Vascular Specialist International最新文献

{"title":"Endovascular Management of Renal Artery Pseudoaneurysm in Autosomal Dominant Polycystic Kidney Disease: A Case Report.","authors":"Garima Sharma, Hira Lal, Narayan Prasad","doi":"10.5758/vsi.240031","DOIUrl":"https://doi.org/10.5758/vsi.240031","url":null,"abstract":"<p><p>Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary kidney diseases. In addition to renal involvement, vascular complications including intracranial arterial, aortic aneurysms and dissections are common in these patients. We report the case of a 35-year-old male patient with ADPKD who presented with hematuria and was diagnosed with two intrarenal arterial pseudoaneurysms. Endovascular embolization using coils was performed to resolve these symptoms. Vascular complications are often encountered in patients with ADPKD; hence, sufficient clinical suspicion and timely diagnosis can help manage the disease. The most common causes of hematuria in ADPKD patients are cyst hemorrhage or infection; however, vascular aneurysms should also be considered a possibility.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"36"},"PeriodicalIF":0.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11474459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480505","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":"Effectiveness of Atherectomy and Drug-Coated Balloon Angioplasty in Femoropopliteal Disease: A Comprehensive Outcome Study.","authors":"Hyeon Ju Kim, Deokbi Hwang, Woo-Sung Yun, Seung Huh, Hyung-Kee Kim","doi":"10.5758/vsi.240071","DOIUrl":"10.5758/vsi.240071","url":null,"abstract":"<p><strong>Purpose: </strong>Atherectomy has been reintroduced for debulking calcified atheroma to enhance the efficacy of drug-coated balloons (DCBs); however, its efficacy in severe calcification and related outcomes have not been fully evaluated. This study aimed to evaluate the outcomes of atherectomy and DCB angioplasty for treating femoropopliteal occlusive disease (FPOD).</p><p><strong>Materials and methods: </strong>From 2014 to July 2022, 85 limbs in 76 patients with FPOD underwent atherectomy with DCB angioplasty. We evaluated the efficacy of this procedure using primary patency (PP) and clinically driven target lesion revascularization (CD-TLR)-free survival. PP was defined as the duration of uninterrupted patency without occlusion or a peak systolic velocity ratio more than 2.5 at the target lesion. Lesion calcification was evaluated according to Peripheral Arterial Calcium Scoring System, and Grade 4 was classified as severe.</p><p><strong>Results: </strong>Seventy-one (84%) cases were male, and 56 limbs (66%) were treated for claudication. Rotational and directional atherectomies were performed in 62 (73%) and 23 limbs, respectively. The improvement in the median ankle-brachial index was 0.36 (interquartile range, 0.25-0.48). Median follow-up duration was 19.4 months. The overall PP and CD-TLR-free survival rates were 77% and 93% at 1 year and 64% and 83% at 2 years, respectively. On multivariable analysis, female sex (adjusted hazard ratio [aHR], 3.77; 95% confidence interval (CI), 1.30-10.87, P=0.014), dialysis (aHR, 4.35; 95% CI, 1.33-13.22, P=0.015), and severe calcification (aHR, 2.42; 95% CI, 1.07-5.46, P=0.033) were independent risk factors for poor PP. Dialysis (aHR, 11.07; 95% CI, 3.72-32.92, P<0.001) and severe calcification (aHR, 3.19; 95% CI, 1.15-8.84, P=0.026) were identified as independent risk factors for CD-TLR.</p><p><strong>Conclusion: </strong>Atherectomy with DCB angioplasty for FPOD did not work well in female patients, patients with lesions with severe calcification, and patients undergoing dialysis. Therefore, careful monitoring of these patients is crucial for patency loss and the requirement for revascularization. Additionally, for these patients requiring revascularization, surgical bypass may be appropriate for suitable candidates; whereas more proactive conservative management may be justified for claudicants.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"34"},"PeriodicalIF":0.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373555","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 Treatment Failure after Stenting and Percutaneous Aspiration for Adventitial Cystic Disease in the Popliteal Artery: A Follow-up Case Report.","authors":"Jisun Lee, Seung-Kee Min","doi":"10.5758/vsi.240070","DOIUrl":"10.5758/vsi.240070","url":null,"abstract":"<p><p>Adventitial cystic disease (ACD), a rare vascular disease characterized by mucus accumulation in the adventitia of blood vessels, typically affects the popliteal artery. We present the case of a 61-year-old female diagnosed with ACD in 2018 who was initially treated with endovascular stenting and percutaneous aspiration of the cyst. The patient, who had been asymptomatic for 5 years, developed a stent fracture and pseudoaneurysm requiring surgical intervention. Despite initial successful treatment, complications such as stent fracture and recurrence can occur; therefore, surgical treatment is recommended to optimize outcomes in patients with ACD. Endovascular treatment and cyst aspiration should only be considered in cases with high surgical risk. After treatment, long-term follow-up and individualized management strategies are important to monitor ACD recurrence.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"33"},"PeriodicalIF":0.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373556","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":"When Anticoagulation Backfires - Heparin-Induced Thrombocytopenia and Acute Stent Thrombosis following Endovascular Therapy for Deep Vein Thrombosis: A Case Report.","authors":"Aman Kumar, Ankush Ankush, Jitender Sharma","doi":"10.5758/vsi.240065","DOIUrl":"10.5758/vsi.240065","url":null,"abstract":"<p><p>We report a rare case of heparin-induced thrombocytopenia with thrombosis (HITT) following treatment for May-Thurner syndrome complicated by deep vein thrombosis (DVT), which resulted in venous stent thrombosis. A 27-year-old male with acute left lower-limb DVT successfully underwent thrombolysis and stenting for May-Thurner syndrome. However, the patient developed recurrent thrombosis and thrombocytopenia 3 days post-procedure. HITT was confirmed by a positive antiplatelet factor 4-heparin antibody test. After discontinuing heparin, the patient was successfully treated with fondaparinux, followed by repeat thrombectomy and thrombolysis, and then transitioned to warfarin. This is the second reported case of venous stent thrombosis due to HITT in May-Thurner syndrome. This case underscores the importance of early recognition and prompt management of HITT using alternative anticoagulants like fondaparinux to prevent complications such as venous limb gangrene. Further randomized controlled trials are required to evaluate the safety and efficacy of fondaparinux in HITT.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"35"},"PeriodicalIF":0.8,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373557","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 versus Open Surgical Repair for Isolated Iliac Artery Aneurysms.","authors":"Eol Choi, Tae Won Kwon","doi":"10.5758/vsi.240041","DOIUrl":"https://doi.org/10.5758/vsi.240041","url":null,"abstract":"<p><strong>Purpose: </strong>Endovascular treatment (EVT) has been shown to be effective and safe for isolated iliac artery aneurysms (IAAs). However, concerns remain regarding the lack of consideration to recent advances in perioperative care and surgical techniques, as well as a significant number of re-interventions with EVT. This study compares the outcomes of open surgical repair (OSR) and EVT using recent clinical data.</p><p><strong>Materials and methods: </strong>This retrospective, single-center study included patients who underwent OSR or EVT for isolated degenerative IAAs between January 2007 and December 2018. Primary outcomes were procedure time, number of transfusions during admission, length of hospital stay, complications, and number of preserved internal iliac arteries. Secondary outcomes included all-cause and aneurysm-related mortality, and re-intervention rates.</p><p><strong>Results: </strong>Fifty-eight consecutive patients underwent treatment for isolated IAAs (25 underwent OSR and 33 underwent EVT), with a median follow-up of 75 months (range: 39-133 months). Baseline characteristics were similar between the groups, except for a lower mean age in the OSR group than in the EVT group (66.0±8.2 vs. 73.1±8.6, P=0.003). Both groups had a mild risk of comorbidity severity score. Early complications (within 30 days of the procedure) occurred more frequently in the OSR group, though not statistically significant (24.0% vs. 6.1%, P=0.07). Late complications, including sac expansion and thrombotic occlusion, were significantly more common in the EVT group (15.2% vs. 0%, P=0.04). Re-intervention rate was higher in the EVT group but not statistically significant (9.1% vs. 4.0%, P=0.44). No significant differences were observed in major adverse cardiovascular events and mortality between the groups (P=0.66 and P=0.27), and there were no aneurysm-related deaths.</p><p><strong>Conclusion: </strong>For patients with mild risk factors, EVT does not offer a survival or re-intervention advantages over OSR in the treatment of isolated IAAs. However, EVT is associated with an increased risk of late complications. Although larger randomized studies are necessary, OSR may be considered the first-line treatment for isolated IAAs in younger and mild-risk patients.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"31"},"PeriodicalIF":0.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332130","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":"May-Thurner Syndrome and Malignancy-Associated Deep Venous Thrombosis: A Case of Successful Treatment with Endovascular Therapy.","authors":"Chang Sik Shin, Ji-Il Kim, Kwon Cheol Yoo","doi":"10.5758/vsi.240045","DOIUrl":"https://doi.org/10.5758/vsi.240045","url":null,"abstract":"<p><p>In May-Thurner syndrome (MTS), the left iliac vein is compressed by the right iliac artery, leading to restricted blood flow from the leg to the heart. MTS commonly manifests in young females; however, its occurrence in older adults necessitates verifying the possibility of malignancy. A 77-year-old female experienced leg swelling and discomfort for 1 week. Computed tomography angiography suggested extensive thrombosis in the left iliac vein. Despite heparin treatment, the thrombus persisted and required mechanical thrombectomy, balloon venoplasty, and stent placement for tight iliac vein stenosis. The procedure was successful; however a biopsy of thrombus revealed malignant cells. An underlying malignancy and a hypercoagulable state were identified as the contributing factors after further evaluations. This case underscores the importance for vigilant diagnosis of hypercoagulable conditions and malignancies in MTS, emphasizing the role of malignancy in the development of DVT and MTS.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"32"},"PeriodicalIF":0.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332131","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":"Spontaneous Isolated Superior Mesenteric Arterial Dissection Treated with a Coronary Covered Stent: A Case Report.","authors":"Felix De Bruyn, Hendrik Verelst, Hozan Mufty, Geert Maleux","doi":"10.5758/vsi.240072","DOIUrl":"https://doi.org/10.5758/vsi.240072","url":null,"abstract":"<p><p>Spontaneous isolated dissection of the superior mesenteric artery is rare with a wide spectrum of clinical symptoms. The management of isolated dissections mainly depends on the clinical symptomatology and imaging presentation. This case report describes a 51-year-old male presenting with persistent abdominal pain. Computed tomography angiography revealed an isolated superior mesenteric arterial dissection associated with severe true lumen stenosis and thrombosed false lumen with an ulcer-like projection. Definitive treatment was performed with a coronary covered stent to reopen the true lumen and completely exclude the false lumen.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"30"},"PeriodicalIF":0.8,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332132","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":"Blunt Trauma-Induced Lymphocele in the Groin - An Uncommon Complication and Management Considerations: A Case Report.","authors":"Thilina Gunawardena","doi":"10.5758/vsi.240052","DOIUrl":"10.5758/vsi.240052","url":null,"abstract":"<p><p>Lymphoceles are common complications after certain surgical procedures. Blunt trauma can occasionally result in similar lymph accumulation. Herein, we present the rare case of a patient who developed a lymphocele in his right groin following a blunt trauma from a fallen tree branch. Aspiration and sclerotherapy were unsuccessful, and the lesion ultimately required surgical excision. Lymphoceles should be considered a rare differential diagnosis for post-traumatic cystic swelling, and their management should follow similar guidelines to those used for post-surgical lymphocele management.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"29"},"PeriodicalIF":0.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300570","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":"Three Cases of Intracardiac Leiomyomatosis with Very Long-term Follow-up.","authors":"Mauricio Gonzalez-Urquijo, Francisco Valdes, Renato Mertens, Leopoldo Mariné, Jose Francisco Vargas, Michel Bergoeing","doi":"10.5758/vsi.240048","DOIUrl":"https://doi.org/10.5758/vsi.240048","url":null,"abstract":"<p><p>Uterine intravascular leiomyomatosis (IVL) with extension into the right heart is uncommon, with no more than 400 cases reported in the literature since 1907. The present study aims to report three patients with intracardiac IVL surgically treated in our institution, with long-term follow-up. Three female patients in their third to fifth decades of life, with a history of difficult hysterectomy due to extensive myomatosis, presented with symptoms of right-sided heart failure. Echocardiography and computed tomography were performed, where IVL extending from the pelvis into the right heart was observed. All three patients underwent a one-stage operation under extracorporeal circulation through a right auriculotomy and inferior vena cavotomy, accessed via a sterno-laparotomy. The tumors were extirpated without complications, with ligation of the vena cava or iliac vein. The patients at 10-, 13-, and 37-year follow-up were well and alive with mild lower extremities symptoms.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"28"},"PeriodicalIF":0.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11391265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300571","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":"Mid-term Outcomes of Thoracic Endovascular Aortic Repair (TEVAR) in Acute Complicated Type B Aortic Dissection: A Comprehensive Analysis of Aortic Remodeling Patterns.","authors":"Supong Worathanmanon, Pong Juntarapatin, Boonprasit Kritpracha, Wittawat Tantarattanapong, Dhanakom Premprapha, Sorracha Rookkapan","doi":"10.5758/vsi.240029","DOIUrl":"10.5758/vsi.240029","url":null,"abstract":"<p><strong>Purpose: </strong>This study provides a comprehensive analysis of the clinical outcomes associated with endovascular treatment for acute complicated type B aortic dissection, with a focus on the complex process of aortic remodeling.</p><p><strong>Materials and methods: </strong>We conducted a retrospective investigation using data extracted from the Songklanagarind Hospital database between January 2010 and January 2022. Electronic medical records of patients who underwent thoracic endovascular aortic repair (TEVAR) for acute complicated type B aortic dissections were reviewed. The analysis focused on in-hospital outcomes, overall survival, aorta-related survival, reintervention-free survival, and changes in aortic lumen diameter to assess aortic remodeling.</p><p><strong>Results: </strong>Over the study period, 32 patients with acute complicated type B aortic dissections underwent TEVAR. The in-hospital mortality rate was 9.4%, with complications occurring in 21.9% of patients. Temporary acute kidney injury was observed in 9.4% of the cases, wound bleeding in 6.3%, pneumonia in 6.3%, and permanent spinal cord ischemia in 3.1%. Re-intervention was necessary in 6.3% of cases. The overall survival rates at 6 months, 1 year, 3 years, and 6 years were 78%, 75%, 65%, and 44%, respectively. Aorta-related survival rates were 87%, 87%, 83%, and 75% at the corresponding time intervals. The reintervention-free survival rates were 96%, 96%, 71%, and 71%, respectively. Survival analysis revealed that patients with ideal aortic remodeling experienced the most favorable outcomes, whereas those with undesirable aortic remodeling exhibited the least favorable survival. Notably, undesirable pattern of aortic remodeling emerged as a singular factor with a statistically significant influence on predicting survival (hazard ratio 4.37, P-value=0.021).</p><p><strong>Conclusion: </strong>TEVAR resulted in favorable aorta-related survival outcomes. Notably, the identification of changes in aortic lumen diameter alongside false lumen thrombosis, encapsulated within the framework of aortic remodeling patterns, has emerged as a robust predictor of post-TEVAR survival outcomes.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"27"},"PeriodicalIF":0.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057313","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}