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Neurotherapeutic potential of erythropoietin after ischemic injury of the central nervous system

Neural Regeneration Research 2019年第8期14卷 1309-1312页

作者： Florian Simon Nicolaos Floros Wiebke Ibing Hubert Schelzig Artis Knapsis department of Vascular and endovascular surgery Heinrich-Heine-University of Düsseldorf

Erythropoietin (EPO) is one of the most successful biopharmaceuticals in history and is used for treating anemia of different origins. However, it became clear that EPO could also work in a neuroprotective, antiapoptotic, antioxidative, angiogenetic and neurotropic way. It causes stimulation of cells to delay cell apoptosis, especially in the central nervous system. In rodent models of focal cerebral ischemia, EPO showed an impressive reduction of infarct size by 30% and improvement of neurobehavioral outcome by nearly 40%. A large animal model dealing with ischemia and reperfusion of the spinal cord showed that EPO could reduce the risk of spinal cord injury significantly. In addition, some clinical studies tested whether EPO works in real live clinical settings. One of the most promising studies showed the innocuousness and improvements in follow-up, outcome scales and in infarct size, of EPO-use in humans suffering from ischemic stroke. Another study ended unfortunately in a negative outcome and an increased overall death rate in the EPO group. The most possible reason was the involvement of patients undergoing simultaneously systemic thrombolysis with recombinant tissue plasminogen activator. An experimental study on rats demonstrated that administration of EPO might exacerbate tissue plasminogen activator-induced brain hemorrhage without reducing the ischemic brain damage. This case shows clearly how useful animal models can be to check negative side effects of a treatment before going into clinical trials. Other groups looked in human trials at the effects of EPO on the outcome after ischemic stroke, relation to circulating endothelial progerdtor cells, aneurysmal subarachnoid hemorrhage, traumatic brain injury, hemoglobin transfusion thresholds and elective first-time coronary artery bypass surgery. Most of the results were pos-让ive, but are based mostly on small group sizes. However, some of the most neglected facts when focusing on experimental setups of ischemia of the central nervous system are issues

关键词： erythropoietin apoptosis central nervous system cerebral ischemia animal model stroke human trials age comorbidity spinal cord ischemia

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endovascular treatment for left innominate vein aneurysm: Case report and literature review

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Journal of Interventional Medicine 2019年第1期2卷 35-37页

作者： Gaopo Cai Zhaohui Hua Peng Xu Zhouyang Jiao Hui Cao Shirui Liu Jing Yuan Zhengyu Peng Zhen Li department of endovascular surgery First Affiliated Hospital of Zhengzhou University

Innominate vein aneurysms originating from the mediastinum are very rare. Previous treatments for this condition often required thoracotomy. We report a case of a 43-year-old male who presented a mediastinal mass by chest radiography. Contrast-enhanced CT and venography confirmed the diagnosis of left innominate vein aneurysm. The patient underwent endovascular treatment with stent placement and coil embolization of the left innominate vein. The patient remains well 18 months after surgery. The objective of this report is to discuss the diagnosis and endovascular treatment results of innominate vein aneurysm and to review the relevant literature to enhance and expand the pool of knowledge for this abnormality.

关键词： Innominate vein aneurysm endovascular treatment Literature review

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Posterobasal left ventricular aneurysm after myocardial infarction with normal coronary arteries:Case-report

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World Journal of Clinical Cases 2018年第6期6卷 139-142页

作者： Roman Evgenyevich Kalinin Igor Aleksandrovich Suchkov Nina Dzhansugovna Mzhavanadze Adelphina Felician Ncheye department of Cardiovascular EndovascularOperative Surgery and Topographic AnatomyRyazan State Medical University

We present a case of a 64-year-old woman with signs of debilitating condition including anginal chest pain, exertional dyspnea, and depression. The patient had previously suffered from a myocardial infarction after a loss of a close family member. Workup showed a posterobasal left ventricular aneurysm and moderate to severe mitral regurgitation in the absence of coronary atherosclerosis. Routine ultrasonography revealed abdominal aortic aneurysm and intraabdominal aortic deviation. The patient was immediately started on optimal medical treatment. On repeat assessment general condition was satisfactory, vital signs were normal, and investigations showed no signs of progressive heart failure or other significant clinical changes. Although prognosis in patients with myocardial infarction with normal coronary arteries is generally considered favorable, mechanical complications such as posterobasal left ventricular aneurysm with moderate to severe mitral regurgitation are possible.

关键词： Myocardial infarction Posterobasal aneurysm Abdominal aortic aneurysm

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Strategies to prevent and detect intraoperative spinal cord ischemia during complex aortic surgery:from drainages and biomarkers

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Neural Regeneration Research 2021年第4期16卷 678-679页

作者： Alexander Gombert Florian Simon department of Vascular surgery University Hospital RWTH Aachen AachenGermany department of Vascular and endovascular surgery Heinrich-Heine-University of DüsseldorfDüsseldorfGermany

Spinal cord ischemia(SCI),a frequent complication following open and endovascular thoracoabdominal aortic aneurysm(TAAA)repair,is a feared complication with relevant impact on a patient's quality of life.In the early days of open TAAA repair,more than one third of the patients suffered from SCI.Nowadays,due to improved preventive measures and the option of staged endovascular TAAA repair,10%of all patients are affected by spinal cord problems after TAAA repair(Rocha et al.,2020).

关键词： ischemia aortic SCI

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How to balance between carotid endarterectomy and carotid artery stenting

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Chinese Medical Journal 2013年第3期126卷 565-568页

作者： WEI Zhou Division of Vascular and endovascular surgery Department of Surgery Stanford University 300 Pasteur Drive Suite 3640 Stanford CA 94305 USA

Stroke is one of the most common causes of permanent disability in industrialized countries and become increasingly prevalent in developing countries. Management of stroke consumes $45 billion annually, and is responsible for greater than one million hospital admissions each year in the U.S. Neurologic sequelae related to cerebral vascular accidents （CVA） severely limit a patient＇s ability to carry out activities of daily living and invariably create an enormous burden on health care costs. As a result, the prevention of CVA with safe treatment of extra-cranial carotid occlusive disease remains an important health care goal.

关键词： carotid vascular surgery endovascular

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Antegrade in situ laser fenestration of aortic stent graft during endovascular aortic repair:A case report

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World Journal of Clinical Cases 2022年第4期10卷 1401-1409页

作者： Zhi-Wei Wang Zhen-Tao Qiao Ming-Xing Li Hua-Long Bai Yuan-Feng Liu Tao Bai department of Vascular and endovascular surgery First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450003Henan ProvinceChina

BACKGROUND The endovascular repair of juxtarenal abdominal aortic aneurysms(JAAA)usually requires combination treatment with various stent graft modifications to preserve side branch patency.As a feasible technique,according to the situation,antegrade in situ laser fenestration still needs to be improved.CASE SUMMARY This report describes a case that was successfully treated with endovascular repair facilitated by antegrade in situ laser fenestration while maintaining renal arterial flow.Laser fenestration was performed using a steerable sheath positioned in the stent graft lumen in front of the renal artery ostium.With the bare stent region unreleased,renal artery perfusion could be maintained and accurate positioning could be achieved by angiography in real time.CONCLUSION This study suggests the feasibility and short-term safety of this novel antegrade in situ laser fenestration technique for select JAAA patients.

关键词： Juxtarenal abdominal aortic aneurysm In situ fenestration Thoracic endovascular aortic repair Antegrade Case report

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Improved Mechanical Properties of Poly(butylene succinate) Membrane by Co-electrospinning with Gelatin

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Chinese Journal of Polymer Science 2018年第9期36卷 1063-1069页

作者： Lu Chen Hui-Hui Cheng Jiang Xiong Ya-Ting Zhu Hong-Peng Zhang Xi Xiong Yu-Man Liu Jian Yu Zhao-Xia Guo Key Laboratory of Advanced Materials (Ministry of Education) Department of Chemical Engineering Tsinghua University department of Vascular and endovascular surgery Chinese PLA General Hospital

Gelatin, a natural proteinous polymer, was used to co-electrospin with poly（butylene succinate）（PBS） in order to improve the mechanical properties of PBS membrane and facilitate its applications in biomedical field. The PBS/gelatin blend membranes have narrower distribution of fiber diameter and smoother surface than neat PBS membrane. The contact angles, water absorption rates and water uptakes of the PBS/gelatin blend membranes were measured, showing increased hydrophilicity. The interaction between PBS and gelatin was investigated by attenuated total reflectance Fourier transform infrared spectroscopy （ATR-FTIR） and differential scanning calorimetry （DSC）. The mechanical properties of PBS/gelatin blend membranes in both dry and wet states were evaluated by uniaxial tensile tests. In the dry state, the PBS/gelatin blend membrane containing 10% gelatin has a 3-times increase in tensile strength without any adverse effect on ductility because of the existence of interaction between the two blend components, little change in crystallinity of PBS, and possible interaction between any adjacent fibers; the tensile strength and elongation at break are even better in the wet state attributed to some gelatin on fiber surfaces, which act as a binder in the presence of water. The potential applications of PBS/gelatin blend membranes were demonstrated by successful immobilization of thrombin, a clinically-used hemostatic drug. The thrombin-loaded membrane could be used for rapid hemostasis.

关键词： PBS Gelatin Electrospinning Mechanical properties Blending

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Total endovascular repair of aberrant right subclavian artery using caster branched stent-graft

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Journal of Geriatric Cardiology 2018年第12期15卷 751-754页

作者： Guo-Yi SUN Wei GUO Xiao-Ping LIU Xin JIA Jiang XIONG Hong-Peng ZHANG Xiao-Hui MA Feng CHEN Sen-Hao JIA Jie LIU Yang-Yang GE department of Vascular and endovascular surgery Chinese PLA General HospitalBeijingChina department of ICU PLA Rocket Force Characteristic Medical CenterBeijingChina

A 57-year-old man has 20-year history of hypertension presented with intermittent chronic pain in the chest area and shoulder blades over the last three months.Computed tomographic angiography(CTA)on admission revealed a chronic type B aortic dissection(TBAD)with an aberrant right subclavian artery(ARSA)crossed behind the trachea and bovine aortic arch(Figure IB).

关键词： Aberrant right subclavian artery Aortic dissection Branch stent-graft Thoracic endovascular aortic repair

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Elastic fiber regeneration in vitro and in vivo for treatment of experimental abdominal aortic aneurysm

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Chinese Medical Journal 2013年第3期126卷 437-441页

作者： XIONG Jiang GUO Wei WEI Ren ZUO Shang-wei LIU Xiao-ping ZHANG Tao department of Vascular and endovascular surgery Vascular Surgery Center of People's Liberation Army Chinese People's Liberation Army General Hospital Beijing 100853 China

Background The pathological characteristics of abdominal aortic aneurysm （AAA） involved the regression of extracellular matrix （ECM） in aortic walls, especially elastic structure in medial layer. As the major structural protein of aorta, elastin contributes to the extensibility and elastic recoil of the vessels. We hypothesized that overexpression of elastin in vessel walls might regenerate the elastic structure of ECM, restore the elastic structure of the aneurysmal wall, and eventually lead to a reduction of aortic diameters （ADs） in an experimental model of AAA. Methods Tropoelastin （TE） of Sprague Dawley （SD） rat was synthesized by reverse transcription polymerase chain reaction and used to construct adneviral vectors containing elastin precursor protein （AdTE-GFP）. Cultured vascular smooth muscle cells （VSMCs） from aortas of male SD rats were transfected with AdTE-GFP, AdGFP, adenoviral vector （AdNull）, and phosphate buffered saline （PBS）. Immunofluorescence staining was performed to determine the expression of elastin in transfected cells. The expression of elastic fibers in ECM of VSMCs transfected with AdTE-GFP were detected by fluorescence microscopy and transmission electron microscopy （TEM） at 1, 3, and 5 days following gene transfer. The AAA vessel walls were infused with AdTE-GFP or an empty AdNull, or PBS directly into the aneurysmal lumen. ADs of the aneurysms were compared in infused aortas. Formation of new elastic fibers in vivo was assessed by hematoxylin and eosin, and elastic von-Giesson staining. Recombinant elastin-GFP in vivo was identified by immunohistochemical staining. Results Elastic fibers were increased both in ECM of VSMC and in vessel walls after gene transfer. Histological studies revealed that the AdTE-GFP-transduced aortas had elastic fiber regeneration in the aneurysmal walls. The AdTE-GFP-transduced aortas showed a decreased AD （23.04%±14.49%, P 〈0.01） in AAA vessel walls. Conclusions Elastic fibers have been successfully overexpressed both in vitro and in a rat model of AAA

关键词： abdominal aortic aneurysm elastic fiber adenovirus animal model vascular smooth muscle cell ultr astructure

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腹腔镜手术治疗腹主动脉瘤的现状及展望

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中国微创外科杂志 2011年第1期11卷 35-37页

作者： Ralf R.Kolvenbach 朱越锋 department of Vascular surgery and endovascular Therapy Augusta Hospital and Catholic Clinics

腹腔镜手术被公认为一种微创的治疗方法，在过去30年腹部外科手术的发展中扮演了重要的角色。导管介入的发展同样也促进了整个血管外科微创治疗的发展。血管内介入通常作为闭塞性疾病和动脉瘤的微创治疗手段，腹腔镜手术在当代血管疾病... 详细信息

腹腔镜手术被公认为一种微创的治疗方法，在过去30年腹部外科手术的发展中扮演了重要的角色。导管介入的发展同样也促进了整个血管外科微创治疗的发展。血管内介入通常作为闭塞性疾病和动脉瘤的微创治疗手段，腹腔镜手术在当代血管疾病的治疗模式中起到越来越重要的作用。腹腔镜在血管外科领域中的应用有以下几种方式：①手助腹腔镜手术（hand assisted laparoscopic surgery，HALS），通过手助方式帮助分离和吻合；②腹腔镜辅助手术（1aparoscopically assisted），在腹腔镜辅助下行小切口分离解剖，常规方式行血管吻合；③完全腹腔镜手术（totallaparoscopiesurgery），解剖分离和血管吻合完全使用腹腔镜技术，有些在开放主动脉手术中无法解剖分离的路径在腹腔镜下可以完成，例如直接进腹路径、结肠后路径、肾后路径、腹膜后路径等”^[1,2]。这些技术的优缺点已经在许多文献中有讨论，本文不作更多评论。目前仍然有很多人支持和反对这些腹腔镜技术在血管外科手术中的应用。当前主流血管外科界未广泛接受腹腔镜技术在主动脉手术中的应用，除非在腹腔镜下缝合、阻断、出血控制、止血等关键技术出现突破性进展，腹腔镜主动脉手术无法像血管介入那样得到广泛使用。然而，并非所有病人都适合血管介入手术。血管的介入治疗存在解剖局限、生存质量差、费用昂贵、远期生存率低、有Ⅱ型内漏、移植物移位、主动脉瘤颈扩张、动脉瘤破裂可能等缺点，促使我们去寻找其他更好的微创治疗手段。

关键词：手助腹腔镜手术腹主动脉瘤手术治疗 laparoscopic 腹腔镜辅助手术小切口分离腹腔镜技术 surgery

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