ABSTRACT
Objective To summarize the experiences of endovascular aortic repair (EVAR) for isolated iliac artery aneurysm (ⅡAA).Methods The clinical data of 23 patients with ⅡAA undergoing EVAR from Aug 2008 to Mar 2016 were retrospectively analyzed.There were 5 cases of internal iliac artey (internal iliac artery ⅡA) aneurysm,10 cases of unilateral common iliac artery(common iliac artery CIA) aneurysm,6 cases of bilateral CIA aneurysms.Unilateral ⅡA aneurysm was treated by coil embolization and covering the entrance;CIA aneurysm without involving ⅡA was treated by EVAR with covered stent,those involved unilateral ⅡAs or combined ⅡA aneurysms were treated by EVAR after ⅡA embolization.Those with bilateral ⅡA involvement were repaired by Sandwich technique;Bilateral ⅡA was treated in two phases.Results All endovascular procedures were successfully performed;No patients died during the perioperation period.Intraoperative endoleak found in 5 cases managed by balloon dilatation,or conservatively were cured.23 patients were followed-up for 2-60 months,one rebuilding ⅡA was occluded.One CIA anurysm complicated with endoleak was cured by coils embolization and stenting.Gluteal claudication and erectile dysfunction occured in 4 out of 15 cases with unilateral or bilateral ⅡAs occlusion.Conclusion EVAR is a safe and effective treatment for ⅡAA,after a proper management for ⅡA.
ABSTRACT
Objective To investigate the efficacy and the course of desensitization treatment in bronchial asthma with positive specific IgE to dust mite in children. Methods A total of 105 children with bronchial asthma with positive specific IgE to dermatophagoides farinae allergens were randomized into the observation group and the control group. Children in the control group were treated to continue anti-asthma according to the routine of prevention and treatment children with asthma. Chinldren in the observation group were treated by dermatophagoides farinae drops in addition to the treatment of children in the control group. The recurrence of asthma was compared between two groups at 25 weeks post-treatment. At 25 weeks post-treatment , children in the observation group was randomly divided into the observation groupⅠand group Ⅱ. Children in the observation groupⅠreceived continuous treatment except for desensitization treatment. Children in the observation group II received the sublingual immunotherapy with dermatophagoides farinae drops (No.4) for 1 year in addition to the treatment in the observation groupⅠ. The recurrence of asthma was also compared between the two sub-groups. Results The rate and times of recurrence of asthma were lower in the observation group than those in the control group(P 0.05). Conclusion The recurrent rate and frequency of asthma could be reduced by the sublingual immunotherapy with dermatophagoides farinae drops in children with asthma of positive specific IgE to dust mite. The course of treatment may be half year long.
ABSTRACT
Objective To evaluate the clinical effect of the endovascular treatment of iliac vein compression syndrome.Methods Thirty-three patients with iliac vein compression syndrome were treated with endovascular treatment.Of which,edema and varicose vein of the left lower extremity in 29 patients,complicated with acute deep vein thrombosis of left lower extremity in 3 patients,post deep venous thrombosis syndrome in 1 patient.Balloon dilatation and stent implantation were performed in all 33 patients.The diameter of balloon was 10-12 mm,diameter 12-14 mm Bard self expandable stent.Five patients with varicose vein and ulcer of left lower extremity were treated with two stage operation.Results The diagnosis was confirmed by left lower extremity deep veins angiography.There was no death patient,and no hematoma of hematoma locus.Follow-up for 3-30 months,the rate of follow-up was 100％(33/33).The edema of the lower extremity was markedly reduced or disappeared in 28 patients.Color Doppler ultrasound and left lower extremity angiography showed that the stent was unobstructed,no stent occlusion and new onset thrombosis cases.Conclusion Endovascular treatment is safe,effective with few complications,and is the first choice for the treatment of iliac vein compression syndrome.
ABSTRACT
Objective To review reoperation on blood vessel prosthesis occlusion after arterial bypass graft in lower limbs. Method The treatment effect of 21 patients with reoperation on blood vessel prothesis occlusion after arterial bypass graft in lower limbs was analyzed retrospectively. Results All the cases were followed up 6-36 (12 ±3) months. The limb salvage rate was 71.4%(15/21) ,the amputation rate was 28.6% (6/21). All 9 limbs that underwent revascularization from deep femoral artery reserved. Conclusions Endomembrane hyperplasy, occlusion of the inflow and outflow tracts are the major reasons for the occlusion of blood vessel prosthesis after arterial bypass graft in lower limbs. Appropriate procedures should be based on careful consideration of the occlusion reasons. Profundaplasty is an effective therapy for those who are treated by reoperation on blood vessel prosthesis occlusion in lower limbs.
ABSTRACT
Objective To summarize experiences in treatment of traumatic aortic rupture. Methods Between July 2001 and December 2008, 17 patients with acute traumatic aortic rupture were treated in our department. One patient died of hemorrhagic shock one hour after admission before opera-tion. Nine patients underwent thoracotomy under general anesthesia with double lumen endotracheal tube and normothermic femoral-femoral partial cardiopulmonary bypass, with bypass time for 35-139 minutes and aortic clamping time for 25-87 minutes. Successful operation was performed in seven patients inclu-ding one treated with simple repair and the other six with partial replacement of thoracic aorta with artifi-cial vascular graft. The other seven patients underwent endovascular repair and received stent grafts at the site of thoracic injury via right lilac-femoral artery under general or local anesthesia. Results One pa-tient free from operation was died of hemorrhagic shock. Of nine patients treated with thoracotomy, two patients died of hemorrhagic shock during operation and the other seven survived, with operation time ran-ging from 100 to 180 minutes. Seven survivors were followed-up for 2-6 years, with no death during fol-low-up period. Seven patients in endovascular repair group recovered, wiht operation time ranging from 50 to 70 minutes. All these seven patients were followed up for 3-14 months, which showed no death. Reex-amined CT in six patients showed no mediastinal hematoma or leakage of contrast medium from the aorta isthmus at 2-5 months after operation. Conclusions Endovascular repair is simple, safe and effective for traumatic aortic rupture. The selection of thoracotomy and endovascular repair is based on following conditions: the combined injuries of patients, the equipments of hospital and the skills of operators.