Objective To summarize the revascularization method of infective femoral false aneurysm caused by drug injection. Methods Between November 2003 and May 2009, 84 patients with infective femoral false aneurysm caused by drug injection were treated, and the cl inical data were analysed retrospectively. There were 67 males and 17 females with anaverage age of 34.6 years (range, 19-51 years). The average duration of drug injection was 2.7 years (range, 1-11 years). In 13 cases, the defect of femoral artery was 3-10 cm; defect ranged from 1.0 cm × 0.3 cm to 3.0 cm × 0.7 cm in the others. The surgical treatment included bypass using synthetic grafts in 5 cases, great saphenous veins transplantation in 29 cases, repair of femoral artery in 24 cases, and l igation of femoral artery in 26 cases. Results Two cases died of intraoperative pulmonary embol ism. Eight cases had postoperative wound infection, which was cured after changing dressings. Incisions healed by first intention in the other paitents. A total of 82 cases were followed up 12-36 months (mean, 17.3 months). In 56 patients undergoing artery reconstruction or repair, dorsal pedis artery pulse was significantly improved, and no distal osteofascial compartment syndrome occurred. In 26 patients undergoing femoral artery l igation, angiography at 1 week after operation showed abundant collateral circulation from ipsilateral internal il iac artery, superior gluteal artery or contralateral internal il iac artery. Three cases had postoperative intermittent claudication which was improved after symptomatic treatment. Conclusion Infective femoral false aneurysm caused by drug injection should be treated surgerically as early as possible, and effective treatments include debridement, drainage, defect repair or bypass with synthetic graft or great saphenous vein from homonymy external il iac artery to superficial femoral artery. Ligation of femoral artery is an option in patients with serious infection when revascularization is impossible.
ObjectiveTo evaluate the clinical features of the retroperitoneal paralangliomas. MethodClinical data of 34 patients with retroperitoneal paragangliomas who underwent surgery in our hospital between January 2005 and January 2015 were enrolled, all patients diagnosed by pathological examination. ResultsClinical manifestation: hypertension (n=4) and headache (n=1) were the main symptoms in all 5 patients with functional tumor. Abdominal distension (n=14) or abdominal pain (n=11) were the initial symptoms in patients with nonfunctional tumor, gastrointes-tinal obstruction was observed in 1 patient, the other 3 patients were diagnosed accidently among the 29 patients with nonfunctional tumors. Blood and urine catecholamines increased notly in 5 patients with functional tumor, increased mildly in 2 patients with nonfunctional tumor; and remained at a normal level in the other patients. All the 34 patients underwent surgery, 4 patients with nonfunctional tumors who suffered from vessel wrapped needed tumor resection combining with main vessel resection or reconstruction, 1 of the 4 patients presented with vascular wall invasion. Two patients presented with lymph-vascular invasion of patients didn't received vessel resection or reconstruction. The mean value of diameter of these tumors was (9.5±5.1) cm (3.5-18.5 cm). Twenty four tumors had complete capsule, the other 10 had partial capsule; 32 tumors were well differentiated, and other 2 patients had apparent strange nucleus. Among the 34 patients, G1 tumors were confirmed in 14 patients and G2 tumors were confirmed in 20 patients. All the 34 patients were followed up with a mean value of follow-up time of 52 months (1-105 months). During the follow-up period, 6 patients suffered from recurrence and 6 patients died. The 1-year and 5-year survival rates were 86.0% and 81.5%, respectively. ConclusionsRadical resection may be the only measure to cure retroperitoneal paragangliomas. Tumor combining with vascular resection or reconstruction provide a chance for patients with ‘unresectable tumors’.
ObjectiveTo discuss the risk factors of type Ⅱ endoleak after endovascular aneurysm repair(EVAR). MethodsThe clinical data of 197 cases of abdominal aortic aneurysm who underwent EVAR in our hospital from Jan. 2006 to Mar. 2011 were analyzed retrospectively, and risk factors of type Ⅱ endoleak were explored by logistic regression. ResultsOf the 197 cases, 18 cases suffered from type Ⅱ endoleak. Result of logistic regression showed that the risk of type Ⅱ endoleak increased per 1 of the increase of lumbar artery number(OR=1.822, P=0.010) and per 1 mm of the increase of lumbar artery diameter(OR=1.256, P=0.040). All of the cases were followed up for 1-36 months(median value of 16.8 months). Only 1 case was intervened by inferior mesenteric artery embolism for the growth rate larger than 5 mm during half a year, who was not found growth of diameter after the embolism. The type Ⅱ endoleaks of other 17 cases closed ultimately or keeping stable. ConclusionsType Ⅱ endoleak after EVAR is affected by the number and diameter of lumbar artery. Persistent type Ⅱ endoleak without enlargement of diameter of aneurysm sac needs to beclosely followed-up instead of re-intervention.
Objective To summarize the present research progress of venous thromboembolism in the elderly. Methods Reviewed the literatures in recent years about the epidemiology, risk factors, diagnosis, prevention, and prognosis of venous thromboembolism in the elderly. Results Venous thromboembolism was a more common cardiovascular system diseases for the elderly, the incidence was higher, but the elderly didn’t pay much attention on it. The clinical manifestations of venous thromboembolism in elderly were different from young people, and all kinds of inspection methods had advantages and disadvantages. It gave priority to anticoagulation therapy, but we should pay attention to the risk of bleeding. Conclusions High incidence of venous thromboembolism was observed in the elderly, and diagnostic measures for venous thromboembolism were various. In the process of treatment, classification, the pros and cons were especially needed to pay attention to, and its special researches were necessary.
ObjectiveTo summarize the current research progress on the relationship between thyroid cancer and venous thromboembolism.MethodsRetrieved the literatures about risk factors associated with thyroid cancer and venous thromboembolism both at home and abroad in recent years and reviewed the literatures.ResultsThe incidence of venous thromboembolism in patients with thyroid cancer was not high, and there were few factors related to risk factors, it might be related to the age of patient and the time of diagnosis of thyroid cancer. In addition, various types of therapeutic drugs for thyroid cancer might lead to the occurrence of venous thromboembolism.ConclusionsThe study of thyroid cancer and venous thromboembolism related factors and prethrombotic state occurrence are necessary to reduce the incidence of venous thromboembolism in thyroid cancer and improve prognosis.
ObjectiveTo explore the efficacy and safety of hybrid surgery in the treatment of thoracoabdominal aortic aneurysm (TAAA). MethodsTwenty patients who were diagnosed with TAAA (including chronic thoracoabdominal aortic dissection aneurysm) and underwent hybrid surgery in Vascular Surgery, West China Hospital, Sichuan University were enrolled between January 2015 and December 2022. All the patients underwent retrograde reconstruction for visceral arteries in the open surgery. Additionally, one-stage or two-stage endovascular aortic repair with covered stents was performed. The patients’ clinical baseline information was collected. Moreover, the patients received clinical follow-up and imaging examinations postoperatively, whose informationwas collected. ResultsOne patient developed paraplegia and acute renal failure 16 days postoperatively in the hospital, and subsequently died in the hospital due to septic shock. Another patient underwent exploratory laparotomy for hemostasis due to anastomotic bleeding in the hospital. The other patients did not experience serious complications perioperatively. Nineteen patients were discharged from the hospital with long-term follow-up ranging from 10 to 144 months (median time: 48 months), and all of them had a long-term survival. No patients were observed with paraplegia, myocardial infarction, stroke, or rupture of aneurysm. None of the patients received reintervention during the follow-up, except for one patient who underwent ultrasound-guided puncture and suctionin the aneurysmallumen. ConclusionHybrid surgery is an effective treatment for TAAA with favorable short- and long-term safety and efficacy.