Hui Zheng

Thoracic endovascular aortic repair (TEVAR) has become the preferred method in the treatment of aortic arch diseases by now. Due to the complex anatomical structure and reconstruction techniques, it is difficult to perform total endovascular aortic arch treatment for patients with aortic arch lesions. Our team initiates the reconstruction of aortic arch vessels using the surgically assisted short-distance retrograde needle puncture (SDRNP) technique for three-fenestration stent grafts. This article aims to demonstrate the feasibility and safety of performing the SDRNP technique for three-fenestration stent grafts in treating aortic aneurysm, dissection, or penetrating ulcer involving the aortic arch. A retrospective review was performed on 12 patients with aortic arch diseases, who underwent surgically assisted SDRNP technique for three-fenestration stent grafts to revascularize supra-arch branches. The overall technical success rate was 100.0% (12/12). The average operative time and intraoperative bleeding were 228.5 ± 69.6 min and 74.5 ± 26.9 mL, respectively. Complications consisted of 1 stroke, 1 acute myocardial infarction, and 2 endoleaks (1 type III and 1 type I). The patient with type III endoleaks improved after coil embolization after re-intervention. There were no aorta-related deaths during the average follow-up of 10.3 ± 2.8 months. All of the bridging stents were patent, with no migration. The three-fenestration stent grafts using the surgically assisted SDRNP technique offer a great advance for the treatment of aortic arch diseases, which might be an ideal operation process for aortic arch vessels.

Thoracic endovascular aortic repair (TEVAR) has become the preferred method in the treatment of aortic arch diseases by now. Due to the complex anatomical structure and reconstruction techniques, it is difficult to perform total endovascular aortic arch treatment for patients with aortic arch lesions. Our team initiates the reconstruction of aortic arch vessels using the surgically assisted short-distance retrograde needle puncture (SDRNP) technique for three-fenestration stent grafts. This article aims to demonstrate the feasibility and safety of performing the SDRNP technique for three-fenestration stent grafts in treating aortic aneurysm, dissection, or penetrating ulcer involving the aortic arch. A retrospective review was performed on 12 patients with aortic arch diseases, who underwent surgically assisted SDRNP technique for three-fenestration stent grafts to revascularize supra-arch branches. The overall technical success rate was 100.0% (12/12). The average operative time and intraoperative bleeding were 228.5 ± 69.6 min and 74.5 ± 26.9 mL, respectively. Complications consisted of 1 stroke, 1 acute myocardial infarction, and 2 endoleaks (1 type III and 1 type I). The patient with type III endoleaks improved after coil embolization after re-intervention. There were no aorta-related deaths during the average follow-up of 10.3 ± 2.8 months. All of the bridging stents were patent, with no migration. The three-fenestration stent grafts using the surgically assisted SDRNP technique offer a great advance for the treatment of aortic arch diseases, which might be an ideal operation process for aortic arch vessels.

Objective: To identify the risk factors associated with pulmonary embolism (PE) in malignant tumor patients with lower limb deep vein thrombosis (LLDVT). Methods: We retrospectively analyzed the clinical data of 45 patients with PE (observation group) and 255 patients without PE (control group) admitted to The Second Affiliated Hospital of Shandong First Medical University between June 2020 and January 2025. Various clinical parameters, including LLDVT density ratio, D-dimer, homocysteine (Hcy) and cardiac troponin I (cTNI), were compared between the two groups. Logistic regression analysis was performed to identify independent risk factors for PE. Results: The observation group had significantly higher values for LLDVT density ratio (P<0.001), D-dimer (P=0.004), Hcy (P<0.001), cTNI (P<0.001), and Wells scores (P<0.001) compared to the control group. Logistic regression revealed that LLDVT density ratio, Hcy, cTNI, and Wells scores were independent risk factors for PE in these patients. Pearson correlation analysis showed significant positive associations between the LLDVT density ratio (r=0.822, P<0.001), Hcy (r=0.899, P<0.001), cTNI (r=0.890, P<0.001), and Wells scores. ROC curve analysis indicated that the combined model (LLDVT density ratio, Hcy, and cTNI) had a higher AUC (0.852) than individual markers. Conclusion: LLDVT density ratio, Hcy, and cTNI are independent predictors of PE in malignant tumor patients with LLDVT. These markers are closely associated with PE severity, which could assist in optimizing clinical management for these patients.

Objective: To evaluate the predictive value of Caprini score, D-dimer levels, and thromboelastography parameters for deep venous thrombosis (DVT) in patients with lung cancer. Methods: A retrospective analysis was conducted on 90 lung cancer patients admitted to Yantaishan Hospital between September 2020 and August 2024. The observation group comprised 50 patients with DVT, while 40 patients without DVT formed the control group. Caprini scores, D-dimer levels, and thromboelastography parameters including coagulation angle (α angle) and maximum amplitude (MA) were compared between groups. Pearson correlation assessed associations with Villalta scores. Logistic regression identified independent risk factors for DVT. Receiver operating characteristic (ROC) curves evaluated the predictive efficacy of single and combined indicators. Results: Compared to controls, the observation group showed significantly higher Caprini scores (P=0.008), D-dimer levels (P<0.001), α angle (P<0.001), and MA (P<0.001). Within severity subgroups, these parameters were elevated in the moderate group compared to the mild group (all P<0.001). Pearson analysis demonstrated positive correlations of Caprini score (P=0.024), D-dimer levels (P=0.029), α angle (P=0.037), and MA (P=0.030) with Villalta scores. Logistic regression revealed these four parameters as independent risk factors for DVT in lung cancer patients. The combined index yielded an AUC of 0.861, outperforming individual indicators (Caprini score 0.771, D-dimer 0.789, α angle 0.747, MA 0.725) in predicting DVT. Conclusions: Caprini score, D-dimer levels, α angle, and MA are independently associated with DVT occurrence and severity in lung cancer patients. Combined assessment enhances predictive accuracy, providing valuable guidance for early identification and clinical management of DVT.