Vascular Specialist International最新文献

{"title":"Algorithm for the Revascularization of Infrainguinal Arterial Disease.","authors":"Jin Hyun Joh","doi":"10.5758/vsi.240113","DOIUrl":"10.5758/vsi.240113","url":null,"abstract":"<p><p>Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient's condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques. However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"41 ","pages":"6"},"PeriodicalIF":0.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651976","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 Treatment of Multiple Pancreaticoduodenal Artery Aneurysms Associated with Celiac Artery Stenosis: A Case Report.","authors":"Ahmet Tanyeri","doi":"10.5758/vsi.240115","DOIUrl":"10.5758/vsi.240115","url":null,"abstract":"<p><p>This case report details the endovascular treatment of multiple pancreaticoduodenal artery (PDA) aneurysms associated with celiac artery stenosis in a 54-year-old male presenting with postprandial abdominal pain. Contrast-enhanced abdominal computed tomography (CT) revealed critical stenosis of the celiac artery and three saccular PDA aneurysms measuring 34, 15, and 21 mm in diameter. Following unsuccessful attempts to access the celiac artery, the aneurysms were embolized in a retrograde manner from the superior mesenteric artery using detachable coils. Follow-up ultrasonography and CT 1 month later indicated reopening of the distal aneurysm, which was subsequently re-embolized. The patient was monitored for 10 months, during which the aneurysm remained occluded. This report highlights the approach and results of endovascular treatment in managing multiple PDA aneurysms in the context of untreated celiac artery stenosis, emphasizing the importance of close surveillance.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"41 ","pages":"5"},"PeriodicalIF":0.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574646","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":"Simulation-based Central Venous Catheter Insertion Training Increases Comfort Amongst Residents.","authors":"David Chow, Tiffany Kippenberger, Fred Kobylarz, Jonathan Livezey, Andrew Anklowitz, Elisabeth Coffin, Jacqueline Simmons, Maeghan Ciampa, Joel Brockmeyer, Marcos Aranda","doi":"10.5758/vsi.240079","DOIUrl":"10.5758/vsi.240079","url":null,"abstract":"<p><strong>Purpose: </strong>Central venous catheter (CVC) insertion is a fundamental skill required for trainees to become proficient. Simulation-based training (SBT) has been shown to improve trainees' CVC insertion performance effectively. However, implementing a CVC curriculum requires substantial costs and resources. Currently, there is a lack of validated CVC curricula that institutions can adopt as frameworks. This study aimed to evaluate the effectiveness of our institution's CVC simulation curriculum in improving residents' confidence and comfort with CVC insertion and management.</p><p><strong>Materials and methods: </strong>First-year residents (n=118) participated in SBT between 2017 and 2023. Among them, 57 (48%) participants completed surveys before training and 6 months post-training to assess changes in comfort levels across various aspects of CVC insertion. Survey responses were analyzed to evaluate the overall changes in comfort by year and items.</p><p><strong>Results: </strong>Overall comfort increased from 42.1% before training to 81.3% after training (P<0.01), with notable improvements in nonprocedural aspects. Comfort with performing the unsupervised procedure increased by 16.7% (P<0.05) but remained low post-training (29.6%).</p><p><strong>Conclusion: </strong>These findings suggest that the curriculum effectively enhances residents' comfort, particularly in nonprocedural aspects, but only partially prepares them for unsupervised CVC insertions. This indicates a gap in procedural skill acquisition despite the overall positive trends. Implementing a similar CVC curriculum may help institutions reduce CVC insertion-associated complications.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"41 ","pages":"4"},"PeriodicalIF":0.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574661","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 Management of Paraganglioma of the Organ of Zuckerkandl with Combined Resection of the Aorta and Inferior Vena Cava with Bifurcation: A Case Report.","authors":"Shalini Shree Krishnamurthy, Saravanan Moorthy, Krishna Muralidharan, Anand Raja","doi":"10.5758/vsi.240099","DOIUrl":"10.5758/vsi.240099","url":null,"abstract":"<p><p>Paragangliomas are rare neuroendocrine tumors that frequently arise in the organ of Zuckerkandl (OZ). Surgical resection remains the cornerstone of treatment. Although vascular resection and reconstruction have been reported in a few cases, no prior reports have documented the simultaneous resection of both the aorta and inferior vena cava (IVC), along with their bifurcation. We present the case of a 50-year-old man with a large paraganglioma of the OZ, successfully managed through combined resection of the aorta, IVC, their bifurcation, and the psoas muscle. Dacron Y-grafts were used to reconstruct both the aorta and IVC. This case underscores the importance of detailed anatomical knowledge of major vessels, meticulous vascular control, and the technical intricacies of vascular reconstruction. We emphasize the significance of comprehensive perioperative management and provide a literature review on en bloc vascular resection for paraganglioma, offering insights into current surgical practices and outcomes.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"41 ","pages":"3"},"PeriodicalIF":0.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544328","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":"Rivaroxaban versus Enoxaparin in Patients with Radial Artery Occlusion after Transradial Coronary Catheterization: A Pilot Randomization Trial.","authors":"Mohsen Maadani, Soudabeh Shafiee Ardestani, Farnaz Rafiee, Kiara Rezaei-Kalantari, Parham Rabiee, Yasmin Mohtasham Kia, Ali Zahedmehr, Bahram Mohebbi, Armin Elahifar, Ehsan Khalilipur, Ata Firouzi, Parham Sadeghipour","doi":"10.5758/vsi.240103","DOIUrl":"10.5758/vsi.240103","url":null,"abstract":"<p><p>The radial artery is currently the main vascular access site for cardiac catheterization. Radial artery occlusion (RAO), although a relatively silent complication, raises concerns because of its potential impact on future procedures. This pilot randomized controlled trial compared the efficacy and safety of two anticoagulation regimens-subcutaneous enoxaparin and oral rivaroxaban-in resolving symptomatic ultrasound-confirmed RAO in 40 patients (median age 55 years [interquartile range, 48-64], including 26 female patients [70.3%]) who underwent diagnostic cardiac catheterization without requiring dual antiplatelet therapy. Thirty-seven patients completed the 28-day ultrasound-based follow-up, demonstrating comparable complete or partial resolution rates between rivaroxaban (16 of 20 patients [80.0%]) and enoxaparin (14 of 17 patients [82.3%]), with an odds ratio of 0.85 (95% confidence interval: 0.16 to 4.50). No major bleeding events occurred during the 28-day follow-up period. While rivaroxaban shows potential in resolving RAO, larger studies are necessary to validate these findings and evaluate the long-term outcomes.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"41 ","pages":"2"},"PeriodicalIF":0.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494737","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":"Infected Paravisceral Aneurysm Repair with Parallel Stent Grafts.","authors":"Iria Fernández Álvarez, Javier Fernández Lorenzo, Jorge Vidal Rey, José Manuel Encisa de Sá","doi":"10.5758/vsi.240093","DOIUrl":"10.5758/vsi.240093","url":null,"abstract":"<p><p>An infected aortic aneurysm (IAA) is a rare but potentially life-threatening pathology characterized by rapid growth and a substantial risk of rupture compared to non-infected aneurysms. Reports on the endovscular treatment of infected paravisceral aneurysms are limited in the literature. This article describes our experience with endovascular repair of IAAs involving the visceral arteries and includes a literature review. We present two cases of symptomatic IAAs located at the celiac trunk ostium in high-risk surgical patients. Both cases were successfully treated with the parallel stent grafting (PG) technique in combination with prolonged antibiotic therapy. A bibliographic review of the endovascular treatment of IAAs was also conducted. Complex endovascular repair of paravisceral IAAs using a combination of a thoracic aortic stent graft and PG, together with prolonged antibiotic therapy, appears to be a reasonable treatment option with promising short- and medium-term results.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"41 ","pages":"1"},"PeriodicalIF":0.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484682","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":"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}