Vascular and endovascular surgery最新文献

{"title":"Flow Diversion for a Cervical Internal Carotid Artery Aneurysm: A Case Report and Literature Review.","authors":"Camila Esquetini-Vernon, Sukhwinder Johnny Singh Sandhu, Richard D Beegle, Rabih Tawk, Young Erben","doi":"10.1177/15385744261494490","DOIUrl":"https://doi.org/10.1177/15385744261494490","url":null,"abstract":"<p><p>IntroductionExtracranial internal carotid artery (ICA) aneurysms are rare (<1% of arterial aneurysms) yet clinically significant due to risks of distal embolization, local compressive symptoms, and, less commonly, rupture. High-quality evidence is limited, and no consensus guidelines exist, management is therefore individualized to aneurysm morphology, cervical segment involvement, vessel tortuosity, and operator expertise. Flow diversion with Pipeline Embolization Device (PED) achieves aneurysm exclusion while reconstructing the parent artery and is especially useful in tortuous cervical segments.Clinical SummaryA 60-year-old woman with incidentally discovered bilateral cervical ICA aneurysms (left 2.3 cm mid-ICA; right 0.5 cm) and a type III bovine arch underwent PED diversion of the lesion. Via femoral access, a long 6-F Fubuki sheath (Asahi Intecc, Irvine, USA) with Sofia catheter (Micro-Vention, Tustin, USA) support and systemic heparinization (ACT >250 s) enabled deployment of a 5.0 × 25 mm Pipeline Flex (Medtronic Neurovascular, Irvine, USA) across the aneurysm neck. Immediate angiography showed intra-aneurysmal stasis while preserving parent-artery flow<b>.</b> At 12 months, she is asymptomatic with a 70% reduction in the contrast-opacified aneurysm component to 7 mm, and the contralateral small aneurysm remains stable.ConclusionFlow diversion with a PED provided an effective, artery-preserving solution for a mid-cervical ICA aneurysm in tortuous anatomy, achieving immediate flow stasis with parent-artery patency. At 12 months, the patient is asymptomatic with a contrast-opacified component reduced to 7 mm. This case supports using flow diversion for extracranial ICA aneurysms when anatomy is favorable, alongside careful antiplatelet therapy and planned imaging follow-up.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744261494490"},"PeriodicalIF":0.7,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083592","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":"Active (Systolic) Reflux Demonstrated in a Below-Knee Isolated Incompetent Perforating Vein Associated With a Symptomatic Varicose Vein Using Infrared Thermography, Illustrated by a Case Report.","authors":"Mark S Whiteley, Oscar F Leveque","doi":"10.1177/15385744261491459","DOIUrl":"https://doi.org/10.1177/15385744261491459","url":null,"abstract":"<p><p>BackgroundThe role of incompetent perforating veins (IPVs) in varicose veins is controversial. There are different views on the mechanism of \"incompetence\" and, hence, the importance of IPVs. Those following CHIVA and \"haemodynamic surgery\" principles suggest higher velocities in the deep veins cause blood to flow inwards due to the Venturi effect. The senior author of this case has previously proposed that increased pressure by muscle activity forces blood out of any IPV, a phenomenon called \"active\" reflux. This case report appears to show active reflux in an isolated IPV using infrared thermography.MethodsA 34-year-old lady presented with a tender lower leg varicose vein due to an isolated IPV. She was placed supine and still for 10 minutes, then performed 10 plantar- and dorsi-flexions. Next, she stood up and stood still for 10 minutes. Her leg was monitored throughout using an infra-red camera (IFC).ResultsImmediately on lying, the IFC showed the vein, indicating blood flowing out of the IPV from the warm deep compartment into the colder superficial compartment (passive/diastolic or gravitational reflux). Over 10 minutes, the signal reduced significantly, suggesting no more blood was being pumped out through the IPV. During 10 plantar- and dorsi-flexions, the signal returned strongly, indicating blood being pumped out of the IPV once again. On standing, the signal was strong initially, but after 10 min of standing still, the signal had faded, indicating a lack of passive (gravitational) reflux in the IPV.ConclusionThis case suggests that reflux through this IPV is due to muscle activity and not by passive reflux due to gravity. This could explain why IPVs can cause fasciocutaneous damage and/or varicose veins in the lower limb. If correct, failure to identify and treat IPVs during varicose vein surgery would mean that the procedure would be inadequate.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744261491459"},"PeriodicalIF":0.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149043187","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":"The Patients' VOICE on Carotid Surgery; Insights From Focus Group Discussions.","authors":"Martijn S Marsman, Giel G Koning, Michel M P J Reijnen, Mirela Habibović, Patrick W H E Vriens","doi":"10.1177/15385744261491476","DOIUrl":"https://doi.org/10.1177/15385744261491476","url":null,"abstract":"<p><p>IntroductionOutcomes of carotid surgery are commonly evaluated using clinical parameters such as mortality and stroke, and these are mostly based on doctors' and scientific perspectives. Patient-centered health care aims to value the evaluation from the patients' perspective, mostly using Patient-Reported Outcomes (PROs). The aim of this study was to gain insights into outcomes that patients undergoing carotid surgery consider important (PROs) and to verify these outcomes by patients themselves.Methods and OutcomesThese protocol-based, exploratory semi-structured, focus group discussions (FGDs) were conducted in a single-center teaching hospital. Included patients were symptomatic and underwent an eversion technique between June 2024 and March 2025. FGDs were conducted, 3-12 weeks after surgery, by a medical psychologist. Patients completed the Shared Decision-Making Questionnaire-9 (SDM-Q-9) and the Short Form-36 Health Survey (SF-36) preoperatively; the SF-36 was repeated three months after surgery. The physician who informed the patient about treatment options completed the corresponding SDM-Q-9 for clinicians.ResultsA total of 24 patients were enrolled across five FGDs, of whom two withdrew consent. The consecutive sample (<i>n</i> = 22) included 4 women and 18 men (mean age of 77.7 years (SD ± 6.5)). Patients reported trusting their healthcare providers but expressed a desire for more information regarding hospital stay, prescribed medication, and overall recovery. Regarding health status, physical function showed a statistically significant difference (<i>p</i> = .04,95%CI0.55-29.86) between preoperative mean score (80.1) and postoperative (66.2). We found no differences (<i>p</i> = .45) between the mean scores of the patients and doctors regarding the ranking in SDM-Q-9.ConclusionThis study showed that FGDs helped to better understand the patients' perspective and experience regarding outcomes in the carotid surgery care-chain. The findings of the FGDs are highly valuable for optimizing local care pathways and patient information materials, while identifying new domains (such as fatigue) for future multicenter validation.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744261491476"},"PeriodicalIF":0.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019054","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":"The Critical Role of Optometric Screening in Carotid Artery Disease: A Comment on \"Cerebrovascular Imaging of Carotid Embolization\".","authors":"Sai Charan Labishetty, Tara Rani","doi":"10.1177/15385744261491451","DOIUrl":"https://doi.org/10.1177/15385744261491451","url":null,"abstract":"","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744261491451"},"PeriodicalIF":0.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149027391","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":"Restoring Cerebral Venous Outflow: Right Internal Jugular to Subclavian Vein Bypass After Ligation in Thoracic Outlet Syndrome.","authors":"Dushan Miladinovic, Luca Borruso, Eshan Affan, Steven Dubenec","doi":"10.1177/15385744261491474","DOIUrl":"https://doi.org/10.1177/15385744261491474","url":null,"abstract":"<p><p>BackgroundIntracranial venous hypertension (IVH) is an underrecognised cause of persistent craniofacial symptoms, often presenting with nonspecific features such as pressure-type headaches, pulsatile tinnitus, and visual disturbances. This case illustrates a complex diagnostic dilemma in which symptoms classically attributed to Eagle Syndrome masked another vascular cause of intracranial venous hypertension. The patient provided informed consent for treatment and for the use of his clinical information in this case report.Case SummaryA 59-year-old woman presented with refractory craniofacial symptoms initially attributed to bilateral Eagle Syndrome. Despite bilateral stylodectomy, internal jugular vein (IJV) decompression, C1 transverse process resection, and right occipital sinus stenting, her symptoms persisted. During right-sided intervention for Eagle Syndrome, the right IJV was found to have been previously ligated at the clavicle during venous thoracic outlet syndrome surgery. Venous manometry demonstrated elevated pressures within the right IJV (32 mmHg) and torcula (29 mmHg), supporting IVH secondary to impaired venous outflow. Definitive treatment consisted of a right IJV-subclavian vein (SCV) bypass using a triple-panel great saphenous vein (GSV) graft to achieve an adequate conduit diameter. The postoperative course was complicated by early graft thrombosis and neck hematoma, requiring urgent hybrid open and endovascular reintervention. This included suction thrombectomy, angioplasty, sequential stenting of the bypass using bare-metal, covered, and dedicated venous stents, and open repair of a graft tear with bovine pericardial patch angioplasty. Following reintervention, the bypass remained patent on follow-up imaging, with complete resolution of headaches, pulsatile tinnitus, and visual symptoms.ConclusionThis case highlights the importance of comprehensive venous evaluation in patients with persistent craniofacial symptoms, particularly following thoracic outlet interventions. It also demonstrates the feasibility of triple-panel GSV grafting for central venous reconstruction and the value of a hybrid surgical-endovascular approach in managing complex venous complications.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744261491474"},"PeriodicalIF":0.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013450","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":"Cardiac Migration of an Inverted Inferior Vena Cava Filter: Successful Retrieval via a Jugular Loop-Snare Technique.","authors":"Huayu Wang, Yutao Wang, Yan Sun","doi":"10.1177/15385744261491449","DOIUrl":"https://doi.org/10.1177/15385744261491449","url":null,"abstract":"<p><p>This report describes a 67-year-old female with lower extremity deep vein thrombosis who developed right atrial migration of an inverted inferior vena cava (IVC) filter 2 weeks post-implantation. After failed femoral retrieval, the filter was successfully extracted via a simplified jugular loop-snare technique using conventional endovascular equipment. No perioperative complications occurred, and postoperative angiography confirmed IVC patency. Inverted deployment is a preventable cause of life-threatening IVC filter migration, and the jugular loop-snare technique offers a safe, reproducible rescue strategy for such complex cases.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744261491449"},"PeriodicalIF":0.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993291","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 Treatment of Bow Hunter's Syndrome Presenting With Acute Vertebral Artery Occlusion: A Case Report.","authors":"Ayumi Hirano, Shunsuke Yamashita, Tatsuo Hori, Yuko Abe, Mitsuru Ikeda, Atsushi Fujita, Takashi Sasayama","doi":"10.1177/15385744261479420","DOIUrl":"https://doi.org/10.1177/15385744261479420","url":null,"abstract":"<p><p>BackgroundBow Hunter's Syndrome (BHS) is a rare condition in which dynamic vertebral artery (VA) compression during neck rotation induces transient symptoms, such as vertigo, whereas major arterial occlusion is extremely uncommon. There is no standardized treatment for BHS, and management includes conservative, surgical, and rarely endovascular approaches. We report a unique case of BHS with acute VA occlusion successfully treated by mechanical thrombectomy followed by elective stent placement.Case ReportAn 87-year-old woman presented with right gaze deviation, dysarthria, right hemiparesis, and sensory disturbance. Magnetic resonance imaging showed acute infarcts in the left pons and cerebellum, while magnetic resonance angiography showed poor visualization from the VA to the basilar artery. Emergency cerebral angiography showed VA occlusion, and subsequent thrombectomy was performed, which resulted in successful recanalization. Post-recanalization angiography showed residual stenosis at the V3 segment and an anomalous course of the VA running caudal to the posterior arch of the atlas. A dynamic ultrasonographic examination with neck rotation showed occlusion of the VA, which confirmed the diagnosis of BHS. Stent placement was planned because compression of the left VA was confirmed to be caused by soft tissue rather than by bony structures. Balloon angioplasty showed resistance to external compression. Subsequently, a balloon-expandable stent was successfully deployed using a distal access catheter and a stiff micro guidewire. Follow-up imaging confirmed VA patency with preserved flow during head rotation. The patient showed neurological improvement without recurrence during 6 months of follow-up.ConclusionWe report a rare case of BHS presenting with acute VA occlusion treated effectively with endovascular therapy. BHS should be considered as a potential cause of large-vessel occlusion in posterior circulation stroke when abnormal arterial courses are identified. In selected cases, stent placement may be a feasible therapeutic option depending on the compressive structure.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744261479420"},"PeriodicalIF":0.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803856","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 Systematic Review of Single vs Multivessel Recanalisation in Critical Limb Ischaemia.","authors":"Lukschana Senathirajah, Navanith Murali, Angela Lee, Philip Stather, Tariq Ali","doi":"10.1177/15385744261479252","DOIUrl":"https://doi.org/10.1177/15385744261479252","url":null,"abstract":"<p><p>AimTo compare wound healing and amputation free survival outcomes in patients with critical limb threatening ischaemia (CLTI) undergoing single-vessel (SV) vs multi-vessel (MV) crural recanalisation.MethodsElectronic databases including OVID, MEDLINE, Pubmed and CINHAL was conducted up until October 1st, 2024. Eligible studies of all languages included adults with CLTI who underwent SV or MV endovascular revascularisation of the crural vessels and reported wound healing outcomes (primary outcome). Risk of bias was assessed using ROBINS-I and RoB 2 tools. Quality of evidence was assessed using the GRADE System.ResultsA total of 154 articles were screened, of which seven studies (n = 2081 patients; 2402 limbs) were included. Of these, 1520 limbs (63.8%) underwent SV and 882 (36.7%) MV recanalisation. Five studies assessed wound healing across follow-up periods ranging from 3 months to 3 years. No consistent or statistically significant differences in wound healing were found between SV and MV groups. Six studies reported amputation-free survival (AFS) at 1 year, with some showing improved outcomes in MV patients. Overall, the quality of evidence was very low due to high risk of bias, heterogeneity in outcome definitions, and imprecision.ConclusionsThere is no clear evidence that MV recanalisation improves wound healing compared to SV in patients with CLTI. While some studies suggest potential benefits in AFS and limb salvage in selected patients, the current evidence is insufficient to support the added benefit of MV strategies. High-quality randomised trials with standardised outcome reporting are needed.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744261479252"},"PeriodicalIF":0.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803772","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 Repair of a Proximal Paraanastomotic Aneurysm Using the Trombone Technique after Open AAA Repair. A Case Report and Review of the Literature.","authors":"Apostolos G Pitoulias, Kamran Zierke, Nicole Jahr, Mathias Wilhelmi","doi":"10.1177/15385744261479257","DOIUrl":"https://doi.org/10.1177/15385744261479257","url":null,"abstract":"<p><p><b>Background:</b> Paraanastomotic aneurysm after open surgical repair (OSR) for the treatment of abdominal aortic aneurysm (AAA) is a long-term and life threatening complication. Because prior abdominal surgery often makes open reintervention technically challenging, endovascular repair (EVAR) should be considered as an alternative. <b>Case presentation:</b> We report a case of a proximal anastomotic paraanastomotic aneurysm treated by endovascular means using two tube stent grafts deployed in a trombone technique, with prior embolisation of lumbal arteries. Follow-up computed tomography angiography at 1 month demonstrated complete exclusion of the aneurysm with no evidence of a persistent endoleak. <b>Discussion:</b> This case highlights the feasibility and safety of EVAR using the trombone technique for proximal paraanastomotic aneurysms after OSR for AAA. It also underscores the role of pre-emptive lumbar artery embolisation in reducing the risk of type II endoleak and emphasizes the importance of long-term postoperative imaging surveillance to ensure durable outcomes following both open and endovascular aneurysm repair.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744261479257"},"PeriodicalIF":0.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803872","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":"Nuances in Secondary Aortoduodenal Fistula Management: Presentation of Two Cases and Review of the Literature.","authors":"Marianna Mpitou, Zoi Gerasimina Tampouratzi, Evgenia Charitaki, Pavlos Antoniadis, Spiros Delis","doi":"10.1177/15385744261479110","DOIUrl":"https://doi.org/10.1177/15385744261479110","url":null,"abstract":"<p><p>IntroductionSecondary aortoduodenal fistula (SADF) is a rare but life-threatening complication of abdominal aortic aneurysm (AAA) repair, most commonly involving the third or fourth part of the duodenum. Diagnosis is challenging, and management remains controversial.Case PresentationWe report two cases of SADF following open AAA repair. Both patients presented with herald bleed preceding massive gastrointestinal haemorrhage and haemodynamic collapse. Initial stabilisation was achieved with emergency endovascular stent grafting (EVAR). In the first case, the patient underwent definitive two-stage repair with axillobifemoral bypass, graft explantation and duodenectomy with duodenojejunal anastomosis, and remains well at three-year follow-up. The second patient underwent duodenectomy with duodenojejunal anastomosis, but due to severe comorbidities and occluded femoral arteries the aortic graft was left in situ. Despite initial recovery, he developed overwhelming sepsis and died on postoperative day 10.DiscussionThese cases highlight the diagnostic and therapeutic challenges, as well as the complex decision-making required in these patients. Endovascular repair provides life-saving haemostasis and can serve as a bridge to surgery. Definitive management must address both the aortic and duodenal components, tailored to patient comorbidities and anatomy.ConclusionSADF requires prompt recognition and multidisciplinary management. EVAR is invaluable in acute stabilisation, but surgical definitive repair offers the best long-term outcomes.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744261479110"},"PeriodicalIF":0.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803897","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}