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Purpose: To compare the safety and efficacy of percutaneous (PEVAR) vs open femoral access (OFA) techniques for endovascular aneurysm repair (EVAR).Methods: A systematic review of English-language articles (Medline, EMBASE, and Cochrane databases) between January 1999 and August 2016 returned 11 studies including 1650 patients with 2500 groin accesses eligible for the meta-analysis. Data extracted from each study were synthesized to evaluate technical success rates, procedure time, and complications for the 2 access approaches. Data are presented as the odds ratio (OR) or mean difference (MD) with 95% confidence intervals (CI). The quality of individual studies was evaluated based on the Newcastle-Ottawa scale.Results: The mean technical success rate in the PEVAR group was 94.5% (785/831). The overall OR was 0.38 (95% CI 0.12 to 1.18, p=0.09), indicating no significant difference between the methods. The procedure time in PEVAR was shorter than OFA (mean difference -24.52, 95% CI -46.45 to -22.60, p<0.001). Overall, the total complication rate was 15.3% in the OFA group vs 7.8% in the PEVAR group (OR 0.52, 95% CI 0.37 to 0.73, p<0.001). The meta-analysis identified significant differences between groups for all complications (p<0.001) and the following individual adverse events: wound infection (OR 0.28, 95% CI 0.10 to 0.81, p=0.02), pseudoaneurysm (OR 8.07, 95% CI 1.54 to 42.32, p=0.01), seroma (OR 0.10, 95% CI 0.02 to 0.55, p=0.008), and lymphocele or lymph leak (OR 0.19, 95% CI 0.04 to 0.92, p=0.04).Conclusion: PEVAR had a similar technical success rate, shorter procedure time, and lower complication rate compared with OFA. Thus, percutaneous access appears to be the preferential approach for EVAR. However, larger and randomized studies are needed to draw definitive conclusions. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the use of percutaneous mechanical thrombectomy in the treatment of acute deep venous thrombosis., Methods: Eight cases of acute deep venous thrombosis were reviewed who had received percutaneous mechanical thrombectomy from January to July, 2015 in Beijing Tsinghua Changgung Hospital. All cases were diagnosed as iliofemoral venous thrombosis, 2 cases with vena cava thrombosis. All cases received anticoagulation treatment for 3 to 6 months and pressure treatment after the procedure. Every patient was scheduled to follow up at 1, 3, 6 months, respectively., Results: Technical success were achieved in all cases with restoring of good flow in previous lesions. Grade Ⅲ (complete) lysis was achieved in 2 cases and grade Ⅱ(50%-99% ) lysis in 6 cases, swelling legs were mostly fade away. Of all study follow up , only one case with mild post-thrombotic syndrome after six months., Conclusion: Percutaneous mechanical thrombectomy is safe and effective in the treatment of acute deep venous thrombosis.

Objective: To evaluate the perioperative complications and effectiveness of carotid endarterectomy (CEA) with diabetes mellitus (DM)., Methods: A total of 148 patients with carotid stenosis undergone CEA from December 2010 to December 2013 were collected and analyzed retrospectively. The patients were distributed into DM group (n=83) and the control group (n=65) according to the comorbidities. Age, gender, risk factors, stenosis degree, cerebral ischemic symptom, shunt in operation, perioperative complications and restenosis after one year in the two groups were analyzed and compared., Results: There were no statistical difference between the two groups in terms of the general characteristic, clinical ischemic symptoms, concomitant disease, operative time, the amount of bleeding, the ratio of shunt (P>0.05). The rates of perioperative complications observed in DM group, including postoperative infection, neck hematoma, cranial nerves injured, acute cardiac infarction, stroke, hyperperfusion syndrome, all-cause mortality and one year restenosis after operation were 7.2%, 12.0%, 10.8%, 3.6%, 6.0%, 9.6%, 2.4% and 9.6% respectively. The complication rates observed in the control group, on the other hand were 3.1%, 9.2%, 4.6%, 1.5%, 4.6%, 7.7%, 1.5% and 3.1% respectively. There were no significant statistical difference between the two groups (χ² =0.551, 0.300, 1.898, 0.069, 0, 0.172, 0.138, 1.559, P>0.05)., Conclusion: CEA may be safe and effective in diabetic patients suffering from carotid stenosis, on the condition that the blood glucoses of the patients are controlled well, and the cardio cerebral vascular system is carefully assessed and intervened before the operation.