Vascular and endovascular surgery最新文献

{"title":"Median Arcuate Ligament Syndrome Without Static Image Findings of Celiac Artery Compression: The Potential Existence of a Pure Neurogenic Subtype.","authors":"Atsushi Okita, Nobuji Yokoyama","doi":"10.1177/15385744251326980","DOIUrl":"https://doi.org/10.1177/15385744251326980","url":null,"abstract":"<p><p>Symptomatic median arcuate ligament syndrome (MALS) is considered to be a diagnosis of exclusion, and there is no consensus about its diagnostic criteria. We present the case of a 39-year-old woman, who presented with persistent epigastric pain. A computed tomography scan did not show external celiac artery (CA) stenosis. Ultrasonography showed that the peak systolic blood flow velocity of the CA in inspiration and expiration position was 1.13 m/sec and 2.16 m/sec, respectively. The difference in the angle between the aorta and CA between maximum inspiration and maximum expiration was >50°. Only the patient's physical findings were suggestive of MALS, as the ultrasonographic findings demonstrated normal flow without compression through the celiac axis. The patient underwent laparoscopic division of the median arcuate ligament (MAL), and her symptoms disappeared postoperatively. The pathophysiology of MALS remains unclear, and our case suggests the potential existence of a neurogenic subtype in which MAL compresses the celiac plexus, but not the CA.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251326980"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627300","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":"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":"https://doi.org/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":"15385744251326336"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","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":"https://doi.org/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":"15385744251327013"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","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":"https://doi.org/10.1177/15385744251323434","url":null,"abstract":"<p><strong>Background: </strong>Older 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.</p><p><strong>Methods: </strong>We 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.</p><p><strong>Results: </strong>Stenosis-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).</p><p><strong>Conclusions: </strong>65-74-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":"15385744251323434"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","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":"Post-Stent Vein Lumen Shape and Clinical Response in Patients Treated for Iliofemoral Venous Occlusive Disease.","authors":"Paul Gagne, Kayode O Kuku, Robert Mendes, Amy Griggs, Edem Segbefia, Lawrence V Hofmann, Anthony Comerota, Hector M Garcia-Garcia","doi":"10.1177/15385744251321900","DOIUrl":"https://doi.org/10.1177/15385744251321900","url":null,"abstract":"<p><strong>Objective: </strong>Interventionalists have noted significant venous luminal gain with nitinol venous stents although post-placement lumen shape differed from the circular shape observed with elgiloy stents. The goal of this study was to determine the characteristics of a stented vein lumen that correspond with clinical outcomes, and to identify metrics that might be relevant for stent design by assessing aspect ratio (AR), lumen diameter (LD), lumen area (LA), and stent shape (symmetry and eccentricity) post-implant.</p><p><strong>Methods: </strong>This post-hoc analysis evaluated patients from the VIVO US Study (NCT01970007) with pre- and post-stent intravascular ultrasound (IVUS) imaging. Patient characteristics, Venous Clinical Severity Score (VCSS) and Venous Disability Score (VDS) were collected in the study. LD, LA, and stent geometry were measured by the core laboratory. Data were analyzed for linear association between core-laboratory assessed pre and post stent LD, LA, AR, stent eccentricity and symmetry index, and VCSS and VDS change.</p><p><strong>Results: </strong>IVUS imaging was available for 29 patients (2 sites) enrolled in the VIVO US Study (55.2% women; mean age: 59.8 ± 17 years). The cohort had post-thrombotic (48.3%), nonthrombotic iliac vein lesion (44.8%) or acute deep vein thrombotic (6.9%) disease. Mean lesion length was 111.8 ± 60.9 mm. Eleven stents extended below the inguinal ligament. Median minimum LD and LA significantly increased after stent placement (<i>P</i> < 0.001); median lumen AR changed from 2.0 pre-stent to 1.4 post-stent (<i>P</i> < 0.001). Mean VCSS improved from baseline to 12 months (7.6 ± 4.3 to 3.7 ± 2.6). No statistically significant linear relationships were identified between VCSS / VDS change and a specific characteristic of LA, LD, or AR.</p><p><strong>Conclusions: </strong>Measures of lumen change pre and post iliofemoral vein nitinol stent placement reflect disease and stent characteristics. After stent placement, minimum LD and LA increased and AR decreased. Stented lumen shape or size with Zilver Vena did not impact 1-year clinical improvement by VCSS.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251321900"},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451359","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":"Disparities in Aortic Aneurysm Mortality Trends: Revealing Sex and Racial Inequalities.","authors":"Masashi Azuma, Andrew Ramirez, G William Moser, Kenny J Oh, Mohammed Abul Kashem, Yoshiya Toyoda, Suyog Mokashi","doi":"10.1177/15385744251321621","DOIUrl":"https://doi.org/10.1177/15385744251321621","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic dissection or aneurysm (AAA) is a significant health concern in developed nations often underdiagnosed with poor outcomes. Despite a decline in aortic dissection and aneurysm mortality rates in the US from 1999 to 2020, reported by the CDC, this improvement disproportionately favors males and Caucasians. This study aims to elucidate these disparities.</p><p><strong>Methods: </strong>Data from the CDC Wonder database from 1999 to 2020 on aortic aneurysm, including abdominal, thoracic, and thoracoabdominal aneurysms and rupture related deaths in the US were analyzed. Mortality rates were compared across sex, race, and geographic location separated by state. Mortality was normalized based on population and analyzed with linear regression models with all plots showing goodness of fit.</p><p><strong>Results: </strong>Overall, the mortality gap between male and female cohorts with aortic aneurysm-related deaths widened by 0.57 per 100,000 deaths per year (<i>P</i> < 0.001). Mortality between Caucasians with African American and Asian American cohorts showed reductions of 0.41 per 100,000 per year (<i>P</i> < 0.001). Caucasian and male cohorts started at higher mortality rates when compared to their competitive cohorts.</p><p><strong>Conclusions: </strong>Despite a reduction in mortality rates among individuals with aortic aneurysm in the US from 1999 to 2020, this decline disproportionately benefits males and Caucasians over African American and Asian populations. Although Caucasians and males had higher mortality in 1999, their decline is significantly greater. Following current trends, Caucasian and male mortalities will be lower than minority groups by 2026. Targeted interventions are needed to address these disparities effectively.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251321621"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417129","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":"Is There a \"Weekend Effect\" on In-Hospital Outcomes of Type a Aortic Dissection Repair? A Population-Based Analysis of National Inpatient Sample From 2015-2020.","authors":"Renxi Li, Stephen J Huddleston","doi":"10.1177/15385744251321293","DOIUrl":"https://doi.org/10.1177/15385744251321293","url":null,"abstract":"<p><strong>Background: </strong>\"Weekend effect\" in type A aortic dissection (TAAD) repair has been identified in several countries where weekend admission is associated with higher mortality rates. However, in the US, findings have been mixed regarding the \"weekend effect\" on TAAD outcomes. This study aimed to conduct a comprehensive, population-based analysis of the association between weekend admission and the in-hospital outcomes of TAAD repair using a large-scale national registry.</p><p><strong>Methods: </strong>Patients who underwent TAAD repair were identified in National Inpatient Sample from Q4 2015-2020. Multivariable logistic regressions were used to compare in-hospital outcomes between patients admitted on the weekend vs weekday, where demographics, comorbidities, hospital characteristics, primary payer status, and transfer-in status were adjusted.</p><p><strong>Results: </strong>There were 1007 and 3275 patients who underwent TAAD repair under weekend and weekday admission, respectively. Patients admitted on the weekend were more likely to get transferred in from a different acute care hospital and have renal malperfusion. After multivariable analysis, patients admitted on the weekend and weekday had comparable times from admission to operation (0.88 ± 2.64 vs 0.92 ± 2.99 days, <i>P</i> = 0.64) and in-hospital mortality (15.99% vs 14.84%, aOR = 1.119, 95 CI = 0.914-1.37, <i>P</i> = 0.28). All other in-hospital outcomes, hospital length of stay, and total hospital charge were similar between the 2 cohorts.</p><p><strong>Conclusion: </strong>Patients admitted on weekends and weekdays had comparable times from admission to operation, as well as similar in-hospital mortality and morbidities. These findings suggest the effectiveness of weekend emergency care protocols for TAAD patients and the lack of a \"weekend effect\" on TAAD repair in the United States.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251321293"},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416607","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":"Preservation of Blood Flow to the Internal Iliac Artery Using a Custom-Made Single Fenestrated Endograft: A Case Report.","authors":"Sara Shakery, Denise Nio, Maarten Truijers","doi":"10.1177/15385744251315998","DOIUrl":"10.1177/15385744251315998","url":null,"abstract":"<p><strong>Purpose: </strong>This report describes the use of a custom-made single-fenestrated endograft to preserve blood flow to the internal iliac artery (IIA) in a patient with an aorto-iliac aneurysm with unsuitable anatomy for a standard iliac branch device (IBD).</p><p><strong>Case report: </strong>A 56-year-old man presented with an abdominal aortic aneurysm (AAA) of 56 mm involving the right common iliac artery (CIA). Use of a standard IBD for preservation of the IIA was deemed impossible due to narrow arrow anatomy of the right CIA. To preserve IIA flow, a custom-made Terumo endograft with an additional single-fenestration for the IIA was designed. The repair was successful and flow to the right IIA was preserved.</p><p><strong>Conclusion: </strong>Using a custom-made single-fenestrated endograft for the IIA in case of unsuitable anatomy for off-the-shelf IBDs prevents exclusion of the IIA and might prevent complications like buttock claudication and erectile dysfunction in patients with an aorto-iliac aneurysm. This report describes the use of a custom-made single fenestrated endograft to preserve blood flow to the IIA as a valuable alternative to standard iliac branched repair in patients with anatomical challenges.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251315998"},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400960","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 Treatment of Superior Vena Cava Syndrome in a Preterm Neonate.","authors":"Safak Alpat, Melih Alma","doi":"10.1177/15385744241284881","DOIUrl":"10.1177/15385744241284881","url":null,"abstract":"<p><p>Superior vena cava syndrome is rare and challenging clinical entity in neonates. Medical treatment options are usually effective. However, when failed, surgery is warranted. Herein, we present a preterm neonate with SVC syndrome and associated chylothorax. When 2 weeks old, he underwent successful open thrombectomy and SVC reconstruction under cardiopulmonary bypass. Immediately after the operation findings of SVC syndrome and chylotorax were completely resolved. To our knowledge, this patient is the smallest baby underwent open SVC reconstruction with cardiopulmonary bypass.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"187-190"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305369","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 Open Repair of a Thoracoabdominal Aortic Aneurysm After Multiple Failed Endovascular Treatments in a 22-Years-Old Individual With Loeys-Dietz Syndrome.","authors":"Annarita Santoro, Mohamed Rizk, Laura Inga Tavara, Moh'd Shafiq Ramadan, Germano Melissano","doi":"10.1177/15385744241285112","DOIUrl":"10.1177/15385744241285112","url":null,"abstract":"<p><p>Loeys-Dietz syndrome is a rare genetically triggered disease characterized by aortic involvement, predisposing individuals to aneurysm and dissection at young age. Open repair is considered the treatment of choice despite the fact that it is associated with significant morbidity and mortality rates. On the other hand, endovascular treatment may be also considered an acceptable option in specific cases such as emergency or in patients unfit for open surgery or when landing zones are within surgical grafts. We report the case of a thoracoabdominal aortic aneurysm (TAAA) open surgical repair (OSR) in a 22-year-old male patient diagnosed with type 2 Loeys-Dietz syndrome, treated by means of a TAAA replacement with a 30-mm multi-branched \"Coselli\" aortic graft (Vascutek, Renfrewshire, Scotland, UK) after multiple previously interventions, including a thoracic endovascular aortic repair (TEVAR) and a custom made endograft for the visceral aorta.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"218-223"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335649","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}