Vascular Specialist International最新文献

{"title":"Procedural Complexity and Clinical Outcomes of Contemporary Iliac Branch Device Implantation Versus Internal Iliac Artery Embolization During Endovascular Repair of Aotoiliac Artery Aneurysms.","authors":"Keiichiro Kawamura, Yoh Hamada, Munetaka Hashimoto","doi":"10.5758/vsi.260018","DOIUrl":"10.5758/vsi.260018","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to compare outcomes between contemporary iliac branch device (IBD) implantation, including adjunctive techniques such as the up-and-over approach, and internal iliac artery (IIA) embolization during endovascular aneurysm repair (EVAR) for aortoiliac artery aneurysms (AIAAs), and to assess whether the increased procedural complexity of modern IBD strategies is justified by their safety and functional outcomes.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed consecutive patients who underwent elective EVAR for AIAAs at a single institution between 2018 and 2024. Ninety-three patients were stratified based on a patient-tailored treatment strategy into Group A (IBD, n=40) and Group B (IIA embolization, n=53). In Group A, 11 patients (27.5%) were treated using the up-and-over technique. Procedural outcomes, limb-based pelvic ischemic symptoms, and midterm durability were compared between groups.</p><p><strong>Results: </strong>Technical success was achieved in all patients in both groups, including all patients treated using the up-and-over technique. No perioperative cardiovascular events occurred in either group. Postoperative acute kidney injury developed in 4 patients (7.5%) in Group B and none in Group A. Fluoroscopy time was significantly longer, and preemptive inferior mesenteric or lumbar artery embolization was more frequent, in Group A, whereas operative time and contrast volume were comparable between the groups. In the limb-based analysis, buttock claudication occurred in 13 of 72 limbs (18.1%) with interrupted IIA flow and in none of 105 limbs with preserved IIA flow (P<0.001). During a mean follow-up of 23.3 months, aneurysm-related mortality (2.5% vs. 3.8%) and type Ib endoleaks requiring reintervention (2.5% vs. 1.9%) occurred at similar rates in Groups A and B, respectively. No type Ic endoleaks or related reinterventions occurred in Group A.</p><p><strong>Conclusion: </strong>Contemporary IBD implantation was associated with acceptable procedural safety and midterm durability, even when complex adjunctive maneuvers such as the up-and-over approach were used. Preservation of IIA flow was associated with a lower incidence of buttock claudication than intentional IIA interruption.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"18"},"PeriodicalIF":1.2,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13168879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935323","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":"Balloon-Assisted Selective Renal Artery Protection in the Endovascular Management of Juxtarenal Aortoiliac Occlusion.","authors":"Tao Shi, Yongbao Zhang","doi":"10.5758/vsi.260001","DOIUrl":"10.5758/vsi.260001","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the feasibility and safety of balloon-assisted selective renal protection during endovascular treatment of juxtarenal aortoiliac occlusive disease (AIOD) and to present a preoperative computed tomography angiography (CTA)-based morphological framework for procedural planning and standardized reporting.</p><p><strong>Materials and methods: </strong>This single-center retrospective study, conducted between 2017 and 2022, included patients with juxtarenal AIOD treated with kissing covered self-expanding stents. Renal protection balloons were applied selectively based on preoperative CTA findings and the anticipated proximal stent extension. Renal reconstruction was performed selectively for planned proximal stent extension above the renal ostium, significant ostial disease, or bailout in cases of embolization or flow limitation. The primary outcomes were acute kidney injury (AKI; Kidney Disease: Improving Global Outcomes creatinine criteria, patient level) and renal embolic events (REEs, renal artery level), defined as angiographic embolization requiring intervention or clinically silent renal infarction on postoperative CTA. Patency and follow-up estimated glomerular filtration rates were also assessed.</p><p><strong>Results: </strong>Eleven patients (21 renal arteries, excluding 1 preexisting renal artery occlusion) were treated with 100% technical success. AKI occurred in 2/11 patients (18.2%), both stage 1. REEs occurred in 3/21 renal arteries: one symptomatic embolization required stenting, and two showed clinically silent partial renal infarction on postoperative CTA. Six renal stents were implanted, with a primary patency rate of 83.3% (5/6). One patient developed acute in-hospital thrombosis requiring thrombolysis, and the same stent became permanently occluded at the 2-year follow-up and was managed conservatively. Aortoiliac primary patency was 95.5% (21/22 limbs), and secondary patency was 100%. No late reinterventions were observed during a mean follow-up of 24.4 months.</p><p><strong>Conclusion: </strong>Balloon-assisted selective renal protection is feasible in juxtarenal AIOD. However, REEs, including clinically silent infarctions, may still occur, and selective renal reconstruction remains necessary in a subset of patients. The CTA-based morphological framework may facilitate preprocedural planning and standardized reporting of renal outcomes alongside traditional aortoiliac endpoints.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"17"},"PeriodicalIF":1.2,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788804","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":"Rapid Expansion of Bilateral Common Iliac Artery Pseudoaneurysms in a Complex Postoperative Patient.","authors":"Eun-Ah Jo","doi":"10.5758/vsi.260005","DOIUrl":"10.5758/vsi.260005","url":null,"abstract":"","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"15"},"PeriodicalIF":1.2,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624629","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":"Chest Port Placement Through a Recently Placed Superior Vena Cava Stent Using a Hemostatic Vascular Sheath: A Case Report.","authors":"Jonathon Schutt, Ravi Malpani, Alexandra Rhodes, Christopher Yeisley","doi":"10.5758/vsi.260009","DOIUrl":"10.5758/vsi.260009","url":null,"abstract":"<p><p>A 57-year-old man with extensive-stage small cell lung cancer presented with superior vena cava (SVC) syndrome caused by a right upper lobe mass and underwent stenting from the SVC to the left brachiocephalic vein. Because ongoing chemotherapy required durable central venous access, chest port placement was subsequently attempted after stent placement. However, advancing a conventional peel-away sheath across the recently placed stent was considered undesirable because of the risk of stent deformation or displacement. A chest wall port was successfully placed by advancing only the guidewire and catheter through the stent interstices using an 8-Fr hemostatic vascular sheath instead of a peel-away sheath. Imaging confirmed appropriate catheter course and tip position within the stented segment. This case illustrates a feasible and practical alternative for central venous access following malignant SVC stenting.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"16"},"PeriodicalIF":1.2,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624616","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":"Cephalic Vein Aneurysm of the Wrist Adjacent to the Superficial Radial Nerve: A Case Report.","authors":"Hee Gyun Yang, Joon-Kee Park, Yang-Jin Park","doi":"10.5758/vsi.250154","DOIUrl":"10.5758/vsi.250154","url":null,"abstract":"<p><p>Venous aneurysms of the upper extremities are uncommon and may be traumatic, iatrogenic, or idiopathic. Herein, we report the case of a 72-year-old female with a cephalic venous aneurysm of the wrist that was closely associated with the superficial radial nerve. To minimize the risk of nerve injury, tangential aneurysmectomy with lateral venorrhaphy was performed. However, early postoperative occlusion occurred despite preserved collateral venous flow, and no neurological deficits were observed. This case highlights the importance of meticulous identification and preservation of adjacent nerves and suggests that vein-preserving repair may have limited durability in superficial venous aneurysms. When adequate collateral circulation is present, aneurysmectomy with ligation may be a safer and more practical option after careful identification and preservation of the superficial radial nerve.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"13"},"PeriodicalIF":1.2,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482312","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":"Use of Transapical Access for Thoracic Endovascular Aortic Repair in Challenging Aortic Anatomy: A Case Report.","authors":"Sean Hormozian, So Un Kim, Aldin Malkoc, Ashley Wang, Daniel Serna, William Mosley, Eric Chou, Iden Andacheh","doi":"10.5758/vsi.250088","DOIUrl":"10.5758/vsi.250088","url":null,"abstract":"<p><p>Few cases have reported the use of a transapical approach for thoracic endovascular aortic repair (TEVAR) when standard retrograde device delivery is not feasible. We present the unique case of a 74-year-old female with a history of descending thoracic TEVAR, a physician-modified fenestrated endograft, and ascending aortic repair who presented with an enlarging aortic arch aneurysm requiring intervention. Her native aorta was notably tortuous, and a patient-centered decision was made to proceed with transapical access via a mini-thoracotomy after unsuccessful retrograde endovascular attempts due to severe tortuosity and prior endografts. The stent graft was successfully deployed without type I or III endoleak. The patient recovered without neurologic deficits and was discharged on postoperative day 7. This case highlights transapical access as a feasible alternative route for TEVAR in selected patients with prohibitive anatomy and underscores the importance of multidisciplinary collaboration and timely management of proximal aortic pathology.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"12"},"PeriodicalIF":1.2,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482331","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":"Delayed Retrograde Reperfusion of the Aneurysmal Sac after Open Repair of an Inflammatory Abdominal Aortic Aneurysm Treated with Catheter-Directed Embolization.","authors":"Geert Maleux, Inge Fourneau, Jo P Peluso, Hozan Mufty","doi":"10.5758/vsi.250133","DOIUrl":"10.5758/vsi.250133","url":null,"abstract":"","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"14"},"PeriodicalIF":1.2,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13000707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482347","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 Following Primary Covered Stent Implantation in Supra-Aortic Arch Vessels for Atherosclerotic Occlusive Disease.","authors":"Georgios Sachsamanis, Piotr M Kasprzak, Wilma Schierling, Milena Pavlovic, Evgenia Zygouridou, Karin Pfister","doi":"10.5758/vsi.250135","DOIUrl":"10.5758/vsi.250135","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to present the mid-term outcomes of patients undergoing treatment for atherosclerotic stenosis or occlusion of the supra-aortic arch vessels using covered stents.</p><p><strong>Materials and methods: </strong>We conducted a retrospective, single-center analysis of patients treated for supra-aortic arch vessel atherosclerotic occlusive disease (AOD) at our institution between 2015 and 2024. The study included symptomatic patients who received endovascular treatment with covered stents for lesions involving the subclavian artery, proximal common carotid artery (pCCA), or the brachiocephalic trunk (BT). All patients underwent preprocedural computed tomography angiography within 6 months and color duplex ultrasonography before and after the intervention.</p><p><strong>Results: </strong>A total of 20 patients (8 male; mean age, 69.5±14.3 years) underwent primary covered stent implantation for supra-aortic arch vessel AOD, with 21 vessels treated (11 [52.4%], 6 [28.6%], and 4 [19.0%] in the subclavian artery, pCCA, and BT respectively). The main presenting symptoms were related to cerebrovascular insufficiency. Two patients presented with ischemic finger lesions due to subclavian artery occlusion. Technical success rate was 100% (21/21), and no intraoperative complications were recorded. Perioperative mortality was 0%. Two patients developed transient cerebral hyperperfusion syndrome after pCCA recanalization, one required temporary hemodialysis, and one underwent wound revision for access-site hematoma. Sixteen patients reported postoperative symptom resolution. Mean follow-up was 47.9±33.1 months (median, 40 months; interquartile range, 32 months). Mortality during follow-up was 30% (6/20), with no AOD-related deaths. During follow-up, no duplex ultrasound findings suggestive of >50% in-stent restenosis were detected, and no reinterventions were required.</p><p><strong>Conclusion: </strong>Covered stent implantation for supra-aortic arch vessel atherosclerotic lesions appears to be associated with acceptable mid-term outcomes.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"11"},"PeriodicalIF":1.2,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436870","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: Relationship Between the Primary Entry Tear Locations and Surgical Outcomes of Acute Type A Aortic Dissection: A Single-Center Experience.","authors":"Duy Hong Son Phung, Thang Duc Vu, The Anh Hoang","doi":"10.5758/vsi.250011.e","DOIUrl":"10.5758/vsi.250011.e","url":null,"abstract":"","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"10"},"PeriodicalIF":1.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367165","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":"Extensive Iliofemoral Intimal Injury after Handlebar Trauma Requiring Iliac Exposure and Saphenous Vein Interposition Grafting: A Case Report.","authors":"Thilina Gunawardena","doi":"10.5758/vsi.250122","DOIUrl":"10.5758/vsi.250122","url":null,"abstract":"<p><p>Blunt trauma caused by bicycle or motor-scooter handlebars is a rare mechanism of femoral artery injury. Three-wheelers, commonly operated with handlebars, are a frequent mode of transportation in Sri Lanka. This case report describes a 22-year-old male driver of a three-wheeler who presented with acute occlusion of the common femoral artery (CFA) after blunt handlebar trauma to the groin during a collision. Intraoperatively, the intimal injury extended from the CFA to the external iliac artery, necessitating iliac exposure and reconstruction with a reversed great saphenous vein interposition graft. Arterial perfusion was successfully restored. Although the postoperative course was complicated by iliofemoral deep vein thrombosis, limb salvage was achieved. This case highlights that handlebar trauma to the groin can result in arterial injury extending beyond the site of impact. Clinicians managing such injuries should be prepared to extend exposure to the iliac vessels and perform appropriate reconstruction when needed.</p>","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"42 ","pages":"9"},"PeriodicalIF":1.2,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367130","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}