Objective:To investigate the treatment of internal carotid artery rupture after radiotherapy for nasopharyngeal carcinoma. Methods:The clinical data of 7 patients with internal carotid artery rupture after radiotherapy for nasopharyngeal carcinoma from March 2020 to March 2023 were retrospectively analyzed. Results:Skull base osteonecrosis with infection occurred in 4 cases, and tumor recurrence with infection in 3 cases. DSA showed that internal carotid artery rupture was located in the internal carotid artery petrosal segment in 6 cases, and in the paravicular segment in 1 case. Balloon occlusion test（BOT） was performed in 6 patients, of which 3 passed and 3 failed. Vascular treatment included internal carotid artery embolization（4 cases）, false aneurysm embolization 1 case（rebleeding）, coated stent 1 case（rebleeding）, muscle compression during operation（1 case）. Patients with rebleeding received high-flow bypass. Three cases developed cerebral infarction after embolization without severe sequelae after treatment, and no death occurred within 90 days. After bleeding control, all 3 patients with cranial base necrosis received surgical treatment to remove the necrotic bone and tissue flap repair, and 1 patient with recurrence received gamma knife and targeted therapy, 1 patient received immune and surgical therapy, and 1 patient received immune and targeted therapy. Conclusion:Rupture and hemorrhage of internal carotid artery after radiotherapy is related to tumor invasion, tissue injury and local infection after radiotherapy. For those caused by tumor invasion, it is recommended to sacrifice the responsible vessels. For those caused by infection, emergency surgery is recommended and blood vessels preserved. Emergency vascular occlusion remains a life-saving option.
目的：探讨鼻咽癌放疗后颈内动脉破裂的治疗策略。 方法：回顾性分析2020年3月—2023年3月收治的7例鼻咽癌放疗后颈内动脉破裂出血患者的临床资料。 结果：7例患者中4例发生颅底骨坏死伴感染，3例肿瘤复发伴感染。DSA造影提示6例颈内动脉破裂位于颈内动脉岩骨段，1例位于斜坡旁段。6例患者行球囊闭塞试验（BOT），通过3例，未通过3例。血管治疗方案：颈内动脉长程栓塞4例，假性动脉瘤栓塞1例（再出血），覆膜支架1例（再出血），手术中肌肉压迫1例，再出血的患者行高流量搭桥。栓塞后脑梗死3例，经过治疗无后遗症，90 d内无死亡患者。出血控制后3例颅底坏死感染者均行手术治疗清除坏死骨质，并组织瓣修复，1例复发患者行伽马刀及靶向治疗，1例行免疫及手术治疗，1例免疫及靶向治疗。 结论：鼻咽癌放疗后颈内动脉爆裂与肿瘤侵犯和放疗后的损伤和局部组织感染密切相关。对于肿瘤侵犯导致的，建议牺牲责任血管；对于感染造成的破裂出血，建议保留血管，并尽早手术。紧急血管闭塞仍是挽救生命的选择。.

Giant femoral arteriovenous fistulas are comparatively uncommon, typically treated through covered stents, coil embolization, and open surgical repair. Nevertheless, these options may not be appropriate for all patients. Herein, we describe a case of traumatic femoral arteriovenous fistulas that led to drastic dilatation of the femoral arteriovenous system and considerable heart failure symptoms due to prolonged lack of treatment. Given the intricate anatomical location of the fistula and the patient\'s severe cardiac dysfunction, surgical repair is often unfeasible. Consequently, we adopted an innovative approach in this case, utilizing a ventricular septal occluder device for fistula closure. This constitutes the first report of an arteriovenous fistula transcatheter closure with a septal occluder.

UNASSIGNED: This study explored the correlation between serum HMGB1 levels and postoperative vascular restenosis in patients with lower extremity arteriosclerosis obliterans (LEASO).
UNASSIGNED: A total of 362 patients LEASO who received vascular intervention were recruited in this study. Serum HMGB1 levels were measured by enzyme-linked immunosorbent assay. Logistic regression analysis was used to identify the influencing factors associated with vascular restenosis. The R procedure was used to create nomogram model. Receiver operating characteristic (ROC) analysis was used to determine the predictive value of serum HMGB1 and nomogram model for vascular restenosis.
UNASSIGNED: Of the 362 LEASO patients included, 103 (28.45%) developed restenosis within 6 months of postoperative follow-up. Postoperative HMGB1 levels were significantly higher in patients with restenosis compared to those with non-restenosis. Postoperative HMGB1 levels were significantly and positively correlated with the severity of postoperative restenosis (r = 0.819). The AUC of postoperative HMGB1 for the diagnosis of postoperative restenosis was 0.758 (95% CI: 0.703-0.812), with a sensitivity and specificity of 56.31% and 82.24%, respectively. Multivariate logistic regression analysis showed that diabetes, smoking, regular postoperative medication, increased fibrinogen, decreased red blood cells, increased hs-CRP, and increased postoperative HMGB1 were independently associated with postoperative restenosis in patients with LEASO. The C-index of the nomogram prediction model constructed based on the seven influencing factors mentioned above was 0.918. The nomogram model was significantly more predictive of postoperative restenosis in LEASO patients compared with a single postoperative HMGB1 (AUC: 0.918, 95% CI: 0.757-0.934).
UNASSIGNED: Postoperative serum HMGB1 is an independent risk factor associated with postoperative vascular restenosis in patients with LEASO, and a novel nomogram model based on postoperative serum HMGB1 combined with clinical characteristics may help to accurately predict the risk of postoperative restenosis in patients with LEASO.