Objective To compare the safety and efficacy of directional atherectomy with anti-restenosis therapy(DAART,drug-coated balloon)versus conventional balloon angioplasty(bare-metal stent,BMS)in elderly patients with femoropopliteal artery disease.Methods A retrospec-tive cohort study was conducted on 116 elderly patients undergoing endovascular intervention due to femoropopliteal artery disease in our hospital between May 2016 and September 2019,divided into DAART group(57 cases)and BMS group(59 cases).Results No statistical differences were observed between the DAART and BMS groups in terms of age,risk factors,distribution of Ruth-erford classification,lesion length,lesion type,lesion location,Global Limb Anatomic Staging Sys-tem grade,infra-popliteal runoff status,or preoperative ankle-brachial index(P＞0.05).However,the BMS group had significantly larger proportion of chronic limb-threatening ischemia than the other group(P＜0.05).Both groups achieved a 100％success rate of surgery.The DAART group obtained obviously higher primary patency rates at 1 and 2 years than the BMS group(90.4％vs 75.0％,76.3％vs 57.3％;P＜0.045).There were no significant differences in the rate of freedom from target lesion revascularization at 1 and 2 years between the two group(96.1％vs 88.8％,91.6％vs 77.7％;P＞0.05).In 2 years of follow-up,the incidence of major adverse events was 10.0％(5 cases)in the DAART group and 20.8％(12 cases)in the BMS group,but no obvious difference(P＞0.05).Conclusion DAART demonstrates superior mid-term efficacy than BMS in treating femoropopliteal artery disease in elderly patients.However,comprehensive preoperative assessment is essential to optimize individualized treatment strategies for this population.

With the aging of the population and changes in lifestyle in China, the number of patients with diabetic infra-popliteal artery occlusion has been growing. Revascularization is of great significance for improving the limb salvage rate and survival rate of patients. By comparing open surgery and endovascular revascularization techniques, although open surgery can improve lower limb ischemia, it has significant trauma and numerous complications. Endovascular treatment, which includes procedures such as lumen recanalization, lumen preparation, and lumen maintenance, has become the preferred option due to its advantages such as minimal trauma. The lumen recanalization technique has continuously advanced with the helping of new devices and the accumulation of experience. Lumen preparation encompasses various methods such as balloon dilation and debulking techniques to address different lesions. In lumen maintenance, drug-coated balloon (DCB) have a certain effect in inhibiting smooth muscle proliferation and improving long-term patency rates. However, the safety of paclitaxel on DCB remains controversial. Stent implantation is not currently recommended due to the characteristics of the infra-popliteal arteries such as small lumen, long lesions, and severe calcification. At present, revascularization for diabetic infra-popliteal artery occlusion still faces challenges. Research on angiogenesis therapy is expected to bring new breakthroughs, and the future development of this field requires the integration of multiple disciplines. This article reviews the development history of revascularization for diabetic infra-popliteal artery lesions, and expounds the transformation of its treatment concept from early arbitrary recanalization to the precise Angiographsome concept.

Objective To make an investigation on the current situation of the general surgical nurse's knowledge-attitude-practice for mechanical prevention of venous thromboembolism(VTE),and to analyze its influencing factors,so as to provide scientific basis for improving the mechanical prevention care work of VTE.Methods Using convenience sampling method,from April 2023 to May 2023 a total of 508 general surgery nurses from 28 provinces,municipalities and autonomous regions were selected as the study subjects.A VTE mechanical prevention knowledge-attitude-practice questionnaire designed based on expert consensus was used to conduct the questionnaire survey.Linear regression analysis was used to determine the related factors affecting the knowledge-attitude-practice level of mechanical prevention care work of VTE in general surgery nurses.Results Multiple linear regression analysis showed that the sub-specialty of vascular surgery(P＜0.001)and the frequency of VTE mechanical prevention theory training in hospital(P=0.023)were the factors influencing VTE mechanical prevention knowledge dimension score of general surgery nurses;the sub-specialty of vascular surgery(P=0.033)was the factor influencing attitude dimension score;the sub-specialty of vascular surgery(P＜0.001)and the frequency of VTE mechanical prevention theory training in hospital(P=0.043)were the factors influencing practice dimension score.Conclusion General surgery nurses have a high level of attitude and practice in mechanical prevention of VTE for hospitalized patients,but their knowledge reserve is relatively insufficient.Therefore,the study of VTE-related knowledge and vascular surgery specialty should be strengthened,meanwhile,the frequency of VTE mechanical prevention training at the hospital and department level should be increased.

Objective:To investigate the prevalence of abdominal aortic aneurysm (AAA) and analyze its risk factors among male residents in nursing homes in Shuangliu district, Chengdu.Methods:A cross-sectional survey was conducted from 2014 to 2023 among male permanent residents aged 65 years or older from 24 nursing homes in Shuangliu district, Chengdu. The prevalence of AAA was calculated. Univariate analysis and multivariate logistic regression analysis were used to identify risk factors for AAA.Results:Among 3 092 elderly males screened, 98 cases of AAA were detected, with a prevalence rate of 3.17%. The mean age of AAA patients was (73.9±6.9)years, with height of (157.79±5.87)cm and weight of (57.90±9.45)kg. Univariate analysis showed that hypertension, systolic blood pressure, cardiovascular disease, cerebrovascular disease, smoking, and alcohol consumption were significantly associated with AAA prevalence (all P<0.05). Multivariate logistic regression analysis identified cerebrovascular disease ( OR=7.201), cardiovascular disease ( OR=12.412), smoking ( OR=2.887), and alcohol consumption ( OR=1.675) as independent risk factors for AAA in this population (all P<0.05). Conclusions:The prevalence of AAA among male nursing home residents in Shuangliu district, Chengdu is 3.17%. The main risk factors include alcohol consumption, cardiovascular disease, cerebrovascular disease, and smoking.

Objective To compare the safety and efficacy of directional atherectomy with anti-restenosis therapy(DAART,drug-coated balloon)versus conventional balloon angioplasty(bare-metal stent,BMS)in elderly patients with femoropopliteal artery disease.Methods A retrospec-tive cohort study was conducted on 116 elderly patients undergoing endovascular intervention due to femoropopliteal artery disease in our hospital between May 2016 and September 2019,divided into DAART group(57 cases)and BMS group(59 cases).Results No statistical differences were observed between the DAART and BMS groups in terms of age,risk factors,distribution of Ruth-erford classification,lesion length,lesion type,lesion location,Global Limb Anatomic Staging Sys-tem grade,infra-popliteal runoff status,or preoperative ankle-brachial index(P＞0.05).However,the BMS group had significantly larger proportion of chronic limb-threatening ischemia than the other group(P＜0.05).Both groups achieved a 100％success rate of surgery.The DAART group obtained obviously higher primary patency rates at 1 and 2 years than the BMS group(90.4％vs 75.0％,76.3％vs 57.3％;P＜0.045).There were no significant differences in the rate of freedom from target lesion revascularization at 1 and 2 years between the two group(96.1％vs 88.8％,91.6％vs 77.7％;P＞0.05).In 2 years of follow-up,the incidence of major adverse events was 10.0％(5 cases)in the DAART group and 20.8％(12 cases)in the BMS group,but no obvious difference(P＞0.05).Conclusion DAART demonstrates superior mid-term efficacy than BMS in treating femoropopliteal artery disease in elderly patients.However,comprehensive preoperative assessment is essential to optimize individualized treatment strategies for this population.

Objective:To investigate the prevalence of abdominal aortic aneurysm (AAA) and analyze its risk factors among male residents in nursing homes in Shuangliu district, Chengdu.Methods:A cross-sectional survey was conducted from 2014 to 2023 among male permanent residents aged 65 years or older from 24 nursing homes in Shuangliu district, Chengdu. The prevalence of AAA was calculated. Univariate analysis and multivariate logistic regression analysis were used to identify risk factors for AAA.Results:Among 3 092 elderly males screened, 98 cases of AAA were detected, with a prevalence rate of 3.17%. The mean age of AAA patients was (73.9±6.9)years, with height of (157.79±5.87)cm and weight of (57.90±9.45)kg. Univariate analysis showed that hypertension, systolic blood pressure, cardiovascular disease, cerebrovascular disease, smoking, and alcohol consumption were significantly associated with AAA prevalence (all P<0.05). Multivariate logistic regression analysis identified cerebrovascular disease ( OR=7.201), cardiovascular disease ( OR=12.412), smoking ( OR=2.887), and alcohol consumption ( OR=1.675) as independent risk factors for AAA in this population (all P<0.05). Conclusions:The prevalence of AAA among male nursing home residents in Shuangliu district, Chengdu is 3.17%. The main risk factors include alcohol consumption, cardiovascular disease, cerebrovascular disease, and smoking.

Objective:To explore the therapeutic effect of interventional treatment on Takayasu arteritis involved renal artery.Methods:A retrospective analysis was conducted on the clinical data of 26 patients (28 blood vessels) with Takayasu arteritis involved renal artery admitted to the Xuanwu Hospital, Capital University of Medical Sciences from January 2012 to July 2023. Balloon dilation or stent implantation were performed, and the t vascular patency rate, blood pressure changes, surgical effects, and complications were followed up and observed.Results:All patients underwent balloon dilation or stent implantation, and the surgery was successful, including 23 cases of balloon dilation (25 blood vessels) and 3 cases of stent implantation (3 blood vessels). During the follow-up period of 12-102 months, one case died of renal failure at 57 months post surgery (unilateral renal artery balloon dilation case), and one case was lost in the first year (unilateral renal artery balloon dilation case). The patency rates of balloon dilated blood vessels at 1 year, 3 years, and 5 years were 23/24(95.83%), 22/24(91.67%), and 20/23(86.96%), respectively. Patients with stent implantation had 2 diseased blood vessels unobstructed at 1 year of follow-up and 1 diseased blood vessel unobstructed at 3 years of follow-up. Some patients showed improvement in clinical symptoms, including 3 cases (3/26, 11.54%) of cured hypertension symptoms, 19 cases (19/26, 73.08%) of improved symptoms, and 4 cases (4/26, 15.38%) of ineffective symptoms. The systolic blood pressure decreased from preoperative (169.29±10.76)mmHg to (150.31±14.62)mmHg, with a statistically significant difference ( P<0.05). There was no statistically significant difference in blood creatinine levels between preoperative (78.42±21.38)μmol/L and postoperative (77.83±21.14)μmol/L ( P>0.05). Conclusions:Endovascular angioplasty is safe, feasible, and has a definite therapeutic effect on patients with Takayasu′s arteritis involved renal artery.

Objective:To investigate the clinical effect of composite surgery in the treatment of chronic common carotid artery occlusion(CCAO).Methods:A retrospective descriptive study was conducted. The clinical data of 7 patients with CCAO admitted to Xuanwu Hospital, Capital Medical University from October 2020 to December 2023 were collected retrospectively. There were 6 males and 1 female. The age was (66.7±10.9) years, ranging from 52 to 83 years. Outpatient or telephone follow-up were conducted after surgery, carotid artery ultrasound or computed tomography angiography were performed at 3 months, 6 months, and 1 year postoperatively to determine vascular patency. The selection of surgical methods and clinical effect were analyzed. Normally distributed measurement data were expressed as mean±standard deviation ( ± s). The measurement data of skewed distribution were expressed by M ( Q1, Q3). Count data were expressed as frequency. Results:All 7 patients were diagnosed with chronic CCAO before operation, 6 on the left and 1 on the right. 3 cases affected the middle and distal segments of the common carotid artery, 1 case affected the proximal segment, and 1 case each affected the middle and distal segments, the remaining case involves the entire common carotid artery. All the procedures were successfully performed, among which 4 cases underwent carotid endarterectomy combined with stent placement, and 3 cases did not receive stent placement after carotid endarterectomy. 1 patient developed neck hematoma after surgery and the remaining patients recovered well after surgery without any complications or deaths. The follow-up time was 13.5(4.0, 20.5) months; 1 patient was lost to follow-up, and 6 patients received effective follow-up. the common carotid artery remained unobstructed in all 6 patients, and there were no transient ischemic attacks or strokes during the follow-up period.Conclusion:Composite surgery is a safe and feasible method that can be used to treat chronic CCAO lesions, and has satisfactory short-term results.

Objective:To explore the predictors and reasons for restenosis in patients with Takayasu′s arteritis(TA) involved renal artery after plain old balloon angioplasty(POBA).Methods:The clinical data of 47 TA patients (47) with renal artery admitted to Xuanwu Hospital, Capital Medical University from January 2014 to December 2020 were analyzed, including 12 man and 35 female. The age ranged from 21 to 43 years old, with an average of (28.52±10.78) years old. All patient were diagnosed as TA and underwent POBA. The patients were divided into restenosis group ( n=18) and non-restenosis group ( n=29). The patients were followed up at 1, 3, and 6 months after surgery, and after 6 months, the patients were followed up every 6 months. All patients were followed up from 36 to 108 months.The basic clinical data of the two groups were compared, and the length of stent and residual stenosis were also compared. Measurement data were expressed as ( ± s), and t-test was used for comparison between groups. Counting data were expressed as the number of cases and percentage, and comparison between groups was analyzed using the chi-square test. Multivariate Logistic regression model was used to analyze the independent risk factors of restenosis after balloon dilation, and the OR value and 95% confidence interval were calculated. Logistic regression model was used to analyze the independent risk factors for restenosis after balloon dilation. Results:All patients received POBA and operation was successfully. Restenosis was found in 18 patients, and 29 patients remained normal during the follow-up. The primary patency rate was 61.7%. Multivariate Logistic regression analysis showed that HDL-C and lesion length were the influencing factors of restenosis after POBA in TA of renal artery. The serum HDL-C level was significantly lower and the lesion was significantly longer in restenosis group than in non-restenosis group ( P<0.05). The proportion of residual stenosis>20% was higher in restenosis group than in non-restenosis group ( P>0.05). Conclusion:Serum HDL-C level, lesion length may be may be independent influencing factors of restenosis after plain old balloon angioplasty in TA of the renal artery restenosis.

Objective:To explore the long-term efficacy and safety of gene therapy with pUDK-hepatocyte growth factor (pUDK-HGF) for rest pain and ulcers caused by critical limb ischemia.Methods:Long-term follow-up were conducted through outpatient and telephone on patients who completed the pUDK-HGF Phase Ⅱ randomized double-blind placebo-controlled trial. The occurrence of tumors was observed, and tumor markers detection, fundus examination, visual analogue scale (VAS), and lower limb CT angiography (CTA) were performed according to voluntary principle. The results were analyzed descri-ptively and statistically.Results:A total of 53 patients were included in the analysis, of which 15 (28.3%) were in the placebo group and 38 (71.7%) were in the pUDK-HGF treatment group in the Phase Ⅱ clinical trial. The median follow-up time was 2.8 years, ranging from 1.7 to 3.5 years. During the follow-up period, no tumor was found in the 53 patients. Among the 38 patients in the pUDK-HGF treatment group, 18 underwent comprehensive examination and evaluation, including tumor markers, fundus and CTA examination, and patients with resting pain underwent VAS evaluation. Among them, 1 patient had transient mild elevation of carcinoembryonic antigen, and no abnormal tumor markers were found in the other 17 patients; no proliferative retinal vasculopathy was found in the fundus examination. At the end of the phase Ⅱ clinical trial (out-group), 3 were effective and 2 were ineffective of the 5 patients with rest pain; at the end of this follow-up period, 4 were evaluated as effectiveness and 1 as ineffectiveness according to CTA, and 5 were all evaluated as effectiveness according to VAS. Of the 13 patients with ulcer, 9 were evaluated as effectiveness and 4 were as ineffectiveness according to CTA at out-group; 10 were evaluated as effectiveness and 3 were as ineffectiveness at the end of this follow-up.Conclusions:pUDK-HGF had relatively good safety in the treatment of rest pain and ulcers caused by critical limb ischemia. No risk of carcinogenesis and proliferative retinal vasculopathy has been found, and the long-term efficacy of pUDK-HGF is good.