Objective To evaluate the cl inical effect of percutaneous transluminal angioplasty (PTA) and PTA and stenting (PTAS) in treating multilevel arteriosclerosis obl iterans (ASO) of lower extremities. Methods Between January 2007 and October 2009, 29 cases of multilevel ASO of lower extremities were treated with PTA or PTAS. There were 17 males and 12females with an average age of 71 years (range, 56-83 years). The cl inical manifestations were l imbs numb with cold sensation, intermittent claudication (lt; 100 m), and 19 patients had rest pain. According to Fontaine stages classification, there were 7 cases of stage II, 14 cases of stage III, and 8 cases of stage IV. Concomitant diseases included hyperl ipidemia in 13 cases, diabetes in 6 cases, hypertension in 12 cases, chronic heart failure in 5 cases, chronic obstructive pulmonary disease in 3 cases, cerebral infarction in 5 cases, and toe ulcer in 15 cases. The preoperative ankle/brachial index (ABI) was 0.28 ± 0.13. Results In 3 cases of below knee lesions for the guide wire puncturing through the artery wall, 1 case gave up, and 2 cases continued recanal ized other arteries without serious bleeding compl ications. After operation, cerebral infarction occurred in 1 case, pulmonary infection in 2 cases, and groin puncture site hematoma in 2 cases. All patients were followed up 3 to 36 months. Limb skin temperature was significantly improved, and intermittent claudication disappeared or claudication distance lengthened, rest pain disappeared or significantly reduced in 27 patients (30 l imbs). The wound of amputee achieved good heal ing in 2 cases (2 l imbs). In 27 patients undergoing endovascular treatment, the postoperative ABI was 0.72 ± 0.19, showing significant difference when compared with the preoperative one (P lt; 0.05). Conclusion The PTA and PTAS treatment for multilevel ASO of lower extremities is a safe and effective option, and the short-term effect is good. Different treatments should be chosen according to the location and length of vascular occlusion.
Objective To evaluate the clinical effect of staging endovascular angioplasty in treatment for iliofemoral venous post-thrombotic syndrome （PTS）. Methods The clinical data of 45 patients with iliofemoral venous PTS from May 2008 to October 2011 in this hospital were analyzed retrospectively. After the identification of the stenosis or occlusion by angiography via femoral vein by percutaneous puncture or incision puncture， recanalization of the occlusion was done by guide wire. Then the percutaneous transluminal angioplasty （PTA） was performed. Results A total of 45 cases （45 legs） had been undergone PTA. The procedures were technically successful in all the patients. No serious complications such as lumen rupture happened. Follow-up time was 6-30 months with （18.06±3.12） months， the symptoms of the affected limb were obviously relieved in 31 cases， partly relieved in 10 cases， not relieved in 4 cases. Reexamination of venous angiography， 9 cases were cured， 18 cases were excellent， 14 cases were improved， 4 cases were ineffective. The total effective rate was 91.11% （41/45）. Conclusion PTA is a safe and effective method in treatment for iliofemoral venous PTS.