Vascular最新文献

{"title":"Influence of balloon type and lesion location on outcomes following fistuloplasty.","authors":"Michael Parker, Philip C Bennett, Baljeet Dhillon, Ahmad Al-Thaher, Zahra Al-Alwani, Lee Elzubeir, Tugce Cetin, Maysoon Elkhawad, Tariq Ali","doi":"10.1177/17085381241273126","DOIUrl":"10.1177/17085381241273126","url":null,"abstract":"<p><p>BackgroundThere is limited evidence supporting the optimal use of fistuloplasty to maintain vascular access at various lesion sites, despite its critical role in facilitating renal replacement therapy and the overall high failure rates of arteriovenous fistulas (AVFs). This study aims to identify covariates affecting primary and secondary patency following fistuloplasty of native upper limb vascular access AVFs.MethodsThis retrospective study included all patients who underwent fistuloplasty at a tertiary vascular centre over 4 years. Baseline characteristics were recorded, and factors associated with primary and secondary patency rates were analysed.ResultsA total of 206 patients (88 male, 118 female) with a mean age of 68 (±14) years underwent fistuloplasty during the study period. The prevalence of diabetes, ischaemic heart disease and antiplatelet usage were 33%, 21% and 70%, respectively. The median number of fistuloplasties per access during the follow-up period was 2 [1-3]. Fistulas were classified as radiocephalic (65), brachiocephalic (102) and brachiobasilic transposition (39). Recurrent stenosis (RS) was identified in 60 patients who had previous fistuloplasty before the study period, while 146 patients had de novo stenoses (DNS). Stenosis location significantly differed between RS and DNS (<i>p</i> = .03), with DNS primarily being anastomotic and RS predominantly in central and mixed locations. Younger fistulas were more likely to have anastomotic stenoses compared to those older than 1 year (<i>p</i> = .001). While no significant differences in primary patency (PP) were observed, secondary patency (SP) varied by stenosis location: Central 32 [13-42] months, Fistula vein 20 [12.5-35.5] months, Mixed 25 [13.5-37.5] months and Anastomotic 19 [7-29.5] months (<i>p</i> = .012).ConclusionStenosis location in AVFs is associated with the age and type of the fistula. Younger fistulas often fail due to anastomotic stenoses, which have lower secondary patency compared to stenoses at other sites. Preliminary data suggest that central stenoses, primarily occurring in older fistulas, exhibit better secondary patency following fistuloplasty than stenoses at other locations.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1215-1223"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraluminal crossing of infrainguinal SFA chronic total occlusions may offer patency superiority compared to subintimal crossing.","authors":"Maraya Camazine, Jack Coorts, Terrell Christian, Chase Schlesselman, Robin L Kruse, Jonathan Bath, Todd R Vogel","doi":"10.1177/17085381241273185","DOIUrl":"10.1177/17085381241273185","url":null,"abstract":"<p><p>ObjectivesPatency for chronic total occlusions (CTO) of the superficial femoral artery (SFA) after endovascular interventions traditionally demonstrate a low 1-year patency ranging from 40%-60%. The optical coherence tomography (OCT) catheter (Avinger Inc., Redwood City, CA) uses light-based technology imaging to cross Trans-Atlantic Inter-Society Consensus D (TASC D) lesions intraluminally with direct intra-arterial visualization. Insufficient data exist evaluating intraluminal crossing with OCT imaging compared with traditional subintimal techniques. We evaluated outcomes for TASC D lesions crossed intraluminally.MethodsA retrospective analysis of patients with SFA TASC D lesions crossed intra-arterially with the OCT catheter imaging. Descriptive statistics evaluated patient characteristics which included patient demographics, Rutherford scores, ABIs, CTA information, lesion categorization, as well as runoff score. Patency at baseline, 30-day, 6-month, and 1-year outcomes were compared using t-tests. Cumulative patency rates were evaluated using Kaplan-Meier analysis.Results101 patients underwent elective intervention for SFA TASC D lesions with the OCT catheter. The crossing rate was 78.2%, mean lesion length was 16.2 cm, and runoff at the tibial level was 2.2 patent vessels. Mean age and BMI were 64 years and 29 kg/m², respectively. Patient characteristics are male (57%); Caucasian (90%); ever smoking (85%); hypertension (82%), hyperlipidemia (70%), and diabetes (46%). Pre-operative computed tomography demonstrated SFA lesions were predominantly eccentric (91%) with mild to moderate calcification (90%). All underwent PTA, 87% were stented (mean stent length: 186.1 mm), mean crossing time was 13.4 min. Pre-operative, 30-day, 6-month, and 1-year post-operative mean Rutherford-Becker scores were 4, 1, 1, and 1, respectively (<i>p</i> < 0.0001). Mean pre-operative ABI was 0.49, compared to 0.84 at 30 days, 0.64 at 6 months, and 0.67 at 1 year (<i>p</i> < .0001). Duplex demonstrated 6- and 12-month primary patency of 89% and 75%; primary-assisted patency was 94% and 84%.ConclusionsThe OCT imaging catheter successfully crossed long chronic total occlusions of the SFA using direct intra-arterial imaging. Compared to subintimal techniques, patients had high 1-year primary patency and prolonged symptom improvement with intraluminal crossing. These data suggest that intraluminal crossing of TASC D lesions may be superior to traditional subintimal crossing techniques.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1102-1107"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141992489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde open mesenteric stenting and outcomes for acute mesenteric ischemia.","authors":"Maraya Camazine, Chase Schesselman, Iris Zachary, Jonathan Bath, Todd R Vogel","doi":"10.1177/17085381241273265","DOIUrl":"10.1177/17085381241273265","url":null,"abstract":"&lt;p&gt;&lt;p&gt;ObjectivesData regarding retrograde open mesenteric stenting (ROMS) for urgent mesenteric ischemia is limited to small single center and case series, with variable utilization across patient populations and ill-defined outcomes. We aimed to evaluate characteristics and outcomes of patients with acute mesenteric ischemia requiring urgent surgical intervention.MethodsRetrospective cohort study of patients with mesenteric ischemia requiring urgent surgical intervention from 2018 to 2020 was queried from the National Inpatient Sample (NIS) database. Study groups were defined as those requiring an open bypass (BYPASS), an open superior mesenteric artery embolectomy (OPEN), or ROMS. Descriptive statistics were used to report variables. Comparisons were mad using &lt;i&gt;t&lt;/i&gt; test, chi-squares tests, and multivariate regression reported as odds ratio (OR), 95% confidence interval (CI) where appropriate.Results898 patients with mesenteric ischemia requiring urgent surgical intervention were included: Bypass: 284, OPEN: 363, ROMS: 251. There was no difference in gender or race between groups. Patients requiring ROMS were more likely to be older 70.2 + 11.3versus Bypass 66.81 + 11.6 and OPEN 67.17 + 14.5, &lt;i&gt;p&lt;/i&gt; = 0.0035. ROMS patients had the highest Charlson Comorbidity Index (CCI) 2.9 versus 2.5 Bypass and 2.6 OPEN, &lt;i&gt;p&lt;/i&gt; = 0.0292 with the most frequent comorbidities: Diabetes 37% (&lt;i&gt;p&lt;/i&gt; = 0.01), renal disease 24.3% (&lt;i&gt;p&lt;/i&gt; = 0.5), and previous preoperative myocardial infarction 9.2%, &lt;i&gt;p&lt;/i&gt; = 0.05; however, the lowest mortality rate was seen within this Group 15.9% versus bypass 19.7%, OPEN 34.5%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001. Patients requiring bypass were more likely to have chronic pulmonary disease 34.5% versus OPEN 24.2% and ROMS 31.5%, &lt;i&gt;p&lt;/i&gt; = 0.013, peripheral vascular disease (PVD) 38% versus OPEN 16%, and ROMS 29.9%, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001. On multivariate regression, ROMS was associated with 50% decreased incidence of mortality (OR 0.45, 95% CI 0.27-0.75). Open SMA embolectomy was associated with nearly 2x mortality rate compared to bypass procedures OR 2.0, 95% CI 1.3-3.0, &lt;i&gt;p&lt;/i&gt; &lt; 0.001. Previous MI was also associated with nearly 2x incidence of mortality (OR 1.9, 95% CI 1.01-3.6), while pre-existing PVD conferred a protective effect (OR 0.56, 95% CI 0.36-0.89). Higher CCI and age were associated with slightly increased risk for mortality OR 1.2 and 1.03, &lt;i&gt;p&lt;/i&gt; &lt; 0.05 for both.ConclusionsIn patients with acute mesenteric ischemia, ROMS demonstrated a significant mortality benefit compared to traditional open procedures. Advanced age, history of MI, and open SMA embolectomy were associated with increased mortality. Little data exists regarding ROMS in a real-world population evaluating ROMS, which is a newer technique. These data suggest that ROMS may be a superior alternative to restore mesenteric flow in the acute setting and further prospective studies evaluating ROMS to other procedural types in urgent and elective settings are ne","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1173-1179"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142081803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Axillary compared to brachial access for endovascular procedures.","authors":"Mustafa A Altaha, Shawn Bailey, Sebastian Mafeld, Arash Jaberi, Kong Teng Tan","doi":"10.1177/17085381241279142","DOIUrl":"10.1177/17085381241279142","url":null,"abstract":"<p><p>ObjectivesLimited knowledge exists regarding access site complication rates between trans-axillary and trans-brachial approaches with sheath sizes ≥6Fr. We retrospectively reviewed our institution experience with access site complications for percutaneous trans-axillary and trans-brachial arterial interventions using sheath sizes ranging from 6Fr to 10Fr.MethodsWe examined 67 endovascular interventions performed over 18 months, restricted to sheath sizes of 6Fr to 10Fr. Procedures utilizing trans-brachial (41 cases) and trans-axillary (26 cases) approaches under sonographic guidance were included. Cases involving hemodialysis accesses and those requiring surgical cut-down were excluded. The primary outcome measure was the occurrence of major access site complications (SIR grade-II/III) within 30 days, with data collected on hemostasis method, sheath size, and complications. Statistical analysis involved ANCOVA and Fisher's exact tests, with significance set at <i>p</i> < .05.ResultsSuccessful percutaneous arterial access was achieved in all cases using either approach (trans-axillary or trans-brachial). Closure devices were employed in all axillary punctures and in 71% of brachial punctures. Major access site complications occurred in 7 out of 41 cases (17%) in the trans-brachial group and in 4 out of 26 cases (15%) in the trans-axillary group. However, there was no statistically significant difference in complication rates between the two groups, regardless of access site or sheath size.ConclusionTrans-axillary access serves as a safe and effective upper limb access method for percutaneous endovascular procedures requiring sheath size of 7Fr or larger when compared to trans-brachial approach.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1089-1096"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of outcomes associated with development of surgical site infection after lower-limb revascularization surgery.","authors":"Aidan M Kirkham, Jasmine Candeliere, Sudhir K Nagpal, Henry T Stelfox, Dalibor Kubelik, George Hajjar, Derek R MacFadden, Daniel I McIsaac, Derek J Roberts","doi":"10.1177/17085381241290039","DOIUrl":"10.1177/17085381241290039","url":null,"abstract":"&lt;p&gt;&lt;p&gt;ObjectivesAlthough surgical site infection (SSI) is a commonly used quality metric after lower-limb revascularization surgery, outcomes associated with development of this complication are poorly characterized. We conducted a systematic review and meta-analysis of studies reporting associations between development of an SSI after these procedures and clinical outcomes and healthcare resource use.MethodsWe searched MEDLINE, Embase, CENTRAL, and Evidence-Based Medicine Reviews (inception to April 4th, 2023) for studies examining adjusted associations between development of an SSI after lower-limb revascularization surgery and clinical outcomes and healthcare resource use. Two investigators independently screened abstracts and full-text citations, extracted data, and assessed risk of bias. Data were pooled using random-effects models. Heterogeneity was assessed using I&lt;sup&gt;2&lt;/sup&gt; statistics. GRADE was used to assess estimate certainty.ResultsAmong 6671 citations identified, we included 11 studies (n = 61,628 total patients) that reported adjusted-associations between development of an SSI and 13 different outcomes. Developing an SSI was associated with an increased adjusted-risk of hospital readmission (pooled adjusted-risk ratio (aRR) = 3.55; 95% CI (confidence interval) = 1.40-8.97; n = 4 studies; n = 13,532 patients; I&lt;sup&gt;2&lt;/sup&gt; = 99.0%; moderate certainty), bypass graft thrombosis within 30-days (pooled aRR = 2.09; 95% CI = 1.41-3.09; n = 2 studies; n = 23,240 patients; I&lt;sup&gt;2&lt;/sup&gt; = 51.1%; low certainty), reoperation (pooled aRR = 2.69; 95% CI = 2.67-2.72; n = 2 studies; n = 23,240 patients; I&lt;sup&gt;2&lt;/sup&gt; = 0.0%; moderate certainty), bleeding requiring a transfusion or secondary procedure (aRR = 1.40; 95% CI = 1.26-1.55; n = 1 study; n = 10,910 patients; low certainty), myocardial infarction or stroke (aRR = 1.21; 95% CI = 1.02-1.43; n = 1 study; n = 10,910 patients; low certainty), and major (i.e., above-ankle) amputation (pooled aRR = 1.93; 95% CI = 1.26-2.95; n = 4 studies; n = 32,859 patients; I&lt;sup&gt;2&lt;/sup&gt; = 83.0; low certainty). Development of an SSI &gt;30-days after the index operation (aRR = 2.20; 95% CI = 1.16-4.17; n = 3 studies; n = 21,949 patients; low certainty) and prosthetic graft infection (aRR = 6.72; 95% CI = 3.21-12.70; n = 1 study; n = 272 patients; low certainty) were both associated with an increased adjusted-risk of major amputation. Prosthetic graft infection was also associated with an increased adjusted-risk of mortality &gt;30-days after the index procedure (aRR = 6.40; 95% CI = 3.32-12.36; n = 1 study; n = 272 patients; low certainty).ConclusionsThis systematic review and meta-analysis suggests that development of an SSI after lower-limb revascularization surgery significantly increases patient morbidity and healthcare resource use. SSI is therefore a valuable quality metric after these surgeries. However, current estimates are based on heterogenous, low-to-moderate certainty evidence and should be confirmed by","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1150-1161"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Common iliac artery aneurysm with narrow inner lumen treated by a novel surgeon-modified inner branch iliac branch device.","authors":"Mingwei Wu, Panpan Yuan, Jiang Xiong","doi":"10.1177/17085381241273325","DOIUrl":"10.1177/17085381241273325","url":null,"abstract":"<p><p>ObjectivesThe iliac branch device (IBD) has emerged as the optimal method for endovascular reconstruction of internal iliac artery (IIA). However, due to its high anatomical requirements, the applicability rate among East Asians is limited, especially for common iliac artery aneurysm (CIAA) with narrow inner lumen cases. Here, we report a case with narrow distal inner lumen of the CIAA treated with a novel surgeon-modified inner branch iliac branch device (IIBD).MethodsThis is a case report, and consent for publication was obtained from the patient.ResultsThe 1-year follow-up CTA showed that the CIAA regressed without abdominal pain. Right CIA, external iliac artery, and IIA were all patent.ConclusionsThe IIBD technique has lower anatomical requirements for the CIA. Therefore, it may be a feasible option for IIA preservation in cases of CIAA with narrow inner lumen.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1028-1031"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular solutions for symptomatic free-floating thrombus in thoracic aorta in rheumatoid arthritis patients: Two clinical cases.","authors":"G Mastrangelo, P Di Sebastiano, V Palazzo","doi":"10.1177/17085381241269747","DOIUrl":"10.1177/17085381241269747","url":null,"abstract":"<p><p>ObjectivesWe present two clinical cases of association between symptomatic free-floating thrombus (FFT) in thoracic aorta and rheumatoid arthritis (RA).MethodsIn the first patient, we observed a recent onset of peripheral and visceral signs of embolization: after a first treatment with anticoagulation, our Aortic team scheduled the coverage of FFT (sited in zone 1 of the aortic arch) with an anatomical debranching of anonymous trunk and left carotid artery, a left carotid-subclavian bypass, and a TEVAR of the aortic arch with proximal landing in zone 0 of the arch. The second case was characterized by chest pain, left upper limb ischemia, and CTA evidence of an FFT in zone 3 of the aortic arch; we planned a chimney-TEVAR on the left subclavian artery and descending thoracic aorta (with proximal landing in zone 2 of the aortic arch) to exclude the FFT.ResultsNo complications resulted and no new embolic episodes were registered.ConclusionsEvaluating the aorta is warranted in all patients with peripheral emboli of uncertain pathogenesis. In our opinion, the endovascular treatment of a symptomatic FFT could represent an effective and safe solution in a patient fit for endovascular surgery, but larger studies are required to define a personalized treatment strategy.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1085-1088"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential miR-195-5p and its potential role during the development of carotid artery stenosis.","authors":"Haining Gao, Liansheng Zhao, Xuemei Cao, Guoxin Zhang","doi":"10.1177/17085381241273320","DOIUrl":"10.1177/17085381241273320","url":null,"abstract":"<p><p>ObjectivesCarotid artery stenosis (CAS) is a leading cause of cerebral ischemic events (CIE). Timely detection and risk assessment can aid in managing CAS patients and improving their prognosis. The aim of the current study is to identify a new biomarker for CAS and to further investigate the impact of miR-195-5p on cellular processes in vascular smooth muscle cells (VSMCs).MethodsThis study involved 112 CAS patients and 65 healthy individuals. Serum miR-195-5p levels were measured using RT-qPCR. The ROC curve was then plotted to evaluate the diagnostic potential of miR-195-5p for CAS. The Kaplan-Meier curve and Cox regression were employed to determine miR-195-5p's prognostic significance. In vitro, the effects of miR-195-5p mimic or inhibitor on VSMC proliferation and migration were assessed using CCK-8 and Transwell assays.ResultsIn CAS patients, serum miR-195-5p levels were elevated and correlated with the degree of CAS. The ROC curve had an AUC value of 0.897, with sensitivity of 71.4% and specificity of 95.4%. Higher levels of miR-195-5p indicated a higher risk of CIE occurrence and may serve as an independent predictor of CIE. The upregulation of miR-195-5p promoted VSMC proliferation and migration, while downregulation had the opposite effect.ConclusionsmiR-195-5p was demonstrated to have diagnostic and prognostic significance in CAS and may serve as a potential biomarker. It may contribute to the progression of CAS by promoting the proliferation and migration of VSMCs.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1208-1214"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embolization of a ruptured cystic artery pseudoaneurysm by percutaneous injection.","authors":"Fatih Hakan Tufanoğlu, Behiç Akyüz","doi":"10.1177/17085381241289821","DOIUrl":"10.1177/17085381241289821","url":null,"abstract":"<p><p>BackgroundPseudoaneurysm of the cystic artery is very rare. It usually presents with rupture and hemorrhagic shock, which may be life-threatening. Ultrasonography and contrast-enhanced tomography can be used for the diagnosis. The mainstay of treatment for this disease is cholecystectomy.ObjectiveHere we present an 86-year-old man with known diabetes and Alzheimer's disease whose pseudoaneurysm was treated with percutaneous thrombin injection and highlight the technical aspect of the procedure.MethodWith ultrasonography guidance, a 21-gauge Chiba needle was passed through the liver and advanced into the pseudoaneurysm sac. A controlled, slow injection of 0.5-cc thrombin into the sac was performed with instant occlusion. Doppler imaging performed immediately following the procedure revealed that the pseudoaneurysm was not filled.ConclusionPseudoaneurysm of the gallbladder is extremely rare, and its diagnosis is difficult. If the condition is not treated right away, it can quickly become life-threatening. The majority of the pseudoaneurysms have already ruptured, and the patients are clinically septic, making surgery dangerous. Also, the use of contrast media in these patients may increase the risk of nephropathy, which is not an issue with percutaneous injection. Due to the obvious risk of rupture and bleeding, we propose injecting pseudoaneurysms only if they have a visible wall.ResultPercutaneous injection of the gallbladder pseudoaneurysms can be an option when treating gallbladder pseudoaneurysms. More research on long-term success rates is required.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1081-1084"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid aorto-iliac reconstruction for acute infrarenal aortic occlusion: A case report.","authors":"Sarah A Loh, Edouard Aboian","doi":"10.1177/17085381241273272","DOIUrl":"10.1177/17085381241273272","url":null,"abstract":"<p><p>ObjectiveAcute aortic occlusion (AAO), though rare, carries a high morbidity and mortality risk. Rapid recognition and revascularization are crucial for limb and life preservation. We present a case of a hybrid approach using open thrombectomy and endovascular arterial stent grafts in lieu of an open bypass for management of AAO.MethodsThis case describes a 77-year-old man who presented with new-onset lower extremity pain with associated sensory deficits and was found to have acute infrarenal aortic occlusion. Open femoral cutdown for open thrombectomy and distal embolic protection with endovascular balloon occlusion was combined with aortic and bilateral iliac artery stenting.ResultsThe patient was discharged home on post-operative day 3 with resolution of his presenting symptoms and remains asymptomatic at 1-month follow-up.ConclusionThis technique of aorto-iliac reconstruction using stent grafts has previously been described in the setting of chronic aorto-iliac occlusive disease; however, its use has not been previously documented in the setting of acute aortic occlusion. This case illustrates the safety and feasibility of a hybrid approach to AAO, particularly in patients who are physiologically unfit for open revascularization.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1032-1036"},"PeriodicalIF":0.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}