OBJECTIVES: To investigate the medium- and long-term efficacy of percutaneous mechanical thrombectomy (PMT) combined with stent implantation for treatment of iliac vein stenosis with lower extremity deep venous thrombosis (LEDVT). METHODS: Clinical and follow-up data of 125 patients with iliac vein stenosis and LEDVT who underwent PMT and stent implantation at five hospitals in northern Zhejiang province from January 2017 to June 2021 were collected. The thrombus clearance rate, thrombus recurrence rate, patency rate of iliac vein stents and post-thrombotic syndrome (PTS) occurrence rate were documented, and safety indicators such as bleeding, death, pulmonary embolism, stent fracture and displacement were assessed. RESULTS: Among 125 patients, for clearance of limb thrombosis, there were 8 cases of grade I (6.4%), 10 cases of grade II (8.0%), and 107 cases of grade III (85.6%). Patients were followed up for a median period of 74 months. According to the Villalta score, the recurrence rates of limb thrombosis at 12, 24 and 36 months were 8.48%, 8.93% and 10.91%; the iliac vein patency rates were 91.52%, 91.07%, and 89.09%; and the incidences of PTS were 5.08%, 5.36% and 6.36%, respectively. There were no major adverse events such as death, massive pulmonary embolism or severe hepatic and renal insufficiency, and no readmission intervention events due to stent fracture or other incidence were found. CONCLUSIONS PMT combined with iliac vein stent implantation is effective for patients with iliac vein stenosis complicated by LEDVT with good medium- and long-term efficacy and safety, which is worthy of clinical application.
Humans ; Stents ; Iliac Vein/pathology* ; Venous Thrombosis/surgery* ; Thrombectomy/methods* ; Female ; Male ; Middle Aged ; Aged ; Adult ; Constriction, Pathologic/surgery* ; Treatment Outcome ; Follow-Up Studies

A 55-year-old male patient with a history of hypertension and type 2 diabetes mellitus received sodium phosphates oral solution 45 ml diluted in 750 ml or more warm water in 2 divided doses for bowel cleansing on the night before and the morning of the day of colonoscopy. After the colonoscopy, the patient developed abdominal distension. Eighteen days after the colonoscopy, elevated serum creatinine (Scr) was found with a peak value of 175 μmol/L. Thirty-five days after the colonoscopy, Scr was 168 μmol/L and the glomerular filtration rate calculated by the plasma-creatinine-based equations Chronic Kidney Disease Epidemiology Collaboration was 38.54 ml/min. Renal puncture and pathological examination showed tubular epithelial cell injury with calcium phosphate deposits, and acute phosphate nephropathy was diagnosed. The patient was advised to drink more water and was given symptomatic treatments such as diuretic furosemide. Five months later, the Scr recovered to 105 μmol/L.

A 55-year-old male patient with a history of hypertension and type 2 diabetes mellitus received sodium phosphates oral solution 45 ml diluted in 750 ml or more warm water in 2 divided doses for bowel cleansing on the night before and the morning of the day of colonoscopy. After the colonoscopy, the patient developed abdominal distension. Eighteen days after the colonoscopy, elevated serum creatinine (Scr) was found with a peak value of 175 μmol/L. Thirty-five days after the colonoscopy, Scr was 168 μmol/L and the glomerular filtration rate calculated by the plasma-creatinine-based equations Chronic Kidney Disease Epidemiology Collaboration was 38.54 ml/min. Renal puncture and pathological examination showed tubular epithelial cell injury with calcium phosphate deposits, and acute phosphate nephropathy was diagnosed. The patient was advised to drink more water and was given symptomatic treatments such as diuretic furosemide. Five months later, the Scr recovered to 105 μmol/L.

Six recombinant plasmids co-expressing the wild-type GP5 gene or the codon-optimized GP5 gene (containing pan-DR epitope) of porcine reproductive and respiratory syndrome virus (PRRSV) and the E2 gene of classical swine fever virus (CSFV) or the E2 fused with the UL49 of pseudorabies virus (PrV) were constructed based on the suicidal DNA vaccine pSFV1CS-E2 described previously. Expression of GP5 and E2 was confirmed by indirect immunofluorescence assay. The immunogenicity of six plasmids was evaluated in BALB/c mouse model. For the six plasmids, low-level of E2 and GP5 protein specific antibodies could be detected in the sera of the immunized mice. Specific lymphoproliferative responses to the PRRSV or CSFV stimulation were induced in the splenocytes of the immunized mice as demonstrated by CFSE staining assay and WST-8 assay. Antigen specific IFN-gamma and L-4 secretion was detected in the splenocytes of some immunized mice by cytokine ELSIA. Fusion with the PrV UL49 in the suicidal vaccines induced significantly higher lymphoproliferative responses and cytokine secretion. Taken together, the suicidal DNA vaccines co-expressing GP5 and E2 could induce PRRSV and CSFV specific humoral and cell-mediated immune responses.
Animals ; Antibodies, Viral ; blood ; Antibody Formation ; Cytokines ; blood ; Female ; Immunity, Cellular ; Lymphocytes ; immunology ; Mice ; Mice, Inbred BALB C ; Random Allocation ; Vaccines, DNA ; biosynthesis ; immunology ; Viral Envelope Proteins ; genetics ; immunology ; Viral Structural Proteins ; genetics ; immunology ; Viral Vaccines ; biosynthesis ; immunology