Drug-coated balloon (DCB) provides a new treatment strategy for peripheral artery diseases (PAD) and its effectiveness has been tested in several controlled studies in different countries, most of which focused on its use in femoropopliteal leisons. Compared with uncoated balloon, DCB can reduce late lumen loss and restenosis of femoropopliteal TASC-A/B lesions at 6 months and even 1 year after operation and decrease the re-intervention rate, but there is a lack of its mid- and long-term follow-up results as well as its efficacy for TASC-C/D lesions. Studies on using DCB in treatment of infra-popliteal diseases are relatively scarce, in which even more unfortunately, the results are not consistent with each other in terms of comparison between DCB and uncoated balloon. Thus, more high-quality well-controlled studies are urgently needed to answer these questions.

Aortic dissection (AD) is characterized by abrupt onset, high mortality and poor prognosis. With the development of endovascular techniques for the management of aortic diseases in recent years, the therapeutic effect of AD has been greatly improved, and the treatment concept has also significantly changed. In respect of classification, many new classification systems have been proposed to guide the management of AD and, as for treatment of AD, although open surgery is still the main treatment approach for Stanford A dissection, endovascular repair has become the preferred procedure for complicated Stanford B dissection, and meanwhile, accumulating evidences indicate that favorable results may be achieved in non-complicated Stanford B dissection by early endovascular intervention.

There has been much confusion about the understanding of congenital venous malformations for a long time, for which the misdiagnosis and wrong treatment often occur in clinical practice so that standardizing the medical processes is an urgent matter. In Chapter 6 of Management of Chronic Venous Disease Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS) published in the ESVS official journal European Journal of Vascular and Endovascular Surgery in June 2015, the classification of congenital vascular malformations was discussed, paying particular attention to the etiology, clinical characteristics, diagnosis and management of congenital venous malformations, as well as the complex congenital venous malformations affecting the venous system, such as Klippel-Trenaunay and Parkes-Weber syndrome. This will be of great significance for the further improvement of their diagnosis and treatment.

Objective: To review the experience in emergency treatment of ruptured abdominal aortic aneurysm (rAAA) and explore the perioperative risk factors. Methods: The clinical data of 27 patients with rAAA admitted from January 2007 to September 2015 were reviewed. Of the patients, 20 cases were male, and 7 cases were female, with a median age of 72 years; 18 cases underwent open surgery and 6 cases had endovascular repair (including one case of hybrid surgery). The diagnosis and treatment procedures, perioperative conditions and postoperative follow-up results were summarized, and the perioperative risk factors were also analyzed. Results: Pre-, intra- and postoperative death occurred in 3, 1 and 9 cases respectively. The causes for postoperative death included acute renal failure, acute respiratory failure, abdominal compartment syndrome, myocardial infarction and hemorrhage of digestive tract, all which finally led to multiple organ dysfunction syndrome. The overall successful salvage rate was 51.9% (14/27), which in open surgery was 50% (9/18) and in endovascular repair was 83.3% (5/6), respectively. Comparison of the clinical variables between patients who survived and those who died during the perioperative period showed that there was significant difference in time from onset to admission, preoperative systolic blood pressure, preoperative serum creatinine concentration, intraoperative blood loss, volume of transfusion and intraoperative urine output (all P<0.05). Conclusion: As rAAA is a lethal condition with high mortality, definitive diagnosis should be made as soon as possible to ensure emergent surgical repair to control the hemorrhage, and enhanced perioperative management is equally important. Endovascular repair is an effective approach for emergency treatment of rAAA.

Objective: To investigate the association between aortic dissection (AD) and functional adrenal tumors. Methods: Two patients with AD and concomitant functional adrenal tumors admitted in recent years were reviewed, and the relationship between the two diseases was analyzed and combined with related literature review. Results: One patient refused surgical treatment, while the other underwent first-stage aortic dissection endovascular repair and second-stage laparoscopic adrenal tumor resection, and recovered after surgery. There were a total of 9 cases with AD and concomitant functional adrenal tumors reported in English literature, and only 2 relevant cases seen in domestic literature. Relationship analysis between the two diseases indicated that the hormones secreted by the functional adrenal tumors may induce the AD formation through secondary hypertension or their direct actions. Conclusion: AD associated with functional adrenal tumors is rare and there may be a connection between the two diseases so, in clinical practice, rigid screening should be performed.

Objective: To investigate the clinical efficacy of percutaneous interventional treatment for complex aortoiliac arterial occlusion. Methods: The clinical data of 16 patients with complex aortoiliac arterial occlusion were retrospectively analyzed. All patients underwent interventional procedures by using subintimal recanalization technique and catheter-capture technique to establish a working guidewire channel via multi-puncture approach, and then underwent balloon dilatation and kissing stent placement. Results: Operation was performed successfully in all the 16 patients with complex aortoiliac arterial occlusion, and the surgical success rate was 100%. Among them, blood flow was completely restored and symptoms were improved significantly in 15 cases, and symptoms were moderately improved in 1 case, in whom the symptoms of lower limb ischemia disappeared. Puncture-site hematoma occurred in one case, and the incidence of postoperative complications was 6.25%. All patients were followed up for 3 to 48 months. Intra-stent stenosis or thrombosis occurred in 5 cases, and blood flow was restored after a second endovascular intervention. The 12-, 24- and 36-month patency rate was 87.5%, 81.25% and 68.75% respectively. Conclusion: For complex aortoiliac arterial occlusion, percutaneous interventional treatment can rapidly recanalize the occlusion and restore the blood flow with low incidence of complications, so it has satisfactory clinical efficacy.

Objective: To investigate the effective management for different types of peripheral arterial pseudoaneurysms (PSA). Methods: The clinical data of 29 patients with peripheral arterial PSA treated from March 2011 to December 2015 were analyzed retrospectively. Among 11 patients with femoral PSA, 9 cases underwent aneurysm resection and artery ligation and 2 cases were treated by arterial bypass. Four patients with brachial PSA and 2 patients with radial PSA underwent aneurysm resection and aneurysmorrhaphy, 10 patients, that included 2 cases with posterior tibial PSA, 2 cases with spleenic PSA, 3 cases with internal iliac PSA, one case with mesenteric PSA, and 2 cases with external carotid PSA, underwent coil embolization, and 2 patients with external iliac PSA underwent covered stent placement. Results: After operation, the lumen of PSA in all patients was completely occluded. One patient with femoral PSA developed limb ischemia and necrosis, and then was subjected to second stage amputation, and one patient with infectious external carotid PSA died of hemoptysis. Satisfactory results were achieved in all of the other patients. Conclusion: According to the causes and locations of peripheral arterial PSA, appropriate selection of treatment method may be important for satisfactory results.

Objective: To investigate the safety and reliability of using high-frequency electric welding device (HFWD) for arterial closure. Methods: Six Tibetan minipigs were equally randomized into HFWD group and harmonic scalpel group (HS group). Under general anesthesia, carotid and femoral arteries of the pigs were isolated and skeletonized, and were then closed and divided using HFWD or HS, respectively. The bursting pressure of the vessels after sealing, sealing time, maximum temperature during sealing and the pathological injuries in the sealing area were compared between the two groups. Results: In all vessels without distinction of diameter, the average burst pressure after sealing in HFWD group was significantly higher than that in HS group (489.64 mmHg vs. 439.88 mmHg, P<0.05); in vessels with diameter ≤3 mm, the burst pressure showed no significant difference between HFWD group and HS group (593.40 mmHg vs. 572.48 mmHg, P>0.05); in vessels with diameter either >3~5 mm or >5~7 mm, the burst pressure in HFWD group was significantly higher than that in HS group (457.02 mmHg vs. 404.32 mmHg; 418.51 mmHg vs. 342.84 mmHg, both P<0.05). No matter what the vessel diameter was, the sealing time in HFWD group was significantly shorter than that in HS group (all P<0.05). The average maximum temperature during sealing in HFWD group was significantly lower than that in HS group (65.91 ℃ vs. 105.25 ℃, P<0.05). The collagen denaturation and smooth muscle injury in vascular wall of the sealing site were milder in HFWD group than those in HS group. Conclusion: Using HFWD for arterial closure is safe and reliable.

Objective: The investigate the effect of transplantation of bone marrow mesenchymal stem cells (MSCs) transfected with TGF-β1 on survival of prefabricated flap and the mechanism. 
Methods: The rat MSCs were isolated and cultured, and then transfected with pcDNA3.1 (+)/TGF-β1 eukaryotic expression vectors through liposome delivery system. The phenotype and tube formation ability in vitro of the MSCs after transfection were determined. Twelve SD rats were used, and random flaps with 5 cm in length and 1 cm in width were established on the symmetric parts of the back of the rats, and then the bottom of the flap on both sides was injected with MSCs after transfection (experimental side) or vehicle (control side), respectively. The survival rate of flap was calculated and the vessel density in the flap was determined by HE and immunohistochemical staining.
Results: Flow cytometry analysis showed that bone marrow stem cells transfected with TGF-β1 exhibited the characteristics of the naïve MSCs, and had better tube formation ability in vitro. In the flaps on experimental side injected with MSCs transfected with TGF-β1, the survival rate was significantly higher than that in the flaps on control sides (82.83% vs. 61.33%, P<0.05), and meanwhile, the capillary density was significantly greater than that in the flaps on control sides (19.69 vs. 8.19, P<0.05).
Conclusion: Transplantation of MSCs transfected with TGF-β1 can promote angiogenesis in skin flaps and thereby improve the survival of the flaps.

Objective: To investigate the application value of postoperative chemoradiotherapy in elderly patients with stage III rectal cancer. Methods: The clinical data of 128 consecutive elderly patients (≥75 years of age) with stage III rectal cancer treated from January 2010 to January 2014 were retrospectively analyzed. Patients were divided into chemoradiotherapy group (60 cases) and control group (68 cases) according to whether or not they received postoperative chemoradiotherapy. The progression-free survival, 2-year survival, health-related quality of life and postoperative complications between the two groups were compared. Results: In chemoradiotherapy group compared with control group, the progression-free survival was significantly prolonged [(793.58±295.39)d vs. (736.59±305.38)d, P=0.029], 2-year survival had an increasing tendency, but did not reach a statistical significance (91.7% vs. 79.4%, P=0.052), the score of higher health-related quality of life at 12 months after operation was significantly increased (70.25 vs. 63.37, P<0.001), the local recurrence rate was significantly reduced (16.7% vs. 33.8%, P=0.035), and the incidence of radiation enteritis (13.3% vs. 0.0%) and myelosuppression (11.7% vs. 0.0%) were significantly increased (P=0.002, P=0.004). There was no significant difference in incidence of intestinal fistula, intestinal obstruction and anemia between the two groups (all P>0.05). Conclusion: Though postoperative chemoradiotherapy increases the rate of postoperative complications, it can significantly improve the long-term outcomes in elderly patients with rectal cancer.