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

{"title":"Cross-pelvic retrograde embolization of an enlarging proximally occluded internal iliac artery aneurysm: A case report","authors":"Alyssa J. Pyun,&nbsp;Ashley C. Hsu ,&nbsp;Sukgu M. Han,&nbsp;Fred A. Weaver,&nbsp;Gregory A. Magee","doi":"10.1016/j.avsurg.2024.100359","DOIUrl":"10.1016/j.avsurg.2024.100359","url":null,"abstract":"<div><div>Internal iliac artery aneurysms are frequently treated by embolization and stent graft coverage, however, retrograde flow from pelvic collaterals may lead to aneurysm progression that can be difficult to treat. We present the case of a 76-year-old male with an enlarging internal iliac artery aneurysm despite occlusion of the proximal internal iliac artery and no antegrade filling of the aneurysm sac. Through cross-pelvic retrograde access of the aneurysm sac via collaterals, we used a triaxial telescoping system for embolization of the aneurysm nidus, without major morbidity. This technique is a safe and effective option that can be used in cases where antegrade access is not feasible.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 1","pages":"Article 100359"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138678","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":"Ultrasound-guided percutaneous aspiration as an alternative method of treatment for Adventitial Cystic Disease: A case series","authors":"Nikolaos Patelis ,&nbsp;Ioannis Tsagkos ,&nbsp;Alia Madi ,&nbsp;Vasiliki Bakalaki ,&nbsp;Maria Psarrou ,&nbsp;Bahaa Arefai","doi":"10.1016/j.avsurg.2024.100358","DOIUrl":"10.1016/j.avsurg.2024.100358","url":null,"abstract":"<div><h3>Introduction</h3><div>Adventitial cystic disease (ACyD) is a rare vascular condition, first documented in 1947, representing approximately 0.1 % of vascular disorders, most commonly affecting the popliteal artery. The condition presents primarily with symptoms of intermittent claudication. Traditional treatment options include cyst excision, arterial segment removal with vein graft reconstruction, or percutaneous aspiration.</div></div><div><h3>Materials and Methods</h3><div>This publication reports on the results of three patients diagnosed with ACyD (males 66 %, mean age 46 years old) and treated with ultrasound-guided percutaneous aspiration (UGPA) as the initial approach. The patients were recruited over a five-year period in two private hospitals and their main symptom was claudication (Rutherford 2 and 3). The main symptom was intermittent claudication.</div></div><div><h3>Results</h3><div>All three patients were succesfully treated with UGPA (100 % technical success) and reported immediate increase of their walking distance and total resolution of claudication. All patients remain symptom-free at 15.7 months (range 7-30). No additional procedures were necessary.</div></div><div><h3>Conclusion</h3><div>Ultrasound-guided percutaneous aspiration for ACyD appears to be a safe and effective initial treatment that restores blood flow in affected vessels. Further long-term follow-up is necessary to establish the durability of the treatment outcomes.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 1","pages":"Article 100358"},"PeriodicalIF":0.0,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138677","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":"Outcome of retrograde approach in management of chronic arterial occlusive disease of lower extremities","authors":"Tran Minh Bao Luan ,&nbsp;Luong Viet Thang ,&nbsp;Viet Huan Le","doi":"10.1016/j.avsurg.2024.100357","DOIUrl":"10.1016/j.avsurg.2024.100357","url":null,"abstract":"<div><h3>Introduction</h3><div>Peripheral arterial disease or chronic arterial occlusive disease of lower extremities is a common problem, and in the advanced stages of the disease, if not re-vascularized, the rate of amputation and mortality can be as high as 43 % and 25 % respectively. Many studies also show that the rate of successful revascularization with an antegrade approach has a failure rate of 10–20 %. Therefore, the retrograde intervention technique was developed to increase the success rate of revascularization.</div></div><div><h3>Objectives</h3><div>Morphological classification of lesions and results of retrograde approach in the treatment of chronic arterial occlusive disease in lower extremities.</div></div><div><h3>Method</h3><div>Retrospective descriptive study. <em>Thirty-five</em> patients with 39 limbs received intervention with the retrograde approach at the Department of Thoracic and Vascular Surgery, University Medical Center. Ho Chi Minh City from February 2017 to December 2021.</div></div><div><h3>Results</h3><div>Most of the patients had multiple risk factors, including hypertension, diabetes, high grade on the Rutherford scale (79.5 % with Rutherford 5), and diffuse vascular disease (89.8 % GLASS III). Recanalization was technically successful in 84.6 % (33/39) limbs, and the patients with limb preservation rate at 6 months after intervention 88.5 %. Results at 12 and 24 months also confirm the procedure's feasibility and positive outlook. The local complication rate was low 7.7 % (3/39). There was 1 case that died 3 weeks after the intervention, not directly related to the procedure.</div></div><div><h3>Conclusion</h3><div>The retrograde technique is safe and effective in managing chronic total arterial occlusive disease of the lower limbs.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 1","pages":"Article 100357"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139036","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":"2024-12-10","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":"Deep venous arterialization in the acute setting for embolic complication after endovascular procedure","authors":"Alejandra P. Rodriguez ,&nbsp;Antonio Solano ,&nbsp;Sofia K. Babool ,&nbsp;Suyue M. Zhang ,&nbsp;Lawrence A. Lavery ,&nbsp;Michael C. Siah","doi":"10.1016/j.avsurg.2024.100355","DOIUrl":"10.1016/j.avsurg.2024.100355","url":null,"abstract":"<div><div>We report a case of a patient that developed acute limb ischemia secondary to atherectomy related embolization that was rescued with a deep venous arterialization (DVA) procedure. For patients with critical limb-threatening ischemia, deep vein arterialization is a viable and crucial intervention for non-surgical candidates who present with wounds or rest pain. This case report underscores DVA's efficacy in addressing severe presentations even in the case of acute ischemia.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 1","pages":"Article 100355"},"PeriodicalIF":0.0,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138676","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":"Symptomatic transverse sinus stenosis. Clinical and angiographic classification and endovascular therapy: A case series","authors":"Alfredo Pedroza ,&nbsp;William Escobar ,&nbsp;Santiago Pedroza Gómez ,&nbsp;Kemel A. Ghotme","doi":"10.1016/j.avsurg.2024.100354","DOIUrl":"10.1016/j.avsurg.2024.100354","url":null,"abstract":"<div><h3>Background</h3><div>Transverse sinus stenosis is a treatable cause of idiopathic intracranial hypertension syndrome and intolerable pulsatile tinnitus syndrome. However, it is often underdiagnosed and left untreated. Stenting at the level of stenosis has emerged as an alternative therapy. This paper presents a clinical and angiographic classification, the technical outcome of the procedure, and the clinical and angiographic follow-up.</div></div><div><h3>Methods</h3><div>We present a case series of idiopathic intracranial hypertension syndrome and intolerable pulsatile tinnitus due to transverse sinus stenosis treated with endovascular angioplasty. We included patients with a pressure gradient ≥ 8 mm Hg across the transverse sinus stenosis with a minimum clinical and angiographic follow-up of 18 months.</div></div><div><h3>Results</h3><div>Twenty-four patients were eligible for this study and were classified into four clinical categories and two angiographic types. Twelve patients had a history of migraine with different clinical types for several years. All patients had satisfactory angioplasty with a single stent (Wallstent®) and complete resolution of idiopathic intracranial hypertension syndrome and intolerable tinnitus. Only one patient presented a complication (subdural hematoma) and required surgery. Twenty-two patients had an angiographic control five and ten months after angioplasty, showing a stable stent, with no stenosis, and with patent Labbé vein.</div></div><div><h3>Conclusion</h3><div>This case series reports excellent technical and clinical outcomes in all patients with idiopathic intracranial hypertension syndrome and intolerable pulsatile tinnitus due to transverse sinus stenosis treated with endovascular angioplasty. We propose a clinical and angiographic classification that will contribute to optimizing diagnosis and therapeutic decision-making processes.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 1","pages":"Article 100354"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139033","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":"Resistant hypertension and mesenteric ischemia: A unique therapeutic journey","authors":"L.N. Klemperer,&nbsp;E. Rosenthal,&nbsp;B. Sheick-Yousif","doi":"10.1016/j.avsurg.2024.100352","DOIUrl":"10.1016/j.avsurg.2024.100352","url":null,"abstract":"<div><h3>Objectives</h3><div>Chronic mesenteric ischemia (CMI) typically presents with postprandial pain, food aversion, and weight loss. This case report describes an atypical presentation of CMI with intolerance to anti-hypertensive drugs.</div></div><div><h3>Methods</h3><div>A 54-year-old woman presented with uncontrolled hypertension, bilateral renal artery stenosis, and intolerance to antihypertensive medications. Angiography revealed occlusion of all three mesenteric arteries, compensated by collateral circulation from internal the iliac arteries. Elevated blood pressure was crucial for maintaining intestinal blood flow via collaterals.</div></div><div><h3>Results</h3><div>A right iliac to IMA bypass successfully improved intestinal perfusion, resolving medication intolerance and successfully lowering the patient's blood pressure.</div></div><div><h3>Conclusions</h3><div>This case highlights an exceptional presentation of occlusive mesenteric disease and underscores the importance of individualized approaches in complex mesenteric ischemia cases.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 1","pages":"Article 100352"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138674","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":"Hybrid Repair of a Thoracoabdominal Aortic Aneurysm as a Bailout Option from Open Repair","authors":"Camila Esquetini-Vernon,&nbsp;Houssam Farres,&nbsp;Mohamed Rajab,&nbsp;Christopher Jacobs,&nbsp;Young Erben","doi":"10.1016/j.avsurg.2024.100353","DOIUrl":"10.1016/j.avsurg.2024.100353","url":null,"abstract":"<div><h3>Introduction</h3><div>Thoracoabdominal aortic aneurysm (TAAA) repair remains associated with considerable morbidity and mortality. An endovascular repair offers a less invasive alternative but is limited by the availability of devices and anatomical constraints. A hybrid approach, combining open visceral debranching with endovascular exclusion, is a viable option for high-risk patients unsuitable for complete open repair.</div></div><div><h3>Clinical summary</h3><div>We report a three-stage hybrid repair of a type IV TAAA in a 62-year-old male with a history of hypertension, hyperlipidemia, seizures, and severe aortic stenosis post-transcatheter aorta valve replacement (TAVR). This repair was initially planned for a single-stage operation. However, due to significant inflammatory findings at the time of the surgical intervention, a staged repair was performed. The inflammation caused significant difficulty in the aorta and vessel dissection and acute blood loss, making this staged approach the safest and most feasible option. On the initial operation, the patient underwent visceral debranching, followed by endovascular thoracic aortic stent placement and a final, physician-modified endograft addressing the right renal artery and exclusion of the aortic aneurysm.</div></div><div><h3>Conclusion</h3><div>This case illustrates the successful use of a staged hybrid approach for TAAA repair when the initial operation cannot be completed as planned due to inflammatory features found at the time of aortic exposure. It demonstrates a pivot to the initial surgical plan yielding a favorable outcome with the preservation of renal function in a high-risk and complex patient.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 1","pages":"Article 100353"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139031","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":"Civilian upper extremity vascular injury: A National Trauma Data Bank study","authors":"Marissa Famularo ,&nbsp;Hunaiz Patel ,&nbsp;Vrutant Patel ,&nbsp;Matthew Ward ,&nbsp;Melissa Scribani ,&nbsp;William Friedman ,&nbsp;Daphne Monie ,&nbsp;Shelby Cooper","doi":"10.1016/j.avsurg.2024.100350","DOIUrl":"10.1016/j.avsurg.2024.100350","url":null,"abstract":"<div><h3>Objective</h3><div>Traumatic upper extremity vascular injuries (UEVIs) pose unique challenges as they are relatively rare injuries. There are various potential treatment modalities to address these injuries which may be influenced by the location of the injury, mechanism of injury, concomitant injuries, and overall patient status. Limited studies are assessing the outcomes of these different treatment modalities and most of the recent literature is focused on combat trauma. Herein we present the largest study of civilian UEVIs with over 7000 patients from a national databank.</div></div><div><h3>Methods</h3><div>The National Trauma Data Bank (NTDB) from 2017 was used to include subjects aged sixteen years and older presenting with UEVIs. These injuries were identified using ICD-10-CM codes with locations classified as subclavian, axillary, brachial, or distal. Isolated superficial injuries were excluded. Vascular procedures were classified using the ICD-10-PCS and specific procedures of interest included surgical amputation, ligation, primary repair, and endovascular stent placement. Demographic data and injury descriptors such as injury severity score (ISS) and mechanism of injury were compiled for all patients. Outcomes including surgical amputation and death were assessed for association with ISS using chi-square analysis and <em>t</em>-tests. Associations between treatment modality and odds of surgical amputation were modeled using logistic regression.</div></div><div><h3>Results</h3><div>Seven thousand and fifty patients were included in the analysis. Penetrating injuries accounted for 63 % of injuries while 35 % were blunt. A total of 234 deaths (3.3 %) occurred and 382 injuries involved traumatic amputation (5.4 %) as seen in Table 2. The commonly documented treatment modality was primary repair in 3072 patients (43.6 %) followed by surgical ligation in 1152 patients (16.3 %). Nine-hundred and forty-four patients (14.4 %) underwent endovascular stent placement, and 445 patients (6.3 %) underwent surgical bypass. Two hundred and seventy patients underwent surgical amputation (3.8 %). Patients who underwent surgical amputation had significantly higher mean ISS when compared with patients who did not (11.6 vs 9.7, P = .007) but a lower prevalence of death (1.1 % vs 3.4 %, P = .036). Those undergoing ligation or primary repair had significantly decreased odds of surgical amputation (OR ligation = 0.45; OR primary repair = 0.68; both <em>p</em> &lt; .01) compared to those who underwent endovascular stent placement (OR = 1.62, P = .002).</div></div><div><h3>Conclusions</h3><div>Both penetrating and blunt civilian trauma may lead to significant UEVIs requiring surgical intervention. Surgical amputation was interestingly associated with lower mortality rates despite those patients having higher ISS. Open surgical interventions were associated with higher limb salvage rates compared to endovascular interventions.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100350"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722896","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":"Spontaneous arteriovenous fistula of the splenic pedicle with isolated heart failure: A case report and litterature review","authors":"Antoine Mathivet,&nbsp;Eric Picard,&nbsp;Pascal Branchereau,&nbsp;Elsa Faure","doi":"10.1016/j.avsurg.2024.100349","DOIUrl":"10.1016/j.avsurg.2024.100349","url":null,"abstract":"<div><div>Arteriovenous fistulas (AVFs) of the splenic pedicle are rare entities. They are sometimes encountered at the stage of complications. The challenge is to treat patients at an early stage, to avoid complications, and possibly reverse it. Here, we discuss the case of a 72-year-old female patient, that we saw in the Vascular Surgery Unit at Nîmes University Hospital, with an incidentally discovered asymptomatic arteriovenous fistula. The patient presented with a large, asymptomatic arteriovenous fistula of the splenic pedicle, responsible of an isolated heart failure, which was treated by embolization in interventional radiology. The treatment was successful, as the follow-up CT scan showed that the fistula had disappeared. It appears necessary to treat patient patients with AVFs, even if asymptomatic, at an early stage to avoid persistence of a heart failure even after a successful treatment.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100349"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706608","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}