{"title":"Distal Bypass Improves Skin Perfusion Pressure at the Whole Foot Regardless of Angiosomes in Patients with Chronic Limb-Threatening Ischemia.","authors":"Fukashi Serizawa, Yoshiyuki Nakano, Munetaka Hashimoto, Yoshihisa Tamate, Hiroko Sato, Masato Ohara, Keiichiro Kawamura, Daijiro Akamatsu, Takashi Kamei","doi":"10.3400/avd.oa.23-00105","DOIUrl":"10.3400/avd.oa.23-00105","url":null,"abstract":"<p><p><b>Objectives:</b> Distal bypass surgery's effect on tissue blood pressure beyond a focal angiosome remains debated. This study assessed tissue blood pressure in both direct revascularized angiosome (DRA) and indirect revascularized angiosome (IRA) after bypass surgery, utilizing repeated skin perfusion pressure (SPP) measurements. <b>Methods:</b> Twenty-nine limbs in 27 chronic limb-threatening ischemia (CLTI) patients (22 males and five females, age: 70.2 ± 9.3 years) who received distal bypass surgery were enrolled. SPP measurements were conducted for the DRA and IRA at 10 time intervals, encompassing both preoperative and postoperative periods of every 3-5 days until 30 days. <b>Results:</b> In total, 486 SPP measurements were collected from 58 measurement sites, and the transition of the SPP at the DRA was 35.4-62.5-59.5-70.2-58.2-62.2-63.1-63.6-63.8-73.4 mmHg and IRA was 29.4-53.4-53.7-58.8-51.3-63.1-47.9-62.1-57.6-61.0 mmHg. No significant differences were observed between SPP at the DRA and IRA. Fifteen wounds on the DRA (63%) and five on the IRA (100%) healed. <b>Conclusion:</b> Distal bypass improves SPP in both direct and IRAs of CLTI patients. These data indicated distal bypass improves tissue blood flow at entire foot regardless of angiosomes.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 2","pages":"150-156"},"PeriodicalIF":0.6,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449438","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":"Interventions in Acute or Subacute Phase for Type B Aortic Dissection.","authors":"Masaaki Kato","doi":"10.3400/avd.ra.24-00012","DOIUrl":"10.3400/avd.ra.24-00012","url":null,"abstract":"<p><p>The treatment strategy for acute and subacute Stanford type B aortic dissection has changed significantly since the advent of thoracic endovascular aortic repair (TEVAR). Indication for invasive treatment: In addition to the conventional complicated cases (rupture or malperfusion case), the indication for invasive treatment now includes cases with refractory hypertension, persistent or recurrent pain, large aortic diameter, and other conditions that are considered to have a poor prognosis with conservative treatment. Treatment methods: TEVAR is the first choice for acute, subacute, and early chronic-stage treatment, and when this is not possible, other techniques (fenestration and graft replacement) are chosen. Treatment timing: The timing of invasive treatment should be emergent in life-threatening conditions (for rupture or malperfusion case) and immediate in symptomatic cases, while in other cases, preemptive TEVAR is considered appropriate on a scheduled timing within 6 months of onset. (This is a translation of Jpn J Vasc Surg 2023; 32: 157-163.).</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 2","pages":"120-127"},"PeriodicalIF":0.6,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452722","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":"Absolute Lymphocyte Count Predicts Bypass Surgery Outcomes in Patients with Chronic Limb-Threatening Ischemia.","authors":"Satoshi Yamamoto, Takuya Hashimoto, Masaya Sano, Masaru Kimura, Osamu Sato, Juno Deguchi","doi":"10.3400/avd.oa.23-00088","DOIUrl":"10.3400/avd.oa.23-00088","url":null,"abstract":"<p><p><b>Objectives</b>: The aim of this study was to evaluate the relationship between absolute lymphocyte count (ALC) and outcomes of infrainguinal bypass surgery for chronic limb-threatening ischemia (CLTI). <b>Methods</b>: From 2004 to 2020, 209 limbs of 189 patients who underwent infrainguinal bypass surgery for CLTI and whose ALCs were available were included. Patients with survival >2 years and limb salvage >2 years were considered discriminant groups, and an ALC cut-off value was calculated. The relationship between preoperative ALC and outcomes was evaluated. <b>Results</b>: Survivorship of the higher ALC group was significantly higher than that of the lower ALC group (cut-off value 1030/μL, p = 0.0009). The limb salvage rate of the higher ALC group was significantly higher than that of the lower ALC group (cut-off value 1260/μL, p = 0.0081). In the dialysis patient group (103 limbs), the limb salvage rate of the higher ALC group was significantly higher than that of the lower ALC group (cut-off value 1170/μL, p = 0.026). ALC was independently associated with limb loss in multivariate analysis. <b>Conclusion</b>: ALC is promising as a predictor of outcomes after bypass surgery in CLTI. In particular, ALC is expected to be useful for limb prognosis in hemodialysis patients.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 2","pages":"142-149"},"PeriodicalIF":0.6,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449397","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":"Serious Adverse Events with Cyanoacrylate Closure of Varicose Veins: An Initial Report from a Large-Scale National Survey in Japan.","authors":"Michihisa Umetsu, Masayuki Hirokawa, Eri Fukaya, Eiichi Teshima, Hitoshi Kusagawa, Toshiya Nishibe, Hiroko Nemoto, Makoto Mo, Tomohiro Ogawa","doi":"10.3400/avd.oa.23-00106","DOIUrl":"10.3400/avd.oa.23-00106","url":null,"abstract":"<p><p><b>Objective:</b> Cyanoacrylate closure (CAC) is a minimally invasive technique for the treatment of varicose veins. A recent paper reported serious adverse events (AEs) associated with this use. This triggered an urgent survey to determine the incidence of AEs in Japan. <b>Methods:</b> The CAC-AE survey was sent to all 1,030 institutions authorized for CAC treatments. Cases performed between January 2020 and October 2023 were surveyed. Data on serious AEs and mortality were collected. <b>Results:</b> There were 623 surveys returned. There were 16 cases of proximal deep vein thrombosis, 3 cases of pulmonary embolism (PE), and 0 cases of stroke. Deep vein occlusion due to cyanoacrylate extension was observed in 1 case. Vein resection due to infection was observed in 4 cases. There were 299 cases of localized phlebitis and/or allergic reactions requiring steroid administration. Systemic allergic reactions requiring steroid administration were observed in 66 cases. There was no anaphylaxis associated with cyanoacrylate. There was one postoperative death from PE. <b>Conclusion:</b> This report's intent is to provide real world data on serious AEs following CAC from Japan given current concern over these events. An extensive report investigation of individual complications with analysis including causality will be provided following a full investigation separately.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 1","pages":"21-24"},"PeriodicalIF":0.8,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11018107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140846904","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 Successful Hybrid Treatment of Dual Arterial Bypass Using Indocyanine Green Fluorescence Angiography and Endovascular Treatment for Recurrent Superior Mesenteric Artery Aneurysm.","authors":"Keisuke Yoshida, Yujiro Miura, Naoki Edo, Atsuyuki Mitsuishi, Tomohiro Matsumoto, Hiroyuki Kitagawa","doi":"10.3400/avd.cr.23-00036","DOIUrl":"https://doi.org/10.3400/avd.cr.23-00036","url":null,"abstract":"<p><p>A 54-year-old woman with a mycotic superior mesenteric artery (SMA) aneurysm underwent emergent aneurysm resection with a great saphenous vein bypass. Follow-up computed tomography revealed a rapidly growing recurrent SMA aneurysm at the stump. Under the diagnosis of recurrent pseudoaneurysm of SMA with a fragile stump, we performed an open dual arterial bypass using indocyanine green fluorescence angiography and endovascular coil embolization. Subsequently, the patient's recurrent mycotic SMA aneurysm was successfully managed without mesenteric ischemic complications. This method may help prevent fatal mesenteric ischemia during SMA aneurysm surgery.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 1","pages":"59-62"},"PeriodicalIF":0.8,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11018100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874444","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":"2020 JAPAN Critical Limb Ischemia Database (JCLIMB) Annual Report.","authors":"","doi":"10.3400/avd.ar.23-00096","DOIUrl":"10.3400/avd.ar.23-00096","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 the patients with CLI to contribute to the improvement of the quality of medical care. This database, called JAPAN Critical Limb Ischemia Database (JCLIMB), is created on the National Clinical Database and collects data of patients' background, therapeutic measures, early results, and long-term prognosis as long as 5 years after the initial treatment. The limbs managed conservatively are also registered in JCLIMB, together with those treated by surgery and/or endovascular treatment. In 2020, 1299 CLI limbs (male 890 limbs: 69%) were registered by 85 facilities. Arteriosclerosis obliterans has accounted for 99% of the pathogenesis of these limbs. In this manuscript, the background data and the early prognosis of the registered limbs are reported. (This is a translation of Jpn J Vasc Surg 2023; 32: 363-391.).</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 1","pages":"73-108"},"PeriodicalIF":0.8,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11018106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851040","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":"Limb Salvage Surgery for Ponatinib-Induced Bilateral Chronic Limb-Threatening Ischemia in a Patient with Chronic Myeloid Leukemia with T315I Mutation in BCR-ABL: A Case Report.","authors":"Takuo Nomura, Akito Hata","doi":"10.3400/avd.cr.23-00059","DOIUrl":"https://doi.org/10.3400/avd.cr.23-00059","url":null,"abstract":"<p><p>A 72-year-old woman with chronic myeloid leukemia with T315I mutation in breakpoint cluster region-abelson (BCR-ABL) was treated with ponatinib. During the course of her treatment, chronic limb-threatening ischemia developed in both lower extremities, and the left lower extremity was amputated below the knee at a previous hospital. She was referred to our department for salvage of the right lower extremity. We performed a foot bypass and multidisciplinary treatment of the wound, and achieved epithelialization in about 1 month. The rate of vascular occlusive events with ponatinib has been reported to be high, and we believe that careful monitoring is important during use.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 1","pages":"51-54"},"PeriodicalIF":0.8,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11018110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856435","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}
Erwin Hadi Chandra, Tom Ch Adriani, Ahmadi Alwi, Mulawardi, Nyityasmono Tri Nugroho, Dewi Yusuf
{"title":"Evaluation of Central Venous Catheter for Dialysis Associated with Bloodstream Infections.","authors":"Erwin Hadi Chandra, Tom Ch Adriani, Ahmadi Alwi, Mulawardi, Nyityasmono Tri Nugroho, Dewi Yusuf","doi":"10.3400/avd.oa.23-00062","DOIUrl":"10.3400/avd.oa.23-00062","url":null,"abstract":"<p><p><b>Objective</b>: Hemodialysis (HD) catheter-related bloodstream infections (CRBSIs) are a major complication of long-/short-term catheter. <b>Material and Methods</b>: Patients with HD CRBSIs were identified, and their blood was taken and sent to clinical pathology for culture and sensitivity testing. The inclusion criteria were adults with end-stage renal disease who required urgent HD access in the presence of a central venous catheter (CVC) infection. <b>Results</b>: The most common isolates among the patients with CRBSIs were gram-positive microorganisms (57.5%) and gram-negative organisms (42.5%). Overall, in our entire study, <i>Staphylococcus aureus</i> was the most common pathogen isolated, accounting for 30%, followed by <i>Pseudomonas aeruginosa</i> (20%), coagulase-negative staphylococci (CoNS) (12.5%), <i>Klebsiella</i> spp. and <i>Acinetobacter</i> (10%), <i>Staphylococcus epidermidis</i> (7.5%), and methicillin-resistant <i>Staphylococcus aureus</i> (MRSA), <i>Escherichia coli</i>, <i>Staphylococcus hominis</i>, and <i>Enterococcus faecalis</i> (2.5%). The commonest bacterial in femoral was <i>S. aureus</i>, and for subclavian was <i>Pseudomonas aeruginosa</i>. All <i>S. aureus</i> were sensitive to aminoglycosides and quinolones. <i>P. aeruginosa</i> was sensitive to the third generation of cephalosporins, especially cefoperazone and carbapenem. <b>Conclusion:</b> Nontunneled CVCs used for more than 2 weeks could increase the risk of CRBSIs. Procalcitonin and erythrocyte sedimentation rate could predict the CRBSIs in this study. This study also revealed that the gram-positive bacteria were <i>primadonna</i> in dialysis of CRBSIs, and most of them were sensitive to aminoglycosides.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 1","pages":"9-13"},"PeriodicalIF":0.8,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11018104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140846991","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":"Super-Elderly Case of Acute Lower Limb Ischemia Treated with Indigo Aspiration System in Japan.","authors":"Shinsuke Kikuchi, Seima Ohira, Tsutomu Doita, Keisuke Kamada, Naoya Kuriyama, Yuya Tamaru, Takamitsu Tatsukawa, Yuri Yoshida, Daiki Uchida, Nobuyoshi Azuma","doi":"10.3400/avd.cr.23-00095","DOIUrl":"10.3400/avd.cr.23-00095","url":null,"abstract":"<p><p>The Indigo Aspiration System (Penumbra Ltd., Alameda, CA, USA), a catheter-based device intended for the endovascular removal of clots from peripheral arteries and veins, was launched in Japan to treat acute limb ischemia after the cessation of urokinase sales. The initial application of this system in Japan was on a 96-year-old male patient. He was diagnosed with acute lower limb ischemia, which was caused by an embolism from a left common iliac artery aneurysm. The treatment significantly enhanced the perfusion to his left foot. This case report elaborates on the patient's treatment experience and discusses the indications for using the device.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 1","pages":"63-68"},"PeriodicalIF":0.8,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11018105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847252","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":"Microvascular Changes Are Associated with Proteinuria and EMG Changes in Patients with Type 2 Diabetes Using Video Capillaroscopy.","authors":"Alireza Rajaei, Pooneh Dehghan, Nikoo Emtiazi, Azadeh Afzalnia, Faraneh Farsad, Seyed Mohamad Hosseinian","doi":"10.3400/avd.oa.23-00066","DOIUrl":"10.3400/avd.oa.23-00066","url":null,"abstract":"<p><p><b>Objectives:</b> Video capillaroscopy is a diagnostic method for evaluating microvascular changes in type 2 diabetes mellitus (T2DM). This study evaluated microvascular changes, including microvascular architecture, capillary distribution (morphology and density), and angiogenesis conditions in T2DM patients via video capillaroscopy. <b>Methods:</b> A total of 256 patients with T2DM enrolled in this study. Based on electromyography (EMG)-nerve conduction velocity results, patients were divided into patients with normal and abnormal EMG. Microalbuminuria was assessed using biochemical urine analysis. Finally, video capillaroscopy was performed to evaluate changes in microvascular architecture, capillary distribution, and angiogenesis status. <b>Results:</b> The differences between microalbuminuria in patients with normal and abnormal EMG were not significant. Other microvascular changes were not significant between normal and abnormal EMG groups. The patients with greater microalbuminuria were at risk of abnormal EMG 2.8 times higher than those with fewer microalbuminuria (odds ratio = 2.804; 1.034-7.601). However, EMG is not a risk factor for microvascular architecture alternation in T2DM (odds ratio = 1.069; 0.323-3.546). <b>Conclusions:</b> Microvascular alternations are common in T2DM and early detection of these changes could help to avoid the progress of nephropathic complications. Also, video capillaroscopy provides a promising diagnostic method for the detection of microvascular alternations in T2DM.</p>","PeriodicalId":7995,"journal":{"name":"Annals of vascular diseases","volume":"17 1","pages":"15-20"},"PeriodicalIF":0.8,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11018102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848722","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}