Journal of Vascular Surgery Cases Innovations and Techniques最新文献

{"title":"Preliminary study on the use of contrast ultrasound in the preoperative workup of patient-candidates for carotid endarterectomy","authors":"Marco Campolmi MD,&nbsp;Sara Speziali MD,&nbsp;Elena Giacomelli MD, PhD,&nbsp;Lapo Dolfi MD,&nbsp;Walter Dorigo MD,&nbsp;Raffaele Pulli MD","doi":"10.1016/j.jvscit.2025.101815","DOIUrl":"10.1016/j.jvscit.2025.101815","url":null,"abstract":"<div><div>This study aimed to prospectively assess the use of the ultrasound signal amplifier in preoperative color Doppler ultrasound (DUS) evaluation of carotid plaques in asymptomatic patients eligible for surgical correction. Between November 2022 and May 2023, 21 patients with asymptomatic carotid stenosis were enrolled. Each patient underwent DUS, contrast-enhanced ultrasound (CEUS), and computed tomography angiography (CTA) during the preoperative workup. Data on demographics, clinical characteristics, risk factors, comorbidities, and therapy were collected. The degree of stenosis was analyzed using North American Symptomatic Carotid Endarterectomy Trial criteria, comparing DUS, CEUS, and CTA with statistical tests. Hemodynamic parameters (peak systolic velocity, end-diastolic velocity, internal carotid artery/common carotid artery ratio) and plaque morphology (juxtaluminal black areas, discrete white areas, and intraplaque neovascularization) were assessed. CEUS examination demonstrated a significantly higher stenosis degree (72%) compared with DUS (68%; <em>P</em> &lt; .001) and differed from CTA (80%; <em>P</em> = .004). Hemodynamic parameters were also higher with CEUS (peak systolic velocity, 321 cm/sec vs 249 cm/sec; end-diastolic velocity, 92 cm/sec vs 88 cm/sec; internal carotid artery/common carotid artery ratio, 4.4 vs 3.8; all <em>P</em> &lt; .001). CEUS examination identified irregular plaque margins more frequently (15 cases vs 8 cases), larger juxtaluminal black areas (17 cases vs 7 cases, mean diameter 3.3 mm vs 2.7 mm), and discrete white areas (6 vs 0). Neovascularization was observed in 10 plaques via CEUS examination. These findings suggest that CEUS examination is a safe, cost-effective, and efficient noninvasive tool for preoperative carotid plaque assessment, offering higher resolution and more detailed plaque characterization compared with DUS. Despite the limited sample size, CEUS examination provides valuable insights into plaque morphology and embolic risk profile. The CEUS examination needs to be validated with larger multicenter cohorts.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 4","pages":"Article 101815"},"PeriodicalIF":0.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090351","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":"Explant of an infected four-vessel fenestrated and bilateral iliac branch stent graft in a patient of Jehovah's Witness faith","authors":"Carlotta Bugna MD ,&nbsp;Lucas Ruiter Kanamori MD ,&nbsp;Priscila Suguita MD ,&nbsp;Ezra Koh MD ,&nbsp;Thanila A. Macedo MD ,&nbsp;Gustavo S. Oderich MD","doi":"10.1016/j.jvscit.2025.101816","DOIUrl":"10.1016/j.jvscit.2025.101816","url":null,"abstract":"<div><div>Infection of fenestrated-branched stent graft is an uncommon but potentially catastrophic complication. The technical challenge of total stent graft explant and reconstruction of the renal-mesenteric arteries is associated with high mortality and morbidity. Among patients of Jehovah Witness faith, refusal to accept blood transfusion adds to the risk given the invasiveness of these operations. We report a Jehovah's Witness faith patient with a recurrent infection of a four-vessel fenestrated and bilateral iliac branch stent graft treated in two stages by axillofemoral bypass, followed by extra-anatomical reconstruction of the mesenteric, renal, and left internal iliac arteries and total stent graft explant and aortic stump closure.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 4","pages":"Article 101816"},"PeriodicalIF":0.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090353","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":"Hybrid bypass exclusion of isolated common iliac artery mycotic aneurysm","authors":"Vanessa Irvine MBBS ,&nbsp;Kalpana Vijaykumar FRCS ,&nbsp;Edward Choke Tieng Chek PhD, FRCS ,&nbsp;Darius Aw Kang Lie FRCS","doi":"10.1016/j.jvscit.2025.101813","DOIUrl":"10.1016/j.jvscit.2025.101813","url":null,"abstract":"<div><div>The management of mycotic aneurysms traditionally involves open surgical resection, extensive debridement, and in-situ revascularization, which carry substantial perioperative morbidity and mortality. Endovascular aneurysm repair offers a less invasive alternative, but risks persistent infection owing to direct prosthetic implantation onto infected aortic segments. We present a novel hybrid approach for common iliac artery mycotic aneurysms that avoids direct endoprosthesis placement onto infected aortic tissue. Performed in two patients, it combines aortouni-iliac endovascular aneurysm repair, contralateral distal embolization, and a crossover femoral bypass. Surveillance confirmed successful aneurysm exclusion.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 4","pages":"Article 101813"},"PeriodicalIF":0.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154417","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":"The clinical course and multidisciplinary management of an in-hospital ruptured mycotic abdominal aortic aneurysm","authors":"Margarita Pipinos BS ,&nbsp;Kelly Cawcutt MD ,&nbsp;Alexandra Sorrick MD ,&nbsp;Jonathan Thompson MD","doi":"10.1016/j.jvscit.2025.101814","DOIUrl":"10.1016/j.jvscit.2025.101814","url":null,"abstract":"<div><div>Mycotic aneurysms are rare, accounting for 1% to 3% of all arterial aneurysms; nevertheless, they are associated with significant morbidity and mortality. We present the case of a 55-year-old man with severe abdominal pain, fevers, and night sweats. Rapid clinical deterioration, alongside blood cultures significant for methicillin-susceptible <em>Staphylococcus aureus</em> bacteremia led to imaging revealing a ruptured and infected abdominal aortic aneurysm, necessitating emergent endovascular repair and intravenous antibiotic therapy. This case report explores the diagnostic challenges of identifying mycotic aneurysms, underscores the importance of early multidisciplinary intervention, and emphasizes the necessity of long-term antimicrobial therapy to prevent graft reinfection.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 4","pages":"Article 101814"},"PeriodicalIF":0.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090352","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":"Beyond summarizing: A guide to literature review in vascular surgery","authors":"Tariq Alanezi MD ,&nbsp;Mohammed Al-Omran MD, MSc","doi":"10.1016/j.jvscit.2025.101811","DOIUrl":"10.1016/j.jvscit.2025.101811","url":null,"abstract":"","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 4","pages":"Article 101811"},"PeriodicalIF":0.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090268","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":"Large iliofemoral aneurysm harboring intramural fibrin-associated B-cell lymphoma","authors":"Christine L. Zickler MS ,&nbsp;Jeffrey T. Bunning MD ,&nbsp;Mikell Jarratt MD ,&nbsp;Amber Johnson CST ,&nbsp;Robert W. Zickler MD ,&nbsp;Paul V. Kochupura MD","doi":"10.1016/j.jvscit.2025.101810","DOIUrl":"10.1016/j.jvscit.2025.101810","url":null,"abstract":"<div><div>Fibrin-associated large B-cell lymphoma (FA-LBCL) is an extremely rare, non-mass forming lymphoproliferative disorder associated with Epstein-Barr virus (EBV). It is typically discovered incidentally on histologic examination of tissue removed for unrelated reasons. The following case report presents only the second reported case in the literature of FA-LBCL found proliferating within the mural thrombus of an aneurysm.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 4","pages":"Article 101810"},"PeriodicalIF":0.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106100","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":"Late aneurysm sac enlargement due to type II endoleak-like bleeding following open abdominal aortic aneurysm repair","authors":"Kotaro Mukasa MD,&nbsp;Yasunori Yakita MD, PhD,&nbsp;Musashi Tsuda MD,&nbsp;Shinichiro Abe MD, PhD,&nbsp;Soichi Asano MD, PhD","doi":"10.1016/j.jvscit.2025.101809","DOIUrl":"10.1016/j.jvscit.2025.101809","url":null,"abstract":"<div><div>Type II endoleak-like bleeding after open abdominal aortic aneurysm (AAA) repair is extremely rare. We report a case of aneurysm sac re-expansion in a 71-year-old man 13 years after open AAA repair. The wrapped aneurysm expanded from 55 mm to 70 mm, with a computed tomography scan showing contrast medium inflow from the aneurysm wall. Reoperation revealed diffuse bleeding without discrete branch vessel hemorrhage. This case demonstrates that type II endoleak-like bleeding can occur as a late complication after open AAA repair, even without bleeding from the branch vessels, highlighting the importance of long-term surveillance.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 4","pages":"Article 101809"},"PeriodicalIF":0.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922072","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":"Robotic-assisted thoracoscopic thoracic duct ligation with fluorescence imaging with indocyanine green for chylothorax after thoracoabdominal aneurysm repair","authors":"Annarita Santoro MD ,&nbsp;Diego Soto MD ,&nbsp;Stefano Viscardi MD ,&nbsp;Pierluigi Novellis MD ,&nbsp;Giulia Veronesi MD ,&nbsp;Germano Melissano MD","doi":"10.1016/j.jvscit.2025.101807","DOIUrl":"10.1016/j.jvscit.2025.101807","url":null,"abstract":"<div><div>Postoperative chylothorax (POC) is an uncommon complication after thoracoabdominal aortic aneurysm (TAAA) open surgical repair. We report the case of a 70-year-old woman previously treated with ascending aorta replacement who presented with a 60-mm extent II TAAA. TAAA open surgical repair was performed. A POC was diagnosed on postoperative day 5. After failed conservative therapy, on postoperative day 24 a robotic-assisted thoracic duct (TD) ligation using indocyanine green fluorescence achieved POC complete resolution, the patient tolerated a full diet and was discharged. At the 3-month clinical follow-up, the patient is well. Robotic-assisted thoracic duct ligation with indocyanine green provided effective minimally invasive treatment with good results.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 4","pages":"Article 101807"},"PeriodicalIF":0.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144116280","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":"A protocolized approach to chyle leaks to mitigate prosthetic graft infection","authors":"John Kucera MD ,&nbsp;Katie F. Lee MD ,&nbsp;Erin Koelling MD, FACS ,&nbsp;Jonathan Jay Sexton MD, FACS","doi":"10.1016/j.jvscit.2025.101808","DOIUrl":"10.1016/j.jvscit.2025.101808","url":null,"abstract":"<div><div>A 63-year-old man presented to the vascular surgery clinic with an enlarging left subclavian artery aneurysm owing to proximal compression by the anterior scalene muscle. He underwent open repair with a rifampin-soaked Dacron graft and developed a postoperative chyle leak. We describe our management and propose a protocolized deployment of surgical, dietary, pharmacological, and interventional techniques to resolve chyle leaks rapidly and prevent infections in the presence of a prosthetic vascular graft.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 4","pages":"Article 101808"},"PeriodicalIF":0.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936526","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":"Artificial intelligence-based machine learning protocols enable quicker assessment of aortic biomechanics: A case study","authors":"Pete H. Gueldner BS ,&nbsp;Katherine E. Kerr BSBME ,&nbsp;Nathan Liang MD ,&nbsp;Timothy K. Chung PhD ,&nbsp;Tiziano Tallarita MD ,&nbsp;Joe Wildenberg MD ,&nbsp;Jason Beckermann MD ,&nbsp;David A. Vorp PhD ,&nbsp;Indrani Sen MD","doi":"10.1016/j.jvscit.2025.101806","DOIUrl":"10.1016/j.jvscit.2025.101806","url":null,"abstract":"<div><div>Analyzing aortic biomechanical wall stresses for abdominal aortic aneurysms remains challenging. Clinical applications of biomechanical and morphological image-based analysis protocols have limited adoption owing to the time and expertise required. Our multidisciplinary and multi-institute team has demonstrated the feasibility of expediting advanced aortic image analysis on a single patient tracked longitudinally. We also demonstrate the utility of a previously trained artificial intelligence-based classifier that accurately predicts patient outcomes, a potential alternative to serial surveillance. This paper describes the overall workflow and processes performed in a 70-year-old man who was incidentally diagnosed to have a 5.4-cm juxtarenal aortic aneurysm in 2016 with successful fenestrated endovascular repair in 2023.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 4","pages":"Article 101806"},"PeriodicalIF":0.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936530","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}