Mid-Term Outcomes Following TEVAR for Chronic Type B Aortic Dissection.

To evaluate the mid-term outcomes following thoracic endovascular aortic repair (TEVAR) for chronic type B aortic dissection (TBD), especially to know which re-entry closure affects the thoracic false lumen remodeling in the late chronic TBD. : From April 2017 to April 2022, 25 patients with chronic TBD underwent TEVAR. The late chronic TBD received the re-entry closure including stent-graft deployment in the renal artery, infrarenal aorta, and unilateral or bilateral iliac artery.

Prognostic factors after open and endovascular repair for infected native aneurysms of the abdominal aorta and common iliac artery.

Objective: Infected native aneurysms (INAs) of the abdominal aorta and iliac arteries are uncommon, but potentially fatal. Endovascular aneurysm repair (EVAR) has recently been introduced as a durable treatment option, with outcomes comparable to those yielded by conventional open repair. However, owing to the rarity of the disease, the strengths and limitations of each treatment remain uncertain.

Surgical Treatment for Popliteal Artery Entrapment Syndrome in Japan: a Retrospective, Multicentre Study Using a National Clinical Registry.

Objective: Surgical treatment is an established method for popliteal artery entrapment syndrome (PAES), which, however, mainly derives from single centre experiences where PAES cases are centralised and treated periodically. This study evaluated clinical outcomes of surgical treatment for PAES in a clinical setting where PAES cases were not centralised.

Methods: Multicentre, retrospective cohort study using a national clinical registry.

Midterm Performance of the Autologous Adventitial Overlay Method in Aortic Surgery.

Background: We developed an adventitial overlay method for reinforcing aortic anastomoses. This study evaluated the midterm morphologic and clinical outcomes of this method.

Methods: We harvested and prepared adventitia from a resected aneurysm or dissected aortic wall and performed aortic repair using the adventitial overlay method.

Nationwide study of surgery for primary infected abdominal aortic and common iliac artery aneurysms.

Background: Primary infected aneurysms of the abdominal aorta and iliac arteries are potentially life-threatening. However, because of the rarity of the disease, its pathogenesis and optimal treatment strategy remain poorly defined.

Methods: A nationwide retrospective cohort study investigated patients who underwent surgical treatment for a primary infected abdominal aortic and/or common iliac artery (CIA) aneurysm between 2011 and 2017 using a Japanese clinical registry.

Anomalous systemic arterial supply to the basal segment of the lung with giant aberrant artery: a case report.

Background: Anomalous systemic arterial supply to the basal segment of the lung (ABLL) is a relatively rare congenital anomaly characterized by aberrant systemic arterial blood flow to the basal segment of the lung. We experienced a rare presentation of ABLL, in which a giant aberrant artery with the same dimensions as that of the descending aorta flowed from the celiac artery to left lower lobe.

Case Presentation: An otherwise healthy 42-year-old man was referred to our department due to an abnormal chest X-ray.

Early and Mid-Term Outcomes Following TEVAR for Chronic Type B Aortic Dissection.

We examined the outcomes of aortic remodeling for chronic type B aortic dissection (cTBD) after thoracic endovascular aneurysm repair (TEVAR). : Thirty-eight patients underwent TEVAR for cTBD at our institution. We classified cTBD patients into the early cTBD group (16 cases, 2 weeks-4 months from onset) and late cTBD group (22 cases, >4 months from onset).

Segmental clamp and distal perfusion technique for reducing myocardial ischemia during coronary onlay grafting on a beating heart.

We present a segmental clamp with distal perfusion technique to reduce myocardial ischemia during onlay grafting, on a beating heart. After a proximal coronary arteriotomy for 2-3 cm, the distal artery is perfused through a cannula, with femoral arterial blood (distal perfusion with external shunt). During proximal and distal coronary snare clamping with distal perfusion, onlay anastomosis is performed, from the heel toward the point of cannula insertion.

Aortic arch surgery in octogenarians: is it justified?

Objectives: Elderly patients are sometimes denied aortic arch surgery because of the perception of poor outcomes and an unacceptable quality of life (QOL). In this study, we evaluated the early clinical outcomes, long-term survival and QOL following surgical treatment for aortic arch disease in octogenarian patients.

Methods: A total of 47 consecutive patients over the age of 80 years were referred to our institutions.

Chimney technique for aortic dissection involving an aberrant right subclavian artery.

We report a case involving a ruptured acute type B aortic dissection originating from an aberrant right subclavian artery (ARSA). A thoracic stent-graft was deployed in the distal arch close to the origin of the ARSA; the entry site at the origin of the ARSA was embolized with metallic coils. Perfusion of the left subclavian artery was preserved without a surgical bypass by using a chimney graft.

Perioperative synbiotic therapy in elderly patients undergoing gastroenterological surgery: a prospective, randomized control trial.

Objective: Enteral administration of synbiotics has been reported to be beneficial during various types of surgery, but its clinical value in elderly surgical patients remains unclear. The aim of this study was to quantitatively evaluate the changes in gut microbiota and environment induced by perioperative synbiotic therapy, and to investigate whether it is possible to reduce infectious complications in elderly patients undergoing gastroenterological surgery.

Methods: Forty-eight patients over the age of 70 y were randomized into a group receiving 7 d of preoperative and 10 d of postoperative synbiotic therapy (S group) and a control group without synbiotic therapy (C group).

Endovascular repair of distal arch aneurysm with double-chimney technique.

We report 2 cases of distal arch aneurysm treated by thoracic endovascular aneurysm repair (TEVAR) with the "double-chimney technique." This technique permitted the implantation of a thoracic stent graft in the ascending aorta over the arch branches while preserving perfusion of innominate and left common carotid arteries without debranching bypasses. The procedure is a feasible and less invasive treatment for distal arch aneurysm with a short proximal neck (<2 cm to the origin of the innominate artery) in patients at high risk when undergoing sternotomy and in emergent cases.

Single-stage thoracic and abdominal endovascular aneurysm repair for multilevel aortic disease.

This investigation evaluated the results of single-stage thoracic endovascular aneurysm repair (TEVAR) and endovascular aneurysm repair (EVAR) for multilevel aortic disease in a series of nine patients. The lesions repaired included thoracic and abdominal aortic aneurysms (n= 7) and subacute type B dissections with abdominal aortic aneurysms (n=2). All procedures were successfully performed, and none of the patients experienced postoperative stroke or spinal cord ischemia.

[Two cases of non-curatively resected scirrhous gastric cancer that responded well to weekly paclitaxel therapy].

We report 2 cases in which the weekly administration of paclitaxel proved to be effective for patients with scirrhous gastric cancer who underwent a curability C operation. Weekly paclitaxel therapy was observed to effectively treat peritoneal and retroperitoneal dissemination. After this treatment the tumor markers decreased markedly.

Experimental and clinical studies investigating the efficacy of distal anastomosis with patch plasty in bypass operations with expanded polytetrafluoroethylene grafts.

Purpose: We investigated the efficiency of distal anastomosis with patch plasty (DAPP), both experimentally and clinically.

Methods: In our experimental study, dogs were divided into two groups: a control group in which anastomosis was performed without DAPP ( n = 7), and a DAPP group in which DAPP was performed at the distal anastomosis ( n = 7). In our clinical study, 169 femoropopliteal bypasses were divided into three groups and analyzed.

Matrix metalloproteinase expressions in arteriosclerotic aneurysmal disease.

Medial degeneration of extracellular matrix (ECM) proteins in the wall of abdominal aortas results in smooth muscle cell destruction, a loss of architectural integrity, and abdominal aortic aneurysm (AAA) formation. It has been theorized that an imbalance between proteinases and their naturally occurring inhibitors is the cause of these observed histologic abnormalities. Therefore, the purpose of this investigation was to determine if differences in the matrix metalloproteinase (MMP) -2 and -9, tissue inhibitor of metalloproteinase-1 (TIMP-1), tissue-type plasminogen activator (tPA), and urokinase-type plasminogen activator (uPA) protein and activity levels existed between infrarenal AAA and normal abdominal aortic tissue specimens.

Enhanced tumor necrosis factor- alpha expression in small sized abdominal aortic aneurysms.

Circulating levels of tumor necrosis factor alpha (TNF- alpha) are elevated in the patients with abdominal aortic aneurysm (AAA). We investigated TNF- alpha expression and cellular infiltration in the walls of AAAs of different sizes. Twenty-seven surgical specimens of AAAs were categorized according to the maximum aneurysm diameter into a small size group (less than 50 mm in diameter, n = 8; S group), a medium-sized group (50 to 59 mm in diameter, n = 11; M group), and a large size group (larger than 59 mm in diameter, n = 8; L group).

Diclofenac (Voltaren)-induced pneumonitis after chest operation.

We report a rare case of nonsteroidal anti-inflammatory drug-induced pneumonitis in a 72-year-old man taking diclofenac for wound pain after pulmonary resection. The pneumonitis and pleural effusion were predominant on the operative side and resolved rapidly after the diclofenac was discontinued. The diagnosis of drug-induced pneumonitis was based on a lymphocyte stimulation test that was positive for diclofenac sodium and negative for other drugs.

Neovascularization induced by autologous bone marrow cell implantation in peripheral arterial disease.

Neovascularization has recently been used as a new treatment for severe ischemic disease. We tried to induce therapeutic neovascularization by autologous bone marrow cell implantation (BMCI) in eight selected patients with chronic peripheral arterial disease (PAD), in whom traditional treatments had failed. Improvement of subjective symptoms was seen in seven patients after treatment.

Improved angiogenic potency by implantation of ex vivo hypoxia prestimulated bone marrow cells in rats.

Therapeutic angiogenesis can be induced by local implantation of bone marrow cells. We tried to enhance the angiogenic potential of this treatment by ex vivo hypoxia stimulation of bone marrow cells before implantation. Bone marrow cells were collected and cultured at 33 degrees C under 2% O(2)-5% CO(2)-90% N(2) (hypoxia) or 95% air-5% CO(2) (normoxia).

Can nonpenetrating vascular closure staples and hepatocyte growth factor prevent intimal hyperplasia following ePTFE grafting of the carotid artery in rabbits?

Purpose: To evaluate whether nonpenetrating vascular closure staples (VCS) and hepatocyte growth factor (HGF) can effectively prevent anastomotic intimal hyperplasia.

Methods: An expanded polytetrafluoroethylene graft, 2 mm in diameter, was implanted in the common carotid artery of rabbits divided into three experimental groups. In the control group, distal anastomosis was performed with interrupted suturing; in the VCS group, clips were applied along the lateral suture line after the placement of stay sutures; and in the VCS + HGF group, the same anastomotic technique was performed as in the VCS group, followed by the administration of the HGF for 4 days.

Hilar lymph nodes in N2 disease: survival analysis of patients with non-small cell lung cancers and regional lymph node metastasis.

Purpose: This study was conducted to accurately define the N status of non-small cell lung carcinoma (NSCLC).

Methods: We retrospectively reviewed 147 patients with NSCLC and pathologically positive regional lymph nodes who underwent major pulmonary resections with complete mediastinal lymph node dissections.

Results: The overall 5-year survival rate was 41% after a median follow-up period of 33 months.