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

{"title":"Ruptured tibioperoneal trunk aneurysm caused by hypermucoviscous invasive Klebsiella pneumoniae infection: A case report","authors":"Shintaro Ninomiya,&nbsp;Takafumi Akai,&nbsp;Takanori Nishimura,&nbsp;Takatoshi Furuya,&nbsp;Motoki Nagai","doi":"10.1016/j.avsurg.2024.100287","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100287","url":null,"abstract":"<div><p>Ruptured tibioperoneal trunk aneurysms are rare, and <em>Klebsiella pneumoniae</em> is seldom reported as a causative bacterium of infectious aneurysms. We report a case of tibioperoneal trunk pseudoaneurysm caused by hypermucoviscous <em>K. pneumoniae</em> infection. The aneurysm ruptured and bled into the abscess cavity of the lower leg. Endovascular coil embolization was performed, and the aneurysm was successfully excluded. After the procedure, collateral circulation was maintained, and infection was controlled. In the present case report, we describe a significant case history in which hypermucoviscous <em>K. pneumoniae</em> contributed to aneurysm formation and demonstrate the efficacy of coil embolization for treating infectious aneurysms.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100287"},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000394/pdfft?md5=6bedb8d39b2a84c81e27ea3ee4f2f19a&pid=1-s2.0-S2772687824000394-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140905366","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":"Glomus tumor in extra subungual locations: A case series","authors":"Felipe Labaki Pavarino ,&nbsp;Adriano Carvalho Guimarães ,&nbsp;Felipe Caetano Mamprim ,&nbsp;Márcia Maria Morales ,&nbsp;Carlos Otávio Gonçalves ,&nbsp;Mariana Collete ,&nbsp;Walter Junior Boim de Araujo","doi":"10.1016/j.avsurg.2024.100286","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100286","url":null,"abstract":"<div><h3>Introduction</h3><p>Glomus tumors are rare benign neurovascular tumors derived from the neuromyoarterial glomus apparatus. They are more frequent in the hand and their cause is unknown. The purpose of this study was to describe a case series of patients who presented with glomus tumors in unusual body parts, in a non-subungual location.</p></div><div><h3>Case series</h3><p>Three cases, from three different Institutions, were reported. All patients were male presenting with lesions characterized as a painful and solitary nodule in unusual areas, specifically in the left lower extremity: one in the calf, the other in the knee, and the third in the thigh. The nodules were not palpable, but with severe induced pain when touched, and with temperature sensitivity relation. Further investigation using Magnetic Resonance Imaging showed low signal intensity on T1 and high signal intensity on T2-weighted images. Ultrasound scanning was also a method to investigate and support the diagnosis. All patients underwent a total surgical resection, and histopathologically confirmed the diagnosis of glomus tumors, revealing oval and circular cell proliferation in association with vascular structures. There was no recurrence reported.</p></div><div><h3>Conclusion</h3><p>Glomus tumors are a rare entity characterized by pain, point tenderness, and temperature sensitivity, particularly where the lesion is located. Clinical history and physical examination invariably clinch the diagnosis. To ensure the correct diagnosis and treatment of glomus tumors, it is essential to have a complete inventory of imaging resources, particularly for differential diagnosis, when dealing with tumors in unusual locations.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100286"},"PeriodicalIF":0.0,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000382/pdfft?md5=305a1909f37758dd553b7dcf3fe3a68b&pid=1-s2.0-S2772687824000382-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140879992","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":"Complex zone 0 aortic arch repair using TBE device: Case report and literature review","authors":"Eman H. Elbayoumi,&nbsp;Houssam Farres,&nbsp;Camilo A. Polania-Sandoval,&nbsp;Santh Prakash Lanka,&nbsp;Young Erben","doi":"10.1016/j.avsurg.2024.100285","DOIUrl":"10.1016/j.avsurg.2024.100285","url":null,"abstract":"<div><h3>Introduction</h3><p>The thoracic branch endoprosthesis (TBE) is intended for the treatment of proximal descending aortic pathology with preservation of the left subclavian artery blood flow. For the treatment of more extensive pathologies comprising the aortic arch, current devices are limited. We present a case and literature review regarding use of TBE device in a proximal (Zone 0) aortic aneurysm repair.</p></div><div><h3>Case report</h3><p>A 59-year-old male patient with a history of ascending aortic open repair due to a type A dissection presented with an enlarging proximal descending aorta. Due to refusal for further open aortic surgical intervention, a two-staged hybrid repair was performed comprising extra-anatomic bypasses followed by zone 0 TBE repair. Complications related to surgical intervention; but, not to the aortic arch repair included anaphylactic reactions that required rescheduling of surgical procedure. Postoperative follow-up demonstrated a successful repair with patent stent grafts and bypasses.</p></div><div><h3>Discussion</h3><p>TBEs are part of the emerging technologies for the treatment of aortic arch pathologies. This case highlights the use of the device in a patient with complex aortic dissection enlargement secondary to a previously emergent surgical management of a type A aortic dissection. The literature review highlights the emerging use of endovascular technologies and its pitfalls as the risk of stroke and endoleak in the short- and long-term are not insignificant.</p></div><div><h3>Conclusion</h3><p>Despite its off-label use, TBEs can be effective and a feasible solution in patients who either refuse or do not qualify for open aortic surgical intervention. However, close follow-up is necessary, as short- and long-term studies suggest a significant rate of stroke and endoleaks.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100285"},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000370/pdfft?md5=bc49e2f7dbfa77940052f5397e77ceeb&pid=1-s2.0-S2772687824000370-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765879","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":"Usefulness of trans-occluded pedal arch access to recanalize chronic total occlusion of the tibial artery in patients with chronic limb-threatening ischemia","authors":"Shinsuke Mori ,&nbsp;Tatsuya Shimogawara ,&nbsp;Masakazu Tsutsumi ,&nbsp;Norihiro Kobayashi ,&nbsp;Yoshiaki Ito","doi":"10.1016/j.avsurg.2024.100284","DOIUrl":"10.1016/j.avsurg.2024.100284","url":null,"abstract":"<div><h3>Background</h3><p>Endovascular therapy (EVT) is often used for revascularization in patients with chronic limb-threatening ischemia. However, achieving revascularization is challenging. In instances where the guidewire cannot pass through the lesion using an antegrade approach, it is common to incorporate a retrograde approach, such as a trans-collateral approach or distal puncture. However, adding a retrograde approach to cases without below-the-ankle runoff is difficult. In such cases, we have successfully treated patients by directly puncturing the occluded pedal arch under extravascular ultrasound (EVUS) guidance and achieved a pull-through. We herein introduced the method and named it as the <strong>T</strong>rans-<strong>O</strong>ccluded <strong>P</strong>edal arch <strong>A</strong>ccess to recanali<strong>Z</strong>e chronic total occlusion of the tibial artery (TOPAZ) technique.</p></div><div><h3>Case Presentation</h3><p>A man in his 60 s with Rutherford class 6 peripheral artery disease presented with resting pain and gangrene in the left foot. Angiography revealed chronic total occlusion from the proximal posterior tibial artery to the plantar artery. EVT was selected; however, the conventional approach failed. Switching to a trans-pedal approach, we faced challenges, leading to a puncture of the occluded common plantar region using EVUS guidance. Successful revascularization was achieved without calcaneal branch loss. The patient's resting pain was alleviated, and his wounds healed 6 months post-EVT.</p></div><div><h3>Conclusions</h3><p>This case shows the efficacy of the novel TOPAZ technique in addressing difficulties in revascularization when conventional approaches, such as retrograde methods, fail.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100284"},"PeriodicalIF":0.0,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000369/pdfft?md5=376398fc32f62a99a889ea17917e70a2&pid=1-s2.0-S2772687824000369-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763206","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":"Intravascular lithotripsy to facilitate transcarotid artery revascularization in patients with heavily calcified carotid arteries","authors":"Maria Coluccio,&nbsp;Anoushiravan Amini,&nbsp;Evan C. Lipsitz,&nbsp;Saadat Shariff","doi":"10.1016/j.avsurg.2024.100283","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100283","url":null,"abstract":"<div><p>Transcarotid artery revascularization (TCAR) is an accepted and approved treatment for carotid artery stenosis in high-risk patients, and recently in standard risk patients under the guidelines of the recent CMS National Coverage Determination. However, it's applicability is limited by certain anatomic criteria, such as heavily calcified internal carotid arteries. We retrospectively reviewed two patients at our institution with heavily calcified internal carotid artery plaques who underwent intravascular lithotripsy and TCAR. These two cases demonstrate the feasibility of lithotripsy for modification of heavy, calcified plaque prior to TCAR for patients at high risk for carotid endarterectomy.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100283"},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000357/pdfft?md5=f3dea982ab2556b5c241a3e6e8860d03&pid=1-s2.0-S2772687824000357-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140650683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of arteriovenous malformation of the forearm","authors":"Crina V. Onciu ,&nbsp;Jacopo Maffeis ,&nbsp;Ion-Andrei Popescu ,&nbsp;Frédéric Teboul","doi":"10.1016/j.avsurg.2024.100282","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100282","url":null,"abstract":"<div><p>A 40-year-old man with a long-standing history of congenital arteriovenous malformation in his right forearm was seen with a large, pulsatile tumour in the hypothenar region extending with multiple tortuous vessels on the volar side of the forearm to the elbow crease. Preoperative Allen test and normal preoperative finger pressure measurement showed revascularization of the hand via radial artery. Ultrasonography, MRI and angiography described an arteriovenous malformation (AVM) type 4 Yakes, suggesting high risk for embolization. Surgical intervention with meticulous dissection and ulnar nerve release was performed in order to prevent important blood loss, distal ischemia and to preserve upper limb functionality. Surgical resection resulted in full recovery.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100282"},"PeriodicalIF":0.0,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000345/pdfft?md5=92dd7c0d6325b09c549d15fb15ca69a3&pid=1-s2.0-S2772687824000345-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140643889","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":"Temporary aneurysm sac perfusion following hybrid thoracic abdominal aortic aneurysm repair and literature review","authors":"Yaman Alsabbagh,&nbsp;Young Erben,&nbsp;Santh Prakash Lanka,&nbsp;Biraaj Mahajan,&nbsp;Houssam Farres","doi":"10.1016/j.avsurg.2024.100281","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100281","url":null,"abstract":"<div><p>Extensive thoracoabdominal aortic aneurysm (TAAA) repair is associated with paraplegia secondary to spinal cord ischemia (SCI), with rates reaching up to 37.5 %. Physiological preventive measures include cerebrospinal fluid (CSF) drainage, hypothermia, and permissive hypertension following TAAA repair. Temporary aneurysm sac perfusion (TASP) can be added as an adjunct procedure to facilitate spinal collateral network development in the post-operative period through an endoleak with subsequent seal. We report of a 70-year-old female patient, who underwent a hybrid TAAA repair using TASP.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100281"},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000333/pdfft?md5=afdf3bcf8255a0fc7693d2da9e6945df&pid=1-s2.0-S2772687824000333-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140533705","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 evolution in carotid care: Contemporary TCAR data and optimization techniques","authors":"Trung Nguyen,&nbsp;Murray Shames,&nbsp;Charles J Bailey","doi":"10.1016/j.avsurg.2024.100272","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100272","url":null,"abstract":"<div><h3>Objective</h3><p>Carotid endarterectomy (CEA) is the gold standard for revascularization of atherosclerotic extra-cranial carotid artery lesions. The introduction of transfemoral carotid artery stenting (TFCAS) led to multiple randomized controlled trials to compare the safety and efficacy of an endovascular approach against traditional CEA in the management of carotid artery stenosis. The operative management of carotid artery stenosis continues to evolve, with the more recent introduction of TransCarotid artery revascularization (TCAR) and a novel flow-reversal neuroprotection system. This manuscript reviews a brief history regarding carotid artery revascularization, as well as the indications, technical considerations, and clinical outcomes of the TCAR procedure.</p></div><div><h3>Technical considerations</h3><p>The preoperative, intraoperative, and postoperative medical and technical considerations are explored. Topics of discussion will include the indications and contraindications for TCAR, anatomic requirements, instructions for use (IFU) and off-label utility, optimal pharmacologic regimen with carotid stent placement, standard deployment and suggestions for hostile anatomy, as well as recommended postoperative management and surveillance imaging.</p></div><div><h3>Discussion</h3><p>The Society for Vascular Surgery (SVS) has published a consensus statement on the pathways available to obtain clinical competency and maintain technical proficiency with TCAR. Meta-analyses reviewing the contemporary technical success and clinical outcomes of TCAR have demonstrated high rates of procedural success and low rates of stroke, myocardial infarction, and death. Studies have further illustrated comparable one-year rates of peri‑procedural stroke between TCAR and CEA, for asymptomatic and symptomatic carotid lesions, with both outperforming TFCAS.</p></div><div><h3>Conclusion</h3><p>Management of extra-cranial carotid artery stenosis utilizing TCAR with the ENROUTE flow-reversal neuroprotection system has been widely adopted, yielding clinical outcomes and stroke prevention similar to traditional CEA and superior to TFCAS.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100272"},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000242/pdfft?md5=91db318944383673d89f1088a718c2d4&pid=1-s2.0-S2772687824000242-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140345095","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":"Retrograde approach for innominate artery stenting using flow reversal for neuroprotection in Re-operative carotid field","authors":"Richard Tan,&nbsp;Amandeep Juneja,&nbsp;Gregg Landis,&nbsp;Yana Etkin,&nbsp;Sean Alcantara","doi":"10.1016/j.avsurg.2024.100280","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100280","url":null,"abstract":"<div><p>A case of a 74 year old female with a prior history of right carotid endarterectomy (CEA) followed by carotid interposition bypass with polytetrafluoroethylene (PTFE) graft several years later due to restenosis. At 1 year follow up, she was found to have low velocities in the bypass and reversal of flow in her right vertebral artery indicating proximal stenosis. A computed tomography angiography (CTA) and magnetic resonance angiography (MRA) were obtained showing high grade occlusive lesion at her innominate artery. After an unsuccessful attempt at transfemoral endovascular intervention, the patient was brought back for a transcarotid retrograde approach utilizing ENROUTE ® Neuroprotection System with flow reversal for embolic protection. The lesions was crossed successfully in this approach and a balloon mounted covered stent was deployed using Gore ® VBX stent. There was significant amount of debris in the filter which would have embolized without neuroprotection. Patient was discharged on postoperative day 1 with no neurological deficits. In conclusion, this case highlights a successful use of ENROUTE ® Neuroprotection System flow reversal for retrograde transcarotid approach to treat difficult innominate lesions with satisfactory embolic protection.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100280"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000321/pdfft?md5=183501c9f8f3eaca36f59596a44d98c7&pid=1-s2.0-S2772687824000321-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140345131","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":"Transcarotid artery revascularization for in-stent restenosis complicated by flow reversal occlusion","authors":"Travis G Hughes ,&nbsp;Samuel C Tyagi","doi":"10.1016/j.avsurg.2024.100277","DOIUrl":"https://doi.org/10.1016/j.avsurg.2024.100277","url":null,"abstract":"<div><p>We report a case of symptomatic high grade in-stent restenosis of a prior placed transradial carotid artery stent. We performed a Transcarotid Artery Revascularization (TCAR) to treat this symptomatic restenosis. The TCAR was complicated by occlusion of our flow reversal system by a large atherosclerotic embolus. We performed a distal common carotid cutdown to retrieve the occlusive embolus and restored flow reversal. Completion neck and cerebral angiogram showed no filling defect, and our patient showed no neurologic deficit, and resolution of pre-operative symptoms.</p></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"4 2","pages":"Article 100277"},"PeriodicalIF":0.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772687824000291/pdfft?md5=632e35a0abb02c3ff2a60a423973b388&pid=1-s2.0-S2772687824000291-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140341098","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}