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Source publication
This study was to evaluate the biomechanical characteristics of the vascular wall during virtual reality- (VR-) assisted percutaneous transluminal angioplasty (PTA) and its effect on the treatment of lower-extremity arteriosclerosis obliterans (LEAO). In this study, a three-dimensional (3D) model and a finite-element model of arteries were construc...
Citations
... Minimally invasive interventional therapy is currently the major clinical treatment for ASO, which can effectively boost ASO patients' lower extremity blood supply and greatly lower the risk of ampu-tation (7). Percutaneous transluminal angioplasty (PTA), as a minimally invasive intervention method commonly used in clinical practice, mainly uses a pressurized balloon to compress plaques to rupture and enlarge the arterial lumen to restore blood supply of the affected limb (8). Acute myocardial infarction (AMI), a common perioperative complication of PTA, may occur in patients with ASO + CHD, bringing huge challenges to clinical treatment and rehabilitation (9). ...
... Tis article has been retracted by Hindawi following an investigation undertaken by the publisher [1]. Tis investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process: ...
... Through these mechanisms, antiplatelet medical therapy can prevent TIA or IS. As an immediate resuscitative therapy for sICAS, percutaneous transluminal angioplasty and stenting (PTAS) is mainly applicable to some vascular lesions with distal ischemia caused by arterial stenosis (6), with the aim to achieve the revascularization of target lesion (7). Additionally, this technique is used extensively in the revascularization of coronary artery, lower extremity artery (8,9). ...
... /fneur. . [1 ] Contraindication or allergy to antiplatelet agents or contrast [2 ] Uncontrolled severe hypertension: systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥115 mmHg [3 ] Severe vascular diseases such as intracranial aneurysm, moyamoya disease, etc. [4 ] Cardioembolic IS or TIA, and high-risk sources of cardio-embolism [5 ] History of symptomatic non-traumatic intracranial hemorrhage [6 ] Use of anticoagulants and non-steroidal anti-inflammatory drugs [7 ] Any other haemorrhagic disease [8 ] Bleeding predisposition [9 ] Blood clotting disorders artery was defined as the level of A2 (the postcommunicating segment of the anterior cerebral artery), M2 (the Sylvian segment of the middle cerebral artery) or P2 (the ambient segment of the posterior cerebral artery) (15). The primary efficacy outcome was defined as the first recurrence of TIA or IS. ...
Background
As one of the most common causes of stroke, symptomatic intracranial artery stenosis (sICAS) is a great threat to public health, and its financial burden is substantial, with annual direct high medical costs particularly in China. Currently, the long-term use of conventional dual antiplatelet therapy (DAPT) as the primary modality of treatment for sICAS decreases the risk of stroke recurrence but increases the risk of bleeding. We aimed to evaluate the efficacy and safety of low dose aspirin plus clopidogrel for the treatment of sICAS in the elderly population.
Methods
This randomized, controlled study included 181 older patients with transient ischemic attack (TIA) or ischemic stroke (IS) attributed to sICAS, who were recruited between April 2015 and November 2020. The 90 patients assigned to the low dose therapy group included aspirin, 75 mg, plus clopidogrel, 50 mg, daily for 90 and 91 patients assigned to the conventional group included aspirin, 100 mg, plus clopidogrel, 75 mg, daily for 90 days (aspirin or clopidogrel alone daily thereafter) were included in this intention-to-treat analysis. Efficacy and safety analyses were done in this trial.
Results
One hundred eighty-one eligible elderly patients with sICAS were enrolled in this trial. The median age was 70 years ranged 60–83 years. Seventy-five participants were with TIA and 106 with IS. The median time of follow-up was 30 months ranged 1–36 months. Ninety patients were assigned randomly to the low dose group and 91 patients to the conventional group. The rate of primary, secondary and composite efficacy were not significantly different between the low dose and conventional group (P > 0.05). The rate of composite safety outcome was 7.8% (7/90) in the low dose group, which was lower than 17.6% (16/91) in the conventional group (χ² = 3.921, P = 0.048). At the time of last follow-up, 17 (9.4%) of 181 patients developed GI injuries, which occurred in four (4.4%) of 90 patients in the low dose group and in 13 (14.3%) of 91 patients in the conventional group (χ² = 4.058, P = 0.044). The primary efficacy outcome occurred in six (18.2%) of 33 patients with severe sICAS and in 22 (38.6%) of 57 patients with moderate sICAS (χ² = 4.064, P = 0.044) in the low dose group.
Conclusion
In this study, the safety of low dose aspirin combined with clopidogrel proved to be equally efficient and significantly safer than those of conventional dose within 24 months in elderly patients with sICAS. However, the small size of this study limits the validity of the results. Further larger longitudinal and randomized controlled trials are necessary to evaluate the role of low dose DAPT in the patients with sICAS.
... However, some data show that there are still some adverse events such as cardiovascular and cerebrovascular diseases, amputation, and death [22]. LEASO, as a systemic disease, is often complicated with many diseases, such as hypertension, diabetes, ulcer, and gangrene in severe lower limb ischemia, which may lead to amputation, and the aggravation of complications may result in death [23]. The incidence of adverse events in the two groups within three years was counted, and no difference was found in death, amputation, and restenosis between them. ...
Objective:
This study was designed to analyse the clinical efficacy of interventional therapy on lower extremity arteriosclerosis obliterans (LEASO) and prognostic factors.
Methods:
A total of 122 patients with LEASO diagnosed in our hospital from March 2017 to March 2019 were retrospectively analysed. Among them, 72 patients who received conservative therapy were assigned to a conservative group, and 50 patients who received interventional therapy additionally based on conservative therapy were assigned to an intervention group. The short-term (12 weeks after therapy) and long-term (3 years after therapy) clinical efficacies on the two groups were compared. Death, amputation, and vascular restenosis (vascular stenosis > 50% in computed tomography reexamination) were defined as unfavourable outcomes, and Cox regression was conducted to analyze the factors influencing the prognosis of patients. The incidence of adverse events in the two groups within 3 years was compared and statistically analyzed. Additionally, the hospital stay, therapy cost, claudication distance, and ankle brachial index were compared between the two groups.
Results:
After therapy, the conservative group showed a notably lower total effective rate than the intervention group (P < 0.05), but the clinical efficacy after 3 years was similar between the two groups (P > 0.05). Additionally, the conservative group experienced notably longer hospital stay than the intervention group (P < 0.05), and cost less in treatment than the intervention group (P < 0.05). However, the conservative group experienced a notably shorter claudication distance and showed a notably lower ankle brachial index than the intervention group (P < 0.05). The two groups were not significantly different in mortality, amputation rate, and vascular restenosis rate (P > 0.05). Moreover, Cox regression analysis revealed that age and conservative therapy were independent risk factors for the prognosis of patients (P < 0.05).
Conclusion:
Interventional therapy can substantially improve the short-term efficacy and prognosis of patients with LEASO, but the cost is high, so the therapeutic regimen should be selected according to the patient's economic condition.
... Arteriosclerosis obliterans (ASO) is a chronic progressive disease of the lower extremities due to arterial stenosis or occlusion, which is clinically characterized by intermittent claudication, pain, and ulcers in the lower extremities, and in severe cases, amputation or even death [1,2]. e femoralpopliteal artery is a common site of ASO, and for patients with Transatlantic Collaborative Group Consensus II (ASC II) classification A-C, the guidelines recommend percutaneous transluminal angioplasty (PTA) as the treatment of choice, but the restenosis rate after PTA is high and the clinical effect is limited [3,4]. ...
The aim in this study was to investigate the efficacy and safety of domestic paclitaxel-coated balloon (DCB) and bare metal stent (BMS) in the treatment of Transatlantic Cooperative Organization Consensus II (ASC II) types A–C femoral-popliteal arteriosclerosis obliterans (ASO). A total of 103 patients with ASC II A–C femoropopliteal ASO, who received treatment in our hospital from March 2020 to March 2021, were retrospectively selected and divided into the DCB group (n = 56) and BMS group (n = 47), according to treatment methods. The general clinical data and surgical results were compared between the two groups. The patients were followed up, and the primary patency rate, restenosis rate, freedom from target lesion revascularization (f-TLR), and limb preservation rate were recorded. The liver and kidney functions before and after operation and the occurrence of major postoperative adverse events were recorded. The operation was successful in both groups. The minimum diameter of the DCB group was smaller than that of the BMS group after treatment P
... In recent years, with the continuous development and progress of computer network technology, the auto-aided diagnosis method based on computer diagnosis technology has gradually become a research hotspot. Deep learning algorithm is widely used in this field [11]. In recent years, more attention has been paid to the faster R-CNN algorithm, which has achieved good results in a series of computer vision tasks such as image classification, target detection, and segmentation. ...
... Equations (11), (12), and (13) show the calculations of these three indexes. ...
In order to explore the adoption of ultrasonic images under deep learning (DL) algorithm to evaluate the efficacy of drug-coated balloon (DCB) for treatment of arteriosclerotic occlusion, 56 patients who underwent DCB surgery of lower limb artery were selected and all the patients received the examinations of algorithmic ultrasound and digital subtraction angiography (DSA) before surgery. According to the examination methods, they were classified into algorithmic ultrasound group and DSA group. One to two months after DCB surgery, ultrasound examination was performed with the region-based faster convolutional neural network (faster R-CNN) target detection algorithm to check the therapeutic effect. The results showed that the image effect processed by the target detection algorithm based on DL was signally better than that of traditional ultrasonic processing algorithm in Dice, precision (Pre), and sensitivity, with significant difference (P
... e results show that a normal and narrow blood vessel and blood model have been successfully constructed; compared with normal blood vessels, if the pressure of the blood vessel at stenosis is greatly reduced, the blood vessel wall will bear greater stress, and the blood return area can be formed in the poststenosis stage. However, there is still such a problem in their research that the experimental technology is not mature enough [5]. In the research of Rozin, the author put forward the reasons that prevented Schedrovitsky and members of the Moscow methodology circle from understanding the essence of thinking, abandoning the interpretation of the world view as an activity, and turning to the development of the theory of mental activity. ...
With the continuous advancement of medicine and computer science, medical image processing technology is also constantly advancing, and at the same time, it puts forward the needs of its own development. The purpose of this article is to combine the three-dimensional reconstruction of medical images and virtual reality (VR) technology in nursing experiment teaching to help students understand more easily and to simplify the teachers’ teaching process and make the VR application technology. It is the most popular and effective in medical teaching. This article proposes the C-V model and the geometric active contour model to help us more clearly understand the pathology in this environment, where the specific symptoms appear, and bring a more easy-to-understand model for teaching and improving teaching quality. This article also designs nursing experiment teaching. The experimental results of this paper show that, after using VR courseware for teaching, the optimal test rate of the experimental class is 15% higher than that of the control class, and the transition rate is 8%. The actual test excellent rate and success rate of the experimental class are much higher than those of the control class. Therefore, it can be concluded that the application of VR technology in nursing teaching helps teachers improve their practical ability. The excellent teaching feedback rate is 95%, which is higher than 80.5% in the control group, indicating that the patient teaching simulation is approved by the observation group. The program can effectively improve the feedback rate of excellent teaching and provide students with better teaching services.
Background
Symptomatic intracranial artery stenosis (ICAS) is a significant worldwide economic and great threat to public health. Currently, little is known about the accurate status of the efficient and tolerable dose of dual antiplatelet therapy (DAPT) as the mainstay treatment for ICAS. The aim of this study is to evaluate the efficacy and safety of aspirin plus clopidogrel in small doses for the treatment of symptomatic ICAS in the elderly.
Methods
This research included 142 older adults with symptomatic ICAS who were enrolled between April 2013 and April 2018. They were split into two groups: 73 patients in the lower dose group who received 75 mg of aspirin daily and 50 mg of clopidogrel daily, and 69 patients in the usual group who received 100 mg of aspirin daily and 75 mg of clopidogrel daily.
Results
Ages of 142 patients ranged from 60 to 81, with a mean of 70.9 ± 6.4. 58 participants were with IS and 84 were with TIA. A total of 132 patients were followed up. The low-dose group had a lower recurrence risk of ischemic stroke (IS) or transient ischaemic attack (TIA) than the conventional group at 1-year and 2-year follow-up, as well as a reduced frequency of adverse events and gastrointestinal injury (P < 0.05). Furthermore, after the 1-year follow-up, patients with severe symptomatic ICAS had a greater recurrence risk of IS and TIA than patients with mild symptomatic ICAS in both groups (P > 0.05).
Conclusion
The efficacy and safety of low-dose aspirin combined with clopidogrel were significantly better than those of ordinary dose within 24 months in elderly patients with symptomatic ICAS. However, the small size of this study limits the validity of the results.
