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Outcome of Percutaneous reconstruction of chronic lateral collateral ligament rupture

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Chinese Journal of Traumatology 2024年第1期27卷 58-62页

作者： Soliudeen Adebayo Arojuraye Ibrahim Abolaji Alabi Ibrahim Usman Mustapha Department of Orthopaedics National Orthopaedic Hospital Dala-KanoNigeria Department of Surgery Bayero University KanoNigeria

Purpose:Many techniques have been described for the reconstruction of chronic lateral collateral ligament(LCL)rupture with different autograft options.The advantages of Percutaneous LCL reconstruction include small incisions,minimal soft tissue disruption,less postoperative pain,and speedy rehabilitation and recovery.The aim of this study was to report the functional outcome of Percutaneous LCL reconstruction and overall patient satisfaction in Africans.Methods:This prospective and interventional study involving 51 patients with chronic LCL rupture who had Percutaneous LCL reconstruction using peroneus longus autograft was conducted between January 2021 and December 2022 in National Orthopaedic Hospital,Dala-Kano,Nigeria.The inclusion criteria were patients between the ages of 18 and 45 years with chronic isolated LCL and not more than 1 injury of knee ligament.Exclusion criteria were active infection,and multi-ligament knee injury requiring 2-staged surgery.The knee functions were assessed preoperatively,3 months,6 months,and 12 months postoperatively using the Lysholm scoring system.Patient satisfaction with the outcome of the treatment was assessed using a 5-point Likert scale.Relevant information was recorded into Microsoft Excel sheet and data was analyzed using SPSS version 23.0 for windows.The paired samples t-test was used to compare the clinical outcomes as continuous variables.Statistical significance was considered at pPercutaneous LCL reconstruction using peroneus longus autograft significantly improves patient knee function and results in excellent patient satisfaction。

关键词： rupture ligament Percutaneous

Influence of cognitive impairment on cardiac mortality after Percutaneous coronary intervention in very elderly patients: a retrospective observational study

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Journal of Geriatric Cardiology 2019年第10期16卷 733-740页

作者： Tomoko Tomioka Ryokichi Takahashi Yosuke Ikumi Shuhei Tanaka Yoshitaka Ito Hiroki Shioiri Jiro Koyama Kanichi Inoue Department of Cardiology South-Miyagi Medical Center

Background Cognitive impairment (CI) increases cardiac mortality among very elderly patients. Percutaneous coronary intervention (PCI) for ischemic heart disease (IHD) patients is considered a favorable strategy for decreasing cardiac mortality. Here, we investigated the influence of CI on cardiac mortality after PCI in very elderly patients. Methods We performed a retrospective observational analysis of patients who received PCI between 2012 and 2014 at the South Miyagi Medical Center, Japan. IHD patients over 80 years old who underwent the Mini-Mental State Examination for CI screening during hospitalization and/or who had been diagnosed with CI were included. Participants were divided into CI and non-CI groups, and cardiac mortality and incidence of adverse cardiac events in a 3-year follow-up period were compared between groups. Statistical analyses were performed using the t-test,χ^2 test, and multivariable Cox regression analysis, with major comorbid illness and conventional cardiac risk factors as confounders. Results Of 565 patients, 95 were included (41 CI, 54 non-CI). Cardiac mortality during the follow-up period was significantly higher in the CI group (36%) compared with the non-CI group (13%)(OR = 4.3, 95% CI: 1.56–11.82, P < 0.05). CI was an independent cardiac prognostic factor after PCI and, for CI patients, living only with a CI partner was an independent predictor of cardiac death within three years. Conclusions CI significantly affected cardiac prognosis after PCI in very elderly patients, particularly those living with a CI partner. To improve patients’ prognoses, social background should be considered alongside conventional medical measures.

关键词： Cognitive impairments Family background Mortality Octogenarians Percutaneous coronary intervention

Comparison of mini-Percutaneous nephrolithotomy and retroperitoneal laparoscopic ureterolithotomy for treatment of impacted proximal ureteral stones greater than 15 mm

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Chinese Medical Journal 2021年第10期134卷 1209-1214页

作者： Guo-Liang Lu Xiao-Jin Wang Bao-Xing Huang Yang Zhao Wei-Chao Tu Xing-Wei Jin Yuan Shao Da-Wei Wang Department of Urology Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China

Background:The optimal treatment for large impacted proximal ureteral stones remains controversial.The aim of this study was to evaluate the efficacy,safety,and potential complications of mini-Percutaneous nephrolithotomy(MPCNL)and retroperitoneal laparoscopic ureterolithotomy(RPLU)in the treatment of impacted proximal ureteral stones with size greater than 15 mm.Methods:A total of 268 patients with impacted proximal ureteral stones greater than 15 mm who received MPCNL or RPLU procedures were enrolled consecutively between January 2014 and January 2019.Data on surgical outcomes and complications were collected and analyzed.Results:Demographic and ureteral stone characteristics found between these two groups were not significantly different.The surgical success rate(139/142,97.9%vs.121/126,96.0%,P=0.595)and stone-free rate after 1 month(139/142,97.9%vs.119/126,94.4%,P=0.245)of RPLU group were marginally higher than that of the MPCNL group,but there was no significant difference.There was no significant difference in the drop of hemoglobin between the two groups(0.8±0.6 vs.0.4±0.2 g/dL,P=0.621).The mean operative time(68.2±12.5 vs.87.2±16.8 min,P=0.041),post-operative analgesics usage(2/121,1.7%vs.13/139,9.4%,P=0.017),length of hospital stay after surgery(2.2±0.6 vs.4.8±0.9 days,P<0.001),double J stent time(3.2±0.5 vs.3.9±0.8 days,P=0.027),time of catheterization(1.1±0.3 vs.3.5±0.5 days,P<0.001),and time of drainage tube(2.3±0.3 vs.4.6±0.6 days,P<0.001)of MPCNL group were significantly shorter than that of the RPLU group.The complication rate was similar between the two groups(20/121,16.5%vs.31/139,22.3%,P=0.242).Conclusions:MPCNL and RPLU have similar surgical success and stone clearance in treating impacted proximal ureteral stones greater than 15 mm,while patients undergoing MPCNL had a lower post-operative pain rate and a faster recovery.

关键词： Laparoscopy Nephrostomy Percutaneous Ureteral calculi

Effects of PEAR1 gene polymorphism on big endothelin-1 levels in Chinese patients with acute myocardial infarction after Percutaneous coronary intervention

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World Journal of Emergency Medicine 2024年第3期15卷 229-231页

作者： Yi Yao Na Xu Xiaofang Tang Ce Zhang Sida Jia Jingjing Xu Ying Song Xueyan Zhao Runlin Gao Jinqing Yuan Center for Coronary Heart Disease National Center for Cardiovascular DiseasesState Key Laboratory of Cardiovascular DiseaseFuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

Acute myocardial infarction (AMI) has been associated with poor prognosis,even after revascularization with Percutaneous coronary intervention (PCI),likely due to coronary endothelial cell dysfunction and injury.^([1,2])Endothelin-1 (ET-1),a peptide that serves as a vasoconstrictor of smooth muscle cell proliferation,can reflect endothelial cell functional states.Due to low circulation levels and short plasma half-life time,measuring plasma ET-1 levels is difficult.In contrast,big ET-1.

关键词： coronary Percutaneous endothelin

Percutaneous recanalization of total saphenous vein graft occlusion with excimer laser treatment

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Journal of Geriatric Cardiology 2020年第4期17卷 234-240页

作者： Yuan HAN Quan-Min JING Qian-Cheng WANG Yan-Bin SU Guo-Jun CHEN Department of Cardiology State Key Laboratory of Organ Failure ResearchNan Fang HospitalSouthern Medical UniversityGuangzhouChina Department of Cardiology General Hospital of Northern Theater CommandShenyangChina

Patients presenting with recurrence of anginal symptoms after saphenous vein bypass surgery pose an increasingly frequent challenge.In general,approximately 40%to 50%of saphenous vein graft(SVG)will become diseased or occluded within the first ten years after surgery.[1]Because adverse clinical outcomes,such as high restenosis rates and distal embolization,have been reported,Percutaneous coronary intervention(PCI)for SVG is not recommended as a first-line strategy.[2]Distal embolization occurs in 2%–17%of patients despite advances in therapy,including the utilization of embolic protection device(EPD),which may lead to increased mortality at both short follow-up and midterm follow-up.[3]However,these patients often associated with inappropriate anatomic characteristics of native vessel intervention including calcification,tortuosity,abundant plaque burden,and complex chronic total occlusion(CTO)lesions.Moreover,repeat coronary bypass surgery is an option but is technically more demanding and is associated with a higher mortality.Therefore,it can sometimes result in SVG stenosis being the only intervention option.This is why the recanalization of SVG lesions,especially totally occluded lesions,remains one of the most challenging procedures in interventional cardiology.

关键词： Excimer laser Percutaneous coronary intervention Saphenous vein graft

Effect of ramipril on progression of nonculprit lesions in patients with ST-elevation myocardial infarction after primary Percutaneous coronary intervention

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Journal of Geriatric Cardiology 2019年第9期16卷 695-700页

作者： Jian WANG Song-Yuan HE Department of Cardiology Aerospace Central Hospital Aerospace Clinical Medical College of Peking University

Objective To investigate the effect of ramipril on progression of nonculprit lesions in patients with ST-elevation myocardial infarction(STEMI) after primary Percutaneous coronary intervention(PPCI). Methods A total of 200 patients(60.1 ± 11.3 years) with STEMI who underwent successful PPCI from January 2010 to December 2013 were enrolled in this study. All patients underwent PPCI as treatment for culprit lesions. Patients were divided into two groups according to the dosage of ramipril used at hospital discharge as follows: high dosage group(2.5–10 mg, q.d.) and low dosage group(1.25–2.5 mg, q.d.). Clinical and angiographic follow-up was performed for 12 months. The primary endpoint was clinically-driven Percutaneous coronary intervention(PCI) for nonculprit lesions. The clinical and angiographic features were analyzed. Results Clinical and angiographic follow-up was performed with 87 patients in the high dosage group and 113 patients in the low dosage group. The numbers of patients who underwent additional PCI were six and 20 in the high and low dosage groups, respectively. The rate of having additional PCI performed was lower in the high dosage group than in the low dosage group(6.90% vs. 17.70%, P = 0.03). Conclusions A high dosage of ramipril may prevent progression of nonculprit lesions, which could be the major cause of recurrent PCI in patients with STEMI after PPCI.

关键词： Nonculprit lesion Primary Percutaneous coronary intervention Ramipril ST-elevation myocardial infarction

Validation of Predictive Value of Patterns of Nonadherence to Antiplatelet Regimen in Stented Patients Thrombotic Risk Score in Chinese Population Undergoing Percutaneous Coronary Intervention:A Prospective Observational Study

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Chinese Medical Journal 2018年第22期131卷 2699-2704页

作者： Xue-Yan Zhao Jian-Xin Li Xiao-Fang Tang Jing-Jing Xu Ying Song Lin Jiang Jue Chen Lei Song Li-Jian Gao Zhan Gao Shu-Bin Qiao Yue-Jin Yang Run-Lin Gao Ro Xu Jin-Qing Yuan Coronary Heart Disease Center State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of Epidemiology State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

Background:The patterns of nonadherence to antiplatelet regimen in stented patients (PARIS)thrombotic risk score are a novel score for predicting the risk of coronary thrombotic events (CTEs)after Percutaneous coronary intervention (PCI)with drug-eluting stents. However,the prognostic value of this score has not been fully evaluated in non-Euro-American PCI populations. Methods:We performed a prospective,observational study of 10,724 patients who underwent PCI in Fuwai hospital,China and evaluated the PARIS thrombotic risk score's predictive value of CTEs in the PCI population.The area under the receiver operating characteristic curve (AUROC)was used to assess the predictive value of the PARIS score for CTE. Results:Among 9782 patients without in-hospital events,a total of 95 CTEs occurred during the 2-year follow-up.The PARIS score was significantly higher in patients with CTEs (3.384-2.04)compared with patients without events (2.53±1.70,P <0.001). According to the risk stratification of the PARIS thrombotic score,the risk of CTEs in the high-risk group was 3.14 times higher than that in the low-risk group (hazard ratio [HR],3.14;95% confidence interval [CI],1.92-5.13;P <0.001).However,the risk of CTEs in the intermediate-risk and low-risk groups was not significant (HR,1.39;95% CI,[0.86-2.24];P =0.184).The PARIS score showed prognostic value in evaluating CTEs in the overall population (AUROC,0.621;95% CI,0.561-0.681),the acute coronary syndrome (ACS)population (AUROC,0.617;95% CI,0.534-0.700;P =0.003),and the non-ACS population (AUROC,0.647;95% CI,0.558-0.736;P =0.001). Conclusions:In a real-world Chinese population,the PARIS thrombotic risk score shows a modest prognostic value for CTEs in patients after PCI.This score also has a predictive value for CTEs in the ACS and non-ACS subgroup populations.

关键词： Coronary Thrombosis Percutaneous Coronary Intervention Prognosis Risk Assessment

Prognostic Value of NT-proBNP in Stable Coronary Artery Disease in Chinese Patients after Percutaneous Coronary Intervention in the Drug-eluting Stent Era

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Biomedical and Environmental Sciences 2018年第12期31卷 859-866页

作者： ZHAO Xue Yan LI Jian Xin TANG Xiao Fang XU Jing Jing SONG Ying JIANG Lin CHEN Jue SONG Lei GAO Li Jian GAO Zhan QIAO Shu Bin YANG Yue Jin GAO Run Lin XU Bo YUAN Jin Qing State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College

Objective The predictive value of N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with stable coronary artery disease(SCAD) in the drug-eluting stent era is not yet clear. We aimed to evaluate the prognostic value of NT-proBNP in SCAD patients after Percutaneous coronary intervention(PCI). Methods We examined 4,293 consecutive SCAD patients who underwent PCI between January 2013 and December 2013 in Fuwai Hospital, China. The primary endpoint was all-cause death. NT-proBNP levels were measured before PCI using Elisa kits(Biomedica, Austria). The indication for PCI was based on the degree of coronary stenosis and evidence of ischemia. Results Among 3,187 SCAD patients with NT-proBNP data, after a 2-year follow-up, NT-proBNP levels were predictive for all-cause death in the SCAD population [area under the receiver operating characteristic curve, 0.768; 95% confidence interval(CI), 0.687-0.849; P < 0.001]. At the optimum cutoff point of 732 pg/mL, the sensitivity and specificity of death was 75.0% and 72.3%, respectively. In a multivariable Cox regression model, the death hazard ratio was 6.43(95% CI, 2.99-13.82; P < 0.001) for patients with NT-proBNP levels ≥ 732 pg/mL, compared with < 732 pg/mL. Conclusion NT-proBNP is a strong predictor of 2-year death with SCAD after PCI in the drug-eluting stent era.

关键词： NT-proBNP Stable coronary disease Death Prognosis Percutaneous coronary intervention

Relationship between fibrinogen levels and cardiovascular events in patients receiving Percutaneous coronary intervention:a large single-center study

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Chinese Medical Journal 2019年第8期132卷 914-921页

作者： Ping Jiang Zhan Gao Wei Zhao Ying Song Xiao-Fang Tang Jing-Jing Xu Huan-Huan Wang Lin Jiang Jue Chen Shu-Bin Qiao Yue-Jin Yang Run-Lin Gao Bo Xu Jin-Qing Yuan Department of Cardiology State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China Information Center State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China

Background:It is currently unclear if fibrinogen is a risk factor for adverse events in patients receiving Percutaneous coronary intervention(PCI)or merely serves as a marker of pre-existing comorbidities and other causal factors.We therefore investigated the association between fibrinogen levels and 2-year all-cause mortality,and compared the additional predictive value of adding fibrinogen to a basic model including traditional risk factors in patients receiving contemporary PCI.Methods:A total of 6293 patients undergoing PCI with measured baseline fibrinogen levels were enrolied from January to December 2013 in Fuwai Hospital.Patients were divided into three groups according to tertiles of baseline fibrinogen levels:low fibrinogen,<2.98 g/L;medium fibrinogen,2.98 to 3.58 g/L;and high fibrinogen,≥3.58 g/L.Independent predictors of 2-year clinical outcomes were determined by multivariate Cox proportional hazards regression modeling.The increased discriminative value of fibrinogen for predicting all-cause mortality was assessed using the C-statistic and integrated discrimination improvement(IDI).Results:The 2-year all-cause mortality rate was 1.2%.It was significantly higher in the high fibrinogen compared with the low and medium fibrinogen groups according to Kaplan-Meier analyses(1.7%vs.0.9%and 1.7%vs.1.0%,respectively;log-rank,P=0.022).Fibrinogen was significantly associated with all-cause mortality according to multivariate Cox regression(hazard ratio 1.339,95%confidence interval:1.109-1.763,P=0.005),together with traditional risk factors including age,sex,diabetes mellitus,left ventricular ejection fraction,creatinine clearance,and low-density lipoprotein cholesterol.The area under the curve for all-cause mortality in the basic model including traditional risk factors was 0.776,and this value increased to 0.787 when fibrinogen was added to the model(IDI=0.003,Z=0.140,P=0.889).Conclusions:Fibrinogen is associated with 2-year all-cause mortality in patients receiving PCI,but provides no additional information

关键词： Fibrinogen Percutaneous coronary intervention Risk factor Prognosis