The surgical and interventional treatment for Takayasu's arteritis / 中华普通外科杂志

Objective To evaluate vascular surgery and interventional technique applied in Takayasu's arteritis. Methods Data of 26 patients of Takayasu's arteritis admitted between January 2006 and December 2009 were retrospectively analyzed. The sex ratio(M/F) was 1: 4. 2, age averaged at (27±15)y. There were 16 cases of type Ⅰ , 7 cases of type Ⅱ and 3 cases of type Ⅲ according to Lupi-Herrera classification. 25 patients received surgery including 16 patients undergoing pecutaneous transluminal angioplasty operations, 9 patients doing traditional bypass surgery, and one patient was treated conservatively. Results 23 case-times of percutaneous transluminal angioplasty (PTA) were performed in 16 patients, including 12 cases of balloon angioplasty and 4 cases of stent angioplasty. Four significantly stenotic and occluded carotid arteries were revascularized successfully in 5 patients. Thrombosis of the carotid artery was found in one patient after balloon angioplasty. There were 4 patients in which repeated PTA treatment up to a total of 11 times were needed to guarantee vessel patency. Open surgery succeeded in 9 patients, and clinical symptoms were relieved in all cases during peri-operative period. 22 patients were followed up for 12 -46 months,one patient died of cerebral hemorrhage 3 months post-operation, one patient was found pseudoaneurysm at anastomotic stoma, and 2 patients suffered from anastomotic restenosis.Conclusions Vascular surgery played important role in the therapy of Takayasu's arteritis. PTA can be used repeatedly. Surgical bypass operation is difficult in technology, and can be used in cases that fail to response to PTA or in patients with severe cerebral ischemia.

Surgical procedure and prognosis analysis for elderly stage Ⅰ NSCLC patients above 70 years old / 中华胸心血管外科杂志

Objective The purpose of this study is to evaluate Surgical Procedure and Prognosis for elderly stage 1NSCLC patients above 70 years old.Methods The patients who were stage Ⅰ non-small cell lung cancer from 2003 to 2007were enrolled ( n =71 ).The median age was 74 years ( ranged from 70 to 84 years).The median follow-up of patients was 30months( ranged from 2 to 81 months).Results The percentages of postoperative complications after sublobar resection and lobectomy patients were 36.4％ and 46.9％,respectively.The period in hospital were 11.36 days and 12.24 days.The 3 year survival was 85.9％ for patients undergoing sublobar resection and 78.8％ for lobectomy.The 5 year survival was 56.4％ and 56.9％ respectively.No significant difference was observed between two types of surgical procedure in the elderly.Staging is the independent factor of prognosis.Conclusion Lobectomy is still the main therapy method for elderly stage Ⅰ NSCLC patients.Especially,for those who can undergo radical resection.But sublobar resection also appears to be a viable surgical treatment for patients with cardiopulmonary physiologic impairment.

Treatment of severe lower extremity ischemia with distal bypass and arteriovenous anastomosis / 中国普通外科杂志

ObjectiveTo explore the effectiveness o f distal arterial bypass for the treatment of severe lower limb ischemia with p oor outflow artery. Method From July 2000 to Dec 2004, we treated 21 cases (21 limbs) of severe lower limb ischemia with poor outflow artery by distal bypass with additional arteriov enous anastomosis at or distal to the distal graft anastomosis. Results Among the 21 cases, one case recei ved reoperation for “void arterial perfusion” distal to the arteriovenous anas tomosis. The operative success rate was 95.2%.The patency rate of graft was 100 % and the healing rate of foot ulcer was 33.3% on discharge. Conclusion Additional areriovenous anastomos is at or distal to the distal graft anastomosis can dramatically increase the pa tency rate of the graft when outflow artery is too poor to guarantee a patent gr afting in the case of severe lower limb ischemia, although long-term effectiven ess needs to be varified.

Minimally invasive treatment for supra-renal abdominal aorta lesions / 中国普通外科杂志

Objective To evaluate endoluminal stent-grafting for diseases of supra-renal abdominal aorta. MethodsWe retrospectively analyzed the clinical data of 42 cases with supra-renal aorta lesions from July 2000 to December 2004, including 32 cases of dissection aorta aneurysm, 7 cases of thoracic aortic aneurysm, and 3 cases of thoracic pseudoaneurysm. ResultsOne died in perioperative period (2.4%). Endoleaks occurred in 8 cases (19.1%) after the deployment of the first stent. Among them, leaks were sealed in 3 cases by balloon dilatation, the remaining 2 cases were treated by the placement of additional stenting-graft, 3 cases were treated conservatively. Patients were followed-up for 1～51 months, with a mean of 16 months. One (2.4%) died during the follow-up. Endoleak disappeared in 3 cases. ConclusionMinimally invasive endoluminal grafting is a relatively safe and effective means for the treatment of high-risk aortic lesions, though the long-term result remains to be proved.

The application of percutaneous trunsluminal stenting angioplasty to high degree stenosis of internal carotid artery / 中华放射学杂志

Objective To evaluate the result of percutaneous transluminal stenting angioplasty(PTSA) to high degree stenosis of internal carotid artery. Methods PTSA was attempted in eight patients with high degree stenosis of internal carotid artery from January 1998 to October 1999. Three types of stent were used for the procedure. After proper preparation, we selected different type of stent and special procedure method according to the patient's lesion. Results Nine stents were implanted in eight internal coratid arteries of nine patients. All cases were successful based on post procedure image, and recovery from neurologic symptoms was satisfactory. Conclusion (1) PTSA is a safe and reliable procedure to treat high degree stenosis of internal carotid artery. (2) It is important to select the appropriate type of stent and the special method according to the individual situation.

Arterial bypass for subclavian arterial occlusion:results in 30 patients / 中国普通外科杂志

Objective To investigate the effect of arterial bypass for subclavian artery occlusive disease. MethodsIn this study, 30 patients with subclavian artery occlusive disease received arterial bypass from Jan 1994 to Jan 2004. Occlusive lesions were documented preoperatively by arteriography. Patency was determined during follow up by Duplex ultrasound. ResultAll 30 patients undergoing bypass procedure were with blood pressure differences of less than 10mmHg between the treated and the healthy arms. The ratio of healthy/diseased side of the mean blood pressure index increased from 0 66?0 11 preoperatively to 0 99?0 09 postoperatively( P

Bypass grafting for the treatment of critical lower limb ischemia with distal single outflow artery: an analysis of 39 cases / 中国普通外科杂志

Objective To evaluate a bypass surgery for the treatment of critical lower limb ischemia. MethodsFourty-five limbs in 39 patients with single outflow artery underwent arterial bypass graft, including femoropopliteal artificial graft to single outflow artery with autograft in 21 limbs (46.7%) and popliteal artery to calf vessel in 10 limbs (22.2%). Results Among 39 patients, one died of respiratory failure 5 days post-op (death rate 2.6%); one suffered from artificial graft occlusion (2.6%). The patency rate of graft was 100% on discharge. Healing rate of foot ulcer was 30%. Conclusions It is difficult to reconstruct blood flow for critical ischemic limb with single outflow artery, but good result is still expected by distal lower limb bypass graft. Distal bypass can result in a limb salvage or lowering of amputation level, providing a better nutritional support for the healing of foot ulcer.