Thoracic endovascular aortic repair (TEVAR) has been increasingly used in the treatment of Stanford type B dissection.The incidence of new entry after thoracic endovascular aortic repair has been gradually increased report including at the proximal end and at the distal end of the endograft.New entry is difficult to handle following thoracic endovascular aortic repair for aortic dissection,and associates with a high substantial mortality.It need pay more attention to prevention and treatment on new entry after thoracic endovascular aortic repair.We summary and analyze the possible causes,prevention and management of new entry after thoracic endovascular aortic repair for aortic dissection.This article review and conclusion the progress on stent graft induced new entry after thoracic endovascular aortic repair.

Isolated resection of bemangioma in the cau-date lobe is challenging due to the surgical anatomy of caudate lobe. The caudate lobe consists three portions: Spiegel's lobe, paracaval portion and caudate process. Most of the blood supply of caudate lobe is provided by the posterior segmental branches of the portal vein and left hepatic artery. The hepatic venous drainage encompasses a few sizable and several small branches that join the inferior vena cava. Selection of the ideal route for bepatectomy, adequate mobilization of the liver, preparatory placement of band for hepatic vascular occlusion are key factors during the operation.

Objective To evaluate the efficacy and safety of catheter-directed thrombolysis (CDT) combined with anticoagulant compared with traditional treatment (Anticoagulant alone A C) for deep venous thrombosis.Methods We searched Medline,Embase,Cochrane Central Register of Controlled Trials,PubMed,Chinese Biomedical Literature Data Base (CBM),Chinese Scientific Journal,Full-text Data Base (CSJD),and,added with hand searcing and other retrievals.The Cochrane Collaboration's RevMan 5.0.18 was used for Meta-analysis.Results Four randomized controlled trials were available and were included in the study.Meta-analysis showed that 6 months after treatment,iliofemoral vein patency rate of CDT group was higher than that of AC group (OR =5.13,95％ CI:2.01-13.14,P =0.0006);Major complications of CDT group compared to those of AC group were not statistically significant(OR =2.74,95％ CI:0.76-8.07,P =0.13),but the minor complications and total complications of CDT group were higher than those of AC group [(OR =7.86,95％ CI:3.10-19.90,P ＜0.0001)and(OR=5.42,95％CI:1.47-20.01,P=0.01)].Conclusions CDT is a positively effective way to treat early DVT.Application of CDT in patients without contraindications to its use can have good therapeuic effect.

Objective The objective of this article is to attempt to propose the endovascular repair principles of distal-end tear of Stanford type B aortic dissection.Methods The vascular surgery of xinjiang uygur autonomous region people's hospital received and cured 101 patients of Stanford B aortic dissection from January 2013 to January 2015.The patients are divided into two groups according different treatment principles:(1)There are 57 cases in sequential treatment group,performing endovascular repair of aortic tears from near to far,(if the tear at visceral artery is not treated then the distal-end tear is also not treated);(2) There are 44 cases in non-sequential treatment group,not performing endovascular repair of aortic tears from near to far (the tears involving visceral artery are not treated and the remaining distal-end tears are performed endovascular repair).After operation,carry out statistical analysis between two groups on the growth rate of aortic diameter of the coeliac axis,occurrence rate of main discomfort complaint,false lumen thrombosis rates.Results After operation,between the two groups,the growth rate of aortic diameter of the coeliac axis is obvious difference(P ＜ 0.05),that the sequential group is with a low rate;there are obvious differences on the occurrence rates of main discomfort complaint and false lumen thrombosis rates (P ＜ 0.05),that the sequential group is superior to the non-sequential group.Conclusions After a preliminary clinical study,we get a conclusion that when treating distal-end tears of Stanford type B aortic dissection,sequential treatment is better than non-sequential treatment.

Objective To assess the treatment of splenic artery aneurysms(SAA) and curative effect evaluation.Methods Twelve SAA patients treated in our hospital from January 2012 to May 2014 were clinical analyzed.The male in Twelve patients was 4 man and others were female.The vagus splenic artery aneurysms are originated from the superior mesenteric artery,tumors are single,from 1.5cm to 2.8cm in diameter,an average of 2.1cm.Twelve cases were performed surgery,4 patients underwent elective surgery,interventional embolization of the splenic aneurysm in 3 patient,The others were performed interventional embolization + superior mesenteric artery covered stents.Results Technical success was achieved in all twelve patients,2 patients had adverse effects such as abdominal pain,fever,etc.There revealed no aneurysm recurrence was found.Twelve patients were followed for 6-24 months,the follow-up by examinations with electronic computer X-ray tomography or color Doppler ultrasonic as well as angiography every 3 months.One patient died of severe abdominal bleeding 1 year later after the operation and the other eleven patients remained in good condition with no occurrence of re-canalization of the lesions.Conclusions For the vagus splenic aneurysm with suitable for anatornic conditions,cavity therapy is safe and effective,for the vagus splenic aneurysm involving hepatic artery,need to open surgery for vascular remodeling.

Objective To explore the misunderstanding and comprehension of hybrid operation for treating aortic dissection involving aortic arch.Methods From March 2009 to November 2013,13 patients received hybrid operation for aortic dissection involving aortic arch in the People's Hospital of Xinjiang Urgur Autonomous Region were enrolled,including male 11 and female 2,and aged 36 ～ 60 years old with a mean age (44 ± 6.8) years old.All patients were type-B aortic dissection.All of them were not suitable to be treated with endovascular exclusion monotherapy.The ascending aorta-brachiocephalic artery bypass and left carotid artery bypass was established with median sternotomy approach and neck incision in 13 patients,and 2 patients did left subclavian artery bypass additionally,then retrograde endovascular stent graft implantation was used.Computed tomography angiography (CTA) scanning at 3-month,9-month,1-year and every-year after operation showed no stent grafts translocation and bypass graft obstruction.Results The surgical operation and stent grafts implantation were completely successful.Angiography showed 1 case had end leakage and other cases no obvious displacement or end leakage of stent grafts in operation.Blood flow in true lumen of aortic dissection was recovered and all of bypass grafts were unobstructed.No death and severe complications occurred.All patients were followed-up with 3 to 56 months [(29.0 ± 10.2) months],and all patients resumed normal life.Enhanced CT scanning after operation showed 1 case had endoleak and other cases no endoleak,stent grafts translocation and bypass graft obstmction.No signs of brain and limb ischemia were observed.Conclusions To summarize misunderstanding and experience by continuous explore feature of hybrid operation for treating disease involving aortic arch,we developed a more reasonable surgical treatment options that can improve the success rate of complex aortic dissection surgery,and ultimately achieve better surgical results.

Objective To explore the distribution characteristics and clinical typing methods in distal crevasses of Stanford B aortic dissection.Methods Review of the cases in the People's Hospital of Xinjiang Urgur Autonomous Region from 2010 January to 2013 June were diagnosis of Stanford type B aortic dissection with computed tomographic angiography data,Observed its distal crevasses distribution and statistical its number,then summarizes the distribution characteristics of the distal crevasses and further put forward a method of clinical typing.Results Refer to 115 cases with Stanford type B aortic dissection computed tomographic angiography data,including 101 cases with distal crevasses (87.83％) and a total of 240 distal crevasses,an average of 2.37 per case.Conclusions The distal crevasses more often appear in the area involving visceral artery,combined with its different in distribution characteristics and processing methods,we put forward the classification method,namely:Type Ⅰ:the distal crevasses are located in the zone of the thoracic artery; Type Ⅱ:the distal crevasses are close to the visceral artery or involvement it; Type Ⅲ:the distal crevasses are lower than the renal artery,not involving the visceral artery; Type Ⅳ:the distal crevasses are located in the zone of the iliac artery.

Objective To study the effect of flee radical on kidney repedusion injury caused by infra-renal abdominal aorta occlusion in rat model and its possible mechanism. Methods Forty-two healthy Wis-ter rats were randondy divided into 6 groups as following ( n = 7) : the control group( sham group) ; simply isehemia 5 h without reperfusion( group I) ; 2 hours reperfusinn following ischemia 5 h ( I/R 2 h), 4 honrs reperfusion following isebemia 5 h ( I/R 4 h), 8 hours reperfusinn following ischemia 5 h( I/R 8 h) and 12 hours reperfusion following ischemia 5 h ( I/R 12 h). In each group the rats were killed to obtain samples of blood and kidney at the specified time points. The contents of BUN, Cr, MDA, SOD in blood and in renal homogenate were measured in each group. We observed the morphological changes of kidney and muscles of lower limb by light microscope. Results BUN level of serum in model group I, I/R 2 h, I/R 4 h, I/R 12 h were higher obvionsly than those of control group, which were maximal in I/R 4 h, then decreased. MDA level of plasma in model group I, I/R 2 h, I/R 4 h, I/R 8 h, I/R 12 h groups were higher obvionsly than those of control group, which were maximal in I/R4 h group, then decreased. SOD level of plasma in model I/R 4 h, I/R 8 h groups were lower obviously than those of control group; SOD level of renal homogenate in model group I, I/R 2 h, I/R 8 h, I/R 12 h groups were higher obviously than those of group I/R 4 h, which were minimal in I/R 4 h group, then increased. By light microscope: The injury degree of kidney and muscles of lower limb in ischemia group was slight, the injury degree of repedusion group was severer than ischemia group. Conclusion The kidney repedusion injury caused by infrarenal abdominal aorta occlusion in rat model might be concerned with the increase of lipid peroxidatian damage after ischemia-repedusion in-jury of lower limbs.

Objective To investigate the clinical efficacy and clinical value of catheter-directed thrombolysis for acute lower limb deep venous thrombosis by the posterior tibial vein.Methods Atotal of 46 patints with acute deep venous thrombosis in the department of vecular surgery of People's hospital of the xinjiang uygur autonomous region,under the protection of the inferior vena cava fillters,we treated by catheter directed thrombosisthrough the posterior tibial vein with urokinase continuous infusion.Results In the total gourp of 46 patients,39 patients effectively relieve the swelling,7 of which was ineffective,and 4 cases of patients ease the swelling after the expansion by the iliac vein balloon,3 patients accepted the iliac vein balloon dilation and stent placement,6 patients who were bleeding were treated with pressure dressing,andthere was no other complications.After the treatment,the venous patency score was low,and the patency rate was high and which have a statistical difference (P ＜ 0.05) before and after thrombolysis.Before and after thrombolytic therapy for lower limb swelling rate,there was statistically significant difference (P ＜ 0.05).Conclusions It is a safe and effective method to treat the deep venous thrombosis of lower limbs with catheter-directed thrombolysis by the protection of inferior vena cava filter.It can enhance the patency of the vein and shorten the swelling time.

Objective Study of interleukin-6 (IL-6),erythrocyte sedimen-tation rate (ESR),C-reactive protein (CRP) in diagnosis and treatment of abdominal aortic aneurysm.Methods Between June 2014 and May 2016,we detected of abdominal aortic aneurysm in 62 cases that were diagnosed and treated at Department of Vascular Surgery,People's Hospital of Xinjiang Uygur Autonomous Region including interleukin-6,erythrocyte sediinen-tation rate,and C-reactive protein.Results There was no significant difference between interleukin-6,erythrocyte sedimen-tation rate and C-reactive protein in the patients with and without complications.The correlation analysis results of interleukin-6,erythrocyte sedimen-tation and C-reactive protein were confirmed to have positive correlation respectively.Compared with non special types of rupture (48.0 ± 34.2) pg/ml,interleukin-6 was higher in special types of rupture (187.6 ± 110.4) pg/ml.Conclusions Preoperative detection of interleukin-6,erythrocyte sedimen-tation and C-reactive protein,combined with patient history and imaging examination were help for predict cause,choose better surgical approach and predict the prognosis in certain guiding significance.