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

{"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}

{"title":"Angioplasty in the treatment of median arcuate ligament compression syndrome combined with splenic aneurysm: A case report","authors":"Sai Xiang ,&nbsp;Xiaodong Wang ,&nbsp;Jifu Lai","doi":"10.1016/j.avsurg.2024.100348","DOIUrl":"10.1016/j.avsurg.2024.100348","url":null,"abstract":"<div><div>Median Arcuate Ligament Syndrome (MALS) is characterized by clinical manifestations resulting from the direct compression of the celiac trunk by the median arcuate ligament. Symptoms typically include postprandial abdominal pain, nausea, vomiting, and weight loss. The patient, a 69-year-old female, presented with complaints of coughing, abdominal pain, and weight loss following positional changes. Physical examination revealed a systolic vascular murmur in the mid and upper abdomen, which was accentuated during exhalation. Abdominal aortic CTA indicated severe stenosis at the origin of the celiac trunk and localized dilation of the splenic artery. These findings strongly suggested MALS. In this case, we proceeded with endovascular treatment, achieving early symptom relief. Given the rarity of MALS and its nature as a diagnosis of exclusion, the diagnosis and treatment approach may lack clarity. Symptom relief can be achieved with a variety of interventions including celiac ganglionectomy as well as open, laparoscopic, or robotic intervention. Endovascular treatment for MALS has been questioned in the past, the diagnosis and treatment of MALS must be patient-centered, tailored to the individual needs of each patient.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 4","pages":"Article 100348"},"PeriodicalIF":0.0,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654690","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":"2024-10-24","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}