Mid- and long-term result of celiac artery coverage in TEVAR treatment for aortic dissection / 中南大学学报(医学版)

To observe the mid- and long-term result of intentional coverage of celiac artery in thoracic endovascular aortic repair (TEVAR) surgery for aortic dissection.
 Methods: We retrospectively analyzed 21 cases who received TEVAR with celiac artery coverage during the operation. The existence of collaterals between celiac artery (CA) and superior mesenteric artery (SMA) was confirmed by preoperative CT angiography (CTA) or digital substract angiography (DSA) for each patient. We used the stent-graft precisely above the orifice of SMA. Follow-ups were carried out at 2 weeks, 1 month, 3 months, 6 months, 1 year after the operation, and once per year thereafter.
 Results: No signs of visceral artery ischemic syptoms such as liver dysfunction, abdominal pain or distention were observed after the operation. There was no signs of spinal cord ischemia (SCI). Seven cases showed type II endoleak upon completion DSA but stopped automatically within 3 months. CTA in follow-ups showed thrombosis formation in false lumen.
 Conclusion: The intentional coverage of CA during the TEVAR for aortic dissection is safe and effective. The incidence of post-operative SCI or visceral artery ischemia is low. Type II endoleak is a major complication but it can be ceased automatically after medication.

Clinical practice and thinking on chimney technique for endovascular aortic repair / 中华外科杂志

Chimney technique is an assistive technology of endovascular aortic repair, which is used to reconstruct the vital branch vessel invaded by aortic pathology. In chimney technique, most of the commercial aortic stent-graft can be used, and covered branch stent-graft is recommended to decrease the risk of type I a endoleak. The suggested oversizing for aortic stent-graft and branch stent-graft is 15% and 5% respectively, and the length of overlapping between stent-grafts should be more than 2 cm. Type I a endoleak is the main concentration, appropriated oversizing and overlapping are important precautions theoretically. Anticoagulation therapy post-operation is crucial in preventing restenosis of the chimney stent-graft.

Operation experience of atypical ruptured abdominal aortic aneurysm / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate and report surgical management and experience of atypical ruptured abdominal aortic aneurysm (RAAA).</p><p><b>METHODS</b>Clinical data of 52 RAAA patients from May 2002 to February 2015 were retrospectively collected and analyzed. Thirty-three cases were included into this study based on atypical clinical presentation and etiology, including 6 infected RAAA, 5 inflammatory RAAA, 1 traumatic aortic rupture, 6 tuberculotic RAAA, 2 aoritc-vena cava fistula, 3 intestinal fistula and 5 spine erosion cases. Two of them refused operation during preparation, 19 of them received emergency open repair and 13 of them received endovascular aortic repair (EVAR) with 1 case converted to open surgery.</p><p><b>RESULTS</b>The systolic blood pressure of atypical RAAA before operation was (88±16) mmHg (1 mmHg=0.133 kPa), duration time from admission to diagnosis making was (17±10) hours. Perioperative death occurred in 1 patient because of hemorrhagic shock induced acidosis. During follow-up for 3 to 72 months, no operation related complications occured, such as artificial graft infection.</p><p><b>CONCLUSIONS</b>Emergent operation including open surgery and EVAR is crucial for RAAA treatment. Early diagnosis, excellent operative techniques and comprehensive perioperative management are measures conducive to reduce the mortality rate of RAAA.</p>

Surgical treatment of ruptured abdominal aortic aneurysm / 国际外科学杂志

Objective To evaluate surgical management of ruptured abdominal aortic aneurysm (RAAA).Methods Clinical data of 36 RAAA patients undergoing emergent graft replacement or endovascular aortic repair (EVAR) from May 2002 to July 2013 were retrospectively analyzed.25 and 21 patients were associated with hypertension and chronic obstructive pulmonary disease respectively.33 patients were treated with graft replacement.3 patients received endovascular treatment and 1 patient converted to open surgery.Results Perioperative death occurred in 3 patients including severe hemorrhagic shock in 1 patient,cardiac arrest in 1 patient and multiple organ failure in 1 patient.During follow up for 3 to 61 months,no operation related complication,such as artificial graft infection happened.Conclusions Emergent operation including open surgery and EVAR is crucial for RAAA treatment.Early diagnosis,excellent operative techniques and effective perioperative management are measures conducive to lowering the mortality rate of RAAA.

Endovascular repair for retrograde type A aortic dissection with an entry tear in the descending aorta / 中华普通外科杂志

Objective To evaluate endovascular aortic repair for retrograde Stanford type A aortic dissection with an entry tear in the descending aorta.Methods From April 2006 to Dec 2012,31 patients with retrograde type A aortic dissection were treated with endovascular technique.22 patients had pleural effusion,14 patients had patent false lumen in the ascending aorta.Emergency operation was performed in 2 patients with acute right renal artery and right common iliac artery ischemia respectively.29 patients received endovascular treatment after 3 weeks conservative treatment.Chimney technique was used in 3 patients.Results All procedures were technically successful without severe complications.Ascending aorta recovered 1-3 months after operation.Pleural effusion subsided 3 days to 3 weeks after endovascular treatment.During follow-up of (31 ± 18) months,no severe complications developed,all the stent-grafts placed by chimney technique were patent.Conclusions Endovascular aortic repair can be used in the treatment of retrograde Stanford type A aortic dissection.Chimney technique can be used to reconstruct supra-aortic branches.

Endovascular repair combined with assistant techniques for the treatment of Stanford Type B aortic dissection involving aortic arch / 中华普通外科杂志

Objective To evaluate endovascular repair combined with assistant techniques for the treatment of Stanford type B aortic dissection involving aortic arch.Method From July 2002 to June 2010,46 patients of aortic arch dissection with the primary entry tear next to the orifice of left subclavian artery,were treated with endovascular repair.Left subclavian arteries were covered with TEVAR in 43 cases.PDA occludes were used in 6 patients.Nine patients received extrathoracic supra-aortic branches bypass.Double-barrel technique was performed in 8 patients.Fenestrated stent graft was used in 1 patient.Result All patients survived and were followed up for 2 to 76 months.No severe neurological complications happened.All synthetic grafts and carotid artery stents were patent.Type Ⅱ endoleak occurred in 10 patients,among them 6 received PDA occlude implantation in the left subclavian artery,and 2 patients recovered by conservative treatment.Nine patients suffered from ischemia of the left upper extremity,and 8 of them were treated with conservative method,one received bilateral subclavian artery bypass because of severe ischemia after endovascular treatment.In follow-up,all of the stent-grafts and grafts were patent.In the descending aorta,the diameter of true lumen increased significantly and the diameter of false lumen shrank gradually.Conclusions Endovascular aortic repair combined with extrathoracic supra-aortic branches bypass,PDA occlude,double-barrel technique and fenestrated technique is a safe and effective method for Stanford Type B aortic dissection involving aortic arch.

Endovascular repair of infrarenal abdominal aortic aneurysm with the complex aortic anatomy / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the safety and efficiency of endovascular repair (EVAR) of abdominal aortic aneurysms (AAAs) which have the complex aortic anatomy.</p><p><b>METHODS</b>The clinical date of 48 AAA patients with complex aortic anatomy treated by EVAR from January 2003 to March 2011 was retrospectively analyzed. There were 37 male and 11 female patients, aged from 50 to 81 years with a mean of 71.4 years. Fourteen patients had short aortic neck (< 15 mm), 13 patients had severe infrarenal angulation (> 60°), 15 patients had severely tortuous iliac, 6 patients had small iliac (< 8 mm). The stent-grafts were deployed by both femoral arteries to treat the AAA.</p><p><b>RESULT</b>The primary technical success rate was 100%. The perioperative survival rate was 100%. Intraoperative angiograms revealed two type I endoleaks, in which one disappeared in two weeks, another existed. Follow-up was available in 40 patients with a median of 63 months (4 to 122 months). During the follow-up period, 2 patients died with no relationship to the procedures. The rest patients survived well. The accumulative survival rate was 95.8%. There were no new endoleak, stent-graft migration, aneurysm expansion, or secondary intervention during the follow-up time.</p><p><b>CONCLUSIONS</b>EVAR is safety and efficiency to treat the patient of infrarenal abdominal aortic aneurysm with the complex aortic anatomy. By the accumulation of experience, EVAR will play a more important role for these patients.</p>

Development and application of bar code management system to hematology analyzer / 医疗卫生装备

Objective To develop a bar code management system for two-way communication between XE-2100 hematology analyzer and LIS.Methods The relevant databases/tables were set based on PowerBuilder 7.0.The bar code ActiveX MSBCODE9.OCX was used for creating bar codes from patient information and test item information.Codes of all objects were translated to an executive file and DLL files.Results The results showed that the bar code was clear with high discernable rate,stable two-way communication and safe data storage.As the only identifier for specimen,the bar code improved work efficiency and management level,and avoided errors in sampling procedure.Conclusion The application of bar code technique to clinical hematology examination normalizes the workflow and provides a new mode for automatization and standardization management.

Development and Application of Self-help Report Printing System in Inspection Process / 医疗卫生装备

Objective To develop a self-help report printing system for management of inspection data and improvement of inspection workflow. Methods The self-help report printing system was compiled based on LIS with ORACLE database management system and was coded with PowerBuilder9.0 development kit. Results The information exchange in self-help report printing system and LIS are implemented successfully, and can print out inspection report with electronic signatures. Conclusion The self -help report printing system simplifies the reporting process and improves work efficiency through application in hospital.

Development of Communication Interface Software and Its Application in LIS for Laboratory Analyzer / 医疗卫生装备

Objective To develop a software for communication interface of laboratory analyzer for single-way or two-way communication of laboratory analyzer so as to ensure the data accuracy.Methods Based on PowerBuilder 9.0,MSCOMM.OCX was programmed to connect PC and the laboratory analyzer by right settings of communication parameters.Results All data were received stably and accurately without errors in running.This software replaced manual recording absolutely.Conclusion The communication interface software for laboratory analyzers not only realizes automatic data acquisition to the greatest extend and ensures the accuracy,but also makes the laboratory working procedure more reasonable and data management more standardized.

Mode Choice and Application of the Bar Code in LIS / 医疗卫生装备

Objective To analyze the application of bar code mode in LIS and help select a fit bar code mode for the hospital. Methods The mode of print bar code was chosen on the base of LIS that was programmed with ORACLE database and PowerBuider9.0 so as to manage laboratory information. Results The bar code management in LIS was realized and no- paper thoroughly in hospital. Conclusion The print bar code mode is more suitable for information-based hospital.