Vascular and endovascular surgery最新文献

{"title":"Unmasking Renal Artery Pseudoaneurysm: A Rare and Elusive Cause of Hypertension.","authors":"Dhyana Shivakumar, Mohammed Fahad Khan, Reddi Prasad Yadavali, Vishwanath Siddini, H Sudarshan Ballal","doi":"10.1177/15385744251355244","DOIUrl":"https://doi.org/10.1177/15385744251355244","url":null,"abstract":"<p><p>A 49-year-old man with hypertension for 2 years, was incidentally found to have right intrarenal aneurysms during a routine abdominal ultrasound examination. He reported fluctuating blood pressure readings over the past 18 months. Laboratory parameters were within normal limits, with a serum creatinine level of 1.05 mg/dL. An abdominal CT angiogram revealed a large lobulated intrarenal aneurysm in the lower pole, which communicated with another smaller cortical aneurysm. Additional features suggested the presence of an arteriovenous (AV) fistula. Upon further questioning, the patient disclosed a history of blunt abdominal trauma following a motor vehicle accident 3 years ago. This trauma likely explains the CT findings and the development of hypertension secondary to renovascular disease in this patient. Angiography confirmed the presence of 2 renal artery pseudoaneurysms in the midpolar region, for which selective coil embolization was performed. The patient was stable and asymptomatic at his 2-week follow-up. His blood pressure reading was 110/80 mmHg, showing improvement compared to his pre-procedure recordings. There are very few reported cases of renal pseudoaneurysms causing secondary hypertension. Additionally, this case highlights that successful embolization can result in a substantial improvement in hypertension in these patients.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251355244"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510209","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":"https://doi.org/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":"15385744251355197"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","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":"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":"https://doi.org/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":"15385744251355218"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","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":"Surgical Treatment of Lower Limb Lipodermatosclerosis Secondary to Congenital Absence of Infrarenal Inferior Vena Cava and Bilateral Common Iliac Veins.","authors":"Peng Wu, Fandong Li, Mengtao Wu, Dianjun Tang","doi":"10.1177/15385744251355191","DOIUrl":"https://doi.org/10.1177/15385744251355191","url":null,"abstract":"<p><p>BackgroundThe management of cutaneous dystrophy of lower limb resulting from congenital absence of inferior vena cava (IVC) primarily includes anticoagulation, compression stocking and bypass surgery. However, the clinical significance of surgical intervention for great saphenous vein (GSV) and pathologic perforator veins (PPVs) in combination with compression therapy remains unrecognized.Case ReportWe present a case report of a 44-year-old man experiencing bilateral legs heaviness and pain upon prolonged standing, as well as left leg lipodermatosclerosis due to congenital absence of infrarenal IVC and bilateral common iliac veins. He underwent ligation and stripping of GSV along with ligation of PPVs followed by postoperative compression therapy. After 7 years of follow-up, all symptoms and signs completely resolved with a decrease in venous clinical severity score from 16 preoperatively to 3 postoperatively.ConclusionFor patient with lower limb cutaneous dystrophy due to the absence of IVC, it is feasible to perform high ligation and stripping of the GSV on the basis of accurate anatomic and hemodynamic evaluation, but long-term compression therapy is required.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251355191"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487606","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":"Unveiling Aortic Angiosarcoma: A Rare and Aggressive Vascular Malignancy in Vascular Oncology - A Case Report.","authors":"Arnolda Marija Baškytė, Donatas Opulskis, Milda Kuprytė, Antanas Jankauskas, Linas Velička","doi":"10.1177/15385744251355185","DOIUrl":"10.1177/15385744251355185","url":null,"abstract":"<p><p><b>Introduction:</b> Primary aortic malignancy is a very rare pathology, with only 190 cases of aortic tumors reported in the literature to date. Usually, symptoms are insidious and nonspecific, so the disease is diagnosed at an advanced stage. <b>Objective:</b> Here, we present a case report of a primary malignant tumor of the aorta. In our case, the diagnosis was established using computed tomography angiography (CTA) and biopsy of indeterminate masses obtained during aortography. <b>Methods:</b> The patient underwent surgical resection of the affected aortic segment along with a tumor. Histopathological examination revealed the diagnosis of a primary malignant tumor of the aorta - angiosarcoma. Postoperatively, patient received adjuvant chemotherapy according to the standard treatment regimen for sarcoma. <b>Results:</b> One month later, postoperative CT of a chest, abdomen and pelvis was performed, revealing no evidence of metastases or pathological lymph nodes in the examined areas. <b>Conclusion</b>: Combined surgical and systemic therapies may improve overall survival.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251355185"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340736","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":"Bilateral Acute Lower Limb Ischemia Caused by Paradoxical Embolism Through a Patent Foramen Ovale Treated With the DISASTER Technique: A Case Report.","authors":"Eitaro Umehara, Yutaro Nagase, Shunpei Yao, Atsushi Miyajima, Naoto Inoue, Arata Hagikura, Takanori Kusuyama","doi":"10.1177/15385744251355186","DOIUrl":"10.1177/15385744251355186","url":null,"abstract":"<p><strong>Background: </strong>Paradoxical embolism (PDE) through a patent foramen ovale (PFO) is a rare cause of acute limb ischemia (ALI). When surgical thrombectomy using a Fogarty catheter is not feasible, the DISASTER technique represents a viable and effective endovascular treatment strategy.</p><p><strong>Case report: </strong>A 51-year-old woman presented with the sudden onset of bilateral lower extremity pain and coldness. She had been receiving estrogen therapy for irregular menstruation. Angiography revealed a claw sign in the distal superficial femoral artery. She declined surgical thrombectomy due to concerns about invasiveness. Catheter-directed thrombectomy and thrombus aspiration were performed using the DISASTER (Diamond-Shaped wire Accelerate Splicing process of Thrombus used for Emergent Revascularization) technique. Ultrasound examination identified a thrombus distal to the left common femoral vein. Anticoagulation therapy with a direct oral anticoagulant (DOAC) was initiated. Comprehensive hematological testing revealed no evidence of an underlying coagulopathy. Additionally, no intracardiac thrombus or valvular vegetations were detected. Transesophageal echocardiography (TEE) identified a Grade 2 patent foramen ovale (PFO), suggesting paradoxical embolism as the likely etiology. The patient remained free of thromboembolic events postoperatively.</p><p><strong>Conclusion: </strong>This report highlights the feasibility of catheter-directed thrombectomy and thrombus aspiration as an effective alternative to surgical intervention for acute limb ischemia. In cases of ALI of unknown etiology, paradoxical embolism should be suspected. Therefore, a comprehensive evaluation, including venous ultrasound and transesophageal echocardiography, is essential to identify a potential PFO or other embolic sources. Early recognition and appropriate management of paradoxical embolism may help prevent recurrent thromboembolic events and improve patient outcomes.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251355186"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334754","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":"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":"15385744251355238"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","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":"15385744251355193"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","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":"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}