Vascular Specialist International最新文献

{"title":"Raynaud's Phenomenon: A Current Update on Pathogenesis, Diagnostic Workup, and Treatment.","authors":"Hirut Yadeta Ture, Nan Young Lee, Na Ri Kim, Eon Jeong Nam","doi":"10.5758/vsi.240047","DOIUrl":"10.5758/vsi.240047","url":null,"abstract":"<p><p>Raynaud's phenomenon (RP) is a condition characterized by episodic, excessive vasoconstriction in the fingers and toes, triggered by cold or stress. This leads to a distinctive sequence of color changes in the digits. Pallor indicates reduced blood flow due to oxygen deprivation, while erythema appears as reperfusion. RP can be primary, with no identifiable underlying cause, or secondary, associated with other conditions. These conditions include autoimmune diseases, most commonly systemic sclerosis, vascular diseases; and neurological conditions. While the exact cause of RP remains unclear, genetic and hormonal (estrogen) factors are likely contributors. The pathogenesis of RP involves a complex interaction between the vascular wall, nerves, hormones, and humoral factors, disrupting the balance between vasoconstriction and vasodilation. In primary RP, the vascular abnormalities are primarily functional. However, in secondary RP, both functional and structural components occur in blood vessels. This explains why digital tissue damage frequently occurs in secondary RP but not primary RP. Diagnosis of RP is primarily clinical. Recent advancements in imaging techniques have aided in diagnosis and monitoring, but nail fold capillaroscopy remains the gold standard for distinguishing between primary and secondary RP. If there are signs of acute ischemic injury, vascular imaging, particularly preoperatively, is crucial to rule out other vaso-occlusive conditions. Management of RP focuses on alleviating symptoms and preventing tissue damage. Vasodilator medications are the first-line treatment when general measures like warmth and stress management are not sufficient. Dihydropyridine calcium channel blockers (CCBs), such as nifedipine, are commonly used for vasodilation. Phosphodiesterase-5 inhibitors and prostaglandin analogs are alternative options for patients who do not respond to CCBs or have ischemic tissue damage. Bosentan, an endothelin-1 receptor antagonist, has shown effectiveness in treating and preventing digital ulcers, especially in patients with multiple ulcers. For severe cases, botulinum toxin injections or sympathectomy surgery can be used to control RP symptoms. However, botulinum toxin injections require repeated administration, and sympathectomy's long-term effectiveness is uncertain. Fat grafting is a promising surgical therapy for promoting healing and preventing tissue injury.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"26"},"PeriodicalIF":0.8,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11266082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749648","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 Removal of a Long-Forgotten, Retained Intravascular Foreign Body: A Case Report and Literature Review.","authors":"Dimitrios A Chatzelas, Apostolos G Pitoulias, Georgios V Tsamourlidis, Theodosia N Zampaka, Vasiliki-Elisavet P Stratinaki, Ioanna I Kiose, Anastasios G Potouridis, Maria D Tachtsi, Georgios A Pitoulias","doi":"10.5758/vsi.240037","DOIUrl":"10.5758/vsi.240037","url":null,"abstract":"<p><p>Intravascular foreign body embolization is a potential complication of any vascular operation. Placement of a central venous catheter (CVC) is a common procedure, especially during surgery, hemodialysis, or in critically ill patients. The complete loss of the introducing guidewire into the circulation is a rare complication, with the majority of cases identified immediately or shortly after the procedure. We report an unusual case of an 82-year-old male with a misplaced CVC guidewire, extending from the right common femoral vein (CFV) to the superior vena cava, that was found incidentally 2 years after internal jugular vein cannulation during colorectal surgery. The patient was asymptomatic at the time, without any signs of deep vein thrombosis or post-thrombotic syndrome. Surgical extraction of the guidewire was successfully performed, under local anesthesia, through venotomy of the right CFV. Proper education and advanced awareness are advised in order to minimize the risk of this avoidable complication.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"25"},"PeriodicalIF":0.8,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11252483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629267","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":"Single Tract Aortic Revascularization Technique in the Treatment of Aortoiliac Occlusive Disease.","authors":"Sungsin Cho, Se Jun Kim, Jin Hyun Joh","doi":"10.5758/vsi.240033","DOIUrl":"https://doi.org/10.5758/vsi.240033","url":null,"abstract":"<p><p>Endovascular treatment is an acceptable option for patients with aortoiliac occlusive disease. However, bilateral passage of guidewires through the aortoiliac occlusion can be a challenging step in achieving successful revascularization. The aim of this article is to present a novel strategy for successfully passing bilateral guidewires through long aortoiliac occlusive lesions. After one guidewire is passed through the aortic and iliac lesions via one side of the femoral artery, the other guidewire is passed using the up-and-over technique and pulled out from the ipsilateral side of the body. This contralateral guidewire is then inserted into the ipsilateral angiographic catheter along with the ipsilateral guidewire. Subsequently, the angiographic catheter is removed in a manner similar to a peel-away sheath. Eventually, bilateral guidewires can be passed through the lesion via a single aortic tract.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"24"},"PeriodicalIF":0.8,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11211738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472444","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 Pseudoaneurysm as a Delayed Complication after Using Rotational Atherectomy in Popliteal Artery Atherosclerosis: A Case Report.","authors":"Je Hyung Park, Sang Su Lee","doi":"10.5758/vsi.240046","DOIUrl":"10.5758/vsi.240046","url":null,"abstract":"<p><p>Although intravascular atherectomy is widely used for debulking calcified atheromas in peripheral arterial disease, it is associated with complications. Delayed rupture with pseudoaneurysm formation is rare. We report the case of a 73-year-old man who developed a 24 mm×20 mm×27 mm popliteal artery (PA) pseudoaneurysm after rotational atherectomy. Initially, the patient presented with intermittent claudication. Preoperative computed tomographic angiography (CTA) showed a severely calcified atheroma in the PA. Rotational atherectomy was performed using the Jetstream™ device (Boston Scientific). Postoperatively, the ankle-brachial index and symptoms improved. However, 6 days after the atherectomy, the patient complained of calf pain and swelling. Follow-up CTA revealed a pseudoaneurysm and hematoma in the popliteal fossa. Open conversion with removal of the heavily calcified plaque and patch angioplasty were performed via the posterior approach. Delayed PA rupture and pseudoaneurysm formation after rotational atherectomy are rare; however, they require prompt management.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"23"},"PeriodicalIF":0.8,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11199937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452106","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":"Vacuum-Assisted Thrombo-Aspiration for Paradoxical Embolism in Left Renal Artery: A Case Report and Literature Review.","authors":"Dimitrios Diamantopoulos-Kogkas, Pavlos Georgiou, Christos Pitros, Chrysanthi Papageorgopoulou, Marios Papasotiriou, Nikolaos Karydis, Nikolaos Koutsoyiannis, Athina Mougiou, Konstantinos Katsanos, Spyros Papadoulas","doi":"10.5758/vsi.240022","DOIUrl":"10.5758/vsi.240022","url":null,"abstract":"<p><p>Paradoxical embolism through the foramen ovale is a rare and devastating event requiring urgent treatment. Herein, we present the case of a 23-year-old male who presented with a pulmonary embolism complicated by a left renal artery paradoxical embolism. Urgent vacuum-assisted thrombo-aspiration restored normal perfusion of the left kidney within 5 hours. The patient had a patent foramen ovale and heterozygous thrombophilia. However, a radioisotopic scan performed 2 years later revealed an unexpected decrease in left renal perfusion. Therefore, despite the angiographic success, functional evaluation using a renal scan should be performed to assess renal function.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"21"},"PeriodicalIF":0.8,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447590","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":"A Rare and Dangerous Combination of COVID-19, Lemierre Syndrome, and Carotid Pseudoaneurysm: A Case Report.","authors":"Panagitsa Christoforou, Costas Constantinou, Christos Kounnos, Konstantinos Kapoulas, Marios Salloumis, Georgios Pantelas, Linos Hadjihannas","doi":"10.5758/vsi.240025","DOIUrl":"10.5758/vsi.240025","url":null,"abstract":"<p><p>Lemierre syndrome is a rare complication of oropharyngeal infection that causes septic thrombophlebitis in the internal jugular vein. Since the onset of the COVID-19 pandemic, this condition has been dangerously overlooked and poses an even greater threat when complicated by vascular pathologies. A case is presented where the patient required emergency endovascular exclusion of a right internal carotid artery pseudoaneurysm due to Lemierre syndrome. The treatment included stent graft placement and drainage of a neck abscess, along with appropriate antibiotic treatment during hospitalization. Recognizing this diagnosis requires a high index of suspicion, particularly during the COVID-19 pandemic. The complexity of the disease necessitates extensive multidisciplinary collaboration for effective treatment.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"22"},"PeriodicalIF":0.8,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447589","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":"CORRIGENDUM: Simultaneous Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm Combined with Saccular Thoracic Aortic Aneurysm.","authors":"Minju Kim, Jeong Hee Han, Dae Hwan Kim, Myunghee Yoon, Hyuk Jae Jung","doi":"10.5758/vsi.230075.e","DOIUrl":"10.5758/vsi.230075.e","url":null,"abstract":"","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"20"},"PeriodicalIF":0.9,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421856","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":"Predisposing Anatomy for Thoracic Outlet Syndrome and Functional Outcomes after Supraclavicular Thoracic Outlet Decompression in Athletes.","authors":"David Jiang, Robert Weiss, Benjamin Lind, Omar Morcos, Cheong Jun Lee","doi":"10.5758/vsi.240011","DOIUrl":"10.5758/vsi.240011","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to examine predisposing anatomic factors and subsequent post-decompression functional outcomes among high-intensity athletes with thoracic outlet syndrome (TOS).</p><p><strong>Materials and methods: </strong>A single-institution retrospective review was performed on a prospective database of patients with TOS from 2018 to 2023 who had undergone operative decompression for TOS. Demographics, TOS characteristics, predisposing anatomy, operative details, and postoperative outcomes were examined. The primary outcome was postoperative return to sport. Secondary outcomes included vascular patency.</p><p><strong>Results: </strong>A total of 13 patients who were engaged in high-demand athletic activity at the time of their diagnosis were included. Diagnoses included 8 (62%) patients with venous TOS, 4 (31%) patients with neurogenic TOS, and 1 (8%) patient with arterial TOS. Mixed vascular and neurogenic TOS was observed in 3 (23%) patients. The mean age of the cohort was 30 years. Abnormal scalene structure was observed in 12 (92%) patients, and abnormal bone structures were noted in 4 (27%) patients; 2 (15%) with cervical ribs and 3 (23%) patients with clavicular abnormalities. Prior ipsilateral upper extremity trauma was reported in 4 (27%) patients. Significant joint hypermobility was observed in 8 (62%) patients with a median Beighton score of 6. Supraclavicular cervical and/or first rib resection with scalenectomy was performed in all patients. One case of postoperative pneumothorax was treated non-operatively. Ten (77%) patients returned to sport. Duplex ultrasonography showed subclavian vein patency in all 8 patients with venous TOS and wide patency with no drop in perfusion indices in the patient with arterial TOS.</p><p><strong>Conclusion: </strong>Athletes with TOS who required operative intervention had a high incidence of musculoskeletal aberrations and joint hypermobility. Supraclavicular decompression was associated with a high success rate, with overall good functional outcomes and good likelihood of patients returning to preoperative high-intensity athletics.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"19"},"PeriodicalIF":0.9,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302010","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":"Splenic Arterial Embolization for Trauma and Beyond: A Case Series.","authors":"Chun Hin Choy, Yat Sing Lee, Pui Lam Cheung, Cheuk Him Ho, Jimmy Chi Wai Siu","doi":"10.5758/vsi.240030","DOIUrl":"10.5758/vsi.240030","url":null,"abstract":"<p><p>Splenic artery embolization plays an important role in the management of various medical and surgical conditions that are non-traumatic in etiology, in addition to its well-established and widely discussed role in managing splenic trauma. In nontraumatic emergencies of catastrophic bleeding originating from the spleen or splenic artery, splenic artery embolization can be effective in achieving hemostasis as a definitive management, temporary stabilizing measure, or preoperative optimization technique. In addition to emergency clinical conditions, splenic artery embolization can be performed electively as an alternative to splenectomy for managing patients with hypersplenism. Herein, we report 6 cases of splenic artery embolization performed at our center to highlight its various indications. This article aims to demonstrate the role of splenic artery embolization in different clinical scenarios and the considerations behind the techniques employed through illustrative cases.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"18"},"PeriodicalIF":0.9,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11157332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285382","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":"Midterm Clinical Outcomes of Endovascular Treatment for Acute Aortic Dissection with Malperfusion Syndrome.","authors":"La Eun Kim, Jong Ha Park, Han Cheol Lee, Mi Ju Bae, Ji Hoon You","doi":"10.5758/vsi.240006","DOIUrl":"10.5758/vsi.240006","url":null,"abstract":"<p><strong>Purpose: </strong>There is limited data on the midterm results of endovascular treatment for acute type B aortic dissection (TBAD) with malperfusion syndrome (MS), particularly in Asia. This study aimed to investigate the clinical outcomes of endovascular treatment of acute TBAD with MS.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 27 patients who underwent endovascular treatment for acute TBAD with MS.</p><p><strong>Results: </strong>Among the 27 patients with TBAD and MS, malperfusion was observed in the isolated renal (44.4%), visceral (7.4%) and iliofemoral (25.9%) arteries, as well as their combinations (22.2%). The patients underwent thoracic endovascular aortic repair (TEVAR) only (25.9%), selective stenting only in arteries affected by malperfusion (22.2%), or combined treatment with TEVAR and selective stenting (51.9%). Primary technical success was achieved in all the patients. No inhospital mortality or early death within 30 days after operation occurred. The rates of stroke, limb ischemia, acute kidney injury, and reintervention at 30 days were 7.4%, 3.7%, 25.9%, and 3.7%, respectively. The mean follow-up period was 4.3±3.1 years. During the follow-up, the rates of death, stroke, maintenance hemodialysis, aneurysmal change, and reintervention were 0%, 3.7%, 7.4%, 7.4%, and 7.4%, respectively. Two patients required reintervention due to limb ischemia and aneurysmal changes in the distal portion of the stent graft. Computed tomography scans revealed a significant increase in aortic diameters in patients who underwent selective stenting compared to those who underwent TEVAR over a 3-year period, with changes in aortic area measuring 878.9 mm² vs. 188.4 mm² at the middle of the lesion (P=0.037), 303.7 mm² vs. 22.8 mm² at the level of the celiac trunk (P=0.025), and 442.9 mm² vs. 37.3 mm² at the level of the renal artery (P=0.019).</p><p><strong>Conclusion: </strong>The endovascular treatment of acute TBAD with MS demonstrated a high primary technical success rate and promising short- and midterm clinical outcomes.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"40 ","pages":"17"},"PeriodicalIF":0.9,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11157333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285381","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}