Annals of vascular surgery. Brief reports and innovations最新文献

{"title":"TEVAR for Type B aortic dissection with right-sided aortic arch and left subclavian vascular ring","authors":"Josue R. Gutierrez ,&nbsp;Shamanth Murundi ,&nbsp;Camilo Martinez ,&nbsp;Mohsen Bannazadeh","doi":"10.1016/j.avsurg.2024.100289","DOIUrl":"10.1016/j.avsurg.2024.100289","url":null,"abstract":"<div><h3>Background</h3><p>Embryological aortic development is characteristically asymmetric, and as such, abnormalities in formation can present unique issues. Right-sided aortic arch is one such variant; repairing acute pathologies in this population requires technical and anatomic proficiency. Yet given the rarity of these conditions, there are few evidence-based guidelines outlining proper interventional management. This case serves as a demonstration of successful endovascular repair of a Stanford type B dissection in the setting of right aortic arch and congenital vascular ring.</p></div><div><h3>Case summary</h3><p>An 82-year-old female with a past medical history of hypertension, status-post coronary artery bypass grafting, presented to the emergency department (ED) with acute onset severe back and chest pain. An urgent computerized tomography angiography (CTA) subsequently revealed a type B aortic dissection with aberrant RAA anatomy along with a vascular ring. Due to hemodynamic instability and concern for hemothorax, the patient was taken emergently to the operative theater for endovascular repair and was successfully treated with a single aortic stent graft. Follow-up CTA 1 month later showed a proximal type I endoleak, and in efforts to promote remodeling, the repair was extended to the proximal descending aorta with coil embolization of the vascular ring.</p></div><div><h3>Discussion</h3><p>In patients with Type B dissection in the setting of right-sided aortic arch, surgical versus endovascular approaches are influenced by anatomic understanding and technical feasibility. This case serves as an example of a successful endovascular repair in an abnormal aortic environment, which may potentially reduce post-procedure morbidities compared to open surgery.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100289"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000412/pdfft?md5=d13649a8d4a40af51da4bba56357d4b4&pid=1-s2.0-S2772687824000412-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141030635","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":"The role of vascular surgery and suction thrombectomy in a community hospital's pulmonary embolism response team","authors":"Jessica Katsiroubas ,&nbsp;Tiffany Pinchinat ,&nbsp;Michael Segal ,&nbsp;Rajesh Malik ,&nbsp;Nicole Ilonzo","doi":"10.1016/j.avsurg.2024.100295","DOIUrl":"10.1016/j.avsurg.2024.100295","url":null,"abstract":"<div><h3>Introduction</h3><p>Numerous pulmonary embolism response teams (PERT) have emerged to direct management of pulmonary embolism in hospitalized patients; few of these teams consist of vascular surgeons.</p></div><div><h3>Methods</h3><p>This study presents a single-center retrospective review aimed at evaluating the outcomes of patients who underwent suction thrombectomy by vascular surgeons within the timeframe of 2022 to 2023. Differences in preoperative and postoperative outcomes were compared using a samples <em>t</em>-test for continuous data. Statistical analyses were performed using JASP Team 2022, JASP (Version 0.16.3) [Computer software]. A <em>p</em> value &lt; 0.05 was considered significant.</p></div><div><h3>Results</h3><p>50 patients were assessed that underwent suction thrombectomy. The majority of patients were female (64 vs 36 %). Ages ranged from 26 to 94 and the mean was 65 years old. The majority of patients were Black or African American (62 %). The majority of patients (52 %) had moderate right heart strain (RHS) preoperatively. There were no postoperative wound infections or bleeding complications. All-cause mortality within 30 days was 2 %; procedure-related or pulmonary embolism-related mortality was 0 %.</p></div><div><h3>Conclusion</h3><p>Suction thrombectomy remains a safe option for management of pulmonary embolism; a PERT can successfully comprise vascular surgeons as the primary proceduralists.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100295"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000473/pdfft?md5=75dad70aadacd4380fb6b80bdb022312&pid=1-s2.0-S2772687824000473-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141141583","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":"Editorial: Original work by women","authors":"Linda M Harris (Professor of Surgery Program Director, Vascular Surgery Residency and Fellowship)","doi":"10.1016/j.avsurg.2024.100297","DOIUrl":"10.1016/j.avsurg.2024.100297","url":null,"abstract":"","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100297"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000497/pdfft?md5=03b33def82471d271daea72b95abdb83&pid=1-s2.0-S2772687824000497-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141278868","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":"Treatment of urgent thoracoabdominal aortic pathologies with physician-modified abdominal aortic extension","authors":"Dimitrios David Papazoglou,&nbsp;Islam Kourampi,&nbsp;Drosos Kotelis,&nbsp;Vladimir Makaloski","doi":"10.1016/j.avsurg.2024.100303","DOIUrl":"10.1016/j.avsurg.2024.100303","url":null,"abstract":"<div><p>Urgent thoracoabdominal aortic (TAA) pathologies pose a major clinical challenge, where physician-modified endografts offer a rapid, off-the-shelf and patient-customized solution. We illustrate the treatment of different urgent thoracoabdominal aortic pathologies with physician-modified abdominal aortic extensions. Due to its short endograft length, modification and re-sheathing can be performed fast and deployment with a high precision. Furthermore, keeping the tip capture closed, target vessel cannulation is enhanced from a femoral access. These features possibly lead to improved clinical outcomes.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100303"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000552/pdfft?md5=4ec5c85a000467ec3b2c315dd8c42ac3&pid=1-s2.0-S2772687824000552-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141274545","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":"Repair of inflammatory celiac artery aneurysm presenting with insidious onset of abdominal pain: A case report","authors":"Kristen Kent ,&nbsp;Christopher Noty ,&nbsp;Maria Camila Castello Ramirez","doi":"10.1016/j.avsurg.2024.100300","DOIUrl":"10.1016/j.avsurg.2024.100300","url":null,"abstract":"<div><h3>Background</h3><p>Visceral artery aneurysms (VAAs) are rare but potentially devastating given the high mortality associated with rupture. Current Society of Vascular Surgery guidelines recommend repair of these at 2.5 cm. Surgical intervention includes endovascular embolization and/or stenting versus open revascularization. This case presents a patient with a large celiac artery aneurysm (CAA) who underwent open ligation of the celiac artery at the origin. Splenectomy was performed given the need for ligation of the splenic artery. He had a replaced right hepatic artery from the SMA; thus, no revascularization was needed. Ultimately, the aneurysm was found to be inflammatory in etiology.</p></div><div><h3>Case report</h3><p>A 41-year old male with history of seizure disorder, smoking, and newly diagnosed hypertension presented with abdominal pain for six months. His-laboratory work was significant for a leukocytosis of 17, 740, mildly elevated C- Reactive Protein (CRP) at 1.63, and normal erythrocyte sedimentation rate (ESR). CT angiogram revealed a 5.2 × 4.2 cm celiac artery aneurysm with stranding. Given its appearance and concern for infection, he underwent emergent laparotomy and ligation. Blood cultures and intraoperative tissues revealed no microorganism growth. Pathology was remarkable only for periarterial abscess with acute and chronic inflammation and focal tissue necrosis, compatible with aneurysm.</p></div><div><h3>Conclusion</h3><p>This case report presents a rare inflammatory CAA, which presented with six months of abdominal pain, and its subsequent management with open intervention. In this case, his vessel anatomy was favorable for open repair with ligation of the celiac axis due to the presence of a replaced right hepatic artery. This also highlights the importance of anatomic vessel variants when making surgical decisions.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100300"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000527/pdfft?md5=23719afaec26b9bc21b16dc146b3a821&pid=1-s2.0-S2772687824000527-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141275630","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":"Thoracic endovascular aneurysm repair of a ruptured zone 0 mycotic thoracic aortic aneurysm","authors":"Valentyna Kostiuk ,&nbsp;Prashanth Vallabhajosyula ,&nbsp;Naiem Nassiri ,&nbsp;Britt H. Tonnessen","doi":"10.1016/j.avsurg.2024.100302","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100302","url":null,"abstract":"<div><p>A 48-year-old woman presented with an acute type B aortic dissection. Despite medical management with anti-impulse therapy in intensive care, she continued to have chest and back pain and underwent aortic arch debranching and thoracic endovascular aneurysm repair (TEVAR). Her post-operative course was complicated by sternal and mediastinal infection. Several weeks later, the patient developed acute onset chest pain and computed tomography angiogram revealed contrast extravasation just proximal to the endograft. Emergent zone 0 TEVAR was performed with exclusion of hemorrhage and continued filling of the debranched vessels. Post-operatively, fevers continued despite 6 weeks of antibiotic treatment and phage therapy was prescribed for 5 days. At 2-year follow-up, there was no recurrence of infection.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100302"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000540/pdfft?md5=3f0a62b34bd305551cb0a387c533c03f&pid=1-s2.0-S2772687824000540-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141241874","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":"Left common carotid urgent reperfusion after inadvertent TEVAR coverage","authors":"Carolyn Postol,&nbsp;Eanas Yassa","doi":"10.1016/j.avsurg.2024.100301","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100301","url":null,"abstract":"<div><p>Type B aortic dissections can carry significant morbidity and mortality when not promptly treated. Although anti-impulse control remains the mainstay treatment of type B aortic dissection, they may often require repair when the dissection becomes complicated or develops high risk features. Thoracic endovascular aortic repair (TEVAR) has been successful for those who require repair but still carry associated procedural risks. Inadvertent coverage of a branch vessel is a rare but serious complication. We describe a case report of a patient with accidental proximal TEVAR deployment resulting in left common carotid artery partial coverage and malperfusion necessitating prompt carotid revascularization with stent placement adjacent to TEVAR.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100301"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000539/pdfft?md5=278fd1367f216154d7b15d613a0cffc9&pid=1-s2.0-S2772687824000539-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239950","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":"First-in-human Implantation of a 3D-printing Fully Bioresorbable Drug Eluting Stent for Treatment of Superficial Femoral Artery Disease","authors":"Hai Feng ,&nbsp;Xuebin Wang ,&nbsp;Mingyuan Liu ,&nbsp;Bin Liu ,&nbsp;Zhong Chen ,&nbsp;Xueming Chen","doi":"10.1016/j.avsurg.2024.100299","DOIUrl":"10.1016/j.avsurg.2024.100299","url":null,"abstract":"<div><h3>Background</h3><p>Bioresorbable stent (BRS) is ideal treatment for superficial femoral artery (SFA) arteriosclerosis obliterans, allowing the target vessel to return to its normal state. A 3D-printing Fully Bioresorbable Drug Eluting Stent (PERISORB® BRS) was implanted for a successful first-in-human treatment of a SFA obstruction.</p></div><div><h3>Methods</h3><p>A 57-year-old female patient suffered from intermittent claudication Rutherford-Becker category 3, the ankle-brachial index (ABI) was 0.70. Pre-procedure CTA showed a calcified 50 mm long severe stenosis in the distal segment of the left SFA.</p></div><div><h3>Results</h3><p>The lesion was dilated with a diameter of 5 mm balloon, no relevant residual stenosis but a local dissection was seen during control-angiograms, the dissection was treated by implantation of a 5 mm × 76 mm 3D-printing biodegradable drug-eluting peripheral stent (PERISORB® BRS). The patient returned for follow-up visits, color duplex ultrasonography (CDUS) and digital subtraction angiography (DSA) was performed at 6-month and 16-month follow-up. No perioperative complications were found. At 16-month follow-up, ultrasonography showed stent patency and no stenosis. The Rutherford-Becker category was 1 and the ABI improved to 0.85.</p></div><div><h3>Conclusion</h3><p>A successful first-in-human implantation was performed with the 3D-printing biodegradable drug-eluting peripheral stent (PERISORB® BRS).</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 3","pages":"Article 100299"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000515/pdfft?md5=0fae83e5a2a73148de9489355961ba05&pid=1-s2.0-S2772687824000515-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141278463","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":"In-situ repair of a mycotic thoracoabdominal aortic aneurysm caused by MRSA bacteremia using cryopreserved artery and autogenous vein","authors":"Dar Chung ,&nbsp;Eanas Yassa","doi":"10.1016/j.avsurg.2024.100296","DOIUrl":"10.1016/j.avsurg.2024.100296","url":null,"abstract":"<div><p>Mycotic aortic aneurysm (MAA) is a rare disease process associated with high morbidity and mortality, especially if left untreated. Currently, there is no consensus on optimal management for MAA but early diagnosis is vital for improving chances of survival. Treatment with antibiotics is recommended followed by surgical repair. We present the unique case of a 33-year-old male who presented with a mycotic thoracoabdominal aneurysm that was treated via open <em>in-situ</em> repair with cryopreserved artery, celiac and superior mesenteric artery bypasses, and ligation of bilateral renal arteries. The patient subsequently underwent a successful kidney transplant several years later and currently remains dialysis free. CT imaging at 1-year and 5-years demonstrated patent bypasses without evidence of re-infection or aneurysmal changes to the cryopreserved arterial graft. This case underscores the myriad of challenges associated with managing MAA, while also presenting the opportunities to surmount these challenges through a personalized and multidisciplinary treatment approach.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100296"},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000485/pdfft?md5=4e373830d88440077574699d160af513&pid=1-s2.0-S2772687824000485-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141143507","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":"Axillary and brachial artery aneurysm associated with a longstanding arteriovenous fistula","authors":"Grace Yu,&nbsp;Luis Rodriguez Cartagena,&nbsp;Yana Etkin","doi":"10.1016/j.avsurg.2024.100293","DOIUrl":"10.1016/j.avsurg.2024.100293","url":null,"abstract":"<div><p>Upper extremity true arterial aneurysms are rare and often present as a pulsatile mass with associated pain and paresthesia from peripheral nerve compression, and can lead to acute limb ischemia from thromboembolic sequela. History of arteriovenous dialysis access and immunosuppression after renal transplantation may contribute to the development of true aneurysms.</p><p>This report describes the management of a patient with end-stage renal disease (ESRD) with multiple left upper extremity dialysis access who presented with an axillary and brachial artery aneurysm.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100293"},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277268782400045X/pdfft?md5=e24f116dc87f25265217e33021818df7&pid=1-s2.0-S277268782400045X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141141398","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}