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

{"title":"Carotid artery intervention for 90 % stenosis forty-years after radiation in a patient with squamous cell carcinoma recurrence: A case report","authors":"Elisa Bass ,&nbsp;Phillip Pirgousis ,&nbsp;Sukhwinder Johnny Singh Sandhu ,&nbsp;David Miller ,&nbsp;Richard D. Beegle ,&nbsp;Young Erben","doi":"10.1016/j.avsurg.2025.100412","DOIUrl":"10.1016/j.avsurg.2025.100412","url":null,"abstract":"<div><h3>Introduction</h3><div>Head and neck cancer recurrence in previously irradiated patients presents complex surgical challenges, particularly when compounded by asymptomatic carotid artery stenosis. Radiation therapy is a known risk factor for carotid stenosis, increasing the likelihood of cerebrovascular events during surgical intervention.</div></div><div><h3>Case Presentation</h3><div>We describe a 74-year-old man with a history of squamous cell carcinoma of the right tonsil treated with surgery and radiation 40 years prior, who presented with a recurrence involving the right oral cavity. Preoperative imaging revealed 90 % asymptomatic stenosis of the right internal carotid artery (ICA). Carotid angioplasty without stenting was performed prior to wide surgical resection to reduce perioperative stroke risk. One month later, the patient underwent oropharyngectomy with reconstruction. Postoperative recovery was uneventful aside from minor wound complications. Final pathology showed negative margins and no nodal involvement, and no adjuvant therapy was required. Angioplasty, lithotripsy, and stenting of the right ICA was performed 11 months after the initial angioplasty due to asymptomatic restenosis.</div></div><div><h3>Discussion</h3><div>This case illustrates the importance of screening for carotid artery stenosis in patients with prior head and neck radiation who are undergoing salvage surgery. Carotid angioplasty without stenting offers a viable preoperative strategy in select patients to mitigate cerebrovascular risk while avoiding complications associated with dual antiplatelet therapy.</div></div><div><h3>Conclusion</h3><div>Carotid angioplasty followed by resection can be safely and effectively performed in patients with recurrent head and neck cancer and radiation-induced carotid stenosis. This case underscores the need for multidisciplinary planning and vigilance in preoperative assessment.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100412"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of diverging buddy wires to aid in precise endovascular stent placement at an arterial branch point","authors":"Thane Gehring,&nbsp;Joshua Gierman","doi":"10.1016/j.avsurg.2025.100402","DOIUrl":"10.1016/j.avsurg.2025.100402","url":null,"abstract":"<div><div>Endovascular stent placement at or near arterial branch points requires precision to avoid complications, including stent jumping or mal-deployment, with potential jailing of adjacent branch ostia. Here we describe the novel use of diverging buddy wires to ensure precise endovascular stent deployment in the innominate artery in a bovine arch initially managed by surgical primary repair. The use of divergent buddy wires provided stability in the complex anatomy, facilitating precise deployment at the arterial branch point with embolic protection in the carotid artery.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100402"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-stage hybrid management of a distal internal carotid mycotic aneurysm in a young adult: A case report","authors":"Ines Zekhnini,&nbsp;Xavier Bérard,&nbsp;Eric Ducasse,&nbsp;Caroline Caradu","doi":"10.1016/j.avsurg.2025.100417","DOIUrl":"10.1016/j.avsurg.2025.100417","url":null,"abstract":"<div><h3>Background</h3><div>Type IV carotid artery aneurysms are uncommon; mycotic variants are rarer and challenging. We report a distal internal carotid aneurysm managed with a two-stage hybrid approach.</div></div><div><h3>Case</h3><div>A 28-year-old man had an enlarging left cervical mass with transient dysphagia and dysphonia. CT showed a distal internal carotid aneurysm measuring 71 × 49 mm, extending to the pre-foraminal segment. FDG-PET/CT demonstrated avid uptake (SUV 8.9). Work-up excluded endocarditis; Quantiferon was positive. Multidisciplinary review deemed endografting unsuitable and bypass unsafe given absent distal control.</div></div><div><h3>Intervention</h3><div>Under local anesthesia, a 50-minute balloon occlusion test of the petrous internal carotid artery was followed by coil embolization and proximal vascular plug, completing arterial sacrifice. Post-procedure transient monocular visual loss corresponded to a small watershed infarct; hemodynamic augmentation achieved full recovery within 24 hours. Six days later, aneurysmectomy was performed with ligation of the common and external carotid arteries. Cultures grew <em>Cutibacterium acnes</em>; clindamycin then six weeks of amoxicillin were given. The patient was discharged day seven. At day 22 the wound had healed, dysphonia improved, and inflammatory markers fell without new neurologic events.</div></div><div><h3>Conclusion</h3><div>When anatomy precludes reconstruction, staged sacrifice after a successful balloon occlusion test can enable definitive aneurysmectomy while preserving cerebral perfusion.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100417"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular treatment of superior vena cava syndrome utilizing an iliac branch endoprosthesis","authors":"Carter Colwell,&nbsp;Bernard Boateng,&nbsp;Marisa Doran,&nbsp;Cole Pieroni,&nbsp;Esmaeel Dadashzadeh,&nbsp;Joshua D. Adams","doi":"10.1016/j.avsurg.2025.100416","DOIUrl":"10.1016/j.avsurg.2025.100416","url":null,"abstract":"<div><h3>Background</h3><div>Endovascular therapy is the preferred treatment for superior vena cava (SVC) syndrome, providing rapid symptom relief and high technical success. Lesions involving the confluence of the bilateral innominate veins and SVC, however, remain challenging due to complex anatomy and limited durability of standard stents.</div></div><div><h3>Methods</h3><div>This case series describes the off-label use of the Gore Iliac Branch Endoprosthesis (IBE) for reconstruction of the SVC confluence in four patients with SVC syndrome: three with malignant etiologies and one with benign catheter-associated thrombosis.</div></div><div><h3>Results</h3><div>Technical success was achieved in all patients, with immediate restoration of venous flow and symptom resolution. In malignant cases, patency was maintained until death from cancer at 5–20 months. The benign case demonstrated durable patency and complete symptom relief at 18-month follow-up. No procedural complications or early device failures occurred.</div></div><div><h3>Conclusions</h3><div>The Gore IBE offers a feasible approach for anatomic reconstruction of the SVC confluence, accommodating bilateral venous inflow while maintaining luminal integrity. This technique may overcome limitations of parallel stenting, providing durable symptom relief in both malignant and benign SVC syndrome. Further investigation is warranted to evaluate long-term outcomes and broader applicability.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100416"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145618259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stent occlusion after catheter-directed thrombolysis and iliac vein stenting in May-Thurner syndrome with iliofemoral deep vein thrombosis: A case report and literature review","authors":"Haijun Huang,&nbsp;Zuoyi Yao,&nbsp;Ke Guo,&nbsp;Yunping Liu,&nbsp;Qian Zhang,&nbsp;Wei Wei,&nbsp;Kan Zhao","doi":"10.1016/j.avsurg.2025.100401","DOIUrl":"10.1016/j.avsurg.2025.100401","url":null,"abstract":"<div><h3>Background</h3><div>Stent occlusion following endovascular management of May-Thurner syndrome (MTS) with iliofemoral deep vein thrombosis (DVT) remains a significant clinical challenge. This case report and literature review examines mechanical, procedural, and patient-specific determinants of stent failure in chronic venous disease.</div></div><div><h3>Case Presentation</h3><div>A 78-year-old female with acute left iliofemoral DVT post-hip arthroplasty underwent catheter-directed thrombolysis (CDT) and iliac vein stenting. Despite initial technical success and rivaroxaban therapy, stent occlusion occurred at 1-month follow-up, necessitating secondary stenting. Venography revealed residual thrombus at the inflow tract and incomplete coverage of the iliocaval confluence as likely contributors.</div></div><div><h3>Literature Review</h3><div>Analysis of 29 studies identified critical factors influencing stent patency:</div><div>Mechanical determinants: Larger stent diameter (≥16 mm) and optimized iliocaval confluence coverage reduced restenosis risk. In-stent shear rate &gt;100 s⁻¹ and inflow luminal area &gt;125 mm² correlated with patency.</div><div>Thrombotic risk: Chronic post-thrombotic lesions (residual thrombus &gt;30 %) and antiphospholipid syndrome increased occlusion risk.</div><div>Anticoagulation: Combined anticoagulant/antiplatelet regimens reduced stent malfunction by 72 % (HR=0.28), while extended anticoagulation (6–12 months) showed no superiority over shorter durations in recent cohorts.</div></div><div><h3>Conclusion</h3><div>This case highlights the multifactorial nature of venous stent failure. Key recommendations include:</div><div>Aggressive thrombus clearance during CDT (&lt;30 % residual burden)</div><div>IVUS-guided stent sizing to achieve optimal shear dynamics</div><div>Tailored anticoagulation incorporating thrombophilia screening</div><div>Anatomic precision in iliocaval confluence coverage</div><div>Prospective studies are needed to validate biomechanical thresholds and pharmacogenetic approaches in venous stent management.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100401"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left internal mammary artery supplying collateral circulation to the epigastric arteries is circumvented with axillofemoral bypass permitting coronary artery bypass grafting and mitral valve repair","authors":"Brady Antolick ,&nbsp;Andrew D. Vogel ,&nbsp;Schafer Paladichuk ,&nbsp;Melissa Obmann ,&nbsp;Christopher Demaioribus ,&nbsp;Tyler J. Wallen","doi":"10.1016/j.avsurg.2025.100405","DOIUrl":"10.1016/j.avsurg.2025.100405","url":null,"abstract":"<div><h3>Introduction</h3><div>Aortoiliac occlusive disease (AIOD) is a subset of peripheral artery disease (PAD) characterized by occlusion of the infrarenal aorta and iliac arteries. Patients with AIOD may develop collateral circulation through the internal thoracic artery–inferior epigastric artery (ITA-IEA) pathway to maintain lower extremity perfusion. Coronary artery disease (CAD) often necessitates coronary artery bypass grafting (CABG), where the left internal mammary artery (LIMA) is the preferred conduit for revascularizing the left anterior descending (LAD) artery. In patients with AIOD, disruption of ITA-IEA collaterals during CABG poses a risk of exacerbating lower extremity ischemia.</div></div><div><h3>Case description</h3><div>We report a case of a 65-year-old female with severe multivessel CAD, mitral valve regurgitation (MVR), and AIOD with ITA-IEA collaterals supplying the lower extremities. Preoperative imaging revealed an occluded distal aorta with inadequate venous conduits. To preserve lower extremity perfusion, the patient underwent axillary-femoral and femoral-femoral bypasses before CABG. A two-vessel CABG was performed using the LIMA to the LAD and the radial artery to the obtuse marginal artery, along with mitral valve replacement. The patient recovered well and was discharged 11 days postoperatively without complications.</div></div><div><h3>Discussion</h3><div>This case highlights the complexities of managing concurrent AIOD and CAD, emphasizing the importance of preserving collateral circulation. Preoperative imaging enabled strategic surgical planning to balance myocardial revascularization and lower extremity perfusion. The successful use of alternative conduits, such as the radial artery, underscores the necessity of flexibility in graft selection. Multidisciplinary collaboration and individualized surgical planning are crucial in managing patients with AIOD and CAD.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100405"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145097896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular exclusion for a left vein brachiocephalic pseudoaneurysm","authors":"Hao Zhao,&nbsp;Baoning Zhou,&nbsp;Gaopo Cai,&nbsp;Zhen Li,&nbsp;Zhaohui Hua","doi":"10.1016/j.avsurg.2025.100414","DOIUrl":"10.1016/j.avsurg.2025.100414","url":null,"abstract":"<div><h3>Background</h3><div>Venous pseudoaneurysms combined with intramural thrombus are rare vascular malformations with few reported cases. Progression of aneurysms may lead to pulmonary embolism, requiring prophylactic measures including surgical resection or intervention. The indications for these treatment modalities, however, are controversial and the salient features supporting the choice of treatment are unclear. We report a case of venous pseudoaneurysm in the left brachiocephalic veincombined with an intratumoral thrombus, which was treated with endoluminal isolation with a laminating stent.</div></div><div><h3>Case presentation</h3><div>A 53-year-old woman was admitted after a physical examination had revealed a mediastinal mass 2 months earlier. CTV showed an irregular tumour-like dilatation at the confluence of the left brachiocephalic vein, with a maximal cross-sectional area of 40.9 mm × 45.3 mm. Intervention wasrecommended due to the risk of progression and rupture of the venous aneurysm. Endovascular surgery was performed, with good postoperative recovery. At 1 year follow-up, the patient was asymptomatic with no complications and the stent lumen remained patent.</div></div><div><h3>Conclusion</h3><div>Endovascular surgery may be a viable treatment option for cases such as the one described; however, its long-term efficacy requires further evaluation.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100414"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular repair of a primary aortoenteric fistula with staged open aortoplasty and omentopexy with duodenal repair","authors":"Amir R. Akhavan ,&nbsp;Charles A. West Jr. ,&nbsp;Jonathan S. Deitch ,&nbsp;John L. Crawford","doi":"10.1016/j.avsurg.2025.100407","DOIUrl":"10.1016/j.avsurg.2025.100407","url":null,"abstract":"<div><div>Primary aortoenteric fistulas (AEFs) are rare and life-threatening. We report the successful hybrid management of a 60-year-old man who presented in hemorrhagic shock from a primary aortoduodenal fistula arising from an unsuspected abdominal aortic aneurysm. The patient underwent emergent endovascular aneurysm repair (EVAR) followed by early, staged open aortoplasty and duodenal repair with omental flap reinforcement two days later. This case illustrates the successful use of a non-traditional approach to management of a primary AEF in an unstable patient. Few reports describing this technique have been found in the literature.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100407"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145121287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute arterial occlusion due to thrombotic occlusion of the great saphenous vein graft following popliteal artery aneurysm surgery: a case report","authors":"Kazuki Nagashima ,&nbsp;Takahiro Toyofuku ,&nbsp;Koji Yonekura ,&nbsp;Takaki Sakoma ,&nbsp;Norihide Sugano","doi":"10.1016/j.avsurg.2025.100413","DOIUrl":"10.1016/j.avsurg.2025.100413","url":null,"abstract":"<div><div>Popliteal artery aneurysms require treatment in symptomatic cases or when the aneurysm diameter exceeds 20 mm, with graft replacement using the great saphenous vein being one of the most common treatment options. Although aneurysmal degeneration of great saphenous vein grafts has been reported, it is rare. We report the case of a 77-year-old woman who had undergone resection of a popliteal artery aneurysm and graft replacement with the left great saphenous vein three years previously. Two years after surgery, angiography revealed a 9.5-mm graft aneurysm, which was managed conservatively. She presented to our hospital with a 3-day history of intermittent claudication and coldness in her left lower limb. On examination, the left popliteal pulse was absent. Ultrasonography suggested acute arterial occlusion due to thrombosis extending from the origin of the superficial femoral artery through the graft to the anterior tibial artery. Emergency surgery was performed, revealing a 35-mm graft aneurysm. Thrombectomy was carried out, followed by aneurysm resection and graft replacement using a newly harvested great saphenous vein. This case highlights that although rare, saphenous vein graft aneurysms can lead to acute arterial occlusion, and early resection and replacement should be considered once detected.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100413"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early to mid-term outcomes of axillo-bifemoral bypass using T-shaped heparin-bonded expanded polytetrafluoroethylene grafts","authors":"Yusuke Nakata,&nbsp;Hikaru Uchiyama,&nbsp;Kazuyuki Miyamoto","doi":"10.1016/j.avsurg.2025.100404","DOIUrl":"10.1016/j.avsurg.2025.100404","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to evaluate the early to mid-term outcomes of axillo-bifemoral bypass (AxBF) using T-shaped heparin-bonded expanded polytetrafluoroethylene (HB-ePTFE) grafts for bilateral aorto-iliac occlusive disease.</div></div><div><h3>Materials and Methods</h3><div>This was a retrospective, observational, and descriptive case series. Between February 2014 and October 2023, ten patients with abdominal aortic to iliac artery lesions underwent AxBF for bilateral aorto-iliac occlusive disease. Before June 2018, nine patients underwent aortic-bilateral femoral artery bypass (AoB) via the open abdomen approach for bilateral aorto-iliac occlusive disease. We investigated the reintervention rate, survival rate, and cause of death of the patients in the AxBF and AoB groups.</div></div><div><h3>Results</h3><div>During the observation period, reintervention was performed for other graft occlusions or residual lesions in more distal vessels in two patients in the AxBF group and for occlusion due to lower extremity thrombosis in one patient from the AoB group. These events were managed appropriately, with no procedure-related mortality.</div></div><div><h3>Conclusion</h3><div>AxBF using T-shaped HB-ePTFE grafts was technically feasible and performed safety, without procedure-related mortality, in this series of high-risk patients with bilateral aorto-iliac occlusive disease. These observations support the viability and perioperative safety of the approach. However, given the retrospective design, small sample size, and selective patient inclusion, these results should be interpreted as descriptive observations, and further prospective studies are warranted to confirm their clinical significance.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100404"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145097897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}