Objective To assess and compare the affects upon renal function after endovascular exclusion (EVE) or conventional surgery (CS) for infrarenal abdominal aortic aneurysms(IAAA). Methods The records of 157 consecutive patients with IAAA from 1997 to 2002 were retrospectively reviewed. There were a group of 115 patients undergoing EVE and a group of 42 patients undergoing CS. The postoperative changes of plasma Cr and BUN with EVE and CS were analyzed respectively and compared. Results The plasma Cr and BUN were significantly increased in the group of CS postoperatively, but no significant difference were shown before and after endovascular repair was discovered in the group of EVE. Moreover, there was a case with acute renal failure in CS group. Conclusion The affects upon renal function with EVE are much less than CS for IAAA patients.

Objective To assess the value and safety of stent placement in treating proximal endoleak after endovascular exclusion for abdominal aortic aneurysms.Methods Three patients with primary endoleak and one patient with secondary endoleak underwent implantation of stent. Stents were deployed below renal artery in 1 case and cross bilateral renal arteries in 3 cases. Results In all 4 patients, the stents were successfully implanted and the endoleaks were completely occluded. No complications such as renal function damage, stent shift or endoleak reappearance were observed. Conclusion Stent placement appears to be a feasible, effective and safe treatment option for endoleak after endovascular exclusion for abdominal aortic aneurysms.

Objective To assess the prophylactic measures of paraplegia and paralysis after endovascular graft exclusion(EVE) for Stanford B thoracic aortic dissections(TAD). Methods The records of 116 consecutive patients undergoing endovascular TAD repair from 1998 to 2001 were retrospectively reviewed. Steroids were administrated postoperatively in high risk patients likely to be candidates for paraplegia or paralysis. Results No paraplegia or paralysis occurred postoperatively in all cases, including the patient undengone selective spinal artery angiography (SSAA). Conclusions Transluminal repair can avoid spinal cord ischemia due to aortic cross-clamping, there is still a risk of spinal cord injury caused by occlusion of intercostal arteries under the cover of endograft. A combination of the prophylactic measures, including SSAA and steroids, have been able to reduce the risk of paraplegia and paralysis. A graft-stent of appropriate length is the key point fo this procedure.

Objective To evaluate popliteal artery local technique in superficial femoral artery antegrade subintimal recanalization.Methods From January 2009 to Dec 2011,550 limbs in 476 TASC (Trans-Atlantic Inter-Society Consensus) Ⅱ C/D cases underwent endo-therapy at our department.The success rate、operation time、symptom progress and follow up were analyzed retrospectively.Results In the 550 limbs,62 limbs received popliteal artery local technique directly.There was 9 technical failures.Procedures succeeded in 53 limbs(85.5％ ).The average operation time was (69 ±24) min,(1.8 ±0.6) stents were used and the main covered length was ( 33 ± 6) cm.Symptoms of 46 limbs was improved and unchanged in 6,amputation needed to be done in one limb.One year follow up accomplished for 39 limb.The 6 and 12 months patence rate was 87.1％ and 69.2％.For 488 limbs using traditional approach 378 achieved anti-grade recanalization,the average operation time was ( 89 ± 30) min,average (2.1 ± 0.6) stents were used and the main covered length is (31 ± 13) cm.Symptom in 300 limbs improved.The half and one year patence rate in 292 limbs was 92.1％ and 61.0％.Conclusions The popliteal artery local technique is as effective as with traditional approach and is time saving.

To study the effect of intraarterial bolus of recombinant human angiogenin (rhANG) on stimulating revascularization in a rabbit hindlimb ischemic model,the limb ischemic model was induced by ligation and excision of every branches of the femoral artery in 28 rabbits. On the 11th day after operation, various doses of rhANG (0,5,20 and 40 ? g) as a single bolus were administered intraarterialy via the catheters inserted into the bifurcation of the iliac artery. Revascularization and perfusion of the ischemic limb were compared in each animal postoperatively by using 99 Tc MAA perfusion scan, serial angiography and thigh muscle biopsy. Rabbits in the 20?g group and the 40?g group had significantly better revascularization and blood perfusion than the control group and the 5?g group.It is concluded that rhANG can promote blood purfusion, revascularization and recovery.

To assess the principles of diagnosis and management of Klippel Trenaunay Syndrome (KTS), ascending venography and PPG were used as the means of diagnosis for KTS. 18 cases received nonoperative therapy with elastic bandages or stockings, and 26 patients were operated on, including stripping of varicose vein, decompression of popliteal vein and segmental transplantation with valve to femoral or popliteal vein. The effective rate in the operative group was 73.1% (19/26),whereas the illness of 18 patients was stable with elastic support. Thirty one of 44 patients have been improved during 1～10 year follow up period . It is important that the indications and styles of operation must be carefully considered according to the clinical manifestations and venogram.

To assess the principles of perioperative management and prevention and treatment of postoperative complications of extracranial carotid artery aneurysm(ECAA),15 patients with ECAA received surgical treatment between 1988 and 2000.Among them,11 patients underwent aneurysmectomy with artery reconstruction,3 had resection of aneurysm and ligation of external carotid artery, and the other patient had aneurysmorrhaphy. No postoperative deaths or severe complications occurred except one patient with Horner's syndrome.Satisfactory results were achieved in 7 out of 8 patients within a 6 month to 7 year follow up period. The results showed that aneurysmectomy with artery reconstruction is a best operative procedure for extracranial carotid artery aneurysm. In order to prevent severe complications,such as brain ischemia and injury of cranial nerves, intensive perioperative management must be emphasized.

This paper is to summarize our experiences in the operation indication and management of perioperative complications in treatment of Stanford B aortic dissection by using endovascular graft exclusion (EVGE). 32 patients underwent the procedure of EVGE . Various sizes of tubular grafts were introduced over the entry tear of aorta via the femoral artery. The procedure was technically successful in all patients. No Severe complication occurred during the perioperative period except one death due to heart infarction. These preliminary results suggest that EVGE is safe and efficient for Stanford B aortic dissection. EVGE is a method of first choice for the patients with this disease.

Objective To investigated the distribution of intraluminal thrombus (ILT) in abdominal aortic aneurysms (AAAs), and to examine the influence of age, gender and aneurysm diameters on the ILT formation. Methods Morphological analysis of ILT in AAA of 103 consecutive patients was undertaken with helical CT angiography. ILT shape, distribution and thickness of ILT were recorded and analyzed in correlation with age, gender and aneurysm diameters. Results ILT were found in 66.9% of all the patients. ILT was always situated in the area away from the main axis of AAA. The incidence of ILT in female group (n=13) was much lower than that in male group (n=90) (15.5% vs 77.4%, P

Objective To observe the clinical effect of percutaneous transluminal angioplasty (PTA)combined with autologous peripheral blood stem cells(PBSC)transplantation in the treatment of lower extremity ischemic disorders.Methods Fourty-two cases of lower extremity ischemic disorders in the treatment group were treated with PTA and autologous peripheral blood stem cells injection and 40 cases in control group were treated with PTA exclusively.Results All the procedures were successful.In treatment group,ABI improved from 0.32 ±0.11 to(at the 3rd month)and 0.49 ±0.13(at the 6th month)(t=-6.765,-6.040,P＜0.05)while TcPO_2 improved from(26.1 ± 2.3)mm Hg to(32.7 ±4.2)mm Hg(at the 3rd month)and(34.5 ±2.7)mm Hg(at the 6th month)(t=-8.901,-14.250,P＜0.05).In control group,ABI improved from 0.30 ±0.12 to 0.47 ±0.15 and 0.47 ±0.130=-5.631,-5.873,P＜0.05)while TcPO_2 increased from(25.9 ±2.4)mm Hg to(28.9 ±2.9)mm Hg(at the 3rd month)and(28.9 ± 2.1)mm Hg(at the 6th month)(t=-5.090,-5.389,P＜0.05).There was significant difference in TcPO_2 on follow-up between the two groups after the treatment(P＜0.05).Conclusion Autologous PBSC transplantation in combination of PTA was effective for the treatment of lower extremity ischemic disorders.PBSC injection helps to increase TcPO_2.