OBJECTIVE To evaluate efficacy and outcome of endovascular therapy for complex arteriosclerosis obliterans of the lower extremities. METHODS In this single-center retrospective study, the clinical data of consecutive 114 cases with TASC II type C/D lower extremity obstructive disease and clinical stage of Fontaine ≥ IIb and ankle brachial index <0.9 underwent endovascular therapy from December 2011 to January 2013 were collected. Telephone or clinic interviews were conducted to investigate the clinical outcomes. RESULTS There were 39 TASC II type C patients and 75 TASC II type D patients, 78 patients were in Fontaine IIb, 30 patients in Fontaine III and 6 patients in Fontaine IV stages. Immediate procedural success rate was 94.9% (131/138). Ankle brachial index was increased from 0.54 ± 0.26 at baseline to 0.83 ± 0.30 at discharge (P < 0.01). No adverse event was observed during the perioperative period. During (15.7 ± 8.7) months follow-up, cumulative patency rate of 6, 12 and 18 months was 75.8% (94/124) , 68.7% (68/99) and 39.2% (20/51) respectively and limb salvage rate was 100%. CONCLUSION Endovascular therapy for complex arteriosclerosis obliterans of the lower extremities is effective and safe.

下肢动脉硬化闭塞症(ASO)是导致慢性下肢缺血的主要原因,是发病逐年增高肢体出现不同程度缺血的疾病,严重者最终导致截肢[1].治疗主要有内科治疗和血运重建,其中血运重建包括导管介入治疗和外科手术治疗.随着介入器材的不断改进,血管内支架腔内成形术(PTA)技术逐步成熟,且其有效、微创、安全、术后恢复快、适用范围广,对下肢动脉硬化导致膝下缺血的治疗,取得满意的临床疗效.2011年11月-2013年1月对54例膝下动脉闭塞病变患者进行PTA,取得明显疗效.

Objective To evaluate the effect and prognosis of two different therapeutic methods for aortic regurgitation caused by aortitis.Methods 380 in-patients with aortic regurgitation caused by aortitis were investigated retrospectively.Among them,38 patients had middling to severe aortic regurgitation,and then were divided into the following 2 group:medical conservative treatment and surgical treatment.Results 22 patients were given medical conservative treatment.In this group,4 patients died and 6 patients worsened;16 patients underwent surgical treatment.4 patients died,2 patients deteriorated.There is no significant difference between two therapeutic methods(P0.05).Conclusion As far as the survival race is concerned,surgical treatment is not better than medical conservative treatment,insufficient cases may be the reason,further than follow-up is necessary.

目的:分析总结主动脉壁内血肿的临床特点、诊断及治疗,以便早期正确处理,降低病死率.方法：回顾性分析连续21例经电子束计算机断层摄影术(EBT)确诊的主动脉壁内血肿住院患者的临床资料,并进行随访.结果：21例患者均有突发持续胸背痛,高血压18例,一半以上患者有血白细胞、中性粒细胞、血沉、C-反应蛋白升高,部分患者X线胸片、经胸超声心动图可见非特异性征象,而EBT均可见特异性征象.其中Stanford A型4例,Stanford B型17例.除1例Stanford A型行外科手术外,均给予降压及负性肌力药物治疗,病情好转出院.共随访到17例,1例Stanford A型死亡,1例Stanford A型进展为典型主动脉夹层,4例Stanford B型血肿吸好转,其余11例无症状存活,但未复查EBT.结论：综合分析临床资料,可提高对主动脉壁内血肿的早期识别,有助于选择合适的治疗方法并改善预后.