Vascular Specialist International最新文献

{"title":"Upper-Limb Ischemia Due to Distal Embolization from a Dissecting Axillary Artery Pseudoaneurysm in an Elite Overhead Athlete: A Case Report.","authors":"Sapna Tiwari, Sumanshi Singh, Dinshaw Pardiwala, Raghuram Sekhar","doi":"10.5758/vsi.260049","DOIUrl":"10.5758/vsi.260049","url":null,"abstract":"<p><p>In overhead-throwing athletes, repetitive shoulder motion may cause intimal injury and pseudoaneurysm formation, most commonly involving the posterior circumflex humeral artery. An elite cricket fast bowler in his 20s presented with 6 months of left shoulder and hand discomfort, followed by rest pain and numbness of the fourth and fifth fingers. Duplex ultrasonography showed thrombosis of an axillary artery pseudoaneurysm with distal radial and ulnar artery embolization, and magnetic resonance imaging demonstrated a 1.5-cm pseudoaneurysm at the origin of the subscapular artery. Surgical exploration revealed a spiral intimal dissection with organized thrombus. The pseudoaneurysm was excised, the intima was secured with tacking sutures, the axillary artery was repaired with a great saphenous vein patch, and thromboembolectomy was performed. The patient returned to work at 6 months without residual deficits. Delayed diagnosis may compromise limb salvage and functional recovery. Early recognition of vascular pathology is essential in overhead athletes.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"38"},"PeriodicalIF":1.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076648","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":"Ruptured Giant Abdominal Aortic Aneurysm with Bilateral Giant Common Iliac Artery Aneurysms: A Case Report.","authors":"Sang Su Lee, Minju Kim, Hyuk Jae Jung","doi":"10.5758/vsi.260109","DOIUrl":"10.5758/vsi.260109","url":null,"abstract":"<p><p>Giant abdominal aortic aneurysms (AAAs), often defined by a maximum transverse diameter exceeding 13 cm, are rarely reported. We report a case of multiple giant aortoiliac aneurysms comprising a ruptured giant AAA and bilateral giant common iliac artery aneurysms (CIAAs). A 59-year-old male was transferred to our emergency department with a ruptured AAA. Computed tomography angiography (CTA) showed a ruptured giant infrarenal AAA measuring 16.9×9.7 cm and bilateral CIAAs measuring 9.6×9.7 cm and 9.0×8.7 cm. The patient underwent successful open surgical repair with an aortoiliac bifurcated graft. An intraoperative left ureteral injury was immediately repaired by end-to-end anastomosis over a double-J stent. Postoperative CTA demonstrated successful graft reconstruction without leakage. The patient recovered without further major complications and was discharged on postoperative day 23. This case highlights the technical challenges of treating multiple giant aortoiliac aneurysms and demonstrates that emergency open repair can achieve a favorable outcome.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"37"},"PeriodicalIF":1.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076645","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":"Acute Limb Ischemia Caused by Distal Embolization from an External Iliac Artery Pseudoaneurysm Associated with a Protruding Acetabular Screw: A Case Report.","authors":"Yuki Tada, Shinsuke Kikuchi, Sayaka Yuzawa, Mishie Tanino, Ryo Mitsutake, Nobuyoshi Azuma","doi":"10.5758/vsi.260095","DOIUrl":"10.5758/vsi.260095","url":null,"abstract":"<p><p>This case report describes a 78-year-old female who presented with acute limb ischemia caused by distal embolization 23 years after total hip arthroplasty (THA). The embolic source was a pseudoaneurysm of the left external iliac artery (EIA) densely adherent to thickened soft tissue in contact with a protruding acetabular screw. The affected EIA segment was replaced with a prosthetic graft, and an above-knee popliteal-to-posterior tibial artery bypass was performed for infrapopliteal occlusion. Histopathology revealed disruption of the elastic laminae, replacement of the arterial wall by granulation tissue with prominent hemosiderin deposition, and organizing thrombus, confined to the side facing the screw, whereas the opposite wall was preserved. Vascular complications of THA are uncommon and usually occur perioperatively; however, chronic mechanical irritation from a protruding acetabular screw may contribute to delayed pseudoaneurysm formation and distal embolization. The patient remained free of recurrent pseudoaneurysm, embolization, and graft stenosis throughout 10 years of follow-up.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"36"},"PeriodicalIF":1.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076621","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":"Carotid Free-Floating Thrombus in the Setting of Bilateral Embolic Strokes: A Case Report.","authors":"Alexis X Chen, Tyler Fox, Ioannis Tsouknidas, Henry Hirsch","doi":"10.5758/vsi.260050","DOIUrl":"10.5758/vsi.260050","url":null,"abstract":"<p><p>Carotid free-floating thrombus (CFFT) is a rare entity that can lead to life-threatening embolic events. An 80-year-old man presented with left-sided weakness. Computed tomography angiography (CTA) demonstrated bilateral carotid plaques with pedunculated mural thrombi and no hemodynamically significant stenosis. After intracranial hemorrhage was excluded, intravenous tissue plasminogen activator was administered. Within 12 hours, he developed a contralateral ischemic stroke; repeat CTA showed disappearance of the left internal carotid artery (ICA) thrombus, while magnetic resonance imaging demonstrated a new left hemispheric infarction. Carotid duplex ultrasound revealed a mobile right ICA thrombus consistent with CFFT. Urgent carotid endarterectomy (CEA) was performed without complications, and no further neurological events or hemorrhagic transformation occurred. This case suggests that urgent CEA may help prevent further embolic events in selected patients with CFFT.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"35"},"PeriodicalIF":1.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026740","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":"The Excluded Saphenous Vein Technique for Great Saphenous Vein Reflux: Five-Year Outcomes from an Institutional Experience.","authors":"Maurizio Pagano, Marco Pagano, Giacomo Rito Marcone, Simone Seratoni, Raffaele Polichetti","doi":"10.5758/vsi.260057","DOIUrl":"10.5758/vsi.260057","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the long-term effectiveness of the Excluded Saphenous Vein Technique (ESVT) in patients with varicose veins (VVs) associated with great saphenous vein (GSV) incompetence.</p><p><strong>Materials and methods: </strong>Patients who underwent ESVT for primary GSV incompetence associated with VVs between January 2017 and December 2019 were included in this retrospective analysis of a prospectively maintained institutional database. Eligible patients had Clinical, Etiologic, Anatomic, and Pathophysiologic class C2 disease. ESVT consists of selective crossectomy, distal ligation of the GSV at the level of the incompetent thigh tributary, catheter-assisted foam sclerotherapy of the excluded GSV segment, and concomitant phlebectomy of non-saphenous varicosities. The primary endpoint was cumulative GSV recanalization during 5-year follow-up. Secondary endpoints included perioperative complications and VV recurrence.</p><p><strong>Results: </strong>Among 312 patients treated during the study period, 268 met the eligibility criteria, and 239 patients with 349 treated limbs had complete 5-year follow-up. The median GSV diameter was 11 mm (interquartile range, 8-14 mm). All procedures were performed in a day-surgery setting. Transient skin dyschromia occurred in 6.3% of patients, persistent dyschromia in 2.1%, and superficial vein thrombosis in 2.1%; all were managed conservatively. No clinically detected deep vein thrombosis or symptomatic pulmonary embolism occurred. During 5-year follow-up, GSV recanalization occurred in 22/349 treated limbs (6.3%), involving 22/239 patients (9.2%). Recurrent VVs were observed in 59 patients (24.7%).</p><p><strong>Conclusion: </strong>ESVT appears to be a safe and effective treatment option for selected patients with primary GSV reflux and VVs.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"34"},"PeriodicalIF":1.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013141","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":"Infection after Endovascular Repair of Complex Aortic and Thoracoabdominal Aneurysms with Fenestrated and Branched Devices: A Systematic Descriptive Review.","authors":"Andreas L Tsimpoukis, Christos F Pitros, Fotios O Efthymiou, Spyros I Papadoulas, John D Kakisis, Konstantinos G Moulakakis","doi":"10.5758/vsi.250162","DOIUrl":"10.5758/vsi.250162","url":null,"abstract":"<p><p>Endograft infection after fenestrated or branched endovascular aortic repair (F/BEVAR) is an uncommon yet serious complication due to the involvement of the visceral branches and the complexity of the required treatment. This systematic review aimed to descriptively synthesize reported cases of infection after F/BEVAR, with an emphasis on clinical presentation, microbiology, associated aortoenteric fistulas (AEFs), management strategies, and reported outcomes. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, with MEDLINE, Scopus, and the Cochrane Library searched up to September 14, 2025; eligible reports included case reports and series describing F/BEVAR-related infections. Eleven studies encompassing 26 patients were identified. The weighted mean patient age was approximately 73 years, and 77% of patients were male. The weighted mean interval from repair to infection was approximately 20 months. Microbiological findings were heterogeneous, with both Gram-negative and Gram-positive organisms and several polymicrobial infections reported. AEFs were confirmed in at least 8/26 (31%) patients. Surgical explantation with reconstruction was performed in 12/26 patients (46%), conservative therapy in 12/26 (46%), and graft-preserving procedures in 2/26 (8%). The overall 30-day mortality rate was 4/26 (15%): 3/12 after graft explantation and reconstruction, 1/12 after conservative treatment, and 0/2 after graft-preserving procedures. Among the 22 patients who survived 30 days, 18 (82%) were alive at the last reported follow-up: 9/9 after graft explantation and reconstruction, 7/11 after conservative treatment, and 2/2 after graft-preserving procedures. Infection after F/BEVAR requires individualized management and has been reported to have a heterogeneous clinical presentation, microbiological findings, and treatment strategies. Given the limited evidence base, consisting primarily of case reports and small case series, these findings should be interpreted descriptively. Multicenter collaboration and standardized reporting are needed to better characterize this complication and inform future management strategies.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"33"},"PeriodicalIF":1.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978652","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":"Ulnar Artery Aneurysm with Ipsilateral Radial Artery Occlusion: A Case Report and Literature Review.","authors":"Dimitrios A Chatzelas, Michail I Kantzas, Apostolos G Pitoulias, Georgios A Pitoulias","doi":"10.5758/vsi.260077","DOIUrl":"10.5758/vsi.260077","url":null,"abstract":"<p><p>Ulnar artery aneurysms (UAAs) are rare vascular lesions, most commonly associated with repetitive hand trauma and hypothenar hammer syndrome. Simultaneous involvement of both the ulnar and radial arteries is exceptionally uncommon. We report the case of a 61-year-old female patient with a true distal UAA in the dominant hand and concomitant ipsilateral radial artery occlusion, possibly associated with prolonged occupational repetitive trauma from sewing machine use. The patient presented with a progressively enlarging pulsatile wrist mass and sensory symptoms in the ulnar nerve distribution. Computed tomography angiography demonstrated a fusiform UAA and complete radial artery occlusion. Because the ulnar artery represented the only patent major arterial inflow to the hand, aneurysm excision and direct end-to-end spatulated reconstruction were performed under local anesthesia. At 2-year follow-up, the patient remained asymptomatic, with a patent reconstruction and preserved hand perfusion. This case highlights the importance of arterial reconstruction in dual-vessel disease.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"32"},"PeriodicalIF":1.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914365","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 Treatment of Symptomatic Carotid Web Assessed by Intravascular Ultrasound.","authors":"Diego Soto V, Gabriel Cassorla J, Sebastián Morales Z, Gonzalo Velez M, José Segundo R, Julián Tique E, Ángel Flores H","doi":"10.5758/vsi.260043","DOIUrl":"10.5758/vsi.260043","url":null,"abstract":"","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"31"},"PeriodicalIF":1.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889201","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":"Conservative Management of a Traumatic Deep Palmar Arch Pseudoaneurysm with Delayed Ulnar Motor Dysfunction: A Case Report.","authors":"Fernando de Juan Santos, Carlos Villar Yus, Javier Pérez Rodríguez","doi":"10.5758/vsi.260029","DOIUrl":"10.5758/vsi.260029","url":null,"abstract":"<p><p>Traumatic pseudoaneurysms of the palmar arch are rare vascular lesions and are typically managed with surgical repair or endovascular exclusion. Deep palmar arch involvement is particularly uncommon, and neurological deficits are often considered indications for exploration. We report the case of a 26-year-old male with a penetrating palm injury resulting in a bilobulated deep palmar arch pseudoaneurysm, a thenar hematoma, and delayed ulnar motor dysfunction. Because there was no digital ischemia, ongoing bleeding, or lesion expansion, conservative management with structured clinical and radiological surveillance was selected. Serial computed tomography angiography demonstrated early interval thrombosis and vascular stability. Intrinsic hand muscle function progressively recovered, and one-year imaging confirmed complete resolution of the pseudoaneurysm. This case suggests that conservative management may be considered in carefully selected, hemodynamically stable patients without digital ischemia, provided that close clinical and radiological surveillance is feasible.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"30"},"PeriodicalIF":1.2,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820148","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":"Outcomes of Intentional Celiac Artery Coverage During Thoracic Endovascular Aortic Repair for Infective Native Aortic Aneurysms: A Case Series.","authors":"Muhammad Aizat Tamlikha Ismail, Karthigesu Aimanan, Michael Arvind, Putera Mas Pian, Hanif Hussein","doi":"10.5758/vsi.260030","DOIUrl":"10.5758/vsi.260030","url":null,"abstract":"<p><p>Intentional celiac artery (CA) coverage during thoracic endovascular aortic repair (TEVAR) may be required to achieve an adequate distal landing zone; however, this strategy remains controversial owing to concerns regarding visceral ischemia, particularly in patients with infective native aortic aneurysms with compromised physiology and hostile anatomy. We retrospectively reviewed three patients who underwent TEVAR with planned CA coverage after angiographic assessment of collateral circulation using balloon occlusion testing and selective superior mesenteric artery angiography, with CA embolization. All patients demonstrated robust collateral perfusion, underwent CA embolization, and subsequently TEVAR with intentional CA coverage. One patient developed a type Ib endoleak on surveillance imaging without sac expansion. No hepatic, gastric, or splenic ischemic events occurred during follow-up. This case series suggests that intentional CA coverage may be feasible in carefully selected patients when guided by meticulous collateral assessment, offering a pragmatic option in urgent or anatomically constrained settings.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"29"},"PeriodicalIF":1.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725114","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}