{"title":"The Effectiveness of Surgical Thrombectomy via Below-Knee Popliteal Artery for the Treatment of Acute Limb Ischemia.","authors":"Kentaro Kasa, Takao Ohki, Kota Shukuzawa, Soichiro Fukushima, Hirotsugu Ozawa, Makiko Omori, Yoshihiko Chono, Hiromasa Tachihara","doi":"10.3400/avd.oa.24-00115","DOIUrl":"10.3400/avd.oa.24-00115","url":null,"abstract":"<p><p><b>Objectives:</b> Surgical thrombectomy has been established as an effective treatment for acute limb ischemia (ALI). Nevertheless, manipulation via the common femoral artery (CFA) to retrieve thrombus in the infra-popliteal artery sometimes proves less effective. <b>Methods:</b> We retrospectively reviewed patients undergoing surgical thrombectomy for infra-inguinal ALI from January 2010 to December 2022. The primary endpoint was the rate of amputation. Secondary endpoints were technical and clinical success rates, incidence of distal embolism, and freedom from reintervention. <b>Results:</b> A total of 35 patients underwent surgical thrombectomy where the popliteal artery or below is occluded. The CFA approach was utilized in 13, and the below-knee popliteal artery (BKPA) approach in 22. There were no differences in background between groups. The reintervention rate was lower in the BKPA group (BKPA group: 0% vs. CFA group: 30.8%; <i>P</i> = 0.01). The BKPA group showed a significantly lower incidence of distal embolism (BKPA group: 4.5% vs. CFA group: 38.5%; <i>P</i> = 0.02) and freedom from reintervention (BKPA group 100% at 12 months vs. CFA group: 68.7% at 12 months; log-rank <i>P</i> = 0.01). <b>Conclusions:</b> The BKPA approach-first strategy for surgical thrombectomy in the management of ALI is feasible with better outcomes compared with the CFA approach.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"18 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057717","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 Elbow Extension Limitation Caused by Phlebosclerosis Following Peripheral Intravenous Chemotherapy: A Case Report and Literature Review.","authors":"Nozomu Ishikawa, Kazunori Inuzuka, Masaki Sano, Kazuto Katahashi, Hajime Tsuyuki, Yusuke Endo, Hiroya Takeuchi, Naoki Unno","doi":"10.3400/avd.cr.25-00055","DOIUrl":"10.3400/avd.cr.25-00055","url":null,"abstract":"<p><p>We report a rare case of phlebosclerosis in the left antecubital region after peripheral intravenous chemotherapy, which caused elbow contracture. A 54-year-old woman with breast cancer underwent partial mastectomy of the right breast and 8 courses of neoadjuvant chemotherapy, 6 of which were administered via venipuncture in the left forearm. She developed progressive flexion contracture of the left elbow despite rehabilitation. Two cord-like fibrotic veins were identified in the antecubital region and surgically excised. Postoperative rehabilitation led to full elbow extension within 5 months. In cases with elbow extension limitation, proactive surgical intervention should be considered.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"18 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551784","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}
Masato Hayama, Go Kuwahara, Hiromitsu Teratani, Mau Amako, Hiroyuki Ito, Hideichi Wada
{"title":"Thoracic Endovascular Aortic Repair for Kommerell's Diverticulum.","authors":"Masato Hayama, Go Kuwahara, Hiromitsu Teratani, Mau Amako, Hiroyuki Ito, Hideichi Wada","doi":"10.3400/avd.oa.25-00091","DOIUrl":"10.3400/avd.oa.25-00091","url":null,"abstract":"<p><strong>Objectives: </strong>Thoracic endovascular aortic repair (TEVAR) has recently emerged as a less invasive alternative to open thoracotomy for the treatment of Kommerell's diverticulum (KD). However, anatomical challenges, including an acute aortic arch and an aberrant subclavian artery, often limit its feasibility. This study aimed to evaluate the outcomes of TEVAR for KD.</p><p><strong>Methods: </strong>Between February 2012 and July 2023, 6 patients with KD underwent TEVAR at 3 institutions. Subclavian artery embolization or reconstruction was performed when necessary. Morphological parameters, including the Kommerell's diverticulum diameter (KDd) and the distance to the opposite aortic wall (DAW), were assessed.</p><p><strong>Results: </strong>Four patients underwent subclavian artery embolization, including 1 requiring bilateral embolization. Subclavian artery reconstruction was performed in 2 cases. Intraoperative type 1a endoleaks were observed in 3 cases and were successfully managed with additional stent grafts. During a follow-up period ranging from 13 to 83 months, 1 patient required open surgical conversion due to graft infection. No other severe complications or aneurysmal progression were noted.</p><p><strong>Conclusions: </strong>Despite the limited follow-up period and lack of long-term data, TEVAR for KD demonstrated favorable short- to mid-term outcomes and may represent an effective treatment option in selected patients.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"18 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145647233","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":"Hybrid Repair of a True Brachiocephalic Artery Aneurysm: A Case Report.","authors":"Takahiro Mizoguchi, Hiroshi Ito, Hiroshi Kurazumi, Masaya Takahashi, Yoshitaka Ikeda, Noriyasu Morikage, Kimikazu Hamano","doi":"10.3400/avd.cr.25-00104","DOIUrl":"10.3400/avd.cr.25-00104","url":null,"abstract":"<p><p>A 74-year-old man with hypertension and hyperuricemia was incidentally diagnosed with a 39-mm brachiocephalic artery aneurysm. Because of a sufficient proximal sealing zone, a hybrid repair was performed, consisting of a right common carotid-axillary bypass with a prosthetic graft, followed by endovascular exclusion using covered stents, a vascular plug, and coils. Completion angiography confirmed complete aneurysm exclusion without endoleak and satisfactory bypass flow. The postoperative course was uneventful. Computed tomography (CT) angiography demonstrated persistent aneurysm exclusion without endoleak and a patent bypass. At 12 months, plain CT confirmed no aneurysm enlargement.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"18 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12719406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145817399","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}
Seishiro Akinaga, Takaaki Maruhashi, Yutaro Kurihara, Koyo Suzuki, Yasushi Asari
{"title":"Pancreaticoduodenal Arcade Aneurysm Secondary to Dissection of the Superior Mesenteric Artery: A Case Report.","authors":"Seishiro Akinaga, Takaaki Maruhashi, Yutaro Kurihara, Koyo Suzuki, Yasushi Asari","doi":"10.3400/avd.cr.25-00063","DOIUrl":"10.3400/avd.cr.25-00063","url":null,"abstract":"<p><p>Pancreaticoduodenal aneurysms are commonly associated with narrowing of the celiac artery, although involvement of the superior mesenteric artery (SMA) is rare. A 77-year-old man presented with a 5-day history of abdominal and back pain. Contrast-enhanced computed tomography revealed hemorrhagic ascites, a pancreatic arcade aneurysm, and dissection of the SMA. Endovascular embolization was performed using metallic coils. Follow-up imaging demonstrated isolation of the aneurysm and improvement in the shrunken true lumen of the dissected SMA. This case suggests that narrowing of the SMA may alter blood flow in the pancreatic arcade and contribute to aneurysm formation.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"18 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12555014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145386084","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":"Double-Pedicled Vertical Rectus Abdominis Myocutaneous Flap for Sternal Dehiscence Due to Deep Sternal Wound Infection: The Twelfth Intercostal Artery Perforator as an Additional Pedicle.","authors":"Ryohei Ishiura, Kohei Mitsui, Kanako Danno, Kento Hosomi, Chihena Hansini Banda, Yasuhisa Urata, Mitsunaga Narushima","doi":"10.3400/avd.cr.25-00024","DOIUrl":"10.3400/avd.cr.25-00024","url":null,"abstract":"<p><p>A 50-year-old male with diabetes mellitus, who experienced recurrent sternal dehiscence secondary to a deep sternal wound infection, failed to respond to treatment with both pectoralis major muscle and greater omental flaps. Consequently, we performed a vertical rectus abdominis muscle flap in a double-pedicle fashion, utilizing the internal mammary artery and the 12th intercostal artery perforator. This intervention successfully addressed the condition. This novel technique offers an excellent therapeutic option for managing this life-threatening complication.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"18 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582891","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 Surgery for a Giant Popliteal Venous Aneurysm Positive for Heparin-Induced Thrombocytopenia Antibodies with Repeated Acute Pulmonary Embolism.","authors":"Satoru Tomita, Koki Yokawa, Kazufumi Yoshida, Kenta Masada, Yosuke Inoue, Yoshimasa Seike, Hitoshi Matsuda","doi":"10.3400/avd.cr.25-00031","DOIUrl":"10.3400/avd.cr.25-00031","url":null,"abstract":"<p><p>A 56-year-old woman with recurrent acute pulmonary embolism was diagnosed with a left popliteal venous aneurysm (PVA) by venous echocardiography. During anticoagulation therapy with heparin for acute pulmonary embolism, she was found to be positive for heparin-induced thrombocytopenia (HIT) antibodies. Surgery was performed with argatroban for anticoagulation, removal of the thrombus in the PVA, and suturing of the vein. Postoperatively, the popliteal vein showed shrinkage, and no recurrence of thromboembolism was observed. We report a case in which a patient with a PVA positive for HIT antibodies was successfully treated with PVA resection and anticoagulation therapy with argatroban.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"18 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324323","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":"Rupture of the Abdominal Aorta without Aneurysm Associated with Giant Cell Arteritis: A Case Report.","authors":"Akito Kuwano, Masaru Yoshikai, Satoshi Ohtsubo, Kiyokazu Koga, Nozomi Yoshida, Naoyo Nishida","doi":"10.3400/avd.cr.25-00010","DOIUrl":"10.3400/avd.cr.25-00010","url":null,"abstract":"<p><p>We report a case of an abdominal aortic rupture without aneurysm associated with giant cell arteritis. A 67-year-old woman presented with lower back pain. Contrast-enhanced computed tomography revealed a massive retroperitoneal hematoma with contrast leakage from the abdominal aorta, suggestive of abdominal aortic rupture. During emergency surgery, a rupture site was identified on the anterior wall of the abdominal aorta, while no aneurysmal changes or dilatation of the abdominal aorta were observed. Histopathological examination of the resected aortic wall revealed infiltration of giant cells positive for CD68, leading to the diagnosis of giant cell arteritis.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"18 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245885","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":"Semi-Clamshell Approach with Rib-Cross for Infected Hybrid TEVAR.","authors":"Taiki Ito, Masato Suzuki, Shun Watanabe, Satoshi Sugimoto, Kiyotaka Morimoto, Yoshinobu Watabe, Hideo Yokoyama, Toshiro Ito","doi":"10.3400/avd.cr.25-00076","DOIUrl":"10.3400/avd.cr.25-00076","url":null,"abstract":"<p><p>A single-stage extensive aortic replacement is necessary for infected stent graft explantation after thoracic endovascular aortic repair (TEVAR). However, establishing selective cerebral perfusion and antegrade myocardial protection while ensuring a clear view of the distal aorta is challenging. We adopted a semi-clamshell approach with rib cross for a case of infection following hybrid TEVAR. This approach provides visualization of the ascending aorta, aortic arch, and the descending aorta down to the diaphragm. It is a viable option for cases requiring total arch and distal descending aorta replacement, offering reliable cerebral and myocardial protection, particularly in open conversion of hybrid TEVAR.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"18 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12518973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298081","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":"2021 JAPAN Chronic Limb Threatening Ischemia Database (JCLIMB) Annual Report.","authors":"","doi":"10.3400/avd.ar.24-00106","DOIUrl":"10.3400/avd.ar.24-00106","url":null,"abstract":"<p><p>Since 2013, the Japanese Society for Vascular Surgery has started the project of nationwide registration and tracking database for patients with critical limb ischemia (CLI) who are treated by vascular surgeons. The purpose of this project is to clarify the current status of the medical practice for patients with CLI to contribute to the improvement of the quality of medical care. This database is created on the National Clinical Database (NCD) and collects data on patients' backgrounds, therapeutic measures, early results, and long-term prognoses as long as 5 years after the initial treatment. The name of this database was changed from the JAPAN Critical Limb Ischemia Database to the JAPAN Chronic Limb Threatening Ischemia Database in 2021 because of the alteration of the definition of registered patients. The abbreviation remains JCLIMB. The limbs managed conservatively are also registered in JCLIMB, together with those treated by surgery and/or endovascular treatment (EVT). In 2021, 1338 CLTI limbs (male 916 limbs: 68%) were registered by 78 facilities. Arteriosclerosis obliterans (ASO) has accounted for 99% of the pathogenesis of these limbs. In this manuscript, the background data and the early prognosis of the registered limbs of the ASO cohort are reported. (This is a translation of Jpn J Vasc Surg 2024; 33: 229-250.).</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 4","pages":"488-507"},"PeriodicalIF":0.6,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891372","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}