scholarly journals Effect of Aortic Stent Implantation in the Treatment of Thoracic Aortic Disease

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Cheng Chen

Objective: To explore the effect of aortic stent implantation on patients in the treatment of thoracic aortic diseases. Methods: Selected patients from Yunnan Fuwai Cardiovascular (YFC) Hospital as a sample group to carry out the study, the main participants were thoracic aortic aneurysm patients admitted from June 2020 to June 2021. The number of patients involved were 80. The patients are divided into two groups and different treatment methods were adopted. A comparative analysis of the effects of aortic stent placement on patients was conducted. Results: Before treatment, there was no significant difference in the levels of various inflammatory factors between the two groups of patients, P>0.05. After treatment, the data indicators of the two groups were significantly different, as there were significant differences in the surgical indicators among the two groups of patients, P<0.05. As a result, the experimental group had shorter operation time, less intraoperative blood loss, shorter ICU observation time, lower levels of inflammatory factors, and better results. Conclusion: In the treatment of patients with thoracic aortic disease, the application of aortic stent implantation has significant clinical effects and are more conducive to the recovery of patients. It can be promoted and used in clinical trials.

Author(s):  
Emir Mujanovic ◽  
Midhat Nurkic ◽  
Jasmin Caluk ◽  
Ibrahim Terzic ◽  
Emir Kabil ◽  
...  

Objective The purpose of this randomized study was to evaluate the effect on graft patency by adding clopidogrel to aspirin in off-pump coronary artery bypass (OPCAB) grafting and the possible side effects of such therapy. Methods Twenty patients who underwent standard OPCAB through median sternotomy were randomized immediately after surgery in two groups. Patients in group A (n = 10) received 100 mg of aspirin starting preoperatively, continuing indefinitely. Patients in group B received 100 mg of aspirin and, in addition, 75 mg of clopidogrel starting immediately after the operation and for 3 months. Postoperative bleeding and other perioperative parameters were compared. Angiography was repeated 3 months after surgery to determine the patency and quality of grafts. Results Preoperative risk factors were similar in the two groups. There was no significant difference in average number of distal anastomosis (P = 0.572), operation time (P = 0.686), postoperative bleeding (P = 0.256), ventilation time (P = 0.635), and intensive care unit stay (P = 0.065). Length of stay was shorter in group B (P = 0.024). There was no postoperative complication in either groups. Eight of 27 grafts in group A and 2 of 29 grafts in group B (P = 0.037) were occluded at the time of control angiography. Conclusions Early administration of a combined regimen of clopidogrel and aspirin after OPCAB grafting is not associated with increased postoperative bleeding or other major complications. Despite the small number of patients in this study and small number of examined grafts, the results suggest that the addition of clopidogrel may increase graft patency after OPCAB grafting.


2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Huaian Li

Objective: To investigate the clinical effects of phlegm and phlegm and magnesium sulfate combined with magnesium sulfate in sea lice in Qinhuangdao City. Methods: A total of 78 patients with sea lice in Qinhuangdao City from June to May 2018 were enrolled. They were randomly divided into control group (n=39 cases) and observation group (n=39 cases). The control group was treated with magnesium sulfate. The observation group was treated with Qibai Colshi Decoction on the basisof the control group. The effect of the patients was evaluated after 5 days of treatment. The disappearance time of symptoms, inflammatory factors and adverse drug reactions were compared. Results: After treatment, the onset, pain time, skin loss, swelling time and course of treatment were shorter in the observation group than in the control group (P<0.05). The levels of inflammatory factors were lower than those before treatment (P<5). The levels of TNF-a, IL-6, HIS and 5-HT in the observation group were lower than those in the control group (P<0.05). The rash, itching, drug allergy, liver and kidney were observed in the observation group and the control group. There was no significant difference in the incidence of dysfunction and blood pressure (P>0.05). Conclusion: The combination of magnesium sulfate and magnesium sulfate in the treatment of sea lice in Qinhuangdao City can shorten the disappearance of symptoms, reduce the level of inflammatory factors, and increase the incidence of adverse drug reactions. It is worthy of popularization and application.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Demolder ◽  
L Muino-Mosquera ◽  
A Pini ◽  
A Evangelista ◽  
A Lopez-Sainz ◽  
...  

Abstract Background Marfan syndrome (MFS), Loeys-Dietz syndrome (LDS) and related heritable thoracic aortic diseases (HTAD) are well-known for their aortic complications. Myocardial dysfunction and arrhythmia are less known in this setting but have been increasingly reported as additional causes of morbidity and mortality. Related to the rarity of the disorders, data on the prevalence of these features and clinical characteristics of the patients are difficult to obtain, calling for a multicentre initiative. Purpose To study the prevalence of myocardial dysfunction and arrhythmia in patients with HTAD and describe their clinical and genetic profile. Methods Nine centres from seven countries participated in this multicentre retrospective study. Medical records of patients 12 years or older carrying a (likely) pathogenic variant in the FBN1 gene, LDS genes (TGFBR1, TGFBR2, TGFB2, TGFB3 and SMAD3) or ACTA2 gene were screened. Patients presenting myocardial dysfunction and/or arrhythmia were identified, and clinical and genetic data were collected. Myocardial dysfunction included (a)symptomatic reduced ejection fraction (EF &lt;50% – HFrEF) or symptomatic preserved EF (HFpEF), as documented in the patient charts. Arrhythmias included atrial fibrillation or flutter (AF/AFL), ventricular tachycardia (VT), ventricular fibrillation (VF) and (aborted) sudden cardiac death (SCD) (presumed arrhythmogenic). Results In total, 3219 patients with HTAD were screened: 2761 with a variant in FBN1, 385 with a variant in one of the LDS genes (TGFBR1, TGFBR2, TGFB2, TGFB3 and SMAD3) and 73 carrying a variant in ACTA2. Myocardial dysfunction and arrhythmia were not reported in patients carrying an ACTA2 variant. Myocardial dysfunction was observed in patients with a variant in FBN1 and the LDS genes, without significant differences in prevalence (2.3% vs. 1.8%, p=0.563). Patients with a variant in the LDS genes presenting myocardial dysfunction were younger than patients carrying a variant in FBN1 (25±11 years vs. 39±17 years, p=0.034). The prevalence of VT/VF/SCD was similar in patients with a variant in one of the LDS genes compared to those with a variant in FBN1 (1.6% vs. 0.8%, p=0.132) and there was no difference in age at time of event (26±13 years vs. 33±14 years, p=0.289). Among patients with a variant in the LDS genes, the prevalence of VT/VF/SCD was highest in patients carrying a variant in the TGFBR2 gene and was significantly higher compared to patients with a variant in FBN1 (3.4% vs. 0.8%, p=0.017). In contrast, AF/AFL was significantly more often reported in patients with a variant in FBN1 compared to those with a variant in one of the LDS genes (1.7% vs. 0.3%, p=0.033). Conclusions Myocardial dysfunction and arrhythmia are rare features in patients with HTAD. They occur predominantly in patients with a variant in FBN1 and LDS genes, but were not reported in patients carrying a variant in the ACTA2 gene. Further analysis to identify other contributing factors is necessary. FUNDunding Acknowledgement Type of funding sources: None. Figure 1


2021 ◽  
Vol 7 (6) ◽  
pp. 6460-6468
Author(s):  
Xijing Yu ◽  
Xiuwu Hu ◽  
Shuisheng Hua ◽  
Rong Guo ◽  
Xiaoyan Zhu

Objective: To explore the clinical efficacy of acupuncture combined with cupping exercise in the treatment of chronic pelvic inflammation. Methods: The subjects of this study were all patients with chronic pelvic inflammation who visited our hospital from November 2018 to November 2019, a total of 90 cases. The patients were divided into control group and research group according to the single and double numbers of the beds, 45 cases in each group. The patients in the control group were treated with conventional Western medicine, while the patients in the study group were treated with acupuncture and cupping exercise, and the clinical effects of the two treatment methods were compared. Results: The total effective rate was 95.56% in the study group and 84.44% in the control group, which was significantly higher in the study group than in the control group. The data between the two groups were statistically significant (P<0.05). The scores of menstrual disorder, abdominal distension, abnormal leucorrhea and lumbosacral pain in the two groups were significantly lower than those before treatment (P<0.05), and the corresponding scores of syndromes in the study group after treatment were (1.05+0.40), (0.73+0.38), (0.74+0.24) and (0.53+0.16), which were significantly lower than those in the control group (P<0.05). The plasma viscosity and hematocrit in both groups were significantly lower than those before treatment (P<0.05). The plasma viscosity and hematocrit in the study group after treatment were (1.14+0.32) mPa * s and (0.41+0.06) %, respectively, which were significantly lower than those in the control group (P<0.05). There was no significant difference in the levels of inflammatory factors between the two groups before treatment (P>0.05). The level of inflammatory factors in the study group after treatment was (5.74 + 2.35) mg/L, which was significantly lower than that in the control group after treatment, and the difference between tne groups was statistically significant (P < 0.05). Conclusion: Acupuncture combined with cupping exercise has a very significant clinical effect in the treatment of chronic pelvic inflammatory disease, can effectively improve the TCM syndrome score of patients, and improve the hemorheology and inflammation level of patients, so it can be widely used in clinical practice.


2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S29-S29
Author(s):  
H Sadaf ◽  
B Zhao ◽  
L Lelenwa ◽  
L Buja ◽  
A Segura ◽  
...  

Abstract Introduction/Objective Sex disparity is reported across all forms of cardiovascular diseases. Only few studies have focused on sex differences in thoracic aortic disease pathology. We aim to identify and understand sex differences in this patient group to bridge the knowledge gap and improve clinicopathologic outcomes. Methods/Case Report This is a retrospective analysis of 83 proximal thoracic aortic aneurysm and dissection (TAAD) cases treated at a single quaternary care center in 2019. Chart review was done for demographics. Consensus criteria (Stone JR et al. Cardiovasc Pathol 2015; 24:267-78; Halushka MK et al. Cardiovasc Pathol 2016; 25:247-57) and a scoring system (Waters KM et al. Cardiovasc Pathol 2017; 30:6-11) were used for pathology reporting. Clinical correlation was also made. Pearson’s chi-square test was used for statistical analysis. Results (if a Case Study enter NA) 83 patients (61 male and 22 female) were retrieved. Overall thoracic aortopathy was higher among males, accounting for 73.4% of individuals with TAAD. In a subgroup analysis, there was no sex difference in dissection, aortic root involvement, and bicuspid aortic valve (p&gt;0.05). Genetic aortopathy was more prevalent in females than males (27.2% vs 9.8%, p=0.04) alongside early age at first aortic event (median age: 31y vs 52y). Histopathologically, females had frequent translamellar mucoid extracellular matrix accumulation (45.4% vs 22.9%, p=0.04), extensive (54.5% vs 27.8%, p=0.02) and severe (59% vs 34.4%, p=0.04) elastic fiber fragmentation, higher band like (9% vs 6.5%, p&gt;0.05) plus extensive (13.6% vs 4.9%, p&gt;0.05) smooth muscle nuclei loss, and extensive (13.6% vs 1.6%, p=0.01) plus dense (4.5% vs 1.6%, p&gt;0.05) laminar medial collapse than males. Conclusion In our patient population, females have a lower prevalence of thoracic aortic disease treated with open repair. However, those who develop TAAD harbor a greater burden of wall pathology and probable worse outcomes. We recommend sex-based analysis of all research on thoracic aortic diseases.


2020 ◽  
Author(s):  
Li Ma ◽  
Binghua Zhou ◽  
Zhenyu Wang ◽  
Guo Zheng ◽  
Xu Tao ◽  
...  

Abstract BackgroundThe aims of this study were to investigate the clinical outcomes of anatomical footprint reconstruction for the treatment of insertional Achilles tendinopathy (IAT) with heterotopic ossification and to provide an effective surgical method for the treatment of this condition.MethodsFrom October 2016 to October 2019, 10 patients underwent anatomical footprint reconstruction for the treatment of IAT with heterotopic ossification at our institution. The operation time and intraoperative bleeding volume were recorded. X-ray and MRI examinations of the calcaneus were performed after the operation. The American Orthopaedic Foot and Ankle Society (AOFAS), visual analog scale (VAS) and Victorian Institute of Sports Assessment–Achilles (VISA-A) scores were used to evaluate the clinical effects on the patients; the time to normal walking and exercise recovery was recorded; and the recovery rate of exercise was recorded at 6 months after the operation.ResultsThe average operation time was 64.4 min (45-74 min), the average bleeding volume was 29.7 ml (5-100 ml), and the average follow-up time was 22.4 months (12-48 months). The patients' wounds healed without infection, splitting, necrosis of the skin margin or other complications. The mean AOFAS score (± SD) was 70.3 ± 11.39 preoperatively and 94.2 ± 5.00 at the last follow-up, showing a significant difference between timepoints (P = 0.00; t = 7.657). The VAS score was 5.4 ± 1.71 preoperatively and 0.4 ± 0.51 at the last follow-up; this decrease was statistically significant (P = 0.00; t = 11.859). The mean VISA-A scores at the preoperative baseline and the last follow-up were 37.6 ± 16.39 and 81.4 ± 8.83, presenting a significant difference between the two timepoints (P = 0.00; t = 9.906). The average time to recover normal walking ability was 9.1 weeks (4-15 weeks), and the average time to resume exercise was 10 weeks (8-12 weeks). At 6 months after the operation, the rate of exercise recovery was 80%.ConclusionIn IAT with heterotopic ossification, anatomical footprint reconstruction enables patients to return to normal life and exercise quickly. The rate of return to sports is high, and the procedure offers satisfactory clinical effects.


2018 ◽  
Vol 100 (8) ◽  
pp. 662-668 ◽  
Author(s):  
GJS Tan ◽  
PLZ Khoo ◽  
KMJ Chan

Introduction The development of thoracic endovascular aortic repair has altered the approach and reduced the risk of treating the majority of descending thoracic aortic conditions. Primarily developed for the exclusion of thoracic aortic aneurysms, it is now used in place of open repair surgery for most descending thoracic aortic diseases, and has also been used to treat aortic arch diseases in selected cases. Methods A literature search was conducted of Medline and Embase databases from January 2007 to February 2017, using the key words ‘aortic disease’, ‘thoracic aorta’ and ‘endovascular repair’; 205 articles were identified, of which 25 studies were selected for review based on their relevance. Findings The key findings of the indications, techniques, outcomes, complications and comparisons with open surgical repair were extracted from the published studies and are summarised in this review. Thoracic endovascular aortic repair is the preferred choice of intervention for patients with descending thoracic aortic disease. With time, it has improved to be safer and has the potential to expand aortic treatment choices in future.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yung-An Tsou ◽  
Wen-Dien Chang

Abstract This study compared the characteristic surgical parameters and clinical effects of transoral robotic surgery (TORS) and other available methods used to alleviate obstructive sleep apnea. Articles on TORS and other surgeries for obstructive sleep apnea were identified in the PubMed and EMBASE databases. Two investigators independently reviewed the articles and classified the data for meta-analysis. The pooled effect sizes of TORS (standardized mean difference; SMD = − 2.38), coblation tongue base resection (CTBR; SMD = − 2.00) and upper airway stimulation (UAS; SMD = − 0.94) revealed significant improvement in the apnea–hypopnea index (AHI; p < 0.05). The lowest O2 saturation reported was significantly increased following TORS (SMD = 1.43), CTBR (SMD = 0.86) and UAS (SMD = 1.24, p < 0.05). Furthermore, TORS (SMD = − 2.91) and CTBR (SMD = − 1.51, p < 0.05) significantly reduced the Epworth Sleepiness Scale (ESS) score. No significant difference in operation time, success rate, or instances of complication were observed between TORS and the other compared interventions. The use of TORS in obstructive sleep apnea has the same rate of success and failure as other methods of surgical intervention for obstructive sleep apnea with no statistical difference in operation times. The reported clinical effects on the AHI, lowest O2 saturation, and ESS scores of TORS were similar to those of other surgeries.


2019 ◽  
Vol 17 ◽  
pp. 205873921983704
Author(s):  
Wentao Wang ◽  
Dequan Zhong ◽  
Hua Cheng ◽  
Chengfu Ji ◽  
Zhouming Shen ◽  
...  

The aim of this study is to investigate the efficacy of expanded endonasal approaches (EEAs) in the treatment of pituitary adenoma, and the effects of serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-12 (IL-12) in patients were further analyzed. A total of 80 cases of patients with pituitary adenoma admitted to our hospital from January 2013 to May 2015 were randomly divided into the observation group and control group, with 40 cases in each group. The observation group was treated with EEA technique, while the control group was treated with transcranial microsurgery. The prolactin (PRL), growth hormone (GH) and other endocrine hormone indexes, as well as inflammatory factors such as TNF-α, IL-6, and IL-12 were compared before and 1 week after the operation between the two groups. Moreover, the scores of Karnofsky performance status (KPS) and Mini-Mental State Examination (MMSE) at preoperative and postoperative 1 week were also compared between the two groups. The operation time, hospitalization time, and postoperative complications were compared between the two groups. And the patients were followed up for 2 years to observe the recurrence rate. The operation time and hospital stay in the observation group were 62.8 ± 9.3 min and 12.5 ± 2.1 days, respectively, while the operation time and length of stay in the control group were 105.6 ± 15.7 min and 18.2 ± 3.4 days, respectively. The operation time and hospitalization time were shorter than those in the control group, and the differences were statistically significant ( P < 0.05). Before surgery, there was no significant difference in serum levels of PRL and GH between the two groups ( P > 0.05). At 1 week after surgery, the levels of PRL and GH in the two groups were significantly lower than those before surgery ( P < 0.05). And the serum levels of PRL and GH in the observation group were significantly lower than those in the observation group at 1 week after the operation ( P < 0.05). Before operation, there was no significant difference between the two groups of KPS and MMSE scores ( P > 0.05). At 1 week after operation, the scores of KPS and MMSE in both groups were significantly higher than those before the operation ( P < 0.05), and the scores of KPS and MMSE in the observation group were significantly higher than those in the control group ( P < 0.05). Furthermore, there was no significant difference in the serum levels of IL-6, IL-12, and TNF-α between the two groups before operation ( P > 0.05). At 1 week after surgery, the serum levels of IL-6, IL-12, and TNF-α in the two groups were significantly lower than those before surgery ( P < 0.05), while the serum levels of IL-6, IL-12, and TNF-α in the observation group were evidently lower than those in the control group at 1 week after the operation. Besides, the incidence of postoperative complications in the observation group was 7.5%, which was significantly lower than that in the control group (17.5%) ( P < 0.05). All the patients in the two groups were followed up for 2 years. And there was no recurrence in the observation group and one case in the control group. The therapeutic effect of EEAs on pituitary adenoma is better. It can improve the level of high endocrine hormone in patients with pituitary adenoma, improve the functional status of the patients, reduce the serum level of inflammatory factors, and shorten the hospital stay. Meanwhile, it also has the characteristics of fewer complications and low recurrence rate, so it can be popularized in clinical practice.


2017 ◽  
Vol 99 (4) ◽  
pp. 325-331 ◽  
Author(s):  
A Tandon ◽  
I Rajendran ◽  
M Aziz ◽  
R Kolamunnage-Dona ◽  
QM Nunes ◽  
...  

BACKGROUND Gastric cancer has a high incidence in the elderly in the UK, with a significant number of patients aged 75 years or more. While surgery forms the mainstay of treatment, evidence pertaining to the management of gastric cancer in the Western population in this age group is scarce. METHODS We retrospectively reviewed the outcomes of laparoscopy-assisted total and distal gastrectomies at our centre from 2005 to 2015. Patients aged 70 years or above were included in the elderly group. RESULTS A total of 60 patients underwent laparoscopy-assisted gastrectomy over a 10-year period, with a predominance of male patients. There was no significant difference in the rate of overall surgical and non-surgical complications, in-hospital mortality, operation time and length of hospital stay, between the elderly and non-elderly groups. Univariate analysis, performed for risk factors relating to anastomotic leak and surgical complications, showed that age over 70 years and higher American Association of Anesthesiologists grades are associated with a higher, though not statistically significant, number of anastomotic leaks (P = 1.000 and P = 0.442, respectively) and surgical complications (P = 0.469 and P = 0.162, respectively). The recurrence rate within the first 3 years of surgery was significantly higher in the non-elderly group compared with the elderly group (Log Rank test, P = 0.002). There was no significant difference in survival between the two groups (Log Rank test, P = 0.619). CONCLUSIONS Laparoscopy-assisted gastrectomy is safe and feasible in an elderly population. There is a need for well-designed, prospective, randomised studies with quality of life data to inform our practice in future.


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