Custom Made Fenestrated Stent Graft Collapse after Thoracic Endovascular Aortic Repair: A Case Report

We present a case of stent graft collapse after performing thoracic endovascular aortic repair with a custom-made fenestrated stent graft. The patient was a 70-year-old woman with an asymptomatic aneurysm of the distal aortic arch, and thoracic endovascular aortic repair was performed. The patient showed a blood pressure difference between the left arm and the right arm on postoperative day (POD) 17 prompting the performance of a chest computed tomography scan which revealed stent graft collapse. She then underwent staged debranching of thoracic endovascular aortic repair. Stent graft collapse is a rare but well-described complication of thoracic endovascular repair. Therefore, patients who undergo such a procedure should be carefully monitored for signs and symptoms, which suggest the possibility of stent collapse.

Autogenous inside-out versus standard vein and skeletal muscle-combined grafting for facial nerve repair

BACKGROUND： In the repair of nerve defects, collapse of the venous wall, as a result of vein grafting alone, could impede nerve regeneration. Therefore, vein lumens filled with muscle and nerve segments have been used to bridge nerve defects. OBJECTIVE： To compare the effects of autogenous, inside-out, vein-skeletal, muscle-combined grafting versus standard, vein-skeletal, muscle-combined grafting for the repair of facial nerve defects. DESIGN, TIME AND SETTING： A randomized, controlled, neuroanatomical, animal study was performed at the Animal Experimental Center and Laboratories of the Capital Medical University Xuanwu Hospital and the Peking Union Medical College Hospital from September 2007 to October 2008.MATERIALS： A total of 10 healthy, male, New Zealand rabbits, aged 6 months, were randomly assigned to inside-out, vein-skeletal, muscle-combined grafting and standard, vein-skeletal, muscle-combined grafting groups, with 5 rabbits in each group. METHODS： A 20-mm gap in the buccal branch of the right facial nerve was made in each animal, which was respectively repaired with inside-out, vein-skeletal, muscle-combined grafts or standard vein-skeletal muscle-combined grafts.MAIN OUTCOME MEASURES： At 6 months after implantation, evoked maximal compound muscle action potentials were recorded on bilateral facial nerves using electromyogram. Myelinated nerve fibers of the regenerating nerves were quantified using myelin sheath osmic acid staining. RESULTS： There was no significant difference between the groups in terms of ratios of bilateral amplitude and latency of compound muscle action potential （P 〉 0.05）. Moreover, morphology of regenerating nerves and quantity of myelinated nerve fibers were similar between the groups （P 〉 0.05）. CONCLUTION： Compared with standard vein grafting, the inside-out vein grafting did not significantly improve nerve regeneration. Therefore, it is not necessary to utilize inside-out vein grafting for the repair of nerve defects, in particular with the combined use of autogenous vein and skeletal muscle grafts.

Total endovascular repair of an intraoperative stent-graft deployed in the false lumen of Stanford type A aortic dissection: A case report

BACKGROUND A 46-year-old male underwent ascending aortic replacement,total arch replacement,and descending aortic stent implantation for Stanford type A aortic dissection in 2016.However,an intraoperative stent-graft was deployed in the false lumen inadvertently.This caused severe iatrogenic thoracic and abdominal aortic dissection,and the dissection involved many visceral arteries.CASE SUMMARY The patient had pain in the chest and back for 1 mo.A computed tomography scan showed that the patient had secondary thoracic and abdominal aortic dissection.The ascending aortic replacement,total arch replacement,and descending aortic stent implantation for Stanford type A aortic dissection were performed 2 years prior.An intraoperative stent-graft was deployed in the false lumen.Endovascular aneurysm repair was performed to address this intractable situation.An occluder was used to occlude the proximal end of the true lumen,and a covered stent was used to direct blood flow back to the true lumen.A three-dimensional printing technique was used in this operation to guide prefenestration.The computed tomography scan at the 1stmo after surgery showed that the thoracic and abdominal aortic dissection was repaired,with all visceral arteries remaining patent.The patient did not develop renal failure or neurological complications after surgery.CONCLUSION The total endovascular repair for false lumen stent-graft implantation was feasible and minimally invasive.Our procedures provided a new solution for stent-graft deployed in the false lumen,and other departments may be inspired by this case when they need to rescue a disastrous stent implantation.

Histological observation on acellular nerve grafts co-cultured with Schwann cells for repairing defects of the sciatic nerve

BACKGROUND： Animal experiments and clinical studies about tissue engineering method applied to repair nerve injury mainly focus on seeking ideal artificial nerve grafts, nerve conduit and seed cells. Autologous nerve, allogeneic nerve and xenogeneic nerve are used to bridge nerve defects, it is one of the methods to promote the repair of nerve injury by culturing and growing Schwann cells, which can secrete various neurotrophic factor activities, in the grafts. OBJECTIVE ： To observe the effect of acellular nerve grafts co-cultured with Schwann cells in repairing defects of sciatic nerve. DESIGN： An observational comparative study.SETTING： Tissue Engineering Laboratory of China Medical University.MATERIALS： The experiment was carried out in the Tissue Engineering Laboratory of China Medical University between April 2004 and April 2005. Forty neonatal Sprague-Dawley rats of 5-8 days （either males or females） and 24 male Wistar rats of 180-220 g were provided by the experimental animal center of China Medical University. METHODS： ① Culture of Schwann cells： The bilateral sciatic nerves and branchial plexus were isolated from the 40 neonatal SD rats. The sciatic nerves were enzymatically digested with collagenase and dispase, isolatd, purified and cultured with the method of speed-difference adhersion, and identified with the SABC immunohistochemical method. ② Model establishment： In vitro Schwann cells were microinjected into 10-mm long acellular nerve grafts repairing a surgically created gap in the rat sciatic nerve. According to the different grafted methods, the animals were randomly divided into three groups： autografts （n=8）, acellular nerve grafts （n=8）, or acellular nerve grafts with Schwann cells （n=8）. ③ The regenerated nerve fiber number and average diameter of myeline sheath after culture were statistically anlayzed. MAIN OUTCOME MEASURES： ① The regenerated nerve ultrastructure, total number and density of myelinated nerve fibers, and the thickness of myeline sheath were observed under electron microscope. ② The images were processed with the Mias-1000 imaging analytical system to calculate the number of myelinated nerve fibers, and the thickness of myeline sheath. RESULTS： All the 24 Wistar rats were involved in the analysis of results. ① Results observed under transmission electron microscope： The regenerated myelinated nerve fibers in the group of acellular nerve grafts with Schwann cells were more even than those in the group of acellular nerve grafts, the number of myelinated nerve fibers and thickness of myelin sheath were close to those in the allografts group （P 〉 0.05）, but significantly different from those in the group of acellular nerve grafts （P 〈 0.05）. ② Results observed under scanning electron microscope： A great amount of Schwann cells with two polars were observed in the group of grafts with Schwann cells, the feature of cultured Schwann cells showed shoulder by shoulder, head to head. ③ The number of myelinated nerve fibers and thickness of myelin sheath analyzed by Mias-1000 imaging system in the group of acellular nerve grafts with Schwann cells were close to those in the autografts group （P 〉 0.05）, but significantly different from those in the group of acellular nerve grafts （P 〈 0.05）.CONCLUSION： Host axonal regeneration is significantly increased after implant of acellular nerve grafts. Acellular nerve grafts with Schwann cells offers a novel approach for repairing the gap of nerve defect.

Clinical Application of Direct Skin Grafting Repair in Popliteal Scar Contracture after Burn in Children

Objective To observe the clinical application of direct skin grafting in repairing popliteal scar contracture after burn in children.Methods From April 2017 to January 2019,30 children with popliteal scar contracture after burn were selected as the research objects.The scar status,knee joint function and quality of life of the patients before and after the operation were compared by direct skin grafting after medium thickness skin removal.Results 30 patients were treated with skin grafting to repair popliteal scar contracture,27 patients healed well,and the survival rate of skin grafting reached 90.00%.The scores of postoperative scar and knee joint function scale(WOMAC)were lower than those before the operation,and the scores of concise health status scale(SF-36)were higher than those before the operation,with statistical significance(P<0.05).Conclusion Scar contracture of popliteal fossa after burn in children can be repaired by direct skin grafting in the skin extraction area after medium thickness skin cutting,which can effectively improve scar condition,restore knee joint function and significantly improve quality of life.

Repair of Rat Segmental Defects with Mineralized Collagen Grafts Combined with or without Mesenchymal Stem Cells and BMP-2

The aim of the present study was to investigate and compare the bone formation capacity with three different grafts. Four millimeter segmental defects were created in adult rat tibias and were either left empty （control defects） or implanted with （1） nano-hydroxyapatite/collagen/PIA （nHAC/PIA） composite, （2） nHAC/ PIA composite added with bone marrow mesenchymal tem cells （ BMSCs ）, （ 3 ） nHAC/ PIA composite added with bone morphogenetic protein 2 （ BMP- 2）. Radiographs of the defects were taken weekly post-surgery. After 1 or 2 months, the rats were eathaaized. Histologic analyses were performed on the harvested tissue. nHAC/ PIA composite could enhance the repair of rat tibia segmental defects. Addition of BMSCs or BMP- 2 to nHAC/ PIA led to an increase in osteogenesis, nHAC/ PIA composite could be an Meal alternative bone-grafi material and it could also be used as an Meal carrier of BMSCs or BMP- 2.

Use of small intestinal submucosa graft for repair of anterior urethral strictures

Objective To investigate the feasibility of using small intestinal submucosa ( SIS) graft for repair of anterior urethral strictures. Methods From June 2009 to August 2010,18 men ( mean age,38 yrs) with anterior urethral strictures underwent urethroplasty using a four layer SIS as an onlay patch graft. SIS was used to

An update–tissue engineered nerve grafts for the repair of peripheral nerve injuries

Peripheral nerve injuries（PNI） are caused by a range of etiologies and result in a broad spectrum of disability. While nerve autografts are the current gold standard for the reconstruction of extensive nerve damage, the limited supply of autologous nerve and complications associated with harvesting nerve from a second surgical site has driven groups from multiple disciplines, including biomedical engineering, neurosurgery, plastic surgery, and orthopedic surgery, to develop a suitable or superior alternative to autografting. Over the last couple of decades, various types of scaffolds, such as acellular nerve grafts（ANGs）, nerve guidance conduits, and non-nervous tissues, have been filled with Schwann cells, stem cells, and/or neurotrophic factors to develop tissue engineered nerve grafts（TENGs）. Although these have shown promising effects on peripheral nerve regeneration in experimental models, the autograft has remained the gold standard for large nerve gaps. This review provides a discussion of recent advances in the development of TENGs and their efficacy in experimental models. Specifically, TENGs have been enhanced via incorporation of genetically engineered cells, methods to improve stem cell survival and differentiation, optimized delivery of neurotrophic factors via drug delivery systems（DDS）, co-administration of platelet-rich plasma（PRP）, and pretreatment with chondroitinase ABC（Ch-ABC）. Other notable advancements include conduits that have been bioengineered to mimic native nerve structure via cell-derived extracellular matrix（ECM） deposition, and the development of transplantable living nervous tissue constructs from rat and human dorsal root ganglia（DRG） neurons. Grafts composed of non-nervous tissues, such as vein, artery, and muscle, will be briefly discussed.

Comparison between direct repair and humana cellular nerve allografting during contralateral C7 transfer to the upper trunk for restoration of shoulder abduction and elbow flexion

Direct coaptation of contralateral C7 to the upper trunk could avoid the interposition of nerve grafts. We have successfully shortened the gap and graft lengths, and even achieved direct coaptation. However, direct repair can only be performed in some selected cases, and partial procedures still require autografts, which are the gold standard for repairing neurologic defects. As symptoms often occur after autografting, human acellular nerve allografts have been used to avoid concomitant symptoms. This study investigated the quality of shoulder abduction and elbow flexion following direct repair and acellular allografting to evaluate issues requiring attention for brachial plexus injury repair. Fifty-one brachial plexus injury patients in the surgical database were eligible for this retrospective study. Patients were divided into two groups according to different surgical methods. Direct repair was performed in 27 patients, while acellular nerve allografts were used to bridge the gap between the contralateral C7 nerve root and upper trunk in 24 patients. The length of the harvested contralateral C7 nerve root was measured intraoperatively. Deltoid and biceps muscle strength, and degrees of shoulder abduction and elbow flexion were examined according to the British Medical Research Council scoring system;meaningful recovery was defined as M3–M5. Lengths of anterior and posterior divisions of the contralateral C7 in the direct repair group were 7.64 ± 0.69 mm and 7.55 ± 0.69 mm, respectively, and in the acellular nerve allografts group were 6.46 ± 0.58 mm and 6.43 ± 0.59 mm, respectively. After a minimum of 4-year follow-up, meaningful recoveries of deltoid and biceps muscles in the direct repair group were 88.89% and 85.19%, respectively, while they were 70.83% and 66.67% in the acellular nerve allografts group. Time to C5/C6 reinnervation was shorter in the direct repair group compared with the acellular nerve allografts group. Direct repair facilitated the restoration of shoulder abduction and elbow flexion. Thus, if direct coaptation is not possible, use of acellular nerve allografts is a suitable option. This study was approved by the Medical Ethical Committee of the First Affiliated Hospital of Sun Yat-sen University, China (Application ID:[2017] 290) on November 14, 2017.

脱矿牙本质基质和脱细胞牙本质基质成骨效果的对比研究

目的比较骨缺损区植入脱矿牙本质基质和脱细胞牙本质基质的成骨效果。方法制备脱矿牙本质基质和脱细胞牙本质基质。将24只SPF级SD雄性大鼠随机分为脱矿组(A组)、脱细胞组(B组)、Bio-Oss骨粉组(C组)、空白组(D组),每组6只大鼠,在麻醉条件下制备双侧股骨骨缺损。A、B、C组大鼠分别在骨缺损区植入脱矿牙本质基质、脱细胞牙本质基质、Bio-Oss骨粉,D组大鼠不植入任何材料。术后4周和8周,每组各随机处死3只大鼠。大体观察骨缺损区愈合情况,血清学检测成骨指标骨形态发生蛋白(BMP)-2及碱性磷酸酶(ALP)浓度,影像学观察骨缺损区高密度灰色区(代表骨愈合)分布情况,组织形态学观察新骨形成情况,计算新骨形成率。结果术后4周和8周,大体观察见A组成骨能力较其他组活跃,血清学检测A组BMP-2及ALP浓度均高于其他组,差异有统计学意义(P<0.05)。8周时,影像学观察可见A组骨缺损区高密度灰色区分布均匀,组织形态学观察见A组排列规则的骨基质。A组4、8周时的新骨形成率分别为28.51%±0.55%、32.57%±2.28%,均高于其他组,差异有统计学意义(P<0.05)。结论脱矿牙本质基质比脱细胞牙本质基质具有更好的成骨潜能。

头皮恶性肿瘤切除后创面局部皮瓣转移联合游离皮片移植术修复11例分析

目的探讨头皮恶性肿瘤切除后形成的创面应用局部皮瓣转移联合游离皮片移植术修复的临床效果。方法回顾分析2017年1月至2022年1月在焦作市人民医院皮肤科治疗并完成随访的11例头皮恶性肿瘤患者资料。患者年龄30~91岁,男4例,女7例,基底细胞癌6例,鳞状细胞癌5例,所有患者均采用局部皮瓣转移联合游离皮片移植术修复头皮恶性肿瘤切除后形成的创面。结果11例患者均一期手术完成,所有转移皮瓣和移植皮片均成活,术后均未出现感染,切口甲级愈合。术后随访6~12个月肿瘤无复发,创面修复良好,患者满意度高。结论局部皮瓣转移联合游离皮片移植术是头皮恶性肿瘤术后创面修复的理想方法,具有手术一期完成、转移皮瓣及游离皮片易于成活、肿瘤复发率低、恢复良好的优点。

皮肤软组织扩张术与复合皮移植术用于烧伤整形患者的效果比较

目的:比较皮肤软组织扩张术与复合皮移植术用于烧伤整形患者的效果。方法:选取2019年12月至2022年12月该院收治的68例烧伤整形患者进行前瞻性研究,按随机数字表法将其分为观察组和对照组各34例。观察组采取皮肤软组织扩张术治疗,对照组采取复合皮移植术治疗。比较两组临床疗效、术后数字分级评分法(NRS)评分、创面愈合时间、血运恢复时间、手术前后生命质量[简明烧伤健康量表(BSHS-B)]、瘢痕评分[温哥华瘢痕评定量表(VSS)]、血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1α(IL-1α)]水平,以及并发症发生率。结果:观察组治疗总有效率为94.12%(32/34),高于对照组的76.47%(26/34),差异有统计学意义(P<0.05);观察组术后NRS、VSS评分及血清TNF-α、IL-1α水平均低于对照组,创面愈合时间、血运恢复时间均短于对照组,BSHS-B评分高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为8.82%(3/34),低于对照组的29.41%(10/34),差异有统计学意义(P<0.05)。结论:皮肤软组织扩张术用于烧伤整形患者效果优于复合皮移植术,可减轻术后疼痛和炎症反应,抑制瘢痕形成,缩短创面愈合和血运恢复时间,降低并发症发生率,提高患者生命质量。

Stanford B型主动脉夹层腔内修复术后主动脉扩张性病变的研究进展

胸主动脉腔内修复术(thoracic endovascular aortic repair,TEVAR)目前是Stanford B型主动脉夹层(type B aortic dissection,TBAD)的主要治疗方法,当下治疗原则以封堵近端破口为主,而旷置远端破口导致假腔血栓化受阻;主动脉形态及支架远端弹性应力变化,导致管腔局部点压力扩大,形成新发破口或再发夹层导致假腔瘤样扩张,甚至急性破裂致死。术后应通过定期CTA随访,严密监测支架远端管径变化、残留破口直径及假腔血栓化程度。本文通过总结国内外文献,对TEVAR后主动脉扩张性病变的发病原因、机制及处理方法等进行归纳并作综述。

Endovascular stent-grafts for acute and chronic type B aortic dissection: comparison of clinical outcomes

Objective To evaluate the early and mid-term results of endovascular repair for acute and chronic type B aortic dissection, and to compare the clinical outcomes between the 2 groups. Methods From May 2002 to December 2006, 50 patients with type B aortic dissection were treated by endovascular stent-graft. There were 23 patients in the acute aortic dissection (AAD) group and 27 patients in the chronic aortic dissection (CAD) group. All patients were followed up from 1 to 54 months (average, 17±16 months).The immediate and follow-up clinical outcomes were documented and compared between the 2 groups. Results Placement of endovascular stent-grafts across the primary entry tears was technically successful in all 50 patients. Compared to the CAD group, the AAD group had a higher percentage of pleural effusion (17.4% vs. 0%, P=0.04) and visceral /leg ischemia (26.1% vs 3.7%, P=0.04). Procedure related complications, including endoleak and post-implantation syndrome, occurred more frequently in the AAD group than in the CAD group (21.7% vs 3.7% and 30.4% vs 11.1%, respectively; P=0.08 and P=0.04). Kaplan–Meier analysis showed no difference in the survival rate at 4 years between the 2 groups (86.4% vs 92.3%, P=0.42 by log-rank test). However, the event-free survival rate was higher in patients with chronic dissection than in patients with acute aortic dissection(96.2% vs 73.9%; P=0.02 by log-rank test). Conclu- sions Endovascular repair with stent-graft was safe and effective for the treatment of both acute and chronic type B aortic dissection. However, both immediate and long term major complications occurred more frequently in patients with acute dissection than in those with chronic dissection.

Ewings sarcoma of patella:A rare entity treated with a novel technique of extensor mechanism reconstruction using tendoachilles auto graft

We report a case of Ewings sarcoma(ES) involving the patella in a young female. ES of patella is a rare entity. The patient was presented with anterior knee pain and swelling arising from the patella. She was treated with neoadjuvant chemotherapy followed by wide excision of the patella and reconstruction of the extensor mechanism using split tendoachilles auto graft. The patella is an uncommon site for primary or metastatic tumors of the bone. ES, though rare, should be included in the differential diagnosis of swellings arising from the patella. Auto graft from the tendoachilles is a good alternative for reconstructing the extensor mechanism of the knee.

Structural bone allografts with intramedullary vascularized fibular autografts for the treatment of massive bone defects in extremities

Objective:To report the clinical outcome of repairing massive bone defects biologically in limbs by homeochronous using structural bone allografts with intramedullary vascularized fibular autografts. Methods: From January 2001 to December 2005, large bone defects in 19 patients (11 men and 8 women, aged 6 to 35 years) were repaired by structural bone allografts with intramedullary vascularized fibular autografts in the homeochronous period. The range of the length of bone defects was 11 to 25 cm (mean 17.6 cm), length of vascularized free fibular was 15 to 29 cm (mean 19.2 cm), length of massive bone allografts was 11 to 24 cm (mean 17.1 cm). Location of massive bone defects was in humerus(n=1), in femur(n=9) and in tibia(n=9), respectively. Results: After 9 to 69 months (mean 38.2 months) follow-up, wounds of donor and recipient sites were healed inⅠstage, monitoring-flaps were alive, eject reaction of massive bone allografts were slight, no complications in donor limbs. Fifteen patients had the evidence of radiographic union 3 to 6 months after surgery, 3 cases united 8 months later, and the remained one case of malignant synovioma in distal femur recurred and amputated the leg 2.5 months, postoperatively. Five patients had been removed internal fixation, complete bone unions were found one year postoperatively. None of massive bone allografts were absorbed or collapsed at last follow-up. Conclusion: The homeochronous usage of structural bone allograft with an intramedullary vascularized fibular autograft can biologically obtain a structure with the immediate mechanical strength of the allograft, a potential result of revascularization through the vascularized fibula, and accelerate bone union not only between fibular autograft and the host but also between massive bone allograft and the host.

Endovascular treatment of aortoiliac aneurysms: From intentional occlusion of the internal iliac artery to branch iliac stent graft

Approximately 20%-40% of patients with abdominal aortic aneurysms can have unilateral or bilateral iliac artery aneurysms and/or ectasia. This influences and compromises the distal sealing zone during endovascular aneurysm repair. There are a few endovascular techniques that are used to treat these types of aneurysms, including intentional occlusion/over-stenting of the internal iliac artery on one or both sides, the "bell-bottom" technique, and the more recent method of using an iliac branch stent graft. In some cases, other options include the "snorkel and sandwich" technique and hybrid interventions. Pelvic ischemia, represented as buttock claudication, has been reported in 16%-55% of cases; this is followed by impotence, which has been described in 10%-17% of cases following internal iliac artery occlusion. The bellbottom technique can be used for a common iliac artery up to 24 mm in diameter given that the largest diameter of the stent graft is 28 mm. There is a paucity of data and evidence regarding the "snorkel and sandwich" technique, which can be used in a few clinical scenarios. The hybrid intervention is comprised of a surgical operation, and is not purely endovascular. The newest branch stent graft technology enables preservation of the anterograde flow of important side branches. Technical success with the newest technique ranges from 85%-96.3%, and in some small series, technical success is 100%. Buttock claudication was reported in up to 4% of patients treated with a branch stent graft at 5-year follow-up. Mid- and short-term follow-up results showed branch patency of up to 88% during the 5-6-year period. Furthermore, branch graft occlusion is a potential complication, and it has been described to occur in 1.2%-11% of cases. Iliac branch stent graft placement represents a further development in endovascular medicine, and it has a high technical success rate without serious complications.

Ganglioside promotes the bridging of sciatic nerve defects in cryopreserved peripheral nerve allografts

Previous studies have shown that exogenous gangliosides promote nervous system regeneration and synapse formation. In this study, 10 mm sciatic nerve segments from New Zealand rabbits were thawed from cryopreservation and were used for the repair of left sciatic nerve defects through allograft bridging. Three days later, 1 mL ganglioside solution （1 g/L） was sub- cutaneously iniected into the right hind leg of rabbits. Compared with non-injected rats, muscle wet weight ratio was increased at 2-12 weeks after modeling. The quantity of myelinated fibers in regenerated sciatic nerve, myelin thickness and fiber diameter were elevated at 4-12 weeks after modeling. Sciatic nerve potential amplitude and conduction velocity were raised at 8 and 12 weeks, while conduction latencies were decreased at 12 weeks. Experimental findings indicate that ganglioside can promote the regeneration of sciatic nerve defects after repair with cryopre- served peripheral nerve allografts.

Angioscopic Observation of an Endoluminal Stent Graft: CT Imaging versus Angioscopic Imaging

We could observe the endoluminal stent graft (SG) following thoracic endovascular aneurysm repair (TEVAR) by a coronary artery angioscope and establish intravascular visualization of SG. The patient was a 70-year-old woman with the distal aortic arch aneurysm and the descending aortic aneurysm, and debranching TEVAR were performed. After 12 months follow up, urgent hospitalization was required for chest pain, and cardiac catheter examination with a coronary artery angioscope was performed. The endoluminal SG was observed. The observation in angioscope which is a video image is better than CT that is a still image, and observation in blood vessel or SG is possible. It may be possible to observe the endoluminal SG, allowing potential investigation of an endoleak, or the covering status of the SG with the native aortic vessel wall, or the state of intimal membrane formation in the endoluminal graft.

Dural Graft-Induced Fibrotic Mass Twelve Years after Successful Treatment of Skull Base Non-Hodgkin Lymphoma Mimicking Recurrence: Case Report and Literature Review

Non-Hodgkin lymphoma involving the skull base is a very rare tumour. The role of surgery for these patients remains controversial, as is the use of dural graft for CSF leak repair. With an increasing incidence of CNS lymphoma, more atypical presentations are reported. It is, therefore, important to include lymphoma in the differential diagnosis of skull base lesions as long-term remission is achievable for such patients, as shown in our case. Dural graft used for CSF leak repair could present with delayed complication mimicking tumour recurrence. Relevant published literature is reviewed.