ABSTRACT
<p><b>OBJECTIVE</b>To summarize the experience of treating aortic arch disease with ascending aorta to carotid artery revascularization and subsequent endovascular repair.</p><p><b>METHODS</b>From January 2002 to June 2013, 10 high risk patients with aortic arch disease were treated with ascending aorta to carotid artery revascularization with subsequent endovascular repair in the First Affiliated Hospital, Sun Yat-sen University. There were 9 male and 1 female patients with a mean age of (54 ± 14) years (ranging from 34 to 71 years). Of the 10 patients, 8 were aortic dissection and 2 were thoracic aortic aneurysm. All aortic arch debranching was performed with mid-sternotomy, including 7 ascending aorta to innominate artery and left common carotid artery bypass, and 3 ascending aorta to left common carotid artery and left subclavian artery bypass.Subsequently, simultaneous (n = 5) and staged (n = 5, mean interval (7 ± 4) days) endovascular repair were performed via femoral artery.</p><p><b>RESULTS</b>Technical success rate was 10/10. The 30 day-mortality was 3/10, including 1 brain stem infarction, 1 circulatory failure and 1 aorto-tracheal fistula. Complication included 1 type II endoleak. The median time of follow-up was 24 (14) months. CT scanning was performed at 1, 3 months and annually thereafter. There was no death and no occlusion of bypass during follow-up.No complication occurred except 1 existing type II endoleak.</p><p><b>CONCLUSION</b>Ascending aorta to carotid artery revascularization with subsequent endovascular repair is suitable for high risk aortic arch pathology patients in poor general condition with little tolerance to aortic arch replacement.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Aortic Dissection , Aorta , Aortic Aneurysm , Aortic Aneurysm, Thoracic , Aortic Diseases , General Surgery , Blood Vessel Prosthesis Implantation , Brachiocephalic Trunk , Carotid Artery, Common , Endoleak , Endovascular Procedures , Femoral Artery , Sternotomy , Subclavian Artery , Tomography, X-Ray Computed , Vascular Surgical Procedures , Wound HealingABSTRACT
Objective To study the etiology, diagnosis and treatment of acute occlusion of abdominal aorta(AOAA). Methods Clinical data of 35 patients with AOAA admitted to our hospital from January 1980 to August 2001 were analyzed retrospectively. Results There were 17 patients with acute aortic embolism(AAE) and 18 patients with acute aortic thrombosis(AAT) . All cases had total occlusion of abdominal aorta,and bilateral iliac arteries were involved. All the 35 cases underwent operations, including bilateral transfemoral thromboembolectomy by Fogarty balloon catheter in 18 cases, thromboembolectomy via laparotomy aortotomy in 11 cases, aortobiiliac reconstruction in 2 cases, aortobifemoral bypass in 2 ( 1 had profundaplasty) and axillobifemoral bypass in other 2 cases. Operative mortality was 25.7%(9/35). After the operations, artery embolism recurred in 3 cases; 3 patients required amputation; renal failure occurred in 3 cases and paraplegia in 4; ischemic colitis occurred in 5, impaired sexuality in 1 and incomplete intestinal obstruction in 1. Conclusions AOAA is an urgent disease with high mortality. Fast preoperative diagnosis and prompt operation are the keys to salvage the patient. Color Doppler is the first choice of diagnosis. Fogarty balloon catheter thromboembolectomy and vascular reconstruction are effective treatments for this disease.
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Objective To sum up clinical experience on subfascial endoscopic perforator surgery (SEPS) for the treatment of severe chronic venous insufficiency (CVI) of the lower extremities. Methods Fifty-one patients (64 limbs) with severe CVI received SEPS from Nov. 1999 to Aug.2002. CEAP classification, scoring of venous dysfunction (SVD), Color Doppler, Color Doppler velocity profile (CDVP), venography and air plethysmography (APG) were applied to assess the status of the affected limbs before and after operation. Results The postoperative follow-up was made from 3 to 35 months with the follow-up rate of 90.6% (58/64 limbs). No limbs suffered from recurrent superficial varicose. Venous ulcer was healed in 40 limbs (97.6%) and the ulcer ameliorated significantly in one limb. Ulcer healing time ranged from 9 to 91 days with the average time of (32?5) days. The average SVD was (13.9?1.7) preoperatively , while (6.4?0.8)postoperatively ( P
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Objective To assess the clinical manifestation, management and outcome of abdominal aortic aneurysm (AAA) in young adult Methods Retrospective study was made on young AAA patients (
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ObjectiveTo evaluate the value of preoperative superselective arteriography plus emboliazation before surgery of carotid body tumor(CBT). Methods11 CBT cases hospitalized from 1995 to 1999 underwent this procedure before resection. ResultsThe intraoperative blood loss (350?170 ml) was significantly different in this group compared with that (averaging 650 ml) in patients not undergoing the preoperative embolization, P
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Objective To study the management and curative effect of the thyroid cancer suspected clinically but with inconclusive frozen-section intraoperatively. Methods The clinical data of 29 consecutive cases of thyroid cancer suspected clinically but with inconclusive frozen-section intraoperatively admitted to our hospital during Jan 1980 to Dec 1999 were analyzed retrospectively. Results Among these 31 suspected patients 29 were negative on frozen-section but confirmed thyroid cancer on postoperative paraffin-section. 20 underwent total involved lobe thyroidectomy in one-stage and other 11 as a second stage. No case recurred or metastased in the follow-up. Complication incidence was significantly different between one-stage and two-stage procedure (P