Reports (MDPI)最新文献

{"title":"Case Report A Rare Cause of Cardiofaciocutaneous Syndrome-KRAS p.Pro34arg: Clinical Delineation, Diagnostic Challenges, and Implications for RASopathy Classification.","authors":"Francisco J Mérida De Ia Torre, Mónica Coll Vidal, Ivette Rubio Martínez, Lucía Quintana Tello, Ramón Brugada Terradellas","doi":"10.3390/reports9040335","DOIUrl":"https://doi.org/10.3390/reports9040335","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Cardiofaciocutaneous syndrome (CFC) is a rare autosomal dominant RASopathy characterized by craniofacial dysmorphism, congenital heart defects, cutaneous abnormalities, growth impairment, and neurodevelopmental delay. Pathogenic variants in <i>KRAS</i> account for a minority of cases and define cardiofaciocutaneous syndrome type 2 (CFC2). Establishing a molecular diagnosis is often challenging because of the substantial clinical overlap among RASopathies, including Noonan and Costello syndromes. <b>Case Presentation</b>: We describe a one-year-old boy presenting with macrocephaly, ventriculomegaly, hypotonia, developmental delay, hypertrophic cardiomyopathy, gastroesophageal reflux, and mild dermatological abnormalities. To clarify the diagnosis, a custom next-generation sequencing panel targeting RASopathy-associated genes was performed. Genetic analysis identified a heterozygous <i>KRAS</i> variant, NM_033360.4:c.101C>G, p.(Pro34Arg), which was confirmed by Sanger sequencing and shown to have arisen de novo through parental testing. Additional variants of uncertain significance were detected in <i>ABCC9</i>, <i>CACNA1G</i>, and <i>DES</i>; however, these were considered unlikely to account for the phenotype because of limited clinical concordance and current ACMG/AMP classification. The <i>KRAS</i> variant was classified as pathogenic based on its de novo occurrence, absence from population databases, localization within a critical functional domain, supportive computational evidence, and previously reported pathogenic substitutions affecting the same residue. <b>Conclusions</b>: This case provides additional evidence supporting the pathogenicity of <i>KRAS</i> p.(Pro34Arg), a variant reported only rarely in association with CFC. The observed phenotype further expands the clinical spectrum of KRAS-associated CFC and highlights the value of comprehensive molecular testing for the differential diagnosis of RASopathies and the refinement of genotype-phenotype correlations.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149278511","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":"Preliminary Clinical Case Series for Evaluation of a Novel Bi-Dimensional Archwire During Miniscrew-Supported En-Masse Retraction of the Maxillary Anterior Teeth.","authors":"Abdulmalek M H Almasri, Mohammad Y Hajeer, Ahmad S Burhan, Safwan Jaber","doi":"10.3390/reports9040334","DOIUrl":"https://doi.org/10.3390/reports9040334","url":null,"abstract":"<p><strong>Background/objectives: </strong>Efficient en-masse retraction of the maxillary anterior teeth requires adequate anchorage control while maintaining acceptable incisor torque. This prospective clinical case series aimed to provide an initial clinical evaluation of a novel laser-welded bi-dimensional archwire designed for miniscrew-supported en-masse retraction in adult patients with Class II Division 1 malocclusion.</p><p><strong>Methods: </strong>Six patients requiring extraction of the maxillary first premolars were treated using a custom-made stainless-steel archwire consisting of a 0.019 × 0.025-inch anterior segment and 0.016 × 0.022-inch posterior segments. Retraction was performed using nickel-titanium closed-coil springs delivering approximately 250 g of force per side. The primary outcome was the monthly rate of maxillary anterior retraction measured on three-dimensional digital models. The secondary outcome was the change in maxillary incisor torque assessed on lateral cephalometric radiographs using the bracket-archwire angle.</p><p><strong>Results: </strong>Repeated measurements showed no statistically significant systematic error, with method errors ranging from 0.14 to 0.31 mm for linear variables and from 0.72° to 1.08° for angular variables; intraclass correlation coefficients ranged from 0.91 to 0.97. The overall mean retraction rate was 0.97 ± 0.05 mm/month, and the mean retraction duration was 5.78 ± 0.79 months. The mean change in maxillary incisor torque was 7.08 ± 1.29°.</p><p><strong>Conclusions: </strong>Within the limitations of this six-participant clinical case series, the novel bi-dimensional archwire was associated with a relatively stable observed rate of anterior retraction, although a measurable change in the bracket-archwire angular relationship remained. These descriptive findings should be regarded as preliminary and hypothesis-generating and require confirmation in adequately powered controlled studies.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT07664215; retrospectively registered on 24 June 2026.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149278473","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":"Intravenous Leiomyomatosis-A Single Centre Experience and Literature Review.","authors":"Olivera Dzatic Smiljkovic, Vesna Mandic Markovic, Ksenija Lalic, Lazar Nejkovic, Aleksandar Ristic","doi":"10.3390/reports9040333","DOIUrl":"https://doi.org/10.3390/reports9040333","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Intravenous leiomyomatosis (IVL) is a rare, histologically benign proliferation of uterine smooth-muscle cells that extend intravascularly. The clinical significance of IVL lies in the potential for mechanical obstruction of the major veins and heart, as well as possible thromboembolic complications. <b>Methods:</b> A retrospective case series included four patients with confirmed IVL, treated at the Clinic for Gynaecology and Obstetrics \"Narodni front\" between 1 January 2020 and 31 December 2025. The following were recorded: medical history, imaging diagnostics (ultrasound, MRI), operative findings, histopathology, and follow-up data. The study was approved by the Ethics Committee, and written informed consent for participation in the study was obtained from all the patients. <b>Results:</b> The series included four patients aged 40 to 73 with histologically confirmed IVL who were treated surgically. In one patient, an intraoperative complication occurred in the form of sigmoid colon lesion and consequential resection, requiring surgical reconstruction, while the remaining procedures were completed without major complications. Histopathological findings in all cases indicated benign smooth-muscle differentiation with the presence of intravascular nodules of smooth-muscle cells (IVL). Residual disease and recurrence were documented in one patient. <b>Conclusions:</b> Our cases reflect a diverse spectrum of clinical presentations of IVL indicating the heterogeneity of the disease and the importance of a multimodal, multidisciplinary approach to the optimal management of this rare entity. The absence of further disease progression in our patients following bilateral oophorectomy, i.e., iatrogenic menopause, suggests the possible hormonal dependence of IVL.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149278406","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":"Peripheral Nerve Schwannoma with an Unusual Anatomical Site.","authors":"Alina Badlaeva, Natalia Mezhelumova, Natalia Arzhanukhina, Dmitry Bulanov","doi":"10.3390/reports9040332","DOIUrl":"https://doi.org/10.3390/reports9040332","url":null,"abstract":"<p><p>We present the case of a 40-year-old woman diagnosed with schwannoma at an infrequent localization. The patient complained of multiple painful lesions in the vulvar region and perianal fold, accompanied by intense, constant pain that slightly increased during menstruation. The initial diagnosis was extragenital endometriosis. Histopathological analysis demonstrated a characteristic proliferation of bland spindle cells arranged in short fascicles containing Verocay bodies, as well as a distinctive immunophenotype, supporting the diagnosis of schwannoma. This case underscores the diagnostic difficulty of distinguishing schwannoma from other mesenchymal tumors and non-tumor lesions at this site using imaging alone and emphasizes the need for histopathological confirmation to reach a definitive diagnosis.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149278357","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":"Polymicrobial Periprosthetic Infection with <i>Pasteurella canis</i> Following Total Knee Arthroplasty: A Case Report.","authors":"Elena Cristina Gîrbovan, Alexandra Ioana Asztalos, Adrian Vlad Pop, Anca Meda Văsieșiu, Mircea Gîrbovan, Anca Cighir","doi":"10.3390/reports9040331","DOIUrl":"https://doi.org/10.3390/reports9040331","url":null,"abstract":"<p><p><b>Background and clinical significance:</b><i>Pasteurella</i> spp. are Gram-negative coccobacilli, aerobic facultatively anaerobic, belonging to the <i>Pasteurellaceae</i> family. In humans, they are known to cause zoonotic diseases, which usually develop after dog or cat bites, licks or scratches. <b>Case presentation:</b> We present the case of a 61-year-old patient, with cardiovascular comorbidities, who presented to the Orthopedics Department, 38 days after knee replacement surgery, with recurrence of pain on walking, an antalgic gait with auxiliary support, and local signs of inflammation at the level of the left knee joint. The patient admitted to owning a dog who accidentally licked the post-surgical wound. The symptoms were suggestive of a post-surgical wound infection with extension to the periprosthetic area. A purulent discharge was collected from the wound during surgical debridement and sent to the microbiological laboratory for diagnosis, where <i>Pasteurella canis</i> was identified using MALDI-TOF MS. Antibiotic susceptibility testing (AST) was performed according to the EUCAST guidelines and empiric antibiotic treatment was started with Cefuroxime. During his future admissions to the Orthopedics and Infectious Diseases departments, two more samples were collected, in which <i>Pasteurella canis</i> was isolated, along with <i>Klebsiella oxytoca</i> (second sample), and <i>Klebsiella oxytoca</i> and <i>Pseudomonas aeruginosa</i> (third sample). Patient evolution was favorable due to the debridement of the wound and combined antibiotic treatment, with Ceftazidime and Gentamicin. <b>Conclusions:</b> Infections with <i>Pasteurella canis</i> are rare but slowly increasing due to more and more humans owning pets. The present case underlines the importance of interdisciplinary collaborations when rare pathogens are identified.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149278399","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":"Combined Endodontic Retreatment and Intentional Replantation for External Cervical Resorption: A Four-Year Follow-Up Case Report.","authors":"Ayman M Abulhamael","doi":"10.3390/reports9040328","DOIUrl":"https://doi.org/10.3390/reports9040328","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> External cervical resorption (ECR) is an insidious form of root resorption that frequently progresses undetected until an advanced stage, particularly when the lesion extends apical to the alveolar crest or involves a substantial proportion of the root circumference, precluding adequate visualization and debridement via conventional intraoral approaches. <b>Case Presentation:</b> This report describes the management of a 30-year-old male who presented with an acute apical abscess associated with a mandibular second molar with inadequate previous root canal treatment, in conjunction with an extensive distal cervical resorption defect and a large periapical radiolucency. Due to lack of availability of a CBCT machine at the time, no preoperative CBCT was obtained; diagnosis and treatment planning were based on clinical examination and periapical radiography. Given the anatomical inaccessibility of the resorptive lesion and the concurrent persistent periapical pathology, treatment consisted of nonsurgical root canal retreatment followed by intentional replantation to permit extraoral access and repair. The tooth was replanted after an extraoral period of less than 15 min and stabilized with a flexible splint. The patient was reviewed at 2 weeks and was then lost to routine follow-up until a 4-year reassessment. At that time, the tooth was functional and asymptomatic, with complete radiographic resolution of the previous periapical radiolucency and no clinically or radiographically evident signs of progressive root resorption or ankylosis. <b>Conclusions:</b> This case documents a favorable four-year outcome following intentional replantation combined with endodontic retreatment and bioceramic repair in a multi-rooted tooth with extensive, conventionally inaccessible ECR.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149278451","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":"Non-Contiguous Cervical and Thoracic Spinal Cord Injuries After Severe Polytrauma: A Case Report.","authors":"Fernando Martins Braga, Elena Tello Santamaria, Margarita Vallès, Hatice Kumru","doi":"10.3390/reports9040330","DOIUrl":"https://doi.org/10.3390/reports9040330","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Non-contiguous traumatic spinal cord injury (SCI) can be difficult to recognise and classify in severe polytrauma, especially when traumatic brain injury (TBI) and limb injuries limit neurological examination. <b>Case Presentation:</b> A 17-year-old male was involved in a motorcycle accident resulting in severe polytrauma with TBI. Brain magnetic resonance imaging (MRI) showed a grade III diffuse axonal injury. Trauma computed tomography (CT) identified C2 and T3-T5 vertebral fractures. Spinal MRI revealed a non-haemorrhagic C3-C6 contusive myelopathy, a T4 spinal cord contusion, and a thoracic posterior epidural haematoma. He underwent posterior T2-T7 fixation. Acute neurological examination was limited by impaired consciousness and associated injuries. At four months, the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) assessment showed a neurological level of C2, and a total motor score of 55. Electrodiagnostic testing showed active bilateral C5-T1 denervation. At seven months and one year, the total motor score increased to 63 and 82, respectively, accompanied by substantial functional improvement. <b>Conclusions:</b> In severe polytrauma with TBI, non-contiguous SCI should be considered when neurological examination is unreliable. In non-contiguous SCI, clinical assessment should integrate neurological examination, including quantitative motor and sensory scores, with imaging and neurophysiological studies, cognitive status, associated injuries, and functional outcomes.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149278425","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":"Secondary Hemophagocytic Lymphohistiocytosis Mimicking Sepsis in Adults: A Case Series.","authors":"Damián Ochoa Guette, Jennifer Patricia Vargas Gomez, Breallan De Jesús Romero Pájaro, Rafael Tous Bertel, Amilkar Almanza Hurtado","doi":"10.3390/reports9040329","DOIUrl":"https://doi.org/10.3390/reports9040329","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Secondary hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome that can closely resemble sepsis in adults, potentially delaying recognition and treatment. Because infection may trigger or coexist with HLH, persistent or disproportionate inflammation despite appropriate antimicrobial therapy should prompt reassessment for concomitant HLH and investigation of the underlying trigger; <b>Case Presentation:</b> We describe three adults initially managed for presumed sepsis or severe infection at a referral hospital in Colombia. All developed persistent fever, cytopenias, organomegaly, and marked hyperferritinemia. HScore values were 222, 246, and 248, respectively; the score in Case 3 was calculated retrospectively from available pretreatment data. Bone marrow hemophagocytosis was demonstrated in Cases 1 and 2 but not in Case 3. The underlying triggers were acute myeloid leukemia, disseminated histoplasmosis in the setting of advanced HIV infection, and visceral leishmaniasis. The malignancy-associated case had an unfavorable outcome. Both infection-associated cases improved after pathogen-directed therapy combined with corticosteroids to control hyperinflammation, without escalation to an etoposide-based regimen; <b>Conclusions</b>: Sepsis and secondary HLH should not be regarded as mutually exclusive diagnoses. Persistent or disproportionate inflammation accompanied by progressive multilineage cytopenias, splenomegaly, markedly elevated or rising ferritin levels, hypertriglyceridemia, and/or decreasing fibrinogen should prompt early HScore calculation, assessment of HLH-2004 criteria, and concurrent investigation for an underlying trigger. Recognition of the clinical pattern and individualized treatment of both the trigger and hyperinflammatory state may facilitate timely management.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149278530","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":"Hepatic Mycotic Aneurysms in TAVI-Associated Infective Endocarditis Caused by <i>Streptococcus gallolyticus</i>: A Case Report.","authors":"Mihai Grigore, Camelia Nicolae, Horațiu Moldovan, Ana-Maria Balahura, Adriana-Mihaela Ilieșiu","doi":"10.3390/reports9040327","DOIUrl":"https://doi.org/10.3390/reports9040327","url":null,"abstract":"<p><p><b>Background and Clinical Significance:</b> Infective endocarditis following transcatheter aortic valve implantation (TAVI) is a severe complication that may be associated with prosthetic valve dysfunction, local infectious extension, and systemic embolization. Visceral mycotic aneurysms are uncommon, particularly those involving the hepatic arterial circulation. <b>Case Presentation:</b> We report the case of an 80-year-old woman who developed <i>Streptococcus gallolyticus</i> TAVI-associated prosthetic valve endocarditis (TAVI-PVE) four months after valve implantation. Despite prolonged antimicrobial therapy and subsequent negative blood cultures, the clinical course was complicated by persistent prosthetic and periprosthetic echocardiographic abnormalities, cerebral and splenic embolic events, and new-onset abdominal pain. Contrast-enhanced computed tomography revealed two hepatic arterial aneurysmal lesions with surrounding inflammatory changes, consistent with mycotic aneurysms. After initially declining surgery, the patient underwent redo surgical aortic valve replacement; cultures of the surgically excised specimens were negative. Abdominal pain resolved and inflammatory markers normalized following surgery and continued antimicrobial therapy. Follow-up contrast-enhanced CT demonstrated marked interval enlargement of the hepatic arterial aneurysmal lesion to 28 mm × 28 mm × 26 mm despite clinical improvement and normalization of inflammatory markers. <b>Conclusions:</b> This case highlights that microbiological, clinical, and biological improvement does not necessarily indicate resolution of local cardiac or extracardiac structural complications and emphasizes the importance of repeated imaging, guideline-based antimicrobial therapy, timely source control, and multidisciplinary vascular management in complicated TAVI-PVE.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149278447","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 Ultrasound (IVUS)-Assisted Fenestrated Endovascular Aortic Repair (FEVAR) for Iuxtarenal Aortic Aneurysm with Pelvic Ectopic Left Kidney and Aberrant Left Renal Arteries: A Case Report.","authors":"Priscilla Nardi, Giulia Guadalupi, Valerio Rinaldi, Edoardo De Meis, Valeria Iacoucci, Greta D'Onofrio, Eleonora Zedda, Rocco Pasqua, Fabio Miraldi, Gaetano Tanzilli, Nicola Viceconte, Francesco Pelliccia, Giampaolo Prezioso, Vito D'Andrea, Giulio Illuminati","doi":"10.3390/reports9040326","DOIUrl":"https://doi.org/10.3390/reports9040326","url":null,"abstract":"<p><p><b>Background and Clinical Significance</b>: Complex abdominal aortic aneurysms (AAAc) involving visceral and renal vessels can be treated via open surgery or less invasive fenestrated endovascular aneurysm repair (FEVAR). Intravascular ultrasound (IVUS) minimizes contrast and radiation while improving placement accuracy, though its specific role in FEVAR remains understudied. This CARE-compliant article reports a FEVAR case guided by IVUS. <b>Case Presentation</b>: A 75-year-old male with multiple comorbidities presented with an enlarging AAAc extending to the renal artery ostia, lacking an adequate neck. Anatomical variants included a left renal artery with a caudal origin (pelvic left kidney), a left renal polar artery originating from the right common iliac artery, and a patent inferior mesenteric artery (<3 mm). Following multidisciplinary evaluation, the patient successfully underwent simultaneous FEVAR and coronary angiography. Guided by IVUS, the fenestrated endograft was deployed with preserved visceral patency. The patient recovered uneventfully and was discharged on postoperative day two. A 30-day CT angiogram detected a stable inferior mesenteric artery endoleak, managed conservatively through a 6-month follow-up. <b>Conclusions</b>: IVUS-guided FEVAR may offer a promising alternative to traditional angiography, reducing radiation and contrast exposure. Further large-scale studies are needed to confirm these findings and establish clinical and economic benefits.</p>","PeriodicalId":74664,"journal":{"name":"Reports (MDPI)","volume":"9 4","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13692385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149278429","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}