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

{"title":"Facial flushing can be a rare presentation of SVC syndrome","authors":"Claire Elizabeth Cassianni ,&nbsp;Noora Jabeen ,&nbsp;Tiziano Tallarita ,&nbsp;Michel K Barsoum ,&nbsp;Vaibhav R. Vaidya ,&nbsp;Indrani Sen","doi":"10.1016/j.avsurg.2025.100369","DOIUrl":"10.1016/j.avsurg.2025.100369","url":null,"abstract":"<div><div>Facial plethora is a rare presentation of superior vena cava syndrome (SVCS). We report facial plethora and feeling of fullness in the head and neck in a 37-year-old female with cardiomyopathy and implantable cardioverter defibrillator (ICD) placement. She remained undiagnosed for a year despite computed tomogram (CT) imaging. Based on her symptoms, a diagnosis of SVCS was suspected and confirmed with diagnostic venogram. Symptoms resolved transiently with initial venoplasty. She presented with recurrent incapacitating symptoms in a year. This required repeat venoplasty, lead extraction and placement of subcutaneous ICD. She remains asymptomatic a year after this procedure.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 1","pages":"Article 100369"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396219","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 experience of a vascular service in the Anglo-Caribbean with COVID-19 associated arterial thrombosis- A case series","authors":"Dave Harnanan ,&nbsp;Kelly Ann Bobb ,&nbsp;Lemuel Pran ,&nbsp;Aruna Rampersad ,&nbsp;Vijay Naraynsingh ,&nbsp;Terrence Seemungal","doi":"10.1016/j.avsurg.2024.100356","DOIUrl":"10.1016/j.avsurg.2024.100356","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to examine the characteristics and clinical outcomes of coronavirus (COVID-19) positive patients presenting with acute limb ischemia (ALI) during the coronavirus pandemic.</div></div><div><h3>Design and methods</h3><div>A multi-center, observational study was undertaken. It included patients from three tertiary parallel healthcare facilities in Trinidad and Tobago who were COVID-19 positive and had an acute thromboembolic event between August 2020 and April 2022. The data was collected in a prospectively maintained database.</div></div><div><h3>Results</h3><div>Over the 21 months, 24 patients with ALI and were infected with COVID-19 were evaluated, analyzing 25 consecutive limbs. The cohort's median age was 62.2 years (42–88 years), of which 62.5% were male. The most common comorbidities were diabetes (45.8%) and hypertension (33.3%). 12.5% (3/24) of patients’ initial manifestation was acute arterial ischemia, with the remaining patients (87.5%) developing signs of ALI during their hospitalization for their COVID-19 infection. Additionally, 12.5% (3/24) of patients were found to have had extremity thrombosis at multiple levels. Treatment arms were categorized as medical (N= 16), surgical (open surgery 7, and endovascular 2) management. There were no major adverse limb events in patients treated surgically. Non-surgical management was more prevalent in severe cases of Covid-19 disease in 37.5%. The in-hospital mortality was 41.7% (the leading cause of death being acute respiratory distress syndrome and multiorgan failure), all of whom were managed medically.</div></div><div><h3>Conclusion</h3><div>COVID-19 posed unique challenges in the management of ALI, with increased mortality and primary amputation rates. However, in patients who underwent surgical revascularization, there was a 100% major amputation-free survival at 24 months.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 1","pages":"Article 100356"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139034","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 case of acute arterial thrombosis revealing undifferentiated arterial leiomyosarcoma","authors":"Masato Tsuchimochi ,&nbsp;Shigeta Miyake ,&nbsp;Taisuke Akimoto ,&nbsp;Yuta Otomo ,&nbsp;Yasunobu Nakai ,&nbsp;Kotaro Oshio ,&nbsp;Tetsuya Yamamoto","doi":"10.1016/j.avsurg.2025.100365","DOIUrl":"10.1016/j.avsurg.2025.100365","url":null,"abstract":"<div><div>Aortic leiomyosarcoma, a rare and elusive malignancy, presents diagnostic and therapeutic dilemmas due to its nonspecific symptoms and aggressive course. We report a unique case where the incidental discovery of arterial leiomyosarcoma occurred during acute cerebral infarction management. A previously healthy 58-year-old woman, initially presenting with severe neurological deficits indicative of acute ischemic stroke, underwent prompt recanalization therapy that resulted in successful restoration. Unexpectedly, a histopathological examination of the extracted thrombus revealed arterial leiomyosarcoma. The diagnostic process involved immunohistochemistry and contrast-enhanced computed tomography, confirming the presence of leiomyosarcoma originating from the ascending aorta. Given the patient's severe disability, a palliative care approach was chosen to prioritize comfort and quality of life. This case underscores the diagnostic potential of acute recanalization therapy for functional recovery as well as histopathological examination, shedding light on rare diseases. Further case accumulation is essential to refine treatment strategies and improve prognostic outcomes for vascular sarcomas.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 1","pages":"Article 100365"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139032","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":"Recurrent disconnection of Gore Iliac Branch Endoprosthesis: Case report and review of contributing factors","authors":"Catherine Boudreau,&nbsp;Caroline Caradu,&nbsp;Xavier Bérard,&nbsp;Eric Ducasse","doi":"10.1016/j.avsurg.2025.100363","DOIUrl":"10.1016/j.avsurg.2025.100363","url":null,"abstract":"<div><h3>Introduction</h3><div>Iliac artery aneurysms (IAAs) which may coexist with abdominal aortic aneurysms (AAAs) or appear as isolated lesions, represent around 2 % of intra-abdominal aneurysms. Endovascular repair using iliac branch devices (IBDs) helps preserve internal iliac artery (IIA) perfusion, reducing complications like buttock claudication. However, device displacement and type III endoleaks are significant challenges, especially in tortuous anatomy.</div></div><div><h3>Report</h3><div>We report two cases of type III endoleak due to displacement of Gore Iliac Branch Endoprosthesis (IBE). In the first case, a 60-year-old male with a left IAA experienced immediate postoperative IBE migration and type III endoleak, necessitating urgent reintervention with bridging stents. In the second, a 74-year-old male treated for a right IAA had recurrent IBE displacements over four years, with repeated type III endoleaks, managed by repeated stenting. Severe iliac tortuosity contributed to both cases.</div></div><div><h3>Discussion</h3><div>These cases highlight the complexities of IAA endovascular repair with IBDs, particularly the risk of device migration and endoleaks, with severe iliac tortuosity, device properties (e.g. conformability, low friction coefficient), and response to cardiac pulsatility increasing migration risk. Future studies should address these challenges, focusing on device design improvements and predictive imaging techniques, including artificial intelligence, to enhance long-term outcomes in IAA repair.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 1","pages":"Article 100363"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139016","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":"Trans-peritoneal repair of a juxta-renal abdominal aortic aneurysm with horseshoe kidney complicated by urine leak successfully managed with urinary diversion and selective renal artery embolization","authors":"Jordyn O'Dell ,&nbsp;Samantha D. Minc ,&nbsp;Michael C. Ost ,&nbsp;Robert Grammer ,&nbsp;Brian Markovich ,&nbsp;Lakshmikumar Pillai","doi":"10.1016/j.avsurg.2024.100336","DOIUrl":"10.1016/j.avsurg.2024.100336","url":null,"abstract":"<div><div>There are a limited number of case reports describing the division of a horseshoe kidney (HSK) during trans- peritoneal repair of an abdominal aortic aneurysm (AAA). We present case of a juxta-renal AAA overlaid by an L shaped HSK, repaired trans- peritoneal with division of the isthmus. This was complicated by post-operative urinoma which was successfully treated interventionally.</div><div>This approach was chosen due to the presence of the juxta-renal AAA with the majority of the HSK being perfused by a large left renal artery originating at the neck of the AAA. Temporary bilateral ureteral stents were placed. The isthmus of the HSK was divided followed by open tube graft repair of the AAA. Postoperative workup revealed an abdominal urinoma, which was successfully treated by urinary diversion and selective renal arterial branch embolization. Two years later, patient remains well with no evidence of hydronephrosis or graft infection.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100336"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142320181","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":"Posttraumatic pseudoaneurysm of the posterior tibial artery – A case report","authors":"Jenna H.C. Beijers ,&nbsp;Anne M. Daniels ,&nbsp;Anne C.M. Cuijpers ,&nbsp;Martine G. Samyn","doi":"10.1016/j.avsurg.2024.100347","DOIUrl":"10.1016/j.avsurg.2024.100347","url":null,"abstract":"<div><div>Arterial pseudoaneurysms as a result of blunt trauma are exceptionally rare, especially when developing in the posterior tibial artery. We describe a case of a 19-year-old patient with a pseudoaneurysm of the right posterior tibial artery following a blunt trauma with compression on the posterior tibial nerve leading to numbness in the sole of the foot. The pseudoaneurysm was successfully treated by open surgical repair with the use of an autologous venous patch from the greater saphenous vein. To the best of our knowledge, only one previous case of a posterior tibial artery pseudoaneurysm following blunt trauma has been described in previous literature. Our patient made an almost complete recovery, with only a persistent sensory deficit of the sole of the foot at three weeks postoperatively.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100347"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554259","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":"Neoplastic material inducing acute limb ischemia during bilobectomy surgery for the treatment of lung cancer","authors":"Caroline Marchand,&nbsp;Ievgen Gegiia,&nbsp;Félix H. Savoie-White MD, MSc,&nbsp;Pascal Rhéaume","doi":"10.1016/j.avsurg.2024.100339","DOIUrl":"10.1016/j.avsurg.2024.100339","url":null,"abstract":"<div><div>Arterial tumor embolization is a severe but rare complication in lung cancer, especially during surgical interventions. We present the case of acute lower limb ischemia developed during a bilobectomy surgery for non-small cell lung carcinoma. Postoperative embolectomy was performed after a CT angiogram identified an occlusive thrombus in the left common iliac artery. Pathological analysis confirmed non-small cell lung carcinoma within the thrombus. Despite successful surgery, the patient later developed cerebral metastasis and chose medical assistance in dying. This case underscores the importance of adopting an open revascularization approach for patients suspected of acute arterial occlusion caused by intraluminal tumors.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100339"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142423216","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 management of an inferior vena cava (IVC) filter penetration and related lumbar artery pseudoaneurysm in an elderly patient","authors":"Javad Jalili,&nbsp;Sarah Vaseghi,&nbsp;Mahdiyeh Baastani Khajeh,&nbsp;Ali Abzirakan Aslanduz","doi":"10.1016/j.avsurg.2024.100345","DOIUrl":"10.1016/j.avsurg.2024.100345","url":null,"abstract":"<div><div>Retrievable filters of Inferior vena cava (IVC) are used to prevent venous thromboembolism (VTE) in high-risk patients, but can result in rare and serious complications like filter penetration into adjacent structures leading to pseudoaneurysm formation. We present a unique case of an 87-year-old male patient with a history of bilateral lower limb deep vein thrombosis (DVT) who developed a large pseudoaneurysm of the third right lumbar artery following prophylactic IVC filter placement before femoral neck fracture surgery. The patient was re-admitted after he experienced dull abdominal pain in the periumbilical region for three days before admission. Abdominal Doppler ultrasound and CT angiography identified an abdominal hematoma and a third right lumbar artery pseudoaneurysm. Angiography confirmed a large pseudoaneurysm resulting from the IVC filter penetration. Endovascular treatment with coil embolization was successfully performed to exclude the pseudoaneurysm. However, the filter could not be retrieved due to the incorporated strut penetration into the IVC wall. The patient had recovered without any complications. He was discharged with therapeutic anticoagulation. This case highlights the importance of anticipating potential complications with indwelling IVC filters, as well as the implications for management in elderly patients undergoing major surgeries.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100345"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535134","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":"Patient-individualized treatment concept in a case of a juxtarenal AAA repair with limited transfemoral access using custom-made fenestrated aortic endografts","authors":"Bernhard Hruschka,&nbsp;Alexander Gombert,&nbsp;Panagiotis Doukas,&nbsp;Christian Uhl,&nbsp;Moustafa Elfeky","doi":"10.1016/j.avsurg.2024.100340","DOIUrl":"10.1016/j.avsurg.2024.100340","url":null,"abstract":"<div><div>Endovascular techniques have become the preferred method for treating complex aortic aneurysms, but some cases require individualized strategies beyond manufacturer specifications. We report a 62-year-old male with a 64 mm juxtarenal abdominal aortic aneurysm, right above-knee amputation, and dependence on the right hypogastric artery. The patient's complex anatomy necessitated a custom solution including fEVAR. Access was gained through the left femoral and brachial arteries due to an occluded right external iliac artery. The right hypogastric artery was treated with covered stents via transbrachial access. This case highlights the potential for treating complex aortic aneurysms using patient-individualized endoprostheses and creative endovascular solutions outside standard instructions-for-use.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100340"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535133","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":"An unusual enemy: Case report of a giant splenic artery pseudoaneurysm of unknown etiology in a young soldier","authors":"Tiffany Kippenberger,&nbsp;Marcos Aranda,&nbsp;Todd Simon,&nbsp;Andrew Soo Hoo","doi":"10.1016/j.avsurg.2024.100338","DOIUrl":"10.1016/j.avsurg.2024.100338","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Splenic artery pseudoaneurysms&lt;span&gt;&lt;span&gt;&lt;sup&gt;a&lt;/sup&gt;&lt;/span&gt;&lt;/span&gt; (SAPA) are rare, with overall incidence reported at 0.01–0.2 % per 100,000. There are only around 200 cases described in the literature to date. The splenic artery is the most common site for a pseudoaneurysm, accounting for 46 % of visceral artery pseudoaneurysms. They occur more commonly in males, with risk factors including pancreatitis, trauma, and iatrogenic injuries from pancreatic surgery. Pseudoaneurysms can be symptomatic, and symptoms can include vague abdominal pain, hematochezia, melena, or hematemesis. Sizes of splenic artery pseudoaneurysms can vary from 0.3 to 17 cm, with lesions greater than 5 cm classified as giant pseudoaneurysms, which are very rare. Diagnosis is typically made with a computed tomography angiography&lt;span&gt;&lt;span&gt;&lt;sup&gt;b&lt;/sup&gt;&lt;/span&gt;&lt;/span&gt; (CTA), which shows a contrast-filled vessel wall outpouching. Because risk of rupture can reach 47 % and this risk is unrelated to the size of the pseudoaneurysm, all pseudoaneurysms should be treated. Failure to intervene resulting in rupture can result in a mortality reaching 90 %. Endovascular interventions are the preferred treatment; however, if the patient is unstable, open ligation of the lesion is required.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A 35-year-old active-duty male with no history of abdominal trauma was transferred to our facility after a 12 cm splenic artery pseudoaneurysm was found incidentally on computed tomography&lt;span&gt;&lt;span&gt;&lt;sup&gt;c&lt;/sup&gt;&lt;/span&gt;&lt;/span&gt; (CT) scan performed for elevated liver enzymes during a hospitalization for new-onset diabetes. This CT also demonstrated new findings of two suspected pancreatic intraductal papillary mucinous neoplasms&lt;span&gt;&lt;span&gt;&lt;sup&gt;d&lt;/sup&gt;&lt;/span&gt;&lt;/span&gt; (IPMN), but no evidence of pancreatitis. He denied abdominal pain, nausea, vomiting, and changes in bowel habits. The patient's physical exam was unremarkable and vital signs were within normal limits. Laboratory studies on arrival were notable for hemoglobin of 8.2 g/dL with no prior baseline available, as well as elevated liver enzymes and alkaline phosphatase. A mononucleosis test was positive.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;: Patient underwent angiography, which confirmed a splenic artery pseudoaneurysm. Wire advancement distal to the pseudoaneurysm revealed normal antegrade flow into the spleen without filling of the pseudoaneurysm sac. Inflow and outflow to the pseudoaneurysm was embolized with Azur CX coils (Terumo, Somerset, NJ, USA), and completion angiography demonstrated complete occlusion of the pseudoaneurysm. On postoperative day two, a CTA was obtained which was limited by coil artifact. Mesenteric duplex ultrasound on postoperative day three confirmed a thrombosed splenic artery pseudoaneurysm with no active flow. He recovered without difficulty and was discharged with strict mononucleosis precautions and follow up for his suspected IPMNs.&lt;/div&gt;&lt;/div&gt;&lt;","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100338"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142423215","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}