{"title":"Spinal Cord Infarction after Endovascular Aortic Repair for Infrarenal Abdominal Aortic Aneurysm.","authors":"Yasunobu Konishi, Daisuke Yano, Hiroshi Banno, Fumiaki Kuwabara","doi":"10.3400/avd.cr.23-00117","DOIUrl":"10.3400/avd.cr.23-00117","url":null,"abstract":"<p><p>Spinal cord infarction (SCI) is a rare but serious complication of endovascular aortic repair (EVAR) for abdominal aortic aneurysms (AAA). It is difficult to predict, prevent, and treat and can cause significant impairment. We describe the case of a patient who experienced paraplegia and thermal pain dysfunction of the lower extremities shortly after EVAR for an infrarenal AAA. Immediately after confirming SCI, we initiated cerebrospinal fluid drainage, administered steroids, naloxone, and free radical scavengers, and maintained high blood pressure. However, the patient's symptoms did not improve sufficiently. Since the possibility of a SCI exists, prompt treatment should be initiated.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 3","pages":"317-320"},"PeriodicalIF":0.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364047","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 Transapical Thoracic Endovascular Repair for Thoracic Aortic Aneurysm with a Complicated Access Route.","authors":"Yuhei Tokuda, Munehiro Saiki, Tomoya Inoue, Yusuke Kinugasa, Kentaro Tamura, Atsushi Tateishi, Yu Oshima, Kunikazu Hisamochi, Keiji Yunoki","doi":"10.3400/avd.cr.24-00033","DOIUrl":"10.3400/avd.cr.24-00033","url":null,"abstract":"<p><p>Thoracic endovascular aortic repair (TEVAR) for thoracic aortic aneurysms (TAAs) is an alternative treatment option for high-risk patients. While conventionally performed via a transfemoral approach, it is sometimes difficult due to poor access routes. We report the case of a 90-year-old man who was incidentally diagnosed with a descending TAA while undergoing computed tomography for esophageal cancer. The patient had undergone Y-graft replacement twice. His Y-graft leg was highly angulated; therefore, a transfemoral approach was considered difficult. Consequently, transapical TEVAR was performed. The postoperative course was uneventful. Transapical TEVAR can be a useful treatment option for TAAs with poor access routes in super-old patients.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 3","pages":"309-312"},"PeriodicalIF":0.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364017","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":"Relationships of Leg Ischemia Symptoms and Carotid Artery Atherosclerosis with Hypertensive-Disorders-of-Pregnancy-Associated Peptides in Patients with Lower Extremity Arterial Disease.","authors":"Ichiro Wakabayashi, Yoko Sotoda, Shigeki Hirooka, Hiroyuki Orita, Mitsuaki Yanagida, Yoshihiko Araki","doi":"10.3400/avd.oa.24-00020","DOIUrl":"10.3400/avd.oa.24-00020","url":null,"abstract":"<p><p><b>Objectives:</b> We have proposed seven peptides with low molecular weights in blood as biomarkers for the diagnosis of hypertensive disorders of pregnancy (HDP). The purpose of this cross-sectional study was to investigate the relationships of the HDP-associated peptides with symptoms of leg ischemia and degree of atherosclerosis in patients with lower extremity arterial disease (LEAD). <b>Methods:</b> The subjects were 165 outpatients with LEAD (145 men and 20 women aged 74.3 ± 8.1 years [47-93 years]). Their symptoms of leg ischemia, leg arterial flow, and degree of atherosclerosis were evaluated using the Rutherford classification of Clinical Ischemia Category, ankle-brachial index (ABI) and the intima-media thickness (IMT) of carotid arteries, respectively. Serum concentrations of the HDP-related peptides were measured by mass spectrometry. <b>Results:</b> The grade of the Rutherford classification was positively associated with levels of the peptides with m/z 2091 and 2378 and was inversely associated with levels of the peptide with m/z 2081. The category of the Rutherford classification was inversely associated with ABI. There were no HDP-associated peptides that showed significant relationships with IMT. <b>Conclusions:</b> The peptides with m/z 2081, 2091, and 2378 are possible biomarkers of leg ischemia but are not associated with carotid atherosclerosis in LEAD patients.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 3","pages":"270-278"},"PeriodicalIF":0.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364042","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":"Revision Surgery for Venous Graft Stenosis of SMA Bypass.","authors":"Takao Nonaka, Tetsuyoshi Takayama, Masaomi Suzuki, Hiroshi Asano, Harunobu Matsumoto","doi":"10.3400/avd.cr.23-00102","DOIUrl":"10.3400/avd.cr.23-00102","url":null,"abstract":"<p><p>A 67-year-old male with postprandial abdominal pain for 4 months obtained medical attention for severe pain. He was diagnosed with small intestinal necrosis, secondary to chronic mesenteric ischemia by CT scan. We performed the surgery including a partial resection of the small intestine and left external iliac artery to the superior mesenteric artery bypass using saphenous vein graft. His symptoms improved after surgery. However, 5 months later, abdominal pain appeared after eating. A CT scan identified graft stenosis, leading to a revascularization. A synthetic vessel was used to perform the re-bypass surgery. Postoperatively, the patient's abdominal pain improved.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 3","pages":"296-300"},"PeriodicalIF":0.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364045","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":"Spinal Cord Injury Risk in Open Repair for Descending Thoracic and Thoracoabdominal Aneurysm.","authors":"Masato Furui, Hitoshi Matsumura, Yoshio Hayashida, Go Kuwahara, Mitsuru Fujii, Masayuki Shimizu, Yuichi Morita, Chihaya Ito, Masato Hayama, Kayo Wakamatsu, Hideichi Wada","doi":"10.3400/avd.oa.24-00028","DOIUrl":"10.3400/avd.oa.24-00028","url":null,"abstract":"<p><p><b>Objective:</b> In open repair for descending thoracic aortic aneurysm (DTAA) or thoracoabdominal aortic aneurysm (TAAA), the influence of re-interventions on spinal cord injury (SCI) remains unclear. This study evaluated the relationships between re-interventions, atherosclerosis, and SCI. <b>Methods:</b> We retrospectively reviewed 78 patients who underwent open surgical repair for DTAA or TAAA between April 2011 and May 2023. The associations of SCI with (i) re-interventions with a history of endovascular therapy and graft replacement and (ii) atherosclerotic factors, including monocyte count, triglyceride levels (TG), and intra-aortic plaques, were examined. <b>Results:</b> The rates of SCI complications and 30-day mortality were both 3.8% (3/78). There was no significant difference between the incidence of SCI in the re-intervention and first-time intervention groups (p >0.90). However, patients with protruding plaque on computed tomography (CT) were more affected by SCI than those without (13.3% vs. 1.6%, p = 0.034). Univariate analysis revealed that SCI was associated with increased monocyte count, TG, protruding plaques on CT, and intraoperative blood loss. <b>Conclusion:</b> Re-interventions for DTAA and TAAA showed no association with the development of SCI under appropriate protective measures. The implicated risk factors may be atherosclerosis factors such as elevated monocyte count, TG, and protruding plaques on CT.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 3","pages":"241-247"},"PeriodicalIF":0.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364048","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":"Infrapopliteal Surgical and Endovascular Intervention.","authors":"Akio Kodama","doi":"10.3400/avd.ra.24-00070","DOIUrl":"10.3400/avd.ra.24-00070","url":null,"abstract":"<p><p>Infrapopliteal revascularization is generally performed for patients with chronic limb-threatening ischemia. As with revascularization in other fields, the indications for endovascular treatment (EVT) have expanded in recent years due to advances in endovascular devices and techniques. However, the optimal revascularization method must be selected based on (1) patient risk, (2) limb severity, and (3) anatomical pattern of disease. Therefore, vascular surgeons need to understand the characteristics of EVT and surgical treatment and improve their technical skills in both procedures. Here is an overview of the current methods of revascularization. (This is a translation of Jpn J Vasc Surg 2024; 33: 61-65).</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 3","pages":"215-218"},"PeriodicalIF":0.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364038","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}
Hiroshi Mitsuoka, Yasuhiko Terai, Yuta Miyano, Takahiro Ozawa, Takahiro Suzuki
{"title":"Skill Mastery and Learning Curve Analysis in Fenestrated Endovascular Aortic Repair with Physician-Modified Endograft.","authors":"Hiroshi Mitsuoka, Yasuhiko Terai, Yuta Miyano, Takahiro Ozawa, Takahiro Suzuki","doi":"10.3400/avd.oa.24-00037","DOIUrl":"10.3400/avd.oa.24-00037","url":null,"abstract":"<p><p><b>Objectives:</b> This study aims to delineate the unique learning curve for fenestrated endovascular aortic repair (FEVAR) at our institution. <b>Materials and Methods:</b> We measured the FEVAR-specific procedure time (FSPT) as the duration from device deployment to bridging stent completion. To maintain consistency in technical complexity, the study focused on 38 cases with four-fenestration FEVAR for juxtarenal abdominal aortic aneurysms, selected from 103 of all FEVAR procedures between June 2011 and February 2024. In these cases, superior mesenteric and bilateral renal arteries were preserved with fenestration with bridging stents insertion, while celiac arteries fenestrations without fenestrations. Learning curve and cumulative sum (CUSUM) analyses assessed FSPT reduction against increased FEVAR experiences. <b>Results:</b> A significant learning curve was observed, with the procedure time (y) and experience (X) correlation given by y = -39.95 log(X) + 283.6 (R<sup>2</sup> = 0.5758). CUSUM indicated that 30 to 50 cases were required for skill stabilization and maturation. <b>Conclusion:</b> Our endovascular team required 30-50 cases to establish reliable FEVAR proficiency. Beyond cumulative experiences, pivotal elements in the learning trajectory seemed to include technological advancements and team augmentation.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 3","pages":"264-269"},"PeriodicalIF":0.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364046","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 Acute Aortic Occlusion Occurring in Association with COVID-19 Infection and Ulcerative Colitis.","authors":"Moeka Yagi, Naoyuki Kimura, Mitsunori Nakano, Naota Okabe, Manabu Shiraishi, Homare Okamura, Hisashi Oshiro, Atsushi Yamaguchi","doi":"10.3400/avd.cr.24-00007","DOIUrl":"10.3400/avd.cr.24-00007","url":null,"abstract":"<p><p>A 53-year-old woman visited her district hospital complaining of right lower limb numbness 8 days after being diagnosed with COVID-19. She had been suffering diarrhea for 25 days before the hospital visit. Computed tomography showed multiple arterial and venous thromboses, and anticoagulation with a therapeutic dose of heparin was initiated. Acute aortic occlusion occurred on hospital day 5, and balloon thromboembolectomy was performed for revascularization of the lower limbs 9 hours after onset. Ulcerative colitis was diagnosed on postoperative day 7. With the anticoagulation and immunosuppression therapy, no thromboembolic event occurred postoperatively.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 3","pages":"287-291"},"PeriodicalIF":0.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364015","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}
Baku Takahashi, Hideyuki Fumoto, Yoshihiro Nakayama
{"title":"Coronary-Pulmonary Artery Fistula Provides Collateral Flow to an Occluded Left Anterior Descending Artery.","authors":"Baku Takahashi, Hideyuki Fumoto, Yoshihiro Nakayama","doi":"10.3400/avd.cr.23-00113","DOIUrl":"10.3400/avd.cr.23-00113","url":null,"abstract":"<p><p>A 59-year-old man presented with angina. Coronary angiography revealed an occlusion in the proximal left anterior descending artery (LAD), the distal segment of which was supplied by the collateral flow of a coronary-pulmonary arterial fistula (CPAF), originating from the right coronary artery and left sinus of Valsalva. Myocardial scintigraphy revealed ischemia in the anteroseptal region. Coronary artery bypass surgery was performed on the LAD, and the CPAF drains were closed. The CPAF may serve as collateral circulation. Even when CPAF serves as collateral circulation, open surgery could be indicated if the collateral flow is insufficient and the structure is complicated.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 3","pages":"301-303"},"PeriodicalIF":0.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364035","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":"Collapse and Occlusion of Balloon-Expandable Covered Stent in the Right Common Iliac Arteries Due to External Stress.","authors":"Seimei Go, Taira Kobayashi, Taiichi Takasaki, Shinya Takahashi","doi":"10.3400/avd.cr.24-00038","DOIUrl":"10.3400/avd.cr.24-00038","url":null,"abstract":"<p><p>The patient previously underwent surgery for cervical cancer. She reported intermittent claudication, and computed tomography (CT) revealed total occlusion of the left iliac artery. We conducted endovascular treatment (EVT) using balloon-expandable covered stents (BECS). The patient underwent colostomy closure after EVT. The patient reported intermittent claudication beginning the day after the procedure. The CT showed a collapse of the distal side of the stent implanted in the right common iliac artery, accompanied by localized thrombo-occlusion. During open surgery, metal hooks typically affect the iliac artery; force transmission through the tissue may indirectly compress the iliac artery, leading to BECS failure.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 3","pages":"313-316"},"PeriodicalIF":0.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364034","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}