ABSTRACT
Objective:To evaluate the safety and feasibility of the in-situ needle fenestration combined with the in vitro physician modified fenestration technique to reconstruct supra-aortic branches during thoracic endovascular aortic repair (TEVAR) for aortic arch lesions requiring landing at Z0 and Z1.Methods:From Nov 2017 to Dec 2019, eighteen patients who underwent both the in-situ needle fenestration and the in vitro physician modified fenestration techniques to extend the proximal landing zone to Z0 and Z1 during TEVAR were included in our study.Results:Sixteen patients underwent in vitro physician modified fenestration ,two patients underwent in vitro physician modified fenestration to reconstruct both the left common carotid artery and the innominate artery. All eighteen patients received in-situ needle fenestration to preserve the left subclavian artery. Supra aortic branches were preserved in all patients (38/38, 100%). There was no Type Ⅰ endoleak. Type Ⅱ endoleak was found in four paitnets (4/18). Type Ⅲ endoleak occurred in one patient (1/18). Type Ⅳ endoleak in four patients (4/18). Type Ⅲ endoleak needed open aortic arch repair 6 months later. The median follow-up time was 12 months. One (1/18) died in 12 months and the other patients were doing well.Conclusions:The joint application of the in-situ needle fenestration and the in vitro physician modified fenestration to reconstruct supra-aortic branches during TEVAR for aortic arch pathologies requiring landing at Z0 and Z1 was satisfactory.
ABSTRACT
Objective:To investigate the feasibility and safety of endovascular repair for traumatic thoracic aortic pseudoaneurysm.Methods:From Oct 2015 to Oct 2018, the clinical and followup data of 7 patients diagnosed as traumatic thoracic aortic pseudoaneurysm in Fuwai Hospital of Chinese Academy of Medical Sciences were analyzed retrospectively.Results:The patients average age was (51.2±11.0) years old. All patients underwent surgery in the hybrid operating room under general anesthesia. Two did thoracic endovascular aortic repair (TEVAR), three did TEVAR combined with chimney technique to reconstruct the left subclavian artery, and 1 had TEVAR combined with fenestration to reconstruct the left subclavian artery. One did TEVAR with left common carotid artery and left subclavian artery bypass. The mean operative time was (90.1±27.4) min, the mean postoperative hospital stay was (8.9±3.7) d, and the mean postoperative follow-up time was 42.4 months. All the patients received CTA reexamination of the aorta after 1, 6, 12 months and yearly thereafter. TypeⅠendoleak was found in one patient with chimney technique to reconstruct of left subclavian artery after operation. CT showed that the type Ⅰ endoleak disappeared 6 months after operation. There was no death, paraplegia or stroke during the perioperative period and follow-up period, and there was no aortic related reintervention.Conclusion:TEVAR is a safe and effective method for the treatment of traumatic pseudoaneurysm of thoracic aorta, and the early and mid-term results were satisfactory.
ABSTRACT
Objective:To explore the effect of ligustrazine on Th17 cell and the expression of Th17/Treg characteristic cytokines in a model of asthma.Methods: Male BALB/c mice were randomly devided into four groups , including the normal control group,the model group,the ligustrazine treatment group and the DXM treatment group ,with 10 mice in each group.In the model group, mice were sensitized with the OVA respectively.In the treatment group ,mice were also sensitized and challenged as model group and in addition were intraperitoneally injected with the ligustrazine or DXM.The mice of control group were intraperitoneally injected normal sodium instead of OVA and challenged by inhaling normal sodium instead of OVA in challenge phase respectively .Animals were sacrificed to detect the percentage of CD 4+CD25+T regulatory cells and Th17 cells in the blood were measured by flow cytometry ,and the cytokines,including IL-17 and IL-10,in the blood serum by ELISA.Results:The mice of model group showed the performances of a typical asthma.In treatment group ,the symptoms above mentioned became lighter.The mice of control group were generally in good condition;the lung tissue from the mice of model group showed widen alveolar septum , narrowed bronchial lumen , thicken bronchial wall,and numerous inflammatory cells infiltrated around the small vessels and bronchioles.In ligustrazine treatment group, the pulmonary inflammation was obviously relieved compared with the model group;the percentages of CD 4+CD25+T regulatory cell both in the peripheral blood and in the total CD 4+T cells were significantly lower in the mice of model group than in the mice of control group , and were higher in the treatment group than in the model group;the level of IL-10 in serum was significantly lower in the model group than in the control group ,and was higher in the treatment group than in the model group.The level of IL-17 of serum was significantly higher in the model group than in the control group , and was significantly lower in the treatment group than in the model group.Conclusion:Ligustrazine can adjust the Th 17/Treg balance and reduce the inflammation of lung tissue in asthma mice by up-regulating CD4+CD25+T regulatory cell and then restraining the Th 17 response , and play a preventive/control asthma attack role in asthma model mouse.