{"title":"Machine Learning and Abdominal Aortic Aneurysm: A New Paradigm in Prediction and Prognosis after Endovascular Aneurysm Repair.","authors":"Toshiya Nishibe, Tsuyoshi Iwasa, Shoji Fukuda, Tomohiro Nakajima, Shinichiro Shimura, Masayasu Nishibe, Alan Dardik","doi":"10.3400/avd.ra.25-00120","DOIUrl":"10.3400/avd.ra.25-00120","url":null,"abstract":"<p><p>Artificial intelligence (AI) and machine learning (ML) are transforming vascular surgery by enabling precise risk stratification, individualized treatment planning, and improved prognostic prediction. In abdominal aortic aneurysm (AAA) management, ML algorithms integrate complex clinical and imaging data to estimate survival, guide procedural decisions, and identify key factors influencing aneurysm remodeling. These models outperform traditional statistical approaches by capturing nonlinear interactions among variables such as nutritional status, immune function, and anatomical features. Despite these advances, challenges remain. Many studies rely on single-center datasets, raising concerns about overfitting and limited generalizability. The use of black-box models can hinder clinical trust due to limited interpretability. However, recent developments in multicenter data collection and explainable AI techniques are improving model robustness and transparency. As these tools continue to evolve, ML is poised to contribute meaningfully to precision vascular care. By supporting more individualized and data-informed decision-making, ML has the potential to enhance long-term outcomes and guide the future of AAA management after endovascular aneurysm repair.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"19 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12826844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045826","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 Case of Superficial True Venous Aneurysm of the Upper Extremity.","authors":"Hiroki Nakabori, Toshiko Kakiuchi, Kenji Iino","doi":"10.3400/avd.cr.26-00040","DOIUrl":"10.3400/avd.cr.26-00040","url":null,"abstract":"<p><p>Venous aneurysms of the upper extremity have rarely been reported. A 78-year-old woman presented with swelling, discomfort, and mild tenderness on the medial side of the right elbow. Ultrasonography showed a 2.1 × 1.8 cm dilated structure connected to the basilic vein. Because a venous pseudoaneurysm was suspected and the patient had discomfort and mild tenderness, aneurysm excision and venous reconstruction were performed under local anesthesia. Histopathological examination confirmed a true venous aneurysm. The postoperative course was uneventful, with complete symptom resolution and no recurrence at 6 months.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"19 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597542","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 Case of Chronic Expanding Hematoma in the Thoracic Cavity Treated with Transcatheter Arterial Embolization.","authors":"Takahiro Higuchi, Shunsuke Inaki, Akira Baba, Keitaro Enoki, Takayuki Suzuki, Hideomi Yamauchi, Tetsuya Shimizu, Saeko Kubomae, Haruki Mori, Naoki Kurata","doi":"10.3400/avd.cr.25-00148","DOIUrl":"10.3400/avd.cr.25-00148","url":null,"abstract":"<p><p>Chronic expanding hematoma (CEH) is a rare late complication of thoracic trauma or surgery, and favorable outcomes with transcatheter arterial embolization (TAE) have rarely been reported. An 80-year-old male presented with recurrent hemoptysis and was diagnosed with intrathoracic CEH. Owing to advanced age and high surgical risk, TAE was performed via bronchial, intercostal, and inferior phrenic arteries using tris-acryl microspheres (700-900 μm) and gelatin sponge. Hemoptysis resolved, and follow-up imaging showed hematoma shrinkage without recurrence for 2 years. This case demonstrates TAE with 700-900 μm microspheres as a safe, minimally invasive alternative to surgery for CEH.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"19 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147508890","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 Case of Surgical Revascularization in a Patient with Uncontrolled Renovascular Hypertension and Renal Dysfunction after Repeated Percutaneous Transluminal Renal Angioplasty (PTRA) for More Than 10 Years.","authors":"Yasutake Momokawa, Koji Maeda","doi":"10.3400/avd.cr.25-00022","DOIUrl":"10.3400/avd.cr.25-00022","url":null,"abstract":"<p><p>Percutaneous transluminal renal angioplasty (PTRA) is a treatment for renovascular hypertension due to renal artery stenosis. However, postoperative complications in stent re-stenosis/occlusion may occur frequently. A 60-year-old male patient presented to our hospital with uncontrolled hypertension and a deterioration of renal function. He had undergone an initial renal stenting 10 years earlier, followed by repeat PTRAs during follow-up for in-stent restenosis. The left renal stent was found to be completely occluded, while the right renal stent was found to be 75% stenosed. We performed an aorto-renal artery bypass. The bypass was patent without stenosis and the renovascular hypertension was recovered.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"19 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147508877","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 Massive Intrathoracic Hematoma in a Patient with Marfan Syndrome.","authors":"Yuma Yokoyama, Kanako Kobayashi, Takahito Itoh, Takashi Murakami","doi":"10.3400/avd.cr.26-00097","DOIUrl":"10.3400/avd.cr.26-00097","url":null,"abstract":"<p><p>Although aortic complications are common in patients with Marfan syndrome (MFS), spontaneous peripheral arterial rupture is rare. Herein, we report a 40-year-old woman with MFS who presented with left-sided chest pain and hoarseness due to a massive intrathoracic hematoma. She had undergone multiple thoracic surgeries for aortic dissection. Rupture of fragile neovessels associated with surgery-related inflammation was suspected. Hemostasis was achieved by transcatheter embolization of the left lateral thoracic and supreme intercostal arteries. Intrathoracic bleeding should be considered in patients with MFS presenting with chest pain or hoarseness, particularly those receiving anticoagulation therapy or those who have undergone prior thoracic surgery.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"19 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966307","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":"Stent-Assisted Double Microcatheter Coil Embolization for an Inferior Pancreaticoduodenal Artery Aneurysm after Multiple Stent-Graft Procedures: A Case Report.","authors":"Yoshiki Yamasaki, Hiroshi Nishimaki, Tsuyoshi Kono, Masahiro Tomita, Satoshi Kinebuchi, Daijun Tomimoto, Masahide Komagamine, Kan Nawata","doi":"10.3400/avd.cr.26-00021","DOIUrl":"10.3400/avd.cr.26-00021","url":null,"abstract":"<p><p>Inferior pancreaticoduodenal artery aneurysms (IPDAAs) are rare visceral aneurysms that may rupture irrespective of size. Here, we report an IPDAA that progressively enlarged after celiac artery (CA) embolization during aortic stent-graft repair. An 84-year-old female developed a wide-necked saccular IPDAA that expanded from 2.5 to 15 mm over 10 years after CA embolization. Stent-assisted coil embolization using the double microcatheter technique was performed to preserve superior mesenteric artery-to-CA collateral flow, achieving a packing density of 31%-45%. This case highlights the need for surveillance after CA embolization and supports the feasibility and effectiveness of this technique in select cases.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"19 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760264","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":"Impact of Limb Severity on the Wall Structure of the Great Saphenous Vein and Its Involvement in Vein Graft Patency.","authors":"Shinsuke Kikuchi, Yuri Yoshida, Tadahiro Sasajima, Tsutomu Doita, Keisuke Kamada, Seima Ohira, Naoya Kuriyama, Nobuyoshi Azuma","doi":"10.3400/avd.oa.26-00166","DOIUrl":"https://doi.org/10.3400/avd.oa.26-00166","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine pathologically how limb severity in chronic limb-threatening ischemia affects the great saphenous vein (GSV) wall, and whether it influences vein graft patency.</p><p><strong>Methods: </strong>In 89 limbs undergoing infrainguinal bypass with the ipsilateral GSV, the intimal and medial thickness of the residual vein segment was measured. Wound (W), ischemia (I), and foot infection (fI) grades were assessed, with loss of primary graft patency as the endpoint.</p><p><strong>Results: </strong>Primary patency was 72.3% at 1 year and 59.3% at 2 years. Independent factors for patency loss were poor-quality vein (hazard ratio [HR] 3.12), severe W grade (HR 2.63), and cerebrovascular disease. Severe W cases had a thicker intima (56.0 vs. 28.1 μm, P <0.01) and media (310.4 vs. 255.8 μm, P = 0.02) than mild cases; the I and fI grades showed no differences. Between the patency-loss (n = 31) and maintained (n = 58) groups, intimal thickness was similar (51.2 vs. 44.1 μm, P = 0.57), whereas medial thickness differed (349.9 vs. 261.1 μm, P <0.01; area under the curve 0.65). Above versus below a 280-μm medial cutoff, patency was 43.0% versus 75.7% (P = 0.03).</p><p><strong>Conclusions: </strong>Medial thickening of the preplacement GSV, seen with a severe wound grade, may be a critical factor in vein graft failure. (This is a secondary publication of Jpn J Phlebol 2025; 36: 89-97.).</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"19 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178409","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":"Clinical Impact of Familial Hypercholesterolemia on Lower Extremity Artery Disease in Premature Patients.","authors":"Eisaku Ito, Takao Ohki, Hiroshi Yoshida, Kenjiro Kaneko","doi":"10.3400/avd.oa.25-00141","DOIUrl":"10.3400/avd.oa.25-00141","url":null,"abstract":"<p><strong>Objectives: </strong>Familial hypercholesterolemia (FH) accelerates systemic atherosclerosis and worsens prognosis from youth. While present in 5%-10% of premature coronary artery disease (pCAD) cases, its prevalence and impact in lower extremity artery disease (LEAD) remain unclear. This study investigated FH prevalence and prognostic impact in premature LEAD (pLEAD).</p><p><strong>Methods: </strong>We retrospectively analyzed LEAD patients aged ≤70 years undergoing first revascularization. FH was diagnosed according to the 2022 Japan Atherosclerosis Society Guidelines, based on dyslipidemia and Achilles tendon thickness. Primary outcomes were survival, amputation-free rate, and secondary intervention-free rate.</p><p><strong>Results: </strong>Among 66 pLEAD patients (median age 66 years, 76% male), 10 (15%) met the FH criteria. Compared with non-FH patients, FH patients more frequently presented with chronic limb-threatening ischemia (CLTI) (90% vs. 36%, p = 0.001), bilateral lesions (100% vs. 36%, p <0.001), and dialysis dependence (90% vs. 25%, p <0.001). Three-year survival (28% vs. 90%, p <0.001), amputation-free rate (64% vs. 89%, p = 0.028), and secondary intervention-free rate (38% vs. 63%, p = 0.031) were significantly lower in FH patients. In the CLTI subgroup, survival was markedly reduced in FH (17% vs. 71%, p = 0.011).</p><p><strong>Conclusions: </strong>FH was present in 15% of pLEAD patients and associated with poor outcomes. Routine FH screening, including pCAD history and Achilles tendon evaluation, may improve prognosis.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"19 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12872392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146140638","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":"Innominate Artery Transection via Combined Suprasternal and Intercostal Approach Prevents Tracheoinnominate Artery Fistula.","authors":"Masahide Shichijo, Hiroyuki Morokuma, Nagi Hayashi, Takashi Teishikata, Masafumi Hiratsuka, Keiji Kamohara","doi":"10.3400/avd.cr.25-00099","DOIUrl":"10.3400/avd.cr.25-00099","url":null,"abstract":"<p><p>Tracheoinnominate artery fistula is a rare but potentially fatal complication of tracheostomy. We report the case of a 22-year-old male at high risk for tracheoinnominate artery fistula due to severe thoracic deformity. To mitigate the risk, a prophylactic transection of the innominate artery was successfully performed using a combined suprasternal and intercostal approach, thereby avoiding limb perfusion. The patient was discharged without complications. This case highlights the effectiveness of the combined approach for safe innominate artery transection in anatomically challenging cases.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"19 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002998","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":"Isolated Brachiocephalic Artery Dissection after Two-Debranching Thoracic Endovascular Aortic Repair: A Case Report.","authors":"Reiko Kemmochi, Kosuke Ujihira, Noriyuki Tokunaga","doi":"10.3400/avd.cr.26-00032","DOIUrl":"10.3400/avd.cr.26-00032","url":null,"abstract":"<p><p>An 87-year-old man with a distal aortic arch aneurysm underwent 2-debranching thoracic endovascular aortic repair (TEVAR). Five days postoperatively, he developed sudden chest pain and syncope, with severe upper-limb hypoperfusion. Contrast-enhanced computed tomography (CECT) revealed brachiocephalic artery (BCA) dissection compressing the true lumen. Although conservative management was initially selected, percutaneous transluminal angioplasty with kissing bare-metal stents from the BCA to the right subclavian and right common carotid arteries was performed for recurrent hypotension. Postprocedural CECT confirmed satisfactory stent expansion and graft patency. This case demonstrates that careful monitoring enables timely intervention for BCA dissection after TEVAR.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"19 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350276","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}