Purpose: To examine the association between the extent of stent-graft coverage and thoracic aortic expansion after thoracic endovascular aortic repair (TEVAR) for type B aortic dissection. Materials and Methods: A retrospective analysis was conducted of 201 patients (mean age 52.4±11.5 years; 178 men) with acute (135, 67.2%) or chronic (66, 32.8%) type B aortic dissection who underwent TEVAR at 4 medical centers. The mean stent-graft length was 157.1±33.3 mm. The percentage of stented descending aorta (PSDA) represented the extent of stent-graft coverage. After using restricted cubic smoothing spline plots to confirm the roughly linear relationship between PSDA and the risk of thoracic aortic expansion, patients were stratified into 2 groups on the median PSDA: the lower group (≤31.3%) and the higher group (>31.3%). Thoracic aortic expansion was defined as a ≥20% increase in the total thoracic aortic volume on the most recent postoperative computed tomography angiography scan compared with the preoperative measurement. The Kaplan-Meier method was used to estimate the cumulative freedom from thoracic aortic expansion after TEVAR; estimates are given with the 95% confidence interval (CI). A multivariable Cox proportional hazards model was used to analyze any independent association of the PSDA as a continuous or categorical variable with the risk of thoracic aortic expansion; results are presented as the hazard ratio (HR) and 95% CI. Results: No patients developed symptoms of spinal cord ischemia during hospitalization. Over a median 12.4 months of imaging follow-up, 34 (16.9%) patients developed thoracic aortic expansion. The estimate of freedom from thoracic aortic expansion at 12 months for the overall PSDA was 84.0% (95% CI 77.8% to 88.6%); between the groups, the freedom from thoracic aortic expansion estimate for the PSDA ≤31.3% group was significantly lower than in the higher group (p=0.032). Regression analysis showed no significant association between the risk of thoracic aortic expansion and the PSDA as a continuous variable (HR 0.97, 95% CI 0.91 to 1.03, p=0.288); however, analyzing the PSDA as a categorical variable indicated a significantly lower risk of thoracic aortic expansion for the PSDA >31.3% group (HR 0.46, 95% CI 0.22 to 0.95, p=0.036) after adjusting for a variety of demographic and anatomical characteristics. Conclusion: More extensive stent-graft coverage appears to improve thoracic aortic remodeling after TEVAR. However, the clinician should balance the benefit of extensive stent-graft coverage and its related risk of spinal cord ischemia.

BackgroundTo investigate the curative effect and utility of the TurboHawk plaque circumcision system in the treatment of patients with superficial femoral atherosclerosis (SFA).Material/MethodsWe retrospectively analyzed 60 cases of superficial femoral atherosclerotic stenosis and occlusion treated with the TurboHawk plaque circumcision system for endovascular ablation of the superficial femoral artery in the People’s Hospital of Xinjiang Uygur Autonomous Region between January 2016 and December 2017.ResultsThe sample comprised of 50 male and 10 female patients with an average age of 65±4.5 years (range 47 to 70 years). This group of patients had varying degrees of limb ischemia, with disease duration ranging from 1 week to 3 years. The main symptoms included markedly cooler lower-extremity skin temperature, pale and cyanotic, intermittent claudication (10 cases), resting pain (31 cases), distal limb mild ischemic ulcer (14 cases), and tissue ischemic necrosis and gangrene (5 cases). All cases were in stages 3–6 of the Rutherford classification. Almost half (28 patients, 47%) had a significant improvement in their affected limbs and more than half (32 cases, 53%) had a moderate improvement in clinical symptoms after the intervention. After surgery, lumen stenosis decreased and ankle brachial index (ABI) increased significantly (P<0.05).ConclusionsThe TurboHawk plaque circumcision system is a feasible and effective method for the treatment of SFA with the advantages of less trauma and better safety, and shows a significant curative effect in a short period.

The wild species Brassica fruticulosa Cyr. (FF, 2n = 16) is closely related to the cultivated Brassica species.Through interspecific reciprocal crosses between B. fruticulosa and three cultivated Brassica allotetraploids (AABB, AACC,and BBCC where A = 10, B = 8, and C = 9), four trigenomic hybrids (F.AC, 2n = 27; F.AB, 2n = 26; F.BC, 2n = 25;BC.F, 2n = 25) were produced. By chromosome doubling of respective hybrids, three allohexaploids (FF.AACC, 2n = 54;FF.AABB, 2n = 52; BBCC.FF, 2n = 50) were synthesized. In pollen mother cells (PMCs) of the trigenomic hybrids, 1–2 autosyndetic bivalents were detected within A, B, and C genomes but only one within F genome; 1–3 allosyndetic bivalents between any two genomes were observed, and a closer relationship of F and B genomes than F and A genomes or F and C genomes was revealed. The all ohexaploids showed a generally low but different pollen fertilities. The chromosomes in PMCs were predominantly paired as bivalents but some univalents and multivalents at variable frequencies were observed.The bivalents of homologous pairing for each genome prevailed, but all osyndetic quadrivalents and hexavalents involving any two genomes were observed, together with autosyndetic quadrivalents for A, B, and C genomes but not the F genome.The nondiploidized cytological behaviour of these allohexaploids contributed to their low fertility. The relationships between the genome affinity and meiotic behavior in these allohexaploids were discussed.

Background: Thromboangiitis obliterans (TAO), also called Buerger's disease, is a chronic peripheral vascular occlusive disease. It is an obliterative vasculitis characterized by arterial thrombosis and strongly associated with tobacco exposure. The pathogenesis and etiology of TAO are not well understood, but genetic factors may be important in its development. A case-control study was undertaken to identify genetic factors potentially involved in the pathogenesis of TAO in a Xinjiang Uyghur population of China, where TAO is common. Methods: We ascertained 177 TAO patients by clinical screening and 86 healthy individuals from the HAPMAP database. The genotypes of single-nucleotide polymorphisms (SNPs) of the participants were identified using the Affymetrix Genome-Wide Human SNP Array 6.0 to perform a genome wide association study (GWAS). The association between the SNPs and incidence of TAO was quantified using race stratification exposure. Results: Through a case-control GWAS study 26 SNPs were significantly associated with incidence of TAO following a Bonferroni correction. However, after genomic control correction for population stratification only three of these SNPS were highly significantly associated with TAO: rs376511 in IL17RC (OR = 24.4, 95% CI:8.68 -68.62, p < 0.0001), rs7632505 in SEMA5B (OR = 29.47, 95% CI:7.16 -121.3, p < 0.0001), and rs10178082 (OR = 18.09, 95% CI: 6.56 -49.92, p < 0.0001) showed a significant risk of TAO in the Uyghur population. Conclusions: This study shows an association between these 3 SNPs and susceptibility to TAO in the Uyghur population, suggesting that polymorphisms in the IL-17RC and Sema 5B genes may pre-dispose individuals in this population to development of TAO. These findings require replication.

Artificial graft infection is one of the most serious complications following EVAR. The gold standard includes the excision of the infected endograft, debridement, and reconstruction. However, these methods are not always the best option for every patient. The authors present the case of a 75-year-old man who was diagnosed with a stent-graft infection following EVAR. A course of antibiotics was administered, and percutaneous drainage was effectively performed twice in succession. After 18 months, the patient was admitted again due to the infection re-occurring. Antibiotics were administered, and percutaneous drainage was effectively re-performed. One year has elapsed since the treatment, and the outpatient followup has lasted until now.