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Objective:To investigate the clinical efficacy of thoracic endovascular aortic repair (TEVAR) in treating Stanford type B traumatic aortic dissection (TAD).Methods:A retrospective case series study was conducted to analyze the clinical date of 26 patients with Stanford type B TAD admitted to Nantong First People's Hospital from June 2011 to December 2019. There were 21 males and 5 females, aged 35-83 years [(56.2±12.9)years]. All patients mainly suffered from chest and back trauma and were treated with TEVAR. The operation time, intraoperative blood loss, intraoperative heparin dosage, duration of ICU stay and postoperative organ complications were collected. The changes of brain natriuretic peptide, urea nitrogen and creatinine were compared before operation and at one day after operation. The CT angiography (CTA) was performed to mainly detect the location of stent, reverse tearing, paraplegia and internal leakage at 6 months after TEVAR. The aortic CTA was used to measure the maximum diameter of aortic dissecting aneurysm and true lumen diameter of distal aorta before operation and at 6 months after operation, and the diameter changes were compared to determine the aortic remodeling after TEVAR.Results:All patients were followed up for 6-36 months [(25.9±6.3)months]. The operation time was 60-200 minutes [(96.7±30.7)minutes], the intraoperative blood loss was 20-45 ml [(31.1±6.8)ml], the dosage of heparin was 0-0.53 mg/kg [(0.4±0.1)mg/kg], the postoperative ICU stay was 1-7 days [(4.7±1.3)days]. Seven patients developed pulmonary infections after operation and showed significant improvement after closed thoracic drainage, airway management and anti-infection treatment. Two patients had abnormal renal function after operation and received medical therapy for improvement. There was no significant difference in brain natriuretic peptide, urea nitrogen and creatinine between before operation and one day after operation ( P>0.05). At 6 months after operation, the CTA showed that the stent position was satisfactory and there were no serious complications such as reverse tearing and paraplegia. Of one patient with type I endoleak, the tumor did not further expand and his condition was stable. At 6 months after operation, the diameter of dissecting aneurysm [(34.4±5.0)mm] was smaller than that before operation [(38.2±5.6)mm], the true lumen of distal stent [(26.8±4.6)mm] was larger than that before operation [(22.6±6.0)mm] ( P<0.05 or 0.01). Conclusion:For Stanford type B TAD, TEVAR has no significant effect on cardiac function and renal function, with no severe complications and good aortic remodeling.
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Objective:To evaluate the efficacy and safety in the treatment of the visceral artery aneurysms (VAAs) by Viabahn stent graft and the detachable coils combined with Onyx embolization.Methods:A retrospective study on clinical and follow up results of 46 patients in the treatment of visceral aneurysms (VAAs) from Jun 2012 to Jun 2018 was carried out.Result:In 18 patients of VAAs treated with Vabahn endovascular stent grafting, the aneurysm cavity was completely isolated after injection of contrast and the technical success rate was 100% (18/18). In 28 patients of VAAs treated with the detachable coils combined with Onyx embolization, the aneurysm cavities of 26 patients among the 28 cases were filled tightly. In 2 patients the aneurysm neck was still visible. The average follow-up period was (36.5±2.3) months by CTA. After treating VAAs with the Viabahn stent graft, the complete isolation rate and the patency of aneurysm bearing artery were respectively 100% (18/18) and 94.4% (17/18). When VAAs was treated with the detachable coils combined with Onyx embolization, the complete isolation rate and the patency of aneurysm bearing artery were respectively 85.7% (24/28) and 92.9% (26/28) (χ 2=3.915, P=0.048), the difference of the patency of aneurysm bearing artery between the two groups was no significant difference (χ 2=0.074, P=0.786). Conclusion:VAAs treated with Viabahn endovascular stent grafting or detachable coils combined with Onyx embolization are both safe and effective.
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Objective To evaluate the therapeutical effect of dopaminergic neurons induced by transplantation on Parkinson's disease (PD) rats. Methods Mesencephalic nerve stem cells (NSCs) were induced by striatal extracts to differentiate into tyroxine hydroxylase (TH) positive dopaminergic neurons. The differentiated cells were transplanted into the striatum of PD rats. The survived cells were detected by TH immunocytochemical staining. The therapeutical effect was observed using apomorphine induced rotation. Results Mesencephalic NSCs could be induced to differentiate into dopaminergic neurons which could survive in the host for long time after cell transplantation, and could improve the apomorphine induced rotation. Conclusion The induced mesencephalic NSCs have the obvious therapeutical effect on PD.