Masato Hayama, Kayo Wakamatsu, Yuko Teratani, Yuki Kunitomo, Chihaya Ito, Masayuki Shimizu, Hiromitsu Teratani, Yuta Sukehiro, Masato Furui, Mizuki Sumi, Mau Amako, Yoshio Hayashida, Go Kuwahara, Hideichi Wada
{"title":"A Case of Surgery for Myxoma in the Inferior Vena Cava Using Deep Hypothermic Circulatory Arrest.","authors":"Masato Hayama, Kayo Wakamatsu, Yuko Teratani, Yuki Kunitomo, Chihaya Ito, Masayuki Shimizu, Hiromitsu Teratani, Yuta Sukehiro, Masato Furui, Mizuki Sumi, Mau Amako, Yoshio Hayashida, Go Kuwahara, Hideichi Wada","doi":"10.3400/avd.cr.24-00118","DOIUrl":"10.3400/avd.cr.24-00118","url":null,"abstract":"<p><p>We experienced a case in which a myxoma in the inferior vena cava (IVC) was surgically removed along with the IVC using deep hypothermic circulatory arrest. A 42-year-old female with no subjective symptoms was incidentally found to have a mass in the IVC at the junction of the hepatic veins on contrast-enhanced computed tomography. Ultrasonography revealed a mobile tumor attached to the junction of the hepatic veins. Surgery was performed via median sternotomy and laparotomy. Cardiopulmonary bypass and deep hypothermic circulatory arrest were utilized to safely operate.</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/PMC11947006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727522","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}
Nikolaos Kontopodis, Michalis Pesmatzoglou, Ifigeneia Tzartzalou, Konstantinos Litinas, George Tzouliadakis, Nikolaos Galanakis, Elias Kehagias, Christos Ioannou
{"title":"Comparative Study of Endovascular Aneurysm Repair in Patients with Narrow Aortic Bifurcation Using the Unibody AFX2 vs the Bifurcated ALTO Endoluminal System.","authors":"Nikolaos Kontopodis, Michalis Pesmatzoglou, Ifigeneia Tzartzalou, Konstantinos Litinas, George Tzouliadakis, Nikolaos Galanakis, Elias Kehagias, Christos Ioannou","doi":"10.3400/avd.oa.25-00027","DOIUrl":"10.3400/avd.oa.25-00027","url":null,"abstract":"<p><p><b>Objectives:</b> A narrow aortic bifurcation poses technical challenges during endovascular aneurysm repair (EVAR). We aim to compare the unibody AFX2 (Endologix, Irvine, CA, USA) vs the bifurcated ALTO (Endologix) system in EVAR patients with a narrow bifurcation. <b>Methods:</b> Retrospective single-center study, including patients undergoing standard EVAR over 3 years. Patients with a bifurcation diameter <20 mm were identified, and outcomes were compared between the AFX2 and ALTO groups. Primary endpoints were primary and overall technical success, primary and overall clinical success, rate of adverse limb events, rate of limb occlusion, and need for secondary interventions. The analysis was repeated using a diameter threshold of <18 mm. <b>Results:</b> Among 151 cases, 26 presented with bifurcations <20 mm and 12 with <18 mm. In the primary analysis, 15 patients were treated with the AFX2 and 11 with the ALTO endograft. Both groups achieved 100% technical and clinical success. No limb occlusions occurred, and no reinterventions were recorded. Preoperative anatomy was suitable for ALTO in all cases, while eligibility for AFX2 was 15 out of 26 cases. Secondary analysis displayed similar results. <b>Conclusions:</b> In patients with narrow aortic bifurcation, the AFX2 endograft can be safely used when appropriate anatomic conditions are met. If the AFX2 system is unsuitable due to other anatomic restrictions, the ALTO endograft is a viable alternative.</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/PMC12170096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309442","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":"Brachial-Ankle Pulse Wave Velocity Reflects Regional Arterial Stiffness and Distensibility in Patients with Abdominal Aortic Aneurysm.","authors":"Toshiya Nishibe, Shinobu Akiyama, Masaki Kano, Shoji Fukuda, Fumio Chiba, Jun Koizumi, Masayasu Nishibe","doi":"10.3400/avd.oa.24-00097","DOIUrl":"10.3400/avd.oa.24-00097","url":null,"abstract":"<p><p><b>Objectives:</b> We investigated the association between brachial-ankle pulse wave velocity (PWV) and arterial stiffness and distensibility in the aneurysmal sac of abdominal aortic aneurysm (AAA). <b>Methods:</b> Data from 49 patients with AAA from June 2020 to November 2022 at Tokyo Medical University Hospital were retrospectively analyzed. Brachial-ankle PWV (cm/s) was obtained via an automated oscillometric method. Regional arterial stiffness and distensibility parameters, such as stiffness parameter (β), pressure-strain elasticity modulus (Ep, kPa), one-point PWV (PWV β, m/s), and arterial compliance (AC, mm<sup>2</sup>/kPa<sup>-1</sup>), were assessed using 2-dimensional automated tissue tracking (2DTT) ultrasonography. Patients were divided into two groups: high PWV (≥1800) and low PWV (<1800). <b>Results:</b> Patients with high PWV showed significantly higher β and PWV β (30.6 ± 10.1 vs. 25.2 ± 6.3, p = 0.047; 11.6 ± 2.3 vs. 10.5 ± 1.5, p = 0.048) and significantly lower AC in the aneurysmal sac (10.6 ± 5.3 vs. 14.7 ± 8.1, p = 0.045) than those with low PWV. AC was negatively correlated with PWV (r = -0.361, p = 0.011). <b>Conclusions:</b> Brachial-ankle PWV can reflect arterial stiffness and distensibility, as measured by 2DTT ultrasonography, in the aneurysmal sac of AAA, suggesting its potential as an elasticity index for assessing regional arterial stiffness and distensibility in AAA.</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/PMC11771152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057711","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 Outcomes after Revascularization in Patients with Chronic Limb-Threatening Ischemia.","authors":"Akio Kodama","doi":"10.3400/avd.ra.24-00135","DOIUrl":"10.3400/avd.ra.24-00135","url":null,"abstract":"<p><p>Chronic limb-threatening ischemia (CLTI) occurs in the advanced stage of peripheral artery disease and is associated with high risks of mortality and amputation. Universal management strategies are not always applicable, owing to population diversity, and the Western trials may not be applicable to Japanese patients, owing to differences in demographics and clinical profiles. This paper examines the outcomes of revascularization in Japanese CLTI patients and emphasizes the benefits of tailored management. Post-hoc analysis of the bypass versus angioplasty in severe ischemia of the leg (BASIL)-1 trial validated the use of the Global Limb Anatomic Staging System for predicting the outcomes of endovascular therapy (EVT) but not bypass surgery (BS). The SPINACH (surgical reconstruction versus peripheral intervention in patients with critical limb ischemia) registry revealed comparable 3-year amputation-free survival rates between patients who underwent EVT and those who underwent BS, with patient-specific factors such as limb status and general health influencing its success. Revascularization improved the quality of life, but benefits declined over time, especially in non-ambulatory and older patients on dialysis. Surgical reconstruction is better for preserving ambulation. Retrospective studies revealed pedal branch artery bypass as a viable option, functional independence as a predictor of survival, and zinc supplementation as promising for wound healing. Future research should focus on refining these strategies and exploring innovative approaches to overcome persistent challenges in CLTI care.</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/PMC11771150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057712","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":"Metagenomic Analysis of Gut Microbiota for Abdominal Aortic Aneurysm.","authors":"Eisaku Ito, Takao Ohki, Naoki Toya, Takuo Emoto, Tomoya Yamashita, Tomomi Sugiyama, Takuji Yamada, Hiroshi Mori, Atsushi Toyoda, Ken-Ichi Hirata","doi":"10.3400/avd.oa.24-00105","DOIUrl":"10.3400/avd.oa.24-00105","url":null,"abstract":"<p><p><b>Objectives:</b> The pathophysiological mechanism of abdominal aortic aneurysm (AAA) remains unclear. We previously reported that <i>Bifidobacterium adolescentis</i> levels were reduced in the feces of patients with AAA by 16S ribosomal ribonucleic acid (RNA) gene sequencing. In this study, we increased the number of cases and conducted metagenomic analyses to examine bacterial genes associated with the pathophysiology of AAA. <b>Methods:</b> For gut microbiota data, feces from 55 patients with AAA and 52 patients with no history of AAA, lower extremity artery disease, or coronary artery disease (control group) were collected. Metagenomic analysis was performed by collecting raw stool samples from patients. For intestinal microbiota analysis, metagenomic analysis of the fecal samples was performed. <b>Results:</b> Oral bacteria, including <i>Actinomyces oris</i> (<i>p</i> <0.0001), <i>Streptococcus salivarius</i> (<i>p</i> <0.001), <i>Lactobacillus salivarius</i> (<i>p</i> <0.001), and <i>Streptococcus</i> sp. (<i>p</i> <0.001), were increased in the feces of patients with AAA. In addition, bacterial genes related to alpha lipoic acid (ALA) biosynthesis (M00882, M00883, and M00884, <i>p</i> <0.0001) were decreased in patients with AAA. <b>Conclusions:</b> In the feces of patients with AAA, there was an increase in oral bacteria, and the expression of bacterial genes related to ALA biosynthesis was reduced. The results suggest the possibility of developing gut microbial drug treatments for AAA.</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/PMC11771153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057715","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":"Surgical Outcomes of the Boat-Form Vein Cuff Technique in Peripheral Artery Bypass Grafting.","authors":"Shun-Ichiro Sakamoto, Anna Tsuji, Motohiro Maeda, Atsushi Hiromoto, Kenji Suzuki, Jiro Honda, Yosuke Ishii","doi":"10.3400/avd.oa.24-00134","DOIUrl":"10.3400/avd.oa.24-00134","url":null,"abstract":"<p><p><b>Objectives:</b> The venous cuff technique has been used primarily for arterial bypass using artificial grafts to the lower extremities. The boat-form vein cuff was designed to allow adjustment of the size and angle of the anastomosis at any anatomic site. We report our experience and outcomes of the original vein cuff technique in various peripheral artery bypass grafting procedures. <b>Methods:</b> A total of 10 patients underwent arterial bypass grafting using a polytetrafluoroethylene (PTFE) graft with a boat-form venous cuff. The indications for the surgery consisted of peripheral artery disease (n = 4), acute limb ischemia (n = 4), chronic mesenteric ischemia (n = 1), and traumatic upper limb ischemia (n = 1). Five patients required emergency surgery. Surgical outcomes, such as mortality and morbidity, limb salvage rate, and graft patency, were examined using perioperative and postoperative follow-up data. <b>Results:</b> There were no operative deaths or serious complications, including amputation of the lower extremity. During the follow-up period (44 ± 36.9 months), the PTFE graft remained patent in 9 patients (90%). In 1 patient, occlusion of the femoropopliteal bypass graft was observed 3 months after surgery. <b>Conclusions:</b> The simple design and creation of the boat-form vein cuff are useful at any anatomical site in peripheral artery bypass grafting with a PTFE graft.</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/PMC12129623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207471","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":"Renal Stent Graft Migration Following Chimney Endovascular Aneurysm Repair.","authors":"Shun-Ichi Kawarai, Yuichi Ono","doi":"10.3400/avd.cr.25-00034","DOIUrl":"10.3400/avd.cr.25-00034","url":null,"abstract":"<p><p>A 78-year-old male presented with progressive enlargement of a pararenal abdominal aortic aneurysm following chimney endovascular aneurysm repair. The aneurysmal expansion was attributed to an endoleak secondary to migration of the left renal artery chimney stent graft, resulting in a 5-mm increase in aneurysm diameter over 6 months. Endovascular reintervention successfully induced aneurysm regression, with no recurrence of endoleak on annual imaging follow-up. While chimney endovascular aneurysm repair presents a minimally invasive alternative for managing complex aortic pathologies, including pararenal abdominal aortic aneurysms, vigilance regarding potential stent graft migration is essential.</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/PMC12162175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282232","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":"Successful Hybrid Endovascular and Open Approach for Exclusion of a Left Subclavian Artery Aneurysm.","authors":"Kotaro Mukasa, Yasunori Yakita, Ryosuke Marushima, Shinichiro Abe, Soichi Asano","doi":"10.3400/avd.cr.24-00139","DOIUrl":"10.3400/avd.cr.24-00139","url":null,"abstract":"<p><p>Subclavian artery aneurysms are rare and challenging to treat owing to their anatomical location and proximity to critical branches, including the vertebral artery. We report the case of a 78-year-old man with a left subclavian artery aneurysm. The aneurysm was located in the mediastinum and measured 31 mm in diameter. The proximal side of the aneurysm was sealed with a stent graft, while the distal side was accessed through a supraclavicular incision and directly ligated. Postoperative imaging confirmed complete exclusion. This hybrid approach avoided invasive open surgery and provided a favorable outcome.</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/PMC12092278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118669","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":"Supplement of Clinical Practice Guidelines for Endovenous Thermal Ablation for Varicose Veins 2019: Laser Ablation of Varicose Tributaries.","authors":"Masayuki Hirokawa, Junichi Utoh, Satoru Sugiyama, Osamu Suzuki, Takashi Yamamoto, Tomohiro Ogawa, Makoto Mo","doi":"10.3400/avd.gl.25-00053","DOIUrl":"10.3400/avd.gl.25-00053","url":null,"abstract":"<p><p>In the treatment of saphenous varicose veins with endovenous laser ablation, simultaneous treatment of varicose tributaries using stab avulsion or sclerotherapy is commonly performed. To address the limitations of these conventional treatments, laser ablation for varicose tributaries has recently gained widespread acceptance. This guideline, developed by the Japanese Society of Phlebology, outlines appropriate treatment protocols for laser ablation of varicose tributaries. Indications include primary varicose veins requiring concurrent treatment of the saphenous trunk and varicose tributaries. The procedure utilizes slim radial fibers, with puncture and ablation performed using either short- or long-axis approaches. Although rare, adverse events such as skin burns, nerve injury, and fiber breakage have been reported. A learning curve is necessary to ensure the safe execution of the procedure. Further clinical studies are essential to enhance the safety and efficacy of laser ablation for varicose tributaries. (This is a secondary publication from Jpn J Phlebol 2025; 36: 51-58.).</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/PMC12148710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265063","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":"Two-Stage Hybrid Treatment of Residual Inferior Pancreaticoduodenal Artery Aneurysm Following Treatment of Ruptured Superior Pancreaticoduodenal Artery Aneurysm: A Case Report.","authors":"Hodaka Wakisaka, Taiki Kakiuchi, Kohei Hachiro, Noriyuki Takashima, Tetsuya Katsumori, Tomoaki Suzuki","doi":"10.3400/avd.cr.25-00018","DOIUrl":"10.3400/avd.cr.25-00018","url":null,"abstract":"<p><p>Herein, we describe the case of a 72-year-old man who presented with a residual inferior pancreaticoduodenal artery aneurysm following the rupture and treatment of a superior pancreaticoduodenal artery aneurysm. Open surgery for pancreaticoduodenal artery aneurysms requires carefully planned vascular reconstruction to prevent organ ischemia and minimize pressure changes caused by fluctuations in mechanical stress. Additionally, in cases of rupture, factors such as the patient's condition, presence of hematoma and adhesions, and pressure changes resulting from prior transarterial embolization must be considered. This case report outlines the surgical strategy employed for managing the residual inferior pancreaticoduodenal artery aneurysm.</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/PMC12127133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207472","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}