Vascular Specialist International最新文献

{"title":"Long-term Patency and Complications of Endovascular and Surgical Revascularization for Takayasu Arteritis.","authors":"Jiyoung Shin, Ara Cho, Ahram Han, Sanghyun Ahn, Sangil Min, Seung-Kee Min","doi":"10.5758/vsi.240090","DOIUrl":"10.5758/vsi.240090","url":null,"abstract":"<p><strong>Purpose: </strong>Takayasu arteritis (TAK) is a rare form of chronic vasculitis that is common in Asian female. As TAK predominantly affects young female with a longer life expectancy than those with atherosclerotic diseases, assessing the specific long-term outcomes of TAK treatment is important. Therefore, this study aimed to evaluate the long-term outcomes and post-procedural complications of surgical and endovascular treatment for TAK.</p><p><strong>Materials and methods: </strong>This single-center retrospective observational study reviewed 545 consecutive patients diagnosed with TAK between 1983 and 2020 at Seoul National University Hospital. Of these, 56 patients who underwent 73 extracardiac interventions were enrolled in the study. The data included clinical features, angiographic and laboratory findings, treatment modalities, and clinical outcomes.</p><p><strong>Results: </strong>The mean age of the participants was 40.3±20.3 years, with a predominance of female (75.0%). The mean follow-up duration was 147.7±111.6 months. The most common comorbidity was hypertension (n=42, 75.0%), followed by heart failure (n=12, 21.4%). The most frequent symptom of TAK was uncontrolled hypertension (n=36, 64.3%). The renal artery (n=23, 31.5%) was the most frequently revascularized vessel, followed by the supra-aortic branches, including the innominate, subclavian, vertebral, and carotid arteries (n=19; 26.0%). In the endovascular group, the primary patency rates at 5, 10, and 20 years were 42.2%, 31.7%, and 17.0%, respectively. The rates in the surgical group were 84.4%, 75.7%, and 59.0%, respectively. This difference was statistically significant (P<0.001). The difference in the secondary patency rates between the two groups was not statistically significant. The most common early complication (≤1 month) was arterial dissection (n=4, 5.5%), whereas the most prevalent late complication (>1 month) was restenosis, which occurred significantly more frequently in the endovascular group than in the surgical group (55.0% vs. 12.1%, P<0.001).</p><p><strong>Conclusion: </strong>Surgical and endovascular treatments for TAK are safe. However, restenosis develops more frequently after endovascular treatment compared to surgical treatment, particularly within the first three years. Increased periodic serial monitoring is recommended during this period.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"46"},"PeriodicalIF":0.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924113","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":"Techniques of Oncovascular Reconstruction of Portal and Mesenteric Veins during Pancreatic and Hepatobiliary Surgery.","authors":"Ahram Han, Sanghyun Ahn, Seung-Kee Min","doi":"10.5758/vsi.240073","DOIUrl":"10.5758/vsi.240073","url":null,"abstract":"<p><p>Major vessel invasion, particularly involving the portal and superior mesenteric veins, poses significant challenges during the radical resection of hepatobiliary and pancreatic cancers. Oncovascular surgery is essential for curative outcomes, and often requires portomesenteric vein reconstruction. Techniques, such as lateral venorrhaphy, patch repair, end-to-end anastomosis, and interposition grafting, have been employed. Autogenous veins such as the internal jugular, left renal, external iliac, or femoral veins are options, although not always available. Alternatives include great saphenous vein grafts, other autogenous materials, including the parietal peritoneum, bovine patches and allografts. Despite the higher risks of infection and thrombosis, prosthetic grafts are also considered. Ensuring long-term patency through meticulous surgical techniques is crucial for preventing complications, such as thrombosis and variceal bleeding.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"45"},"PeriodicalIF":0.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907720","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":"Endovascular Management of an Isolated Common Iliac Artery Aneurysm in a Patient with an Ectopic Pelvic Kidney: A Case Report.","authors":"Vasiliki Manaki, Vangelis Bontinis, Alkis Bontinis, Argirios Giannopoulos, Ioannis Kontes, Andreas Kitromilis, Kiriakos Ktenidis","doi":"10.5758/vsi.240089","DOIUrl":"10.5758/vsi.240089","url":null,"abstract":"<p><p>Isolated iliac aneurysms are rare, and their management becomes complex when accompanied by ectopic pelvic kidneys due to altered vascular anatomy. We report a 58-year-old male with an incidentally discovered 53.5 mm left common iliac artery (CIA) aneurysm and an ectopic pelvic kidney. The main renal artery originated from the left proximal CIA, with two smaller polar arteries arising from the left internal iliac artery (IIA). The aneurysm was treated endovascularly with two Gore Excluder iliac limbs and coil embolization of the IIA, successfully excluding the aneurysm while preserving renal circulation. Postoperative creatinine levels remained stable, and follow-up imaging showed no complications. This case highlights the challenges of treating iliac aneurysms in patients with ectopic kidneys, where renal perfusion and adequate sealing are crucial. Endovascular techniques, including stent grafts and IIA embolization, offer safe and effective options for such complex cases.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"44"},"PeriodicalIF":0.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904012","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":"Cyanoacrylate Glue Ablation for Symptomatic Reflux in a Duplicated Femoral Vein: A Case Report.","authors":"Kilsoo Yie, Eun-Hee Jeong, A-Rom Shin, Bo-Mi Kim, Eun-Jung Hwang","doi":"10.5758/vsi.240085","DOIUrl":"10.5758/vsi.240085","url":null,"abstract":"<p><p>The literature on minimally invasive techniques specifically targeting reflux in symptomatic femoral vein duplication (FVD) is limited. We present a rare case of symptomatic reflux in FVD, successfully treated with cyanoacrylate glue ablation under ultrasonographic guidance. Our findings suggest that the unique anatomy of FVD can be effectively addressed through percutaneous endovenous glue ablation, providing a technically safe and feasible alternative without open surgery. Our patient experienced symptom resolution, no post-procedural complications, and maintained stable occlusion at a 1-year follow-up. This outcome highlights the potential of endovenous glue ablation as an innovative approach in managing deep vein reflux, particularly in cases involving FVD. To broaden its application in clinical practice, further research is crucial to establish appropriate patient selection criteria and refine treatment protocols.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"43"},"PeriodicalIF":0.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883428","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":"Surgical Repair of a Giant Inferior Vena Cava Aneurysm Associated with a Congenital Vascular Anomaly: A Case Report.","authors":"Konstantinos Dimitriadis, Nikolaos Papatheodorou, Nikolaos Triantafyllou, Stavros Parisidis, Christos Argyriou, George S Georgiadis","doi":"10.5758/vsi.240087","DOIUrl":"10.5758/vsi.240087","url":null,"abstract":"<p><p>Inferior vena cava aneurysms (IVCAs) are rare yet potentially lethal, especially if they are symptomatic or complicated. Among the IVCAs reported in the literature, only a few are associated with congenital vascular anomalies, including congenital IVC obstruction, tetralogy of Fallot, left-sided IVC, duplicated IVC, Ehlers-Danlos syndrome, blue rubber bleb nevus syndrome, and Klipper-Trenaunay syndrome. We present the case of an 8-cm symptomatic saccular IVCA in a patient with tetralogy of Fallot, treated successfully with surgical repair. Although rare venous pathologies can sometimes be managed with endovascular treatment, open surgical reconstruction remains the mainstay of durable and definitive repair.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"42"},"PeriodicalIF":0.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848421","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":"Evaluation of Aortic Diseases Using Four-Dimensional Flow Magnetic Resonance Imaging.","authors":"Hyun Jung Koo, Hojin Ha, Gyu-Han Lee, Jong En Lee, Sang-Hyub Park, Kyoung-Jin Park, Joon-Won Kang, Dong Hyun Yang","doi":"10.5758/vsi.240066","DOIUrl":"10.5758/vsi.240066","url":null,"abstract":"<p><p>The complex hemodynamic environment within the aortic lumen plays a crucial role in the progression of aortic diseases such as aneurysms and dissections. Traditional imaging modalities often fail to provide comprehensive flow dynamics that are essential for precise risk assessment and timely intervention. The advent of time-resolved, three-dimensional (3D) phase-contrast magnetic resonance imaging (4D flow MRI) has revolutionized the evaluation of aortic diseases by allowing a detailed visualizations of flow patterns and quantification of hemodynamic parameters. This review explores the utility of 4D flow MRI in the assessment of thoracic aortic diseases, highlighting the key hemodynamic parameters, including flow velocity, wall shear stress, oscillatory shear index, relative residence time, vortex, turbulent kinetic energy, flow displacement, pulse wave velocity, aortic distensibility, energy loss, and stasis. We elucidate the significant findings of studies utilizing 4D flow MRI in the context of aortic aneurysms and dissections, highlighting its role in enhancing our understanding of disease mechanisms and improving clinical outcomes. This review underscores the potential of 4D flow MRI to refine risk stratification and guide therapeutic decisions, ultimately contributing to better management of aortic diseases.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"41"},"PeriodicalIF":0.8,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848415","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":"Duplex Ultrasound of the Femoral Vein for Monitoring Endovascular Treatment of Aortocaval Fistula: A Case Report.","authors":"Christiana Anastasiadou, Vasileios Intzos, Freideriki Sifaki, Savvas Symeonidis, Christos Giankoulof, Stamatis Angelopoulos, Angelos Megalopoulos","doi":"10.5758/vsi.240082","DOIUrl":"10.5758/vsi.240082","url":null,"abstract":"<p><p>Aortocaval fistulas, typically linked to aortoiliac aneurysms, are rare vascular conditions. Currently, endovascular therapy is preferred treatment approach. However, endovascular therapy requires frequent and extended follow-up evaluations. Herein, we emphasize a noteworthy clinical finding in this disease: the presence of a pulsatile femoral vein. Additionally, we propose a novel, simple, and easily performed radiation-free method for postoperative assessment of fistula presence or resolution: duplex ultrasound of the femoral vein. While duplex ultrasound cannot substitute other diagnostic modalities, this technique offers a quick, cost-effective, and repeatable adjunct for monitoring.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"39"},"PeriodicalIF":0.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830272","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":"Management of Renal Angiomyolipomas in Tuberous Sclerosis: A Case Series.","authors":"Ganesh G Gowda, Maureen Prativa Tigga, Rashmi Hosahalli Sreenath","doi":"10.5758/vsi.240039","DOIUrl":"10.5758/vsi.240039","url":null,"abstract":"<p><p>Renal angiomyolipomas, benign tumors composed of blood vessels, adipose tissue, and smooth muscle, affect approximately 70% to 80% of patients with tuberous sclerosis. Angiomyolipomas smaller than 4 cm are usually asymptomatic, whereas larger ones can cause lumbar pain, anemia, and hematuria. Contrary to its sporadic counterparts, tuberous sclerosis-associated angiomyolipomas often present at a young age, are multicentric and large, and carry a higher risk of life-threatening hemorrhage. Therapeutic strategies include selective tumor embolization, nephrectomy for severe cases, and medical treatment such as everolimus. Despite a correlation between tuberous sclerosis and renal angiomyolipomas and their described high complication rates in literature, disease awareness in clinical practice remains low. This case series describes the management and outcomes of three patients with tuberous sclerosis-associated renal angiomyolipomas treated with selective arterial embolization.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"40"},"PeriodicalIF":0.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830285","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":"An Uncommon Presentation of a Ruptured Right Common Iliac Artery Infected Pseudoaneurysm as Deep Vein Thrombosis: A Case Report and Literature Review.","authors":"Deshan Mario Gomez, Lumini Edirisuriya, Praneeth Athukorale, Thushan Gooneratne","doi":"10.5758/vsi.240064","DOIUrl":"https://doi.org/10.5758/vsi.240064","url":null,"abstract":"<p><p>Isolated iliac artery pseudoaneurysms are extremely rare and typically asymptomatic. However, symptoms may arise from rupture or compression of adjacent structures, such as the ureter, bowel or deep veins. A 46-year-old male presented with right lower limb swelling and preceding lower abdominal pain of 6 months. Duplex imaging showed iliofemoral deep vein thrombosis. Blood tests showed neutrophil leukocytosis and elevated inflammatory markers. Contrast-enhanced computed tomography demonstrated a large eccentric, irregular right common iliac artery pseudoaneurysm with hydronephrosis, hydroureter, and inferior vena cava compression. Based on the radiological and biochemical investigations, a tentative diagnosis of infected iliac artery pseudoaneurysm was made. The patient was successfully managed with endovascular stent grafting. Deep vein thrombosis is a rare presentation of a infected iliac artery pseudoaneurysm. Early referral and timely intervention are crucial for achieving optimal outcomes.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"38"},"PeriodicalIF":0.8,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774682","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":"Learning Curve of Autologous Arteriovenous Fistula Formation for Junior Vascular Surgeons.","authors":"Mun Chae Choi, Seung Hyuk Yim, Seong Wook Shin, Seok Jeong Yang, Deok-Gie Kim, Seon-Hee Heo, Soo Jin Kim","doi":"10.5758/vsi.240049","DOIUrl":"10.5758/vsi.240049","url":null,"abstract":"<p><strong>Purpose: </strong>Autologous arteriovenous fistulas (AVFs) are considered the gold standard for hemodialysis access, with outcomes largely dependent on the surgeon's experience. Nevertheless, few studies have been conducted on the learning curve of junior vascular surgeons in AVF creation. This study aims to address this by examining the development of surgical skills among junior vascular surgeons.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 100 patients who underwent autologous AVF procedures performed by five junior surgeons between January 2018 and December 2023. To establish the cutoff number of cases for the learning curve, we examined the cubic spline curve using the hazard ratio for primary failure.</p><p><strong>Results: </strong>The cutoff number for operation cases was 15.33, and we divided the analysis into a pre-learning curve period (≤15 cases of AVF) and a post-learning curve period (>15 cases of AVF). The 1-year primary patency rate for AVF during the post-learning curve period was 84.0%, which was higher than the 65.5% rate observed during the pre-learning curve period. In a subgroup analysis based on AVF type, the radiocephalic fistula patient group demonstrated a significant increase in 1-year primary patency in the post-learning curve period compared to that in the pre-learning curve period (80.0% vs. 43.0%, log-rank P=0.033). In contrast, there was no significant difference in the primary patency rates between the post- and pre-learning curve periods in the brachiocephalic fistula patient group (90.0% vs. 89.2%, log-rank P=0.930).</p><p><strong>Conclusion: </strong>Junior vascular surgeons demonstrated improved primary AVF patency beyond the learning curve benchmark in 15 patients, with particularly notable enhancements in radiocephalic fistulas.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"37"},"PeriodicalIF":0.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11573482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669594","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}