The Accuracy and Reliability of Automated Oscillometric Measurement of Ankle-Brachial Index in the Diagnosis of Peripheral Artery Disease.

BACKGROUND: Comparing the accuracy and reliability of ankle-brachial index (ABI) measured by an oscillometric device with the Doppler method in peripheral arterial disease (PAD). METHODS: 122 patients admitted to the department of interventional radiology with PAD were studied. ABI was measured with the 2 methods in random order. After excluding the inconclusive results, Doppler ABIs were compared with the oscillometric ABIs in each limb, the reliability was evaluated by intraclass correlation coefficient (ICC), and the accuracy and consistency were assessed by receiver operating characteristic curves and Bland-Altman method. RESULTS: In 122 patients (244 legs), 27 legs got inconclusive oscillometric results, 4 legs got inconclusive oscillometric and inconclusive dorsalis pedis artery Doppler results, 2 legs had oscillometric cuff pressure intolerance. Using Doppler ABI <0.9 as a diagnostic threshold, compared with the high Doppler ABI, oscillometric method had a sensitivity of 57.81%, a specificity of 95.18%, the ICC was 0.626 (95% confidence interval [CI]: 0.536-0.701), Bland-Altman method showed 11/211 (5.21%) difference points outside the 95% limits of agreement. Compared with the low Doppler ABI, oscillometric method had a sensitivity of 50.66%, a specificity of 98.31%, the ICC was 0.541(95% CI: 0.483-0.630), Bland-Altman method showed 11/211 (5.21%) difference points outside the 95% limits of agreement. Using 1.00 as the diagnostic threshold and considering error oscillometric results as abnormal ABIs, the sensitivity improved to 88.05% with high Doppler ABI and 81.42% with the low. CONCLUSIONS: The accuracy and reliability of oscillometric ABI in patients with PAD is unsatisfied, which makes it not suitable as an alternative method in clinic disease assessment. Using 1.0 as the ABI oscillometric threshold for PAD diagnosis can improve the diagnostic value.

Rheolytic thrombectomy using an AngioJet ZelanteDVT catheter or a Solent Omni catheter for patients with proximal vein thrombosis.

PURPOSE: The present study aimed to investigate the preliminary safety and efficacy of rheolytic thrombectomy (RT) using an AngioJet Zelante DVT catheter or a Solent Omni catheter for acute proximal deep vein thrombosis (DVT). MATERIAL AND METHODS: We conducted a retrospective review of 40 patients who were treated with an AngioJet RT between January 2019 and January 2021, and then the patients were divided into the ZelanteDVT group (n = 17) and the Solent group (n = 23). Data on demographics, clinical characteristics, technical success, clinical success, complications, and early follow-up were analysed. RESULTS: No significant differences regarding demographics were detected (all p > .05). The technical success rates were both 100%. The ZelanteDVT group had a shorter duration of RT and a higher primary RT success than the Solent group (all p < .05), and the percentage of adjunctive catheter-directed thrombolysis (CDT) was 29.4% in the ZelanteDVT group, which was significantly lower than the 73.9% in the Solent group (p = .010). The clinical success rates for the ZelanteDVT group and Solent group were 100% (17/17) and 95.7% (22/23), respectively, and these values were high in the two groups (p > .05). Apart from transient macroscopic haemoglobinuria occurring in all the patients during the first 24 hours post-RT, none of the patients in either group suffered other procedure-related adverse events or major complications. Minor complications included bleeding events in 21.7% (5/23) of the patients in the Solent group and one (5.9%) patient in the ZelanteDVT group (p > .05). At 6 months, the frequency of PTS was 5.9% (1/17) in the ZelanteDVT group and 17.4% (4/23) in the Solent group (p > .05). CONCLUSION: Both catheters are safe and effective in managing patients with proximal DVT, thus leading to improved clinical outcomes with few complications. The ZelanteDVT catheter was more effective than the Solent catheter in thrombectomy, thus allowing for faster extraction of the DVT with a shorter run time and lower proportions of patients with adjunctive CDT.

Angiojet pharmacomechanical thrombectomy versus anticoagulant therapy alone in massive cancer-associated thrombosis: a single centre retrospective cohort study.

The therapeutic regimen option for the cancer-associated thrombosis (CAT) patients is still a major clinical challenge. The present study aimed to investigate the safety and efficacy of pharmacomechanical catheter-directed thrombolysis (PCDT) with AngioJet treatment compared with the conventional anticoagulation alone therapy in the patients with CAT. We retrospectively reviewed the patients who underwent PCDT and/or anticoagulation for the treatment of CAT between August 1, 2016 and March 1, 2022. Each patient was divided into the PCDT group or the anticoagulation alone group. The baseline demographics, comorbidities, clinical characteristics, treatment details, course data were reviewed. A total of 51 eligible patients were included, of whom 21 were in PCDT group (mean age, 60.1 ± 13.0 years; 52.4% male) and 30 in anticoagulation alone group (mean age, 66.6 ± 11.1 years; 50.0% male). No significant differences regarding age, sex, onset time, limb characteristics, cancer conditions or risk factors were detected (p > .05). After PCDT, grade III lysis was achieved in 8 and grade II lysis in 11 patients. Clinical success was achieved in 90.5% (19/21) patients. The symptoms of leg pain and swelling were significantly improved in both groups. Except for transient macroscopic hemoglobinuria occurring in PCDT group, none of all patients suffered from procedure-related and major complications. Minor complications such as bleeding events occurred in 23.8% (5/21) of patients in PCDT group compared with 10.0% (3/30) in anticoagulation alone group (p > .05). At the 6-month follow-up, iliofemoral patency was found an absolute risk reduction of 37.9% (70.0 vs. 32.1%) (95% CI: 1.183-4.008%; P = 0.010). The incidence of mild PTS was 5.0% (1/20) in PCDT group compared with 10.7% (3/28) in anticoagulation alone group (p > .05). The PCDT is a safe and effective modality in managing patients with CAT, leading to improved clinical outcomes with a low complication. The PCDT was more effective than anticoagulation alone in massive symptom relief and venous patency.

Thioethers as Dichotomous Electrophiles for Site-Selective Silylation via C-S Bond Cleavage.

The development of aryl alkyl sulfides as dichotomous electrophiles for site-selective silylation via C-S bond cleavage has been achieved. Iron-catalyzed selective cleavage of C(aryl)-S bonds can occur in the presence of ß-diketimine ligands, and the cleavage of C(alkyl)-S bonds can be achieved by t-BuONa without the use of transition metals, resulting in the corresponding silylated products in moderate to excellent yields. Mechanistic studies suggest that Fe-Si species may undergo metathesis reactions during the cleavage of C(aryl)-S bonds, while silyl radicals are involved during the cleavage of C(alkyl)-S bonds.

Transcriptome analysis and characterization of genes associated to leaf tannin content in foxtail millet [Setaria italica (L.) P. Beauv.].

BACKGROUND: Chinese chestnut is an economically important tree species whose yield and quality are seriously affected by red spider attack. Tannins is one of the most important class secondary metabolites in plants, and is closely associated with plant defense mechanisms against insect and herbivory. In our previous studies, it was revealed that several low-tannin foxtail millet varieties growing under the Chinese chestnut trees could attract red spiders to feed on their leaves and protect the chestnut trees from the infestation of red spiders, meanwhile, the growth and yield of foxtail millet plants themselves were not greatly affected. RESULTS: To identify genes related to leaf tannin content and selection of foxtail millet germplasm resources with low tannin content for interplanting with Chinese chestnut and preventing the red spider attack, the leaves of 4 varieties with different levels of tannin content were harvested for comparative transcriptome analysis. In total, 335 differentially expressed genes (DEGs) were identified. For acquisition of gene functions and biological pathways they involved in, gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analyses were performed, and several DEGs were found to possibly participate in the tannins biosynthesis pathway and transport processes of precursors. In addition, according to the PlantTFDB database, some transcription factors were predicted among the DEGs, suggesting their role in regulation of tannins biosynthesis pathway. CONCLUSION: Our results provide valuable gene resources for understanding the biosynthesis and regulation mechanisms of tannins in foxtail millet, and pave the way for speeding up the breeding of low-tannin varieties through marker-assisted selection, which could be utilized for interplanting with Chinese chestnut trees to confer protection against red spider attack.

Outcomes of Fluoroscopy-Guided Percutaneous High Ligation of the Great Saphenous Vein Combined With Foam Sclerotherapy for Symptomatic Great Saphenous Veins.

PURPOSE: To evaluate the effectiveness and safety of fluoroscopy-guided percutaneous high ligation (FPHL) combined with fluoroscopy-guided foam sclerotherapy (FGFS) to treat varicose veins of the great saphenous veins (GSVs). MATERIALS AND METHODS: This was a retrospective study of 113 patients (mean age, 62.1 ± 10.8 years; 60 men) with varicose veins of the GSVs (133 limbs) that were treated with FPHL combined with FGFS between April 1 and October 31, 2019. Demographic and clinical data were collected from these patients before the FPHL procedure, after which FGFS was performed. The preterminal GSV was ligated percutaneously by a percutaneously-positioned polypropylene ligature under fluoroscopic guidance. The outcome of ligation was confirmed by venography. Then, foam sclerotherapy was performed under fluoroscopy. At 1-year follow-up, GSV occlusion was evaluated by ultrasound. The venous clinical severity scores (VCSSs) were compared between the preoperative and 1-year follow-up periods. RESULTS: The technical success rate was 100% (133 limbs). Complete 12-month follow-up was available for 112 limbs (84.2%) and 103 of these limbs (92.0%) remained occluded during this period. The VCSS improved from 4.71 ± 2.15 to 0.74 ± 0.60 (V = 6328, P < .001). During follow-up, there were 16 limbs with thrombophlebitis and 38 limbs with saphenous junction pain; these events were alleviated within 2 weeks of the procedure. There was no deep venous thrombosis or other severe adverse events. CONCLUSIONS: FPHL combined with FGFS to treat varicose veins in the GSVs achieved an occlusion rate of 92% and improved the clinical symptoms within 1 year; this minimally-invasive procedure was safe and effective.

Genome-wide identification and characterization of the BES/BZR gene family in wheat and foxtail millet.

BACKGROUND: BES/BZR family genes have vital roles in plant growth, development, and adaptation to environmental stimuli. However, they have not yet been characterized and systematically analyzed in wheat and foxtail millet. RESULTS: In the current study, five common and two unique BES/BZR genes were identified by genome-wide analysis in wheat and foxtail millet, respectively. These genes were unevenly distributed on 14 and five chromosomes of wheat and foxtail millet, respectively, and clustered in two subgroups in a phylogenetic analysis. The BES/BZR gene family members in each subgroup contained similar conserved motifs. Investigation of cis-acting elements and expression profile analysis revealed that the BES/BZR genes were predominantly expressed in leaf tissues of wheat and foxtail millet seedlings and responded to brassinosteroid, abscisic acid, and NaCl treatments. CONCLUSIONS: Our results provide a basis for future studies on the function and molecular mechanisms of the BES/BZR gene family in wheat, foxtail millet, and other plants.

Experimental and Computational Studies of the Iron-Catalyzed Selective and Controllable Defluorosilylation of Unactivated Aliphatic gem-Difluoroalkenes.

The first iron-catalyzed defluorosilylation of unactivated gem-difluoroalkenes was developed, delivering gem-disilylated alkenes and (E)-silylated alkenes with excellent efficiency. This protocol features good functional group compatibility and excellent regio- and stereoselectivity, enabling the late-stage silylation of biologically relevant compounds, thus providing good opportunities for applications in medicinal chemistry. Preliminary mechanistic studies and DFT calculations reveal that a nucleophilic addition and elimination of the second C-F bond might be involved in the disilylation catalytic system, demonstrating unusual reactivity characteristics of iron catalysis.

Genome-wide identification and characterization of long non-coding RNAs related to grain yield in foxtail millet [Setaria italica (L.) P. Beauv.].

BACKGROUND: Long noncoding RNAs (lncRNAs) have been reported to play critical roles in diverse growth and development processes in plants. However, the systematic identification and characterization of lncRNAs in foxtail millet is nearly blank. RESULTS: In this study, we performed high-throughput sequencing of young spikelets from four foxtail millet varieties in different yield levels at booting stage. As a result, a total of 12,378 novel lncRNAs were identified, and 70 were commonly significantly differentially expressed in comparisons between high-yield varieties and conventional varieties, suggesting that they involved in yield formation and regulation in foxtail millet. Functional analysis revealed that among the 70 significantly differentially expressed lncRNAs, 67 could transcriptionally modulate target genes in cis and in trans. Moreover, 18 lncRNAs related to grain yield in foxtail millet were predicted to function as miRNA target mimics and regulate gene expression by competing for the interaction between miRNAs and their target mRNAs. CONCLUSION: Our results will provide materials for elucidation of the molecular mechanisms of lncRNAs participate in yield regulation, and will contribute to high yield foxtail millet breeding.

Copper-Catalyzed Asymmetric Silylation of Propargyl Dichlorides: Access to Enantioenriched Functionalized Allenylsilanes.

A copper-catalyzed silylation of propargyl dichlorides was developed to access chloro-substituted allenylsilanes under mild reaction conditions. Moreover, enantioenriched chloro-substituted allenylsilanes can be synthesized in moderate to high yields and good enantioselectivities with this protocol.

Synthesis of Highly Substituted Racemic and Enantioenriched Allenylsilanes via Copper-Catalyzed Hydrosilylation of (Z)-2-Alken-4-ynoates with Silylboronate.

Copper-catalyzed highly efficient hydrosilylation reaction of enynoates was developed. Under simple reaction conditions, various di-, tri-, and tetrasubstituted racemic allene products could be obtained in high yields. The asymmetric 1,6-addition of silyl group to the (Z)-2-alken-4-ynoates could be achieved under mild reaction conditions to afford the silyl-substituted enantioenriched chiral allene products in good yields and with high enantioselectivities.

Characterization of an extracellularly derived α-mannosidase from the liquid exudate of the sclerotia of Sclerotinia sclerotiorum (Lib.) de Bary.

Class I α-mannosidases play an important role in co- and post-translational N-glycosylation modification of proteins, and also in glycoprotein glycan hydrolysis. Herein, we investigated a protein named Man-41, from liquid exudate droplets secreted on the surface of developing sclerotia by Sclerotinia sclerotiorum. The protein was identified by MALDI-TOF mass spectrometry to be a α-mannosidase. The full-length open reading frame of Man-41 consists of 1581 bp, encoding 526 amino acid residues and containing a putative signal peptide at amino acid residues 1-20, and a conserved sequence at residues 50-521. Man-41 was classified into glycoside hydrolase family 47 (GH47) by clustering analysis. The catalytic residues include Glu(125), Arg(129), Asp(270), Ser(271), Glu(274), Arg(420), Glu(422), Glu(425), Glu(485), Thr(514), and Glu(515), which are conserved in all Class I α-1,2-mannosidases. Recombinant Man-41 protein had 26.67 ± 2.18 U/mg of α-mannosidase activity, about one-half of intracellular mannosidase activity of sclerotia. In conclusion, this is the first time that mannosidase has been identified in an extracellular fluid and Man-41 is also a new member of GH47 with Ca(2+)-dependent characteristics. This work lays the foundation for further study of the function of Man-41 in sclerotial development.

AngioJet rheolytic thrombectomy coupled with dose-reduced rt-PA for massive inferior vena cava filter-related thrombosis: A single-center retrospective study.

OBJECTIVE: To evaluate the efficacy and safety of AngioJet rheolytic thrombectomy (ART) coupled with dose-reduced rt-PA, compared to catheter-directed thrombolysis (CDT) alone, for the treatment of massive inferior vena cava filter (IVCF)-related thrombosis. METHODS: We conducted a retrospective analysis of 40 patients who received either ART or CDT alone as the first-line endovascular therapy (ET) between January, 2016 and September, 2022. The data on demographics, clinical characteristics, technical success, clinical success, complications, and early follow-up were reviewed. RESULTS: Of the 40 included patients, 24 received ART and 16 received CDT alone. The demographics, presentation, lesion characteristics, comorbidities and risk factors were comparable (all p > .05). Technical success rates were 100% in both groups. The total CDT time and infusion agent dosage were lower in the ART group than those in the CDT group (both p < .05). At the end of CDT, clinical success was 81.8% in the ART group, which was slightly higher than that of 70.8% in the CDT group (p > .05). At the 6-month follow-up, the incidences of recurrent thrombosis in the two groups were 6.9% and 15.8%, respectively, and the incidence of post-thrombotic syndrome was 10.3% and 21.1%, respectively. However, these differences were not statistically significant (p > .05). No major complications were noted in either group, ART seemed to have slightly higher risk of transient macroscopic hemoglobinuria and recoverable acute kidney injury, but with a lower minor bleeding incidence when compared with CDT alone (4.2 vs. 31.3%, p < .05). CONCLUSIONS: ART or CDT alone as the first-line ET for IVCF-related thrombosis has comparable outcomes but with different adverse event profiles. Both modalities are safe and effective in patients with massive IVCF-related thrombosis.

Characterization and risk factors of inferior vena cava thrombosis in situ detected by computed tomography venography following filter placement: A single-center retrospective cohort study.

OBJECTIVE: This study aimed to characterize radiographic characteristics on computed tomography venography and risk factors of inferior vena cava thrombosis (IVCT) in situ after retrievable vena cava filter (VCF) placement. METHODS: Between September 2018 and June 2023, a single-center retrospective cohort study was conducted in patients with or without IVCT in situ following VCF placement. Patient baseline demographics, presentation of lower extremity deep vein thrombosis (LEDVT), thrombus characteristics, concurrent pulmonary embolism, comorbidities and risk factors for LEDVT, and IVCT and VCF-related information were collected and analysed. Univariable analysis followed by multivariable analysis was performed to evaluate the odds ratio (OR) with a 95% confidence interval (CI). RESULTS: One hundred and seventeen eligible patients were included, regionally isolated filling-defect surrounding the support pillars of VCF and contacting inferior vena cava (IVC) wall on computed tomography venography images were identified, clots were more frequently found on the minor axis or anterior wall of IVC. Univariable analyses suggested that the incidence of IVCT in situ (31.6%, 37/117) was closely associated with age (P = .001), thrombus limb (left (P = .001) and bilateral side (P = .001)), hypertension (P = .008), filter shapes (P < .001), short IVC diameter (P = .009) or magnification percentage (P = .004), and long IVC diameter (P = .006). Multivariable analyses suggested that bilateral side LEDVT (OR, 4.92; 95% CI, 1.56-15.51; P = .007) and increased short IVC magnification percentage (OR, 1.01; 95% CI, 1.00-1.03; P = .013) statistically significant increase the IVCT in situ risk, whereas increased age (OR, 0.96; 95% CI, 0.94-0.99; P = .013) and short IVC diameter (OR, 0.87; 95% CI, 0.77-0.98; P = .026) were associated with decreased odds against IVCT in situ. CONCLUSIONS: IVCT in situ represents regionally isolated filling-defect at points of filter contact with IVC wall. Bilateral side LEDVT and increased short IVC magnification percentage may be potential risk factors impacting the occurrence of IVCT in situ, while increased age and short IVC diameter may decrease the incidence of IVCT in situ and seem to be protective factor against IVCT in situ emergence.

Gel-to-Solution Transition of Sulfhydryl Self-Assembled Peptide Hydrogels Undergoing Oxidative Modulation.

The design of self-assembling biomaterials needs to take into consideration the timing and location of the self-assembly process. In recent decades, the principal strategy has been to control the peptide self-assembly under specific conditions to enable its functional performance. However, few studies have explored the responsive elimination of functional self-assembled peptide hydrogels after their function has been performed. We designed peptide ECAFF (ECF-5), which under reductive conditions can self-assemble into a hydrogel. Upon exposure to oxidizing conditions, disulfide bonds form between the peptides, altering their molecular structure and impacting their self-assembly capability. As a result, the peptide hydrogels transition to a soluble state. This study investigates the utilization of oxidation to induce a gel-to-solution transition in peptide hydrogels and provides an explanation for their degradation following free radical treatment. Self-assembled peptide hydrogel materials can be designed from a fresh perspective by considering the degradation that takes place after functional execution.

Transcriptome analysis and identification of genes associated with leaf crude protein content in foxtail millet [Setaria italica (L.) P. Beauv.].

Introduction: Spruce spider mite is a primary insect pest of Chinese chestnut in China and seriously influences its yield and quality. However, the current management against this mite is costly and poorly effective. In previous research, we bred several foxtail millet materials for interplanting with chestnut tree, and found that they had high levels of crude protein (CP) in leaves and attracted spruce spider mite to feed on the leaves, thereby reducing chestnut damage. Methods: In this study, four foxtail millet varieties with significant differences in leaf crude protein content were used for high-throughput sequencing and identification of genes associated with leaf crude protein content. Gene enrichment analyses were carried out to comprehend the functions of these genes and the biological processes in which they are involved. In addition, transcription factors (TFs) were evaluated. Results: 435 differentially expressed genes (DEGs) were identified, suggesting their potential role in crude protein accumulation. Some differentially expressed genes were found to be associated with nitrogen metabolism and ubiquitin-mediated proteolysis pathways. Moreover, we identified 40 TF genes categorized into 11 transcription factor families. Discussion: Our findings represent an important resource that clarifies the mechanisms of accumulation and control of leaf crude protein in foxtail millet, and provide an opportunity for suppression of spruce spider mite attack on Chinese chestnut by interplanting with foxtail millet varieties with high concentrations of leaf crude protein.

AngioJet rheolytic thrombectomy for the treatment of deep vein thrombosis in elderly patients: Increase the risk of acute kidney injury?

Objective: The objective of this study was to investigate the risk of acute kidney injury in elderly patients compared with nonelderly patients undergoing AngioJet rheolytic thrombectomy for treatment of acute deep vein thrombosis. Methods: A retrospective review of all patients who underwent AngioJet rheolytic thrombectomy for the treatment of acute deep vein thrombosis between November 1, 2014 and August 1, 2022 was conducted. Their baseline demographics, comorbidities, clinical characteristics, procedural details, and postoperative course were reviewed. Results: A total of 105 eligible patients were reviewed; 45 patients were in the elderly group, and 60 were in the nonelderly group. Except for age (p < 0.001), no significant differences regarding demographics were detected (p >0.05). Transient macroscopic hemoglobinuria occurred in all patients during the first 24 h post-AngioJet rheolytic thrombectomy. The overall morbidity of acute kidney injury in the two groups was 11.4%, and the nonelderly group had a similar rate of acute kidney injury (8.3%) to the elderly group (15.6%). None of the 12 patients progressed to dialysis within the postoperative period, and the mean acute kidney injury recovery time of the elderly group was 5.86 ± 1.57 days, which was longer than the 3.60 ± .89 days of the nonelderly group (p = 0.017). Conclusion: The use of AngioJet rheolytic thrombectomy for the treatment of patients with acute deep vein thrombosis is associated with a potential risk of acute kidney injury, which seems to have a comparable rate in elderly and nonelderly patients. acute kidney injury in the elderly group tends to need a longer recovery time, which requires postoperative vigilance for this population.

Catheter-based therapies and short-term outcomes in the oncological patients with acute inferior vena cava thrombosis: a single centre experience.

OBJECTIVE: To investigate the safety and effectiveness of catheter-based therapy (CBT) using AngioJet rheolytic thrombectomy (ART) device or large lumen catheter (LLC) in the oncological patients with inferior vena cava thrombosis (IVCT). METHODS: This was a retrospective study including eligible patients with IVCT treated with CBT coupled with dose-reduced thrombolysis as the first-line treatment from February 1, 2015 to January 1, 2022. The baseline demographics, comorbidities, clinical characteristics, treatment details, course data were all reviewed. RESULTS: A total of 33 patients (mean age 58.8 years, 57.6% male) was included, of whom 17 patients underwent ART and 16 underwent LLC aspiration, the technical success rates were 100%. All patients subsequently underwent catheter-directed thrombolysis relative to reduced-dose thrombolysis. At the end of catheter-directed thrombolysis, clinical success was achieved in 26 (78.8%) patients. In the subgroup analysis, ART seemed to receive a slightly higher rate of thrombus removal Grade III (47.1% vs 12.5%, p = .057). The symptoms of leg pain and swelling post-treatment were significantly improved in both groups (p < .001). Except for transient macroscopic hemoglobinuria occurring in patients with ART, none of all patients suffered from procedure-related adverse events and major complications. Minor complications such as bleeding events occurred in 6.1% (2/33) of patients. At the 6 month follow-up, the incidence of recurrent thrombosis and mild post-thrombotic syndrome (PTS) were 9.7% (3/31) and 6.5% (2/31). CONCLUSION: CBT is a safe and effective modality for the management of IVCT in the oncological patients, leading to high levels of technical and clinical success, symptoms alleviation, as well as a low incidence of minor complication, mild PTS and recurrence. ADVANCES IN KNOWLEDGE STATEMENT: The available data and evidence of endovascular therapy (ET) on oncologic patients with IVCT remains insufficient. The purpose of present single center retrospective study including 33 oncological patients is to investigate the preliminary safety and efficacy of CBT using ART device or LLC. The results demonstrated that CBTs are safe and effective as an ET modality in majority of eligible patients with symptomatic acute cancer-associated IVCT, indicating high levels of technical and clinical success, symptoms alleviation, as well as a low prevalence of minor complication, mild post-thrombotic syndrome and recurrence. Furthermore, they have the advantages of accelerated reduction of thrombus burden in a moderate time, speedy restoration of blood flow, but at the risk of potentially increased economic cost. Notably, in the condition of parallel time and dosages of lytic agents, ART tends to achieve a slightly higher thrombus removal Grade III than LLCA.

Association Between Inferior Vena Cava-Involved Thrombosis, Severe Iliac Vein Stenosis, and Proximal Pulmonary Embolism in Patients With Deep Vein Thrombosis.

To investigate the possible risk factors for proximal pulmonary embolism (PE) in patients with lower extremity deep vein thrombosis (LEDVT). A single-center, retrospective cohort study was conducted. Consecutive patients diagnosed with unilateral LEDVT and confirmed PE by computed tomography (CT) pulmonary angiography and indirect CT venography between September 2015 and January 2022 were included. Patient demographics, presentation of LEDVT, laboratory examination, thrombus characteristics, comorbidities and risk factors for LEDVT, and imaging findings were analyzed to determine the univariable and multivariable associations. The associations between thrombus location, stenosis, and proximal PE were assessed using a stratified analysis. A total of 115 eligible patients (60.08 ± 15.18 years, 59.1% male) were included. Of these patients, 40 (34.8%) were in the proximal PE group (proximal thrombus involved main or lobar pulmonary artery), and 75 (65.2%) were in the distal PE group (without main and labor pulmonary artery involvement). The univariable analysis showed that onset time of LEDVT symptoms ≤ 7 days (P = .041), inferior vena cava (IVC) involvement (P = .035), and severe iliac vein stenosis (IVS) (stenosis ratio > 61.3%) (P = .010) were associated with the occurrence of proximal PE. Further multivariant analysis showed that IVC involvement was associated with an increased odds of proximal PE (OR: 4.45, 95% CI: 1.083 - 18.248, P = .038), whereas severe IVS (stenosis ratio > 61.3%) was associated with a decreased odds of proximal PE (OR: 0.294, 95% CI: 0.110-0.783, P = .014). Among patients with unilateral LEDVT, IVC involvement increased the risk of proximal PE; patients with severe IVS (stenosis ratio > 61.3%) had a lower risk of developing proximal PE compared with distal PE; and severe IVS seemed to be a protective factor for proximal PE.