Vascular and endovascular surgery最新文献

{"title":"Innovative Approach for Successful Cure of a Digital AVM With Glue and Venous Tourniquet.","authors":"Puneet Garg, Geetika Sindhwani, Aditi Saini, Resham Singh","doi":"10.1177/15385744251355238","DOIUrl":"10.1177/15385744251355238","url":null,"abstract":"<p><p>BackgroundArteriovenous malformations (AVM) of the digits are rare and carry a poor prognosis after surgical resection and embolisation and usually end up in digital amputation. We present a unique case of a digit AVM treated using glue by dual approach, ie, transarterial and percutaneous route with a proximal tourniquet, where we could completely salvage the digit involved with a significant reduction in symptoms.Case PresentationWe report a case of a 20-year-old male who presented with swelling of the right ring finger for the past 10 years, with new onset pain and increased swelling size in the last 2 years. A diagnosis of arteriovenous malformation was made on ultrasound and magnetic resonance angiography (MRA) imaging. To salvage the digit, meticulous planning and multidisciplinary discussion for embolization using super-selective angiography were done. Successful embolisation of nidus with feeder from both metacarpal arteries of the ring finger was done using glue by transarterial and percutaneous route with a proximal tourniquet. Near total obliteration of nidus was achieved with no early opacification of the draining vein. Short-term follow-up of 4 months revealed a significant reduction of swelling and pain with no major complication.ConclusionsGlue embolization with a dual approach and proximal tourniquet is safe and effective in digital AVM for symptom reduction with no major complication.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"758-762"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334755","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":"Successful Management of Spontaneous Iliac Vein Rupture With Coil Embolization: A Case Report.","authors":"Yoshihiro Aoki, Takanobu Otaguro, Takeshi Hayashida, Koichi Hayakawa, Ichiro Sakamoto","doi":"10.1177/15385744251355193","DOIUrl":"10.1177/15385744251355193","url":null,"abstract":"<p><p>BackgroundSpontaneous iliac vein rupture is a rare but life-threatening condition, often associated with deep vein thrombosis (DVT). Current treatment options include surgical repair and endovascular interventions, but consensus on optimal management is lacking.Case ReportA 74-year-old woman presented with hypotension, altered consciousness, and left leg swelling. Imaging revealed a massive retroperitoneal hematoma with active bleeding from a ruptured left external iliac vein. Successful hemostasis was achieved using coil embolization, followed by anticoagulation for DVT management.ConclusionThis case demonstrates that coil embolization can be an effective minimally invasive treatment option for spontaneous iliac vein rupture, particularly in patients who may not tolerate surgical intervention.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"754-757"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334756","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":"Systematic Review and Meta-Analysis of the Effect of Chronic Kidney Disease on Amputation and Mortality in Patients With Peripheral Artery Disease.","authors":"Yahui Zhang, Yuan Liao, Hongbao Guo","doi":"10.1177/15385744251355230","DOIUrl":"10.1177/15385744251355230","url":null,"abstract":"<p><p>BackgroundThe influence of presence/absence chronic kidney disease (CKD) on the clinical course and outcomes of patients with peripheral artery disease (PAD) has not been extensively investigated. We aimed to measure the relative rates of amputation and mortality in individuals with different stages of CKD compared to those without CKD, and to assess whether revascularization treatments might reduce these risks for PAD patients.MethodsWe conducted a thorough search of the literature across multiple databases, including MEDLINE, EMBASE, the Cochrane Library, and Web of Science. The risk of bias assessment was assessed using the Newcastle-Ottawa Quality Assessment scale. All studies that reported relevant results in PAD patients were included. The statistical analysis involved the calculation of pooled prevalence estimates using a random-effects model, along with the performance of subgroup analyses and meta-regression to evaluate heterogeneity.ResultsWe included fourteen observational studies encompassing a total of 554,270 patients with PAD that met the predefined inclusion criteria. Eleven studies reported on amputation rates in patients with and without CKD. Our analysis showed that CKD patients faced nearly double the risk of amputation compared to those without CKD (1.94; 1.90 to 1.97; <i>P</i> < 0.001; I² = 96.8%, <i>P</i> < 0.001). Additionally, a significant rise in mortality risk among CKD patients was observed across 14 studies, in comparison to patients without CKD (OR 2.04; 95% CI 1.99 to 2.08; <i>P</i> < 0.001; I² = 78.6%, <i>P</i> < 0.001). Moreover, we observed a graded increase in both amputation and mortality rates with the progression of CKD severity. In terms of therapeutic interventions, the potential of revascularization procedures to lower mortality and amputation rates appeared to be attenuated in the presence of CKD in PAD patients. Meta-regression analysis revealed that only a baseline diabetic population exceeding 50% exhibited a borderline association with amputation rate (β 0.422; 95% CI [-0.189; 1.035]) after adjusting for other covariates, including sample size, percentage of patients with critical limb ischemia, and follow-up time.ConclusionThe significant association noted between CKD and risk of amputation and mortality with PAD, with this risk intensifying as renal insufficiency progresses. Furthermore, the effectiveness of revascularization procedures in reducing amputation and mortality rates is diminished in patients with PAD who also have CKD.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"706-718"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562531","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":"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":"681-689"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","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":"Expanding the Use of the Comaneci Neck-Bridging Device for Endovascular Treatment of Complex Renal Artery Aneurysms.","authors":"David Clemo, Pablo Giacaman, Luis Nuñez, Cristian Lindner, Andrés Concha","doi":"10.1177/15385744251355197","DOIUrl":"10.1177/15385744251355197","url":null,"abstract":"<p><p><b>Background:</b> Renal artery aneurysms (RAA) carry significant rupture risks, yet wide-neck variants challenge conventional endovascular techniques. Purpose: We report the successful exclusion of a wide-neck RAA using the Comaneci neck-bridging devide in a patient with renal fibromuscular dysplasia (FMD), highlighting its utility and limitations. <b>Research design:</b> Single-case report. <b>Study sample:</b> A 50-year-old hypertensive female with renal FMD presenting with a 27-mm saccular, wide-neck RAA. Data collection: Following multidiscplinary discussion favoring renal parenchyma preservation, endovascular coiling using the Comaneci device was performed via brachial access. The device stabilized the aneurysm neck during sequential coil (Hydroframe, Cosmos, Complex) placement. Posprocedural and 24-month follow-up imaging assesed occlusion, renal perfusion, and complication. <b>Results:</b> Postprocedural imaging confirmed complete aneurysm occlusion, preserved renal perfusion, and the abscense of complications, which was sustained at the 24-month follow-up. <b>Conclusion:</b> This case demonstrated the Comaneci device's safety and efficacy for excluding anatomically complex RAAs, particularly in FMD-associated vessels where permanent stents risk endothelial injury. Technical challenges include device sizing limitations in larger visceral arteries and the need for dual microcatheter strategies, underscoring operator expertise importance. Critical gaps identified are the lack of standarized protocols for visceral applications and insufficient long-term coil stability data. Findings advocate for device modifications for non-cerebral anatomies and prospective trials compating outcomes with balloon-assisted coiling or flow diversion. While highlighting the Comaneci's niche role in RAA management, cautious adoption is urged pending robust evidence.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"788-793"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510207","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":"Endovascular Skirt Reconstruction of Aortoiliac Bifurcation Using Bare-nitinol Stents: ESCORT Technique.","authors":"Takenobu Shimada, Yoshihisa Shimada, Daisuke Tonomura, Kazunori Terashita, Yuki Yamanaka, Daiju Fukuda","doi":"10.1177/15385744251339967","DOIUrl":"10.1177/15385744251339967","url":null,"abstract":"<p><p>BackgroundEndovascular treatment for aortoiliac occlusive disease (AIOD) is still challenging. We propose a stent deployment technique for AIOD using only bare-nitinol stents (BNSs) in a form that is ultimately similar to the normal aortoiliac bifurcation structure.Methods and case seriesThe Endovascular Skirt reCOnstruction of aoRToiliac bifurcation using bare-nitinol stents (ESCORT) technique involves primary implantation of a large BNS, with its distal edge being placed just at the edge of the carina by mounting onto 2 pull-through guidewires from the side of an upper extremity followed by V-stenting using BNSs into the pre-implanted BNS at the terminal aorta. The results of experiments showed that this technique can be achieved by the unique structural characteristic of an E-Luminexx Vascular stent (BD, Tempe, AZ, USA) as a main body in which the stent edge can be advanced beyond the catheter tip. This technique without using stent grafts can avoid recrossing of the jailed guidewire and can reduce the procedural and long-term care that is necessary when using stent grafts, and a future cross-over approach may be established also after treatment. Between 2017 and 2021, the ESCORT technique was performed in 7 consecutive cases of AIOD at our institute. The procedural success rate was 100%, and no complication occurred in any of the patients. Symptom resolution was obtained in all patients. Target lesion revascularization (TLR) was performed in 1 patient with extremely severe calcified lesions. Except for the 1 case requiring TLR, at least 2-year patency was confirmed in patients who were followed up. The establishment of a cross-over system was tried in 2 patients after the procedure, and it was successful in both cases.ConclusionThe ESCORT technique for AIOD is a feasible and beneficial stenting strategy.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"725-732"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060858","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":"Outcomes in Endovascular Management of May Thurner Syndrome Without Access to IVUS in a Latin American Cohort: A Retrospective Study.","authors":"Mariana Pinzón-Pinto, Esteban Portilla-Rojas, Angie Ebratt, Juan Miguel Mutis-Toro, Daniela Arévalo-Montaño, Martín Contreras, Leonardo Randial, Luis-Felipe Cabrera-Vargas","doi":"10.1177/15385744251355218","DOIUrl":"10.1177/15385744251355218","url":null,"abstract":"<p><p>Introduction and ObjectiveMay Thurner Syndrome (MTS) is a condition characterized by left iliofemoral vein compression, often leading to lower limb symptoms and complications. This study aimed to evaluate the outcomes of endovascular management for symptomatic, non-thrombotic MTS in a Latin American population.MethodsA retrospective cohort study analyzed 43 patients with MTS who underwent endovascular stenting and anticoagulation between 2018 and 2023 in Bogotá, Colombia. Clinical data, including demographics, symptoms, and comorbidities, were collected. Perioperative outcomes, such as procedure time, complications, and length of stay, were recorded. Postoperative follow-up included stent patency, symptom resolution, and the occurrence of complications.ResultsEndovascular management demonstrated high efficacy, with 83.7% of patients achieving symptom resolution and 100% stent patency at 6 months. No major complications were reported. The average procedure time was 52.6 minutes, and patients were discharged within 1 day of the procedure.ConclusionEarly intervention with endovascular embolization is crucial for patients with MTS and symptomatic pelvic varices. This approach offers a safe and effective solution for managing the condition and preventing complications. The presence of symptoms should be considered an indication for endovascular intervention, rather than waiting for thrombosis development.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"690-694"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510208","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":"Dual Endovascular Approach for Post-traumatic Rupture of Left Iliac Vein in Emergent Setting.","authors":"Domenico Baccellieri, Ferdinando B A Valente, Giorgia Guazzarotti, Elena Miglioranza, Vincenzo Ardita, Francesco De Cobelli","doi":"10.1177/15385744251355235","DOIUrl":"https://doi.org/10.1177/15385744251355235","url":null,"abstract":"<p><p>Traumatic venous injuries are associated with high mortality rates. When they involve the inferior vena cava and iliac veins, prompt treatment is necessary in cases of patient instability. Endovascular treatment of a traumatic injury at the iliac confluence extending to the proximal external iliac vein was performed in a 50-year-old patient following a fall. A GORE Excluder PLC141400 endograft was placed at the bleeding site via percutaneous transfemoral access, combined with simultaneous embolization of the internal iliac vein through right percutaneous jugular access. Effective haemostasis was achieved, along with normalization of blood pressure. Prompt diagnosis and recognition of the condition are vital for achieving blood pressure stabilization and haemostasis in unstable patients.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251355235"},"PeriodicalIF":0.7,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042766","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":"IntraVascular UltraSound After Below-The-Knee Endovascular Therapy: an Observational Pilot Study.","authors":"Emilien C J Wegerif, Joost A Bekken, Michiel A Schreve, W Hogendoorn, Gert J de Borst, Çağdaş Ünlü","doi":"10.1177/15385744251375275","DOIUrl":"https://doi.org/10.1177/15385744251375275","url":null,"abstract":"<p><p>ObjectiveRestenosis limits the benefit of below-the-knee (BTK) endovascular therapy (EVT). Restenosis may be attributable to limited information from digital subtraction angiography. A promising alternative is intravascular ultrasound (IVUS). However, data regarding the association between post-EVT IVUS-detected lesions and the risk for future major adverse limb events (MALE) after BTK EVT are scarce.DesignProspective single-arm observational pilot study.MethodsPatients scheduled for BTK EVT were eligible. Altogether, 50 patients were included after informed consent. IVUS was performed in treated BTK vessels to analyze vessel characteristics and, if present, lesions. Lesions were defined as; significant stenoses (≥50%), substantial vessel wall irregularities (highly calcified multisided sharp wall irregularities without significant stenosis and over a longer track post-PTA), any dissections, and incorrect stenting. Follow-up included duplex ultrasound (DUS) after 3, 6 weeks, and 3 and 6 months after EVT by trained independent nurses blinded to IVUS findings. Primary endpoint was MALE, including restenosis/occlusions and major amputation.ResultsIn total, 33/50 (66%) participants had at least one lesion following IVUS. Compared to the group without any lesions, no difference in baseline characteristics was found. Lesions contained mostly significant stenosis (52%) or wall irregularities (20%). Within 6 months, 28 (56%) participants experienced MALE, including 23 restenosis/occlusion. In total, 21/28 (75%) participants with MALE had a lesion on IVUS imaging. Participants with MALE had a higher incidence of any lesions on IVUS compared with the no-lesion group (64% vs 41%), leading to a sensitivity of 0.75 and specificity of 0.45.ConclusionThis study suggests a good sensitivity for IVUS in detecting post-treatment lesions leading to MALE. However, a well-powered study is warranted to confirm these results. Ultimately, a randomized trial should assess the effect of interventions for IVUS-detected lesions post-EVT on reduction of risk of future MALE. However, the first needs are standardized reporting definitions, categorization of IVUS-detected lesions, and standardization of operating procedures.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251375275"},"PeriodicalIF":0.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007033","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":"Novel Use of the RevCore^TM Device in Extensive Subacute Iliocaval Thrombus.","authors":"Elizabeth Hahn, Elise Snyder, Trevor Dorey, Steven Abramowitz, Geetha Jeyabalan","doi":"10.1177/15385744251375280","DOIUrl":"https://doi.org/10.1177/15385744251375280","url":null,"abstract":"<p><p>A 49-year-old female presented with subacute onset of severe worsening bilateral lower extremity swelling. Bilateral iliac venous thrombus and extensive thrombus of the inferior vena cava with extension to the right atrium and bilateral segmental pulmonary emboli was identified on imaging. She was initiated on therapeutic anticoagulation prior to undergoing percutaneous mechanical thrombectomy with the RevCore TM device (Inari Medical, Irvine, CA) with retrieval of white, relatively well-formed organized clot vs mass. Intravascular ultrasound and venography showed significant improvement in the IVC and iliac vein patency, but some narrowing of the vena cava. The patient's course was complicated by hypotension and acidemia requiring extracorporeal membrane oxygenation for seventy-two hours. She was taken back during her hospitalization for additional venogram and intravascular ultrasound with long segment IVC stenting of the IVC stenosis. She was ultimately discharged with significant clinical improvement. While the nitinol coring element on this device is meant for use in venous stent thrombus, this case demonstrates additional uses for the RevCoreTM device in organized thrombus in the native system in selective patients.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251375280"},"PeriodicalIF":0.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002295","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}