ObjectiveTo compare the efficacy of varicose great saphenous vein (GSV) treatment alone versus combined treatment with iliac vein compression (IVC) intervention in improving lower extremity symptoms and prognosis among the patients with varicose GSV complicated by IVC. MethodsBased on inclusion and exclusion criteria, the patients with varicose GSV complicated by IVC treated at the Day Service Center of the First Affiliated Hospital of Chongqing Medical University from May 2022 to January 2025 were retrospectively enrolled. The patients were assigned into two groups according to the treatment strategies: the varicose GSV treatment alone group (control group) and the combined treatment group for varicose GSV and IVC (observation group). The primary endpoints included the closure rate of the GSV trunk, venous clinical severity score (VCSS), and venous insufficiency epidemiological and economic study quality of life/symptom (VEINES-QOL/Sym) questionnaire score at 6 and 12 months postoperatively. The significance level was set at α=0.05. ResultsA total of 264 patients with left lower extremity varicose GSV complicated by IVC were included. The observation group comprised 32 patients, while the remaining 232 patients underwent 1∶3 propensity score-matching, resulting in 96 matched patients in the control group. The baseline characteristics, including gender, age, and comorbidities, showed no statistically significant differences between the two groups (P>0.05). At 12 months postoperatively, the GSV trunk closure rate was 100% in both groups. Within-group comparisons revealed significant improvements in the VCSS and VEINES-QOL/Sym points at 6 and 12 months as compared with preoperative (on admission) values (P<0.05). Between-group comparisons showed that the observation group had greater improvement in the VEINES-QOL/Sym score at 6 months (P=0.028), but no significant difference in the VCSS (P=0.775); At 12 months, the observation group demonstrated significantly better the VCSS (P<0.001) and VEINES-QOL/Sym points (P<0.001) as compared with the control group. ConclusionsFor patients with left lower extremity GSV varicosities complicated by IVC, both treatment strategies significantly improve symptoms. Results of short-term follow-up (6 months) demonstrate early advantages in quality of life improvement with concurrent IVC intervention, while results of 12-month follow-up indicate superior efficacy in both symptom relief and quality of life enhancement. Therefore, concurrent IVC intervention may provide greater clinical benefits for mid- to long-term prognosis for patients with left lower extremity GSV varicosities complicated by IVC.
Main iliac artery disease is a common lesion that leads to arteriosclerosis and occlusion of the lower limbs. Effective treatment of complex main iliac artery disease has always been a difficult problem. The author’s team successfully treated a patient with long segment iliac artery occlusive disease from the left common iliac artery to the opening of the left femoral artery (118 mm) with Gore viabahn VBX balloon dilated intravascular covered stent and viabahn covered stent, and be reported.
过去十几年，我国血管外科蓬勃发展，一方面血管疾病的发病率显著上升，另一方面腔内血管技术正迅速渗透到血管疾病诊疗的各个方面。同时，相关学科的发展促进了血管外科实验研究的深入开展，产生出许多新的研究热点。
ObjectiveTo investigate the therapeutic strategies of endovascular repair for complicated Stanford type B aortic dissection. MethodThe clinical data of 36 patients with complicated Stanford type B aortic dissection treated by endovascular repair were analyzed retrospectively. ResultsThirty-six patients with complicated Stanford type B aortic dissection were treated successfully by endovascular repair. Twenty-two cases were treated by endovascular repair combined with covering left subclavian artery (LSA). Ten cases were treated by endovascular repair combined with chimney technique. Two cases were treated by endovascular repair combined with vascular prosthesis bypass from left common carotid artery to LSA. Two cases were treated by endovascular repair combined with vascular prosthesis bypass from right common carotid artery to left common carotid artery, whose proximal part were ligated. The viscera artery and lower extremity artery supply were restored gradually. No complication such as endoleak occurred. ConclusionFor endovascular repair of complicated Stanford type B aortic dissection, strategies combined with covering LSA, chimney technique, and hybrid operation of small incision could extend anchor zone, expand the range of endovascular repair of aortic dissection, improve curative effect, reduce complications.
ObjectiveTo investigate the therapeutic effect of endovascular therapy for TASC-ⅡC/D lesion of iliac artery occlusion. MethodThe clinical data of 25 patients (28 limbs) who underwent endovascular therapy for TASC-ⅡC/D lesions of iliac artery occlusion were reviewed retrospectively. ResultsTwo limbs failed to recanalize the occlusions, recanalization rate was 92.86%. Twenty-six iliac arteries were successfully treated by percutaneous transluminal angioplasty and implanted stent. The ankle-brachial index increased from preoperative 0.23±0.18 to postoperative 0.76 ±0.19 (P < 0.05). Two patients had hematomas in puncture point, which were improved by conservative treatment. One patient had thrombosis in stent, which was disappeared by local thromblysis after thrombolytic catheter placement. Twenty patients (24 iliac arteries) were followed up for a mean time of 8 months (3-24 months). The follow-up rate was 85.71%. The limb patency rates of 6 months, 1-and 2-year was 85%, 80% and 73%, respectively. ConclusionEndovascular therapy for TASC-ⅡC/D lesion of iliac artery occlusion is safe and has a good short-term therapeutic effect, microtrauma and little complications.
Objective To investigate the security and efficiency of endovascular repair for Stanford type B aortic dissection (AD) with severe complications. Methods Between January 2003 and December 2009, 60 patients having Stanford type B AD with severe compl ications were treated, including 39 males and 21 females with an average age of 43.7 years (range, 34-71 years). Severe compl ications included 27 cases of huge hemothorax, 1 case of paraplegia, 7 cases of acute renal failure,10 cases of cel iac trunk ischemia, 10 cases of superior mesenteric artery ischemia, and 5 cases of severe limb schemia. Emergency stent-graft deployment were appl ied in all patients, and 64 stent-grafts were successfully implanted. Results All patients survived and were followed up 3-86 months. Hemothorax disappeared after 28 days to 3 months of operation in all hemothorax patients; renal function returned normal after 1 to 9 days; l imb and visceral ischemia disappeared gradually after 1 to 14 days; and muscular strength of lower limb in the paraplegia patient began to recover after 4 hours of operation. The postoperative CT angiography showed enlarged true lumen and thrombosis in the false lumen. Conclusion Emergency endovascular repair is a safe and effective method to treat Stanford type B AD with severe complications.
As one of the stimulus-response polymeric intelligent materials, shape memory polymers have been widely applied in biomedicine due to their better biocompatibility, higher controllability, stronger deformation restorability and biodegradability compared with shape memory alloys and shape memory ceramics. This review will introduce the structural principles of shape memory polymers and summarize their applications in the treatment of vascular diseases, especially in endovascular therapy. At the same time, the related technical problems and the future of shape memory polymers are prospected. With the continuous development of processing technology and materials, it can be predicted that shape memory polymers will be more widely used in the medical field.