Clinical significance and outcomes of pleural effusion in patients with type B aortic dissection treated by endovascular repair / 中华普通外科杂志

Objective To explore clinical implications of pleural effusion in thoracic endovascular aorta repair (TEVAR) of type B aortic dissection.Methods Clinical data of 28 patients (23 males,5 females) hospitalized from Jan 2015 to Dec 2016 were analyzed retrospectively.There were ruptured aortic dissection (RAD) (n =7) and the contained aortic dissection (CAD) (n =21).26 patients underwent TEVAR,and two patients received conservative treatment.Results 26 patients received TEVAR and operations were successful.2 patients treated conservatively died.Six patients had bilateral pleural effusion,while 20 had left pleural effusion and two had right pleural effusion.The distribution of pleural effusion was significantly different between CAD and RAD group (x2 =10.4,P ＜ 0.05),and the rupture risk was the highest in right sided pleural effusion.The median volume of pleural effusion on right side in RAD group are higher than that in CAD group (Z =-3.293,P =0.001).One patient died of sudden death on post-op 9th day.Pleural effusion disappeared in all 24 patients who were followed-up for more than 3 months.There were no ensuing pleural thickening,pulmonary atelectasis,and lung consolidation.Conclusious Pleural effusion on left side are common in type B aortic dissection,while bulk right pleural effusion may indicate impending rupture.Endovascular therapy is a feasible,safe and effective therapy for aortic dissection with pleural effusion.

Preservation of Internal Iliac Artery after Endovascular Repair of Common Iliac Artery Dissection Using Modified Fenestrated Stent Graft

Standard endovascular repair of iliac/aortoiliac pathologies can lead to complications, such as buttock claudication, colon ischemia and erectile dysfunction. Branch grafts have been developed but require at least 6 weeks for customization and are not currently available in China; they are also quite expensive. To our knowledge, modified fenestrated stent grafts (MFSGs) are a safe and effective alternative for treating patients with juxtarenal aneurysms. Most MFSGs are used for the preservation of renal and left subclavian arteries. Few cases of MFSGs have been reported in the treatment of iliac pathologies. The use of an MFSG is decided on a case-by-case basis. This report presents our first clinical use of an MFSG for preservation of the internal iliac artery.

The placement of inferior vena cava filters for the treatment of deep venous thrombosis / 中华普通外科杂志

Objective To explore the effect and technical consideration of placement of inferior vena cava filter (IVCF) in the treatment of low extremity deep venous thrombosis (DVT).Methods From Jun 2011 to Jun 2013,73 consecutive DVT cases were for IVCF placement.There were 47 males and 26 females with a mean age of (51 ± 23) years (ranging from 36 to 80 years).Results Procedures were successful in 70 out of 73 cases.There were 18 permanent and 52 temporary IVCFs deployed.The indications for filter insertion were pulmonary embolism (PE) (25 cases,34％),perioperative prophylactic implantation (18 cases,24％),contraindication to anticoagulation therapy (15 cases,20％) and iliofemoral vein thrombosis(10 cases,13％).17 filters were successfully removed with a successful rate of 33％.After the follow-up of mean 24 months (4 to 36 months) of 68 patients,no pulmonary embolism occurred,but symptomatic DVT recurred in 5 patients,and the conditions were improved after anticoagulation treatment.No serious complication of post thrombotic syndrome occurred.Conclusions IVCF placement is effective for prevention of PE,when the therapeutic indications and contraindications are properly controlled.

Approach on diagnosis and treatment of acute infrarenal abdominal aortic occlusion / 中国医师进修杂志

Objective To discuss rational diagnosis and treatment of acute infrarenal abdominal aortic occlusion. Methods Retrospective analysis was made on 6 cases with acute infrarenal abdominal aortic occlusion from January 2005 to December 2008. Emergency operations of retrograde catheter were done on 3 cases, 2 cases received transaortic embolectomy, 1 case received anticoagulation therapy successfully. Results Two cases were cured, 2 cases with 3 legs received amputation, 2 cases died. The time in hospital was 4 hours to 122 days, averaged (24±55) days. Conclusions A prompt thrombolytic, anticoagulation therapy and operation are suggested. It is emphasized to prevent reperfusion injury after arterial ischemia during the peri-and post-operation. Conservative treatment may be used in the patients incorporated with seriously multiple organ failure.

Comprehension in treatment of 7 patients with abdominal aortic aneurysm / 临床外科杂志

Objective To explore the diagnosis of abdominal aortic aneurysm(AAA), operative opportunity, the way of operation selecting and the application of blood vessel prosthesis. Method The clinical data of 7 patients with AAA were analysed retrospectively.Results The type of DeBakey I thoracoabdominal aortic aneurysm patient was died of aortic aneurysm broke suddenly before operation, the other 6 patients with AAA underwent aortic aneurysm blooking, opening and replacement of blood vessel prosthesis. Dumbbell thoracoabdominal aortic aneurysm was operated by stayes. No complications of operation occurred. Conclusions Operation is a efficient way in treatment of abdominal aortic aneurysm. Diagnosis timely and definitly, selecting the way of operation in reason and blood vessel prosthesis are the keys to operation, while the correct treatment of perioperation period is the important guaranty of successful therapy.