ABSTRACT
Objective:To evaluate Castor single-branch covered-stent in the treatment of Stanford B aortic dissection(TBAD)with insufficient anchorage zone.Methods:Clinical data of 25 TBAD patients (proximal healthy landing zone ≤15 mm) treated with Castor branched stent-graft at Weifang People's Hospital from Apr 2019 to Sep 2021 were analyzed retrospectively.The stent model was selected according to preoperative CTA examination and intraoperative angiography,the operation result and follow up data were reviewed.Results:The operation success rate was 100%,the mean operative time was (137.8±35.8)min, and the mean blood loss was (52.8±24.5)ml. There were 2 cases of internal leakage (IA) and it was disappeared after balloon dilation, Branched stent stenosis occurred in 2 cases and relieved by balloon dilatation. The mean follow-up time was 14.6 months, and the patency rate of branch stent was 100% during the follow-up period. The true lumen diameter of thoracic aorta was significantly expanded and the false lumen diameter was significantly reduced 3 months after surgery compared with that before surgery ( P<0.05). Conclusion:Castor stenting in the treatment of TBAD with insufficient proximal anchoring area is simple and feasible, with satisfactory short term clinical effect.
ABSTRACT
Objective To explore the mechanism of gene Nelin on the differentiation of vascular smooth muscle cells(VSMC).Methods Human VSMCs were stably infected with over-express lentiviral vector [Nelin-VSMC] and interference lentiviral vector [LV-Nelin-SiRNA-VSMC] by Western blotting and RT-PCR.The effect of Nelin expression on phenotypic transition of VSMCs was observed and the mechanism involved was explored.Results The Nelin-VSMC cells take on the contractile phenotype of long slender cells possessing hill-valley characteristics.Overexpression of Nelin can enhance SMoα-actin expression with the increase of total RhoA and nuclear serum response factor(SRF) expression.Treated with a selective Rho kinase inhibitor Y-27632,the expression of SMα-actin and nuclear SRF protein induced by Nelin was effectively reduced.Meanwhile,the opposite results were observed in the Nelin-depression VSMC.Conclusions Nelin can enhance the expression of SMα-actin and carry a pivotal role in the process of VSMCs differentiation and phenotype modulation by activating Rho and SRF.