Objective:To investigate surgical treatment of carotid artery diseases in neck tumor surgery. Methods:A retrospective analysis of the clinical data on carotid artery treatment was conducted in the five cases of neck tumor surgeries treated at Department of Surgical Oncology, the First Peoples Hospital of Lanzhou from March 2010 to May 2020. Surgical methods, including carotid artery resection and ligation, tumor-involved artery resection and vascular reconstruction, and tumor peeling and carotid rupture repairing were used, respectively. Results:Five cases were successfully operated on. One case of carotid artery ligation was followed by intermittent dizziness and decreased contra-lateral limb strength after the surgery. The remaining patients exhibited no neurological complications. A patient with cervical low-grade myofibroblastoma developed into lung metastases 8 months after the surgery. Another patient with cervical lymph node metastases in papillary thyroid cancer developed into lung metastases 24 months after the surgery. Conclusion:Currently, surgical methods for clinical treatment of diseased carotid arteries include carotid artery resection and ligation, simple tumor peeling, tumor invasion artery resection and vascular reconstruction, and interventional therapy. Each surgical method has its own advantages and disadvantages. Therefore, the choice of treatment depends on the patient's specific conditions, physician's clinical experience, and the equipment available.
Humans ; Retrospective Studies ; Carotid Arteries/pathology* ; Head and Neck Neoplasms/pathology* ; Thyroid Neoplasms/surgery* ; Lung Neoplasms/pathology*

An asymptomatic 71-year-old woman was admitted to the hospital due to aneurysm of visceral artery. CT angiography revealed that she possessed a hepatosplenic artery aneurysm with hepatosplenomesenteric trunk anomaly. The aneurysm was big with diameter about 28 mm, and is very adjacent to the superior mensenteric artery. The neck of the aneurysm is wide (the diameter of the neck was 5.5-6.0 mm) and short (length of the proximal landing zone was about 2.0 mm). The patient received endovascular reconstruction of the hepatosplenic artery and coil embolization of the aneurysm, and got satisfactory result.
Aged ; Aneurysm ; diagnostic imaging ; pathology ; surgery ; Arteries ; diagnostic imaging ; pathology ; surgery ; Computed Tomography Angiography ; Embolization, Therapeutic ; Endovascular Procedures ; Female ; Humans ; Treatment Outcome

OBJECTIVE: To analyze clinical features, surgical treatment and outcomes of neurilemmoma and carotid body tumors in bifurcation of carotid artery. METHODS: The clinical data of 17 patients with neurilemmomas and 76 patients with carotid body tumors at the bifurcation of carotid artery, who were surgically treated in Zhongshan Hospital of Fudan University from March 2012 to November 2016, were retrospectively analyzed. The clinicopathological characteristics, surgical procedures and outcomes were compared between two groups. RESULTS: No difference of preoperative clinical demographic data was found between two groups. Operation time of the neurilemmoma group was significantly shorter than that of the carotid body tumor group[(93.9±30.8) min vs. (159.3±52.9) min, <0.01]. The neurilemmoma group had lower volume of intra-operative blood loss[(110±96) mL vs. (356±239) mL, <0.01] and lower rate of external carotid artery resection (11.8% vs. 68.4%, <0.01) than the carotid body tumor group. In the neurilemmoma group, 17 tumors were completely resected and no malignant disease was found. In the carotid body tumor group, 76 patients underwent complete surgical resection for the tumor, of which 5 (6.6%) were malignant. Tumor size of the neurilemmoma group was larger than that of the carotid body tumor group[(4.5±1.4) cm vs. (3.1±1.0) cm, <0.01]. There was no significant difference in the incidence of peri-operative complications and length of hospital stay between two groups (>0.05). CONCLUSIONS The clinical manifestations of neurilemmoma and carotid body tumors at carotid artery bifurcation are similar. The carotid body tumor group has a longer operating time, larger intra-operative blood loss, higher external carotid resection rate and relative higher incidence of malignancy. More cautions should be given when carotid body tumors at carotid artery bifurcation are treated.
Carotid Arteries ; surgery ; Carotid Body Tumor ; pathology ; surgery ; Humans ; Neurilemmoma ; pathology ; surgery ; Retrospective Studies ; Treatment Outcome

In quadrupeds, the three-dimensional orientation of the heart with respect to the thorax is fundamentally different from that in humans. In this study, we assessed the best surgical approach to the tricuspid valve in sheep. Firstly, different surgical access sites to the tricuspid valve were tested in sheep cadavers, the anatomy was analyzed, and the optimal surgical approach to the tricuspid valve was determined. Secondly - along with cardiopulmonary bypass and cardioplegic arrest -the chosen approach was tested in six adult sheep in vivo. Anatomical analyses revealed that a left thoracotomy provided optimal access to the aorta and left heart. However, visualization of the right heart was significantly impaired. In contrast, a right thoracotomy provided good access to the right heart, but the ascending aorta was difficult to approach. Therefore, in the in vivo studies, arterial cannulation was performed through a carotid (n = 4) or femoral (n = 2) artery. In conclusion, a right-sided thoracotomy allows good visualization of all components of the tricuspid valve complex in sheep, but not of the ascending aorta. Consequently, peripheral vessels are preferred for arterial cannulation. This work may stimulate the investigation of pathomechanisms and/or novel treatment options for tricuspid valve pathologies.
Adult ; Aorta ; Arteries ; Cadaver ; Cardiopulmonary Bypass ; Catheterization ; Heart ; Humans ; Models, Animal ; Pathology ; Sheep* ; Thoracic Surgery ; Thoracotomy* ; Thorax ; Tricuspid Valve*

Objective: To investigate the feasibility of establishing a model of allograft penile transplantation in adult beagle dogs and explore the conditions for constructing a stable animal model of penis transplant. METHODS: Following the principles of similarity, repeatability, feasibility, applicability, and controllability in the construction of experimental animal models, we compared the major anatomic features of the penis of 20 adult beagle dogs with those of 10 adult men. Using microsurgical techniques, we performed cross-transplantation of the penis in the 20 (10 pairs) beagle dogs and observed the survival rate of the transplanted penises by FK506+MMF+MP immune induction. We compared the relevant indexes with those of the 10 cases of microsurgical replantation of the amputated penis. RESULTS: High similarities but no statistically significant differences were observed in penile anatomic features between the 20 beagle dogs and 10 men. All the 10 cases of cross-transplantation of the penis were successfully completed in the 20 beagle dogs, of which the transplanted glans survived with normal micturition in 12 but developed necrosis in the other 8; the success rate of one-time venous anastomosis was 95.0% (38/40) and that of one-time arterial anastomosis was 87.5% (35/40), with an average vascular anastomosis time of (71.0±9.0) minutes, a mean operation time of (133.0±10.3) minutes, and a mean blood loss of (135.8±41.4) ml. In the 10 cases of penile replantation, the success rate of one-time venous anastomosis was 100% (20/20) and that of one-time arterial anastomosis was 90.0% (18/20), with an average vascular anastomosis time of (65.0±7.9) minutes, a mean operation time of (117.4±10.0) minutes, and a mean blood loss of (85.0±10.8) ml. In the 12 cases of replantation of the amputated penis, the success rate of one-time venous anastomosis was 100% (24/24) and that of one-time arterial anastomosis was 95.8% (23/24), with an average vascular anastomosis time of (79.0±17.6) minutes, a mean operation time of (125.0±20.6) minutes, and a mean blood loss of (140.0±44.3) ml. No statistically significant differences were found in the relevant indexes among the three groups. CONCLUSIONS The anatomic structure of the corpus cavernosum penis of beagle dogs is highly similar to that of men, almost the same in cross-section anatomy. Microsurgical replantation and allograft transplantation of the penis were both successfully performed in beagle dogs, which showed similar operative indexes to those of human penile replantation. The construction of the allograft penile transplantation model in adult beagle dogs is feasible clinically, with the advantages of operability and repeatability.
Adult ; Anastomosis, Surgical ; Animals ; Arteries ; surgery ; Dogs ; Feasibility Studies ; Graft Survival ; Humans ; Male ; Microsurgery ; Models, Animal ; Necrosis ; etiology ; Operative Time ; Penis ; anatomy & histology ; pathology ; transplantation ; Postoperative Complications ; etiology ; Replantation ; Survival Rate ; Urination ; Veins ; surgery

OBJECTIVE: We aimed to evaluate the efficacy and safety of a newly developed, partially retrievable flow-diverter (the FloWise) in an elastase-induced rabbit aneurysm model. MATERIALS AND METHODS: We developed a partially retrievable flow diverter composed of 48 strands of Nitinol and platinum wire. The FloWise is compatible with any microcatheter of 0.027-inch inner diameter, and is retrievable up to 70% deployment. The efficacy and safety of the FloWise were evaluated in the elastase-induced rabbit aneurysm model. The rate of technical success (full coverage of aneurysm neck) and assessment of aneurysm occlusion and stent patency was conducted by angiograms and histologic examinations at the 1-month, 3-month, and 6-month follow-up. The patency of small arterial branches (intercostal or lumbar arteries) covered by the FloWise were also assessed in the 5 subjects. RESULTS: We attempted FloWise insertion in a total of 32 aneurysm models. FloWise placement was successful in 31 subjects (96.9%). Two stents (6.2%) were occluded at the 3-month follow-up, but there was no evidence of in-stent stenosis in other subjects. All stented aneurysms showed progressive occlusion: grade I (complete aneurysm occlusion) in 44.4% and grade II (aneurysm occlusion > 90%) in 55.6% at 1 month; grade I in 90% and II in 10% at 3 months; and grade I in 90% and II in 10% at 6 months. All small arterial branches covered by the FloWise remained patent. CONCLUSION: A newly developed, partially retrievable flow-diverter seems to be a safe and effective tool of aneurysm occlusion, as evaluated in the rabbit aneurysm model.
Alloys ; Aneurysm/*chemically induced/radiography/*surgery ; Angiography ; Animals ; Arteries/pathology/surgery ; Catheters ; Cerebrovascular Circulation/physiology ; Constriction, Pathologic/chemically induced/radiography/surgery ; *Disease Models, Animal ; Humans ; Male ; Pancreatic Elastase/*pharmacology ; Platinum ; *Rabbits ; Stents/*adverse effects

The histopathological features of the middle cerebral artery (MCA) and superficial temporal artery (STA) from moyamoya disease (MMD) and their relationships with gender, age, angiography stage were explored. The causes and the clinical significance of vasculopathy of STA were also discussed. The clinical data and specimens of MCA and STA from 30 MMD patients were collected. Twelve samples of MCA and STA from non-MMD patients served as control group. Histopathological examination was then performed by measuring the thickness of intima and media, and statistical analysis was conducted. The MCA and STA specimens from MMD group had apparently thicker intima and thinner media than those from the control group. There was no significant pathological difference between the hemorrhage group and non-hemorrhage group, and between the males and females in MMD patients. Neither the age nor the digital subtraction angiography (DSA) stage was correlated with the thickness of intima in MCA and STA. MMD is a systemic vascular disease involving both intracranial and extracranial vessels. Preoperative external carotid arteriography, especially super-selective arteriography of the STA, benefits the selection of donor vessel.
Adult ; Angiography ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery ; diagnostic imaging ; pathology ; Moyamoya Disease ; diagnostic imaging ; pathology ; surgery ; Temporal Arteries ; diagnostic imaging ; pathology ; Tunica Intima ; diagnostic imaging ; pathology

Symptomatic vertebral artery (VA) stenosis associated with bilateral carotid rete mirabile (CRM) has not been reported. We report the long-term clinical and angiographic outcome after stenting for symptomatic VA stenosis in the patient with bilateral CRM. This report is the first case that symptomatic VA stenosis associated with bilateral CRM was treated with stenting.
Adult ; Angioplasty, Balloon ; Carotid Arteries/pathology/*radiography/*surgery ; Cerebral Angiography ; Female ; Humans ; *Stents ; Syncope/etiology ; Treatment Outcome ; Vertebrobasilar Insufficiency/*radiography/*surgery ; Young Adult

OBJECTIVETo investigate the clinical effect of anastomosis of superficial veins for improving the drainage of perforator propeller flaps.

METHODSFrom Sept. 2011 to Dec. 2012, 11 cases with soft tissue defects and chronic ulcer wound at extremities were treated with adjacent perforator propeller flaps, which were pedicled by the peroneal artery(5 cases), or the lateral supramalleolar artery(3 cases), or the ulnar artery (2 cases), or the posterior interrosseous artery (1 case). The wound size ranged from from 3.0 cm x 2. 5 cm to 11. 0 cm x 4. 0 cm, and the falps size ranged from 6 cm x 3 cm to 21 em x 5 cm. One superficial vein in all the flaps was anastomosed with superficial vein in the recipient area. The blood supply of the flaps were recorded after operation 1 - 3 months after operation, the fluency of anastomosed vein was detected by color Doppler ultrasound. Flap swelling evaluations were performed in early 3 months and later 3 - 6 months, and the results were classified into 4 grading degrees. 6 months later, Questionnaire of the flap aesthetic satisfactory was performed for seven patients during follow-up period.

RESULTS9 flaps survived completely, two flaps had partial marginal skin necrosis in the distal end, which were both managed with surgical debridement, and both wounds healed in two months. 9 cases were followed up for more than 12 - 19 months. The early rsults of flap swelling evaluations were: I degree 0 case, II degree 8 cases, III degree 3 cases, IV degree 0 case, and the later results were: I degree 7 cases, II degree 4 cases, III degree 0 case, IV degree 0 case. The flaps had ideal appearance, good contour, and high aesthetic satisfactory (100%). The mean flap survival area rate of veins anastomosed was (98. 6 ± 9. 7) %.

CONCLUSIONSPerforator propeller flaps with anastomosis of superficial veins can improve the flap venous drainage, avoid transient venous venous congestion, so as to increase the flap survival. It is an effective way for improving the vein drainage.

Anastomosis, Surgical ; methods ; Debridement ; Extremities ; blood supply ; Graft Survival ; Humans ; Leg Ulcer ; pathology ; surgery ; Perforator Flap ; transplantation ; Regional Blood Flow ; Tibial Arteries ; Ulnar Artery ; Ultrasonography, Doppler, Color ; Veins ; surgery

Endovascular repair has gradually become the mainstream treatment of aortic dilatation disease. However, endovascular therapy requires sufficient landing zone both in the proximal and distal region of aortic lesion. A large proportion of aortic dilatation lesion was excluded from traditional endovascular therapy due to the visceral artery involvement or being too close to the orifice of viceral artery. Recently, with the adoption of chimney technique, sandwich technique and hybrid technique and the advent of fenestrated and branched stent graft expand the application of endovascular repair technology, rendering these specific type of aortic disease gradually got the chance to endovascular surgery. Different technology has its own characteristics and scope. The surgeons should make their own judgment and selection based on the specific characteristics of lesions, their experience and accessibility to special equipment and other related factors.
Aorta ; pathology ; Aortic Diseases ; surgery ; Aortography ; Arteries ; surgery ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; Endovascular Procedures ; Humans ; Stents ; Tomography, X-Ray Computed ; Treatment Outcome