ObjectiveTo analyze the main points and advantages of covered endovascular reconstruction of aortic bifurcation (CERAB) technique in the treatment of complex aortic and iliac artery lesions. MethodThe data of the patient with bilateral common iliac artery stenosis and lower abdominal aortic calcification treated by CERAB technology in the Department of Vascular Surgery of West China Hospital of Sichuan University and the technology in combination with the characteristics of balloon-expandable covered stent were analyzed. ResultsThe lesions were successfully treated by CERAB technique. The stents of bilateral iliac arteries were in perfect shape and good adherence. The radiography of the abdominal aorta and bilateral internal and external iliac arteries were well displayed. ConclusionsFrom analysis results of this case, CERAB technology is effective and feasible in treatment of lesions at the bifurcation of the main aortic and iliac artery. The shape of aortic bifurcation is satisfactorily recovered. The key point for the successful implementation of this technology is balloon-expandable covered stent.
Main iliac artery disease is a common lesion that leads to arteriosclerosis and occlusion of the lower limbs. Effective treatment of complex main iliac artery disease has always been a difficult problem. The author’s team successfully treated a patient with long segment iliac artery occlusive disease from the left common iliac artery to the opening of the left femoral artery (118 mm) with Gore viabahn VBX balloon dilated intravascular covered stent and viabahn covered stent, and be reported.
ObjectiveTo explore the efficacy and safety of hybrid surgery in the treatment of thoracoabdominal aortic aneurysm (TAAA). MethodsTwenty patients who were diagnosed with TAAA (including chronic thoracoabdominal aortic dissection aneurysm) and underwent hybrid surgery in Vascular Surgery, West China Hospital, Sichuan University were enrolled between January 2015 and December 2022. All the patients underwent retrograde reconstruction for visceral arteries in the open surgery. Additionally, one-stage or two-stage endovascular aortic repair with covered stents was performed. The patients’ clinical baseline information was collected. Moreover, the patients received clinical follow-up and imaging examinations postoperatively, whose informationwas collected. ResultsOne patient developed paraplegia and acute renal failure 16 days postoperatively in the hospital, and subsequently died in the hospital due to septic shock. Another patient underwent exploratory laparotomy for hemostasis due to anastomotic bleeding in the hospital. The other patients did not experience serious complications perioperatively. Nineteen patients were discharged from the hospital with long-term follow-up ranging from 10 to 144 months (median time: 48 months), and all of them had a long-term survival. No patients were observed with paraplegia, myocardial infarction, stroke, or rupture of aneurysm. None of the patients received reintervention during the follow-up, except for one patient who underwent ultrasound-guided puncture and suctionin the aneurysmallumen. ConclusionHybrid surgery is an effective treatment for TAAA with favorable short- and long-term safety and efficacy.
ObjectiveTo understand the characteristics of patients who have undergone the removal of the inferior vena cava (IVC) filter so as to provide a reference for optimizing the clinical application strategy of IVC filters. MethodThe demographic and clinical characteristics of patients underwent IVC filter removal in the Department of Vascular Surgery of West China Hospital, Sichuan University from December 2016 to December 2023 were retrospectively collected. ResultsA total of 102 patients were enrolled, including 48(47.1%) males and 54(52.9%) females. The age of the patients was (46.75±16.72) years old, and 75(73.5%) patients were aged between 20 and 59 years old. The proportion of patients who had an IVC filter placed due to concurrent central deep vein thrombosis was the highest, accounting for 48.0% (49/102). Among them, 72(70.6%) patients had the filter removed within 90 d, and 6(5.9%) patients had the filter removed after more than one year. The median duration of filter placement for all patients was 35 d (ranging from 5 to 7 300 d). The filter was removed via interventional method in 91(89.2%) patients, and via open surgery in 10(9.8%) patients. In 1(1.0%) patient failed by endovascular retrieval and followed-up observation. Compared with the interventional treatment, patients who had the filter removed by open surgery had a longer placement time of the filter in the body (median: 32.5 d vs. 136.5 d, P=0.002). ConclusionsFrom the analysis results of this cases data, patients with IVC filters don’t show obvious gender characteristics. The majority of them are young and middle-aged, and interventional method is mostly used for the removal of IVC filters. Patients who use open surgery to remove the filter have a longer placement time in the IVC, suggesting the necessity of early removal of the IVC filter.
