ObjectiveTo compare the effectiveness of radiofrequency ablation (RFA) combined with transilluminated powered phlebectomy (TIPP) vs. high ligation and stripping (HLS) combined with TIPP in patients with varicose veins of lower limbs.MethodsA retrospective analysis was made on the clinical data of 190 patients (206 limbs) of varicose veins of lower limbs who underwent surgical treatment in our hospital from December 2017 to July 2018, of them 88 patients (96 limbs) in RFA combined with TIPP group and other 102 patients (110 limbs) in HLS combined with TIPP group. The treatment effectiveness and quality of life was assessed with venous clinical severity score (VCSS) and chronic venous insufficiency questionnaire (CIVIQ-14) in three months and one year after surgery. Doppler ultrasound was used to evaluate the closure of great saphenous vein.ResultsBaseline characteristics were similar between the two groups (P>0.05). The RFA combined with TIPP group was better than the HLS combined with TIPP group in operation time, intraoperative bleeding, hospital stay time, postoperative bed time, resumption time of activities, as well as incidences of skin induration and limb numb (P<0.05). Occlusion rates of great saphenous vein in 3 months was 93.8% (90/96) in the RFA combined with TIPP group and 97.3% (107/110) in the HLS combined with TIPP group, and in one year was 91.7% (88/96) and 97.3% (107/110) respectively, there was no significant difference between the two groups at the same time point (P>0.05). The VCSS scores and CIVIQ-14 scores also improved significantly in two groups in 3 months and 1 year follow up (P<0.05), but there was no significant differences between the two groups at the same time point (P>0.05).ConclusionsRFA combined with TIPP is an effective method for the treatment of varicose veins of lower limbs. Compared with HLS, RFA has the same good effectiveness and quality of life, but it has the advantages of short operation time, rapid postoperative recovery, and less postoperative complications.
ObjectiveTo explore the technique experience and short- term and long-term effect of endovascular treatment on aorioiliac artery occlusive disease.MethodsClinical data of 131 patients were admitted for aorioiliac artery occlusive disease in the Department of Vascular Surgery of Beijing Chaoyang Hospital Affiliated to Capital Cedical University in recent years were analyzed.ResultsAll the 131 patients underwent surgical operation, including 5 cases of pure catheterization (CDT); 94 cases of balloon dilatation and stent implantation; 23 cases which combind CDT, balloon dilatation, and stent implantation; 3 cases of pure balloon dilatation and 6 complicated cases of hybrid surgery. The mean operative time was 90 minutes, mean hospitaliztion time was 5 days. There were 6 cases occurred complications during perioperative period, including 3 cases of hematoma, 1 case of retroperitoneal hematoma, 1 case of acute transient ischemic attacks (TIA), and 1 case of pulmonary infection. There were 113 patients were followed-up for 1–32 months, and the median time was 16 months, the follow-up rate was 86.3% (113/131). During the follow-up period, 2 patients died, 1 died of myocardial infarction and 1 died of multi-organ failure. The one-year patency rate was 89.3% (100/112). During the follow-up period, 13 patients relapsed, including 5 patients who underwent secondary stent implantation, 1 patient who underwent CDT and percutaneous transluminal angioplasty (PTA), and 7 patients who received conservative treatment due to mild symptoms.ConclusionsThe treatment of aorioiliac artery occlusive disease still needs to choose reasonable measures according to the lesions, and even several measures should be combined to simplify the lesions, lower risk and receive better effect.
ObjectiveTo analyze the therapeutic effects of open surgery and endovascular treatment for mesenteric venous thrombosis.MethodsThe clinical data of 22 patients with mesenteric venous thrombosis from March 2005 to January 2014 were analyzed retrospectively. One patient underwent open surgery including removal of necrotic small intestine and thrombectomy of superior mesenteric vein immediately admission to the hospital. Five cases were treated with simple anticoagulation and cured. Sixteen cases received thrombolytic therapy after primary anticoagulant therapy.ResultsOne case who underwent open surgery died of multiple organ failure at 72 h after the surgery. Five cases who received simple anticoagulant reached clinical relief finally. Sixteen patients who received thrombolytic therapy achieved recanalization totally or partially. Three cases died during follow-up (3 months to 7 years, average) of which 1 died of recurrence of acute superior mesenteric venous thrombosis, 1 died of myocardial infarction, and 1 died of stroke.ConclusionsFor patients with symptomatic mesenteric venous thrombosis, if there is no intestinal necrosis, there will be encouraging results by interventional thrombolytic therapy. And the treatment effect needs further experience accumulation in more cases.