Journal of Vascular Surgery Cases Innovations and Techniques最新文献

{"title":"Abdominal aortic aneurysm classification based on dynamic intraluminal thrombus analysis during cardiac cycle","authors":"Alice Guest PhD ,&nbsp;Arianna Forneris PhD ,&nbsp;Alessandro Satriano PhD ,&nbsp;Randy D. Moore MD ,&nbsp;Elena S. Di Martino PhD","doi":"10.1016/j.jvscit.2025.101736","DOIUrl":"10.1016/j.jvscit.2025.101736","url":null,"abstract":"<div><div>The major complication of abdominal aortic aneurysm (AAA) is sudden rupture with an associated high mortality rate. The only clinical classifier for the risk of AAA rupture is the size of the aneurysm or its maximum diameter. We reviewed the role of intraluminal thrombus (ILT) by investigating the motion of both the lumen and wall surfaces of ILT throughout the cardiac cycle. We hypothesize that the response of the thrombus to the cyclic blood pressure provides insight into the state of the thrombus and its propensity to rupture, akin to what could be obtained from a mechanical compression test. Patients were selected from two studies: patients who underwent surgical intervention and patients from a retrospective study of AAA growth. Patients were selected to provide a wide range of AAA behaviors leading to a disease progression. Multiphase computed tomographic images of 14 patients were obtained from Peter Lougheed Hospital in Calgary, Canada. The geometries of the aortic wall and lumen were segmented from the images, and thrombus volume was determined at ten evenly spaced phases of the cardiac cycle. Where possible, the results were matched to known ex vivo mechanical properties, growth, and clinical outcomes for each AAA. The relative changes of wall, lumen, and thrombus volumes throughout the cardiac cycle classified AAAs into four types: (1) type I, aneurysms with a minimal wall movement, negative lumen expansion, and positive ILT expansion, (2) type II, aneurysms whose lumen undergoes small expansion, while the expansion is accommodated by the ILT and wall, (3) type III, a transition type characterized by lumen, wall, and thrombus expansions, and (4) type IV, characterized by lumen expansion matching or exceeding wall expansion, while the thrombus exhibits very small or negative deformation. This last behavior leads to an over-pressurized thrombus, which could enable the formation of permeable channels, often observable in medical images obtained in patients experiencing aneurysm rupture. By providing insight into thrombus behavior and the likelihood of channel development in the thrombus, AAA classification can improve the assessment of clinical risk for aneurysms: type I is associated with a stiff aneurysm wall that resists thrombus deformation and may be related to the risk of dissection, type II and type III are transition types, and type IV is associated with the formation of permeable channels and thrombus cracks which may indicate possible risk of rupture.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 3","pages":"Article 101736"},"PeriodicalIF":0.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143427646","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":"Hybrid approach for recurrence nutcracker syndrome involving left renal vein stenting with laparoscopic stent external fixation","authors":"Mattia Mirandola MD ,&nbsp;Bruno Migliara MD ,&nbsp;Gaetano Grosso MD ,&nbsp;Rossella Bertoloni MD ,&nbsp;Andrea Griso MD ,&nbsp;Daniele Bissacco MD","doi":"10.1016/j.jvscit.2025.101739","DOIUrl":"10.1016/j.jvscit.2025.101739","url":null,"abstract":"","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 2","pages":"Article 101739"},"PeriodicalIF":0.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349246","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":"A novel hybrid approach to treatment of multiple mesenteric aneurysms in a patient with celiac artery occlusion from Suspected chronic median arcuate ligament syndrome","authors":"Prashanth S. Iyer MD ,&nbsp;Vamsi K. Potluri MD ,&nbsp;Jennifer L. Worsham MD ,&nbsp;Christine L. Shokrzadeh MD ,&nbsp;Zulfiqar Cheema MD ,&nbsp;Charlie Cheng MD ,&nbsp;Michael B. Silva Jr. MD","doi":"10.1016/j.jvscit.2025.101730","DOIUrl":"10.1016/j.jvscit.2025.101730","url":null,"abstract":"<div><div>The management of visceral artery aneurysms is evolving with endovascular coiling and covered stent placement used as alternatives to open repair. Celiac artery occlusion or compression complicates ablative endovascular management. The purpose of this report was to discuss the etiology of this uncommon phenomenon and describe a novel hybrid approach to treatment.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 3","pages":"Article 101730"},"PeriodicalIF":0.7,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464821","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":"Parallel endograft repair of an aortic anastomotic pseudoaneurysm in a patient with middle aortic syndrome","authors":"Arash Fereydooni MD, MS, MHS,&nbsp;Marcos T. Kuroki MD, PhD,&nbsp;Jason T. Lee MD","doi":"10.1016/j.jvscit.2024.101718","DOIUrl":"10.1016/j.jvscit.2024.101718","url":null,"abstract":"<div><div>A 66-year-old female, with a history of middle aortic syndrome, who had been treated with aorto-iliac bypass, presented 47 years later with a pseudoaneurysm at the distal anastomosis. She was treated with parallel grafting and preservation of a large lumbar artery via periscope approach. This case highlights the challenges and considerations in managing aortic anastomotic pseudoaneurysms, particularly in patients with complex surgical histories with extra-anatomic debranching bypasses.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 2","pages":"Article 101718"},"PeriodicalIF":0.7,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081586","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":"Total transfemoral approach for Gore Excluder thoracoabdominal branch endoprosthesis (TAMBE), external tour de graft technique","authors":"Saurabh Gupta MD ,&nbsp;Joshua Plant MD ,&nbsp;Javaneh Jabbari MD ,&nbsp;Arian Savadkohi ,&nbsp;Shahab Toursavadkohi MD","doi":"10.1016/j.jvscit.2024.101717","DOIUrl":"10.1016/j.jvscit.2024.101717","url":null,"abstract":"<div><div>Total transfemoral endovascular repair of thoracoabdominal aneurysms is feasible with physician-modified endografts. We present our technique for exclusively delivering the Gore Excluder thoracoabdominal branch endoprosthesis (W. L. Gore &amp; Associates) via transfemoral access. A 16 Fr steerable sheath is positioned outside the partially deployed thoracoabdominal branch endoprosthesis device, and the preloaded wires are individually snared, allowing for a stable 8 Fr coaxial system to cannulate and deliver stents to target vessels. This technique avoids upper extremity access and maintains all wires within the descending thoracic aorta, allowing implantation in patients with challenging aortic arch configurations and potentially mitigating stroke risk.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 2","pages":"Article 101717"},"PeriodicalIF":0.7,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143161760","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":"Tactful with Stat Tacks – inferior epigastric artery pseudoaneurysm post-hernia repair","authors":"Alexandra Sim MD ,&nbsp;David Evans BSc, MBBS, FRACS ,&nbsp;Thomas M. Warburton BMed, MTrauma ,&nbsp;Wingtung M. Ma BMed","doi":"10.1016/j.jvscit.2024.101716","DOIUrl":"10.1016/j.jvscit.2024.101716","url":null,"abstract":"<div><div>Pseudoaneurysm is a rarely reported but recognized complication of abdominal surgery. We present the workup and endovascular intervention of an inferior epigastric artery (IEA) pseudoaneurysm that developed 5 years after a laparoscopic hernia repair using a Stat Tacks (Medtronic) mesh fixation device.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 2","pages":"Article 101716"},"PeriodicalIF":0.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081590","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":"Successful management of mycotic visceral aneurysms in a LVAD patient and navigating LVAD postoperative challenges","authors":"Kendall Wermine MD ,&nbsp;Salman Gohar MD ,&nbsp;Rusty Milhoan MD ,&nbsp;Bryan Youree MD ,&nbsp;Vivek Ramarathnam MD ,&nbsp;Mohammad Alqaim MD","doi":"10.1016/j.jvscit.2024.101715","DOIUrl":"10.1016/j.jvscit.2024.101715","url":null,"abstract":"<div><div>This report presents a unique case of concurrent mycotic aneurysms in a 64-year-old male left ventricular assist device (LVAD) recipient. Initially admitted with odontogenic maxillary fungal sinusitis and fungemia, he later presented to our clinic with significant weight loss, fatigue, and LVAD complications. Imaging revealed a large complex mid-superior mesenteric artery aneurysm with multiple associated jejunal branches and a ruptured splenic aneurysm. Although these aneurysms were successfully managed, it is important to note the challenges in postoperative care, including anticoagulation-related complications such as post-splenectomy hematoma and intracranial bleeding. This case highlights the delicate balance between therapeutic interventions and managing LVAD-related complexities.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 2","pages":"Article 101715"},"PeriodicalIF":0.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081588","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":"Aberrant right renal perfusion from right internal mammary artery","authors":"Avkash J. Patel MD ,&nbsp;Woosup Michael Park MD ,&nbsp;Jirat Chenbhanich MD ,&nbsp;Heather L. Gornik MD ,&nbsp;Jae S. Cho MD","doi":"10.1016/j.jvscit.2024.101713","DOIUrl":"10.1016/j.jvscit.2024.101713","url":null,"abstract":"<div><div>Renal artery (RA) anomaly is common and may have significant clinical implications. We present a case of a 29-year-old man in whom the upper two-thirds of the right kidney were supplied by the right internal mammary artery and collateral network. Additionally, the superior left RA had proximal stenosis with a distal aneurysm. Renin sampling confirmed renovascular hypertension. He successfully underwent aorta-to-superior right RA bypass and primary repair of superior left RA aneurysm. This case adds to existing knowledge of RA anomalies, and underscores the importance of comprehensive evaluations for alternate renal blood supply for effective surgical management of renovascular hypertension.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 2","pages":"Article 101713"},"PeriodicalIF":0.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068580","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":"Novel approach to treating calcified infrarenal aortic stenosis using intravascular lithotripsy without stenting","authors":"Sara Allievi MD,&nbsp;Igor Raunig MD,&nbsp;Sebastiano Tasselli MD,&nbsp;Stefano Bonvini MD, PhD","doi":"10.1016/j.jvscit.2024.101709","DOIUrl":"10.1016/j.jvscit.2024.101709","url":null,"abstract":"<div><div>This case report presents the use of intravascular lithotripsy (IVL) in a 68-year-old woman with disabling bilateral claudication owing to a heavily calcified subocclusive stenosis of the infrarenal aorta. The patient had a history of tobacco use, dyslipidemia, and chronic obstructive pulmonary disease, with absent femoral pulses and severe arterial calcification. A 12-mm Shockwave L6 lithotripsy catheter was employed to treat the aortic lesion, resulting in a significant decrease in the aortic pressure gradient without the need for stenting. The patient experienced complete symptom resolution postoperatively, and at 1 month, follow-up imaging confirmed vessel patency with no sign of restenosis. IVL, used here as a standalone treatment, demonstrated effectiveness in modifying calcified plaques and restoring vessel compliance, offering a less complex and potentially more cost-effective alternative to stent grafting in calcified aortic lesions. This case highlights the potential of IVL as a safe and effective treatment option in select patients with calcified infrarenal aortic stenosis.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 2","pages":"Article 101709"},"PeriodicalIF":0.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048205","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":"Hybrid repair of aortic aneurysm in a patient with a congenital pelvic kidney","authors":"Halli Krzyzaniak MD, BSc ,&nbsp;Naomi Wedel MD, BSc ,&nbsp;Ali Fatehi Hassanabad MD, PhD ,&nbsp;Richard Cormack MD, FRCPC ,&nbsp;Kenton Rommens MD, FRCSC","doi":"10.1016/j.jvscit.2024.101708","DOIUrl":"10.1016/j.jvscit.2024.101708","url":null,"abstract":"<div><div>We describe a patient with an asymptomatic infrarenal abdominal aortic aneurysm. Treatment decisions were complicated by the presence of a left congenital pelvic kidney supplied by two renal arteries originating from the proximal common iliac arteries bilaterally and respiratory status that was prohibitive to open repair. A hybrid surgical repair was performed with a bifurcated aortic endograft and parallel grafting to revascularize the pelvic renal arteries. This procedure was combined with a right common iliac endovascular occlusion and femoral-femoral bypass. This case adds to the limited reports of endovascular management of patients with concomitant aneurysmal disease and ectopic kidneys.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 2","pages":"Article 101708"},"PeriodicalIF":0.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068583","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}