EJVES Vascular Forum最新文献

{"title":"Undifferentiated Intimal Sarcoma of the Visceral Aorta With Recurrent Renovisceral Ischaemia Misdiagnosed as Takayasu's Arteritis","authors":"Martin Wenkel ,&nbsp;Kirsten de Groot ,&nbsp;Marius Fried ,&nbsp;Achim Neufang","doi":"10.1016/j.ejvsvf.2025.01.002","DOIUrl":"10.1016/j.ejvsvf.2025.01.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Malignant tumours of the aorta are a rare disease and often misdiagnosed as they masquerade as wall adjacent thrombus or inflammatory disease. Due to the often delayed diagnosis and the rapidly progressing illness, the outcome is very poor.</div></div><div><h3>Report</h3><div>A 50 year old female patient who had received coeliac and mesenteric artery stenting followed by an aortomesenteric bypass after stent occlusion two years earlier was treated. After an episode of hypertensive crisis caused by high grade stenosis of the renal arteries and review of previous tissue biopsies the diagnosis of Takayasu's arteritis was established, but the results were inconclusive. When presenting with a penetrating aneurysm of the renovisceral aorta, a complete reconstruction was performed of the renovisceral aorta due to impending rupture. Pre-operative imaging incidentally showed a sarcoma of the femur which was interpreted as an unrelated entity at the time. Finally, two years after the onset of the first symptoms, the diagnosis of an undifferentiated intimal sarcoma was established after extensive histological workup. However, the patient's condition deteriorated too quickly for her to recover as she had already developed multiple distant metastases and she died within three months of surgery.</div></div><div><h3>Discussion</h3><div>Due to its extreme rarity, this disease is not widely recognised, even among specialists. Accordingly, the patient was initially misdiagnosed and a malignant process was not considered. An accurate diagnosis at the time of the first open surgery might have presented the opportunity for radical resection of the affected aorta. Unfortunately, there are no non-invasive tools available to diagnose intimal sarcoma and, given the rapid progression of the disease, the prognosis remains poor, with a survival of only a few months.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"63 ","pages":"Pages 21-24"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143402567","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":"Feasibility of Portable Laser Doppler Flowmeter for Foot Blood Flow Assessment in Patients With Chronic Limb Threatening Ischaemia","authors":"Masahiro Tezuka,&nbsp;Shotaro Hirota,&nbsp;Masashi Kawamura,&nbsp;Taisuke Konishi,&nbsp;Ikuko Shibasaki,&nbsp;Hirotsugu Fukuda","doi":"10.1016/j.ejvsvf.2025.09.003","DOIUrl":"10.1016/j.ejvsvf.2025.09.003","url":null,"abstract":"<div><h3>Objective</h3><div>The portable, non-invasive laser Doppler flowmeter (LDF) provides a practical alternative, enabling bedside blood flow assessment for chronic limb threatening ischaemia (CLTI). The present study aimed to evaluate whether LDF could identify CLTI and to assess the utility of LDF in determining the efficacy of revascularisation.</div></div><div><h3>Methods</h3><div>The study enrolled 50 patients with non–lower extremity arterial disease (LEAD) and 24 patients with CLTI (25 limbs) from March 2021 to December 2024; blood flow in the dorsal and plantar areas was measured using a portable LDF (Pocket LDF, JMS Co., Ltd., Tokyo, Japan). Blood flow and skin perfusion pressure (SPP) were compared before and after surgical bypass, and correlations between LDF and SPP were also determined for 17 limbs with CLTI.</div></div><div><h3>Results</h3><div>The mean dorsal plantar blood flow was 12.0 ± 9.3 and 13.3 ± 6.6 mL/min for the non-LEAD and CLTI groups, respectively (<em>p</em> = .48), however, the mean plantar blood flow was statistically significant lower in the CLTI group (26.1 ± 11.7 mL/min) than in the non-LEAD group (52.2 ± 18.6 mL/min, <em>p</em> &lt; .001). In the 17 limbs with CLTI that underwent surgical bypass, the mean blood flow in the dorsal area was 13.7 ± 5.5 and 15.7 ± 6.2 mL/min before and after surgery, respectively (<em>p</em> = .30). However, the post-operative mean plantar blood flow improved statistically significant (45.4 ± 18.6 mL/min) from its pre-operative status (25.0 ± 11.8 mL/min, <em>p</em> &lt; .001). The mean SPP changes before and after surgical bypass were 27.3 ± 14.7 and 52.7 ± 18.3 mmHg, respectively (<em>p</em> &lt; .001), in the dorsal area, showing improvement in correlation with the LDF measurements (<em>p</em> = .023).</div></div><div><h3>Conclusion</h3><div>The portable LDF measurement in the plantar area may help in identifying CLTI and evaluating the effectiveness of revascularisation.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 166-173"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332422","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":"Developing a Scanning Electron Microscopy Approach to Evaluate Paclitaxel Deposition From Drug Coated Balloons in a Human Cadaveric Peripheral Artery Disease Model","authors":"Judit Csore ,&nbsp;Alexander B. Crichton ,&nbsp;Jianhua Gu ,&nbsp;Bright Benfor ,&nbsp;Stuart Corr ,&nbsp;Kelvin Boateng ,&nbsp;Trisha L. Roy","doi":"10.1016/j.ejvsvf.2025.06.004","DOIUrl":"10.1016/j.ejvsvf.2025.06.004","url":null,"abstract":"<div><h3>Objective</h3><div>Drug coated balloons (DCBs) are used to treat peripheral artery disease (PAD) but concerns about their efficacy and safety persist. Current evaluation methods, relying on benchtop studies and animal models, do not replicate the complexity of human PAD lesions. This study aimed to develop a novel methodology to assess paclitaxel delivery from DCBs to human peripheral arteries with complex plaque morphologies using scanning electron microscopy (SEM) with the purpose of examining how plaque morphology and vessel preparation affect drug transfer in human cadaveric legs.</div></div><div><h3>Methods</h3><div>An amputated leg model from patients with PAD and standardised vessel preparation, imaging, and quantification methods was used. Arteries were treated with plain balloon angioplasty, cutting balloon angioplasty, or no preparation before DCB treatment. Vessels were imaged with high vacuum SEM, and drug coverage was quantified with ImageJ. Lesions were classified as nodular or smooth based on magnetic resonance imaging. Drug distribution was analysed at 300×300 μm field of view (FOV), categorised as minimal, moderate, good, or excellent.</div></div><div><h3>Results</h3><div>SEM was effective at imaging paclitaxel crystals transferred to the vessel wall. Plaque morphology affected the amount of drug transferred with smooth plaques exhibiting greater drug coverage than nodular plaques. In nodular plaques, drug was concentrated on the protruding portions of the plaque and not in the recesses, while smooth plaques showed more uniform distribution. Excellent coverage was seen in 38.31% of FOVs of smooth plaques <em>vs.</em> 10.58% of nodular plaques. Drug transfer was more consistent in smooth vessels, regardless of vessel preparation method. Cutting balloons enhanced drug delivery when grooves were formed.</div></div><div><h3>Conclusion</h3><div>This SEM based method effectively evaluated drug transfer in human PAD lesions, revealing greater drug delivery in smooth lesions and the impact of vessel preparation. This novel analytic model offers a platform for optimising DCB strategies to improve PAD patient outcomes.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 105-112"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145219173","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":"Re-Thinking Antithrombotic Strategies in Non-Cardiac Arterial Procedures: Time for Standardisation?","authors":"Maria Katsarou ,&nbsp;Giuseppe Baldino","doi":"10.1016/j.ejvsvf.2025.03.003","DOIUrl":"10.1016/j.ejvsvf.2025.03.003","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 1-2"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490986","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":"Ultrasound Guided Needle Penetration Technique for Recanalisation of Short Segment Chronic Femoral Vein Occlusion","authors":"Tamás Büki,&nbsp;Vasileios Leivaditis,&nbsp;Manfred Dahm","doi":"10.1016/j.ejvsvf.2025.02.004","DOIUrl":"10.1016/j.ejvsvf.2025.02.004","url":null,"abstract":"<div><h3>Introduction</h3><div>This case report presents an ultrasound guided needle penetration technique as a novel method for the recanalisation of short segment chronic femoral vein occlusion in a patient with a history of intravenous drug use.</div></div><div><h3>Case report</h3><div>A 41 year old male presented with a painful calf ulcer. Initial ultrasound imaging identified a chronic short segment occlusion in the proximal femoral vein, with extensive scarring from repeated intravenous drug injections. Traditional endovascular approaches were unsuccessful due to dense tissue scarring. The ultrasound guided needle penetration technique was employed to perforate the occlusion, achieving successful wire passage and subsequent stent placement. The patient experienced significant symptomatic relief after the procedure.</div></div><div><h3>Conclusion</h3><div>This case highlights the feasibility and benefits of ultrasound guided needle penetration as an alternative recanalisation approach in severe scarring peripheral chronic venous occlusion.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"63 ","pages":"Pages 61-64"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768139","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":"Strategies for Antithrombotic Management During Non-cardiac Arterial Procedures: Results of the International ACTION Survey","authors":"Max Hoebink ,&nbsp;Vincent Jongkind","doi":"10.1016/j.ejvsvf.2025.01.005","DOIUrl":"10.1016/j.ejvsvf.2025.01.005","url":null,"abstract":"<div><h3>Objective</h3><div>Peri-procedural antithrombotics are used extensively to prevent thromboembolic complications during non-cardiac arterial procedures (NCAP) worldwide. However, there is a lack of evidence to support recommendations on antithrombotic strategies, possibly leading to substantial variation in local practices. A comprehensive overview of antithrombotic strategies is needed to identify the most widely accepted protocols employed during NCAP, highlight variations in local practices, and identify new research targets to establish evidence based peri-procedural anticoagulation management.</div></div><div><h3>Methods</h3><div>An international, web based survey study was conducted from March to October 2023, targeting vascular clinical specialists who applied antithrombotic strategies during NCAP in daily practice.</div></div><div><h3>Results</h3><div>The survey was completed by 436 vascular clinical specialists from 45 countries (Europeans: 93%, vascular surgeons or vascular surgery residents: 98%). Systemic unfractionated heparin was used by nearly all vascular specialists during all procedures (varying between 98–99%, depending on the procedure type), but could vary depending on specific NCAP. A fixed starting dose (39–52%, most often 5 000 IU [80–89%]) or an actual bodyweight dependent dose (42–52%, most commonly 100 IU/kg [40–67%] or 50 IU/kg [17–40%]) was mainly used. Except during fenestrated or branched endovascular aneurysm repair procedures (51%), activated clotting time (ACT) was employed by a minority (26–31%). A large variety in measurement protocols was observed, yet a target ACT of 200 seconds was most often used for all NCAP types (44–54%). Most vascular specialists considered a heparin follow up dose (61–81%) and heparin reversal using protamine (54–63%), both for a variety of indications. Of the participants, 68% expressed discontent with their current antithrombotic protocol(s).</div></div><div><h3>Conclusion</h3><div>This comprehensive, international survey study revealed large variation among vascular clinical specialists’ heparinisation strategies during NCAP. Together with the considerable discontent expressed regarding protocols, this emphasises the urgent need for comparative, randomised studies on antithrombotic management during NCAP.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 8-15"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501354","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":"Overexpression of αVβ3 Integrin in an Aortic Aneurysm Murine Model: Confirmation in Ex Vivo Human Abdominal Aortic Aneurysm Tissue and Its Potential Application for Molecular Imaging Characterisation","authors":"Javier E. Anaya-Ayala ,&nbsp;Brenda J. Galicia-Vega ,&nbsp;Jacqueline Mejía-Cervantes ,&nbsp;Ezequiel Solano-Mendivil ,&nbsp;Ingrid A. Landero-Aguilar ,&nbsp;Brenda Marquina-Castillo ,&nbsp;Carlos Bravo-Reyna ,&nbsp;Carlos Serrano-Gavuzzo ,&nbsp;Luis A. Medina-Velázquez ,&nbsp;Carlos A. Hinojosa","doi":"10.1016/j.ejvsvf.2025.08.003","DOIUrl":"10.1016/j.ejvsvf.2025.08.003","url":null,"abstract":"<div><h3>Background</h3><div>The pathophysiological mechanisms that occur in the wall of aortic aneurysms are not fully understood. Angiogenesis is a characteristic change in aneurysmal disease; αVβ3 integrin is a glycoprotein overexpressed in this biological process. This study aimed to evaluate angiogenic activity in a murine model of thoracic aortic aneurysm (TAA) using molecular imaging and immunofluorescence, and to assess differences in αVβ3 integrin expression in <em>ex vivo</em> human aneurysmal and non-diseased aortic tissues.</div></div><div><h3>Methods</h3><div>Eight Wistar rats underwent experimental induction of TAA with peri-adventitial calcium chloride (CaCl2) and were evaluated with micropositron emission tomography (MicroPET) using arginine-glycine-aspartate with gallium 68 (⁶⁸Ga-RGD) as a radiotracer. The Wilcoxon test was used to compare the chemically induced site (aneurysm) and intact aortic tissue (control). Six months later, the specimens were euthanised and tissues were evaluated with immunofluorescence. For human aorta analysis, diseased and non-diseased arterial portions were obtained from 13 patients (mean age 67 years, 85% males) who underwent open abdominal aortic aneurysm repair and were evaluated with the same protocol as the experimental specimens.</div></div><div><h3>Results</h3><div>An overall MicroPET uptake was obtained in the murine models; the median standard uptake value of ⁶⁸Ga-RGD in the aneurysm was 0.0125, while the uptake in controls was 0.0003 (<em>p</em> = 0.011). Immunofluorescence confirmed overexpression of integrin αVβ3 in the aneurysm wall in comparison with the control tissue (<em>p</em> &lt; 001). Human aneurysmal samples also had a statistically significant overexpression of αVβ3 (<em>p</em> = 0.031).</div></div><div><h3>Conclusions</h3><div>Significant differences in the angiogenic process were demonstrated with molecular imaging and immunofluorescence in the murine TAA model. Differences in αVβ3 integrin expression were confirmed when comparing diseased and non-diseased aortas in humans.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 117-123"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265193","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 Repair of a Subclavian Artery Aneurysm With Re-purposed Aorto-Iliac Stent Graft Components","authors":"Tomohiro Nakajima,&nbsp;Tsuyoshi Shibata,&nbsp;Yutaka Iba,&nbsp;Nobuyoshi Kawaharada","doi":"10.1016/j.ejvsvf.2025.05.001","DOIUrl":"10.1016/j.ejvsvf.2025.05.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Subclavian artery aneurysms (SAAs) are rare, and reports on their treatment remain limited.</div></div><div><h3>Report</h3><div>An 83 year old male patient who had undergone endovascular aortic repair (EVAR) for an abdominal aortic aneurysm two years previously was referred to the institution for endovascular treatment of a SAA which he preferred over open surgery. Endovascular repair was undertaken under general anaesthesia and open, access of the right axillary artery with introduction of a 14 F guide sheath; subsequently a 23 × 16 × 100 mm limb graft (Gore Excluder, WL Gore and Associates, Flagstaff, USA) was deployed distally with an additional 23 × 23 × 33 mm proximal cuff (Excluder) with successful SAA exclusion.</div></div><div><h3>Discussion</h3><div>A case of endovascular treatment for a right subclavian artery aneurysm is reported. A successful stent graft from the abdominal EVAR device portfolio was successfully employed.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 62-65"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604351","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":"Aortic Intimal Invagination and Septectomy Following Electrosurgical Septotomy in a Patient With a Type B Dissection","authors":"Cecilie Markvard Møller,&nbsp;Steen Fjord Pedersen,&nbsp;Jacob Budtz-Lilly","doi":"10.1016/j.ejvsvf.2025.02.003","DOIUrl":"10.1016/j.ejvsvf.2025.02.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Thoracic endovascular aortic repair (T-EVAR) is the standard treatment in patients with a type B aortic dissection and appropriate indications for repair. The procedure requires anatomical, clinical, and technical scrutiny, as well as consideration for potential further repair. Supplementary procedures are not uncommon. Septotomy has received renewed interest as an adjunctive procedure, in the form of electrosurgical techniques, with the objective of improving true lumen landing zones and better access to important target branch vessels. Emerging reports suggest favourable clinical outcomes, although there are associated thromboembolic risks that clinicians should recognise.</div></div><div><h3>Case report</h3><div>This case report describes an important complication of electrosurgical septotomy causing aortic intimal invagination in a patient with a type B aortic dissection.</div></div><div><h3>Conclusion</h3><div>Electrosurgical septotomy is an effective method to gain improved landing zones for TEVAR endograft placement, but caution is warranted in the timing of this procedure.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"63 ","pages":"Pages 57-60"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686695","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":"Defying the Clock: Restoring Renal Function After 72 Hours of Subacute Renal Thrombosis","authors":"Roberto Cunha ,&nbsp;Nuno Coelho ,&nbsp;Alexandra Canedo","doi":"10.1016/j.ejvsvf.2025.09.004","DOIUrl":"10.1016/j.ejvsvf.2025.09.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute renal artery occlusion, especially of thrombotic origin, is rare and often challenging to diagnose. Although early revascularisation is generally recommended, the optimal timing of intervention, especially beyond six hours, remains uncertain.</div></div><div><h3>Report</h3><div>A 51 year old man, an active smoker, with a history of ST elevation myocardial infarction and previous triple coronary artery bypass grafting, hypertension, and dyslipidaemia, developed subacute renal artery thrombosis. He presented to the emergency department, with non-specific symptoms, &gt;72 hours after symptom onset. Computed tomography angiography confirmed right renal artery occlusion with preserved distal arterial patency and contrast enhancement of the renal parenchyma, except in the lower third of the kidney. Endovascular revascularisation was performed with primary placement of a covered stent (Advanta 5×22 mm), resulting in improved estimated glomerular filtration rate (eGFR) from 30 to 77 mL/min/1.73 m². At the six month follow up, there were no recurrent symptoms, and laboratory results showed eGFR &gt;90 mL/min/1.73 m².</div></div><div><h3>Discussion</h3><div>A thrombotic aetiology was presumed, based on the patient's cardiovascular history, smoking status, atherosclerotic changes in the renal arteries, and absence of dysrhythmias. While standard practice favours revascularisation within six hours, this case supports that delayed intervention may still be effective in thrombotic occlusions. This aligns with emerging evidence from fenestrated endovascular aortic repair related renal artery thrombosis, which shows favourable outcomes despite delayed treatment. Clinical decisions should therefore consider factors such as preserved renal parenchyma perfusion and distal arterial patency. Timing of revascularisation should be individualised, rather than strictly time dependent.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 174-177"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332436","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}