Hybrid aortic endovascular repair with one stage supra-aortic branch or tliac artery revascularization / 中华普通外科杂志

Objective Repair of aortic arch aneurysm is technically demanding and usually requiring complex circulatory management. Operative morbidity and mortality may be prohibitive with traditional surgical intervention. We described our experience with 5 hybrid endovascular procedure for aorta repair with different kinds of bypass followed by concomitant placement of stent graft in the aorta. Methods We retrospectively reviewed the clinical data of 5 consecutive patients presenting with aortic aneurysm or dissection from 2007 to 2008 treated by the hybrid aorta repair. Complete surgical rerouting of the supra-aortic vessels was followed by endovascular repair of aortic arch aneurysm with a Zenith TX2 stent graft. Hybrid left carotid-subclavian bypass with Zenith stent graft deployment covering the ostium of the LSA was performed in a Debakey type Ⅲ aortic dissection case. Procedures were successfully completed with exclusion of the aortic aneurysm. All stent grafts were deployed retrograde from the femoral artery in these patients. Results Technical success with complete aneurysmal exclusion was achieved in all patients (100%). At a follow-up period of 2-10 months, there was no incidence of endoleak. Documented perioperative neurelogic events did not occurred in all patients. Postoperatively one patient suffered from ARDS and cardiac failure and recovered. One patient died of myocardial infarction. Conclusions Hybrid arch repair provides an alternative to patients otherwise considered prohibitively high risk for traditional open arch and thoracoabdominal aorta repair.

Clinical application of virtual US-CT or MRI fusion navigation system in interventional radiology / 中华放射学杂志

Objective To evaluate the clinical value of virtual US-CT or MRI navigation system for guidance of interventional procedures. Methods Virtual US-CT or MRI fusion navigation system was applied on 47 cases for guiding various interventional procedures. The operating method, success rate, clinical outcome,and complication of the navigating interventional technique were retrospectively analyzed. Thirty-eight cases of hepatic tumors underwent percutaneous needle biopsy and/or radiofrequency ablation (RFA); 4 cases of hepatic abscess underwent percutaneous abscess drainage, 5 cases of musculoskeletal diseases underwent biopsy, RFA or RFA with cementoplasty. Results For 38 cases of hepatic tumors who underwent RFA, 27 acquired complete ablation in one session, no recurrence after 3.0-6. 0 months (median time4. 8 months) follow-up; while the other 11 cases present with no significant change. Five cases of musculoskeletal diseases improved significantly after interventional therapy and pathological diagnoses were also acquired. Four cases of hepatic abscesses were cured after drainage. All cases were free of significant complication, except one local skin thermal damage. Conclusion Virtual US-CT or MRI navigation guiding technique provides mutual aid to different imaging modalities for guiding interventional procedure. After application of navigation system, those interventional procedures may become more convenient, more effective and safer.