Objective To evaluate the feasibility of endovascular repair for retrograde type A aortic dissection.Method 35 patients of retrograde type A aortic dissection admitted to Peking University People's Hospital from December 2001 to March 2014 were treated with endovascular repair.There were 33 males and 2 females with mean age of 46 ± 9 years.29 were on acute stage,2 on subacute stage and 4 on chronic stage.The entry tear was in the descending thoracic aorta in 32 cases,between the left subclavian artery and the left common carotid artery in one,and between the left common carotid artery and the innominate artery in two.Results Entry closure was achieved in all patients with a covered stent.2 patients died in 30 days postoperatively (5.7％).1 patient with two chimney developed acute renal artery embolized which was infused by false lumin (2.9％).One patient developed transient paraparesis after graft deployment(2.9％).During the follow-up period,the aortic remodeling is perfect,no entry tear was noted in the ascending thoracic aorta.All the endografts for preserving supra-aortic branches were patent.Conclusions The endovascular repair for retrograde type A aortic dissection is feasible and effective.

Objective To evaluate the value of using ultraharmonic contrast imaging(UHCI) and acoustic densitometry(AD) technique to quantify cortex blood perfusion of acute rejection in renal allograft.Methods The canine models with acute renal allograft rejection were established. The examinations of renal allograft were performed by intravenous contrast ultrasound and AD technique on the days 1,3,5,7,9,11 after transplantation,some parameters related to perfusion such as peak intensity(PI),the area under the curve(AUC),the half time of descending(HT) and the mean transit time(MTT) of renal cortex were measured,and the graft biopsies were done simultaneously.Results The cortex of renal allograft with acute rejection showed nonenhancing defects after contrast agent injection. From 5 to 11 days after transplantation,the PI,AUC,HT,MTT of renal cortex were increasingly decreased,and the 50% wash-out slope was increasingly increased; furthermore,there were significant differences between those of the first day of post-operation(P

Objective:In view of the immunological and clinical manifestation of SIgAD.Methods:Single radial immunodiffusion technique was emploied to determine serum IgG?IgA?IgM and the enzyme linked immunosorbent assay(ELISA) had been used to measure serum IgE;anti unclear antibodies(ANA) were test with indirect immunofluorescence technique,cellular immunity was test with lymphocyte translation assay.Results:Tweenty eight patients with selective IgA deficiency were seen during the last tween years(IgA

Objective To investigate the clinical features of spontaneous isolated superior mesenteric artery dissection (SISMAD), and to discuss its interventional therapy. Methods The clinical data of 10 patients with SISMAD, who were admitted to authors' hospital to receive interventional treatment during the period from January 2006 to June 2014, were retrospectively analyzed. All the 10 patients were males, aged 44-66 years with a mean of (53±8) years. Clinically, all patients presented with acute-onset abdominal pain or pain around umbilicus, as the effect of conservative treatment was poor, implantation of self-expandable bare stent was carried out. Results Successful implantation of self-expandable bare stent was accomplished in all 10 patients;only one stent was used in 7 patients and 2 stents were used in 3 patients. The blood in the true lumen of superior mesenteric artery (SMA) restored and the residual stenosis extent was less than 15%. The technical success rate was 100%. The abdominal pain was relieved in 8 patients on the operative day after treatment, and in 2 patients the abdominal pain was relieved in 2 days after treatment. All the patients were followed up for 7-71 months (mean of 36 months) and the follow-up rate was 100%. After the treatment patients had no symptoms of abdominal discomfort. Contrast-enhanced CT scan performed at 6, 12 and 24 months after the treatment showed that SMA and stent was patent and no aneurysmal dilatation was observed. Conclusion For the treatment of SISMAD endovascular implantation of self-expandable bare stent is clinically safe and feasible, and its long-term effect is satisfactory.

SUMMARY An involved internal iliac artery is usually embolized when performing endovascular aneu -rysm repair for aortoiliac or isolated iliac artery aneurysm .This can lead to complications such as buttock claudication ,colon ischaemia and erectile dysfunction .Iliac branch device ( IBD ) is an endograft de-signed specifically for iliac bifurcation to preserve internal iliac flow .It was performed with high technical success rates and encouraging mid-term patency .Here we report a case of right iliac aneurysm developed 3 years after endovascular aneurysm repair for an aortoiliac aneurysm , with the patient ’ s left internal ar-tery been sacrificed then .Using a handmade IBD , we excluded the aneurysm without occlusion of the ip-silateral internal iliac artery or any type of endoleak .Both the design and deployment of this IBD are dis-tinctive that we would like to share our experience with all the colleagues .

Objective To present our initial experience with modified branched stent gratis in endovacular repair of common iliac artery aneurysms.Methods In 5 patients,3 were aortobiiliac aneurysms and 2 were single common iliac aneurysms,receiving endovascular repair by a novel modified branched stent graft to keep at least one internal iliac artery patency.Results All cases were successfully completed with patent external and internal iliac artery on the target side.There were no inhospital mortality nor major complications after graft stenting.During a follow-up period of 27.6 months (21 to 33 months),there have been no stenting related endoleak and branch occlusion.Conclusions Modified branched stent graft is safe and efficient,providing an effective way to protect internal iliac artery in endovascular treatment of common iliac aneurysms.

Objective:To report a rare type of aortic arch aneurysm. Methods: Three cases of aortic arch aneurysm derived from the fourth aortic arch were retrospectively analyzed. The pathogenesis and treatment of this type of aortic arch aneurysm were investigated. Results:Most of the aneurysm body was located in the Z2 zone, which was the stem from the fourth aortic arch in the embryonic development period. All of the 3 cases could not be explained by common etiology. We speculated that the cause might be developmental anomaly of the fourth aortic arch. All the 3 aortic arch aneurysms were totally ex-cluded with a covered stent. The technical success rate was 100%. Endoleak of typeⅠwas seen in one case, which was resolved in a later open surgery. During the follow-up, no type of complications was found. Conclusion:To the best of our knowledge, this is the first report of this type of aortic arch aneurysm. The cause may be developmental anomaly of the fourth aortic arch. Endovascular treatment of this type of aortic arch aneurysm is feasible.

Objective To evaluate iliac artery rupture during endovascular treatment of aorto-iliac disease and treatment with covered stent.Methods From November 2008 to August 2014,iliac artery rupture happened in 8 patients of 225 patients of aorto-iliac artery disease admitted to our hospital.Clinical data of the 8 patients were analyzed retrospectively.Four were of intraoperative rupture and four were of delayed rupture.The aorto-iliac diease of all the 8 patients were TSAC D.Direct placement of a covered stent was performed in all the cases,except for one patient who refused further treatment.Results All of the procedures finally achieved technical success and all patients become hemodynamically stable.One patient was complicated with heart failure who died of multiple organ dysfunction syndrome.Another one died of aspiration.5 patients were followed up from 9-52 moths,average 9-52 moths without recurrence.Conclusions Iliac artery rupture is a serious and life-threatening complication in the endovascular treatment of aorto-iliac disease.Covered stent provided a safe and effective treatment for iliac perforations.

To investigate the effectiveness of retrograde puncture of popliteal artery in lower extremity arteriosclerosis obliterans ( ASO ) patients classified as TASC ( Tans-Atlantic Inter-Society Consensus) C/D.Retrospective analysis of 35 lower extremity ASO patients, 28 male and 7 female , the mean age was 72 ±8, 23 cases of Rutherford 3, 8 cases of Rutherford 4 and 4 cases of Rutherford 5. Preoperative ABI was 0.35 ±0.14, Lesion length in CT angiography ( CTA ) was ( 18 ±5 ) cm.The technique success rate of 35 cases was 100%.The puncture time was (6 ±4) min.6 cases used 4 F sheath and 29 cases used no sheath technology at the puncture site.In 27 cases guide wires passed retrograde through the occluded superficial femoral artery lesion and returned to the true lumen.8 cases of SAFARI technology to established the guild wire track.The complication rate of retrograde puncture was 14.2%( 5/35), 2 cases of postoperative hematoma appeared at the puncture site the next day, 2 cases of pseudoaneurysms emerged and 1 case of postoperative arteriovenous fistula at the puncture site of popliteal area were found by Doppler ultrasonography before discharged.All 5 patients were recovered by conservative treatment.The retrograde puncture of popliteal artery is a safe and reliable method.

Objective:To study the use of radioactive I-125 seed implantation in the treatment of transarterial chemoembolization (TACE)-refractory hepatocellular carcinoma (HCC).Methods:A retrospective study was conducted on 70 patients with HCC who were initially treated with TACE between July 1, 2016 and August 31, 2019 at the Second Affiliated Hospital of Guangzhou Medical University. After these patients were found to be refractory to TACE, 29 patients were converted to radioactive I-125 seed implantation (the 125I seed group), and 41 patients were continued with TACE (the TACE group). The objective response rate, progression-free survival (PFS), overall survival (OS), total overall survival (TOS) of the two groups were compared. Results:There were 59 males and 11 females, aged (60.5±11.9 ) years in this study. At 1, 3, 6 months after treatment, the objective response rates of the 125I seed group were 20.7%, 40.7%, 34.6%, respectively, which were significantly higher than that of the TACE group of 2.6%, 3.3%, 5.0%, respectively. The PFS, OS, TOS in the 125I seed group were 7.6, 21.1, 32.1 months, respectively, which were significantly better when compared with the TACE group (3.5, 8.5, 14.8 months, respectively, all P<0.05). There was no significant difference in the embolization syndrome between the two groups [93.1%(27/29) vs 100.0%(41/41), P>0.05]. Child-Pugh B grading ( HR=0.311, 95% CI: 0.160-0.603, P=0.005) and TACE ( HR=0.308, 95% CI: 0.159-0.597, P=0.002) were independent risk prognostic factors for survival. Conclusion:This study showed better treatment efficacy and safety using radioactive I-125 seed implantation in TACE-refractory HCC and this treatment significantly improved survival of patients when compared with TACE alone.