Objective To compare the effectiveness, complications, and follow-up results between endovascular recanalization (EVR) and open surgical revascularization (OSR) in the treatment of peripheral pseudoaneurysm, so as to provide a reference for choosing a appropriate surgical procedure. Methods Clinical data of 62 cases of peripheral pseudoaneurysm between January 2001 and January 2012 were analyzed retrospectively. EVR was performed in 28 patients (EVR group) and OSR in 34 patients (OSR group). There was no significant difference in gender, age, cause of injury, tumor location, and diameter of tumor between 2 groups (P gt; 0.05). Results The operation time, blood loss, ICU monitoring time, and hospitalization time in EVR group were significantly shorter than those in OSR group (P lt; 0.05). In OSR group, 12 cases (35.29%) had early postoperative complications, including 2 deaths due to acute respiratory distress syndrome, 5 cases of pulmonary infection, 3 cases of wound infection, and 2 cases of deep vein thrombosis; in EVR group, 2 cases (7.14%) had early postoperative complications, including 1 case of hematoma at puncture site and 1 case of thrombosis in stent. There was significant difference in early postoperative complication incidence between 2 groups (χ2=6.691, P=0.008). The patients were followed up 12-39 months (mean, 26 months). In OSR and EVR groups after operation, the patency rates of the reconstructed vessels were 96.88% (31/32) and 92.86% (26/28) respectively at 12 months, showing no significant difference (χ2=0.014, P=0.905); the patency rates were 89.29% (25/28) and 84.00% (21/25) respectively at 24 months, showing no significant difference (χ2=0.322, P=0.570). Conclusion Compared with OSR, EVR is a minimally invasive, safe, and effective therapy for peripheral pseudoaneurysm with the advantages of less bleeding, shorter hospitalization time, and less complications. Long-term effectiveness still needs further observation, and patients have to take antiplatelet drugs for long time after EVR.
ObjectiveTo identify risk factors for severe elastic recoil after percutaneous transluminal angioplasty (PTA) in the femoropopliteal artery disease basing on intravascular ultrasound (IVUS) imaging and to develop a risk prediction model. MethodsA retrospective analysis was conducted on the clinical data from the patients with femoropopliteal artery disease treated at the First Affiliated Hospital of Chongqing Medical University from September 2020 to February 2022. Based on the IVUS images, a multivariate logistic regression analysis was conducted to identify the risk factors for severe elastic recoil in the patients with femoropopliteal artery disease after PTA. A nomogram prediction model was established to predict the occurrence of severe elastic recoil, and the area under receiver operating characteristic curve (AUC) was used to evaluate its ability to distinguish the occurrence of severe elastic recoil, which was validated using a calibration curve. ResultsA total of 34 patients with femoropopliteal artery disease who received PTA treatment were collected. Of the 803 vessel slices were analyzed, 451 (56.16%) demonstrated severe elastic recoil on IVUS imaging. The patients with preoperative plaque burden, luminal eccentric index, plaque eccentric index, and the external elastic membrane-balloon area ratio were higher, the probability of severe elastic recoil after PTC were higher. The AUC of the nomogram prediction model basing on these risk factors exhibited strong discriminatory [AUC (95%CI)=0.775]. The predicted probability of the nomogram model for severe elastic recoil was in a good agreement with the actual probability (P=0.862). ConclusionsThe severe elastic recoil prediction model developed in this study, based on IVUS imaging data, can effectively identify high-risk factors for severe elastic recoil following PTA in patients with femoropopliteal artery disease, demonstrating moderate predictive discrimination capability.