Progress in Diagnosis and Endoscopic Treatment of Stanford B Penetrating Aortic Ulcers

Penetrating aortic ulcers is rare in clinical practice, and it is necessary to intervene in this type of aortic perforating ulcer because it can be accompanied by major arterial dissection and intermural hematoma. With the widespread application and technical advancement of follow-up thoracic aortic endovascular repair (TEVAR), endovascular treatment has become the first choice for symptomatic aortic perforating ulcers. In this review, we will review the diagnosis, diagnosis and endovascular treatment of aortic perforating ulcer.

The first case of renal artery prosthetics using a vascular stent graft during renovisceral debranching

The article demonstrates the first clinical case of using the vascular stent graft in renal artery prosthetics in the framework of hybrid treatment of a patient with Stanford B type aortic dissection with renovisceral debranching and subsequent aortic endoprosthetics. Currently available approaches to nephropothecation in prosthetics of renal arteries, surgical technique for using the graft, and the features and advantages of its use are described. The place of this new technique in the surgery of thoracoabdominal aorta is discussed.

Can thiệp nội mạch trong điều trị tách thành động mạch chủ Stanford B cấp

Tách thành động mạch chủ là bệnh nặng nguy cơ tử vong cao. Can thiệp nội mạch điều trị bệnh lý động mạch chủ là phương pháp ít xâm lấn và hiệu quả. Nghiên cứu nhằm mục tiêu đánh giá hiệu quả của can thiệp nội mạch điều trị tách thành động mạch chủ cấp. Đây là nghiên cứu can thiệp không có đối chứng. Nghiên cứu 96 bệnh nhân có độ tuổi trung bình 59 ± 10 được chẩn đoán tách thành động mạch chủ cấp có biến chứng được can thiệp nội mạch. Tỷ lệ thành công về mặt kỹ thuật 97,9%. Tỷ lệ sống còn qua theo dõi thời gian trung bình 30 tháng là 91,67%, yếu tố vỡ động mạch chủ thì 1 làm tăng nguy cơ tử vong (HR = 4,46 với p = 0,03). Tái cấu trúc động mạch chủ sau can thiệp làm tăng kích thước lòng thật nhỏ nhất (19,4 ± 4,3 mm so với 24 ± 5,4 mm p < 0,05), giảm đường kính lòng giả lớn nhất (37,1 ± 11.4 mm so với 26,5 ± 13,1 mm p < 0,05). Như vậy can thiệp nội mạch điều trị bệnh nhân tách thành động mạch chủ Stanford B cấp có tỷ lệ sống còn cao và giúp tái cấu trúc động mạch chủ.

Identification and assessment of regression models of the learning curve for automotive manufacturing

The problem of identification and assessment of the reliability of regression models of the learning curve for the automotive industry is considered. For regression analysis, four learning curve models of a given type are used: Wright's, Stanford-B, Deyong's, and exponential. The parameters of the learning curve models are determined using a nonlinear least squares method. The estimation of the significance and reliability of the regression models is carried out. It is shown that the models of learning curves in the automotive industry are well approximated by the Stanford-B power function.

Management of Acute Uncomplicated Stanford B Aortic Dissection in The Era of Endovascular Repair: A Case Report

Introduction: Uncomplicated type B aortic dissections have been traditionally treated with medication therapy. While it may provide good short-term results, longterm prognosis may be less favorable. With improvements in endovascular repair and the potential risk of disease progression, thoracic endovascular aortic repair (TEVAR) has been considered inpatients with uncomplicated type B aortic dissection. We present the case of 78-year-old gentleman who presented with acute uncomplicated type B aortic dissection managed by endovascular repair Case illustration: A 78 year-old hypertensive patient admitted to the hospital with persistent chest discomfort and cough for 2 weeks. The CT aortic angiogram showed type B dissection. Based on the recent guidelines, TEVAR should be considered in patients with uncomplicated type B aortic dissection, thus we prepared the patient for TEVAR procedure. First we established multidisciplinary vascular team for the pre-procedural preparation of the patient. We perform careful measurement through detailed CT angiography reconstruction from carotid to femoral arteries. We found proximal diameter was 30-35mm, distal diameter was 23mm and landing zone right after left brachial ostium, suitable for stent graft Valiant Captivia 36-32x150mm. The CT also showed that both femoral artery were normal, we decided to use right femoral artery as the access. We proceed to the procedure 2 days later, under general anaesthesia, digital subtraction angiography revealed dissection of descending aorta, and selected device was inserted. Subsequent contrast injection revealed total occlusion of the false lumen. Patient was transferred to ICU for postprocedural care, and extubated the day after. The hospital stay was uneventful, and one-month follow up CT shows no endoleak. Conclusion : Management of uncomplicated Stanford B dissections is very challenging. TEVAR has emerged as an alternative to surgery with lower morbidity and mortality rates that might offer good long-term results.