Objective:To study the application effect of carotid-subclavian artery blood vessel prosthesis bypass grafting in the reconstruction of cerebral blood supply.Methods:The clinical data of 14 patients undergoing carotid-subclavian artery blood vessel prosthesis bypass grafting to reconstruct cerebral blood supply in the Department of Vascular Surgery, Beijing Tiantan Hospital, Capital Medical University from March 2019 to March 2022 was retrospective collected. And the surgical indications, clinical effect and complications were analyzed.Results:There were 12 males and 2 females, aged from 47 to 74 years, with an average age of 60.5 years. Of 14 patients, 2 patients suffered from common carotid artery stenosis with posterior dilatation, 12 patients suffered from subclavian artery occlusion with vertebral artery steal. All the procedures were successfully performed without intraoperative cerebral infarction, cardiovascular accident, lymphatic leakage or artificial vascular infection. Phrenic nerve injury occurred in 1 patient after operation. During the follow-up of 3-27 months, average 14 months, there were no artificial vascular stenosis, anastomotic stenosis, vertebral artery steal, new cerebral infarction, upper limb ischemia or cerebral ischemia.Conclusion:Carotid-subclavian artery blood vessel prosthesis bypass grafting can be used in reconstructing the blood supply of both the anterior circulation, and the posterior circulation safely and effectively.

Objective To evaluate the effect of surgical treatment on extracranial supra-aortic aneu-rysms and summarize the experience.Methods The clinical data of 10 patients undergoing surgical treatment of extracranial supra-aortic aneurysms from May 2019 to November 2023 in the Department of Vascular Surgery of Beijing Tiantan Hospital affiliated to Capital Medical University were collected.The 10 patients included 5 pa-tients with internal carotid artery aneurysm,2 patients with subclavian artery aneurysm,2 patients with vertebral artery aneurysm,and 1 patient with internal carotid artery aneurysm combined with ipsilateral subclavian artery aneurysm.The surgical indications,surgical regimens,clinical efficacy,and complications were retrospectively analyzed.Results All the 10 patients underwent surgery successfully,with the surgery duration range of 60-420 min and the median surgery duration of 180.0(121.5,307.5)min.Intraoperative bleeding volume varied with-in 30-400 mL,with a median of 90(50,125)mL.The time of carotid artery blocking and vertebral artery bloc-king varied within the ranges of 10-20 min and 20-30 min,with the medians of 15.0(11.5,16.3)min and 25.0(15.0,22.5)min,respectively.No cardiac accident,cerebral infarction,or cerebral hemorrhage oc-curred during the perioperative period.The 10 patients were followed up for 3-58 months,with the median follow-up time of 8.5(5.3,17.0)months.One patient with subclavian artery aneurysm developed artificial vessel oc-clusion 20 months after surgery.One patient with internal carotid artery aneurysm developed distal carotid artery stenosis 6 months after surgery.Conclusion Surgical treatment should be actively adopted for extracranial supra-aortic aneurysms,and individualized surgical regimens should be designed according to patient conditions.

Objective To assess the effect of statin therapy on serum inflammatory cytokines in patients with abdominal aortic aneurysm (AAA).Methods The clinical data of 126 AAA patients who were hospitalized in the Department of Vascular Surgery,Peking Union Medical College Hospital,from September 2014 to September 2017 were retrospectively analyzed.Patients were divided into treatment group and control group according to whether statins were used or not.The levels of serum lipids and serum inflammatory factors were compared between these two groups.Results There was no significant difference in gender,age,body height,body weight,smoking ratio,and AAA diameter between these two groups (all P ＞ 0.05).While the levels of total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were not significantly different before treatment (all P ＞ 0.05),the treatment group had significantly lower TC (t =2.868,P =0.009),TG (t =3.472,P =0.006),and LDL-C (t =3.924,P =0.005) and significantly higher HDL-C level (t =3.322,P =0.007) after treatment.In addition,the concentrations of interleukin (IL)-1β,IL-6,high-sensitivity C-reactive protein (hs-CRP),and tumor necrosis factor-α (TNF-α) were not significantly different between these two groups before treatment (all P ＞0.05);after treatment,the serum levels of IL-1β and IL-6 in the treatment group were (224.32 ± 78.54) and (116.49 ± 19.64) ng/L,respectively,which were lower than those in the control group [(254.68 ±96.77)ng/L (t=1.765,P=0.058) and (126.71 ±23.59) ng/L (t=1.692,P=0.063)],although the differences were not statistically significant.The serum levels of hs-CRP and TNF-α in the treatment group were (6.46 ± 1.24) mg/L and (0.77 ± 0.21) μg/L,respectively,which were significantly lower than those in the control group [(10.93 ± 4.18) mg/L (t =2.007,P =0.012) and (1.28 ± 0.49) μg/L (t =2.144,P =0.016)].Conclusion Statin treatment reduces the levels of hs-CRP and TNF-α in AAA patients.