EJVES Vascular Forum最新文献

{"title":"Primary Intra-operative Embolisation During Urgent Parallel Graft Endovascular Repair in Paravisceral Symptomatic Aortic Pseudoaneurysm","authors":"Paolo Spath ,&nbsp;Federica Campana ,&nbsp;Enrico Gallitto ,&nbsp;Chiara Mascoli ,&nbsp;Stefania Caputo ,&nbsp;Rodolfo Pini ,&nbsp;Gianluca Faggioli ,&nbsp;Mauro Gargiulo","doi":"10.1016/j.ejvsvf.2024.11.001","DOIUrl":"10.1016/j.ejvsvf.2024.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>Paravisceral aortic lesions present significant challenges for endovascular treatment. This retrospective analysis of consecutively treated patients from April 2017 to June 2021 aimed to analyse the outcome of primary intra-operative embolisation of aortic complicated pseudoaneurysms and gutter channels during parallel graft (PG) repair of paravisceral symptomatic aortic pseudoaneurysms.</div></div><div><h3>Methods</h3><div>Patients with symptomatic pseudoaneurysms of the paravisceral aorta treated with PGs using chimney or periscope configurations were included. Thoracic endografts were positioned to exclude the aortic lesions. Coil embolisation of both the lesions and gutter channels was performed after graft deployment and prior to ballooning of the stent grafts. The primary endpoints were technical success (defined as exclusion of the pseudoaneurysm, target visceral vessel [TVV] patency, absence of gutter endoleaks) and clinical success (technical success + resolution of symptoms + absence of major adverse events) at 30 days. Secondary endpoints included overall survival, TVV patency, gutter endoleaks, and freedom from re-interventions during follow up.</div></div><div><h3>Results</h3><div>Six patients (four women) were treated for pseudoaneurysm rupture (three cases) and symptomatic aortic pseudoaneurysm (three cases) of the paravisceral aorta. The patients' anatomies were unsuitable for off the shelf devices and patients were all deemed to be at prohibitive surgical risk. A total of 15 TVVs were revascularised (comprising three coeliac arteries, five superior mesenteric arteries, and seven renal arteries) using 10 chimney and five periscope PGs. One coeliac artery was occluded. Seventy coils were deployed to embolise both the aortic ruptures and gutter channels. Both technical and clinical success rates were 100%. The median follow up was 17 months (IQR 5, 35), during which time three patients died due to non-aortic related causes. One coeliac artery (6%) was occluded, and no endoleak evidence was found.</div></div><div><h3>Conclusion</h3><div>Primary intra-operative embolisation during parallel graft endovascular repair of paravisceral symptomatic aortic pseudoaneurysms may be both safe and effective in excluding the pseudoaneurysm when other options are unavailable.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"63 ","pages":"Pages 1-10"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972448","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":"Definition of Carotid Artery Free Floating Thrombus: A Systematic Review and Call for Standardisation of Imaging and Nomenclature","authors":"Oumaima Aouam ,&nbsp;Carolijn J.M. de Bresser ,&nbsp;Eline S. van Hattum ,&nbsp;W. Marnix de Fijter ,&nbsp;Hidde Jongsma ,&nbsp;Patrick W.H.E. Vriens ,&nbsp;Vincent van Weel ,&nbsp;Gert J. de Borst","doi":"10.1016/j.ejvsvf.2025.10.002","DOIUrl":"10.1016/j.ejvsvf.2025.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>Free floating thrombus in the carotid artery (cFFT) is a rare and poorly understood condition with an unclear definition and diagnostic criteria. This systematic review aimed to propose a reporting standard to ensure diagnostic consistency and a universal definition of cFFT.</div></div><div><h3>Methods</h3><div>PubMed and EMBASE were systematically searched from inception until 01 May 2025, using terms including “free floating thrombus” and “carotid”, along with imaging modalities. Eligibility criteria included studies on patients with cFFT, diagnosed through well defined imaging criteria. Two authors independently screened eligible literature and extracted data. Study quality was assessed with the Methodological Index for Non-Randomized Studies (MINORS) score. The composite endpoint was the radiological description of cFFT per imaging modality.</div></div><div><h3>Results</h3><div>A systematic search identified 611 publications, from which 20 were included. These studies were predominantly of low quality, with a mean MINORS score of 9 for non-comparative and 16 for comparative studies. These 20 studies identified 17 distinct imaging based descriptions of cFFT. The descriptions were derived from five different imaging modalities, encompassing both static and dynamic imaging. Computed tomography angiography (CTA) was the most reported modality, followed by duplex ultrasound (DUS). On CTA, cFFT is diagnosed as a thrombus with circumferential flow, proximal attachment to the vessel wall, and extending distally in the lumen. On DUS, cFFT is diagnosed by circumferential flow, attachment to the arterial wall, and synchronous movement with the cardiac cycle.</div></div><div><h3>Conclusion</h3><div>The published literature lacks high quality studies. It is suggested that the diagnosis of cFFT requires static imaging, preferably with CTA. If static imaging is inconclusive, a dedicated dynamic assessment by DUS, performed by an experienced sonographer, is suggested. The proposed definition aims to standardise the diagnostic workflow for cFFT, thereby ensuring consistent interpretation and unified terminology across research and clinical practice, which should also enhance individual patient data meta-analyses on cFFT in the future.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 199-207"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575863","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 Round Up of the Prize Winning Papers From the European Journal of Vascular and Endovascular Surgery 2024","authors":"Francisco Álvarez Marcos,&nbsp;Oliver T.A. Lyons,&nbsp;Arindam Chaudhuri","doi":"10.1016/j.ejvsvf.2025.08.004","DOIUrl":"10.1016/j.ejvsvf.2025.08.004","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 163-165"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332434","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":"Idiopathic Inflammatory Superior Mesenteric Artery Aneurysm: Case Report and Systematic Literature Review","authors":"Candice Vallauri ,&nbsp;Salomé Kuntz ,&nbsp;Anne Lejay ,&nbsp;Nabil Chakfé","doi":"10.1016/j.ejvsvf.2025.08.005","DOIUrl":"10.1016/j.ejvsvf.2025.08.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Superior mesenteric artery aneurysm (SMAA) is a rare presentation mostly secondary to atherosclerosis, infection, cystic medial dysplasia, collagen vascular disorders, trauma, and arterial dissection. However, inflammatory SMAAs are sometimes idiopathic. The aim of the article is to report the case of an idiopathic inflammatory SMAA and perform a systematic literature review.</div></div><div><h3>Case report</h3><div>A 61 year old man presented with chronic abdominal pain. Computed tomography angiography showed a typical 65 mm diameter inflammatory abdominal aortic aneurysm and a SMAA with similar signs of wall inflammation. Positron emission tomography computed tomography confirmed the inflammation by active fixation. A full workup including all inflammatory markers was negative, and no cause was found. Treatment consisted of fenestrated endograft implantation. At 11 months, follow up confirmed aneurysm exclusion and patency of the stents and a similar SMAA diameter with some mild remaining inflammation.</div></div><div><h3>Literature review</h3><div>A systematic review of the MEDLINE and PubMed databases extending from 1979 to 2024 by a combined strategy of Medical Subject Headings terms returned only two publications of idiopathic inflammatory SMAA in two patients. In both cases, the symptoms were abdominal or lower back pain and the diagnosis was made by computed tomography angiography. Treatment was open surgery in one case and medical in the other. Median follow up was 18 months.</div></div><div><h3>Conclusion</h3><div>Idiopathic inflammatory SMAA is rarely described in the literature. The aetiological assessment including histological data should be exhaustive in order not to miss a differential diagnosis.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 178-182"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361554","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 Case of Successful Explantation of an Infected Fenestrated Aortic Endograft Using a Composite Xeno/Biosynthetic In Situ Reconstruction","authors":"Tania Panettella ,&nbsp;Maani Hakimi ,&nbsp;Juan Antonio Celi de la Torre","doi":"10.1016/j.ejvsvf.2025.01.001","DOIUrl":"10.1016/j.ejvsvf.2025.01.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Graft infections after open or endovascular repair can be devastating, and their treatment is always challenging. For thoraco-abdominal and abdominal aortic aneurysms, fenestrated and branched endografts are used increasingly. Because of the involved materials and anatomy, infective complications can be even more complex.</div></div><div><h3>Report</h3><div>One year after double fenestrated endovascular endorepair for a type Ia endoleak after standard endovascular repair, a 77 year old patient developed clinical signs for sepsis at an external clinic. As his clinical situation deteriorated, he was then referred to the centre, where an infection focus search revealed a <em>Staphylococcus aureus</em> bacteraemia, and computed tomography (CT), and fludeoxyglucose positron emission tomography CT showed signs of endograft infection. Trestment by endograft explantation followed, and <em>in situ</em> reconstruction with a composite xeno/biosynthetic graft was performed. Through a median laparotomy, endograft explantation as well as <em>in situ</em> reconstruction were technically successful, and sepsis control was achieved under concomitant anti-infective therapy. After a 48 day hospital stay (22 days in the intensive care unit), the patient was discharged to a rehabilitation clinic. After three months of uneventful follow up, precision dual antibiotic therapy with ciprofloxacin and rifampicin was stopped. Four year follow up confirmed freedom from infection and a properly functioning aortic reconstruction.</div></div><div><h3>Discussion</h3><div>After fenestrated stent graft procedures, successful late conversion is challenging and is known to correlate with high morbidity and mortality. The present case confirms the feasibility of this approach, even in patients with sepsis, with good results.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"63 ","pages":"Pages 25-29"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422401","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":"Collateral Vein Ligation for Arteriovenous Fistula Maturation: A Pilot Study","authors":"Bogdan Bratu ,&nbsp;Bettina Chenesseau ,&nbsp;Andreea Luchianov ,&nbsp;Salomé Kuntz ,&nbsp;Nabil Chakfé ,&nbsp;Anne Lejay","doi":"10.1016/j.ejvsvf.2025.03.001","DOIUrl":"10.1016/j.ejvsvf.2025.03.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Native arteriovenous fistulae (AVF) may fail to achieve adequate blood flow or size for successful cannulation and dialysis. No clear strategy exists concerning the effectiveness of collateral vein ligation (CVL) to improve AVF maturation. The aim of this study was to evaluate the effectiveness of CVL in improving AVF maturation.</div></div><div><h3>Methods</h3><div>A retrospective study was performed, including all patients who underwent CVL for delayed AVF maturation between January 2023 and December 2023. Combined procedures, such as concomitant venous stenosis angioplasties, were excluded. Evolution of AVF flow after CVL compared with AVF flow before CVL was recorded. The primary endpoint was defined as successful maturation after CVL. The AVF was considered mature when it could be routinely cannulated for the total duration of dialysis, for at least six months.</div></div><div><h3>Results</h3><div>Median follow up was eleven months (range 6–14 months). CVL allowed successful maturation in five of the six patients, with a median AVF flow increase of 44%. In these five patients, sustained dialysis after CVL was uneventful, without need for any additional interventions.</div></div><div><h3>Conclusion</h3><div>These results highlight the potential effectiveness of CVL in improving AVF maturation, although larger studies are needed to confirm these findings.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"63 ","pages":"Pages 69-72"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864227","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":"More Reasons to Submit to the EJVES Vascular Forum: A Look Through 2024 into 2025","authors":"Arindam Chaudhuri,&nbsp;Francisco Alvarez Marcos","doi":"10.1016/j.ejvsvf.2025.02.002","DOIUrl":"10.1016/j.ejvsvf.2025.02.002","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"63 ","pages":"Pages 65-67"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808251","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":"“Bottom Up” Treatment for Vulvar and Lower Extremity Varicose Veins of Pelvic Origin: Keeping It Simple and Effective","authors":"Maria Katsarou","doi":"10.1016/j.ejvsvf.2025.02.001","DOIUrl":"10.1016/j.ejvsvf.2025.02.001","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"63 ","pages":"Page 52"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610201","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":"Cerebral Hypoperfusion Caused by Brachiocephalic Artery Stenosis","authors":"Nusr Ghamri ,&nbsp;Donald Harris ,&nbsp;David Lindström ,&nbsp;Anastasia Dean","doi":"10.1016/j.ejvsvf.2025.09.005","DOIUrl":"10.1016/j.ejvsvf.2025.09.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Extracranial cerebrovascular disease can cause cerebral ischaemia through embolism or hypoperfusion. Managing cerebral ischaemia in patients with hypoperfusion and multivessel cerebrovascular disease can pose challenges owing to the risks of embolisation and haemodynamic instability, especially when normal embolisation protection techniques and cross clamping are hazardous.</div></div><div><h3>Report</h3><div>This article presents the case of a 74 year old woman who experienced a peri-operative cardiac arrest during femoropopliteal bypass surgery, secondary to undiagnosed severe left ventricular hypertrophy with dynamic outflow obstruction. Following recovery, she developed recurrent right hemispheric transient ischaemic attacks including left hemiplegia. Imaging revealed mild to moderate bilateral carotid bulb, carotid siphon, and vertebral stenoses, but the most significant lesion was a severe, calcified stenosis of brachiocephalic artery. Given the recent cardiac arrest and multiple levels of the disease, the initial plan was for conservative management. Despite medical management with permissive hypertension, the patient continued to experience transient ischaemic attacks as soon as the systolic pressure dropped below 160 mmHg. This scenario led to a multidisciplinary decision to proceed with brachiocephalic artery stenting. The neurointerventional team recommended avoidance of cross clamping if possible given the severe lesions and lack of intact circle of Willis. The procedure was done under general anaesthesia via open, retrograde right axillary access without carotid cross clamping. The post-operative course was uneventful.</div></div><div><h3>Discussion</h3><div>This case underscores the importance of procedural planning and a multidisciplinary approach in managing complex cerebrovascular conditions, and that unusual pathologies may need unusual treatment.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 159-162"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332433","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":"RAPID-HANDLE Technique for Catheter Retrieval From the Pulmonary Artery Using a Homemade Snare With Adjustable Loop","authors":"Naotoshi Wada,&nbsp;Tetsuya Nomura,&nbsp;Tetsuya Tatsumi","doi":"10.1016/j.ejvsvf.2025.05.002","DOIUrl":"10.1016/j.ejvsvf.2025.05.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Percutaneous retrieval of foreign bodies (PRFB) requires effective grasping of the foreign body and its safe removal through the sheath, a process that can be challenging. While both single loop and multi loop snare retrieval methods are available, no standard PRFB method has been established to date. This Technical Note proposes a foreign body removal technique using a homemade snare and an introducer sheath with an adjustable diameter haemostatic valve, named the Reliable grAsPing and secure retrieval of Intravascular foreign boDies with a HomemAde sNare and an introducer sheath with adjustable Diameter haemostatic valve (RAPID-HANDLE technique). This method enables safe, reliable, and efficient PRFB.</div></div><div><h3>Report</h3><div>A 75 year old man underwent subcutaneous infusion port placement in the right subclavian vein for gastric cancer therapy. Eight months later, radiography revealed a retained catheter fragment in the pulmonary artery. Computed tomography confirmed a 10 cm catheter fragment straddling the main trunk of the pulmonary artery. PRFB was performed the same day using a 14 F DrySeal Flex introducer sheath inserted through the right common femoral vein. A 7 F guiding catheter was positioned into the main pulmonary artery trunk and the transected end of the catheter was successfully grasped and retrieved using a homemade snare. The total procedure time was 39 minutes.</div></div><div><h3>Discussion</h3><div>PRFB was successfully completed with the RAPID-HANDLE technique. It is believed that this approach could serve as a standardised procedure for PRFB and is applicable to other intravascular or intracardiac cases.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 3-7"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144490985","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}