EJVES Vascular Forum最新文献

{"title":"Is Robotic Surgery the Next Disruption in Vascular Surgery?","authors":"Young Erben, Francisco Álvarez Marcos","doi":"10.1016/j.ejvsvf.2026.05.002","DOIUrl":"10.1016/j.ejvsvf.2026.05.002","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 227-228"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13292761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333522","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":"Chronic Q Fever Presenting as a Contained Rupture of an Infected Native Aortic Aneurysm: A Case Report","authors":"Lea Schacher ,&nbsp;Laina Passos ,&nbsp;Michel Bosiers ,&nbsp;Vladimir Makaloski ,&nbsp;Daniel Becker ,&nbsp;Drosos Kotelis","doi":"10.1016/j.ejvsvf.2025.11.003","DOIUrl":"10.1016/j.ejvsvf.2025.11.003","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Coxiella burnetti</em> (<em>C. burnetii</em>) is the causative agent of Q fever. Chronic Q fever may lead to various complications, including infected native aortic aneurysms (INAA). Both INAA and chronic Q fever typically present with non-specific symptoms, often resulting in delayed diagnosis. While current guidelines provide recommendations for the management of INAA, there are no specific or standardised protocols addressing INAA in the context of chronic <em>C. burnetii</em> infection. However, antimicrobial therapy should be directed towards the causative pathogen. This case report describes a rare case of INAA secondary to chronic Q fever.</div></div><div><h3>Case</h3><div>A 64 year old man presented with lumbar pain due to contained rupture of a juxtarenal abdominal aortic aneurysm. Urgent open surgical repair with inter-renal clamping, resection of infected tissue, reconstruction with pericardial tube graft and omental flap plasty was performed due to suspicion of infection. Intra-operative samples revealed <em>C. burnetii</em> to be the causative agent of chronic Q fever. Oral antibiotic treatment with doxycycline 100 mg twice daily and hydroxychloroquine 200 mg thrice daily was established.</div></div><div><h3>Discussion</h3><div><em>C. burnetii</em> infection should be considered as a possible pathogen in a case of culture negative INAA. Early diagnosis, open surgical treatment using bovine material and omental flap plasty, prolonged targeted antimicrobial therapy, and follow up assessment with blood samples and computed tomography scans in close cooperation with infectious disease specialists are recommended to improve outcomes in these rare and challenging cases. Case reports such as this contribute to raising clinical awareness and provide valuable insights into the absence of standardised treatment guidelines.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 21-24"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939137","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":"Validation of a Deep Learning U-Net Algorithm for Multistructure Segmentation of Infrarenal Abdominal Aortic Aneurysms including Lumen, Thrombus, and Calcifications","authors":"Lucie Derycke ,&nbsp;Asmaa Doudouh ,&nbsp;Florian Cotte ,&nbsp;Abdelmalek Habi ,&nbsp;Jean-Noel Albertini ,&nbsp;Antoine Millon","doi":"10.1016/j.ejvsvf.2025.11.001","DOIUrl":"10.1016/j.ejvsvf.2025.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>Artificial intelligence and digital twin technologies provide a new way to plan endovascular interventions and can help practitioners anticipate complications. The accuracy of these methods is based on reliable automated aortic segmentation, including intraluminal thrombus (ILT), calcifications, and detection of collateral arteries. The aim of this study was to validate a new fully automated deep learning based aortic segmentation algorithm that could be used for optimised digital twin generation.</div></div><div><h3>Methods</h3><div>After training on 1280 computed tomography angiography scans, including 1000 for pre-training and 280 for fine tuning, a convolutional neural network based on a U-Net architecture was externally validated on 48 computed tomography angiography scans to segment lumen, collateral arteries, ILT, and parietal calcifications of the abdominal aorta and iliac arteries. Blinded, manually corrected segmentations from a senior radiologist and surgeon were performed to create the ground truth comparison.</div></div><div><h3>Results</h3><div>The comparison between fully automated and manually corrected segmentation methods revealed a mean dice similarity coefficient of 0.97 ± 0.01, 0.94 ± 0.05, and 0.87 ± 0.04 for aortic lumen, ILT, and calcifications, respectively. Average surface distance was 0.30 ± 0.15, 0.61 ± 0.72, and 0.28 ± 0.28 mm for aortic lumen, ILT, and calcifications, respectively. Mean segmentation time was four minutes and 20 seconds with the fully automated method.</div></div><div><h3>Conclusion</h3><div>The deep learning algorithm developed in this study provided valid, fast, and accurate aorto-iliac segmentation. This may be used to automatically generate reliable aortic digital twins for endovascular aortic repair planning.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 1-10"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145718924","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":"Endovascular Management of Right Renal Vein Thrombosis Involving Inferior Vena Cava Using an Intelligent Aspiration System","authors":"Vincenzo Ardita ,&nbsp;Domenico Baccellieri","doi":"10.1016/j.ejvsvf.2025.10.003","DOIUrl":"10.1016/j.ejvsvf.2025.10.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal vein thrombosis (RVT) is a rare but potentially serious condition, particularly when extending into the inferior vena cava (IVC). It can arise from nephrotic syndrome, hypercoagulable states, or infection, and may compromise renal function or lead to embolic complications. While anticoagulation remains the cornerstone of therapy, endovascular mechanical thrombectomy is emerging as a viable option in selected cases. This case report describes a right RVT with IVC involvement that was successfully treated with a new generation aspiration device.</div></div><div><h3>Report</h3><div>A 60 year old man with recent pyelonephritis presented with nephrotic range proteinuria, microhaematuria, and normal renal function. Computed tomography imaging revealed a 4 cm thrombus in the right renal vein extending into the IVC. Following anticoagulation with low molecular weight heparin and exclusion of thrombophilia or malignancy, the patient underwent urgent endovascular thrombectomy using the Penumbra Lightning 12 system. Dual venous access via the right internal jugular and femoral veins allowed aspiration under intravascular ultrasound guidance. Two aspiration passes achieved complete thrombus removal, which was confirmed by phlebography and follow up duplex ultrasound. No malignancy was found on histology. The patient was discharged with preserved renal function and showed complete thrombus resolution at one month imaging follow up.</div></div><div><h3>Discussion</h3><div>This case demonstrates the feasibility and effectiveness of mechanical thrombectomy for RVT with IVC extension using the Penumbra Lightning 12 system. Originally developed for pulmonary embolism, this large lumen aspiration catheter enables efficient thrombus removal with minimal blood loss. In this patient, the procedure led to rapid vessel clearance, avoidance of thrombolytics, and excellent short term outcomes. The case highlights the expanding role of advanced endovascular techniques in managing complex venous thromboses and supports a multidisciplinary approach. Further studies are needed to define the optimal indications and outcomes for such interventions in renal vein thrombosis.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 11-14"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798698","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":"Delayed Diagnosis of a Traumatic Popliteal Arteriovenous Fistula After 54 Years: Case Report, Surgical Management, and Literature Review","authors":"Corrado Cirielli ,&nbsp;Federica Orlando ,&nbsp;Francesco Snider ,&nbsp;Pietro Modugno","doi":"10.1016/j.ejvsvf.2025.11.004","DOIUrl":"10.1016/j.ejvsvf.2025.11.004","url":null,"abstract":"<div><h3>Objective</h3><div>Traumatic popliteal arteriovenous fistulas are rare vascular disorders, usually resulting from penetrating injuries. Most cases become symptomatic within a few months; however, exceptionally long latency periods have been reported, usually spanning two to three decades. This report describes a case of a traumatic popliteal arteriovenous fistula caused by penetrating trauma to the popliteal region during childhood with an extraordinary latency of 54 years before the onset of symptoms. Diagnostic and therapeutic approaches and a literature review are discussed in the context of this rare presentation.</div></div><div><h3>Methods</h3><div>A 61 year old woman presented to the hospital’s outpatient clinic with progressive pain, venous hypertension in the left lower limb, and exertional dyspnoea, which had become evident over the past 6 months. Physical examination revealed left leg oedema with significant lymphovenous stasis, diminished tibial pulses, and a palpable pulsatile mass in the popliteal fossa, accompanied by a systolic bruit—findings suggestive of an arteriovenous fistula. Initially, the patient did not recall any recent trauma or associate her symptoms with a past injury. However, a detailed medical history revealed a penetrating injury to the popliteal region sustained at the age of 7 years. Doppler ultrasound and computed tomography angiography confirmed a high flow popliteal arteriovenous fistula with venous dilation.</div></div><div><h3>Results</h3><div>Following a thorough evaluation, surgical repair was preferred over endovascular intervention due to the complex anatomical characteristics and location of the fistula. After surgery, the patient experienced complete resolution of symptoms.</div></div><div><h3>Conclusions</h3><div>This case demonstrates that traumatic popliteal arteriovenous fistulas can have an exceptionally prolonged latency period, emphasising the need for clinical vigilance and comprehensive diagnostic imaging, even in patients with a remote history of trauma. Although endovascular treatments are increasingly favoured, open surgical repair remains a crucial and effective option for particularly complex post-traumatic popliteal arteriovenous fistulas.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 15-20"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885013","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":"Clinician Attitudes towards Analgesia for Chronic Limb Threatening Ischaemia: A Survey of Vascular Specialists to Inform a Topical Morphine Trial","authors":"Henry Davies ,&nbsp;Marie-José Vleugels ,&nbsp;Mimmie Kwong ,&nbsp;Anahita Dua ,&nbsp;Nasim Akhtar ,&nbsp;Barend M.E. Mees ,&nbsp;Sarah Mitchell ,&nbsp;David Russell","doi":"10.1016/j.ejvsvf.2025.12.001","DOIUrl":"10.1016/j.ejvsvf.2025.12.001","url":null,"abstract":"<div><h3>Objective</h3><div>Current analgesic strategies often treat pain associated with chronic limb threatening ischaemia (CLTI) inadequately and frequently result in significant side effects. This cross sectional, web based, vascular specialist survey study aimed to explore clinician perspectives on current pain management and the potential role of topical morphine to inform future research in this area.</div></div><div><h3>Methods</h3><div>A cross sectional online survey was distributed to vascular surgeons, physicians, and allied health professionals involved in the care of patients with CLTI. The 16 question survey included both closed and open ended items exploring perceptions of current analgesia adequacy, experience with topical morphine (e.g., morphine in gel preparations), and attitudes toward future clinical research. The questionnaire was disseminated via national and international vascular societies, professional mailing lists, and social media platforms. Responses were recorded anonymously and stratified using five point Likert scales (strongly disagree to strongly agree).</div></div><div><h3>Results</h3><div>Of the 104 respondents, most were consultant vascular surgeons (57%) or speciality registrars (14%), with the majority based in the UK (89%). Pain control for CLTI was rated as suboptimal by 96% of respondents in outpatient settings and 78% in inpatient settings. No respondents strongly agreed that pain was adequately managed in either context. Only eight respondents reported experience using topical morphine; of these, three reported it as effective most of the time and five said it was effective sometimes. Nonetheless, 79% expressed willingness to randomise patients with ulcers to a trial of topical morphine, and 85% were willing to include patients without ulcers. All but one of the 104 respondents agreed that reducing systemic analgesia would be of significant patient benefit.</div></div><div><h3>Conclusion</h3><div>There is both a clinical need and strong support among vascular clinicians for research into optimised analgesic regimens for CLTI. Despite limited current experience with topical morphine, the majority are willing to recruit to a trial.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 43-48"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143912","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":"Wall Derived Atypical Type II Endoleak 10 Years After Endovascular Aneurysm Repair: Intra-operative and Histopathological Evidence of Vasa Vasorum Mediated Haemorrhage","authors":"Yusuke Kinugasa,&nbsp;Ryuta Tai,&nbsp;Hideki Teshima","doi":"10.1016/j.ejvsvf.2026.02.003","DOIUrl":"10.1016/j.ejvsvf.2026.02.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Wall derived atypical type II endoleak (aT2EL) is characterised by aneurysm sac enlargement with delayed phase mural enhancement in the absence of conventional branch feeders. Comprehensive clinicopathological correlation is rare.</div></div><div><h3>Report</h3><div>A 76 year old man presented with progressive sac growth 10 years after infrarenal endovascular aortic repair (EVAR) with previous inferior mesenteric artery (IMA) and right internal iliac artery embolisation at the index procedure, and additional embolisation for a recurrent IMA related type II endoleak at five years. Pre-conversion computed tomography angiography (CTA) revealed no patent IMA or lumbar arteries but showed patchy delayed phase enhancement of the mural thrombus. Open conversion demonstrated multiple sites of diffuse oozing from the luminal (intimal) surface of the aneurysm wall without branch inflow or endograft defect. Histopathology identified a distinctive triad: extensive intimal denudation, media exposure with luminally oriented microvessels, and adventitial vasa vasorum proliferation. Targeted sacotomy with selective oversewing was performed while preserving the endograft. Recovery was uneventful. Follow up CTA at three years demonstrated sustained sac reduction without residual endoleak.</div></div><div><h3>Discussion</h3><div>Integration of delayed phase imaging, direct intra-operative luminal wall oozing, and a histopathological triad supports a vasa vasorum mediated mechanism for wall derived aT2EL. Recognising this pattern can guide surgical planning towards sacotomy with selective haemostasis and endograft preservation, and supports incorporating delayed phase CTA or time resolved contrast enhanced magnetic resonance angiography into post-EVAR surveillance.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 127-130"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147612432","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":"Endoscopic Femoropopliteal Bypass Surgery Without Groin Incision: A Feasibility Study on Cadavers with the Da Vinci Single Port System","authors":"Rouven Berndt ,&nbsp;E. Sebastian Debus ,&nbsp;Hubert Stein ,&nbsp;Mark Preuss ,&nbsp;Glenn Stante ,&nbsp;Fabien Thaveau","doi":"10.1016/j.ejvsvf.2026.04.005","DOIUrl":"10.1016/j.ejvsvf.2026.04.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Femoropopliteal bypass surgery (FPBS) is a standard surgical procedure but is still associated with complications, especially surgical site infections and groin seromas. This feasibility study aimed to investigate whether endoscopic, robot assisted surgery enabled FPBS with minimal surgical trauma and without a groin incision.</div></div><div><h3>Method</h3><div>The da Vinci single port (SP) system (Intuitive Surgical, Sunnyvale, USA) was used to perform the novel technique of endoscopic FPBS on fresh frozen cadavers. For this novel technique, a 4 cm incision was made in the distal third of the medial thigh for supragenicular exposure of the proximal femoral artery. Thereafter, an end to side anastomosis between the common femoral artery and a polytetrafluoroethylene (PTFE) graft was performed endoscopically with the da Vinci SP system. Success of the procedure was defined by completion of the proximal bypass anastomosis and the avoidance of injuries to anatomic key structures. First evaluation of the technique was performed by assessment with a slightly modified Northwestern Objective Microanastomosis Assessment Tool (NOMAT) score.</div></div><div><h3>Results</h3><div>Two proximal bypass anastomoses were successfully sutured without injury to the five pre-defined key anatomic structures. Skin to skin complete duration of the intervention including removal of the robotic system was 105 minutes and 92 minutes, respectively. The modified NOMAT score representing the efficiency of surgical handling and quality of the anastomosis was 29 of 45 and 37 of 45, respectively.</div></div><div><h3>Conclusion</h3><div>The current study demonstrates that endoscopic, robot assisted FPBS was feasible within an acceptable timeframe and without injury to key anatomic structures. Further clinical development of endoscopic FPBS could enable minimally invasive bypass surgery including the advantages of conventional surgery but avoiding its limitations.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"65 ","pages":"Pages 222-226"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184297","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":"Successful Surgical Repair of Large Extracranial Internal Carotid Artery Pseudoaneurysms Causing Cervical Aerodigestive Compression","authors":"Uoc Huu Nguyen,&nbsp;Thang Ngoc Duong,&nbsp;Hien Thi Thu Do","doi":"10.1016/j.ejvsvf.2026.06.003","DOIUrl":"10.1016/j.ejvsvf.2026.06.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Extracranial internal carotid artery pseudoaneurysms are well recognised; however, those large enough to cause airway or oesophageal compression are exceedingly rare. Surgical management of complicated lesions remains difficult and is often accompanied by significant potential for adverse events.</div></div><div><h3>Report</h3><div>Two patients were diagnosed with extracranial internal carotid artery pseudoaneurysm presenting with airway and oesophageal compression. Both were successfully treated by surgical excision and revascularisation of the internal carotid artery. Post-operative recovery was uneventful in both patients, with no complications observed.</div></div><div><h3>Discussion</h3><div>Extracranial internal carotid artery pseudoaneurysm should be detected and treated early in cases of rapid progression or when complications are present. Surgical excision of the pseudoaneurysm combined with revascularisation provides a definitive solution to the lesion and represents a relatively safe approach.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"66 ","pages":"Pages 22-25"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148500797","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":"Intravascular Papillary Endothelial Hyperplasia of the Upper Limb Mimicking a Vascular Neoplasm: Case Report and Literature Review","authors":"María Gutiérrez Fernández de Velasco,&nbsp;Geraldinne Raiveliz Ruiz Quintero,&nbsp;Xabier Cabezuelo Adame,&nbsp;Melina Vega de Ceniga","doi":"10.1016/j.ejvsvf.2026.07.003","DOIUrl":"10.1016/j.ejvsvf.2026.07.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Intravascular papillary endothelial hyperplasia (IPEH), also known as Masson’s tumour, is a rare benign vascular lesion caused by reactive endothelial proliferation within vascular spaces. Despite its benign nature, IPEH may clinically and radiologically mimic malignant vascular tumours, particularly when arising in the upper extremity, posing a diagnostic challenge.</div></div><div><h3>Report</h3><div>A 38 year old woman presented with a slowly enlarging subcutaneous nodule in the left antecubital fossa, with no history of trauma. Ultrasonography revealed a well defined solid mass with heterogeneous echotexture and suspected vascular communication. Magnetic resonance angiography demonstrated a solid lesion in continuity with the ulnar artery, with segmental arterial interruption and distal reconstitution, raising concern for a vascular neoplasm. An <em>en bloc</em> surgical resection was performed, including ligation of the involved ulnar vessels, without compromising distal perfusion. Histopathological examination showed papillary endothelial proliferation confined within a venous type vessel, without cytological atypia or necrosis, confirming primary IPEH.</div></div><div><h3>Discussion</h3><div>To contextualise this case, a review of the literature was conducted, identifying 103 reported cases of IPEH involving the upper extremities. Lesions most frequently affected the fingers, followed by the forearm and elbow, with a slight female predominance and a mean age in the fourth decade of life. Primary (type I) IPEH accounted for nearly all cases. Complete surgical excision was associated with excellent outcomes and low recurrence rates. Awareness of IPEH is important, and it should be included in the differential diagnosis of vascular tumours to avoid unnecessarily aggressive oncological resections, although complete surgical excision remains the standard initial management.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"66 ","pages":"Pages 77-88"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148853981","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}