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Venous leg ulcer (VLU) is the most common chronic ulcer of lower extremity caused by persistent venous hypertension. Although the mortality rate is low, VLU seriously affects the quality of life of patients, and has the potential for infection, deterioration, and amputation. The compression therapy is simple and easy to implement, it can effectively reduce venous hypertension and is the most important conservative therapy for treating and preventing recurrence of VLU. There are various devices and applications of compression therapy, and this article reviews the classification of compression therapy, and its application in treatment and recurrence prevention of VLU.
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Informatization is an effective way to promote the reform and innovation of higher education and improve its quality. Virtual simulation teaching is indispensable in the educational informatization. Here, we describe the development and current situation of virtual simulation teaching, and introduce electronic standardized patient (ESP) based-virtual human body system powered by the real-time human physiological parameters. We also discuss how to build an ESP-based community in the teaching of human physiology, preclinical integrated case learning and other teaching projects. These ESP-based virtual simulation projects display the advantages of interdisciplinary fusion and the combination of basic and clinical knowledge, and open up the third type of functional experiments. Therefore, ESP-based virtual simulation teaching platform presumably becomes a considerable option for the first-class course construction in physiology.
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Humans , Computer Simulation , Electronics , Learning , User-Computer InterfaceABSTRACT
Drug prophylaxis is commonly used for prevention of deep vein thrombosis (DVT), but it has deficiencies such as causing thrombocytopenia and weakening coagulation function. Compression therapy is a safe and economical physiotherapy method, which can effectively prevent the occurrence of DVT with less adverse reactions. This article reviews the clinical application and efficacy of four pressure treatment methods: graduated compression stockings, intermittent pneumatic compression, venous foot pumps and continuous enhanced circulation therapy.
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Drug prophylaxis is commonly used for prevention of deep vein thrombosis (DVT), but it has deficiencies such as causing thrombocytopenia and weakening coagulation function. Compression therapy is a safe and economical physiotherapy method, which can effectively prevent the occurrence of DVT with less adverse reactions. This article reviews the clinical application and efficacy of four pressure treatment methods: graduated compression stockings, intermittent pneumatic compression, venous foot pumps and continuous enhanced circulation therapy.
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Cancer patients complicated with venous thromboembolism (VTE) face treatment problems, very high recurrence rate and bleeding rate. Cancer itself and the antitumor treatment plan are the important factors causing the recurrence. After the relapse, the prognosis of the patients is extremely bad, and more than 50% of the patients died within 1 year. Until now, there is no unified effective treatment plan for the relapse. This paper reviews the recurrence of VTE and the related research progress.
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<p><b>Background</b>Arterial grafts had better mid-term and long-term patency than saphenous vein grafts in coronary artery bypass grafting (CABG). We summarized our experience with total arterial off-pump coronary artery bypass grafting (OPCAB) and assessed the early clinical results, surgical complications, and follow-up.</p><p><b>Methods</b>From January 2007 to May 2017, 508 coronary artery disease patients undergoing total arterial OPCAB were enrolled. Clinical features, approaches, outcomes of surgical treatments, and follow-up data of these patients were studied retrospectively. A total of 122 patients underwent single left internal mammary artery (IMA)-left anterior descending artery grafts, whereas the other 386 patients underwent multiple vessel grafts.</p><p><b>Results</b>The average distal anastomosis was 2.34 ± 0.97 (range: 1-4). All the patients were discharged from hospital except one died. A total of 457 (90.32%) patients were followed up. In the 4-, 7-, and 10-year follow-up groups, the rate of death from any cause was 1.19%, 6.47%, and 10.67%; rate of cardiac death was 0.60%, 2.88%, and 3.33%; rate of repeat revascularization was 0.00%, 3.60%, and 8.67%; rate of ischemic symptoms was 1.79%, 7.91%, and 11.33%; and incidence of stroke was 2.38%, 4.32%, and 6.67%, respectively. Poor medication adherence was observed in 9.38% of the follow-up population.</p><p><b>Conclusions</b>Total arterial OPCAB with bilateral IMA, radial artery, and right gastroepiploic artery grafting yielded satisfactory early and midterm outcomes in this patient group, without a significant increase in early mortality or morbidity. Moreover, the long-term outcomes are also positive.</p>
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Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Coronary Angiography , Coronary Artery Bypass, Off-Pump , Follow-Up Studies , Retrospective Studies , Treatment Outcome , Vascular PatencyABSTRACT
Erectile dysfunction (ED) is a common male condition, which is closely related with cardiovascular diseases. With the increasing incidence of cardiovascular events, arteriogenic ED (AED) is becoming more prevalent in recent years. Despite the variety of therapies for ED, no effective treatment has been found for this arteriogenic type. Based on the experience in the successful treatment of cardiovascular diseases by endovascular therapy, some scholars are carrying out clinical researches on this therapy for AED, which has shed some new light on its management. This review outlines recent advances in the studies of endovascular therapy for AED.
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Humans , Male , Cardiovascular Diseases , Therapeutics , Endovascular Procedures , Impotence, Vasculogenic , TherapeuticsABSTRACT
Objective To investigate the effects of microRNA-486 (miR-486) expression on the cardiac function in rats with myocardial infarction (MI),through direct injection of an adenovirus carrying the miR-486 gene into the myocardium.Methods Totally 120 male rots were divided into 4 groups.Different target materials were infused into the surrounding areas of MI after building a successful disease model.Expression of miR-486 in the surrounding areas of left ventricular MI was detected using real-time PCR at different time points.Cardiac function was measured by cardiac ultrasound at 4 weeks.Using TUNEL,TTC,Masson,and CD31 staining to measure the organic changes in heart tissues.Results The expression of miR-486 in miR-486 group was higher than the other three groups.The expression of miR-486 in the three groups decreased when the time of MI in rats was prolonged.The cardiac function of the miR-486 group was better than that of the MI and AD groups.The MI area in the miR-486 group was smaller than that in the other two groups.Compared to the Sham group,the CVF at the infarct border zone was increased in the MI,Ad,and miR-486 groups.The AI in the MI and Ad groups was significantly increased compared to that in the miR-486 group.MVD was increased in the miR-486 group compared to that in the Sham,MI,and Ad groups.Conclusion miR-486 improved the cardiac function after MI in rats,through lightening collagen deposition,inhibiting apoptosis,and inducing angiogenesis in ischemic regions.
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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.
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Objectives To compare Doppler noninvasive vascular testing and computed tomographic angiography(CTA) with vascular angiography in the assessment of arteriosclerotic occlusion of the lower limbs. Methods In this study 97 lower extremities in 64 patients suffering from arteriosclerotic occlusion underwent both Doppler and CTA plus angiography. Angiogram results were taken as golden standard.The sensitivity and specificity of Doppler was calculated,the diagnostic accuracy of Doppler scanning and CTA plus angiography was calculated and compared.The statistic analysis was performed using x2 test in SPSS 16.0 format. Results Compared with CTA,Doppler scanning is equally accurate at the segments of iliac artery,common femoral artery,superficial femoral artery,dorsal pedis artery and posterior tibial artery (P ＞ 0.05).At segment of popliteal artery,Doppler scanning yields more accurate results (P ＜0.05 ). Conclusions Being noninvasive convenient and of good accuracy,Doppler examination has a role for the diagnosis of arteriosclerotic occlusion of the lower limbs.
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Objective To analyze the monitoring results of human and animal plague in Zhangye city from 1982 to 2011,and further explore the prevention and control policies and measures to control the spread of the disease.Methods The trends of human and animal plague were studied by retrospective survey in Zhangye city.Information of animal and human plague epidemic and prevention and control measures were collcoted and assessed with epidemiology methods,and the density of rodents,the rodents infected with flea,flea index and other indicators were calculated.Results 1982-2011,there were 6 cases of human plague incidence of 6 cases,of which 2 cases cured,4 cases died,the mortality rate was 67％; detection of Yersinia pestis from the captured 5167 animals was 93 strains from 1982 to 2011,the detection rate was 1.80％; 29 840 various vector insects were collected from the body surface of the 5167 animals captured,21 206 hole dries,and three marmot dens.A total of 7050 groups of Marmota parasites and hole stem fleas were inspected,52 strains of Yersinia pestis were isolated,and the average detection rate was 0.74％; 3912 marmot serums were detected,178 were positive,and the positive rate was 4.55％.Conclusions The prevention and control of plague is still very grim in Zhangye city.It is recommended to take publicity,education and active surveillance measures in the future to deal with emergencies and other.
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ObjectiveTo study the changes of iodine uptake of the follicular thyroid carcinoma cell line (FTC-133) and nude mice bearing human follicular thyroid carcinoma after the induction with alltrans retinoic acid (ATRA),trichostatin A (TSA) or ATRA combined with TSA.MethodsAfter the induction with ATRA,TSA,or ATRA combined with TSA in different concentrations for 96 h,the iodine uptake of FTC-133 cells was observed.The concentrations for different groups were as follows:ATRA 1.0 ×10-6 mol/L(Alow group),ATRA 1.0 × 10-4 mol/L(Ahigh group),TSA 1.65 ×10-7 mol/L(T group),Alow +T group,Ahigh +T group and ethanol (control group).Cell quantities and morphology were observed by HE staining.FTC-133 cells were subcutaneously injected into nude mice.Twelve nude mice were randomly divided into 4 groups after tumor formation:ATRA group (2 mg/kg,intragastric administration),TSA group (10 mg/kg,intraperitoneal injection),combined therapy group (ATRA + TSA,the same doses as above) and saline control group (10 ml/kg,intragastric and intraperitoneal administration,respectively).Drugs were administered to the tumor-bearing mice according to the mouse body mass daily.At the 22nd day,the tumor-bearing mice were injected with 37 MBq 131I intraperitoneally.The biodistribution of 131I and gamma imaging were performed at 4,6,12 and 24 h after the injection respectively.Histopathological examinations of the tumor samples were taken after imaging completion.The results were analyzed by analysis of variance (ANOVA) with SPSS 13.0.ResultsThe cellular iodine uptake were (23 885 ± 616.0 ) and ( 13 849 ±728.2) counts · min-1 · 10-6 cells in the Alow + T group and Ahigh + T group respectively,and the data were (985 ± 84.2) - ( 17 600 ± 782.7 ) counts · min-1 · 10-6 in the other groups ( F =600.879,P ＜0.001 ).The ％ ID/g of tumor at 6 h was 6.17 ±0.46 in the combined group and it increased to 9.34 ±0.61 at 12 h and 11.19 ± 0.98 at 24 h.The ％ ID/g of tumor in the other groups were from ( 1.97 ± 0.34)to (5.14 ± 0.65 ).The tumor qualities of the 4 groups were significantly different ( F =3.723,P ＜ 0.05 ).ConclusionThe iodine uptake of the tumor could be enhanced in the tumor-bearing mice administered with ATRA combined with TSA,a potential way for treating follicular thyroid carcinoma.
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Objectives To evaluate the safety and efficacy of endovascular angioplasty for extracranial vertebral artery ( VA ) stenosis caused by atherosclerosis. Methods We analyzed retrospectively data of the 24 patients with extracranial vertebral artery stenosis who had been placed endovascular angioplasty from April 2006 to March 2010. According to Mori classification, there were 21 type A and 3 type B among all cases.The artery stenosis rate was 60％ -95％ , the average was 79％ ± 10％. Results Twenty-four balloon mounted stents were placed, the successful rate was 100％. Postoperatively the stenosis rate decreased to 4％ ± 6％. Patients were followed up from 3 to 36 months, the average was 22 months. Symptomes disappeared in 15 out of 17 patients. Postoperative restenosis on the treatment site with transient brain ischemia occurred in one patient. The symptoms in another patient of multiple cerebral infarction with ataxia and episodic vertigo were not relieved, although the patient didn't suffer from apoplectic seizure after the intervention. Postoperative color Doppler ultrasound revealed an over 50％ residual stenosis in 5 patients. The postoperative restenosis rate was 20. 8％. According to Malek scoring, 22 patients were scored 1 point, 1 patient scored 2 and one scored 4. Conclusions Endovascular angioplasty with stent placement is a safe and effective treatment. The restenosis rate could be futher reduced by technology improvement.
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<p><b>BACKGROUND</b>Endovascular therapy is a treatment option for localized occlusion of the subclavian artery. In this report the long-term experience with 59 patients is presented.</p><p><b>METHODS</b>Between June 1998 and September 2008, we used endovascular therapy to treat 61 subclavian arterial obstructive lesions in 59 patients (46 males and 13 females, 34 - 82 years of age with a mean age (61.9 + or - 11.0) years). Twenty patients (34%) had clinical symptoms due to vertebrobasilar insufficiency, 26 (44%) had disabling arm ischemia, and 13 (22%) had both symptoms. We performed all procedures under local anesthesia. The approaches were from the femoral artery (n = 47), brachial artery (n = 1, involving bilateral subclavian disease) or both (n = 11). Sixty stents were implanted. All patients were followed-up at 1, 3, 6, and 12 months post-procedure, and annually thereafter.</p><p><b>RESULTS</b>We achieved technical success in 58 (95.1%) arteries, all of which were stented. There were three technical failures; two were due to the inability to cross over an occlusion, necessitating the switch to an axillo-axillary bypass, and the third was due to shock after digital subtraction angiography and prior to stenting. Arterial stenosis pre- and post-stenting was (83.6 + or - 10.8)% and (2.5 + or - 12.5)% (P < 0.01). Clinical success was achieved in 55 of the 59 patients (93.4%). Of the four clinical failures, three were technical and the remaining patient had a stent thrombosis. Systolic blood pressure difference between the two brachial arteries was (44.7 + or - 18.5) vs. (2.2 + or - 3.9) mmHg (P < 0.01). Primary patency was 98% at 12 months, 93% at 24 months, and 82% at 5 years. Five patients were lost to follow-up by 12 months post-stenting. Significant recurrent obstruction developed in five patients with resumption of clinical symptoms. The overall survival rate was 98.2% at 12 months, 89.5% at 24 months, and 84.5% at 5 years.</p><p><b>CONCLUSIONS</b>Endovascular therapy for proximal subclavian arterial obstructive lesions is effective and successful. This minimally invasive treatment may be the first choice of treatment for proximal subclavical arterial obstructive lesions.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Arterial Occlusive Diseases , Pathology , Therapeutics , Stents , Subclavian Artery , Pathology , Subclavian Steal Syndrome , Pathology , Therapeutics , Vertebrobasilar Insufficiency , Pathology , TherapeuticsABSTRACT
<p><b>BACKGROUND AND OBJECTIVE</b>The effectiveness rate of all-trans-retinoic acid (RA) is only about 30% in the clinical application of inducing thyroid carcinoma differentiation. In addition, there are severe toxic side effects, which limit its clinical application. Phase I-III clinical studies have been conducted on the combined application of two or more kinds of inductors in tumors. Nevertheless, the combination of RA with histone deacetylase inhibitors is rarely reported. This article studied the effects of differentiation for papillary thyroid carcinoma and follicular thyroid carcinoma cell lines induced by RA combined with trichostatin A (TSA), enhancing the effect of induction, while reducing the toxic side effects of a single drug, to provide a theoretical basis for preclinical trials.</p><p><b>METHODS</b>After incubation with RA combined with TSA, K1 and FTC-133 were grouped into Group 1 (RA 10(-4) mol/L plus TSA 1.65 x 10(-7) mol/L), Group 2 (RA 1 x 10(-4) mol/L plus TSA 3.31 x 10(-7) mol/L), Group 3 (RA 10(-5) mol/L plus TSA 1.65 x 10(-7) mol/L), Group 4 (RA 1 x10(-5) mol/L plus TSA 3.31 x 10(-7) mol/L) by four varied concentrations and three time points (12 h, 24 h, and 48 h). The cell proliferation, conformation, toxic effect, and induced differentiation on K1 and FTC-133 cell lines were studied microscopically with hematoxylin-eosin (HE) to observe cell quantity and morphology, methyl-thiazolyl-tetrazolium (MTT) to calculate cell survival rates, and electrochemiluminescence analysis measuring in vitro thyroglobulin (Tg) levels.</p><p><b>RESULTS</b>The research showed that K1 and FTC-133 cells had cell spacing increases, with an outer edge of smooth, nuclear chromatin condensation after RA combined TSA. Survival rate were assessed by an analysis of variance (ANOVA) by concentration and time point, F values of K1 and FTC-133 were 23.52 and 170.14, and 57.09 and 224.35, respectively. There were significant differences for both cells (P < 0.01). The SNK analysis indicated that survival rates were in the order of Group 2 < Group 1 < Group 4 < Group 3. Tg was also assessed by ANOVA, F values of K1 were 69.63 and 101.07, and F values of FTC-133 were 79.77 and 81.72 (P < 0.01). Group 1 was compared with Group 3 of K1 and FTC-133 by the least significant difference (LSD) method, and there was no statistical difference between the two group (P = 0.06, 0.2, respectively; P > 0.05), yet a significant difference was seen between the other Groups.</p><p><b>CONCLUSIONS</b>Lower concentrations of RA combined with lower concentrations of TSA have both inhibited cell proliferation, decreased toxicity of the drugs, and increased the effect of K1 and FTC-133 cell differentiation. The mechanism of action may be that TSA has pretranscription DNA regulation and that RA has posttranscriptional signal regulation to enhance the effects of inhibited proliferation and differentiation of cells by transcription systems.</p>
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Humans , Adenocarcinoma, Follicular , Antineoplastic Agents , Pharmacology , Apoptosis , Carcinoma , Carcinoma, Papillary , Cell Differentiation , Cell Line, Tumor , Cell Proliferation , Dose-Response Relationship, Drug , Drug Synergism , Histone Deacetylase Inhibitors , Pharmacology , Hydroxamic Acids , Pharmacology , Thyroglobulin , Bodily Secretions , Thyroid Neoplasms , Pathology , Bodily Secretions , Tretinoin , PharmacologyABSTRACT
Objective To evaluate the safety and efficacy of endovascular intervention to revise peripheral bypass problems through prosthetic approach.Methods Among 17 cases undergoing graft bypass anastomotic stenosis and graft thrombosis was identifled in 16 cases(inflow or outflow obstructive lesions in 10),inflow obstructive lessions in 1(without anastomotic and graft thrombosis).All revision procedures were taken under local anesthesia,16 patients were treated by means of surgical thrombectomy followed by endovascular intervention through prosthesis itself in addition to one who had no thrombectomy.The graft patency and clinical outcome were observed.Resuits Thirteen stents were implanted in 13patients with distal anastomotic stenosis and 1 with proximal anastomotic stenosis including 10 stentings/PTAs in iliac popliteal,posterior tibial or anterior tibial arteries.One stent was implanted in 1 patient with common femoral stenosis.Stenting were not used(abandoned)in 2 patients,of which one underwent a foot amputation and calf gangrene occurred a week later,and the other had a redo of grafting.Follow-up time is 1-35 months.with an average of 12±4 months.One had a below-knee amputation two months after intervention,the other had symptoms recurred and treated with a redo 3 months afterwards.the third died of myocardial infarction six months later.Grafts remained patent in the rest 13 patients at follow-up.Conclusions Endovascular intervention through prosthesis is a safe and effective method,which offers an alternative means to treat anastomotic stenosis.inflow or outflow obstructive lesions.
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<p><b>OBJECTIVE</b>To observe the influence of endoscopic radial artery harvesting techniques on the prevalence of complications after coronary artery bypass grafting, and to assess the potential trauma to the radial artery through the histological changes.</p><p><b>METHODS</b>From August 2003 to June 2008, 87 patients undergoing CABG had radial artery harvested by endoscopic harvesting system. About 4 mm proximal and distal radial artery end segment of 10 patients undergoing endoscopic and conventional harvesting were examined with light and electro-microscope.</p><p><b>RESULTS</b>The endoscopic harvest time was 42 to 98 min, with a mean of (57.6 +/- 17.3) min. The harvested conduit length was 15 to 20 cm, with a mean of (17.5 +/- 1.6) cm. Objective dorsal thenar numbness remained in 7 patients, none complained of forearm numbness at 3-month follow-up. The result of light and electro-microscope had no differences in the intima, media, or adventitia between endoscopically and conventionally obtained radial artery segments.</p><p><b>CONCLUSION</b>The use of endoscopic radial artery harvesting in coronary artery bypass grafting can be performed safely with infrequent complications. This method results in excellent patient satisfaction, particularly regarding the cosmetic outcome.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Coronary Artery Bypass , Endoscopy , Radial Artery , Transplantation , Tissue and Organ Harvesting , Methods , Treatment OutcomeABSTRACT
Objective The aim of this study was to evaluate the diagnostic value of thyroglobulin(Tg)mRNA in peripheral blood samples of patients with differentiated thyroid carcinoma(DTC)after remnant ablation.Methods Tg mRNA Was detected by reverse transcription-polymerase chain reaction(RT-PCR)in peripheral blood of 162 patients.SPSS 13.0 was used for date analysis.Results The Tg mRNA assay had higher sensitivity than the conventional serum Tg measurement[86.61%(97/112)vs 53.57%(60/112),X2=29.153,P＜0.001]which Was the"gold standard"for the identification of recurrence or metastases.In the anti-Tg antibodies(TgAb)positive DTC patients,the sensitivity of Tg mRNA was higher than that of serum Tg[86.54%(45/52)vs 0]in identifying recurrent or metastatic thyroid disease(X2=79.322,P＜0.001).There was a significantly positive correlation between Tg mRNA expression and the clinical stages(Kendall correlation coefficient=0.515,P＜0.001).There was no difference of Tg mRNA expression in peripheral blood among ages,sex,pathological types and location of metastases,respectively(Kendall correlation coefficient=0.020,0.069,0.050 and 0.028;all P＞0.05).Conclusions Circulating Tg mRNA is a more sensitive marker than serum Tg in identifying recurrent or metastatic DTC,particulady in patients during levo-thyroxine(l-T4)therapy and with TgAb-positive.The DTC patients who have positive expression of Tg mRNA indicates poor prognosis.
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<p><b>OBJECTIVE</b>To explore the relationship between the expression of cyclooxygenase-2 (COX-2) and angiogenesis in hepatocellular carcinoma.</p><p><b>METHODS</b>Forty Wistar rats were divided into two groups: a model group (30 rats) and a normal group (10 rats). Hepatocellular carcinoma was induced with 0.01% diethylnitrosamine (DEN) in the model group rats. The rats were sacrificed in batches at the 6th, 12th and 18th week of the experiment. Histological sections of liver tissues were made using routine methods. The expressions of COX-2, VEGF, VEGFR-2/KDR, and MMP-2 protein in the liver tissues were evaluated using immunohistochemical methods.</p><p><b>RESULTS</b>In liver sections from the model group there were marked pathological changes (steatosis, cell infiltration, cirrhosis and liver cancer). The expressions of VEGF, VEGFR-2/KDR, and MMP-2 in those liver tissues were remarkably increased during the hepatocellular carcinogenesis. Microvessel density (MVD) was also obviously raised during the process of the cancer development. There was a direct correlation between the MVD and VEGF/KDR/MMP-2 (r=0.858, 0.788, 0.684, respectively; all P less than 0.01). There was also a direct correlation between the COX-2 and VEGF/KDR/MMP-2/MVD (r=0.771, 0.599, 0.690, 0.788, respectively; all P < 0.01).</p><p><b>CONCLUSION</b>COX-2 can promote tumor angiogenesis during rat hepatocellular carcinogenesis. This may be one of the mechanisms in which COX-2 promotes carcinomas.</p>
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Animals , Male , Rats , Carcinoma, Hepatocellular , Metabolism , Pathology , Cyclooxygenase 2 , Liver Neoplasms , Metabolism , Pathology , Neovascularization, Pathologic , Rats, WistarABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of endovascular therapy and artery bypass for subclavian artery occlusion disease and to explore a suitable therapeutic procedure.</p><p><b>METHODS</b>Thirty-nine patients with subclavian artery occlusive disease received endovascular therapy or arterial bypass from June 1997 to May 2004. Twenty-seven endovascular stenting were performed on 26 patients through the femoral artery (n = 14) or combined brachial artery (n = 12). Retrograde endovascular balloon angioplasty and stent placement were performed on 12 patients. Eight subclavian arteries were punctured with ultrasound localization. On account of unsuccessful stenting, 13 cases received arterial bypass. In addition, endovascular stenting were performed on 9 cases with carotid or vertebrarterial stenoses.</p><p><b>RESULTS</b>The blood pressure difference was less than 10 mm Hg between the treated and the healthy arms in all 39 patients. The ratio of healthy/diseased side of the mean blood pressure index increased from 0.62 +/- 0.11 preoperatively to 0.98 +/- 0.04 postoperatively (P < 0.01). The mean patency time for endovascular therapy and arterial bypass was (57.6 +/- 3.7) and (60.2 +/- 7.2) months, respectively.</p><p><b>CONCLUSIONS</b>Both endovascular therapy and arterial bypass have good curative effect for subclavian artery occlusion. Endovascular therapy is the preferred treatment for subclavian artery occlusion with mini-trauma and safety.</p>