing coronary angiography and invasive interventions.

METHODSFrom January 2001 to April 2011, 997 inpatients underwent coronary angiography and interventions with arterial closure using Perclose (486 cases) or Angioseal (511 cases). The time to ambulation and hemostasis, major vascular complications and deployment success rate with the two devices were compared.

RESULTSThe time to hemostasis was significantly shorter in Angioseal group than in Perclose group (3∓0.9 min vs 10.8∓4.8 min, P<0.001), but the time to ambulation was comparable between the two groups (6.4∓1.2 h vs 6.3∓0.7 h, P>0.05). The incidences of vascular complications showed no significant differences between the two groups (4.5% vs 3.7%, P>0.05), and none of the cases in either group developed femoral artery thrombosis or low limb embolism following the procedures. The deployment success rate was comparable between the two groups (97.8% vss 98.6%, P>0.05), and deployment failure was associated mainly with mishandling and design defect of the devices.

CONCLUSIONSAngioseal and Perclose are both effective and safe for arterial closure with reduced hemostasis and ambulation time and low incidences of vascular complications. Angioseal appears to have better performance than Perclose in shortening the hemostasis time and is easier to handle.

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; China ; Coronary Angiography ; adverse effects ; Coronary Disease ; diagnostic imaging ; therapy ; Female ; Femoral Artery ; surgery ; Hemostatic Techniques ; instrumentation ; Humans ; Male ; Middle Aged ; Peripheral Vascular Diseases ; etiology ; Retrospective Studies

BACKGROUNDFemoral artery thrombosis is one of the most common complications of catheterizations in infants and young children. This study was conducted to investigate the feasibility and effectiveness of thrombolytic therapy for femoral artery thrombosis after left cardiac catheterization in children.

METHODSThrombolytic therapy with urokinase was carried out in children with femoral artery thrombosis after left cardiac catheterization. Each patient was given a bolus injection of heparin (100 U/kg). A bolus of urokinase (30,000 - 100,000 U) was injected intravenously, and then a continuous infusion of 10 000 - 50 000 U/h was administered. Transcatheter thrombolysis was performed once previous procedures failed.

RESULTSEight patients (aged (3.1 +/- 2.3) years (8 months to 7 years), body weight (13.1 +/- 4.2) kg (7 to 20 kg)) presented lower limbs ischemia after left cardiac catheterizations was performed. Seven patients accepted thrombolytic therapy with urokinase. In 5 patients, peripheral intravenous thrombolysis was successful with restoration of a normal pulse. In the other 3 cases, peripheral intravenous thrombolysis failed, followed by successful transcatheter thrombolysis. The average duration of therapy was (7.25 +/- 5.31) hours (1 - 17 hours). The average doses of heparin and urokinase were (1600 +/- 723) U (800 - 3000 U) and (268 571 +/- 177 240) U (50 000 - 500 000 U), respectively. There were no statistically significant differences in partial thromboplastin time before and during urokinase therapy ((40.6 +/- 22.3) to (49.9 +/- 39.2) seconds). However, the prothrombin time was significantly longer ((12.7 +/- 2.58) to (48.1 +/- 18.6) seconds, P < 0.05). Patency of the target vessel was evaluated in all the patients for 2 weeks and no occlusion recurred.

CONCLUSIONThrombolytic therapy with urokinase is a safe and useful modality in children with femoral artery thrombosis after left cardiac catheterization.

Cardiac Catheterization ; adverse effects ; Child ; Child, Preschool ; Female ; Femoral Artery ; diagnostic imaging ; pathology ; Fibrinolytic Agents ; therapeutic use ; Heparin ; therapeutic use ; Humans ; Infant ; Male ; Radiography ; Thrombolytic Therapy ; methods ; Thrombosis ; diagnostic imaging ; drug therapy ; etiology ; Treatment Outcome ; Urokinase-Type Plasminogen Activator ; therapeutic use

PURPOSE: Currently, using perforator artery flaps especially anterolateral thigh flaps are widely used for reconstruction of extremities, head and neck. Obtaining a precise anatomical picture prior to operation will translate to a more accurate, efficient and safe procedure. Authors used 3D-image work up via 64-slice MDCT to make a more precise preoperative plan. METHODS: A total of 10 patients underwent soft tissue reconstruction with anterolateral thigh flap from December 2006 to December 2007. The 64-Channel MDCT (LightSpeed VCT, GE, USA) was used and 3D images were reconstructed. Findings from MDCT were applied to the preoperative planning and confirmed with intraoperative findings. RESULTS: The average number of perforator arteries from lateral circumflex femoral artery was 2. The average lengths of vascular pedicle from the origin of lateral circumflex femoral artery to the first and second perforator artery were 11.0cm and 20.0cm, respectively. The average diameter of the pedicle artery was 2.2mm. The locations of the perforator arteries were mapped and localized on the body surface based on the MDCT result. These were confirmed through direct visualization intraoperatively. CONCLUSION: MDCT has an advantage of obtaining accurate images of the general anatomy and even fine structures like perforator arteries. By using this state- of-the-art diagnostic imaging technique, it is now possible to make an operative plan safely and easily.
Arteries ; Diagnostic Imaging ; Extremities ; Femoral Artery ; Head ; Humans ; Imidazoles ; Neck ; Nitro Compounds ; Thigh