Safety and Efficacy of Endovascular Aortic Repair for Abdominal Aortic Aneurysms with a Hostile Neck Anatomy

Objective This study aimed to investigate the safety and efficacy of endovascular aortic repair(EVAR)for the treatment of an abdominal aortic aneurysm(AAA)with a hostile neck anatomy(HNA).Methods From January 1,2015 to December 31,2019,a total of 259 patients diagnosed with an AAA who underwent EVAR were recruited into this study.Based on the morphological characteristics of the proximal neck anatomy,the patients were divided into the HNA group and the friendly neck anatomy(FNA)group.The patients were followed up for up to 4 years.Results The average follow-up time was 1056.1±535.5 days.Type I endoleak occurred in 4 patients in the HNA group,and 2 patients in the FNA group.Neither death nor intraoperative switch to open repair occurred in either group.The time of the operation was significantly longer in the HNA group(FNA vs.HNA,99.2±51.1 min vs.117.5±63.8 min,P=0.011).There were no significant differences in short-term clinical success rate(P=0.228)or midterm clinical success rate(P=0.889)between the two groups.The overall mortality rate was 10.4%,and Kaplan-Meier survival analysis indicated that the two groups had similar cumulative survival rates at the end of the follow-up period(P=0.889).Conclusion EVAR was feasible and safe in patients with an AAA with a proximal HNA.The early and midterm results were promising;however,further studies are needed to verify the long-term effectiveness of EVAR.

The History of Controlling and Treating Infectious Diseases in Ancient China

Infectious diseases are the common enemies of mankind.In the course of historical development,they persistently threaten human health and safety.Even today,despite the developments in medical science,we cannot escape the fear and suffering caused by infectious diseases.Whether in ancient or modern times,the source of infection,route of transmission,and a susceptible population are the three key conditions for the prevalence and spread of infectious diseases.All factors closely related to these three conditions can affect the prevalence of infectious diseases.China is one of the cradles of world civilization.The ancient people accumulated a great deal of experience and lessons in the long struggle against infectious diseases.In the face of the current threat posed by widespread infectious disease,it is imperative to review and summarize ancient Chinese ideas and health policies on epidemic prevention and control to inspire contemporary efforts in the prevention and control of infectious disease.The combination of prevention-oriented epidemic prevention ideology and traditional medicine provides valuable insights,especially for impoverished and medically underserved regions.

Effect of Anti-KDR Antibody on the Proliferation of Hemangioma Vascular Endothelial Cells in vitro

The suppressive effect of anti-KDR antibody against VEGF on proliferation of hemangioma-derived vascular endothelial cells （HVECs） was investigated. HVECs from one case of hemangioma in proliferative phase were cultured. Both primary culture and sub-culture were conducted in M199 medium. The HVECs of passage 3 were divided into 4 groups based on the concentrations of anti-KDR antibody. Cell count was performed and inhibitory rate of HVECs was measured before and 9 days after interference. The results showed that the number of HVECs in the anti-KDR anti- body-treated groups was significantly decreased and the inhibitory rate of HVECs by anti-KDR antibody （50, 10 and 2 μg/mL） was 84%, 63% and 39% respectively at 9th day after interference, with the difference being significant. In the control group, the number of HVECs was increased significantly. In was concluded that the anti-KDR antibody could suppress the activity of VEGF through blocking the KDR, indicating the potential clinical applications of anti-KDR antibody in the treatment of hemangioma.

Longitudinal Mechanical Properties of Small-Diameter Polyurethane Vascular Graft Reinforced by Tubular Knitted Fabric

The vascular graft with 4 mm diameter was prepared by casting one layer of polyurethane (PU) film onto the knitting tubular fabric as the reinforced support. The effects of different PU content and wall thickness on the longitudinal mechanical properties of vascular graft were investigated. The breaking elongation, breaking force, initial modulus and breaking work were studied. The results showed that the longitudinal mechanical properties of vascular graft were enhanced as the content of polyurethane increased, which resulted from the combination of PU excellent elasticity and fabric preferable strength.

Mechanical Properties of Small-diameter Superfine Silk Powder/Polyurethane Vascular Graft Reinforced by Tubular Knitted Fabric

In this paper,a kind of composite microtube,which is made from superfine silk powder and polyurethane,reinforced by polyster and spandex tubular fabrics,was examined.The cross-section of composite microtubes were microporous,and micropores were uniform distributed,the inner surface was relatively smooth.The results showed that the wall thickness of composite microtubes increased,which led to the strength,the breaking work and the initial modulus incresead;that the spandex content increased brought about the initial modulus and the breaking work decreased,but the breaking extension and the breaking load were firstly increased and then decreased;and all the mechanical properties decreased as the SFSP content increased.

Inhibitory Effects of Rap1GAP Overexpression on Proliferation and Migration of Endothelial Cells via ERK and Akt Pathways

Rapl is expressed in human umbilical vein endothelial cells （HUVECs）. Rapl-GTPase activating protein （RaplGAP）, with its specific target, Rapl, has been shown to be important in the regulation of many physiological and certain pathological processes. In this study, we investigated the effect of RaplGAP expression on endothelial cell function, or, more specifically, proliferation and migration of endothelial cells. HUVECs were transfected with pcDNA3.1 （empty vector）, pcDNA3.1 containing Flag-tagged-RaplGAP or Myc-tagged-RaplN17. The proliferation, migration and tube formation were examined and compared among the 3 groups. Expression of Rapl, RaplGAP, extracellular signal-regulated kinase （ERK）, phospho-ERK, Akt, phosphor-Akt was detected by Western blotting. The results showed that the proliferation, migration and tube formation were significantly reduced in RaplGAP- and RaplN17-transfected HUVECs as compared with empty vector-transfected control. These changes were coincident with increased expression of Rap 1GAP and decreased expression of activated Rap l, phospho-ERK and -Akt. After treatment of Rap l GAP-transfected HUVECs with a stimulator of Rapl guanine-nucleotide-exchange factor （RaplGEF） 8CPT-2＇OMe-cAMP, it was found that Rapl activity was decreased as compared with empty vector-transfected control. Pretreatment of HU- VECs with an ERK inhibitor PD98059 or a PI3K inhibitor LY294002 prior to stimulation not only blocked 8CPT-2＇OMe-cAMP-induced phosphorylation of ERK and Akt, but also significantly reduced cell proliferation and migration. Finally, we examined the effect of vascular endothelial growth factor （VEGF） on HUVECs overexpressing RaplGAP. VEGF-stimulated Rapl activity, phosphorylation of ERK and Akt, cyclin D1 expression and cell proliferation were repressed in HUVECs overexpressing RaplGAP as compared to empty vector-transfected Control. Taken together, our findings demonstrate that RaplGAP/Rapl and their downstream effectors regulate proliferation and migration of HUVECs via ERK and Akt pathways.

Analysis of 287 Patients with Aortic Dissection:General Characteristics,Outcomes and Risk Factors in a Single Center

The general characteristics,outcomes and risk factors of the patients with aortic dissection（AD） were evaluated in a single medical center.From January 2002 to December 2008,284 patients with AD were treated and followed-up at our institution,including 105 cases of type A AD and 179 cases of type B AD.The patients in each type were divided into three groups according to management：medical treatment group（A or B）,open surgery group（A or B）,and stent-graft group（A or B）.The characteristics and follow-up outcomes were compared between the groups or subgroups.The results showed that there was significant difference in the prognosis for type A AD between medical treatment group and open surgery group,but there was no significant difference in the prognosis for type B AD between medical treatment group and stent-graft group.Independent risk factors of follow-up mortality for patients with type A AD included a history of atherosclerosis（HR,3.80795% confidence interval [CI],1.489 to 7.611P=0.003）,in-hospital hypotension/shock（HR,4.68795% CI,1.846 to 11.900P=0.001）,in-hospital myocardial ischemia or infarction（HR,3.73495% CI,1.613 to 8.643P=0.002）,pleural effusion（HR,2.21095% CI,1.080 to 4.521P=0.030）,branch vessel involvement（HR,2.74795% CI,1.202 to 6.278P=0.016） and surgical treatment（HR,0.17795% CI,0.063 to 0.502P=0.001）.And there were insignificant independent predictors for mortality of the patients with type B AD.It was concluded that there were significant differences in characteristics and one year mortality between type A AD and type B AD,but after one year,there was no significant difference in the mortality and complications of them.There were several discordant risk factors of AD,such as female gender,age,thrombus,abrupt onset of pain that were considered as the risk factors in some papers.And there was no definite risk factor of mortality in this study in the patients with type B AD.

Radiological Aspect of Klippel-Trénaunay Syndrome:A Case Series With Review of Literature

Klippel-Trénaunay syndrome (KTS)is arare angio-osteo-hypertrophic syndrome characterized by vascular malformations,soft tissue and/or bone hypertrophy, and varicose veins.For the purpose of describing the imaging findings and elucidating the role of medical imaging in the diagnosis and assessment of patient with KTS,we have reviewed the imaging data of 14 KTS patients.The imaging features on different imaging modalities were analyzed.Unilateral lower limb involvement was evident in 71% of cases (n=10)and bilateral but asymmetric lower limb involvement in the remaining 29% of cases (n=4).The most commonly depicted imaging features were varicosities in 93% (n=13),muscle hypertrophy in 79%(n=11)and venous anomalies in 64%(n=9).Other less common imaging findings included lymphedema in 29%(n=4),arterial malformations 29%(n=4),soft tissue hemangiomas 21%(n=3),pelvic and thigh phleboliths 21%(n=3), venous aneurysrns 21%(n=3),bone abnormalities 14%(n=2)and lymphadenopathy 14%(n=2).A severe unilateral lower limb deformity resulting in contractures and muscle atrophy of the whole limb was depicted in 1 case.The pathognomonic marginal vein of Servelle was identified in 2 cases.AV shunt was highly suspected in 4 cases and was confirmed by DSA in 1 case,making Klippel-Trénaunay-Weber syndrome a more apt diagnosis.Associated ipsilateral duplicated renal artery:was found in 1 case.We have concluded that medical imaging is the cornerstone in the.diagnosis and assessment of severity and complications,follow-up and differentiation of KTS from other similar conditions.Different imaging modalities play complementary roles in the evaluation of KTS patients.

Risk Factors and Management of Postoperative Pancreatic Fistula Following Pancreaticoduodenectomy:Single-center Experience

Pancreatic fistula(PF)remains the most frequent complication after pan­creaticoduodenectomy(PD).This study was undertaken to explore the risk factors of postoperative PF following PD and discuss the management of PF in our center.A single-center respective study,involving 241 patients who underwent PD between September 2015 and June 2018,was conducted.Differences in the demographic data,preoperative,intraoperative and postoperative variables between the group with PF[International Study Group on Pancreatic Surgery(ISGPS)grade B/C]and the group without PF(no PF and ISGPS grade BL)were evaluated.The diagnosis and grading of PF were in strict accordance with ISGPS.Risk factors were analyzed by univariate analysis and multivariate logistic regression analysis.The results showed that postoperative PF occurred in 50(20.7%)of the patients;25(10.4%)patients had a PF type BL,46(19.1%)patients developed a PF type B and 4(1.6%)had a PF type C.Univariate analysis showed that fasting blood glucose(P=0.02),pancreatic texture(P<0.001)and pancreatic duct diameter(P=0.01)were correlated with PF.Multivariate logistic regression analysis identified one independent risk factor for postoperative PF:soft pancreatic texture(OR=3.251,P=0.002).Among the cases,there were three postoperative deaths,giving a 60-day hospital mortality rate of 1.2%(3/241),and the mortality related to PF was 4.0%(2/50).One of the patients died from multiple organ failure caused by postoperative abdominal hemorrhage.In conclusion,soft pancreatic texture is an independent risk factor for PF.Surgeons should be well aware of this risk factor when performing a PD.

Current Status and Prospect of Stent Placement for May-Thurner Syndrome

Stent implantation has been proven to be safe and has become the first-line intervention for May-Thumer syndrome(MTS),with satisfactory mid-term patency rates and clinical outcomes.Recent research has demonstrated that catheter-directed thrombolysis is the preferred strategy when MTS is combined with deep vein thrombosis after self-expanding stent placement.However,the stent used for the venous system was developed based on the experience obtained in the treatment of arterial disease.Consequently,relatively common corresponding complications may come along later,which include stent displacement,deformation,and obstruction.Different measures such as adopting a stent with a larger diameter,improving stent flexibility,and increasing stent strength have been employed in order to prevent these complications.The ideal venous stent is presently being evaluated and will be introduced in detail in this review.

In Vivo Histocompatibility Evaluation of Polyurethane Membrane Modified by Superfine Silk-fibroin Powder

In this study, a novel polyurethane membrane, modified by superfine silk-fibroin powder, was prepared for small-diameter vascular grafting. Scanning electron microscopy, transmission electron microscopy, and histological examination were applied to evaluate histocompatibility of this polyurethane membrane. The polyurethane membrane was compared with polytetrafluoroethylene material. A pseudomembrane and gap formed between polytetrafluoroethylene and the surrounding tissues, and no cells infiltrated or grew into the polytetrafluoroethylene material. On the contrary, superfine silk-fibroin powder/polyurethane blend membrane merged tightly with the surrounding tissues without gaps, and cells infiltrated and grew into the material. Moreover, the negative effects of superfine silk-fibroin powder/polyurethane blend membrane on cells were less than those of its polytetrafluoroethylene counterpart. Our findings indicated that the superfine silk-fibroin powder/polyurethane blend membrane has better histocompatibility than polytetrafluoroethylene membrane. It is concluded that the superfine silk-fibroin powder/polyurethane blend membrane is a promising biomaterial for small-diameter prosthesis.

Intravenous Leiomyomatosis with Right Heart Involvement—A Report of 4 Cases and Literature Review

Intravenous leiomyomatosis（IVL） is a rare benign neoplasm which originates from the smooth muscle cells and is usually confined to the pelvic venous system.Rarely,intracaval and intracardiac extension has been described.Death can occur as a result of intracardiac involvement.We reported 4 cases of IVL with right heart involvement（intracardiac leiomyomatosis,ICL）.Three of them suffered recurrent sudden syncope,and the other one was totally asymptomatic.All of them were successfully treated through one-stage operation under extracorporeal circulation.

Transthoracic arterial bypass for the treatment of severe cerebral ischemia induced by brachiocephalic arteritis: A report of 15 cases

BACKGROUND： Carotid arterial reconstruction is hard to cure the extensive lesions of carotid arteries and subclavian arteries in patients with brachiocephalic arteritis; however, transthoracic arterial bypass surgery provides an opportunity for the treatment of brachiocephalic arteritis. OBJECTIVE： To report the improving effects of transthoracic arterial bypass surgery on the clinical symptoms of severe cerebral ischemia induced by brachiocephalic arteritis and observe the occurrence of complications after the intervention. DESIGN： Case observation. SETTING： Department of Vascular Surgery, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology. PARTICIPANTS： Fifteen patients with Takayasu arteritis, including 1 male and 14 females, were selected from Department of Vascular Surgery, Wuhan Union Hospital from June 2003 to June 2007. Their ages ranged from 16 to 37 years. All patients were finally diagnosed by clinical histories, health examinations and color Doppler detection. All patients provided the confirmed consent. METHODS： All patients had received transthoracic artificial vascular bypass surgery. Among them, 6 patients had the bridge from ascending aorta to bilateral axillary arteries to lateral internal carotid artery; 3 from ascending aorta to bilateral axillary arteries; 5 from ascending aorta to lateral axillary artery to lateral internal carotid artery; In particular, one patient combining with abdominal aorta occlusion had received two step surgical interventions. In the first step, bridging surgery was performed from ascending aorta to bilateral axillary arteries to lateral internal carotid artery; in the second step, patients received left axillofemoral bypass. MAIN OUTCOME MEASURES：① Detecting blood velocity in variously intracranial-arterial systoles by using transcranial Doppler postoperatively; ② following-up the improve of clinical symptoms at 40 months after surgery; ③ observing postoperative complications. RESULTS： All 15 patients were involved in the final analysis. ① Intracranial-arterial blood velocity： Average intracranial-arterial blood velocity was significantly increased postoperatively （P 〈 0.01）. ② Following-up results of clinical symptoms： All patients did not have death and blindness; while, transient cerebral ischemia, dizzy, photophobia, giddiness, hemoptysis and other symptoms disappeared gradually; therefore, patients were able to live by themselves. ③ Postoperative complications： Among them, 3 patients had injury of hypoglossal nerve and 3 patients had injury of recurrent laryngeal nerve. All recovered after 1 - 3 months conservative treatment. One patient with injury of brachial plexus nerve on one side relieved gradually after a half-year treatment. One patient had occlusion in subclavian arterial bridge on the third day after surgery and once more embolism after arterial embolectomy on the next day; however, the limb did not have obvious ischemic symptoms but low skin temperature as compared with the contralateral side. CONCLUSION： Transthoracic arterial bypass surgery can relieve clinical symptoms of brachiocephalic arteritis postoperatively, complications are mild, and the effects are confirmed.

Carotid endarterectomy for ameliorating the symptoms of transient ischemic attack A six-month postoperative follow-up

BACKGROUND： Carotid endarterectomy has certain risks, but it has obvious effects on preventing the occurrence of stroke. OBJECTIVE： To identify the effects of carotid endarterectomy on ameliorating the clinical symptoms and physical signs of patients with cerebral ischemia. DESIGN： A follow-up study. SETTING： Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology. PARTICIPANTS： Sixteen patients with carotid atherosclerotic stenosis accompanied by ischemic symptoms were selected from the Department of Vascular Surgery, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from March 2005 to May 2007. There were 11 males and 5 females, aged from 40 to 81 years old with a mean age of 60 years old, and they were all clearly diagnosed by carotid color Doppler ultrasound. Informed consent was obtained from all the patients. The study was approved by the hospital ethical committee. METHODS： （1） All the 16 patients were performed with unilateral stripping of arteriosclerotic plaque and Carotid endarterectomy, and 6 of them with bilateral stenosis was operated on the side with more serious stenosis. （2） The clinical symptoms, physical signs before and after operation, and the operative complications were observed. （3） The patients were followed up for 6 months postoperatively. The smoothness of carotid arteries was detected with color Doppler ultrasound. The degrees of satisfaction to the quality of living were evaluated. MAIN OUTCOME MEASURES： （1） Amelioration of clinical symptoms postoperatively; （2） Smoothness of carotid arteries postoperatively; （3） Degrees of satisfaction to the quality of living; （4） Postoperative complications. RESULTS： All the 16 patients were involved in the final analysis of results. （1） Amelioration of clinical symptoms and physical signs： The postoperative muscle strengths of 3 patients with stroke history were significantly ameliorated; For the 8 patients with TIA symptoms, and the symptoms disappeared completely in 6 cases of them; For the 5 patients with atypical nervous symptoms, the symptoms disappeared completely in 3 cases, and obviously alleviated in 2 cases. （2） All the patients were good in smoothness of carotid arteries. （3） The degree of satisfaction to the quality of living was a little satisfied in 2 patients, very satisfied in 1 patient, and satisfied in the others. （4） Postoperative complications： The complications were injury of hypoglossal nerve in 4 patients （25%） and injury of recurrent laryngeal nerve in 1 patient （6%）, and the complications recovered or turned better after conservative treatments for 1 - 3 months. CONCLUSION： Carotid endarterectomy can ameliorate the symptoms and physical signs of patients with cerebral ischemia, and it has mild postoperative complications.

Hypoxia Enhances the Therapeutic Potential of Superparamagnetic Iron Oxide-labeled Adipose-derived Stem Cells for Myocardial Infarction

Adipose-derived stem cells（ASCs） induce therapeutic angiogenesis due to pro-angiogenic cytokines secretion. Superparamagnetic iron oxide（SPIO） nanoparticles are critical for magnetic resonance（MR） tracking of implanted cells. Hypoxia is a powerful stimulus for angiogenic activity of ASCs. In this study, we investigated whether therapeutic potency could be enhanced by implantation of hypoxia-preconditioned SPIO-labeled ASCs（SPIOASCs） into the infarcted myocardium. ASCs and SPIOASCs were cultured under 2% O_2（hypoxia） or 95% air（normoxia）. Cells were intramyocardially injected into the infarcted myocardium after 48-h culture. We found that hypoxia culture increased the m RNA expression of hypoxia-inducible factor-1 alpha（HIF-1α） and vascular endothelial growth factor（VEGF） in ASCs and SPIOASCs. The VEGF protein in the conditioned medium was significantly higher in hypoxic ASCs and SPIOASCs than in normoxic ASCs and SPIOASCs. The capillary density and left ventricular contractile function in the infarcted myocardium were significantly higher 4 weeks after implantation with hypoxic ASCs and SPIOASCs than with normoxic ASCs and SPIOASCs. Improvement in the capillary density and left ventricle function didn＇t differ between hypoxic ASCs-transplanted rats and hypoxic SPIOASCs-transplanted rats. Hypoxic culture enhanced the angiogenic efficiency of ASCs. It was concluded that implantation of hypoxic ASCs or SPIOASCs promotes therapeutic angiogenesis and cardiac function recovery in the infarcted myocardium. SPIO labeling does not impact the beneficial effect of hypoxic ASCs.

Current status and future development of aortic stent fenestration-assisted techniques

To the Editor:In 1996,Parodi et al^([1])introduced the technique of fenestrated endovascular aneurysm repair(f-EVAR)for treatment of pararenal abdominal aortic aneurysms.They use physician modified stent grafts(PMSGs)for fenestration,which allows for stent grafts to gain sufficient proximal sealing zones and maintain the blood perfusion of visceral arteries.^([2])Stent grafts used in the f-EVAR technique developed from PMSGs to Company Modified Devices(CMDs)and off-the-shelf devices.^([3])To improve the precision of PMSGs and shorten the time of stent graft modification,various techniques that assist in the process of fenestration have been researched and developed,including 3-dimensional(3D)printing technique,the Mixed Reality(MR)technique,and the 3D parametric surface planar topological guide plate.This article describes the current status and future development of these techniques.

Topical Propranolol Hydrochloride Gel for Superficial Infantile Hemangiomas

The clinical efficacy and safety of topical propranolol hydrochloride gel in the treatment of superficial infantile hemangiomas (IHs) were assessed. Fifty-one cases of IHs from Oct. 2010 to Sept. 2011 were subjected to the topical propranolol hydrochloride gel intervention in Fuzhou General Hospital of Nanjing Military Commands, China. Changes in size, texture, color, peak systolic velocity of the hemangiomas, resistance index and adverse effects were observed. The results were evaluated by using Achauer system, and responses of IHs to pranpronolol were considered scaleⅠ(poor) in 4 patients (17.24%), scaleⅡ(moderate) in 18 patients (24.14%), scale Ⅲ (good) in 22 patients (44.83%) and scale Ⅳ (excellent) in 7 patients (13.79%). The response of superficial hemangiomas was significantly better than other hemangiomas (P<0.05), and no differences in response were found among different primary sites (P>0.05). Our study indicates that topical application of 3% propranolol hydrochloride gel is effective and safe in treating IHs.

Liquid biopsy:Precise diagnosis and therapy for cholangiocarcinoma

The following letter to the editor highlights the review titled“Liquid biopsy in cholangiocarcinoma:Current status and future perspective”in World J Gastrointest Oncol 2021;13:332-350.It is necessary to realize individualized therapy to improve the clinical prognosis of patients with cholangiocarcinoma.

Carbohydrate Antigens as Potential Biomarkers for the Malignancy in Patients with Idiopathic Deep Venous Thrombosis:A Retrospective Cohort Study

A variety of biomarkers have been identified in recent prospective and retrospective re- ports as being potentially predictive of venous thromboembolis （VTE）, particularly idiopathic deep venous thrombosis （IDVT）. This study identified a serum tumor biomarker for early screening of IDVT. A total of 128 IDVT patients （54 females and 74 males; average age： 50.9＋17.4 years） were included. Carcinoembryonic antigen （CEA）, ferritin, β2-microglobulin, cancer antigen （CA） 125, CA 15-3, CA 19-9, squamous cell carcinoma antigen （SCC）, alpha-fetoprotein （AFP）, prostate specific antigen （PSA）, free PSA （f-PSA）, and beta-human chorionic gonadotropin （13-HCG） in patients with IDVT were detected. Malignancies were histo- or cytopathologically confirmed. Of the 128 IDVT patients, 16 （12.5%） were found to have malignarteies. Serum CEA, CA 125, CA 15-3, and CA 19-9 were found to be helpful for detecting malignancies in IDVT patients. Our study revealed a positive association between these markers and tumors in IDVT patients. On the other hand, SCC and AFP were not sensitive enough to be markers for detecting tumors in patients with IDVT. No significant differences were found in positive rates of ferritin and 132-microglobulin between turnor and non-ttmaor groups, and no significant difference exists in serum levels of ferritin and 132-microglobulin between the two groups. Carbohydrate antigens, CA 15-3 in particular, may be useful for differential diagnosis and prediction of malignancies in patients with IDVT.

Successful infrainguinal revascularization with autologousvein for inadvertent stripping of superficial femoral artery:a case report

A referral patient who had previously under-gone varicose vein surgery was admitted as an emergency case.On admission,the patient complained of intolerable pain,paralysis and paresthesia of the affected limb,which was characterized by acute arterial ischemia symptoms.Color Doppler of the artery of the affected limb indicated that no bloodflow signal existed in the superficial femoral artery.During exploratory operation,we found that the right superficial femoral artery instead of the great saphenous vein of the affected limb had been stripped and ligated.Therefore,the intact right great saphenous vein was taken for auto-transplantation by inverse end-to-end anastomosis to the proximal and distal residual superficial femoral artery,which resulted in gradual recovery.Except for ischemic reperfusion injury,no other post-operative complications occurred after a 10 month follow-up;however,the long-term curative effect needs further observation.Here we report our treatment experience.