Lefeng Qu

Second Military Medical University, Shanghai, Shanghai, Shanghai Shi, China

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Publications (27)63.56 Total impact


  • No preview · Article · Dec 2015 · Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases]
  • Ziheng Wu · Liang Xu · Dieter Raithel · Lefeng Qu
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    ABSTRACT: To evaluate the safety, efficacy and durability of endovascular repair for proximal para-anastomotic aneurysms after previous open abdominal aortic aneurysms prosthetic reconstruction and share our experience. We retrospectively reviewed the data of all patients with previous open abdominal aortic aneurysms prosthetic reconstruction who underwent endovascular repair for proximal para-anastomotic aneurysms between May 2003 and January 2013 in our center (Nuremberg South Hospital). Key clinical outcomes included technical success rate, peri-operative morbidity and mortality, mid-term complications, reinterventions and open conversion rates. Totally, 24 patients of proximal para-anastomotic aneurysm were treated by endovascular repair. Successful deployments of stent graft were achieved in all patients (100%). Median hospital stay was 6.7 days. One patient had minor type Ia endoleak and one patient developed wound infection. There were no early open conversions and deaths. During a median follow-up of 43 months (range, 7-67 months), computed tomography angiography revealed type Ia endoleaks in four patients (16.7%). The overall reintervention and open conversion rates during follow-up were 16.7% (4/24) and 4.2% (1/24), respectively. Estimates of freedom from reintervention were 91.7% at 1 year, 87.1% at 3 years and 80.9% at 5 years. There was significant difference in freedom from reintervention between proximal para-anastomotic aneurysms patients treated with tube and unibody bifurcated stent grafts (p = 0.034). The cumulative mortality rate was 12.5% (3/24), actuarial analysis for all patients estimated survival rates of 95.8% at 1 year and 87.3% at 5 years. Proximal para-anastomotic aneurysms are severe complications after abdominal aortic aneurysm open reconstruction. Closer follow-up and prompt treatment are necessary. Endovascular treatment for proximal para-anastomotic aneurysms is effective, safe and durable. Unibody bifurcated stent graft proved to be suitable for most proximal para-anastomotic aneurysms with various anatomical features. © The Author(s) 2015.
    No preview · Article · Jun 2015 · Vascular
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    ABSTRACT: Carotid endarterectomy (CEA) is an established operation performed to prevent strokes, but its other potential effects, such as improving neurocognitive, visual, and auditory functions, remain unconfirmed. This study examined these effects of CEA on patients with symptomatic carotid stenosis. This was a prospective controlled study that included 80 patients with minor strokes who had severe extracranial internal carotid stenoses (>70%). Forty patients, who did not receive or who postponed the CEA due to concerns about age, fear of surgery, limited life expectancy because of cancer, or financial problems, formed the medicine-treatment group. Another 40 patients who received CEA 1 week after recruitment formed the CEA group. For both groups, visual acuity chart tests, perimetry tests, audiometry tests, and neurologic scales (National Institutes of Health Stroke Scale, Mini Mental State Examination, and Barthel Index of Activities of Daily Living) were used to assess ophthalmic functions, auditory acuity, and neurocognitive functions before treatment and 3 months after treatment. Intragroup and intergroup comparisons were conducted to examine the effect of CEA. No deaths or strokes occurred during the 3-month follow-up. The intragroup and intergroup comparisons of ipsilateral function showed that CEA could improve visual acuity, visual field, and auditory acuity at all tested frequencies (250 Hz, 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz) and could improve the visual field and the auditory acuity for contralateral functions at 1000 Hz. The auditory acuity at 2000 Hz and 4000 Hz were unchanged in the intragroup comparison but showed no deterioration in the intergroup comparison with the medicine group. General neurocognitive function and independent living ability were significantly improved by CEA, as shown by intergroup comparisons (change rate of National Institutes of Health Stroke Scale: -8.1% ± 9.0% vs -2.7% ± 3.0%, P < .001; change rate of Mini Mental State Examination: 15.5% ± 10.5% vs 1.6% ± 2.6%, P < .001; change rate of Barthel Index: 28.0% ± 24.6% vs 2.0% ± 5.5%, P < .001). In patients with minor strokes caused by severe carotid stenosis, CEA improves neurocognitive, ophthalmic, and acoustic functions. Studies with a larger sample and longer follow-up are needed to substantiate these results, and the underlying mechanisms need further investigation. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.
    No preview · Article · Jun 2015 · Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
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    L Xu · Z Wu · L Qu · S Burchell
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    ABSTRACT: The aim of the present study was to investigate the effects and safety of a patent ductus arteriosus occluder (PDAO) in the management of major abdominal arteriovenous fistula. A 56-year-old man was admitted into our hospital, presenting with impeded defecation and claudication. Computed tomographic angiography (CTA) was conducted upon admission, which revealed an aneurysm-like lesion, with the left internal iliac artery as its feeding artery. Super-selective embolization treatment was accomplished using a single PDAO. The results of the CTA at follow-up showed no recanalization of the lesion and that a PDAO was at the site. The patient had no pelvic ischemia complications. © The Author(s) 2015.
    Full-text · Article · Apr 2015 · Perfusion

  • No preview · Article · Apr 2015 · International Journal of Cardiology
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    ABSTRACT: Background/Aims: Integrin activation and lymphocyte migration to the vascular intima is a key event in early atherosclerosis. α4β7 integrin (LPAM-1) and its ligand, mucosal addressin cell adhesion molecule (MAdCAM-1) are known to play an important role in homing of activated lymphocytes to gut-associated lymphoid tissues. However, it is unclear whether α4β7 integrin is involved in the pathogenesis of atherosclerosis. Methods: The expressions of α4β7 integrin and its ligands in atherosclerosis plaques from 12 week high fat diet (HFD) fed ApoE(-/-) and C57BL/6 mice were examined using immunofluorescent and immunohistochemical assays, respectively. We also generated ApoE/β7 double deficient mice and compared atherosclerotic lesion development in β7(+/+)ApoE(-/-) and β7(-/-)ApoE(-/-) mice that were fed with HFD for 12 weeks. Results: We found an upregulation of α4β7 integrin and its ligands VCAM-1 and MAdCAM-1 at atherosclerosis plaques in Apolipoprotein E deficient (ApoE(-/-)) mice fed with HFD for 12 weeks. Over the 12 week HFD period, peripheral blood lymphocyte (PBL) expression of α4β7 integrin increased in parallel with aortic lesion size. A removal of α4β7 integrin by genetic deletion of the β7 chain in the ApoE(-/-) mouse resulted in a markedly decreased 12 week-HFD atherosclerotic plaque area. β7(-/-) ApoE(-/-) macrophages showed reduced acetylated and native LDL uptake and phagocytic activity, revealing possible roles for α4β7 at two distinct stages of macrophage dysfunction during atherogenesis. Finally, a reduced activity of integrin downstream signalling components focal adhesion kinase (FAK) and MAPK/ERK1/2 in macrophage indicates their possible engagement during α4β7 integrin signalling in atherosclerosis. Conclusions: Together our results reveal a critical role of α4β7 in diet-induced atherosclerosis in mouse. © 2014 S. Karger AG, Basel.
    No preview · Article · Jun 2014 · Cellular Physiology and Biochemistry
  • Ziheng Wu · Liang Xu · Lefeng Qu · Dieter Raithel
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    ABSTRACT: Purpose To investigate the causes and results of late open surgical conversion (LOSC) after failed abdominal aortic aneurysm repair (EVAR) and to summarize our 17 years’ experience with 13 various endografts. Methods Retrospective data from August 1994 to January 2011 were analyzed at our center. The various devices’ implant time, the types of devices, the rates and causes of LOSC, and the procedures and results of LOSC were analyzed and evaluated. Results A total of 1729 endovascular aneurysm repairs were performed in our single center (Nuremberg South Hospital) with 13 various devices within 17 years. The median follow-up period was 51 months (range 9–119 months). Among them, 77 patients with infrarenal abdominal aortic aneurysms received LOSC. The LOSC rate was 4.5 % (77 of 1729). The LOSC rates were significantly different before and after January 2002 (p
    No preview · Article · May 2014 · CardioVascular and Interventional Radiology
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    ABSTRACT: Objective: To evaluate the clinical outcomes of unibody bifurcated stent-graft in endovascular repair (EVAR). Methods: Retrospective analyses were conducted for the clinical data and postoperative follow-up results of 125 patients (102 cases from Shanghai Changhai Hospital and another 23 from Shanghai Changzheng Hospital) undergoing EVAR with unibody bifurcated stent-graft from January 2008 to January 2013. Results: The technical success rate was 100%. Perioperative complications including type I endoleak (n = 3, 2.4%) and type II endoleak (n = 4, 3.2%). The incidence of type I endoleak in challenging neck cases was higher than non-challenging ones. And the difference was statistically significant (P = 0.001). Except for 1 dead case, the remainder was followed up for a mean of 26.4 ± 1.5 (1-60) months. Neither aneurysm rupture nor stent-graft migration occurred. Late type I endoleak occurred (n = 2, 1.6%). There were left lower extremity arterial thrombosis (n = 1, 0.8%) and surgical reintervention (n = 1, 0.8%). Among 3 dead cases, 2 died from acute myocardial infarction and another 1 contrast-induced nephropathy. Conclusion: Unibody bifurcated stent-graft is both safe and efficacious in the treatment of abdominal aortic aneurysm without the risk of long-term migration. Moreover, it has excellent outcomes for hostile neck or narrow abdominal aortic bifurcation.
    No preview · Article · May 2014 · Zhonghua yi xue za zhi
  • Jun Bai · Lefeng Qu · Kangkang Zhi · Zhiwei Gao · Yongfa Wu · Liang Xu
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    ABSTRACT: This paper aims to evaluate the clinical applyment of "Anatomical fixation" and its long-term efficacy . Retrospective analysis of clinical data and postoperative follow-up results of 125 patients undogoing EVAR using "anatomical fixation" enrolled in Shanghai Changhai hospitai and Shanghai Changzheng hospitai from January 2008 to January 2013. The technical success rate was100%, Perioperative complications including Type I endoleak occurred in 3 patients (2.4%), 4 cases of type II endoleak (3.2%). Incidence of Type I endoleak in challenging neck cases was high than non- challenging neck cases, the difference was statistically significant (P < 0.001). After 30 days and through current follow-up of 124 successful cases(mean:26.4 ± 1.5 months, range1-60 months). No rupture of the aneurysm and stent graft migrations occurred. Secondary type I endoleak in 2 cases (1.6%), Two cases of secondary type II endoleak (1.6%). Left lower extremity arterial thrombosis in 1 case (0.8%), and secondary surgical intervention in 1 case (0.8%). Three cases of deaths in cumulative, 2 patients died died of acute myocardial infarction. At 3 months, a patient died of the contrast-induced nephropathy, renal failure. The clinical applyment of "Anatomical fixation" enriched the theory of EVAR, completely solved the complication of incidence of stent-graft migration, greatly improve the repair rate of hostile neck cases, expand the indications for EVAR.
    No preview · Article · Jan 2014 · Zhonghua yi xue za zhi
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    ABSTRACT: Peripheral artery disease is growing in global prevalence. Its most severe form, critical limb ischemia (CLI), is associated with high rates of limb loss, morbidity, and mortality. Neovascularization is the cornerstone of limb preservation in CLI. In the field of regenerative medicine, basic research and preclinical studies have been conducted using mesenchymal stem cells (MSCs) from adult tissues, including bone marrow and adipose tissue, to overcome clinical shortcomings. Adipose-derived stem cells (ASCs) display stable growth and proliferation kinetics and can differentiate into osteogenic, chondrogenic, adipogenic, myogenic or neurogenic lineages. ASCs are readily available from autologous adipose tissue, and have significant potential for tissue repair under conditions of myocardial infarction, heart failure, hind limb ischemia, and inflammation. This review highlights some of the key reports underlining the potential of ASCs, particularly in diseases involving neovascularization.
    No preview · Article · Jan 2014 · Frontiers in Bioscience
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    ABSTRACT: YKL-40 has been demonstrated to be related to atherosclerosis, but its role in predicting plaque status and the outcome of carotid atherosclerosis (CAS) caused by CagA-positive helicobacter pylori remains unclear. This study was aimed to investigate the role of YKL-40 in predicting the outcome of carotid atherosclerosis with CagA-positive Helicobacter pylori infection. The serum concentrations of YKL-40, C-reaction protein in 310 patients undergoing color Duplex assessment of carotid atherosclerosis were recorded and divided into 3 groups according to the infectious statuses of helicobacter pylori. We also examined serum YKL-40, C-reaction protein and the plaque morphology in animal model of carotid atherosclerosis with different types of helicobacter pylori infection. Overexpression of YKL-40 was only found in carotid atherosclerosis group with CagA-positive helicobacter pylori infection; C-reaction protein failed to distinguish different infectious statuses of helicobacter pylori infection. In patients with CagA-positive helicobacter pylori infection, elevated YKL-40 expression was accompanied by more severe clinical symptoms. We also confirmed similar findings in rabbit model of carotid atherosclerosis with CagA-positive helicobacter pylori infection. We found that in 7 rabbits treated with anti-helicobacter pylori therapy, the serum YKL-40 level decreased and the plaque became more stable. Our findings suggested that increased serum YKL-40 level indicates plaque instability and more severe clinical symptoms of carotid atherosclerosis with CagA-positive helicobacter pylori infection. Compared with C-reaction protein, YKL-40 seems to be a more specific predictor of plaque status and outcome of carotid atherosclerosis with CagA-positive helicobacter pylori infection.
    Preview · Article · Apr 2013 · PLoS ONE
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    ABSTRACT: Fig 1. A, Measurement of the aorta, true lumen, and false lumen on four planes: P1, at the level of the descending aorta with maximum diameter; P2, at the level of the descending aorta with narrowest true lumen; P3, at the level of the distal end of the stent graft; P4, at the distal re-entry; a, the designed distal diameter of the stent graft. B, Measurement and definition of mismatch rate (MR). The cartoon is the cross-sectional view of the descending aorta at the level of the distal end of the stent graft. TL, true lumen; FL, false lumen; SD, short diameter; LD, long diameter. The LD of the true lumen was taken as the b value. The SD was measured to evaluate morphological remodeling of the dissected aorta, whereas the LD was measured to choose the size of the restrictive bare stent and calculate the mismatch rate. C, We took the short tracks as the diameters of the true lumen and false lumen in evaluating aortic remodeling. T, True lumen; F, false lumen.
    Preview · Article · Feb 2013 · Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
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    ABSTRACT: Aim —To investigate the immunomodulatory effects of β-(1,3/1,6)-D-glucan on atherosclerosis as well as on the molecular mechanisms of its transition. Methods and Results —Human monocytic leukemia (THP-1) cells were differentiated into the macrophage phenotype by incubation with oxLDL in the absence or presence of β-glucan. β-glucan attenuated CD86 and CD80 expression and simultaneously reduced secretion of the inflammatory cytokines IL-2, IL-8, IL-12, TNF-α and IFN-γ. Western blot analysis showed that oxLDL treatment induced phosphorylation of p38 MAPK and ERK1/2 in PMA-differentiated THP-1 cells. However, β-glucan inhibited p38 MAPK activation. In experiments with monocytes derived from healthy donors, β-glucan inhibited IL-8, IL-12 and TNF-α production. The anti-inflammatory effects of β-glucan were also observed in atherosclerotic plaque cells. Conclusions —β-glucan inhibited oxLDL-induced pro-inflammatory effects in macrophages via regulation of p38 MAPK phosphorylation. This novel finding may provide insight for new therapeutic strategies.
    No preview · Article · Jan 2013 · Nutrition, metabolism, and cardiovascular diseases: NMCD
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    ABSTRACT: OBJECTIVES: This paper sought to report the outcomes of patients who are considered unfit for urgent surgical repair of ascending aortic dissections who were treated using a novel endovascular repair strategy. BACKGROUND: Ascending aortic dissection is best treated by direct surgical repair. Patients who are unable to undergo this form of treatment have poor prognoses. Previously, clinical case reports related to endovascular repair of ascending aortic dissection have been controversial. METHODS: Between May 2009 and January 2011, 41 consecutive patients with ascending aortic dissection were treated in our institution. Fifteen patients were considered poor candidates for direct surgical repair and subsequently underwent the endovascular repair. RESULTS: The nature of the referral process to our tertiary care facility made the median time from aortic dissection onset to treatment 25.5 days (range: 6 to 353 days). Dissections in 5 patients (33.3%) were considered acute, and those in 10 patients (66.7%) were considered chronic. The rate of successful stent-graft deployment was 100%, and there were no major morbidities or deaths in the perioperative period. Median follow-up was 26 months (range: 16 to 35 months). One new dissection occurred in the aortic arch at 3 months and was treated with a branched endograft. Significant enlargements of true lumens and decreases of false lumens and overall thoracic aorta were noted after the procedures. CONCLUSIONS: Endovascular repair of ascending aortic dissection was an appropriate treatment option in patients who were considered poor candidates for traditional direct surgical repair by the clinical criteria used in our institution. A larger series of cases with longer follow-up is needed to substantiate these results.
    Preview · Article · Oct 2012 · Journal of the American College of Cardiology
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    Dieter Raithel · ZiHeng Wu · LeFeng Qu

    Preview · Article · Dec 2011 · Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
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    Preview · Chapter · Sep 2011
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    ABSTRACT: But Etudier le rôle potentiel de quatre et demi Lin-11, Isl-1, et de la protéine Mec-3 (FHL1) dans la pathogénie de la dissection de l’aorte thoracique (DAT). Méthodes Les niveaux d’expression et la localisation de la protéine FHL1 dans le tissu aortique des DAT ont été analysés en employant un Western Blot et de l’immunohistochimie. En outre, un petit acide ribonuclétique d’interférence a été employé pour démanteler le gène FHL1 dans les cellules musculaires lisses aortiques de rat (CMLs). Après évaluation de l’efficacité et de la spécificité de la précipitation par amplification de réaction en chaîne en temps réel et par Western blot, l’effet de la précipitation de FHL1 sur la prolifération des cellules et l’apoptose ont été évalués par analyse du 3 - (4,5-Dimethylthiazol-2-yl) bromure de −2.5 diphenyltetrazolium et par cytometrie en flux, respectivement. Résultats Comparée au tissu aortique normal, l’expression de la protéine FHL1 dans le tissu aortique des patients avec DAT était significativement freinée. L’analyse en immunohistochimie a prouvé que FHL1 était principalement localisé dans le cytoplasme des CMLs. Dans le tissu aortique malade, l’immunoreactivité de FHL1 était inférieure dans les CMLs des médias aortiques fissurées et dans le secteur adjacent, mais relativement élevée dans les CMLs de l’intima et de l’adventice aortique. La précipitation FHL1 empêchait de manière significative la prolifération des CMLs aortiques chez le rat mais n’avait aucun effet évident sur l’apoptose cellulaire. Conclusion L’expression de la protéine FHL1 est freinée dans les DAT. Le frein de l’expression de FHL1 pourrait contribuer à la pathogénie de la DAT, peut-être en supprimant la prolifération de CMLs aortiques et en affectant le remodelage de la paroi aortique.
    No preview · Article · Feb 2011 · Annales de Chirurgie Vasculaire
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    ABSTRACT: PURPOSE: To evaluate the efficacy and safety of preliminary hypogastric artery (HA) embolization prior to endovascular aneurysm repair (EVAR). METHODS: A retrospective review was conducted of all 101 consecutive patients (91 men; mean age 73.4 ± 8.7 years) who underwent preliminary embolization of 133 HAs ∼4 to 6 weeks prior to EVAR from January 2005 to August 2009. Fourteen patients with 19 HAs were treated using coils, while 87 patients were treated with Amplatzer Vascular Plugs (AVP) in 114 HAs. All the patients were evaluated before discharge; at 1, 3, and 6 months; and annually thereafter to evaluate the clinical symptoms, potential endoleaks, and the aneurysm size. Results: In the coil group, complete occlusion was achieved in 16 (84.2%) of 19 procedures. There were no acute pelvic ischemic symptoms after HA embolization or EVAR. Five (35.7%) patients had buttock claudication and 2 (16.7%) of 12 men experienced new erectile dysfunction after embolization. At a mean 42.2-month follow-up (range 14-58), 3 (21.4%) patients had a type II leak via retrograde flow in the HA without aneurysm growth and were under observation. In the AVP group, all 114 HAs in 87 patients were successfully occluded; there was no device dislodgment or acute pelvic or limb ischemia observed. Buttock claudication and new sexual dysfunction developed in 12 (13.8%) patients and 4 (5.1%) of 79 men after the procedure, respectively. During a mean 26.4-month follow-up (range 4-54), 2 (2.3%) patients developed distal type I endoleaks after EVAR, but angiography confirmed that neither of the endoleaks was related to the vessel embolized with the AVP. Comparing the outcomes of the treatment groups, the AVP was placed with fewer intraoperative complications (p = 0.013) and more complete occlusion (p = 0.01) than coil embolization. The rate of buttock claudication was lower in the AVP group (p = 0.042). Conclusion: Hypogastric artery embolization prior to EVAR is safe and effective. In our experience, the AVP affords easier and more precise placement and provides more complete occlusion, with fewer intraoperative and postoperative ischemic complications than coil embolization.
    No preview · Article · Feb 2011 · Journal of Endovascular Therapy
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    ABSTRACT: To investigate the potential role of four and a half Lin-11, Isl-1, and Mec-3 (FHL1) protein in the pathogenesis of thoracic aortic dissection (TAD). The expression levels and localization of FHL1 protein in aortic tissue of TAD were analyzed using Western blot and immunohistochemistry. Furthermore, small interfering ribonucleic acid was used to knock down the FHL1 gene in rat aortic smooth muscle cells (SMCs). After assessing knockdown efficiency and specificity by real-time polymerase chain reaction and Western blot, the effect of FHL1 knockdown on cell proliferation and apoptosis was evaluated by 3- (4,5-Dimethylthiazol-2-yl) -2,5-diphenyltetrazolium bromide assay and flow cytometry, respectively. Compared with normal aortic tissue, FHL1 protein expression in aortic tissue from TAD patients was significantly downregulated. Immunohistochemistry analysis showed that FHL1 was mainly localized in the cytoplasm of SMCs. In diseased aortic tissue, FHL1 immunoreactivity was lowest in SMCs in the split aortic media and adjacent area, but relatively high in SMCs in the aortic intima and adventitia. FHL1 knockdown significantly inhibited the proliferation of rat aortic SMCs but exerted no obvious effect on cell apoptosis. FHL1 protein expression is downregulated in TAD. Downregulation of FHL1 expression might contribute to the pathogenesis of TAD, perhaps by suppressing the proliferation of aortic SMCs and affecting aortic wall remodeling.
    No preview · Article · Feb 2011 · Annals of Vascular Surgery
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    Lefeng Qu · Dieter Raithel
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    ABSTRACT: Precise endograft placement in the thoracic aorta is challenging due to the special local anatomy and unique hemodynamic blood flow. We are employing many techniques together to launch the endograft precisely to the target location: various debranching techniques to extend the proximal landing zone, magnified imaging with full exposition of the supra-arch branches and the proximal landing area to achieve a clear and accurate view, screen markers of the landing target for guidance of deployment, 1-2 cm proximally to the cranial landing marker before launching in case of any displacement, steady deployment of the endograft in hypotensive status or within the temporary heart asystole period induced by intravenous adenosine administration. If a balloon angioplasty or a proximal cuff is inevitable, the abovementioned techniques should be repeated. Our single center results have proved the combined techniques for precise thoracic endograft placement reliable, effective, simple and practical.
    Preview · Article · May 2009 · Journal of vascular surgery: official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter

Publication Stats

144 Citations
63.56 Total Impact Points

Institutions

  • 2008-2015
    • Second Military Medical University, Shanghai
      Shanghai, Shanghai Shi, China
  • 2014
    • Tongji University
      Shanghai, Shanghai Shi, China
  • 2004-2009
    • Changhai Hospital, Shanghai
      Shanghai, Shanghai Shi, China