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Objective To explore the outcomes in patients who receive the endovascular abdominal aortic aneurysm repair(EVAR)and have concomitant intra-abdominal malignancy.Methods Between January 2014 and December 2019,all the patients who underwent surgery for malignancy and/or EVAR were retrospectively reviewed.Results Twenty-eight abdominal aortic aneurysm(AAA)patients with concomitant intra-abdominal malignancy were included.The patients were treated by two-stage operation and the priority was given for EVAR in 21 patients.There was no perioperative death or major complications.In the follow-up,one patient developed graft thrombosis and one had type Ⅱ endoleak.There was no AAA-associated death.Conclusions It is preferred that EVAR should come first followed by operation for malignancy.Details of treatment strategy still need further investigation.

Atherosclerosis-related diseases have increasingly become health concerns with the increased living conditions and aging.Globally,about 200 million people have suffered from arteriosclerosis obliterans(ASO),which can even be life-threatening in some cases.The past seven decades have witnessed the rapid advances in the treatment of ASO,which has developed from surgery to endovascular interventions including plain balloon angioplasty,bare metal stent placement,drug-coated balloon,and drug-eluting stent.However,the roles of these new techniques for femoral-popliteal lesions,especially their real-world clinical outcomes and indications,remain unclear.This article reviews the latest evidences on the use of drug-eluting devices in treating femoral-popliteal arteriosclerosis obliterans.

Objective To determine whether interval-spaced sessions of partial splenic artery embolization(PSE) is a safe and effective alternative treatment for hypersplenism in juvenile patients. Methods Eight patients(3 males and 5 females) were included in this retrospective study.All patients were diagnosed as hypersplenism and underwent PSE in 2-3 sessions separated by 1-2 month intervals.Immediate,short,and long term follow-up were done.The effectiveness of the treatment was evaluated.Results No major postoperative complication was noted.No patient developed septic shock,splenic abscess,or spleen rupture.Postoperative pain and fever were common and manageable;only two patients developed loculated pleural effusions,which were well alleviated after conservative treatment.All patients showed significant increase in thrombocytes and white blood cells count after the first session of embolization.The cell counts became remarkable after the last session and remained at normal levels during the follow-up period.Conclusions PSE using 2-3 interval-spaced sessions can effectively decrease spleen size and reverse hypersplenism in juvenile patients.Also,it may reduce the postoperative complications commonly seen in traditional PSE.

Objective To investigate the optimal treatment strategy of spontaneous isolated dissection of superior mesenteric artery (SIDSMA) and the effect of anticoagulation therapy on the prognosis of SIDSMA. Methods The clinical data of 29 patients presented with acute or subacute mesenteric ischemia (a history of less than 14 days) due to SIDSMA admitted to the Department of Vascular Surgery of Peking Union Medical College Hospital from January 1st 2003 to December 31th 2016 were retrospectively analyzed. Results In this study,28 cases were male and the remaining one was female,with an average age of (49.1±7.6) years. The emergency endovascular treatment were performed on 4 cases with severe mesenteric intestinal ischemia,and the symptoms were relieved postoperatively. The remaining 25 cases were treated with conservative treatment. Among 13 cases who were received adequate anticoagulantion therapy,symptoms were relieved or disappeared in 9 cases (69.2%),whereas conservative treatment was ineffective in 4 cases (30.8%),for whom surgical intervention were performed. Among 12 cases who received conservative treatment without sufficient anticoagulation,the abdominal pain was relieved in only 2 cases (16.7%) and the remaining 10 cases (83.3%) were converted to surgical intervention. The success rate of conservative treatment for patients with adequate anticoagulant therapy was significantly higher than that of patients who had not received adequate anticoagulant therapy (P=0.015). Conclusions Adequate anticoagulation therapy has good therapeutic effect in most SIDSMA cases with acute or subacute mesenteric ischemia. For patients with severe mesenteric ischemia or those fail to respond to initial conservative treatment,endovascular treatment may be a more reasonable option.

Objective To report experience and result of endovascular repair for acute type B aortic dissection (ATBD). Methods Totally 125 ATBD patients receiving endovascular repair with stent-graft were enrolled in this study. Demographic data,operation details,perioperative findings,and follow-up results were retrospectively analyzed. Results All the 125 patients were successfully implanted with 135 stent-grafts. Thirteen cases were covered left subclavian artery,16 cases underwent left subclavian artery revascularization,and 10 cases underwent visceral artery revascularization. No perioperative mortality occurred. Meanwhile,the perioerative major adverse events included renal infarction (n=1),renal artery bleeding (n=2),stroke (n=2),myocardial infarction (n=1),and renal dysfunction (n=2;one of them suffered from permanent dialysis),and incision complication (n=5). The mean cost during hospital stay was (112 657±58 921) Yuan;more specifically,the cost for complicated dissection cases was significantly higher than uncomplicated cases [(171 623±93 635)Yuan vs. (92 531±48 721) Yuan,P<0.001]. All the patients received regular follow-up for 3-120 months [mean (23.5±11.2) months],except that 14 cases (11.2%) lost to follow-up. During the follow-up,three deaths were reported,among whom one died due to rupture of distal dissection one year after primary operation. No re-intervention case was noted. Conclusions Endovascular repair for ATBD is safe and feasible. Emergency repair for complicated ATBD cases can get satisfactory results,although the medical cost is higher than uncomplicated cases.

Objective To explore the effect of the action time of inducers on the differentiation of 3T3-L1 cells to adipocytes. Methods According to the "Cocktail" method,3T3-L1 cells were divided into three groups according to the action time of inducers,with the action time being 2,3 or 4 days,respectively. Cell morphology was observed using inverted microscope and adipose content were detected by Oil red "O" staining and detection of triglyceride. The cell viability was identified by trypan blue staining method. Results The proportion of samples (n=12) with differentiation rate above 80% in group A was 66% (12/18),while the differentiation rate of all the samples (n=18)in group B and group C were above 80%. For the Oil red "O",the OD value at 510 nm in group C was 2.59±0.17,which was significantly higher than that in group A (2.12±0.47;F=6.62,P=0.0001)and group B (2.20±0.17;F=5.15,P=0.0001),while no significant difference was found between group A and group B (F=1.14,P=0.74). As for the triglyceride,the value in group C was (1351.04±119.01)ng/ml,which was significantly higher than that in group A[ (1077.88±272.75)ng/ml;F=6.73,P=0.001] and group B [(1089.38±115.39)ng/ml;F=5.78,P=0.001],while no difference was found between group A and group B (F=0.27,P=0.64). The cell viability in group A,B,and C was (98.3±1.2)%,(98.5±1.8)%,and (98.9±2.1)%,respectively,showing no significant difference (F=0.18,P=0.83). Conclusions The modified procedure for the differentiation of 3T3-L1 cells to adipocytes can increase the differentiation rate and thus may be applied for establishing adipocyte models. The recommended action time is three days.

Objective: To investigate the depression in arteriosclerosis obliterans (ASO) patients and its risk factors., Methods: The self-rating depression scale (SDS) was applied in 228 ASO patients hospitalized in the vascular surgery department of Peking Union Medical College Hospital from March 2010 to October 2011. The risk factors of depression were analyzed by using univariate and multivariate Logistic regression analysis., Results: Of these 228 ASO patients, 133 (58.3%) were found to be depressive. Univariate and multivariate analysis showed that female (OR=0.15,95% CI:0.05-0.45), hypertension (OR=4.63,95% CI:1.90-11.29), coronary heart disease (OR=3.62,95%CI:1.43-9.18), as well as Fontaine 2a (OR=20.76,95% CI:3.21-134.28), 2b (OR=26.34,95% CI:4.20-164.97), 3(OR=192.28,95% CI:25.97-1423.51), and 4(OR=291.41,95% CI:28.67-2962.21) were the risk factors of depression in ASO patients., Conclusions: ASO patients can easily develop depression. Female, hypertension, coronary heart disease, and Fontaine 2a, 2b,3,and 4 are the risk factors of depression in ASO patients.

Objective: To compare the clinical efficacies of endovascular aortic repair(EVAR)and open surgical repair(OSR)for ruptured abdominal aortic aneurysm(rAAA)., Methods: The clinical data of 28 rAAA patients undergoing emergent treatment between February 2002 and February 2013 in PUMC Hospital were retrospectively reviewed. Among them 13 cases were treated by EVAR and 15 cases by OSR., Results: Before the surgery,the general conditions,comorbidities,and hemodynamics were not significantly different between these two groups(all P>0.05),although the EVAR group had significantly higher mean age than OSR group(P=0.041). In the perioperative period,the EVAR group showed significantly lower 30-day mortality(P=0.044),less blood loss(P=0.005),less blood transfusion(P=0.003),less infusion quantity(P=0.000),shorter length of procedure(P=0.001),and shorter hospital stay(P=0.020). Also,the EVAR group had no severe perioperative complications and showed superior 1-year follow up survival(P<0.05)., Conclusions: EVAR is an effective treatment for rAAA and can improve the clinical outcomes. EVAR may be adopted as the first-line treatment for rAAA,especially for the aged.

When more abdominal aortic aneurysms are repaired by endovascular approaches, the post-operative endotension without endoleak increase along with the extended follow-up. An early detection of such endotension and a proper differentiation from endoleaks are particularly important for the treatment decision-making. This article reviews the mechanism, diagnosis, and management of endotension.

Objective: To establish a stable cell line overexpression heme oxygenase-1 (HO-1) mediated by a modified lentivirus system and identify its function., Methods: The HO-1 gene was amplified by polymerase chain reaction and cloned into the modified pLentiLox3.7 expression vectors. The recombinant plasmids were transfected into HEK293T cells and the HO-1 was detected by Western blot. The recombinant plasmids were transfected into HEK293T cells to produce the viruses, with the helping plasmids including plp1, plp2, and VSVG. HEK293T cells were infected by the viruses and the cells that can express HO-1 were identified by Western blot. The reactive oxygen species were detected in the HO-1-overexpression HEK293T cells and the normal cells after the adding of hydrogen peroxide. The same experiment was performed with human umbilical vein endothelial cells., Results: The stable cell line that can overexpress HO-1 was established, which was verified by Western blot. The reactive oxygen species in the HO-1-overexpression HEK293T cells and human umbilical vein endothelial cells decreased obviously after exposure to hydrogen peroxide., Conclusions: The lentivirus-carrying HO-1 was successfully packaged and the stable cell line overexpression HO-1 was established. HO-1 can play a protective role in the course of oxidative damage.

Objective: To analyze the effectiveness and costs of the eversion carotid endarterectomy (eCEA) and the carotid endarterectomy with patch angioplasty (pCEA) in treating carotid artery stenosis., Methods: Patients with carotid artery stenosis who underwent the carotid endarterectomy in the vascular surgery department of Peking Union Medical College Hospital from October 2009 to October 2012 were enrolled in this study. According to the two different surgical procedures, the patients were divided into eCEA group and pCEA group., Results: The two groups were not significantly different in terms of gender ,age ,risk factors, stenosis degree of carotid artery, and the ratio of bilateral lesions (all P>0.05).The ratio of shunt and antibiotics application, operative time, hospitalization cost, and length of hospital stay in the eCEA group were significantly lower than those in pCEA group (P<0.05).The therapeutic effectiveness, complications, surgery-related death, restenosis, and ipsilateral stroke were not significantly different between these two groups (P>0.05)., Conclusion: Both surgical procedures are safe and effective in treating the carotid artery stenosis;however, eCEA has lower cost when compared with pCEA and therefore can be used as the first choice.

Objective: To construct an experimental abdominal aortic aneurysm (AAA) swine model with Dacron patch for evaluating endovascular aneurysm repair (EVAR) technique., Methods: The experimental pigs were generally anesthetized for the open procedure of an aneurysm model creation with Dacron and subsequent arteriography and EVAR with stent graft. Repeat arteriography was performed after 3-month follow-up., Results: AAA models were successfully constructed in all 10 experimental pigs. The average aneurysm diameter was (26.3±3.1)mm, increasing by (15.7±3.1)mm comparing to the primary aorta diameter (10.5±0.4)mm. The aorta diameter before and after the experiment showed significant difference (P<0.001). All the animals were survived after the procedure. One swine died 24 hours after the subsequent EVAR because the covering of both renal arteries by the stent graft. The rest 9 animals survived well after the whole operation and 3-month follow-up. The surviving rates at 1 month and 3 months after the operation were both 90%. One type 2 endoleak (10%) was observed after the EVAR, which disappeared at 3-month follow-up., Conclusions: Open construction of experimental AAA swine models with Dacron patch is safe and feasible. The model can be used in the developing new EVAR techniques and implant training.

Carotid endarterectomy(CEA)has been proved to be an effective surgery to treat the cerebral ischemia caused by carotid atherosclerotic stenosis. However,there is still no effective mean for the early diagnosis of the CEA-related severe complications such as stroke and death. Many studies have explored the potential biomarkers for stroke alert,although there is still a long way to go for their actual application in clinical settings. The carotid atherosclerotic stenosis,the perioperative complications of CEA,and the stroke share similar pathogenic mechanisms,and some biomarkers such as S100B,matrix metalloproteinase 9,asymmetric dimethylarginine,and neuron-specific enolase have been studied in the clinical trails of CEA. This article summarizes recent advances in this field.

Objective: To investigate the cell viabilities of vascular smooth muscle cells and vascular endothelial cells stimulated by cigarette smoke extract(CSE) ., Methods: The CSE was prepared by smoke-bubbled phosphate buffered saline(PBS) generation.After culturing cells with different concentrations of CSE, we used the cell counting kit-8 to determine the cell viability.The expression levels of c-jun and cyclinD1 were analyzed through Western blot.The c-jun plasmid was transfected to detect the change of cyclinD1 expression., Results: The smooth muscle cell viability increased when the CSE concentration ranged 0.625%-10%, whereas the endothelial cells viability decreased when exposed to the CSE concentration. After exposure to CSE for 48 hours, there was no difference in c-jun expression between toxin group and PBS group;however, the expression of p-c-jun in the smooth muscle cells significantly increased in the toxin groups than in the PBS group(P<0.05) and the expression of p-c-jun in the vascular endothelial cells significantly decreased(P<0.05) . The level of cyclinD1 significantly increased after exposed to CSE, and its expression level also increased in respond to the c-jun overexpression., Conclusion: CSE can enhance the proliferation of vascular smooth muscle cells and decrease in the activity of endothelial cells proliferation, which may be explained by the phosphorylation of c-jun and the expression of cyclinD1.

Objective: To investigate the risk factors and surgical management of limb prosthetic vascular graft exposure., Methods: The clinical data of 17 patients suffering from limb prosthetic vascular graft exposure in Peking Union Medical College Hospital from August 2006 to December 2011 were retrospectively analyzed. Among 17 cases, 5 suffered from prosthetic vascular graft exposure after vascular bypass for the lower limb ischemia, whereas 12 were affected after the artificial graft arteriovenous fistula construction in the upper limbs for hemodialysis. The surgical procedures mainly included the local debridement as well as the local flap and transferred muscle-cutaneous flap reconstruction to preserve the prosthetic vascular graft., Results: All 17 patients underwent local flap or muscle-cutaneous flap coverage procedure. After the surgery, the prosthetic vascular graft was successfully salvaged in 14 cases. The total successful rate was 82.4%. The surgery failed in three patients, in whom the prosthetic vascular grafts were finally removed., Conclusion: Local flap and transferred muscle-cutaneous flap reconstruction is an effective surgical management to salvage the exposed grafts.

Objective: To evaluate the application of carotid endarterectomy (CEA) in the treatment of patients with bilateral moderate to severe carotid stenosis., Methods: We retrospectively analyzed the clinical data of 82 patients with bilateral moderate to severe carotid stenosis who were admitted to our hospital from January 2006 to December 2009. Of these patients, 64 underwent ipsilateral CEA and 18 underwent bilateral CEA., Results: A total of 100 endarterectomies including 92 patching and 94 carotid shunt were performed. Seventy-six patients smoothly recovered from the surgery. Two patients suffered from cardiac ischemia and infarction and one died of massive cerebral infarction. Three patients presented with hyperperfusion syndrome,and one of them developed cerebral hemorrhage. Of 79 patients who were followed up regularly, 76 (96.2%) had no cerebral ischemia relevant to the operated carotid artery,one developed mild re-stenosis, and 2 suffered from neurological dysfunction., Conclusion: CEA should be performed in patients with bilateral moderate to severe carotid stenosis once the indication is confirmed.

Objective: To assess the patency and complications of the polytetrafluoroethylene (PTFE) graft for hemodialysis access and to summarize the experiences in the treatment of graft occlusions., Methods: The clinical data of 30 patients who underwent forearm PTFE graft for hemodialysis access from March 2003 to December 2008 in our hospital were retrospectively analyzed., Results: Patients were followed up for (28.7+/-17.6) months (range: 8-78 months).The peri-operative mortality was zero. Primary patency rate was 70.0% at Year 1 and 56.7% at Year 2. Accumulative secondary patency rate was 90.0% and 80.0%, respectively at Year 1 and Year 2. Postoperative complications included graft thrombosis (n=13, 43.3%), venous anastomosis stenosis (n=1, 3.3%), graft infection (n=2, 6.7%), and edema of the forearm (n=10, 33.3%). Totally 24 graft revisions were performed, including thrombectomy (12 times), thrombectomy and venous anastomosis plasty with artificial patch (4 times), arterial and venous anastomosis plasty with patch (2 times), venous anastomosis angioplasty with a balloon (2 times), new graft hemodialysis access construction in the contralateral arm (1 case), and graft removal (3 cases)., Conclusions: PTFE graft is an important backup hemodialysis access in uremic patients. Proper revision according to different cause of graft occlusions can prolong the service time of the graft.

Objective: To evaluate the etiology, diagnosis, and treatment of lower limb arterial occlusion in patients below 45 years old., Methods: The clinical data of 58 patients with lower limb arterial occlusion (except for Buerger's disease) below 45 years old admitted to PUMC Hospital from July 1997 to November 2007 were retrospectively analyzed., Results: Among these 58 patients, 31 patients (53.4%) had confirmed thrombophilic risk factors, including 12 patients had two or more thrombophilic risk factors. Follow-up (ranged 2-43 months, mean 10 months) showed higher rates of revascularization and amputation in patients with thrombophilic risk factors (22.6% and 22.6%, respectively) than in those without thrombophilic risk factors (14.8% and 11.1%, respectively) (P > 0.05). Among patients with two or more thrombophilic risk factors, the rates of revascularization and amputation were 25.0% and 33.3%, respectively., Conclusions: Lower limb arterial occlusion in young adults is often caused by thrombophilic risk factors. Attention should be taken to identify these etiologies before surgical treatment.

Objective: To investigate the perfusion restoration of type 1 diabetic mouse under the setting of surgically induced hind limb ischemia and the number and function of bone marrow endothelial progenitor cells (EPCs)., Methods: Forty mice were randomly divided into two groups: one group was injected with alloxan through tail vein to induce type 1 diabetes mellitus, and another group was set as control group. All mice were surgically induced to hind limb ischemia. Blood flow was monitored with Laser Doppler perfusion imaging for 4 weeks after artery ligation. Ten mice in each group were sacrificed and muscle tissues were harvested for histological detection. The remaining mice were sacrificed 7 days after surgery, bone marrow mesenchymal stem cells were harvested and EPCs were analyzed by flow cytometry and then were collected to culture for functional detection., Results: All mice received alloxan injection showed typical symptoms of type 1 diabetes mellitus. Restoration of blood flow was significantly slower in type 1 diabetic mice with lower level of vascular density in ischemic muscles than control group (P < 0.001, P < 0.05). The number and function of EPCs (CD34 and vascular endothelial growth factor receptor 2 double positive cells) in type 1 diabetic mice were significantly lower than that in control mice (P < 0.05)., Conclusions: The spontaneous angiogenesis is attenuated with a decreased number and function of EPCs in the setting of type 1 diabetes mellitus. This may partly explain why diabetic patients with peripheral artery diseases have more aggressive disease and poorer outcome.

Objective: To explore the feasibility of endovascular stent-graft prostheses in treating acute transaction of thoracic aorta. (TAT) METHODS: A patient with injury from a car accident was diagnosed by computed tomography angiography (CTA) , and then treated by endovascular therapy immediately., Results: After treatment, symptoms such as chest pain and shortness of breath were improved, hemoglobin became normal, and no complication was found. CTA revealed that stent-graft was located in a satisfactory position, and subclavian artery was clearly demonstrated 6 months later., Conclusions: Potential TAT should be examined in patients with trauma in the chest. Active treatment should be performed in patients with severe symptoms or CTA-confirmed endoartial injury of aorta, for whom endovascular therapy may be the first choice.

Arteriosclerosis obliterans (ASO) of the lower extremities is a common peripheral vascular disease. Its incidence gradually increased in China in recent years. ASO may severely affect the quality of life, and even be fatal. This article summarizes the author's own experiences, along with literature review, with an attempt to discuss the therapeutic principles, indications, and strategies of the surgical therapy for ASO of the lower extremities.

Objective: To assess the effectiveness and safety of non-permanent filter in preventing pulmonary embolism (PE) caused by deep venous thromboembolism (DVT)., Methods: The clinical data of 12 patients who were implanted with non-permanent filter for documented deep venous thromboembolism in Peking Union Medical College Hospital from September 2003 to June 2006 were retrospectively analyzed., Results: Among these 12 patients, 10 were implanted with temporary filters, and 2 with retrievable filters. All the 12 operations were successful without major complications. In the 10 patients who received temporary filters, filters were smoothly removed after 4 weeks in 9 patients, while one patient was further treated with anticoagulation therapy for 12 weeks because large emboli were entrapped by filter. In the 2 patients who received retrievable filters, filter were smoothly removed 2 weeks later in one patient; however, in another patient, the filter was left inside because large emboli were entrapped by filter. In all the 12 patients, emboli were entrapped in 6 filters (50%), in which the emboli were larger than 2 cm in 2 patients, larger than 1 cm but less than 2 cm in 1 patient, and less than 1 cm in 3 patients. PE scanning was performed in 10 patients before primary implantation, and PE was found in 5 patients. PE scanning was performed in 8 patients 6 months after implantation, and minor PE was found in 4 patients, whose symptoms and affected pulmonary artery were obviously improved. All patients received regular follow-up (ranged from 3 months to 2 years), 1 patient died of malignant tumor 4 months after operation, 1 patient suffered inferior vena cava occlusion due to large emboli entrapped by the temporary filter, and 1 patient experienced the recurrence of symptomatic DVT. Symptoms were improved in all the 5 patients with PE., Conclusions: Non-permanent filter can safely and effectively protect patients from PE. More standardized criteria for placement and protocols to ensure timely removal should be developed and implemented.

Objective: To assess the value of subintimal angioplasty in treating patients with iliac artery occlusive disease., Methods: We retrospectively analyzed the clinical data of 13 patients with iliac artery occlusion who received subintimal wire placement followed by percutaneous transluminal angioplasty and stent placement in our hospital from May 2004 to August 2006., Results: Initial success was obtained in all the 13 patients with an improvement in both the symptoms and the mean ankle-brachial index of 0.55 (range: 0.39-0.94, P = 0.004) without any complication. During the follow-up (range: 3-21 months; mean: 12 months), the one-year stent patency rate reached 100%., Conclusion: Subintimal angioplasty is a valuable approach to treat iliac artery occlusion with reliable efficacy and safety.

Objective: To evaluate the outcomes of percutaneous transluminal angioplasty (PTA) and stenting in the treatment of critical lower extremity ischemia of arteriosclerosis obliterans., Methods: From April 2005 to May 2006, PTA and stenting was performed on 29 limbs of 24 patients with critical lower limb ischemia. Among all these patients, their main clinical symptom was rest pain, while ulceration and gangrene were also found in 12 patients. Four limbs underwent PTA, 4 limbs underwent prosthetic femoral-popliteal bypass with infrapopliteal balloon dilatation simultaneously, and the remaining 21 limbs were performed by PTA and stent placement., Results: The success rate of endovascular procedure was 100% for femoral-popliteal artery, and 88% for infrapopliteal artery. Rest pain disappeared and the ulcers were healed after the operations. Only 1 patient received amputation during the operation., Conclusion: Endovascular therapy is an effective and safe procedure for the treatment of critical lower limb ischemia.

Objective: To evaluate the curative effect of the combination of endovenous laser treatment of varicose saphenous vein (ELVS) and classic ligation and stripping treatment., Methods: We retrospectively analyzed the clinical data of 21 patients with varicose saphenous vein (VS) who were treated with ELVS alone or combined with ligation and stripping in our hospital., Results: All the patients got good therapy result. The early symptom relief rate was 82.4%, while the late symptom relief rate was 100%. No infections, haematoma of wound, and any other major complications were reported. The common complications included pain induced by remains of the thrombosis phlebitis (n = 2, 11.7%), minor skin burn (n = 1, 5.9%), residue vein varicose (n = 1, 5.9%), numbness of the calf (n = 1, 5.9%), and mild peri-phlebitis (n = 1, 5.9%). All the complications were resolved after proper management. The 1-year follow-up showed no recurrence., Conclusion: The combination of ELVS and classic ligation and stripping is safe and effective in the treatment of varicose saphenous.

Objective: To discuss the diagnosis and surgical treatment of carotid body tumour., Methods: Thirty-eight cases (41 carotid body tumours) admitted from 1983 to 2002 were analyzed retrospectively., Results: All patients were examined by ultrasound and angiography routinely before operation. The diagnostic coincidence rates of ultrasound and angiography are 95% and 98% respectively. Thirty-eight tumours were resected successfully. Twelve patients underwent external carotid artery severed, internal carotid artery repaired and tumour resected operation. Eleven patients underwent external carotid artery severed and tumour resection. Eight patients underwent tumour simple resected operation. Six patients underwent external carotid artery severed and internal carotid artery reconstruction. One patient underwent tumour resection, while common, external, and internal carotid artery were partially resected., Conclusions: For suspected carotid body tumour patients, ultrasound and angiography reconstruction of carotid artery should be applied routinely before operation. The early stage and one stage tumour resected operation as well as internal carotid artery reconstruction are the key factors of decreasing operative complication rate.

Objective: To evaluate the diagnosis and treatment of mesenteric venous thrombosis., Methods: The clinical data of 11 cases diagnosed as mesenteric venous thrombosis between 1992 and 2001 in PUMC Hospital were analyzed retrospectively., Results: Postoperative state(27.3%), especially cirrhosis and portal hypertension, and other history of thrombosis (27.3%) were the most common causes. Thrombolysis was performed successfully in two of the eleven cases. The rest of them were misdiagnosed in other hospitals and operated. No patient died after operation, and one (11.1%) recurrence was found., Conclusions: Early application of anticoagulant is necessary for patients with thrombosis risks. For suspected patients, early computed tomography (CT) and DSA examination should be performed, and prompt thrombolysis and anticoagulation therapy can be performed to avoid the bowel resection after definite diagnosis. To reduce the recurrence, anticoagulant should be maintained for a proper time.