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

{"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":"2024-10-24","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":"Midterm outcomes of surgical strategy for secondary aorto-enteric fistula","authors":"Shuhei Miura,&nbsp;Ayaka Arihara,&nbsp;Yutaka Iba,&nbsp;Tomohiro Nakajima,&nbsp;Junji Nakazawa,&nbsp;Tsuyoshi Shibata,&nbsp;Yu Iwashiro,&nbsp;Kei Mukawa,&nbsp;Nobuyoshi Kawaharada","doi":"10.1016/j.avsurg.2024.100346","DOIUrl":"10.1016/j.avsurg.2024.100346","url":null,"abstract":"<div><h3>Objectives</h3><div>Our surgical strategy for secondary aorto-enteric fistula (sAEF) encompasses one-stage open repair consisting of in situ anatomical prosthetic graft replacement with omentopexy following fistula repair. This study aimed to evaluate the midterm outcomes of our comprehensive surgical strategies for sAEF in a single-center series.</div></div><div><h3>Methods</h3><div>Between 2010 and 2022, 16 patients (14 male individuals; median age, 76.3 years) who underwent surgical repair of sAEF were reviewed. Nine and seven patients previously underwent open repair (OR-AEF) and endovascular repair (EVAR-AEF) for abdominal aortic aneurysm (AAA), respectively.</div></div><div><h3>Results</h3><div>Among patients who underwent OR-AEF (56.3 %) and EVAR-AEF (43.7 %), there were no significant differences in all variables, except for age (74.2 ± 4.8 vs. 79.1 ± 4.6 years, <em>p</em> = 0.028), interval from primary operation for AAA (66.9 ± 16.3 vs. 12.0 ± 11.4 months, <em>p</em> = 0.043), and clinical presentation with melena (77.8 % vs. 28.6 %, <em>p</em> = 0.049). Thirteen (81.3 %) patients were repaired with in situ anatomical graft replacement, whereas three (18.7 %) patients were unintentionally repaired with extra-anatomical bypass grafting based on intraoperative findings. Fistula repair was performed with duodenectomy in 14 (87.6 %) patients, direct suture closure in 1 (6.2 %), and sigmoid colectomy in 1 (6.2 %). The in-hospital mortality rate was 25.0 %. The 1- and 5-year overall survival and AEF-related event-free survival rates were 72.7 % and 49.8 %, and 77.0 % and 67.4 %, respectively. Patients who underwent complete removal of the contaminated prosthesis required suprarenal aortic clamping more frequently (72.7 % vs. 0 %, <em>p</em> = 0.007) than those who underwent partial removal. However, most were discharged without further oral antibiotic treatment (72.7 % vs. 0 %, <em>p</em> = 0.007). Patients who underwent complete removal had higher 5-year AEF-related event-free survival rate than those who underwent partial removal (69.3 % vs. 25.0 %, <em>p</em> = 0.069).</div></div><div><h3>Conclusions</h3><div>Midterm outcomes of our surgical strategy may be acceptable in patients with sAEF. AEF-related event-free survival is potentially affected by complete infected prosthesis removal.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100346"},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554258","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":"Persistent Left Superior Vena Cava: An Unusual Radiographic Discovery","authors":"Said Adnor,&nbsp;Mehdi EL Kourchi,&nbsp;Soukaina Wakrim","doi":"10.1016/j.avsurg.2024.100344","DOIUrl":"10.1016/j.avsurg.2024.100344","url":null,"abstract":"<div><div>The persistence of the left superior vena cava is a rare and benign congenital malformation. This malformation is usually asymptomatic and is detected incidentally by imaging exams performed for other causes. We report two cases of persistence of the left superior vena cava, the first in a 62-year-old patient admitted for chronic renal failure for whom a thoracic radiograph after venous catheterization objectified this malformation; and the second in a 60-year-old patient for whom we performed a CT scan with contrast agent which objectified a double superior vena cava.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100344"},"PeriodicalIF":0.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535132","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":"2024-10-19","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":"2024-10-11","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":"Axillary-femoral hypogastric bypass for spinal cord protection during fenestrated, branched endovascular repair of post-dissection thoracoabdominal aortic aneurysm","authors":"Dorothy Han ,&nbsp;Alyssa J Pyun ,&nbsp;Mark Mueller ,&nbsp;Wesley Lew ,&nbsp;Sukgu M Han","doi":"10.1016/j.avsurg.2024.100343","DOIUrl":"10.1016/j.avsurg.2024.100343","url":null,"abstract":"<div><div>We present a case of a 65-year-old male who previously underwent left axillofemoral bypass, left carotid stenting, and right iliac stenting followed by ascending and hemiarch repair for type A aortic dissection, complicated by left external iliac artery occlusion. He presented to our center with a symptomatic 8.5 cm post-dissection extent II thoracoabdominal aortic aneurysm. A staged repair was performed to decrease spinal cord ischemia. The first stage employed the novel use of a jump graft from the left axillary-femoral bypass to the left internal iliac artery to restore pelvic circulation, combined with zone 2 thoracic branched endoprosthesis (TBE). The second stage included thoracic endovascular repair (TEVAR) extension and 3-vessel custom-modified fenestrated/branched endovascular repair (FBEVAR).</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100343"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442527","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":"Percutaneous retrieval of symptomatic bone cement embolus from the pulmonary artery","authors":"Tiequan Yang ,&nbsp;Dehai Lang ,&nbsp;Zuanbiao Yu","doi":"10.1016/j.avsurg.2024.100341","DOIUrl":"10.1016/j.avsurg.2024.100341","url":null,"abstract":"<div><div>Bone cement pulmonary embolism (CPE) is not a rare complication. Most cases are asymptomatic and detected incidentally. In this study, we reported a female patient who was suffering from hemoptysis. To address this condition, our clinical group performed a percutaneous procedure to successfully retrieve the cement embolism on the right pulmonary artery.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100341"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433919","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":"Blind peroneal artery outflow bypass for limb salvage in patients with severe CLTI: A case series","authors":"Jorge Rey MD,&nbsp;Karen Manzur-Pineda MD,&nbsp;Christopher Montoya MD,&nbsp;Stefan Kenel-Pierre MD,&nbsp;Naixin Kang MD,&nbsp;Kathy Gonzalez MD,&nbsp;Arash Bornak MD","doi":"10.1016/j.avsurg.2024.100342","DOIUrl":"10.1016/j.avsurg.2024.100342","url":null,"abstract":"<div><h3>Objective</h3><div>Limb loss carries a high risk of morbidity and mortality in patients with chronic limb-threatening ischemia (CLTI). Multiple medical and surgical strategies have been studied to address complications and lower amputation rates, especially in patients with poor outflow in the infrageniculate arteries. Our case series highlights the use of the peroneal bypass without angiographic runoff but acceptable intraoperative back-bleed as an option for patients with CLTI.</div></div><div><h3>Methods</h3><div>A single-center retrospective review was performed on adult patients who underwent lower extremity bypass using the peroneal artery as the outflow for CLTI from 2012 to 2022. Two subgroups were classified as blind peroneal arteries and non-blind peroneal arteries, according to the Darling et al.'s 1998 classification.</div></div><div><h3>Results</h3><div>A total of twenty-five patients with lower extremity bypass for CLTI with the peroneal artery as the outflow target were included. From those, seventeen were classified as non-blind and eight were defined as blind peroneal, according to preoperative angiography runoff. Blind peroneal bypass primary patency rate was 45%, primary-assisted was 60%, and secondary was 60%, with a limb loss rate of 25.0%. Among the seventeen non-blind peroneal bypasses, primary patency was 64.5%, primary assisted was 77%, and secondary was 77%, with a limb loss rate of 5.9%. There were no significantly different p-values observed between both groups.</div></div><div><h3>Conclusion</h3><div>Blind peroneal bypasses serve as a last resort strategy to attempt limb salvage before amputation if adequate back-bleed is observed intraoperatively.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100342"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586338","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":"2024-10-05","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":"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":"2024-10-02","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}