Vascular Specialist International最新文献

{"title":"Extra-Anatomic Bypass from Ascending Thoracic Aorta to Abdominal Aorta in Takayasu Arteritis with Middle Aortic Syndrome.","authors":"Hye Young Woo, Seung-Kee Min","doi":"10.5758/vsi.220058","DOIUrl":"https://doi.org/10.5758/vsi.220058","url":null,"abstract":"Middle aortic syndrome (MAS) is a rare disease causing steno-occlusion of mid-aorta (descending thoracic to abdominal aorta) due to Takayasu arteritis (TAK) [1]. Extraanatomic ascending aorto-abdominal aortic bypass with a prosthetic graft has been reported for the treatment of MAS with TAK [2]. We suggest a new graft pathway thru which graft passes posterior to liver left lobe, through lesser sac, to prevent bowel contact which might cause aortoenteric erosion or fistula [3]. A 23-year-old male was referred to vascular clinic due to uncontrolled hypertension. At the age of 3, he had hypertension due to both renal artery stenoses due to TAK. Repeated angioplasties of renal arteries and aorta were performed, however, despite of multiple medications, hyIm ge of Vacular Srgery Extra-Anatomic Bypass from Ascending Thoracic Aorta to Abdominal Aorta in Takayasu Arteritis with Middle Aortic Syndrome","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"43"},"PeriodicalIF":0.9,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/48/70/vsi-38-43.PMC9826738.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10554653","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":"Safety and Efficacy of Peripherally Inserted Central Catheter Placement by Surgical Intensivist-Led Vascular Access Team.","authors":"Byunghyuk Yu,&nbsp;Jihoon Hong","doi":"10.5758/vsi.220054","DOIUrl":"https://doi.org/10.5758/vsi.220054","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the safety and efficacy of bedside peripherally inserted central catheter (PICC) placement under ultrasonography (USG) guidance in the general ward by a surgical intensivist-led vascular access team versus that of PICC placement in the intensive care unit (ICU) or fluoroscopy unit.</p><p><strong>Materials and methods: </strong>We conducted this retrospective study of all patients who underwent PICC placement between March 2021 and May 2022. Clinical, periprocedural, and outcome data were compared for PICC placement in the ICU, general ward, and fluoroscopy unit groups, respectively.</p><p><strong>Results: </strong>A total of 354 PICC placements were made in 301 patients. Among them, USG-guided PICC placement was performed in 103 and 147 cases in the ICU and general ward, respectively, while fluoroscopy-guided PICC placement was performed in 104 cases. USG-guided PICC placement more often required post-procedural catheter repositioning than fluoroscopy-guided PICC placement (P<0.001), but there was no significant difference in any adverse events (P=0.796). In addition, USG-guided PICC placement in the general ward was more efficient than fluoroscopy-guided PICC placement (0.73 days vs. 5.73 days, respectively; P<0.001). In the multivariate analysis, previous PICC placement within 6 months was an independent risk factor for a PICC-associated bloodstream infection (odds ratio, 2.835; 95% confidence interval, 1.143-7.034; P=0.025).</p><p><strong>Conclusion: </strong>USG-guided PICC placement in the general ward by a surgical intensivist-led vascular access team has comparable safety and efficiency to that of USG-guided PICC placement in the ICU or fluoroscopy-guided PICC placement.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"41"},"PeriodicalIF":0.9,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/2f/vsi-38-41.PMC9812687.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10538925","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":"Renovascular Hypertension due to Median Arcuate Ligament Syndrome Treated by Open Bypass after Failed Endovascular Treatment.","authors":"Kwang Woo Choi,&nbsp;Seung-Kee Min","doi":"10.5758/vsi.220057","DOIUrl":"https://doi.org/10.5758/vsi.220057","url":null,"abstract":"Median arcuate ligament syndrome (MALS) is a rare condition in which the median arcuate ligament compresses the celiac artery (CA) and celiac ganglia, causing abdominal pain [1]. The superior mesenteric artery (SMA) is occasionally compressed because of anatomical variations [2,3]. We recently experienced a rare case of MALS that compressed the CA, SMA, and right renal artery (RA), resulting in renovascular hypertension. A 20-year-old male presented with uncontrolled hypertension. Four years earlier, he presented with high blood Im ge of Vacular Srgery Renovascular Hypertension due to Median Arcuate Ligament Syndrome Treated by Open Bypass after Failed Endovascular Treatment","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"42"},"PeriodicalIF":0.9,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/62/7d/vsi-38-42.PMC9826740.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10554652","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":"Late Type IIIb Endoleak after Low-Profile Endograft Implantation for Abdominal Aortic Aneurysm Treated by Hybrid Surgery.","authors":"Younghye Kim,&nbsp;Woo-Sung Yun,&nbsp;Hyung-Kee Kim","doi":"10.5758/vsi.220055","DOIUrl":"https://doi.org/10.5758/vsi.220055","url":null,"abstract":"A 71-year-old male presented with abdominal discom-fort for 7 days. His medical history included hypertension, coronary artery disease","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"37"},"PeriodicalIF":0.9,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/ea/vsi-38-37.PMC9808498.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10512754","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":"Catheter-Directed Thrombolysis for Persistent Sciatic Artery Presenting with Acute Limb Ischemia.","authors":"Masaya Nakashima,&nbsp;Masayoshi Kobayashi","doi":"10.5758/vsi.220036","DOIUrl":"https://doi.org/10.5758/vsi.220036","url":null,"abstract":"<p><p>Persistent sciatic artery (PSA) is a rare congenital peripheral artery disorder that is usually detected incidentally on computed tomographic examination. PSA can also cause iliac aneurysm and acute thromboembolism, which are potentially associated with rest pain, claudication, and limb-threatening ischemia. Patients with PSA and leg ischemia should be treated with revascularization and appropriate management of PSA aneurysm. The authors often choose emergent bypass surgery or endovascular intervention for aneurysmal rupture and acute lower-extremity arterial occlusion. This report describes an emergency procedure using catheter-based thrombolysis for acute limb ischemia in a patient with PSA.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"44"},"PeriodicalIF":0.9,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/69/vsi-38-44.PMC9826739.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10547403","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":"Debates on Surgical Ethics for Young Vascular Surgeons.","authors":"Seung-Kee Min","doi":"10.5758/vsi.223841","DOIUrl":"https://doi.org/10.5758/vsi.223841","url":null,"abstract":"During a recent semester at the Seoul National University (SNU) Graduate School, I developed a new lecture series titled “Debates on surgical ethics” for postgraduates majoring in Surgery. I am not a specialist in surgical ethics, but I am very interested in education and ethics, and enjoy reading the articles published in the section “Surgical Ethics Challenges” in the Journal of Vascular Surgery (JVS), edited by Dr. James W. Jones [1,2]. Therefore, I designed a practical lecture series for young surgeons to introduce many ethical issues encountered in daily practice, discuss personal experiences and ideas on specific issues, and uncover hidden ethical problems in the surgical field. The lecture plan describes the course as follows: “Surgical techniques and devices have been rapidly developing and advancing in recent years. However, current medical ethics cannot address the delicate issues that arise with novel advanced surgical treatments. We aim to collect data on modern surgical ethics involved in various clinical scenarios and discuss the pros and cons of each topic. These debates will clarify the concept of future surgical ethics and help develop guidelines for surgical ethics. After providing the related texts and materials, debates will be held by students in the roles of moderator and those arguing for the pros and cons of a particular viewpoint, under the supervision of a facilitator professor.” The lecture series was held every Thursday afternoon and included various ethical issues with the following titles: 1) Surgical ethics concerning endovenous varicose vein (VV) treatment; 2) Turf war: Ethics of professional territorialism; 3) Surgical tourism; 4) Ethics of live surgery demo or broadcast; 5) They decide who lives and who dies; 6) Ethics of organ donation and transplantation; 7) Industry and surgical innovation; 8) Ethical price of stardom and show doctors; 9) Operative over-scheduling; 10) The question of an impaired surgeon dilemma; 11) Discovering over-treatment; 12) Who should protect the public against bad doctors?; 13) Refusal of life-saving treatment in the aged; and 14) Ethical problems specific to surgery. Many of the titles were benchmarked based on the JVS Surgical Ethical Challenges and other articles [3,4]. However, only eight students enrolled in the class. I changed the roles of the presenter of a specific issue allowing for free discussion with the participants, and every student was encouraged to speak about their experiences and ideas on that issue. We enjoyed the weekly Thursday meetings more than expected. Similar to the film “Tuesdays with Morrie”, I enjoyed every “Thursday with surgical ethics students” for the last four months. After the final class, I conducted an anonymous survey on the lecture course, and most postgraduate students gave positive feedback. One student wrote “Thanks to the materials provided, I discovered something new in the field of ethics. In particular, for the first time, I read an inte","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"36"},"PeriodicalIF":0.9,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/49/b3/vsi-38-36.PMC9808493.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10512756","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":"Ultrasound Elastography to Differentiate the Thrombus and Plaque in Peripheral Arterial Diseases.","authors":"Ki Duk Kim,&nbsp;Hyangkyoung Kim,&nbsp;Sungsin Cho,&nbsp;Seung Hwan Lee,&nbsp;Jin Hyun Joh","doi":"10.5758/vsi.220046","DOIUrl":"https://doi.org/10.5758/vsi.220046","url":null,"abstract":"<p><strong>Purpose: </strong>Arterial stiffness and steno-occlusion of the lower-extremity can result from many vascular lesions, including acute thromboembolisms, soft plaques, calcified plaques, or inflammatory disease. Ultrasound (US) elastography measures the tissue deformation response to compression and displays tissue stiffness. This study aimed to evaluate the characteristics of arterial lesions in the lower extremities using US elastography.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed the data of 20 patients who visited our institute for arterial disease treatment between May 2016 and November 2017. An US examination with B-mode and strain elastography (SE) was performed of four different lesion types at 45 sites: acute and subacute thromboembolisms, soft plaques, calcified plaques, and thromboangiitis obliterans lesions (TAOs). During SE, stress was externally applied by the operator using the transducer. Strain ratio (SR) was calculated as the fraction of the average strain in the reference area divided by the average strain in the lesion. The SR was compared among different lesion types, with the accompanying vein as the reference region of interest.</p><p><strong>Results: </strong>The strain was highest in the soft plaques (0.63%±0.23%), followed by the TAOs (0.45%±0.11%), calcified plaques (0.44%±0.13%), and acute thromboembolisms (0.34%±0.23%), which were statistically significant (P=0.026). However, the mean SR was highest for the calcified plaques (2.33%±0.80%), followed by the TAOs (1.63%±0.40%), acute thromboembolisms (1.60%±0.48%), and soft plaques (1.51±0.39), and which were statistically significant (P=0.013).</p><p><strong>Conclusion: </strong>Despite several limitations, vascular elastography may be useful for differentiating between lesion types in peripheral arterial disease.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"34"},"PeriodicalIF":0.9,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/af/5e/vsi-38-34.PMC9794493.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10559189","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 Isolated Endarterectomy and Patch Angioplasty of the Common Femoral Artery According to Current Inclusion Criteria for Endovascular Treatment.","authors":"Suehyun Park,&nbsp;Taewan Ku,&nbsp;Deokbi Hwang,&nbsp;Woo-Sung Yun,&nbsp;Hyung-Kee Kim,&nbsp;Seung Huh","doi":"10.5758/vsi.220040","DOIUrl":"https://doi.org/10.5758/vsi.220040","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the outcomes of isolated common femoral endarterectomy with patch angioplasty (IFEA) in the endovascular era.</p><p><strong>Materials and methods: </strong>In 2012-2022, 189 limbs underwent femoral endarterectomy with patch angioplasty. Of them, 45 IFEAs were included. We evaluated safety based on early complications; efficacy with primary patency (PP) and reintervention, above-ankle amputation, or stenosis (RAS)-free survival. We also evaluated lesion characteristics and outcomes according to the inclusion criteria (IC) of vascular mimetic implant-common femoral artery (VMI-CFA) stenting trial.</p><p><strong>Results: </strong>Forty-one patients were male, and 30 IFEAs were required for claudication. No cases of early mortality occurred. Ten limbs (22%) developed local/nonvascular complications (hematoma, 3; lymphocele, 5; wound infection, 2), of which 8 resolved spontaneously. The overall PP and secondary patency rates were 100% at 1 year and 87% and 97% at 3 years, respectively. Twenty-one lesions (47%) did not meet the IC. The PP within the IC was 100% at 1 and 3 years, and the PP outside the IC was 100% at 1 year and 73% at 3 years (P=0.068). The overall RAS-free survival rates were 91% at 1 year and 81% at 3 years. All cases of RAS occurred in lesions outside the IC. The multivariate analysis showed that dialysis was associated with poor RAS-free survival (adjusted odds ratio, 8.56; 95% confidence interval, 1.9-35.5; P=0.005).</p><p><strong>Conclusion: </strong>The recent VMI-CFA trial results should be interpreted with caution. IFEA is a low-risk and durable procedure; however, careful follow-up is warranted in patients undergoing dialysis.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"32"},"PeriodicalIF":0.9,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dd/01/vsi-38-32.PMC9794491.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10535046","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":"Characteristics and Effect of Rivaroxaban on Venous Thromboembolism in Korean Patients Compared to Western Population: A Subgroup Analysis from XALIA(-LEA) Study.","authors":"Seung-Kee Min,&nbsp;Ji-Sun Kim,&nbsp;Jang Yong Kim,&nbsp;Ui Jun Park,&nbsp;Taehoon Lee,&nbsp;Jin Mo Kang,&nbsp;Sun Cheol Park,&nbsp;Won-Il Choi,&nbsp;Ki-Hyuk Park,&nbsp;Martin Gebel","doi":"10.5758/vsi.220039","DOIUrl":"https://doi.org/10.5758/vsi.220039","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare the characteristics of venous thromboembolic disease (VTE) in Korean to Caucasian population.</p><p><strong>Materials and methods: </strong>XALIA-LEA and XALIA were phase IV non-interventional prospective studies with identical designs that investigated the effect of rivaroxaban versus standard anticoagulation for VTE. Koreans accounted for the largest proportion of the overall enrolled population of XALIA-LEA. However, in the XALIA study, most patients were Caucasian. Therefore, Korean data from XALIA-LEA and Caucasian data from XALIA were used in this study. This study compared the clinical characteristics and primary outcomes of the XALIA program, including major bleeding, recurrent VTE, and all-cause mortality.</p><p><strong>Results: </strong>The Korean population was older, was less obese, and had more active cancer at baseline than the Caucasian population. Provoked VTE was more common in the Korean population. Interestingly, Koreans showed less accompanying thrombophilia than Caucasians, and factor V Leiden mutations were not detected. Korean analyses comparing the effects of rivaroxaban and standard anticoagulation with primary outcomes showed a lower incidence of major bleeding, recurrent VTE, and all-cause mortality with rivaroxaban. Similar results were obtained in the propensity score matching analysis.</p><p><strong>Conclusion: </strong>Characteristic differences were found between Korean and Caucasian VTE patients. Despite these ethnic differences, the effectiveness and safety of rivaroxaban therapy in these patients were consistent.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"33"},"PeriodicalIF":0.9,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10445312","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":"Repeated Pseudoaneurysm after Endovascular Repair of Popliteal Aneurysm due to Graft Disintegration and Fabric Tear.","authors":"Min-Kyu Kim,&nbsp;Jun-Gon Kim,&nbsp;Cho-Shin Kim,&nbsp;Kwang-Bo Park,&nbsp;Shin-Seok Yang,&nbsp;Yang-Jin Park","doi":"10.5758/vsi.220035","DOIUrl":"https://doi.org/10.5758/vsi.220035","url":null,"abstract":"<p><p>Endovascular repair of popliteal artery aneurysms (PAA) using a stent graft is suitable for patients with favorable anatomy. In the domestic situation where Gore Medical withdrew, we report two cases of unusual complications of pseudoaneurysm after endovascular repair of PAA. A 44-year-old male with a history of bypass surgery for a PAA presented with recurrent vein graft pseudoaneurysm. Endovascular treatment using a domestic stent graft was performed. However, pseudoaneurysm developed due to the graft fabric tear 1 month later, requiring surgical removal. In another case, an 84-year-old female presented with acute limb ischemia related to PAA. Endovascular aneurysm repair with the same domestic stent graft was performed. However, stent graft failure occurred 2 years later and the patient underwent open surgical repair. There was a graft fabric disintegration. When proper endovascular device is not available, open surgical treatment is the best option for treating PAA.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"38 ","pages":"31"},"PeriodicalIF":0.9,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/f9/vsi-38-31.PMC9745565.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10390491","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}