EJVES Vascular Forum最新文献

{"title":"Early UK Experience with Aspiration Thrombectomy Followed by Urgent Surgical Decompression for Acute Venous Thoracic Outlet Syndrome","authors":"Peter Labib (Vascular Surgery Trainee) ,&nbsp;Gary Lambert ,&nbsp;Fatemeh Sakhinia ,&nbsp;Arun D. Pherwani","doi":"10.1016/j.ejvsvf.2026.04.007","DOIUrl":"10.1016/j.ejvsvf.2026.04.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Venous thoracic outlet syndrome (vTOS) results from compression of the axillary or subclavian vein and may present with acute upper limb deep vein thrombosis. Catheter directed thrombolysis followed by decompression is widely performed but carries bleeding risk and may delay definitive surgery. Mechanical thrombectomy offers a lysis free alternative. This study aimed to assess early outcomes of mechanical thrombectomy followed by urgent surgical decompression in vTOS patients.</div></div><div><h3>Method</h3><div>This paper reports a retrospective single centre case series of patients with vTOS treated with Penumbra Indigo (Penumbra Inc., California, USA) mechanical thrombectomy followed by urgent surgical decompression between January 2025 and February 2026.</div></div><div><h3>Results</h3><div>Four patients (ages 17, 27, 42, and 35 years) underwent successful thrombectomy between one and 21 days after the deep vein thrombosis but within one and six days from referral, followed by first rib decompression within zero to four days. All patients achieved full resolution of symptoms and technical success, evident on follow up venograms, with restoration of central venous flow and no major complications.</div></div><div><h3>Conclusion</h3><div>Early experience suggests that mechanical thrombectomy followed by urgent decompression is feasible and safe in selected patients with acute vTOS. Larger studies with longer follow up are required.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 218-221"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148001286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of a Left Common Carotid Artery Aneurysm by Double Branched Endovascular Arch Replacement Using Tandem Thoracic Branch Endoprosthesis Deployments","authors":"Arindam Chaudhuri,&nbsp;Ramita Dey","doi":"10.1016/j.ejvsvf.2026.03.008","DOIUrl":"10.1016/j.ejvsvf.2026.03.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Branched thoracic endovascular aneurysm repair has become an increasingly common intervention since the advent of custom made and now off the shelf devices. This report describes the use of a sequential double deployment of the Gore TAG Thoracic Branch Endoprosthesis (TBE; WL Gore and Associates, Flagstaff, AZ, USA) to exclude a left common carotid artery aneurysm (LCCAA) due to large vessel vasculitis (LVV).</div></div><div><h3>Report</h3><div>A 39 year old man (smoker, schizophrenic, known antiphospholipid syndrome, and previous deep vein thromboses) presented with a 45 mm LCCAA eight months after resection of a left carotid bulb aneurysm (using a reversed great saphenous vein, which had later occluded). Special investigations and multidisciplinary discussion highlighted the suspicion of LVV involving the arch outflow, and thus an endovascular treatment approach was selected. Sequential dual TBE devices were deployed for branch thoracic endovascular aneurysm repair from Ishimaru zone 3 to zone 0C with coil embolisation of the LCCAA. Successful exclusion of the LCCAA and maintenance of arch branch patency were achieved. Following referral to a tertiary rheumatology centre, the post-operative phase was particularly complicated by a haemorrhagic stroke, which was successfully treated by neurosurgical intervention. The patient continues to be stable at four months and is maintained on long term immunosuppressant, antiplatelet, lipid lowering, and anticoagulant therapy.</div></div><div><h3>Discussion</h3><div>The use of an off the shelf device like the TBE allows modular totally endovascular arch reconstruction, facilitated here by the permissive effect of the left carotid outflow already being sacrificed. Endovascular options may provide an initial solution for treating aortic arch branch vessel aneurysms, thus reducing the morbidity and mortality of open surgical arch reconstructions, but an overall multidisciplinary approach is mandated for the management of such patients with long term follow up.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 195-199"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying Constructive Alignment to Enhance the Educational Structure of the European Society for Vascular Surgery Podcasts","authors":"Carlota F. Prendes ,&nbsp;Laurence Bertrand ,&nbsp;Vaiva Dabravolskaite ,&nbsp;Suzanne Stokmans ,&nbsp;Egle Kavaliunaite ,&nbsp;Melina Vega de Ceniga","doi":"10.1016/j.ejvsvf.2026.02.002","DOIUrl":"10.1016/j.ejvsvf.2026.02.002","url":null,"abstract":"<div><h3>Objective</h3><div>Medical podcasts are increasingly being recognised as flexible, accessible tools for lifelong learning. However, their educational structure and cognitive demands often remain informal and unstandardised. This study aimed to evaluate the educational quality of the European Society for Vascular Surgery (ESVS) vascular surgery podcasts using pedagogical frameworks and propose enhancements to improve their impact.</div></div><div><h3>Methods</h3><div>A mixed methods educational design was employed, structured around three core components: an exploratory online survey guided by the Kirkpatrick Evaluation Model; application of Bloom's Revised Taxonomy to analyse three selected podcast episodes; and creation of pedagogical enhancements for them according to constructive alignment principles. The primary outcome was to identify areas where targeted improvements could enhance their overall educational impact.</div></div><div><h3>Results</h3><div>Fifty-seven participants completed the online survey. Over 70% indicated that the podcasts had improved their understanding of vascular surgery topics (Kirkpatrick Level 2) and 75% reported that they had applied podcast content in practice (Kirkpatrick Level 3). Content analysis of the selected podcast episodes revealed good alignment with Bloom's lower order cognitive skills (remembering, understanding, applying), with occasional support for higher order domains (analysing, evaluating, creating). Potential educational enhancements also supported by survey responders included brief episode summaries (68%), links to further readings and references (51%), and inclusion of intended learning objectives (37%). These enhancements were categorised as low to moderate effort with high potential educational impact.</div></div><div><h3>Conclusion</h3><div>The ESVS podcast series is a valued educational tool. Integration of pedagogically informed features such as intended learning outcomes, summaries, and linked references, could enhance learning outcomes and retention without significantly increasing production demands.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 100-106"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147612435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building an Endovascular Skeleton: Prophylactic Stenting in a Hybrid Approach to a Thymic Carcinoma with Supra-aortic Trunk Encasement","authors":"Giulia Landini,&nbsp;Marco Campolmi,&nbsp;Alessandro Gonfiotti,&nbsp;Sara Speziali","doi":"10.1016/j.ejvsvf.2026.08.002","DOIUrl":"10.1016/j.ejvsvf.2026.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Locally advanced thymic carcinomas with supra-aortic vessel involvement pose significant surgical challenges and are historically often deemed unresectable. Neoadjuvant radiotherapy further complicates surgical resection by inducing severe tissue fibrosis. The integration of endovascular techniques with open surgery can expand the boundaries of oncological radicality; however, literature on such hybrid approaches for mediastinal tumours remains limited.</div></div><div><h3>Report</h3><div>A 45 year old man presented with a 6 × 9 cm locally advanced thymic squamous cell carcinoma causing tracheal compression. The mass entirely encased the left common carotid artery (LCCA) and partially encased the innominate and left subclavian arteries. Following a partial response to neoadjuvant chemoradiotherapy, a staged multidisciplinary surgical approach was planned. To mitigate the risk of catastrophic vascular injury during dissection of irradiated tissues, prophylactic stent grafts were first deployed in the innominate and left subclavian arteries via right axillary access under local anaesthesia. Radical tumour resection was performed via a combined median sternotomy and cervical approach three days later. The pre-placed stents acted as a rigid “endovascular skeleton”, allowing safe and aggressive sub-adventitial tumour dissection. The LCCA was resected <em>en bloc</em> with the tumour, and vascular continuity was restored using a left subclavian to carotid prosthetic bypass. The patient recovered well and was discharged on post-operative day 19. At the three month follow up, he was asymptomatic, with imaging confirming the patency of both the stents and the bypass.</div></div><div><h3>Conclusion</h3><div>Prophylactic endovascular stenting of partially encased supra-aortic vessels offers crucial structural and haemostatic protection, facilitating safe and aggressive oncological resection in hostile, irradiated fields. This tailored, hybrid multidisciplinary approach provides a viable pathway to achieving true oncological radicality (R0) in highly complex mediastinal tumours previously considered inoperable.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"66 ","pages":"Pages 98-102"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148994692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Cross Sectional Survey on the Management of Visceral Artery Aneurysms and Isolated Dissections from the European Visceral Artery Revascularisation (EVisAR) Study Participants","authors":"Nicola Leone,&nbsp;Mario D’Oria,&nbsp;George A. Antoniou,&nbsp;Mark J. Koelemay,&nbsp;Elena Iborra,&nbsp;Jos C. van den Berg,&nbsp;Sonia Ronchey,&nbsp;Giovanni F. Baresi,&nbsp;Alexander Gombert,&nbsp;Stefano Gennai","doi":"10.1016/j.ejvsvf.2026.07.005","DOIUrl":"10.1016/j.ejvsvf.2026.07.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Visceral artery aneurysms (VAAs) and isolated mesenteric and renal artery dissections (IMAD and IRAD) are uncommon conditions with unclear natural histories and uncertainties due to the lack of level 1 evidence guiding optimal management. This study was part of the European Visceral Artery Revascularisation (EVisAR; <span><span>ClinicalTrial.gov</span><svg><path></path></svg></span> NCT06913530) study initiative. A single round, international, cross sectional online survey, in compliance with the Checklist for Reporting of Survey Studies (CROSS), was conducted to assess current heterogeneity for the management of VAAs, IMAD, and IRAD across Europe.</div></div><div><h3>Method</h3><div>EVisAR physicians were invited and surveyed with questions on caseload, diagnostic pathways, treatment indications and strategies, and follow up protocols. Responses were analysed descriptively, and inter-physician agreement was estimated with the Fleiss κ method.</div></div><div><h3>Results</h3><div>A total of 54 physicians completed the survey (of 107 invited); 98% were vascular surgeons from 12 European countries and one from Australia. Institutional caseloads were low (fewer than ten cases/year) for both conditions. Aneurysm size thresholds for intervention varied depending on the location, with 2 – 3 cm being common for several arteries and an agreement for a 3 cm threshold for renal and splenic artery aneurysms (74% and 65%, respectively). Endovascular intervention was the preferred approach for VAAs and dissections (98%). Initial IMAD management largely depended on clinical status and most frequently included triple medication (antihypertensive, anticoagulant, and antiplatelet, 68%), fasting (63%), monitoring of biomarkers for intestinal ischaemia (89%), and a second scan at one to three days (63%). Overall agreement on management was moderate for VAA (κ = 0 .41) and IMAD and IRAD (κ = 0.40). For both, the lowest agreement was observed for follow up indications (κ = 0.03 and κ = 0.32, respectively).</div></div><div><h3>Conclusions</h3><div>Current management shows substantial heterogeneity and a lack of consensus, particularly concerning long term surveillance and specific therapeutic approaches, although endovascular interventions seem to be the preferred strategy. These findings underscore the urgent need for high quality data and support the ongoing need for the EVisAR study.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"66 ","pages":"Pages 58-65"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148854098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operation Techniques and Outcomes in Patients with Chronic Limb Threatening Ischaemia Undergoing Minor Amputations—A Cohort Study","authors":"Kasper H.F. van der Heijden ,&nbsp;Erwin J. Peters ,&nbsp;Marie-José P.J. Vleugels ,&nbsp;Jan Willem H.C. Daemen ,&nbsp;Barend M.E. Mees ,&nbsp;Willemien van de Water","doi":"10.1016/j.ejvsvf.2026.05.001","DOIUrl":"10.1016/j.ejvsvf.2026.05.001","url":null,"abstract":"<div><h3>Introduction</h3><div>For patients with chronic limb threatening ischaemia (CLTI), minor amputations are frequently performed; however, evidence regarding surgical technique and outcomes is limited. This study aimed to investigate the association between toe amputation technique and clinical outcomes.</div></div><div><h3>Method</h3><div>A retrospective cohort study was conducted, including all patients with Rutherford 5 or 6 CLTI who underwent a toe amputation at a single university centre between January 2018 and December 2023. Data were extracted from electronic patient records. Surgical techniques included metatarsophalangeal disarticulation, metatarsophalangeal disarticulation with cartilage removal, and transmetatarsal ray decapitation. Primary outcomes were wound healing status at 30 days after the procedure and time to wound healing. Secondary outcomes included complications, length of stay, additional interventions, additional amputations, and overall mortality rate.</div></div><div><h3>Results</h3><div>One hundred and seventy-eight patients were included, with a median age of 72.2 years. Wound healing at 30 days and median time to wound healing were not associated with amputation technique (overall healing rate 68.0%, <em>p</em> = 0.16; median healing time eighty-three days (interquartile range 31.3, 146.3 days), <em>p</em> = 0.21). In multivariable analysis, toe pressure &lt; 30 mmHg, diabetes mellitus, and procedures performed in an acute setting were independently associated with non-healing at 30 days. Overall, 34.3% of patients underwent additional revascularisation and 30.9% required a subsequent minor or major amputation. During a median follow up of 1.6 years, 91 patients (43.1%) died.</div></div><div><h3>Conclusion</h3><div>The toe amputation technique was not associated with wound healing outcomes in CLTI. Clinical decision making should prioritise optimisation of vascular status and patient specific factors over the choice of amputation technique alone.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"66 ","pages":"Pages 9-16"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148246503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Damage Control Surgery for Wartime Carotid Artery Injuries: Interaction Between Role 2 and Role 3 Facilities in Ukraine and a Clinical Case Series Analysis","authors":"Ihor Rusanov ,&nbsp;Dmytro Mialkovskyi ,&nbsp;Iurii Mikheiev ,&nbsp;Roman Kuziv ,&nbsp;Kostiantyn Gumeniuk ,&nbsp;Serhii Machuskyi ,&nbsp;Alex Valadka ,&nbsp;Rocco A. Armonda","doi":"10.1016/j.ejvsvf.2026.01.004","DOIUrl":"10.1016/j.ejvsvf.2026.01.004","url":null,"abstract":"<div><h3>Introduction</h3><div>This case report aimed to describe patterns of combat related carotid artery injury in Ukrainian military personnel and to evaluate outcomes of damage control surgery (DCS) at Role2 facilities followed by definitive management at Role 3 facilities.</div></div><div><h3>Method</h3><div>A retrospective, observational analysis was conducted over a 12 month period at military Role 2–3 facilities. Medical records, operation reports, imaging studies, and evacuation data were reviewed for patients with penetrating neck trauma and confirmed extracranial carotid artery injury. All patients received individualised surgical management at Role 2 and Role 3 facilities according to DCS principles, tailored to clinical severity, associated injuries, and available resources.</div></div><div><h3>Results</h3><div>Ten male patients with penetrating carotid artery injuries were identified. Six patients presented at Role 2 facilities with hard signs of vascular injury, including active arterial bleeding in four cases and expanding neck haematoma in two cases. Temporary intravascular shunts were used as a DCS measure at Role 2 facilities in four patients (40%). Definitive management included primary arterial repair in four patients (40%), carotid ligation in two patients (20%), and reconstruction with interposition grafts following shunting or ligation in four patients (40%). Shunt thrombosis occurred in two of four shunted patients, both involving improvised temporary shunts. The overall stroke rate was 30% (three of ten), including one non-disabling stroke and two disabling stroke, one of which was fatal. Peri-operative mortality was 10% (one of ten). Among patients with available follow up, most demonstrated favourable neurological outcomes, particularly after primary repair.</div></div><div><h3>Conclusion</h3><div>Combat related carotid artery injuries are life threatening and require rapid application of DCS principles. Temporary shunting at Role 2 facilities can be lifesaving but carries risks, particularly when improvised shunts are used. Primary repair at Role 3 facilities provides favourable neurological outcomes when feasible. Close coordination between Role 2 and Role 3 facilities is essential to optimise survival and neurological outcomes in modern warfare.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 107-113"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147612431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alto Deployment in Patients With Severe Tortuosity of the Proximal Aorta: An In Vitro Study","authors":"Yasutaka Yokoyama ,&nbsp;Shizuyuki Dohi ,&nbsp;Minoru Tabata","doi":"10.1016/j.ejvsvf.2026.01.003","DOIUrl":"10.1016/j.ejvsvf.2026.01.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The Alto stent graft system accommodates various anatomies but presents unique challenges. In Japan, polymer filling failures occurred in 1.1% of cases, prompting an investigation into potential causes. It was hypothesised that polymer port location and proximal neck angulation contribute to these failures. The Alto device limits the suprarenal angle to &lt;60° but does not specify the infrarenal neck angle. Because a 90° infrarenal angle is off label for many devices, the infrarenal angle was set at 90° for this study. The aim of this study was to identify the optimal port position for severe proximal aortic tortuosity and to determine the appropriate timing for stiff guidewire withdrawal.</div></div><div><h3>Report</h3><div>An <em>in vitro</em> experimental system was set up using an artificial blood vessel bent at an aortic angle of approximately 90°, immersed in a warm bath (physiological saline at 36°C). Using this system, device outcomes were evaluated on the basis of the presence or absence of a guidewire and the placement position of the polymer port (greater curvature or lesser curvature) under fluoroscopy, performing one evaluation per experiment across a total of six patterns. When the polymer port was on the lesser curvature without a guidewire and nose cone facing downwards, the primary seal ring was incompletely filled, indicating minimal polymer injection. When the polymer was on the greater curvature without a guidewire and nose cone facing downwards, the polymer reached the primary seal ring but not the contralateral limb. However, port placement at the greater curvature with a guidewire allowed the polymer to reach the contralateral limb.</div></div><div><h3>Discussion</h3><div>For the Alto system, aligning the polymer port with the greater curvature of the proximal aortic neck and straightening the aorta with an extra stiff guidewire in cases of severe tortuosity (approximately 90°) are key to ensuring complete polymer filling and preventing failure.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 89-91"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Haemodynamic Evaluation of a Novel Physician Modified Inner Branch Iliac Branch Device for East Asians","authors":"Mingwei Wu ,&nbsp;Li Zhang ,&nbsp;Shichao Liang ,&nbsp;Wei Guo ,&nbsp;Jiang Xiong","doi":"10.1016/j.ejvsvf.2026.01.005","DOIUrl":"10.1016/j.ejvsvf.2026.01.005","url":null,"abstract":"<div><h3>Introduction</h3><div>The anatomic suitability of the iliac branch device remains limited, particularly in East Asians, in whom the common iliac arteries (CIAs) are notably short. This study aimed to evaluate the safety and haemodynamic effects of the physician modified inner branch iliac branch device (PM-IIBD) via clinical outcomes and computational fluid dynamics (CFD) analysis.</div></div><div><h3>Method</h3><div>In this observational case series study, clinical safety was evaluated in ten patients treated with the PM-IIBD for internal iliac artery preservation. CFD analyses were performed before surgery and at 12 month follow up to compare haemodynamic changes in four CIA regions. CFD parameters included velocity, pressure, time averaged wall shear stress (TAWSS), relative residence time, oscillatory shear index (OSI), energy loss, and flow distribution ratios.</div></div><div><h3>Results</h3><div>Technical success was 100%, with no peri-operative or follow up adverse events. CFD revealed minimal changes in pressure and velocity after PM-IIBD implantation, with only a slight post-operative decrease in external iliac artery average velocity (0.51 ± 0.12 m/s <em>vs</em>. 0.45 ± 0.16 m/s, <em>p</em> = .039). High oscillatory shear index areas in the CIA region significantly decreased after surgery (0.22 ± 0.14 <em>vs</em>. 0.11 ± 0.07, <em>p</em> = .036). In the PM-IIBD region, both the average TAWSS (0.40 ± 0.45 <em>vs</em>. 0.72 ± 0.22, <em>p</em> = .015) and maximum TAWSS increased statistically significantly (4.47 ± 4.16 <em>vs</em>. 8.44 ± 6.52, <em>p</em> &lt; .001). The PM-IIBD inner branch region showed an increase in high TAWSS areas (0.11 ± 0.39 <em>vs</em>. 0.20 ± 1.44, <em>p</em> = .002). Energy loss decreased significantly after surgery (3.82 ± 2.13 <em>vs</em>. 3.11 ± 1.76, <em>p</em> = .013), with no significant changes in the relative residence time and flow distribution ratio.</div></div><div><h3>Conclusion</h3><div>Preliminary clinical and CFD analyses have demonstrated the efficacy and haemodynamic stability of the PM-IIBD. By reducing spatial demands on the CIA, the PM-IIBD expands anatomic suitability, offering a feasible solution for internal iliac artery preservation in East Asians.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 92-99"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal Jugular Vein Interposition Bypass for an Attigah Type II Extracranial Internal Carotid Artery Aneurysm: A Case Report of an Underused Autologous Conduit","authors":"Ana Quiles Rocher,&nbsp;Beatriz Genovés Gascó,&nbsp;Francisco Soler Presas,&nbsp;Salvador Martínez Meléndez","doi":"10.1016/j.ejvsvf.2026.06.002","DOIUrl":"10.1016/j.ejvsvf.2026.06.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Extracranial internal carotid artery aneurysms are uncommon and may cause cerebral ischaemia through embolisation or thrombosis. Attigah type II aneurysms require complex exposure, and conventional reconstruction options include saphenous vein grafts, prosthetic conduits, or arterial transposition. The use of the internal jugular vein (IJV) as an autologous conduit for a carotid aneurysm repair is rarely described in the literature. A case of a successful repair using this conduit is reported.</div></div><div><h3>Report</h3><div>A 69 year old man presented with a progressively enlarging right cervical mass. Computed tomography angiography demonstrated a 22 × 31 mm Attigah II extracranial internal carotid artery aneurysm with mural thrombus. An open repair was performed. After high cervical exposure and control of the carotid vessels, the external carotid artery was ligated, and the aneurysm was resected under shunting. A reversed ipsilateral IJV segment was used as an interposition graft, as bilateral great saphenous vein mapping showed inadequate diameters. Post-operative recovery was uneventful except for transient vocal cord paresis. No venous congestion developed despite IJV ligation. Duplex ultrasound at one and six months and computed tomography angiography at one year confirmed graft patency without stenosis.</div></div><div><h3>Discussion</h3><div>The IJV provides favourable calibre matching, wall characteristics, and harvest through the same cervical incision. This case demonstrates its feasibility as an autologous conduit when traditional options are unsuitable. IJV interposition may be considered a viable option for reconstructing complex Attigah II aneurysms.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"66 ","pages":"Pages 66-69"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148843524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}