The way of intravenous drug abuse is to puncture the peripheral blood vessels and inject the drug directly into the blood. Therefore, this method has an impact on the peripheral artery and venous system of the users, and can cause a variety of peripheral vascular diseases, such as phlebitis, deep vein thrombosis, chronic venous insufficiency, phlebangioma, atherosclerosis, acute arterial ischemia, pseudoaneurysm, etc. However, due to the particularity of drug abusers, the vascular complications caused by intravenous drug abuse have not attracted enough attention. This paper reviewed the types and pathogenesis of peripheral vascular diseases caused by intravenous drug abuse, so as to improve the clinical understanding of peripheral vascular diseases caused by intravenous drug abuse, improve the prognosis of patients, reduce occupational exposure of medical staff, and play a certain role in social warning.
Trans-radial access (TRA) has been a common approach to percutaneous coronary intervention (PCI). Comparing with trans-femoral access (TFA), TRA is used as an alternative approach for PCI with less local complications, higher comfort level, and better outcome. In recent years, TRA has been paid more and more attention in peripheral vascular interventions. We reviewed recent developments in peripheral vascular intervention using TRA, with detail summary of the effectiveness, safety, limits, and future developments of it, aiming to improve the understanding and performance of TRA in interventionalists to benefit patients.
【摘要】 目的 探討外周血管動靜脈瘺的超聲特征及其鑒別診斷。 方法 回顧性分析2003年1月-2010年3月間收治的36例先天性及后天性動靜脈瘺患者的臨床資料，使用彩色超聲診斷儀觀察受累血管的內徑、血管壁的連續性，根據血流動力學變化尋找瘺口；對受累血管血流頻譜進行分析，并與健側對照。 結果 18例先天性動靜脈瘺查見紆曲擴張的血管網，無法辨認瘺口；18例后天性動靜脈瘺全部可顯示瘺口，2例合并靜脈破裂的為囊瘤型，其余后天性動靜脈瘺均為洞口型。受累動脈近心端血流為高速低阻型，全部患者受累靜脈出現動脈樣血流，近心端靜脈呈高速低阻型頻譜；10例患者遠心端靜脈內出現逆向離心血流。 結論 引流靜脈出現高速、動脈樣血流頻譜是動靜脈瘺的特征性表現；先天性動靜脈瘺可見異常血管網，不能辨認瘺口；后天性動靜脈瘺均可顯示瘺口。彩色超聲多普勒檢查對動靜脈瘺能夠正確診斷及鑒別診斷。【Abstract】 Objective To observe characteristic imaging of arteriovenous fistulas (AVF) of periphery vessel, and to evaluate the differential diagnosis of AVF by ultrasonography. Methods Thirty-six patients suffering from congenital and acquired AVF in this hospital from January 2003 to March 2010 were selected to undergo Doppler ultrasonography. The blood flow of arteriovenous fistulas, diameter, morphology and blood flow characters of affected vessels were observed. Spectral of fistula and affected vessels were analyzed and compared with the healthy side. Results Deformed vascular net was observed, and the localization of arteriovenous fistulas was not observed directly in 18 congenital AVF patients.Inversely the localization of arteriovenous fistulas was observed directly in 18 acquired AVF patients.Two acquired AVF patients with venous rupture belonged to kystoma form, and others acquired AVF patients belonged to orifice form.Spectral analysis of proximal arteries of the fistula revealed high velocity and low resistance.Arterialized flow pattern was observed in affected veins.Proximal veins of the fistula revealed arterialized spectral with high velocity and low resistance.Reversed blood flow was observed in the distal veins of the fistulas in 10 patients. Conclusion Arterialized flow with high velocity in veins are characteristic signs of AVF.Deformed vascular net is observed, and the localization of arteriovenous fistulas in not observed directly in congenital AVF patients, but the localization of arteriovenous fistulas is observed directly in acquired AVF patients.Color Doppler ultrasonography has great value in confirming diagnosis and differential diagnosis of AVF.
Peripheral vascular path is an important approach for minimally invasive cardiovascular surgery and cardiovascular interventional diagnosis and treatment, and the treatment of the vascular approach after surgery is directly related to the postoperative braking time and comfort of patients. The traditional treatment methods mainly include compression fixation of puncture point or incision of skin to suture blood vessels, but the disadvantages such as long postoperative immobilization, potential vascular complications and patient discomfort are obvious. The application of vascular closure devices can reduce the shortcomings of traditional treatment methods, but different vascular closure devices have their characteristics and application scope, and improper application may lead to serious complications. This paper reviewed the information of several commonly used vascular closure device and relevant clinical research data in recent years, and introduced the characteristics, application and clinical effects of common vascular closure devices.
Objective To evaluate the efficacy and safety of the Perclose ProGlide vascular closure system for femoral artery access site closure in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR). Methods We retrospectively analyzed the perioperative data of patients who underwent transfemoral TAVR at the Second Hospital of Hebei Medical University from January 2023 to September 2025. Based on the closure method for the main arterial access site, patients were divided into a surgical group (surgical cut-down and repair) and a ProGlide group (pre-closure with the ProGlide system). The effectiveness of access site closure and clinical outcomes were compared between the two groups. Results A total of 413 patients were included, with 183 in the surgical group and 230 in the ProGlide group. The surgical group consisted of 112 males and 71 females, with a mean age of (68.2±6.3) years. The ProGlide group included 141 males and 89 females, with a mean age of (69.2±5.2) years. No mortality was observed in either group. In the ProGlide group, immediate hemostasis was successfully achieved with two ProGlide devices in 220 (95.7%) patients. An additional 10 patients required a third device to achieve hemostasis. At 6 hours post-procedure, no active bleeding was observed. Subcutaneous hematoma occurred in 5 patients, all of whom resolved after 10 minutes of manual compression. The final hemostasis success rate was 97.8% for the ProGlide group. In the surgical group, no active bleeding or subcutaneous hematoma was observed at 6 hours post-procedure, yielding a hemostasis success rate of 100.0%. Poor wound healing occurred in 28 patients and access site-related nerve injury in 41 patients in the surgical group. In contrast, no patients of poor wound healing or nerve injury were reported in the ProGlide group. No major vascular complications occurred in either group. At 6 hours post-procedure, the Kolcaba Comfort Scale score was significantly higher in the ProGlide group than that in the surgical group (P<0.001). Compared to the surgical group, the ProGlide group had significantly shorter procedure times and postoperative hospital stays (both P<0.001). ConclusionThe Perclose ProGlide vascular closure system provides effective closure for the main femoral access site in transfemoral TAVR. Compared with the conventional surgical cut-down method, it offers the advantages of being less invasive, enabling faster recovery, and providing greater procedural convenience, making it a valuable technique worthy of broader clinical adoption.