Objective: To investigate the diagnosis and treatment strategy of spontaneous isolated dissection of the superior mesenteric artery (SIDSMA). Methods: The clinical data of 15 patients with SIDSMA undergoing endovascular stent placement from January 2008 to December 2010 were retrospectively analyzed. Results: None of the 15 patients had complication of rupture/hemorrhage of the dissection or bowel infarction. Of the patients, single layer stents were deployed in 12 cases, and overlapping stents were deployed in 3 cases. A total of 18 stents (2 balloon expandable stents and 16 self-expandable stents) were deployed. Fourteen (93.3%) patients had relief of symptoms, one (6.7%) patient’s symptoms remained unchanged, and no death or severe complications such as intestinal infarction, abdominal bleeding, cardiac infarction, cerebrovascular accident, renal failure, gastrointestinal tract hemorrhage or pneumonia occurred after operation or during follow-up. The average length of hospital stay and follow-up was 3 d (2–7 d) and 11 months (6–23 months), respectively. All of the 15 patients underwent CTA examination 6 months later, and the results showed that the stent patency rate was 100% and one (6.7%) patient developed a new dissection distal to the stent. Conclusion: For SIDSMA patients without rupture/hemorrhage or bowel infarction, endovascular stent placement is a feasible, minimally invasive and effective treatment option.

Objective: To compare the clinical efficacies of large-lumen catheter thrombus aspiration and thrombolytic treatment for mixed type of acute lower extremity deep venous thrombosis (DVT). Methods: The clinical and follow-up data of 458 patients with acute mixed type of lower extremity DVT admitted over 11 years were retrospectively analyzed. Of the patients, 327 cases (group A) underwent large-lumen catheter thrombus aspiration, and the other 131 cases (group B) received systemic thrombolytic therapy with urokinase. Results: No severe complication occurred in group A during operation, while in group B, life-threatening bleeding occurred in 2 patients during thrombolytic therapy. The average length of hospital stay for patients in group A was 6.5 d and in group B was 9.5 d (P<0.05), and the cure rate in group A and group B was 94.8% and 37.4%, respectively (P<0.05). During 36–48 months follow-up period, the difference between the diameter of the two legs at 15 cm below knee joint was (0.53±0.42) cm in group A and (1.42±1.35) cm in group B (P<0.05); the incidence of edema, skin pigmentation, and ulceration were 27.83%, 13.15% and 0 in group A, and 55.73%, 83.97% and 9.16% in group B, respectively (all P<0.05); the vein patency rate and rate of normal functioning valves were 90.83% and 73.09% in group A, both of which were significantly higher than those in group B (37.41% and15.27%) (both P<0.05); the overall effective rate in group A and group B was 100% and 71.76%, respectively (P<0.05). Conclusion: Large-lumen catheter thrombus aspiration has better efficacy than thrombolytic therapy for acute mixed type of lower extremity DVT, especially in the aspect of venous valves protection.

Objective: To assess the arterial intimal changes of rats, which were injured with intra-arterial injection of distilled water and fed with high-fat diets, for a further understanding of the pathogenesis of arteriosclerosis obliterans. Methods: After distilled water was injected into the left side of femoropopliteal artery form the non-mechanical, superficial injury, rats were fed with high-fat diets. At 7, 15, 30 and 90 d after the intimal injury, the femoropopliteal artery of the left hind limb was excised. HE and other staining were performed, and the results were observed by light microscope. Results: A large number of endothelial cells exfoliated after 7 d; endothelial cells completely exfoliated after 15 d. Endothelial thickening and lumen stenosis was observed after 30 d and endothelial thickening, partial calcification, thrombus formation and luminal occlusion were noted after 90 d. Conclusion: Injection of distilled water into the femoropopliteal artery of rats, and then fed with high-fat diets can form an arteriosclerosis obliterans model in a relatively short period of time.