Journal of Vascular Surgery Cases Innovations and Techniques最新文献

{"title":"Short-term analysis of botulinum toxin A for functional popliteal artery entrapment syndrome","authors":"Sari H. Goossens MD ,&nbsp;Jeroen J. van der Reijden MD ,&nbsp;Carroll M.E.S.N. Tseng MD ,&nbsp;Adwin R. Hoogeveen MD, PhD ,&nbsp;Roel Vaes MD, PhD ,&nbsp;Gert Jan de Borst MD, PhD ,&nbsp;Geert Willem Schurink MD, PhD ,&nbsp;Marc R.M. Scheltinga MD, PhD","doi":"10.1016/j.jvscit.2026.102139","DOIUrl":"10.1016/j.jvscit.2026.102139","url":null,"abstract":"<div><h3>Objective</h3><div>Functional popliteal artery entrapment syndrome (fPAES) is characterized by exertional leg pain caused by hypertrophic musculature in young adults. If history, examination and imaging suggest fPAES, treatment is surgical including removal of plantaris and part of medial gastrocnemius muscle. Intramuscular botulinum toxin type A (BTX) injections are a less invasive alternative, but the therapeutic evidence is low. The aim of this prospective study was to determine the short-term clinical effects of BTX.</div></div><div><h3>Methods</h3><div>In this prospective single-center cohort study, young patients with a history suggestive of fPAES (calf pain within 5-10 minutes after starting exercise, disappearance 5-10 minutes after exercise cessation) and suggestive imaging (occluding or stenotic popliteal artery on duplex ultrasound [DUS] examination and/or magnetic resonance imaging) received 100 IU BTX into the medial head of the gastrocnemius and plantar muscles using ultrasound guidance. The primary end point was patient-reported therapeutic effect 6 weeks after injection. Secondary end points were changes in treadmill testing and DUS 6 weeks after injection and number of patients free of symptoms or from surgery at 1 year of follow-up.</div></div><div><h3>Results</h3><div>Between December 2022 and November 2024, 32 patients (50% male; median age, 21 years) were studied. Injections were well-tolerated without side effects. At 6 weeks, lower leg pain during daily life was significantly attenuated, but was unchanged during exercise. Change in pain free walking distance during a treadmill test was not significant (before: median, 150 m; interquartile range, 78-258 m; after: median, 205 m; interquartile range, 120-299 m; <em>P</em> = .25). Popliteal artery DUS examination detected occlusion rates during provocation decreased from 31% to 3% (<em>P</em> = .004). Sixty percent reported fewer symptoms (40% some improvement, 20% much or fully recovered). One-half of the patients were satisfied.</div></div><div><h3>Conclusions</h3><div>Botulinum toxin A injections for fPAES are safe and patient friendly. Six weeks after injection, approximately one-half of the patients report fewer symptoms and are satisfied. Long-term follow-up is needed before widespread implementation can be recommended.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 2","pages":"Article 102139"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188721","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":"Intravascular ultrasound-mediated stent-assisted coil embolization and follow-up of a large renal artery aneurysm with ostial stenosis in a solitary kidney","authors":"Eunsaem Cho BS ,&nbsp;Mitchell Rits BS ,&nbsp;Pedro Furtado Neves MD ,&nbsp;Alexia Paganotti MD ,&nbsp;Emily A. Malgor MD ,&nbsp;Rafael D. Malgor MD, MBA","doi":"10.1016/j.jvscit.2026.102137","DOIUrl":"10.1016/j.jvscit.2026.102137","url":null,"abstract":"<div><h3>Objective</h3><div>To describe an intravascular ultrasound (IVUS)-guided, stent-assisted coil embolization for a large renal artery aneurysm with ostial stenosis in a solitary kidney, and report outcomes over 2.5 years.</div></div><div><h3>Methods</h3><div>A 46-year-old man with a prior left nephrectomy presented with resistant hypertension. Computed tomography angiography revealed a 3.8 × 3.9 cm saccular aneurysm of the right renal artery with ostial stenosis. Given the solitary kidney and poorly controlled hypertension, a branch-preserving endovascular approach was chosen. IVUS guided device selection and deployment.</div></div><div><h3>Results</h3><div>Through femoral artery access, an 8 × 60 mm stent was deployed across the aneurysm neck and the ostial lesion, followed by postdilation angioplasty. Nineteen detachable coils were deployed through the stent interstices, achieving sac occlusion while preserving branch perfusion. Completion imaging showed preserved renal flow and complete aneurysm exclusion. During 36-month follow-up with ultrasound examination and IVUS, the stented segment remained patent after angioplasty for restenosis at 6 months. Blood pressure improved with fewer medications, and renal function remained stable.</div></div><div><h3>Conclusions</h3><div>In patients with a solitary kidney and complex renal artery aneurysm, IVUS-guided stent-assisted coil embolization can achieve durable aneurysm exclusion while preserving renal function. Using an open-cell stent and IVUS guidance may optimize outcomes in challenging cases.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 2","pages":"Article 102137"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182757","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 surgical and endovascular management of severe gastrointestinal hemorrhage from mesenteric arteriovenous malformation","authors":"Tuong-Anh Mai-Phan MD, PhD ,&nbsp;Hien Minh Tran MD, MSc ,&nbsp;Ngoc Son Vu MD ,&nbsp;Duc Chi Tieu MD, PhD ,&nbsp;Khanh-Phat Thai MD ,&nbsp;Kim-Long Le MD, MSc","doi":"10.1016/j.jvscit.2025.102083","DOIUrl":"10.1016/j.jvscit.2025.102083","url":null,"abstract":"<div><div>Mesenteric arteriovenous malformation is a rare vascular anomaly that can worsen portal hypertension and cause life-threatening gastrointestinal bleeding. We report a 37-year-old man with chronic portal and mesenteric vein thrombosis who presented with recurrent hematochezia refractory to endoscopic and medical therapy. Imaging demonstrated diffuse mesenteric arteriovenous malformation with venous congestion. A staged hybrid strategy was performed: selective embolization reduced shunt flow, followed by bowel resection and creation of a mesocaval shunt. Histopathology confirmed extensive venous abnormalities. The patient recovered uneventfully, and no recurrent bleeding occurred during 9 months of follow-up.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 2","pages":"Article 102083"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145939651","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":"PRKG1 pathogenic variants cause thoracic aortic dissection with minimal aortic dilation: Insights from the UTHealth Houston multidisciplinary aortic and vascular disease conference","authors":"Ali Askari BSA ,&nbsp;Jennifer R. Landes MEd ,&nbsp;Alana Cecchi MS, CGC ,&nbsp;Cihan Duran MD ,&nbsp;Bihong Zhao MD, PhD ,&nbsp;Gustavo S. Oderich MD ,&nbsp;L. Maximilian Buja MD ,&nbsp;Dianna M. Milewicz MD, PhD ,&nbsp;Anthony L. Estrera MD ,&nbsp;Rana O. Afifi MD ,&nbsp;Siddharth K. Prakash MD, PhD","doi":"10.1016/j.jvscit.2025.102088","DOIUrl":"10.1016/j.jvscit.2025.102088","url":null,"abstract":"<div><div>A single, recurrent, gain-of-function pathogenic variant in <em>PRKG1</em> (p.Arg177Gln, also referred to as p.Arg192Gln) causes heritable thoracic aortic disease with a high lifetime risk for aortic dissections that frequently occur before there is enlargement of the proximal thoracic aorta. This report summarizes the clinical manifestations of the <em>PRKG1</em> pathogenic variant in two unrelated families, including early-onset type A dissection, chronic thoracoabdominal dissection with visceral complications, and elective aortic repair of the proximal aorta with minimal enlargement. In both families, multiple individuals experienced acute dissections at young ages that led to five fatalities. These cases illustrate the early onset of manifestations of <em>PRKG1</em>-related disease, which are primarily dissections, and underscore the essential role of aggressive gene-based management to prevent dissection in these cases.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 2","pages":"Article 102088"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940072","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 case of protein S-specific activity triggers detection with potential thrombosis development","authors":"Hideaki Yamada MD, PhD ,&nbsp;Mitsumasa Ohgi ,&nbsp;Naoki Tominaga MD ,&nbsp;Akira Tsujimoto MPharm ,&nbsp;Akiyoshi Fujishima ,&nbsp;Shinya Matsumoto PhD","doi":"10.1016/j.jvscit.2025.102105","DOIUrl":"10.1016/j.jvscit.2025.102105","url":null,"abstract":"<div><div>Protein S gene abnormalities are the most common congenital predisposition to thrombophilia in the Japanese population, but not in the Caucasian population. It is important to measure protein S activity, specific activity, and antigen levels in patients with thrombophilia. A 52-year-old man presented with suspected deep vein thrombosis after previously visiting an orthopedic clinic with right lower extremity swelling after his long-distance walk 5 days prior. His D-dimer level was elevated, and a thrombus was found from the femoral to the below-the-knee veins on ultrasonographic echography. Anticoagulation therapy was initiated. His parents had previously been diagnosed with deep vein thrombosis; therefore, he was examined for thrombophilic predisposition. The results showed normal protein S activity and antigen levels, but decreased protein S-specific activity. Genetic testing revealed the presence of a protein S variant (protein S Tokushima). In addition to measuring protein activity and antigen levels, protein S-specific activity measurements can reveal increased risks of thrombosis.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 2","pages":"Article 102105"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940071","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":"Single port endoscopic transaxillary first rib resection for thoracic outlet syndrome","authors":"Stephanie Carter MD ,&nbsp;Brandon Creisher MD ,&nbsp;Ocean Setia MD ,&nbsp;Justin Blasberg MD ,&nbsp;Jennifer Schwartz MD ,&nbsp;David Strosberg MD","doi":"10.1016/j.jvscit.2025.102111","DOIUrl":"10.1016/j.jvscit.2025.102111","url":null,"abstract":"<div><div>Thoracic outlet syndrome is caused by the compression of neurovascular structures in the thoracic outlet. We present an alternative approach to open treatment that uses single port laparoscopy. This minimally invasive technique allows for improved exposure and precise dissection and is more efficacious in morbidly obese patients. Additionally, this technique offers a smaller incision with the single port system and improved ergonomics with the laparoscopic instruments. In the standard open approach, it can be difficult to obtain full posterior/medial exposure safely, and there is risk of excess retraction that could result in neurovascular complications. In open approach only one person can look inside the field at any time, whereas laparoscopic visualization allows all surgeons to examine the operative field simultaneously and provide input. This novel approach represents a promising advancement in thoracic outlet syndrome management, offering patients a less invasive alternative.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 2","pages":"Article 102111"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940079","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":"Comparing neurological complications between endovascular and open surgical repair of the descending thoracic aorta","authors":"Raiyan Talukder BS ,&nbsp;Kristina Montez BS ,&nbsp;Zain Moin BS ,&nbsp;Ahmed Abdou MS ,&nbsp;Brianna Whithorn DO ,&nbsp;Dimitry Sayenko MD, PhD ,&nbsp;Amir Faraji MD, PhD ,&nbsp;Maham Rahimi MD, PhD","doi":"10.1016/j.jvscit.2025.102086","DOIUrl":"10.1016/j.jvscit.2025.102086","url":null,"abstract":"<div><h3>Background</h3><div>Diseases of the descending thoracic aorta (DTA) can require endovascular, open, or a hybrid repair. Endovascular repair involves the minimally invasive placement of a stent graft, whereas open repair requires a thoracotomy to replace tissue with a graft. This study aims to compare the neurological morbidity associated with endovascular vs open repair of the DTA, and specifically for unruptured DTA aneurysm and DTA dissection.</div></div><div><h3>Methods</h3><div>We utilized TriNetX, a deidentified patient database to query adult patients with endovascular and open repair of DTA disease, unruptured aneurysm, and dissection. Propensity score matching was conducted for age, sex, and several comorbidities including tobacco use, diabetes mellitus, chronic kidney disease, hypertension, and connective tissue disorders. We studied ischemic stroke, intracranial hemorrhage, spinal cord ischemia, and mortality at 30 days and 1, 5, and 10 years postoperatively. χ² analyses and odds ratios were calculated for each cohort at each time point.</div></div><div><h3>Results</h3><div>After propensity matching, we studied 3229 patients for repair for DTA disease, 116 for unruptured descending thoracic aortic aneurysm, and 126 for descending thoracic aortic dissection. We find that endovascular repair of the DTA is associated with a lower likelihood of stroke at all time points and spinal cord ischemia and mortality within 30 days of surgery. At 5 and 10 years, patients with open procedures have a lower likelihood of all-cause mortality. No significant difference in odds were observed for patients with aneurysms or dissections.</div></div><div><h3>Conclusions</h3><div>Patients undergoing repair of the descending thoracic aorta should be monitored closely intraoperatively and postoperatively for neurological events to allow for early rescue maneuvers and interventions to reduce overall morbidity and complication rates.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 2","pages":"Article 102086"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940080","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":"Report of a human avian-type aortic arch variant with a descending thoracic aortic aneurysm","authors":"Tuna Aras MD, FEBVS ,&nbsp;Julia Khabyuk MD ,&nbsp;Adel Aswad MD ,&nbsp;Martin Scaal MD ,&nbsp;Payman Majd MD","doi":"10.1016/j.jvscit.2025.102099","DOIUrl":"10.1016/j.jvscit.2025.102099","url":null,"abstract":"","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 2","pages":"Article 102099"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940084","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 fatal case of VEXAS syndrome with a brief review","authors":"Grant Stoltman BA ,&nbsp;Rashid Skeik BS ,&nbsp;Jesse Manunga MD ,&nbsp;Nedaa Skeik MD","doi":"10.1016/j.jvscit.2026.102126","DOIUrl":"10.1016/j.jvscit.2026.102126","url":null,"abstract":"<div><div>VEXAS syndrome (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) is a recently described adult-onset autoinflammatory condition characterized by somatic mutations in the X-linked UBA1 gene. UBA1 mutations cause defective protein ubiquitination, driving widespread inflammation and hematologic dysregulation. VEXAS predominantly affects males aged &gt;50 years, with a prevalence of approximately 1 in 4000 in this population.<span><span>¹</span></span> Diagnosis requires strong clinical suspicion and is confirmed via genetic testing. Currently, no standardized treatment exists, and patients often fail conventional immunosuppression. We present a VEXAS case complicated by recurrent thromboinflammatory events and progressive vascular involvement leading to a fatal outcome despite optimal multidisciplinary care. The patient consented to have his case published.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 2","pages":"Article 102126"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038725","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 iliac preparation for renal transplant using Viabahn stenting","authors":"Jennifer Canonge MD, MSc ,&nbsp;Jana Hammoud MD ,&nbsp;Cecile Champy MD ,&nbsp;Jean Senemaud MD, PhD ,&nbsp;Joseph Touma MD, PhD ,&nbsp;Pascal Desgranges MD, PhD","doi":"10.1016/j.jvscit.2025.102117","DOIUrl":"10.1016/j.jvscit.2025.102117","url":null,"abstract":"<div><div>Severe iliac calcifications may preclude standard renal transplantation (RT) because of hostile vascular access. We report a technique of iliac endovascular preparation using Viabahn stent-grafts (W. L. Gore &amp; Associates) as arterial landing zones for RT in five high-risk patients. Endoclamping and arteriotomy and prosthotomy enabled direct anastomosis through the stent and artery. All grafts remained patent with no vascular complications or stenosis. This minimally invasive strategy avoids major bypass surgery and facilitates RT in patients previously considered ineligible. Although early outcomes are encouraging, strict patient selection and experienced surgical teams are essential. Larger studies are needed to validate long-term efficacy and safety.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 2","pages":"Article 102117"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978905","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}