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Objective To investigate the feasibility and safety of laparoscopic aortobifemoral bypass (LABF) for diffuse aortoiliac occlusive diseases.Methods Clinical data of 18 cases who underwent LABF were retrospectively analyzed.The intraoperative procedures and postoperative outcome were evaluated.Results LABF was performed successfully in 17 of 18 patients.The mean operation time was (280 ±57) minutes,with a mean aortic cross-clamp time of (117 ±32) minutes.Estimated blood loss was(524 ±45) ml.Mean ICU stay was ( 1.0 ± 1.2) days.The mean postoperative hospital stay was ( 10 ±5) days.Mean time to resume diet was (3 ± 3 ) days.Postoperative myocardial infarction developed in 1 case,lung infection in 2 cases.There was no perioperative mortality.Graft thrombosis developed in 1 case and embolectomy surgery was successfully performed.All patients were followed up from 3 to 27 months,with mean follow-up of (18 ± 8) months,grafts were all patent.Conclusions Laparoscopic aortic bypass is feasible and miniinvasive in patients with diffuse aortoiliac occlusive disease.Short-term outcomes are comparable to those with open conventional aortic bypass.
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Superior mesenteric vein (SMV) thrombosis is a relatively rare disease. Most patients may be successfully treated with anti-coagulation alone. However, bowel stricture may develop due to intestinal ischemia which may require surgical treatment. This report describes a rare case of small bowel stricture occurring one month after successful treatment of SMV thrombosis. After segmental resection of strictured bowel, the patient's post-operative course was uneventful.
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Conventional aorto-iliac surgery has the disadvantages of major surgical trauma, more complications, long hospital stay and postoperative recovery. Although endovascular surgery is a minimally invasive surgical technology, but it is not suitable for all patients and long-term outcomes are still uncertain. Laparoscopic aorto-iliac surgery affords advantages of minimally invasive surgical techniques and certain long-term outcomes, it is now becoming a third way to treat patients with aorto-iliac diseases.
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Objective To observe the expression of Vascular endothelial growth factor 165 (VEGF165) in transplantation of MSCs to repair an ischemically damaged bind limb in a rabbit model.Methods MSCs were cultivated in vitro and transfected with non-replicative adenoviral vector with VEGF165 gene. Four weeks after treatment, Real-time PCR assessed the expression of VEGF165 in the damaged limb.Results It was confirmed that VEGF165 was successfully transfected into MSCs.Real-time PCR assessments revealed the expression of Vascular endothelial growth factor 165 (VEGF165) in 4 weeks after treatment. Conclusion VEGF165 can be transfected into MSCs and express in rabbit model of ischemic limb.
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<p><b>OBJECTIVE</b>To explore the management of cerebral ischemia caused by Takayasu's arteritis.</p><p><b>METHODS</b>Ninety-three cases treated from June 1984 to September 1999 at the General Post & Telecom Hospital, the Sir Run Run Shaw Hospital, the First Affiliated Hospital of Zhejiang University, the Second Medical College of Beijing University, Beijing An Zhen Hospital, and the Beijing Union Medical College Hospital, including 10 men and 83 women, were reviewed. Of the 93 cases, bypasses from the ascending aorta to the axillary or subclavian artery and from graft to the carotid artery were performed in 47 cases. Subclavian to carotid bypass was performed in six cases. Percutaneous transluminal angioplasty (PTA) was used in five cases and stenting in one.</p><p><b>RESULTS</b>Marked improvement was achieved in 30.3%, fair in 34.9%, improvement in 21.2%, unchanged in 4.6%, and death in 9.0% before discharge; 30.6%, 38.8%, 16.3%, 4.1%, and 2.0% respectively during a mean follow-up of 48 months, and recurrence requiring revision in 8.2%.</p><p><b>CONCLUSION</b>Patients with occlusive lesions of all four cervical arteries always have severe cerebral ischemia and their distal runoff is always unvisualised by angiography. However, we found by exploration that the internal carotid artery is patent in all but one patient. Therefore, an ascending aorta to carotid bypass is feasible in most instances, and this can and should be done when the cerebral perfusion is jeopardized at a time when the patient is in a stable or relatively stable condition. Unfortunately, the cerebral re-perfusion syndrome is still a serious and not completely solved problem.</p>