To investigate the efficacy, safety and long-term patency of transfemoral and brachial artery percutaneous transluminal angioplasty (PTA) combined with thrombolysis in the treatment of completely occlusive autologous arteriovenous fistula (AVF).

From March 2016 to June 2018, 53 patients with AVF occlusion who underwent PTA combined with thrombolysis via arterial approach were analyzed retrospectively. The baseline data, surgical outcome, complications, radiation dose and fluoroscopy time were analyzed, and the patency time and patency rate of AVF were observed.

Among the53 patients with AVF occlusion, 48 cases were successful and 5 failed, with an overall technical success rate of 90.6%. The power of brachial artery approach was better than that of femoral artery approach with significant difference (P<0.05), but there were no significant differences in complications and primary patency rate between the two groups. The fluoroscopy time in the femoral artery approach group was (2 601.5 ±1 803.9) s, which was much longer than that in the brachial artery approach group [(1 191.8±844.5) s] with significant difference (P<0.05), and the radiation dose in the brachial artery approach group [(25.15 ±26.06) s] was significantly lower than that in the femoral artery approach group [(97.58 ±69.85) s](P< 0.05).

PTA combined with thrombolysis via femoral artery and brachial artery approach can effectively treat completely occlusive AVF, and postoperative AVF has good long-term patency during continuous follow-up. The brachial artery approach group is significantly better than the femoral artery approach group in terms of radiation dose and fluoroscopy time during operation.

To investigate the clinical efficacy and safety of superselective parent artery embolization in the treatment of ruptured-abdominal pseudoaneurysm on branched artery.

The clinical data of patients with ruptured-abdominal pseudoaneurysm on branched artery treated by superselective parent artery embolization from February 2017 to June 2020 were retrospectively analyzed. The hemostatic effect and complications were analyzed, and the clinical experience was summarized.

All the21 patients received superselective parent artery embolization with micro-coils. Among them, 10 patients were embolized with gelfoam particles additionally for consolidated embolization. 18 patients were embolized at the proximal part of the parent artery and 3 patients were treated with "sandwich" embolization technique. The technical success rate was 100% (21/21). The clinical success rate of primary embolization was 81.0% (17/21), and the overall clinical success rate after secondary embolization was 85.7% (18/21). Transient mild abdominal pain was observed in 4 patients and partial splenic infarction occurred in 1 patient after embolization. All the sympotoms relieved after treatment.

Superselective parent artery embolization is of high success rate and easy to repeat. It is an alternative treatment for ruptured-abdominal pseudoaneurysm on branched artery. Reasonable selection of embolic materials can achieve better hemostasis effect and reduce the incidence of complications.

To investigate the relationship between intracranial bleeding complications after mechanical thrombectomy with or without tirofiban treatment.

Retrospective analysis on 173 patients with acute ischemic stroke due to large artery occlusion underwent endovascular treatment in our center were reviewed.. The baseline characteristics, ways and the efficacy of endovascular treatment, intracranial bleeding complications of two groups were retrospectively analyzed.

173 patients received endovascular treatment were categorized to tirofiban group (n=87) and no tirofiban group (n=86). Prevalence of diabetes (24.14% vs 10.47%, P=0.026) and posterior circulation in tirofiban group were higher than those in the no tirofiban group. The prevalence of atrial fibrillation was significantly higher in the no tirofiban group than that in the tirofiban group (P<0.001). The rate of final recanalization and good clinical outcome were comparable between the two groups. There were no differences in intracranial bleeding complications between the two groups.

Conjunctive use of tirofiban didn’t increase the risk of intracranial bleeding complications during the endovascular reperfusion therapy.