Vascular and endovascular surgery最新文献

{"title":"Stent Graft Intervention in a Lumbar Artery Pseudoaneurysm Improved Cauda Equina Syndrome: A Case Report of Combined Embolization Strategy.","authors":"Yuta Murai, Kouki Nakashima, Yukio Tamura, Kagami Miyaji","doi":"10.1177/15385744251326336","DOIUrl":"10.1177/15385744251326336","url":null,"abstract":"<p><p>A lumbar artery pseudoaneurysm following a lumbar vertebral compression fraction is rare. Cauda equina syndrome due to spinal canal compression is a rarer complication of this pseudoaneurysm. Endovascular treatment, which involves embolization of the inflow and outflow vessels, is the first-line treatment for lumbar artery pseudoaneurysms. We report a case of a lumbar artery pseudoaneurysm with spinal canal compression that was treated with coil embolization of the outflow vessel and stent graft placement to occlude the inflow vessel. After treatment, the symptoms of cauda equina syndrome improved. Using a stent graft is particularly effective when the inflow vessel to be occluded is short and, combined with other endovascular therapies such as coil embolization, increases the potential for complete exclusion of a lumbar artery pseudoaneurysm.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"538-542"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Popliteal Artery Interposition Graft Infection by Extra-anatomic Bypass.","authors":"Daanish Sheikh, Shri Timbalia, Maham Rahimi","doi":"10.1177/15385744251327013","DOIUrl":"10.1177/15385744251327013","url":null,"abstract":"<p><p>ObjectivesInfection of peripheral interposition grafts is a rare but devastating complication following aneurysm repair. Typically, graft infection necessitates explantation and, if possible, revascularization of the limb. However, treatment complexity varies substantially depending on the location and extent of infection. This case describes the management of a popliteal artery interposition graft infection.MethodsWe describe an 84 year old male with a history of left popliteal artery aneurysm repair with PTFE interposition graft (found on workup a year prior for a gangrenous great toe) who presented with four days of night sweats, chills, and a painful posterior left knee. Laboratory findings indicated leukocytosis, while ultrasound and CT imaging revealed complex fluid surrounding the graft without evidence of pseudo-aneurysm. Surgical management was conducted in two stages, the first with the patient supine for bypass from the superficial femoral artery to the posterior tibial artery using ipsilateral reversed great saphenous vein. The patient was then repositioned prone for the second stage of the procedure, and the infected popliteal fossa was entered posteriorly for debridement with caution to avoid injury to the tibial nerve and popliteal vein. The infected graft was removed, and antibiotic beads were placed in the infected region.ResultsFollowing this procedure and serial washouts one week later, the patient retained motor function, sensation, and palpable posterior tibial and dorsal pedal pulses. The patient was placed on IV cefazolin for 6 weeks following the procedure and discharged with 6 months of oral suppression to achieve long-term prevention of further infection.ConclusionsWhen managing popliteal artery graft infection, the presence of purulent material in the popliteal fossa can make anatomic bypasses high-risk for recurrent infection, and caution must be taken to avoid the nearby popliteal vein and tibial nerve during irrigation and debridement.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"549-553"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymptomatic Carotid Stenosis is Associated With Mobility Dysfunction: Results From the InChianti Study.","authors":"Sarasijhaa K Desikan, James Borrelli, Vicki L Gray, Aman A Kankaria, Michael Terrin, Brajesh K Lal","doi":"10.1177/15385744251323434","DOIUrl":"10.1177/15385744251323434","url":null,"abstract":"<p><p>BackgroundOlder adults with mobility dysfunction are at risk for falls, hospitalization, and death. In an earlier pilot study, individuals with asymptomatic carotid artery stenosis (ACAS) demonstrated mobility dysfunction when compared to individuals without ACAS. We tested whether carotid stenosis affected mobility function in a larger community-dwelling cohort using the Invecchaire in Chianti (InCHIANTI) database.MethodsWe analyzed data from participants in the InCHIANTI study who completed a medical history, carotid duplex testing, and mobility function testing (Short Physical Performance Battery- SPPB). Participants with a history of stroke, transient ischemic attack, or carotid endarterectomy were excluded. 709 participants met inclusion criteria (116 ACAS, 593 no ACAS). Our analytic approach sought to evaluate the impact of stenosis on mobility after accounting for age, sex and cardiovascular risk factors. Age was stratified into 2 age-groups (65-74 and 75-84 years). Two-way ANOVA was used to test the effect of stenosis-group, age-group, and their interactions on SPPB score with sex as a covariate.ResultsStenosis-group (<i>P</i> = 0.0002), age-group (<i>P</i> < 0.0001), and the interaction between stenosis-group and age-group (<i>P</i> = 0.0008) significantly affected SPPB. Post-hoc testing showed that participants with ACAS demonstrated worse performance on the SPPB (9.81 ± 0.37) compared to those with no ACAS (11.10 ± 0.11) in the 65-74 years age-group (<i>P <</i> 0.0001).Conclusions65-74-year-old adults with ACAS performed significantly worse on the SPPB than those without ACAS. These results lend further support that ACAS may be associated with mobility dysfunction in older adults.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"479-486"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shattered by Light: Catheter Fractures and the Hidden Danger of Angio-Seal Device Failure in the Femoral Artery.","authors":"Rouzbeh Kotaki, Ravi Shastri, Mohammad Ghasemi-Rad","doi":"10.1177/15385744251332765","DOIUrl":"https://doi.org/10.1177/15385744251332765","url":null,"abstract":"<p><p>We report a case of a 77-year-old male with pancreatic cancer and thrombocytopenia who presented with acute stroke symptoms and underwent successful endovascular thrombectomy. During femoral artery closure, an 8-F Angio-Seal device fractured, leaving catheter fragments in the right femoral artery, confirmed on imaging. Device analysis revealed oxidation-induced brittleness, leading to sheath fragmentation. This case highlights a rare complication of Angio-Seal devices, suggesting potential material vulnerabilities that warrant further investigation.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251332765"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial Palmar Arch Aneurysms Management: Case Series.","authors":"Ricardo Augusto Carvalho Lujan, Miguel Godeiro Fernandez, Fernanda Costa Sampaio Silva, Giselli Azevedo Lujan, Diego Antonio de Melo Mascarenhas, Marcelo Luis Pereira de Souza Filho, Roque Aras Junior","doi":"10.1177/15385744251343706","DOIUrl":"https://doi.org/10.1177/15385744251343706","url":null,"abstract":"<p><p>IntroductionTrue aneurysms of the upper limb, particularly in the hands, are rare and challenging to manage. We aim to report two cases of true arterial palmar arch aneurysms surgically treated.Case ReportThe first case involved a 45-year-old male professional martial artist with an ulnar artery aneurysm extending to the superficial palmar arch in the right hand. The second case was a 32-year-old female administrative assistant with a radial artery aneurysm in the left hand. Despite their respective professions, neither patient had a history of significant trauma, recent excessive training, or prolonged work hours. Clinically, both presented with local pain. Diagnostic imaging confirmed the aneurysms. The surgical interventions included proximal and distal vessel ligation and aneurysm resection under local anesthesia. Both patients were discharged on the first postoperative day without complications and showed no vascular complications during a 5-year follow-up.ConclusionAneurysms with marked rarity require individualized treatment with surgical options tailored to the clinical presentation and vascular status.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251343706"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcarotid Artery Approach for Endovascular Aortic Repair in Treating Complex Descending Thoracic Aortic Pseudoaneurysm With Aortoiliac Occlusion: A Case Report.","authors":"Haofan Shi, Xingyou Guo, Chengkai Su, Haoyue Huang, Yihuan Chen, Jinlong Zhang, Bowen Zhang, Xiang Feng, Zhenya Shen","doi":"10.1177/15385744251339956","DOIUrl":"https://doi.org/10.1177/15385744251339956","url":null,"abstract":"<p><p>BackgroundEndovascular aortic repair has emerged as the preferred treatment modality over open surgery for aortic diseases, primarily because of its association with lower perioperative morbidity and mortality rates. Current diagnostic and treatment guidelines generally advocate for endovascular aortic repair in most cases, with the femoral artery serving as the conventional access route. However, this approach may not be feasible for all patients, particularly those with aortoiliac artery occlusion, necessitating alternative access strategies.Case SummaryThis paper presents a complex case study of a patient with aortoiliac artery occlusion who underwent endovascular aortic repair via the left carotid artery approach for a pseudoaneurysm at the anastomotic site of a descending aortic prosthetic graft. This case underscores the potential value of utilizing the carotid artery as an alternative access route in anatomically challenging situations.ConclusionResearch on transcarotid artery approach endovascular aortic repair is limited and predominantly consists of case reports, with a notable absence of randomized controlled trials. This case report suggests that endovascular aortic repair via the carotid artery approach may be a viable alternative for selecting patient groups when the conventional femoral artery approach is not feasible. While our single case demonstrated successful management with minimal complications, larger studies are needed to fully establish the safety profile and determine if perioperative complications and mortality rates are indeed manageable across diverse patient populations.Clinical ImpactThis study provides valuable insights into the feasibility of the carotid artery as an alternative access route for endovascular aortic repair in patients with aortoiliac artery occlusion. It offers clinicians a potential strategy for cases where the conventional femoral artery route is not feasible. The findings presented herein aim to demonstrate the practicality and relative safety of utilizing the carotid artery for endovascular procedures in anatomically challenging scenarios, contributing to the broader understanding of access alternatives in aortic repair interventions.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251339956"},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortoenteric Fistulas Following Endovascular Aortic Aneurysm Repair: A Review.","authors":"Jorge Rey, Arash Bornak, Christopher Montoya, Camilo Polania, Stefan Kenel-Pierre, Naixin Kang, Matthew Sussman, Kathy Gonzalez, Young Erben","doi":"10.1177/15385744251339966","DOIUrl":"https://doi.org/10.1177/15385744251339966","url":null,"abstract":"<p><p>BackgroundSecondary aortoenteric fistulas (SAEF) following endovascular aortic repair (EVAR) is an extremely rare event but life threatening. Our review offers comprehensive knowledge on pathophysiology, clinical presentation, diagnosis, and treatment options.AimTo summarize the current literature regarding pathophysiology, clinical, diagnostic and therapeutic approach of aortoenteric fistulas secondary to EVAR.MethodsWe performed a literature search in Pubmed/MEDLINE to identify the literature published about SAEF after EVAR. Cases were summarized in a table and prevalences. Other relevant literature was included in the results sections.ResultsA total of 35 reports (single cases and small series) with 45 patients were included. SAEF after EVAR can result from infection, inflammation, or mechanical factors. Clinical presentation is often non-specific, ranging from a gastrointestinal herald bleed to hemorrhagic shock, or malaise and general infection-related symptoms. Cross-sectional imaging plays a critical role in diagnosing SAEF. The treatment approach involves a multidisciplinary team approach and requires broad-spectrum intravenous antibiotics, endovascular intervention for urgent hemorrhage control, and open surgical intervention for definitive repair. Long-term antimicrobial therapy is essential to avoid reinfection.ConclusionsSAEF following EVAR represents a complex, life-threatening condition with limited evidence-based management strategies. Given the growing prevalence of endovascular procedures, comprehensive knowledge of SAEF is crucial for all health care providers to improve early diagnosis and outcomes.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251339966"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Options and Outcomes for Renal Vein Entrapment.","authors":"Gabrielle Schweitzer, Georges Jreij, Eleanor Dunlap, Suzanna Fitzpatrick, Khanjan Nagarsheth","doi":"10.1177/15385744251339965","DOIUrl":"https://doi.org/10.1177/15385744251339965","url":null,"abstract":"<p><p>BackgroundRenal vein entrapment is compression of the left renal vein (LRV) between the superior mesenteric artery and the aorta. When symptomatic, this condition is referred to as nutcracker syndrome (NCS).MethodsThis retrospective study reviews outcomes of 53 patients who underwent surgical correction of NCS at a tertiary care university medical center. Preoperatively, each patient underwent outpatient workup, including diagnostic venography with intravascular ultrasound (IVUS).ResultsThe patients were 98% female, average age of 33.6 years, and body mass index of 21.5 kg/m². Those who became surgical candidates, had either left flank or left upper quadrant abdominal pain. Preoperative venography and IVUS demonstrated a mean left renal vein (LRV) stenosis of 74%, and dilated LRV collaterals were identified in 64%. Presenting symptoms were provoked with catheter advancement, and with contrast injection into the LRV or its tributaries in 74% and 45% of venograms, respectively. Surgery consisted of renal vein transposition (RVT) in 43 patients, autotransplantation (AT) in 6, and gonadal vein transposition (GVT) in 4. Renal artery denervation was done in 39/47 patients (83%) who had RVT or GVT. LRV reconstruction was needed in 15/43 patients (35%) who had RVT because the vein was too short or scarred for transposition. There were 7 renal vascular complications after RVT (none with AT or GVT), most following bovine pericardial neoconduit. After 11.2 ± 1.2 months of follow up, patients in this study reported that their symptoms had resolved in 43%, improved in 36%, improved then recurred in 13%, and had not changed in 8%. Good outcome was achieved after AT in 100%, after RVT in 79%, and after GVT in 50%.ConclusionsAlgorithm-based surgical management of NCS leads to symptom resolution or improvement in most patients. Renal vein reconstruction with bovine pericardial neoconduit is associated with a high rate of vascular complications.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251339965"},"PeriodicalIF":0.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Technique for Creation of Femoral Vein Monocusp Neovalve for Patients With Primary Deep Vein Incompetence.","authors":"Natarajan Sekar, Archana Rajan, Rahul Sima","doi":"10.1177/15385744241296605","DOIUrl":"10.1177/15385744241296605","url":null,"abstract":"<p><p>Chronic venous insufficiency due to deep vein incompetence (DVI) is difficult to treat and is prone for failure and recurrence of venous ulcers. A variety of techniques have been tried to create valve competency but majority of them have been difficult to perform and have not shown long term results. Opie reported a technique for construction of a monocusp neo valve. We have modified this procedure and successfully corrected the deep vein reflux in a patient with primary DVI.MethodsMonocusp valve was created by folding the vein wall flap so that both sides of the valve will have intimal surface.ResultPatient had excellent symptomatic improvement. The venous ulcer healed with skin grafting and had not recurred at 30 months follow up. Descending venogram and duplex scan showed mild reflux.ConclusionMonocusp neo valve creation for primary DVI is a simple procedure with good long-term result.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"447-452"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open Distal Venous Arterialization Technique as an Opportunity for Patients With Critical Limb Ischemia: A Latin American Experience.","authors":"Leonardo Jose Randial-Pérez, Esteban Portilla-Rojas, Mariana Pinzón-Pinto, Santiago Andrés Suárez-Gómez, Mateo Amorocho-Suárez, Carla Contreras, Luis Felipe Cabrera-Vargas","doi":"10.1177/15385744241306497","DOIUrl":"10.1177/15385744241306497","url":null,"abstract":"<p><p>BackgroundChronic limb-threatening ischemia (CLTI) leads to decreased quality of life and increased disease burden, resulting in progressive patient deterioration, limb amputation, and mortality.ObjectivesThis study aims to present the outcomes of a Latin American experience using the open distal venous arterialization (DVA) technique for no-option limb salvage in a high volume CLTI center.MethodsA retrospective case series study was performed including patients from 2018 to 2022 using a population from Bogotá, Colombia. Patients with no-option chronic limb-threatening ischemia underwent open DVA with a 12 month follow-up period. Variables such as operative time, hospital and ICU length of stay, graft material, re-interventions, 1-year patency, amputations and 1-year mortality were recorded.Results5 patients with a mean age of 71 years were intervened. 60% were male and 80% had a diabetes mellitus diagnosis. Four patients underwent a reverse great saphenous vein graft procedure and 1 composite polytetrafluoroethylene graft. A total of 80% of patients demonstrated graft patency after 1 year. No perioperative mortalities were recorded but one late postoperative mortality due to myocardial infarction occurred. One major amputation was required, minor amputations were performed in 2 of the patients.ConclusionOpen DVA is a feasible low cost technique for adequately selected patients with favorable saphenous vein, as evidenced by the limb salvage and graft patency outcomes.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"428-434"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}