Objective To study the diagnostic procedures and management of aortic stent graft infection. Methods Clinical data of 4 patients with aortic stent graft infection from 1998 to 2008 were analyzed retrospectively. Results Primary disease was thoracic endovascular aortic repair in 2 cases and endovascular aneurysm repair in another 2 cases. Constitutional symptoms and abscess information on imaging studies were presented in all patients. Salmonella choleraesuis was revealed in 2 cases. Surgical debridement, drainage and systematic antimicrobial therapies were given to 2 patients. The remaining 2 patients were managed with antimicrobial therapy only. During follow-up, there was no recurrence of infection. Conclusions Infection of aortic stent graft infection is a rare but potentially devastating complication. Radiologic studies can serve as important adjuncts in the diagnosis of endovascular graft infections. Several treatment options are available, some cases may be managed with conservative treatment.
Objective To summarize selection of therapeutic method for isolated iliac aneurysms and analyze its advantages and disadvantages. Method The clinical data of 21 patients with isolated iliac aneurysms from January 2006 to January 2017 in this hospital were analyzed retrospectively. Results Four patients were treated with an open surgery such as the unilateral iliac prosthetic graft interposition, aorto-biiliac or aorto-bifemoral arterial bypass graft, ligation of internal iliac artery, etc.. Seventeen patients were treated with an endovascular treatment such as the unilateral iliac stent-grafts, bifurcated aortic stent-grafts, or coil embolization alone, etc.. One patient with ruptured isolated iliac aneurysms died during the endovascular repair, and the rest patients were cured after the operation. The average operative time was 2.83 h and 1.58 h, the average hospital stay was 17.5 d and 7.7 d respectively for the patients with the open surgery and the endovascular treatment. Except 1 case of type Ⅰ and 1 case of type Ⅱ endoleaks were found in the patients with the endovascular treatment, no complications such as the ureteral and intestinal injuries, the gluteal muscle claudication, and the sigmoid ischemia were found in all the patients. Seventeen cases were followed-up. The following-up rate was 85%. The following-up time was 1–60 months with an average of 22 months. During the following-up period, the grafts and stent grafts were patent and the aneurysm sac diameter was unchanged. The abscess of the iliac fossa occurred in 1 patient with systemic lupus erythematosus and improved after the symptomatic treatment. Two patients died of other diseases during the following-up period, and the rest had no obvious clinical symptoms. Conclusions Preliminary results of limited cases in this study show that endovascular repair and open surgery in treatment of appropriately selected patients with isolated iliac artery aneurysms is safe and effective. But in special situation, technical controllability of open surgery might be better than endovascular repair, treatment should be selected according to patient’s general condition and anatomy of aneurysm.
ObjectiveTo investigate the effect of distal tears on postoperative aortic remodeling after Thoracic Endovascular Aortic Repair (TEVAR) for the patients with subacute stage of Stanford type B aortic dissection.MethodsForty three cases with Stanford type B aortic dissection, admitted in Anhui Provincial Hospital from July 2011 to April 2015, who underwent TEVAR to repair the proximal aortic entrance tear, after which the blood reflex from distal tears were still observed were analyzed retrospectively. According to the number of heart volume required to fill the two groups, group A (≤2 heart rate) group B （>2 heart rate）, We then assessed the changes of the true and false lumen area and analyzed the effects of direction of blood flow and the number of heart rate to fill the false lumen on formation of false lumen thrombosis in the period of 3–24 months.ResultsAll the stents were successful implanted. There was a statistically significant difference in lumen area between the two groups before and after surgery, and univariate analysis showed that the direction of distal rupture of blood flow into the false lumen had no effect on postoperative aortic remodeling (P<0.05), but postoperative hypertension (≥140/90 mmHg) slows down the formation of false lumen thrombosis.ConclusionPatients had entrance tear in the distal of aortic, still broken and faster flow after TEVAR stent-graft implantation in the proximal closed entrance tear. Blood pressure should be strictly controlled and close follow-up also needed, meanwhile, the distal entrances can be closed the same period if there is a faster flow from them.