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Objective:To evaluate the therapeutic effect of excimer laser ablation (ELA) in the treatment of lower extremity arterial ischemic diseases.Methods:The clinical data of 44 patients with lower extremity ischemic diseases treated with ELA in the People′s Hospital of Xinjiang Uygur Autonomous Region from December 2020 to April 2021 were analyzed retrospectively. Among the 44 patients, there were 29 patients in lower extremity arteriosclerosis obliterans (ASO), including 3 patients with femoral artery stent occlusion. 8 patients of diabetes foot (DF) and 7 patients of thromboangiitis obliterans (TAO). Observation indicators include target vascular patency rate, amputation rate, vascular reintervention rate and mortality rate. The measurement data were expressed as mean ± standard deviation ( ± s), one-way analysis of variance was used for inter-group comparison, and paired sample t-test was used for intra-group comparison. The Chi-square test was used for comparison between count data. Results:The success rate of operation was 100% in 44 patients. The rate of major amputation in ASO group was 10.3%, while the other two groups had a major amputation rate of 0. The minor amputation rates of the three groups were 6.9%, 25.0% and 28.6%, respectively. The vascular reintervention rate was 10.3% in ASO group, 12.5% in DF group and 0 in TAO group. The 1-year mortality rate in the ASO group was 10.3%, while the other two groups had a mortality rate of 0. The 2-year mortality rate of the three group were 31.0%, 12.5% and 0, respectively.Conclusion:For the treatment of lower extremity arterial ischemic diseases, ELA is safe and effective, but the curative effect need to further clarify by large sample and long-term clinical follow-up observation.
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Objective:To explore the clinical efficacy of excimer laser atherectomy (ELA) in the treatment of diabetic foot with infrapopliteal arteriopathy.Methods:The clinical data of 36 patients (40 limbs) with diabetic foot complicated with inferior knee artery disease treated by ELA in Xinjiang Uygur Autonomous Region People′s Hospital from December 2019 to May 2021 were analyzed retrospectively. The success rate of ELA in the treatment of diabetic inferior genicular artery disease, ankle-brachial index (ABI), limb salvage rate and Visual Analogue Scale (VAS) score at 3 days and 3 and 6 months after operation was observed.Results:All the 36 patients were operated successfully, including 2 cases of flow-limiting dissection, 2 cases of arterial embolism and 1 case of hematoma at the puncture point. The ABI of patients 3, 6 months after operation was significantly higher than that before operation (all P<0.05), and the VAS score 3, 6 months after operation was significantly lower than that before operation (all P<0.05). The rate of limb (toe) salvage were 92.5%(37/40), 82.5%(33/40) at 3 d, 3 months and 77.5%(31/40) at 6 months after operation. Conclusions:ELA is safe and effective in the treatment of diabetic foot infrapopliteal arteriopathy, and the recent efficacy is fair.
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Objective:To explore the strategies for the treatment of difficult iliac artery approach in endovascular repair of abdominal aortic aneurysm.Methods:The clinical data of 275 patients with abdominal aortic aneurysm who underwent endovascular surgery at the Department of Vascular Surgery, People′s Hospital of Xinjiang Uygur Autonomous Region from March 2010 to March 2019 were retrospectively analyzed, and the general clinical data such as age, gender, and comorbidities of the patients were recorded. The resource index was to carry out corresponding measures to perform surgery for patients with difficult access, analyze the incidence of the type of difficult access, treatment measures and effects.Results:Two hundred and seventy-five patients underwent endovascular repair, 78 of them (28.3%) had difficulty in accessing the iliac artery, including 29 cases (10.5%) with mild iliac artery stenosis, 7 cases (2.54%) with severe stenosis, and 3 cases with occlusion ( 1.09%), 39 cases (14.2%) were twisted. For patients with vascular twist, super-hard guide wire was used to correct iliac artery angulation. For patients with iliac artery stenosis, balloon dilation was performed. For severe stenosis, the artificial blood vessel was passed through the lateral peritoneum. After road transplantation, stent placement and other treatments were successfully performed endovascular repair.Conclusions:Pathway vascular disease can cause difficulties in endovascular treatment of abdominal aortic aneurysms. Endovascular repair can be successfully performed after corresponding treatments according to different difficulties, and the long-term patency rate is good.
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Objective To explore the feasibility of rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models using magnetic compression anastomosis (MCA) technique. Methods Twelve healthy adult crossbred dogs were evenly divided into the MCA and hand suturing (HS) groups according to the anastomosis method between abdominal aorta and artificial blood vessels. The intraoperative duration of abdominal aorta occlusion, intraoperative condition of anastomotic stoma and postoperative imaging examination of anastomotic stoma were compared between two groups. Results The intraoperative duration of abdominal aorta occlusion in the MCA group was significantly shorter than that in the HS group [(5.2±2.3) min vs. (24.4±4.3) min, P < 0.001]. No anastomotic leakage of blood or anastomotic stenosis occurred in the MCA group during the operation. Intraoperative anastomotic leakage of blood occurred in all of the 6 dogs in the HS group. Among them, 1 dog died of excessive blood loss, and 2 dogs experienced mild anastomotic stenosis due to repeated repair. Postoperative color Doppler ultrasound and angiography showed smooth blood flow at the anastomotic stoma without stenosis or thrombosis in the MCA group. In the HS group, 4 dogs presented with anastomotic stenosis on angiography at postoperative 4 weeks. Conclusions MCA technique may achieve rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models, which reduces the incidence of anastomotic complications and accelerates postoperative recovery.
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Objective:To investigate and compare the efficacy and safety of percutaneous mechanical thrombectomy (PMT) combined with catheter directed thrombolysis and catheter directed thrombolysis alone in the treatment of acute lower extremity deep venous thrombosis.Methods:Retrospective analysis of clinical data of 69 patients with acute lower extremity deep venous thrombosis who met the inclusion criteria of this study from January 2018 to December 2018 in department of vascular surgery, People′s Hospital of Xinjiang Uygur Autonomous Region was performed. There were 35 males and 34 females, with an average age of 59 years and an age rang of 20 to 80 years. Patients were divided into PMT combined catheter directed thrombolysis treated group ( n=38) and catheter directed thrombolysis treated group ( n=31) according to different methods of intra-luminal thrombolysis. The thrombolysis time, dosage of urokinase, thrombotic clearance rate, perimeter difference of suffered limb, and total number of adverse events during perioperative period between two groups were recorded. At 1 month, 3 months, and 6 months after discharge, patients underwent an ultrasonographic examination of lower extremity vessels to check and evaluate residual thrombolysis and thrombosis recurrence by outpatient review. The quantitative data in the two groups were expressed as mean±standard deviation( Mean± SD), t test was used for comparison between groups. Enumeration data in the two groups were expressed as percentage (%) and χ2 test was used for comparison between groups. Results:The thrombolysis time of PMT combined catheter directed thrombolysis treated group and catheter directed thrombolysis treated group were (3.7±2.1) d and (5.2±2.1) d, respectively. The differences between the two groups were statistically significant ( P=0.005). The dosage of urokinase were respectively (225.0±122.3)×10 4 units and (315.8±108.6)×10 4 units, the differences were statistically significant ( P=0.001). PMTⅠ, Ⅱ, Ⅲ thrombus clearance rate in patients with PMT combined catheter directed thrombolysis treated group were 18.4% (7/38), 73.7% (28/38), 7.9% (3/38), while 16.1% (5/31), 77.4% (24/31), 6.5% (2/31) were observed in patients with catheter directed thrombolysis treated group, with no statistically significant difference between the two groups ( P= 0.803, P=0.720, P=0.818). After a period of 48h thrombolytic therapy, the cross-section diameters of suffered thigh and calf were (2.16±0.87) cm and (1.38±0.66) cm in PMT combined catheter directed thrombolysis treated group respectively. While the cross-section diameters of suffered thigh and calf were (1.21±0.59) cm and (1.02±0.49) cm in catheter directed thrombolysis treated group respectively. The differences in the cross-section diameters of suffered thigh and calf were statistically significant after a period of 48h thrombolytic therapy ( P<0.001, P=0.014). Three cases (7.89%) had occurred adverse events during perioperative period in PMT combined catheter directed thrombolysis treated group, while there were 4 cases (12.90%) in catheter directed thrombolysis treated group, with no statistically significant difference between two groups ( P=0.692). The six month follow-up rate of PMT combined with catheter directed thrombolysis treated group was 71.05%(27/38), while that of the catheter directed thrombolysis treated group was 64.52% (20/31), with no statistically significant difierence between the two groups ( P=0.532). During the six month of follow-up, the recurrence rate of thrombus in PMT combined catheter directed thrombolysis treated group (3/27, 11.11%) was lower than those patients in catheter directed thrombolysis treated group (3/20, 15.00%), with no statistically significant difference between the two groups ( P=0.693). Conclusions:Compared with catheter directed thrombolysis treated group, PMT combined catheter directed thrombolysis treated group has a similar clinical efficacy for treatment of acute lower extremity deep venous thrombosis. PMT combined catheter directed thrombolysis treated group has advantages of reducing dosage of urokinase, shortening duration of thrombolysis time and relieving the swelling of suffered limb in a short time rather than catheter directed thrombolysis treated group. It shows a great result in the short term follow up.
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Objective@#To explore the clinical application indications, filter selection and filter removal techniques of inferior vena cava filter.@*Methods@#Retrospective analysis of the clinical data of 108 cases of inferior vena cava filter implantation in the Department of Vascular Surgery, People's Hospital of Xinjiang Uygur Autonomous Region from January 2018 to February 2019 was performed. One hundred and eight patients with inferior vena cava filter were eligible for filter placement, including 50 males and 58 females; the average age was 59 years, and the age ranged from 23 to 90 years. Different types of inferior vena cava filters were selected according to the patient's condition, the location of the thrombus, the type of surgery and the prognosis of the disease. In this study, lower extremity vascular ultrasound was performed by the outpatient in 2 weeks after the filter placement, 1 month after the operation, 2 months after the operation, and 3 months after the operation. The inferior vena cava filter was recovered by a catcher. Loop technology, Loop and biopsy forceps were used for patients with difficult filter recovery. After removal of the filter, the angiography confirmed the integrity of the inferior vena cava wall. Observe whether the filter was completed, deformed, broken and whether there was thrombus in the filter.@*Results@#The removal of inferior vena cava filter was performed in patients with no free floating thrombus or fresh thrombus in popliteal, femoral, iliac and inferior vena cava confirmed by ultrasound. In this group, 108 patients with inferior vena cava filter implantation included 11 patients anticoagulant contraindications, 11 patients with pulmonary embolism, 5 patients with floating thrombosis in iliac vein, femoral vein or inferior vena cava, 35 patients with acute deep venous thrombosis of lower extremity received catheter-directed thrombolysis or percutaneous mechanical thrombectomy, 46 patients with abdominal, pelvic or lower extremity surgery for acute deep venous thrombosis of lower extremity and high risk factors of pulmonary embolism. One hundred and three patients received retrievable inferior vena cava filters and 5 patients received temporary inferior vena cava filters. Ninety-two patients were followed up successfully in this group. In 74 patients, the filter trap was recovered using a catcher, and the inferior vena cava filter of 12 patients were successfully removed by Loop technology and Loop with biopsy forceps.The success rate of the filter removal was 93.5%. After removal of the filter, angiography of inferior vena cava showed smooth wall, blood flow patency and no extravasation of contrast agent. The removal filters have normal shape, no fracture and no deformation.@*Conclusions@#Operators should strictly observe the indication of inferior vena cava filter placement, master a variety of filter removal methods to improve the success rate of filter removal and maximize the benefit of patients with inferior vena cava filter implantation.
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Objective To explore the clinical application indications,filter selection and filter removal techniques of inferior vena cava filter.Methods Retrospective analysis of the clinical data of 108 cases of inferior vena cava filter implantation in the Department of Vascular Surgery,People's Hospital of Xinjiang Uygur Autonomous Region from January 2018 to February 2019 was performed.One hundred and eight patients with inferior vena cava filter were eligible for filter placement,including 50 males and 58 females;the average age was 59 years,and the age ranged from 23 to 90 years.Different types of inferior vena cava filters were selected according to the patient's condition,the location of the thrombus,the type of surgery and the prognosis of the disease.In this study,lower extremity vascular ultrasound was performed by the outpatient in 2 weeks after the filter placement,1 month after the operation,2 months after the operation,and 3 months after the operation.The inferior vena cava filter was recovered by a catcher.Loop technology,Loop and biopsy forceps were used for patients with difficult filter recovery.After removal of the filter,the angiography confirmed the integrity of the inferior vena cava wall.Observe whether the filter was completed,deformed,broken and whether there was thrombus in the filter.Results The removal of inferior vena cava filter was performed in patients with no free floating thrombus or fresh thrombus in popliteal,femoral,iliac and inferior vena cava confirmed by ultrasound.In this group,108 patients with inferior vena cava filter implantation included 11 patients anticoagulant contraindications,11 patients with pulmontary embolism,5 patients with floating thrombosis in iliac vein,femoral vein or inferior vena cava,35 patients with acute deep venous thrombosis of lower extremity received catheter-directed thrombolysis or percutaneous mechanical thrombectomy,46 patients with abdominal,pelvic or lower extremity surgery for acute deep venous thrombosis of lower extremity and high risk factors of pulmonary embolism.One hundred and three patients received retrievable inferior vena cava filters and 5 patients received temporary inferior vena cava filters.Ninety-two patients were followed up successfully in this group.In 74 patients,the filter trap was recovered using a catcher,and the inferior vena cava filter of 12 patients were successfully removed by Loop technology and Loop with biopsy forceps.The success rate of the filter removal was 93.5％.After removal of the filter,angiography of inferior vena cava showed smooth wall,blood flow patency and no extravasation of contrast agent.The removal filters have normal shape,no fracture and no deformation.Conclusions Operators should strictly observe the indication of inferior vena cava filter placement,master a variety of filter removal methods to improve the success rate of filter removal and maximize the benefit of patients with inferior vena cava filter implantation.
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Objective To analyze and summarize the experience of surgical treatment of carotid body tumor and prevention of relevant complications.Methods The clinical data of 45 cases of carotid body tumor diagnosed and treated by Department of Vascular Surgery,People's Hospital of Xinjiang Uygur Autonomous Region from August 1996 to June 2016 were retrospectively analyzed.All the patients were followed up for 18 months and were followed up in Department of Vascular Surgery,People's Hospital of Xinjiang Uygur Autonomous Region inpatient or outpatient review form,the main observation during follow-up of patients with postoperative complications and recovery.Carotid compression test (Matas test) will be performed 2 weeks preoperation.There were 20 males (4 carotid body lesions located on both sides,16 carotid body lesions on the unilateral side) and 25 females (1 carotid body lesion located on both sides of the neck,neck arteriomatous lesions in unilateral patients were 24 cases),duration of 0.5 to 6.0 years,the average duration of 3 years,analysis of postoperative complications.Results All the operations were successful.There were no perioperative deaths.Among the 45 patients undergoing surgical treatment,one or more surgical procedures were used.Thirty patients were followed up and the remaining 15 patients were lost to follow-up.During an average follow-up of 18 months,complications included 1 stroke,8 hypoglossal nerve injury,13 vagal injury ard 9 homer syndrome.No recurrence of patients was followed up within 6 months,the basic symptoms of nerve injury,1 case of vagus nerve and the tumor was followed up for 6 months,there was still difficulty swallowing and hoarseness.Five cases of bilateral lesions,including 3 cases underwent bilateral staging surgery,the operation was successful.One case of unilateral excision after vagal injury,it did not contralateral surgery;one case of one-sided surgery after the lost,the contralateral did not receive surgery.Conclusions Hoarseness after operation is not caused by recurrent laryngeal nerve injury,and it was recommended that bilateran lesions with smaller one should removed firstly.Matas test could not be regarded as criterion of intraoperative ligation during the operation.
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Objective To discuss the application of double parallel stent for preserving arch branch vessels during thoracic endovascular aortic repair.Methods During the period from June 2015 to June 2016,double parallel stents were carried out in 9 cases at department of vascular surgery,the People's Hospital of Xinjiang Uygur Autonomous Region.Results One patient died of an acute ischemic stroke and subsequently resulted in multiple organ failure after thoracic endovascular aortic repair.Eight patients received an aorta CT angiography during follow up at 1,3,6 months.During follow up,the patency rate for double parallel stents was 100％.There were no endoleak in 8 cases.Conclusion Double parallel stents are suited to patients with emergency situation and unsuited to open surgery in complicated aortic arch pathologies.Surgical approach is determined by preoperative evaluation.Prevention of endoleak and stroke is important in all cases.
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Objective Study of interleukin-6 (IL-6),erythrocyte sedimen-tation rate (ESR),C-reactive protein (CRP) in diagnosis and treatment of abdominal aortic aneurysm.Methods Between June 2014 and May 2016,we detected of abdominal aortic aneurysm in 62 cases that were diagnosed and treated at Department of Vascular Surgery,People's Hospital of Xinjiang Uygur Autonomous Region including interleukin-6,erythrocyte sediinen-tation rate,and C-reactive protein.Results There was no significant difference between interleukin-6,erythrocyte sedimen-tation rate and C-reactive protein in the patients with and without complications.The correlation analysis results of interleukin-6,erythrocyte sedimen-tation and C-reactive protein were confirmed to have positive correlation respectively.Compared with non special types of rupture (48.0 ± 34.2) pg/ml,interleukin-6 was higher in special types of rupture (187.6 ± 110.4) pg/ml.Conclusions Preoperative detection of interleukin-6,erythrocyte sedimen-tation and C-reactive protein,combined with patient history and imaging examination were help for predict cause,choose better surgical approach and predict the prognosis in certain guiding significance.
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Objective To investigate the clinical efficacy and clinical value of catheter-directed thrombolysis for acute lower limb deep venous thrombosis by the posterior tibial vein.Methods Atotal of 46 patints with acute deep venous thrombosis in the department of vecular surgery of People's hospital of the xinjiang uygur autonomous region,under the protection of the inferior vena cava fillters,we treated by catheter directed thrombosisthrough the posterior tibial vein with urokinase continuous infusion.Results In the total gourp of 46 patients,39 patients effectively relieve the swelling,7 of which was ineffective,and 4 cases of patients ease the swelling after the expansion by the iliac vein balloon,3 patients accepted the iliac vein balloon dilation and stent placement,6 patients who were bleeding were treated with pressure dressing,andthere was no other complications.After the treatment,the venous patency score was low,and the patency rate was high and which have a statistical difference (P ＜ 0.05) before and after thrombolysis.Before and after thrombolytic therapy for lower limb swelling rate,there was statistically significant difference (P ＜ 0.05).Conclusions It is a safe and effective method to treat the deep venous thrombosis of lower limbs with catheter-directed thrombolysis by the protection of inferior vena cava filter.It can enhance the patency of the vein and shorten the swelling time.
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Objective The objective of this article is to attempt to propose the endovascular repair principles of distal-end tear of Stanford type B aortic dissection.Methods The vascular surgery of xinjiang uygur autonomous region people's hospital received and cured 101 patients of Stanford B aortic dissection from January 2013 to January 2015.The patients are divided into two groups according different treatment principles:(1)There are 57 cases in sequential treatment group,performing endovascular repair of aortic tears from near to far,(if the tear at visceral artery is not treated then the distal-end tear is also not treated);(2) There are 44 cases in non-sequential treatment group,not performing endovascular repair of aortic tears from near to far (the tears involving visceral artery are not treated and the remaining distal-end tears are performed endovascular repair).After operation,carry out statistical analysis between two groups on the growth rate of aortic diameter of the coeliac axis,occurrence rate of main discomfort complaint,false lumen thrombosis rates.Results After operation,between the two groups,the growth rate of aortic diameter of the coeliac axis is obvious difference(P ＜ 0.05),that the sequential group is with a low rate;there are obvious differences on the occurrence rates of main discomfort complaint and false lumen thrombosis rates (P ＜ 0.05),that the sequential group is superior to the non-sequential group.Conclusions After a preliminary clinical study,we get a conclusion that when treating distal-end tears of Stanford type B aortic dissection,sequential treatment is better than non-sequential treatment.
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Thoracic endovascular aortic repair (TEVAR) has been increasingly used in the treatment of Stanford type B dissection.The incidence of new entry after thoracic endovascular aortic repair has been gradually increased report including at the proximal end and at the distal end of the endograft.New entry is difficult to handle following thoracic endovascular aortic repair for aortic dissection,and associates with a high substantial mortality.It need pay more attention to prevention and treatment on new entry after thoracic endovascular aortic repair.We summary and analyze the possible causes,prevention and management of new entry after thoracic endovascular aortic repair for aortic dissection.This article review and conclusion the progress on stent graft induced new entry after thoracic endovascular aortic repair.
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Objective To evaluate the efficacy and safety of catheter-directed thrombolysis (CDT) combined with anticoagulant compared with traditional treatment (Anticoagulant alone A C) for deep venous thrombosis.Methods We searched Medline,Embase,Cochrane Central Register of Controlled Trials,PubMed,Chinese Biomedical Literature Data Base (CBM),Chinese Scientific Journal,Full-text Data Base (CSJD),and,added with hand searcing and other retrievals.The Cochrane Collaboration's RevMan 5.0.18 was used for Meta-analysis.Results Four randomized controlled trials were available and were included in the study.Meta-analysis showed that 6 months after treatment,iliofemoral vein patency rate of CDT group was higher than that of AC group (OR =5.13,95％ CI:2.01-13.14,P =0.0006);Major complications of CDT group compared to those of AC group were not statistically significant(OR =2.74,95％ CI:0.76-8.07,P =0.13),but the minor complications and total complications of CDT group were higher than those of AC group [(OR =7.86,95％ CI:3.10-19.90,P ＜0.0001)and(OR=5.42,95％CI:1.47-20.01,P=0.01)].Conclusions CDT is a positively effective way to treat early DVT.Application of CDT in patients without contraindications to its use can have good therapeuic effect.
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Objective To assess the treatment of splenic artery aneurysms(SAA) and curative effect evaluation.Methods Twelve SAA patients treated in our hospital from January 2012 to May 2014 were clinical analyzed.The male in Twelve patients was 4 man and others were female.The vagus splenic artery aneurysms are originated from the superior mesenteric artery,tumors are single,from 1.5cm to 2.8cm in diameter,an average of 2.1cm.Twelve cases were performed surgery,4 patients underwent elective surgery,interventional embolization of the splenic aneurysm in 3 patient,The others were performed interventional embolization + superior mesenteric artery covered stents.Results Technical success was achieved in all twelve patients,2 patients had adverse effects such as abdominal pain,fever,etc.There revealed no aneurysm recurrence was found.Twelve patients were followed for 6-24 months,the follow-up by examinations with electronic computer X-ray tomography or color Doppler ultrasonic as well as angiography every 3 months.One patient died of severe abdominal bleeding 1 year later after the operation and the other eleven patients remained in good condition with no occurrence of re-canalization of the lesions.Conclusions For the vagus splenic aneurysm with suitable for anatornic conditions,cavity therapy is safe and effective,for the vagus splenic aneurysm involving hepatic artery,need to open surgery for vascular remodeling.
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Objective To explore the distribution characteristics and clinical typing methods in distal crevasses of Stanford B aortic dissection.Methods Review of the cases in the People's Hospital of Xinjiang Urgur Autonomous Region from 2010 January to 2013 June were diagnosis of Stanford type B aortic dissection with computed tomographic angiography data,Observed its distal crevasses distribution and statistical its number,then summarizes the distribution characteristics of the distal crevasses and further put forward a method of clinical typing.Results Refer to 115 cases with Stanford type B aortic dissection computed tomographic angiography data,including 101 cases with distal crevasses (87.83％) and a total of 240 distal crevasses,an average of 2.37 per case.Conclusions The distal crevasses more often appear in the area involving visceral artery,combined with its different in distribution characteristics and processing methods,we put forward the classification method,namely:Type Ⅰ:the distal crevasses are located in the zone of the thoracic artery; Type Ⅱ:the distal crevasses are close to the visceral artery or involvement it; Type Ⅲ:the distal crevasses are lower than the renal artery,not involving the visceral artery; Type Ⅳ:the distal crevasses are located in the zone of the iliac artery.
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Objective To explore the misunderstanding and comprehension of hybrid operation for treating aortic dissection involving aortic arch.Methods From March 2009 to November 2013,13 patients received hybrid operation for aortic dissection involving aortic arch in the People's Hospital of Xinjiang Urgur Autonomous Region were enrolled,including male 11 and female 2,and aged 36 ～ 60 years old with a mean age (44 ± 6.8) years old.All patients were type-B aortic dissection.All of them were not suitable to be treated with endovascular exclusion monotherapy.The ascending aorta-brachiocephalic artery bypass and left carotid artery bypass was established with median sternotomy approach and neck incision in 13 patients,and 2 patients did left subclavian artery bypass additionally,then retrograde endovascular stent graft implantation was used.Computed tomography angiography (CTA) scanning at 3-month,9-month,1-year and every-year after operation showed no stent grafts translocation and bypass graft obstruction.Results The surgical operation and stent grafts implantation were completely successful.Angiography showed 1 case had end leakage and other cases no obvious displacement or end leakage of stent grafts in operation.Blood flow in true lumen of aortic dissection was recovered and all of bypass grafts were unobstructed.No death and severe complications occurred.All patients were followed-up with 3 to 56 months [(29.0 ± 10.2) months],and all patients resumed normal life.Enhanced CT scanning after operation showed 1 case had endoleak and other cases no endoleak,stent grafts translocation and bypass graft obstmction.No signs of brain and limb ischemia were observed.Conclusions To summarize misunderstanding and experience by continuous explore feature of hybrid operation for treating disease involving aortic arch,we developed a more reasonable surgical treatment options that can improve the success rate of complex aortic dissection surgery,and ultimately achieve better surgical results.
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Isolated resection of bemangioma in the cau-date lobe is challenging due to the surgical anatomy of caudate lobe. The caudate lobe consists three portions: Spiegel's lobe, paracaval portion and caudate process. Most of the blood supply of caudate lobe is provided by the posterior segmental branches of the portal vein and left hepatic artery. The hepatic venous drainage encompasses a few sizable and several small branches that join the inferior vena cava. Selection of the ideal route for bepatectomy, adequate mobilization of the liver, preparatory placement of band for hepatic vascular occlusion are key factors during the operation.
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Objective To study the effect of flee radical on kidney repedusion injury caused by infra-renal abdominal aorta occlusion in rat model and its possible mechanism. Methods Forty-two healthy Wis-ter rats were randondy divided into 6 groups as following ( n = 7) : the control group( sham group) ; simply isehemia 5 h without reperfusion( group I) ; 2 hours reperfusinn following ischemia 5 h ( I/R 2 h), 4 honrs reperfusion following isebemia 5 h ( I/R 4 h), 8 hours reperfusinn following ischemia 5 h( I/R 8 h) and 12 hours reperfusion following ischemia 5 h ( I/R 12 h). In each group the rats were killed to obtain samples of blood and kidney at the specified time points. The contents of BUN, Cr, MDA, SOD in blood and in renal homogenate were measured in each group. We observed the morphological changes of kidney and muscles of lower limb by light microscope. Results BUN level of serum in model group I, I/R 2 h, I/R 4 h, I/R 12 h were higher obvionsly than those of control group, which were maximal in I/R 4 h, then decreased. MDA level of plasma in model group I, I/R 2 h, I/R 4 h, I/R 8 h, I/R 12 h groups were higher obvionsly than those of control group, which were maximal in I/R4 h group, then decreased. SOD level of plasma in model I/R 4 h, I/R 8 h groups were lower obviously than those of control group; SOD level of renal homogenate in model group I, I/R 2 h, I/R 8 h, I/R 12 h groups were higher obviously than those of group I/R 4 h, which were minimal in I/R 4 h group, then increased. By light microscope: The injury degree of kidney and muscles of lower limb in ischemia group was slight, the injury degree of repedusion group was severer than ischemia group. Conclusion The kidney repedusion injury caused by infrarenal abdominal aorta occlusion in rat model might be concerned with the increase of lipid peroxidatian damage after ischemia-repedusion in-jury of lower limbs.