Le-feng Qu

Changhai Hospital, Shanghai, Shanghai, Shanghai Shi, China

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Publications (12)12.16 Total impact

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    ABSTRACT: BACKGROUND: Multilayer stent has become a new endovascular strategy for visceral artery aneurysm repair. However, its use was not allowed in some areas, such as China. This study evaluates an alternative method: multiple overlapping bare stents for repairing visceral artery aneurysms. METHODS: Twenty-four patients with celiac artery aneurysm (n = 2), splenic artery aneurysm (n = 8), hepatic artery aneurysm (n = 3), superior mesenteric artery aneurysm (n = 6), and renal artery aneurysm (n = 5) were treated with 2 to 4 overlapping bare stents. Long-term results, including clinical achievement ratio and target artery patency, were followed up with computed tomographic angiography. RESULTS: Insertion of overlapping bare stents was successful in all patients. Five aneurysms (21%) were totally excluded 3 months after operation, increasing to 12 (50%) and 20 (83%) aneurysms with total isolation at 6 and 12 months' follow-up, respectively. The clinical achievement ratios of multiple overlapping bare stents on splenic artery aneurysms, hepatic artery aneurysms, renal artery aneurysms, celiac artery aneurysms, and superior mesenteric artery aneurysms were 75%, 100%, 80%, 50%, and 100%, respectively. All cases combined had 100% target artery patency. CONCLUSIONS: Preliminary experience showed that repair using multiple overlapping bare stents seemed to be a potential alternative strategy for treating visceral artery aneurysm, resulting in target artery patency. However, the exact mechanism requires further study and more cases should be involved.
    Annals of Vascular Surgery 03/2013; · 0.99 Impact Factor
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    ABSTRACT: To clarify the outcome of surgical reconstruction for renal artery in Takayasu arteritis-induced renal artery stenosis (TARAS). A retrospective chart review was conducted on 33 consecutive patients with TARAS, who underwent aortorenal bypass (ARB) with autologous saphenous vein graft. There were 9 male and 24 female patients, with a mean age of (25 ± 11) years. The effects on blood pressure and renal function were analyzed. Primary, primary assisted, and secondary patency rates were determined. The effects of various factors on primary patency rate were analyzed. All patients showed hypertension. The mean blood pressure was (175 ± 26)/(100 ± 19) mmHg (1 mmHg = 0.133 kPa). The mean antihypertensive dosage was (2.1 ± 0.6) defined daily dose (DDD). Seventeen patients showed intractable hypertension. Mean estimated glomerular filtration rate was (78 ± 5) ml/min. One patient was dialysis-dependent, and 3 patients were combined with congestive heart failure. ARB was performed for the 39 renal arteries, including 27 unilateral and 6 bilateral bypasses. Postoperative morbidity was 15.2%. All patients survived. During follow-up of mean (56 ± 18) months, two graft occlusions and four graft restenoses occurred. All graft restenoses were eliminated successfully with percutaneous angioplasty, but one patient experienced restenosis again six months later. At 1, 3, and 5 years of follow-up, primary patency was 92%, 89%, and 79%, respectively, primary assisted patency was 95%, 95%, and 91%, respectively, and secondary patency was 95%, 95%, and 91%, respectively. ARB resulted in a decrease in mean blood pressure to 139/85 mmHg (one month post-ARB, P = 0.000) and 136/80 mmHg (last follow-up, P = 0.000), and a reduction in mean antihypertensive dosage to 1.4 DDD (one month post-ARB, P = 0.084) and 0.6 DDD (last follow-up, P = 0.000). Mean estimated glomerular filtration rate increased to 82 ml/min (P = 0.458) one month post-ARB, and 91 ml/min (P = 0.044) at last follow-up, respectively. The dialysis-dependent patient no longer required hemodialysis, and left ventricular dysfunction resolved in all of the three patients. ARB using the autologous saphenous vein graft is safe, effective and durable for treating TARAS.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 11/2011; 49(11):1011-6.
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    ABSTRACT: To clarify the outcome of aortorenal bypass (ARB) in Takayasu arteritis-induced renal artery stenosis (TARAS). A retrospective chart review was conducted on thirty-three consecutive patients (24 females; mean age, 25 years) with TARAS, who underwent ARB with autologous saphenous vein graft. The effects on blood pressure and renal function were analyzed. Primary, primary assisted, and secondary patency rates were counted. The effects of various factors on primary patency rate were analyzed. All patients showed severe hypertension (mean BP, 175 ± 26/100 ± 19 mm Hg; mean anti-hypertensive dosage, 2.1 ± 0.6 DDD). Mean estimated glomerular filtration rate was 78 ± 5.1 ml/min. One patient was dialysis-dependent, and three patients had congestive heart failure secondary to left-ventricular dysfunction. ARB was performed for the 39 renal arteries, including 27 unilateral and 6 bilateral bypasses. Postoperative morbidity was 15%. All patients survived. During follow-up (mean, 56 months), two graft occlusions and four graft restenosis occurred. All graft restenosis were eliminated successfully with percutaneous angioplasty, but one patient experienced restenosis again six months later. At 1, 3, and 5 years of follow-up, primary patency was 92%, 89%, and 79%, respectively; primary assisted patency was 95%, 95%, and 91%, respectively; and secondary patency was 95%, 95%, and 91%, respectively. ARB resulted in a decrease in mean BP to 139 ± 15/85 ± 13 mm Hg at one month (P < .05) and 136 ± 19/80 ± 8 mm Hg at last follow-up (P < .05). Mean anti-hypertensive dosage decreased to 1.4 ± 0.8 DDD at one month (P < .05) and 0.6 ± 0.8 DDD at last follow-up (P < .05). Mean estimated glomerular filtration rate increased to 82 ± 4.7 ml/min (P > .05) at one month and 91 ± 4.1 ml/min (P < .05) at last follow-up. The dialysis-dependent patient no longer required haemodialysis, and congestive heart failure resolved in all three patients. Our data suggest that ARB with autologous saphenous vein graft is safe, effective and durable in treating TARAS.
    European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery 04/2011; 42(1):47-53. · 2.92 Impact Factor
  • Zi-heng Wu, Dieter Raithel, Le-feng Qu
    Chinese medical journal 09/2010; 123(18):2623-4. · 0.90 Impact Factor
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    Chinese medical journal 07/2008; 121(12):1148-9. · 0.90 Impact Factor
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    ABSTRACT: To evaluate the effect of the diameter of abdominal aortic aneurysm (AAA) on endovascular exclusion (EVE) and its results. From March 1997 to June 2007, 429 AAA patients were treated with endovascular stent-graft exclusion. According to the maximal diameter of abdominal aortic aneurysm, the patients were divided into two groups: group A (diameter < 55 mm, n = 274) and group B (diameter > or = 55 mm, n = 155). The diameter of AAA, involvement of iliac artery, length, diameter and distortion of aneurismal neck in the two groups were recorded and compared retrospectively. Patients in group B were significantly older than group A (73.7 vs 71.1 years, P < 0.05). More patients in group B was complicated with coronary artery disease than those in group A (P < 0.05). The mean diameter of AAA in group A was (46.6 +/- 6.8) mm, and (66.8 +/- 11.2) mm in group B (P < 0.05). Proximal aneurysmal necks were shorter, wider and more tortuous in group B than those in group A (P < 0.05). Extraperitoneal approach, embolism of inner iliac artery and reconstruction of another inner iliac artery and stretch technique were more applied in group B. There were more endoleak during operation in group B and more stent-grafts were used. There was significant difference in morbidity rate between the two groups, while no statistic difference in mortality. And in group B, there were a high rate of endoleak and secondary intervention post operation. The diameter of AAA affects EVE and its results. In small aneurysms, EVE carries better outcome than in big aneurysms.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 04/2008; 46(6):420-2.
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    ABSTRACT: To classify the genes responsible for apoptosis in QGY-7703 cells induced by homoharringtonine (HHT). Apoptosis in QGY-7703 cells induced by HHT was demonstrated by DNA fragmentation and morphological observation. cDNA microarray technology was used to detect gene transcription, and the result of microarrays for genes was confirmed by RT-PCR. Seventy-eight individual mRNA were identified and their transcription levels changed significantly. Those genes, of which 68% were upregulated and 32% were downregulated, were partially related to apoptosis. They were mostly oncogenes, tumor suppressors, enzymes, and kinases. HHT is a potential drug in the treatment of liver cancer. TGF-beta, TNF, FAS, p38MAPK, and p53 apoptosis signaling pathways were activated during apoptosis in QGY-7703 cells. Such inducible genes may play important roles in apoptosis and deserve to be further studied.
    Acta Pharmacologica Sinica 07/2007; 28(6):859-68. · 2.35 Impact Factor
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    ABSTRACT: To assess the 7-year results of endovascular aortic aneurysm repair using the Powerlink unibody bifurcated endovascular stent-graft in our single center. A prospective, nonrandomized trial was conducted in our unit within 7 years. Endovascular aortic aneurysm repair (EVAR) was planned, performed and followed-up by a fixed endovascular specialized group, including 2 vascular surgeons and 1 interventional radiologist. All the relative data were input into the SPSS statistical analysis software. All patients received abdomen X-ray plain films and CTs or duplex before discharge and 1 month, 6 months, 1 year after discharge, and then annually. From February 1999 to September 2006, a total of 378 abdominal aortic aneurysms (AAAs) patients were intended to treat with Powerlink device, 372 cases were implanted successfully, the technical success rate was 98.4%. The average operation time was 66 min (range, 35-150 min). The late 210 cases (56.5%) were implanted sitting on the aortic bifurcation, the other 162 early cases (43.5%) were not implanted sitting on the aortic bifurcation, proximal cuff was implanted in 209 cases (56.2%), and distal limb extension was used in 42 cases (11.3%), 22 cases (5.9%) received Palmaz stent. One hundred and ninety- four cases (52.2%) had infrarenal fixation, 178 cases (47.8%) had suprarenal fixation. Intraoperative complications included immediate conversion in 6 cases (1.6%), primary proximal type I endoleak in 8 cases (2.2%), primary distal type I endoleak in 2 cases (0.5%), type II endoleak occurred in 20 cases (5.4%). Mean follow-up was 26.7 months (range 1 month 7 years). Postoperative complications included secondary type I endoleaks in 10 cases (2.7%), secondary type II endoleaks in 9 cases (2.4%), limb occlusion in 8 cases and limb stenosis in 5 cases, endograft limb kinking/twisting in 2 cases, partial renal infarction in 9 cases (2.4%). A total of 7 cases (1.9%) had distal migration and all 7 cases were not implanted sitting on the aortic bifurcation. Post-EVAR conversion occurred in 6 cases (1.6%). There were a total of 18 deaths (4.8/%) and 6 deaths (1.6%) within 30 days. The Powerlink device is safe and effective in preventing AAA rupture in mid-term. It proved simple and easy for size choice. The unique design of this device may confer some advantages in terms of durability. The distinct anatomic fixation of stent-graft sitting on the aortic bifurcation simplifies the deployment procedures and minimizes the potential of distal migration. Prospective longer follow-up in multicenter randomized controlled larger series is necessary to confirm the encouraging outcomes.
    The Journal of cardiovascular surgery 03/2007; 48(1):13-9. · 1.51 Impact Factor
  • Gefasschirurgie. 01/2006; 11(1):36-39.
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    ABSTRACT: Purpose Our aim was to explore the feasibility and effectiveness of endovascular therapy for chronic, central type, deep vein thrombosis (DVT).Patients and Methods A total of 46 iliac vein thrombotic patients with a history of 3 months to 12 years received endovascular therapy. There were 38 cases involving the left lower limb and eight the right lower limb. The average circumference of the affected lower extremities, which was taken 10 cm above the knee before surgery, was 8.9±6.4 cm longer than the corresponding unaffected limb. One to three self-expanding stents with a diameter of 12 or 14 mm were deployed in each thrombotic iliac vein through incision of the femoral vein under supervision of digital subtraction angiography with general or epidural anaesthesia. Strict anticoagulation with an internationalized normalised ratio between 2–3 and an elastic support with elastic stockings were then used life long.Results Three cases failed because of the inability to pass through a wire or catheter. Forty-three cases were successful (93.5%). An average of 2.2 stents were deployed in each occluded iliac vein. Complete venography demonstrated immediate reactivation of the occluded iliac veins with an obvious decrease in compensational collateral venous branches. The average difference in the circumference of the thigh dropped to 2.6±1.7 cm within 3 days postoperatively. A follow-up of 2–36 months showed eight patients suffering from re-occlusion because of a pause or interruption in the anticoagulation therapy. The remaining 35 cases remained patent.Conclusions Endovascular therapy is a choice for chronic, central type DVT, and postoperative anticoagulation and compression therapy are of great importance for patency. The mid- and long-term results must still be determined.
    Gefässchirurgie 01/2006; 11(1):36-39. · 0.24 Impact Factor
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    ABSTRACT: To identify genes responsive to apoptosis in HL-60 cells treated by homoharringtonine. cDNA microarray technology was used to detect gene expression and the result of microarrays for genes (TIEG and VDUP1) was confirmed by Northern analysis. Seventy-five individual mRNAs whose mass changed significantly were identified. Among these genes (25 were up-regulated and 50 were down-regulated), most are known related to oncogenes and tumor suppressor. Some genes were involved in apoptosis signaling pathways. TGF beta and TNF apoptosis signaling pathways were initiated during apoptosis in HL-60 cells. TIEG and VDUP1 play important roles in mediating apoptosis.
    Acta Pharmacologica Sinica 04/2004; 25(3):319-26. · 2.35 Impact Factor
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    ABSTRACT: To assess the operation indications, preoperative evaluation, technique essentials and clinical prospect of endovascular stent-graft exclusion for aortic dissection. From September 1998 to April 2003, endovascular stent-graft exclusion for aortic dissection (Stanford B) was preformed in 146 patients. CTA or MRA were used as preoperative evaluation methods. Graft was constructed from self-expanding Z-stents covered with a woven Dacron polyester fabric graft (Talent). The stent-grafts were inserted from the femoral or iliac artery to exclude the tear of dissection, and all operations were performed under DSA guidance. The grafts were installed successfully in 145 patients. In 119 patients only proximal tears were excluded, and 26 patients who had both the proximal and distal tears were excluded. The mean follow-up period was 16 months (1 - 54 months). Six patients died within the perioperative period, 2 patients died during the follow-up, 2 patients had recurrence of aortic dissection (Stanford A) and cured by Bentall operation. The others were in good state. No accidents related to the dissection and operation occurred. Endovascular graft exclusion may be a safe and effective treatment for selected patients with thoracic aortic dissection. Endoleak may lead to aneurysmal expansion and rupture. Further follow-up is necessary to evaluate its long-term effect.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 08/2003; 41(7):483-6.