EJVES Vascular Forum最新文献

{"title":"Trends in Management and Outcomes of Blunt Thoracic Aortic Injury in the United States","authors":"Anne-Sophie C. Romijn ,&nbsp;Vinamr Rastogi ,&nbsp;Patrick D. Conroy ,&nbsp;Yuchen Liu ,&nbsp;Sai Divya Yadavalli ,&nbsp;Lars Stangenberg ,&nbsp;Vincent Jongkind ,&nbsp;Noelle N. Saillant ,&nbsp;Hence J.M. Verhagen ,&nbsp;Marc L. Schermerhorn","doi":"10.1016/j.ejvsvf.2025.07.004","DOIUrl":"10.1016/j.ejvsvf.2025.07.004","url":null,"abstract":"<div><h3>Objective</h3><div>Blunt thoracic aortic injury (BTAI) is a significant cause of mortality and morbidity in the United States. The diagnosis and treatment of BTAI has evolved over the last few decades. This study aimed to examine the incidence and outcomes of thoracic endovascular aortic repair (TEVAR), non-operative management (NOM), and open aortic repair (OAR) for BTAI over a 14 year period.</div></div><div><h3>Methods</h3><div>Patients with BTAI from the National Inpatient Sample between 2006 – 2019 were studied and compared within three time periods: 2006–2010, 2011–2015, and 2016–2019. Waldtest and Pearson's chi-squared were performed to test whether management, patient characteristics, and in hospital mortality changed over time.</div></div><div><h3>Results</h3><div>An estimate of 8 175 BTAI patients was identified, with an increasing estimate from 375 patients in 2006 to 750 patients in 2019. TEVAR utilisation increased from 17% to 37% during the study period, while those who received OAR and NOM decreased (OAR 16%–1.3%; NOM 67%–61%). There was an increasing trend in patients treated in an urban teaching hospital (2006–2010 <em>vs</em>. 2016–2019: 88% <em>vs</em>. 95%; <em>p</em> trend &lt;0.001), and more patients were transferred from another hospital (12% vs. 18%; <em>p</em> trend = 0.027). Over the years, patients who received NOM were older (45 <em>vs</em>. 50 years; <em>p</em> &lt; 0.001) and had more concurrent injuries, while the mortality rate among this group did not change (adjusted odds ratio [aOR] 0.65, 95% confidence interval [CI] 0.42–1.02; <em>p</em> = 0.060) Patients who received TEVAR were also older over the years (41 years <em>vs</em>. 46 years; <em>p</em> &lt; 0.001), but they had fewer concurrent injuries, and the mortality rate remained stable (aOR 0.97, 95% CI 0.33–2.88; <em>p</em> = 0.96).</div></div><div><h3>Conclusion</h3><div>The estimated number of patients with BTAI was twice as large in 2019 compared with 2006, and the use of TEVAR increased, largely replacing OAR.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 128-140"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265192","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 Coil Embolisation With Isolation Technique of Ulnar Artery Aneurysm in Hypothenar Hammer Syndrome: A Case Report","authors":"Hiroshi Yukimoto ,&nbsp;Takayuki Miyauchi ,&nbsp;Takashi Nakamura","doi":"10.1016/j.ejvsvf.2025.04.002","DOIUrl":"10.1016/j.ejvsvf.2025.04.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypothenar hammer syndrome is a rare vascular condition characterised by ulnar artery damage, which can manifest as thrombosis or aneurysm formation. While surgical treatment has been the mainstay of therapy, endovascular treatment may offer a minimally invasive alternative. Reports of successful coil embolisation of ulnar artery aneurysms in hypothenar hammer syndrome are extremely limited in the literature.</div></div><div><h3>Report</h3><div>A woman in her sixties with a history of smoking and atrial fibrillation on anticoagulants presented with a one month history of a painful pulsatile mass in her dominant right hypothenar eminence. Imaging revealed a 15 mm ulnar artery aneurysm with corkscrew deformity characteristic of hypothenar hammer syndrome. Digital subtraction angiography demonstrated adequate collateral circulation through palmar arches during selective compression tests. Endovascular coil embolisation using isolation technique was performed via the ipsilateral brachial artery access under axillary nerve block. A triple coaxial system was used to deploy detachable coils for aneurysm isolation. The procedure achieved complete aneurysm occlusion while maintaining adequate blood flow to all digits through collateral circulation from the radial artery via the palmar arch. Three month follow up contrast enhanced magnetic resonance imaging demonstrated complete resolution of the ulnar artery aneurysm with no evidence of ischaemic complications.</div></div><div><h3>Discussion</h3><div>Pre-procedural confirmation of adequate collateral circulation is essential for endovascular treatment, which can provide effective minimally invasive treatment for ulnar artery aneurysm in hypothenar hammer syndrome without leaving a palmar surgical scar. While the initial results are promising, careful patient selection and longer follow up are needed to establish the durability of this treatment approach.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 57-61"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589282","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":"Re: Sartorius and Gracilis Muscle Flaps as Adjuncts to the Management of Complicated Femoral Wounds in Vascular Surgery","authors":"Prajnasini Satapathy,&nbsp;Rachana Mehta,&nbsp;Ranjana Sah","doi":"10.1016/j.ejvsvf.2025.08.007","DOIUrl":"10.1016/j.ejvsvf.2025.08.007","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Page 208"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145690183","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":"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":"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":"Recovery of EndoAnchors Using a Four Loop Vascular Retriever Snare: Adaptive Solutions for Adverse Events Related to Endovascular Material","authors":"Clara Raventós,&nbsp;Fabricio Barahona,&nbsp;Vicente Riambau","doi":"10.1016/j.ejvsvf.2025.05.004","DOIUrl":"10.1016/j.ejvsvf.2025.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>EndoAnchors are adjuncts used for the prevention and treatment of type I endoleak and graft migration in thoracic or abdominal endovascular aortic aneurysm repair in patients with a challenging aortic neck. They secure the stent graft mechanically to the aortic wall by means of metallic screws. Adverse events are infrequent; however, the most common ones are fracture and or dislodgment (0.3–0.9%) and applicator malfunction (0.3%), as observed in this case.</div></div><div><h3>Case</h3><div>A 77 year old woman showed symptoms of increasing interscapular chest pain for three months. A computed tomography angiography scan revealed a large and symptomatic ascending thoracic aortic aneurysm with extension to the arch and descending thoracic aorta. The patient was operated on urgently using a frozen elephant trunk technique, with pain cessation. The residual thoracic aneurysm was repaired six months later with two overlapped thoracic endografts placed 15 mm above the celiac trunk and distal EndoAnchors, an off label use, due to a severely angulated distal landing zone. During the seventh and last EndoAnchor deployment on an angulated surface, a malfunction of its applicator was detected, which caused EndoAnchor detachment and migration, flying into the aorta's lumen and landing close to the aortic wall below the graft. It was then trapped with a CloverSnare four loop vascular retriever (CookMedical, Bloomington, IL, USA), supported by an 8.5 F TourGuide steerable sheath. During extraction, it fractured into two pieces at the common iliac artery. The previous manoeuvre was repeated at this level, recovering the fractured piece. Final completion angiography showed a good result without endoleak. The immediate post-operative and follow up scans were uneventful.</div></div><div><h3>Conclusion</h3><div>EndoAnchor detachment is uncommon but when it does occur, it is a solvable issue and can be retrieved using a snare and extracted with the proper endovascular tools and expertise.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 66-70"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653435","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":"Indocyanine Green Fluorescence Angiography to Assess Tissue Perfusion Before Common Femoral Artery Aneurysm Ligation After Transfemoral Amputation","authors":"Steven J.G. Leeuwerke ,&nbsp;Harry G.M. Vaassen ,&nbsp;Robbert Meerwaldt","doi":"10.1016/j.ejvsvf.2025.01.003","DOIUrl":"10.1016/j.ejvsvf.2025.01.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The superiority of indocyanine green fluorescence angiography (ICG-FA) to the clinical eye alone to assess tissue perfusion has been demonstrated in various surgical fields. This short report demonstrates the <em>in vivo</em> use of ICG-FA to assess skin perfusion before ligating the external iliac artery (EIA) to exclude a common femoral artery (CFA) aneurysm.</div></div><div><h3>Report</h3><div>A 70-year-old man presented with a CFA aneurysm after a previous transfemoral amputation. Ligation of the EIA was proposed, but concerns about tissue perfusion warranted a careful approach. The CFA was exposed using an infra-inguinal incision. Intra-operative ICG inflow and washout patterns were semi-quantitatively analysed to assess dermal perfusion of the femoral stump before and after EIA clamping. Based on similar patterns, distal EIA ligation was performed without ischaemic complications.</div></div><div><h3>Conclusion</h3><div>Indocyanine green fluorescence angiography is a promising technique for <em>in vivo</em> assessment of tissue perfusion in peripheral arterial disease, but standardised protocols for perfusion quantification are required to more accurately predict tissue viability.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"63 ","pages":"Pages 41-44"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143445674","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":"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":"Bottom up Treatment for Vulvar and Lower Extremity Varicose Veins of Pelvic Origin: A Case Report","authors":"Aleksandra Jaworucka-Kaczorowska ,&nbsp;Marianne De Maeseneer","doi":"10.1016/j.ejvsvf.2024.12.004","DOIUrl":"10.1016/j.ejvsvf.2024.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Extrapelvic varices of pelvic origin, such as vulvar varices, and lower extremity varicose veins (VVs) of pelvic origin are being diagnosed with increasing frequency. A proper management strategy, including history, physical examination, duplex ultrasound (DUS) of the lower extremities, DUS of pelvic escape points, selection of appropriate treatment, and post-treatment care, is essential for good patient outcomes and satisfaction.</div></div><div><h3>Case report</h3><div>A non-pregnant, 27 year old female presented with prominent vulvar varices in combination with right sided VVs on the anterior and medial thigh, calf, and buttock. She was successfully managed by bottom up treatment with ultrasound guided foam sclerotherapy. The bottom up technique involves treatment of VVs of pelvic origin by direct puncture of the pelvic escape points and associated VVs, without embolisation of the pelvic veins.</div></div><div><h3>Conclusion</h3><div>This case illustrates successful bottom up treatment in accordance with recent guidelines in a female patient with extensive VVs of pelvic origin.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"63 ","pages":"Pages 53-56"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143610200","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":"Preservation of One Anterior and One Posterior Internal Iliac Artery Branch in a Case of Bilateral Common and Internal Iliac Arterial Aneurysms","authors":"Anna Stene Hurtsén ,&nbsp;Artai Pirouzram ,&nbsp;Tal Hörer","doi":"10.1016/j.ejvsvf.2025.05.009","DOIUrl":"10.1016/j.ejvsvf.2025.05.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Endovascular treatment of iliac aneurysms with sparing of the internal iliac arterial circulation is feasible with iliac branch devices. However, insufficient distal seal with the endovascular devices on the market can be challenging. In this case, the anatomy was complex due to the extent of the aneurysms, and the available technical options were limited.</div></div><div><h3>Report</h3><div>A 65 year old man with aneurysms in the left common iliac (43 mm) and bilateral internal iliac arteries (right 41 mm; left 49 mm) was treated with an aortobi-iliac stent graft and bilateral iliac branch devices with extensions to opposing anterior (right) and posterior (left) branches of the internal iliac artery through staged interventions. At six weeks of follow up all treated aneurysms had decreased or were stable in size. Clinical signs of right sided gluteal claudication were evident at six weeks of follow up but no symptoms remained 20 weeks post-operatively.</div></div><div><h3>Discussion</h3><div>The presented case illustrates a technique to preserve pelvic circulation in a case of bilateral common and internal iliac arterial aneurysms. Extensions of the internal iliac limb of the iliac branch device, into the opposing anterior and posterior divisions of the internal iliac artery, may offer a strategy to reduce pelvic ischaemia in scenarios where the anatomy limits the use of standard iliac branch devices.</div></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"64 ","pages":"Pages 71-74"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679696","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}