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
BACKGROUND:Studies have shown that intramuscular transplantation of xenogeneic umbilical cord mesenchymal stem cel s in a certain dose range is safe and reliable, and it also confirm that this approach is equal y safe and effective for heart failure in rats with dilated cardiomyopathy. OBJECTIVE:To explore the effect of human umbilical cord mesenchymal stem cel s through intramuscular injection on the cytokine expression in adriamycin-induced dilated cardiomyopathy (DCM) rats. METHODS:Total y 160 rats were randomly divided into control group (n=20) and DCM group (n=140). Rats in the DCM group were administered adriamycin intraperitoneal y to establish DCM model. The DCM rats were randomly subdivided into model control group (served as model group), cel supernatant group, the low-dose mesenchymal stem cel group (served as low-dose group), the middle-dose mesenchymal stem cel group (served as middle-dose group), and the high-dose mesenchymal stem cel s group (served as high-dose group). Secondary injection was performed at 4 weeks after first injection. RESULTS AND CONCLUSION:The ELISA test showed that the serum levels of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), leukemia inhibitor factor (LIF) and granulocyte macrophage colony stimulating factor (GM-CSF) were higher in the model group than the control group before and after intramuscular injection (P0.05). Both the immunohistochemical and RT-PCR results showed that the expressions of insulin-like growth factor-1, VEGF and HGF were increased in al the DCM rats as compared with the control group, which were increased most in the middle-dose group. These findings indicate that low-dose and middle-dose human umbilical cord mesenchymal stem cel s intramuscular injection can increase the serum levels of HGF, LIF, GM-CSF, VEGF and the expressions of IGF-1, HGF and VEGF in the myocardium of DCM rats.