Surgical management of aortic diseases / 中国普通外科杂志

Objective To explore the surgical management of aortic diseases. Methods The clinical data of 45 cases of aortic diseases were analysed retrospectively. Results There were 37 males and 8 females.The age ranged from 21 85 years with a mean age of 64.7 years, Among these cases, 11 were thoracic aortic dissection, 2 were ruptured descending aortic local dissection and formed an aneurysm;above and below the renal artery abdominal aortic aneurysms( AAAs) were 3 and 23 respectively; complicated with rupture of the AAA in 2, and with aortojejumal fistula in 1;the other 3 cases were traumatic aortal rupture. Among the 45 cases, 18 underwent endoluminal treatment, 25 underwent AAA resection and artificial vessel implantment, and 3 underwent repair of the ruptured aorta. The operative mortality was 6.67% ( 3/45 ). 36 patients were followed up for 2 months to 4 years, all the 36 patients still alive well. Conclusions In the management of appropriate aortic diseases, endoluminal technique is much simple,safe, less trauma, and less complications, it can also short the hospital stay of the patient . However, with improvement of the surgical skills,the surgical operation is still very important and effective, especially for the cases who can not be treated via endovascular technique.

Surgical management of arterial diseases / 中国普通外科杂志

Objective To explore the surgical management for arterial diseases. Methods The clinical data of 86 cases of arterial diseases were analysed retrospectively. These cases included:3 cases of thoracic aortic aneurysm,2 cases of descending aortic dissection with rupture and aneurysm formation,2 cases of abdominal aortic dissection with false aneurysm,1 case of abdominal aortic aneurysm(AAA)with duodenojejunal fistula and GI bleeding,5 cases of ruptured AAA with shock, 3 cases of traumatic rupture of abdominal aorta,21 cases of AAA combined with unilateral or bilateral iliac aneurysms,6 cases of iliac aneurysms,9 cases of popliteal aneurysms,21 cases of false aneurysm of iliac or popliteal artery,1 case of rupture of junction of subclavian and vertebral artery with false aneurysm,3 cases of rupture of subclavian artery with false aneurysm,2 cases of aneurysm of carotid artery and 7 cases of false aneurysm of carotid artery. Prosthetic vascular graft was performed in 71(cases),autologous vein graft in 3 cases and suture(repair) of arterial rupture in 12 cases.Results Operative (mortalty) was 3.5%(3/86)in this series.Seventy-one cases were followed-up for 1 month to 5 years, the results showed that all the patients were alive and well.Conclusions In the(management) of(appropriate) aortic diseases, the use of endoluminal technique is simple, microtraumtic, safe and has few complications. It also can shorten the hospital stay of the patient. Endovascular technique should be the first choice for patients with aortic diseases.

Endovascular technique for Stanford B type aortic dissection / 中国普通外科杂志

Objective To explore the effect of endovascular treatment on Stanford type B aortic dissection. Methods The clinical data of 12 cases of Stanford type B aortic dissection were analysed retrospectively. Results All the cases were male, the age ranged from 40-68 years with a mean of 52.1 years. Among the 12cases, 10 patients underwent endoluminal treatment, the instant technique was successfully performed in 10 patients. Endoleak happened in 1 case because of the stent-graft deployment, but automatically stopped 3 days later. In other 9 patients, Angiography after the operation showed that all the rupture areas were sealed completely, and the celiac arteries blood supply were recovered via the true lumen and no blood stream was shown in the false cavity. 2 patients received conservative treatment died, one died of failure of respiration and another died of rupture of the dissection. Conclusions In the treatment of Stanford B type aortic dissection, if the selection of the patient is correct, endoluminal technique is much simple, safe, less trauma, and less complications as compared to the traditional operation, and it can also shorten the hospital stay of the patient. Conservative treatment can not control the development of the diseases, and easily results in death of the patient.

Treatment of the abdominal aortic aneurysms / 中国普通外科杂志

Objective To explore the management of abdominal aortic aneurysms (AAAs) .Methods The clinical data of 26 patients with AAAs were reviewed retrospectively. Results In the 26 cases,dissection and true aneurysms were found in 3 and 21 respectively, 1 AAA ruptured followed by a false aneurysm formation,and 1 involved duodenojajunary curve to form an aorto intestinal fistul. The lesions involved the renal artery in 3, below renal artery in 23; AAA extended to both common iliac arteries in 12, to both common iliac arteries and one or both internal iliac artery in 5,to both or one common and ,lexternal.internal arteries in 2; Emergency operation was done on 3 patients, elective operation on 14, endoluminal treatment in 7 and conservative treatment in 2. Three cases developed mild postoperative complications. Operative mortality was 3.8% ( 1 case ). 22 patients were followed up for 3 month to 4 years, and living well. Conclusions Endolumianal treatment is the first choice for the AAAs patients . However, the traditional operation is still very important and effective for the patient who can not be treated by endoluminal treatment,especially with improvement of the surgical skills.

Surgical management of acute thoracoabdominal aortic diseases / 中国普通外科杂志

Objective To explore the surgical management for acute cases of aortic diseases. Methods The clinical data of 18 acute cases of thoracoabdominal aortic diseases were analysed retrospectively. Results This study included ruptured thoracoabdominal aortic dissection of 15 cases and open wound of the abdominal aorta of 3 cases. There were 15 males and 3 females, with mean age of 42.7 years. Eight patients were received open emergent operation, and the other 10 cases underwent endovascular procedure. The mortality was 11.1% (2/18). Follow-up from 2 months to 3 years revealed all patients in a good condition. Conclusions In cases of emergent aortic diseases, endoluminal technique is simple, mini-invasive and safe. However, open surgery is still mandatory and effective especially when endovascular procedure is not indicated or failed.