We report the case of a 69-year-old man with chronic type B aortic dissection and progressive aneurysmal dilatation. Zone 2 thoracic endovascular aortic repair was performed with carotid-subclavian bypass. Nonobstructive general angioscopy identified additional tiny entry tears in the descending aorta, guiding adequate stent graft coverage. Subsequent left subclavian artery coil embolization under balloon occlusion revealed satisfactory packing on fluoroscopy, but angioscopy revealed residual flow through coil gaps, prompting additional coil placement. Blood flow cessation was confirmed by angioscopy. Completion angiography revealed no antegrade false lumen flow or endoleaks. Follow-up computed tomography at 3 months showed favorable aortic remodeling with complete thoracic false lumen thrombosis.
{"title":"Angioscopy-assisted thoracic endovascular aortic repair for chronic type B aortic dissection: Optimizing stent graft coverage and left subclavian artery coil embolization","authors":"Yukihisa Ogawa MD, PhD, FJCR , Hiroyuki Nishi MD, PhD , Hidekazu Furuya MD , Ryuichi Tamimoto MD , Satoru Takahashi MD , Shunsuke Kamei MD","doi":"10.1016/j.jvscit.2025.102058","DOIUrl":"10.1016/j.jvscit.2025.102058","url":null,"abstract":"<div><div>We report the case of a 69-year-old man with chronic type B aortic dissection and progressive aneurysmal dilatation. Zone 2 thoracic endovascular aortic repair was performed with carotid-subclavian bypass. Nonobstructive general angioscopy identified additional tiny entry tears in the descending aorta, guiding adequate stent graft coverage. Subsequent left subclavian artery coil embolization under balloon occlusion revealed satisfactory packing on fluoroscopy, but angioscopy revealed residual flow through coil gaps, prompting additional coil placement. Blood flow cessation was confirmed by angioscopy. Completion angiography revealed no antegrade false lumen flow or endoleaks. Follow-up computed tomography at 3 months showed favorable aortic remodeling with complete thoracic false lumen thrombosis.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 1","pages":"Article 102058"},"PeriodicalIF":0.7,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736328","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}
Pub Date : 2025-11-21DOI: 10.1016/j.jvscit.2025.102059
George Apostolidis MD, MSc , Petroula Nana PhD , Daour Yousef al Sarhan MD , Lennart Bax MD , Tilo Kölbel PhD , Giuseppe Panuccio PhD
Maintaining left subclavian artery (LSA) patency is essential for preventing spinal cord ischemia before extensive aortic coverage. We present a case of in situ fenestration on a zone 2 frozen elephant trunk graft to restore the native LSA perfusion after a prior LSA bypass occlusion. Fenestration was performed using the electrified wire technique, followed by balloon-expandable covered stent implantation. The procedure was completed with distal thoracic extensions. The postoperative imaging confirmed LSA patency. This approach offers a feasible, reproducible solution for selected patients requiring LSA recanalization after frozen elephant trunk.
{"title":"In situ fenestration of a frozen elephant trunk prosthesis to recanalize the left subclavian artery","authors":"George Apostolidis MD, MSc , Petroula Nana PhD , Daour Yousef al Sarhan MD , Lennart Bax MD , Tilo Kölbel PhD , Giuseppe Panuccio PhD","doi":"10.1016/j.jvscit.2025.102059","DOIUrl":"10.1016/j.jvscit.2025.102059","url":null,"abstract":"<div><div>Maintaining left subclavian artery (LSA) patency is essential for preventing spinal cord ischemia before extensive aortic coverage. We present a case of in situ fenestration on a zone 2 frozen elephant trunk graft to restore the native LSA perfusion after a prior LSA bypass occlusion. Fenestration was performed using the electrified wire technique, followed by balloon-expandable covered stent implantation. The procedure was completed with distal thoracic extensions. The postoperative imaging confirmed LSA patency. This approach offers a feasible, reproducible solution for selected patients requiring LSA recanalization after frozen elephant trunk.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 1","pages":"Article 102059"},"PeriodicalIF":0.7,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736331","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}
Iliac branch endoprosthesis is an effective method for preserving the internal iliac artery blood flow during endovascular aortic repair. We describe the case of a right common iliac artery aneurysm complicated by a left internal iliac artery occlusion in a 74-year-old man. To preserve perfusion of the right internal iliac artery in a patient with a short common iliac artery, an iliac branch endoprosthesis device was connected to the AFX and deployed 15 mm above the aortic bifurcation. The absence of an endoleak on postoperative computed tomography indicated technical success and potential effectiveness of the procedure.
{"title":"Endovascular aortic repair with iliac branch endoprosthesis for short common iliac aneurysm","authors":"Satoshi Sakakibara MD , Kazuo Shimamura MD, PhD , Yoshiki Watanabe MD, PhD , Takashi Shirakawa MD, PhD , Fumio Yamana MD , Shigeru Miyagawa MD, PhD","doi":"10.1016/j.jvscit.2025.102066","DOIUrl":"10.1016/j.jvscit.2025.102066","url":null,"abstract":"<div><div>Iliac branch endoprosthesis is an effective method for preserving the internal iliac artery blood flow during endovascular aortic repair. We describe the case of a right common iliac artery aneurysm complicated by a left internal iliac artery occlusion in a 74-year-old man. To preserve perfusion of the right internal iliac artery in a patient with a short common iliac artery, an iliac branch endoprosthesis device was connected to the AFX and deployed 15 mm above the aortic bifurcation. The absence of an endoleak on postoperative computed tomography indicated technical success and potential effectiveness of the procedure.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 1","pages":"Article 102066"},"PeriodicalIF":0.7,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839178","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}
Pub Date : 2025-11-20DOI: 10.1016/j.jvscit.2025.102057
Mark L. Lessne MD, FSIR , Charles Y. Kim MD, FSIR
Venous in-stent reocclusion can result in recurrent obstructive symptoms. Occlusions that are recalcitrant to traditional crossing techniques are inaccessible to effective therapies. However, radiofrequency-assisted recanalization techniques can mitigate the risk of therapy failure and allow treatment of previously untreatable lesions. The feature of automatic disabling of the radiofrequency wire upon metal contact can be exploited to increase the safety of crossing by ensuring intraluminal traversal and avoidance of unintended perforation of adjacent structures.
{"title":"Radiofrequency wire-assisted recanalization of chronic venous stent occlusions","authors":"Mark L. Lessne MD, FSIR , Charles Y. Kim MD, FSIR","doi":"10.1016/j.jvscit.2025.102057","DOIUrl":"10.1016/j.jvscit.2025.102057","url":null,"abstract":"<div><div>Venous in-stent reocclusion can result in recurrent obstructive symptoms. Occlusions that are recalcitrant to traditional crossing techniques are inaccessible to effective therapies. However, radiofrequency-assisted recanalization techniques can mitigate the risk of therapy failure and allow treatment of previously untreatable lesions. The feature of automatic disabling of the radiofrequency wire upon metal contact can be exploited to increase the safety of crossing by ensuring intraluminal traversal and avoidance of unintended perforation of adjacent structures.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 1","pages":"Article 102057"},"PeriodicalIF":0.7,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790011","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}
Pub Date : 2025-11-20DOI: 10.1016/j.jvscit.2025.102065
Daemar H. Jones MD, Nicole A. Heidt MD, Laura B. Pride MD, Chandler A. Long MD, Young Kim MD, MS
In this report, we present a 67-year-old man who was transferred from an outside facility with complaints of severe back pain. Computed tomography imaging demonstrated a type IIIa endoleak with complete junctional dissociation of his prior fenestrated endograft, between the visceral and the bifurcated components. Given the perpendicular configuration of the dissociated stent grafts, no endovascular salvage was feasible, and open explantation was indicated. His preoperative evaluation was significant for a positive cardiac stress test warranting coronary artery stenting. The patient underwent subsequent open graft explantation and aortic repair, and was ultimately discharged home after an uncomplicated hospital course.
{"title":"Explantation of fenestrated endograft complicated by complete junctional dissociation and symptomatic type IIIa endoleak","authors":"Daemar H. Jones MD, Nicole A. Heidt MD, Laura B. Pride MD, Chandler A. Long MD, Young Kim MD, MS","doi":"10.1016/j.jvscit.2025.102065","DOIUrl":"10.1016/j.jvscit.2025.102065","url":null,"abstract":"<div><div>In this report, we present a 67-year-old man who was transferred from an outside facility with complaints of severe back pain. Computed tomography imaging demonstrated a type IIIa endoleak with complete junctional dissociation of his prior fenestrated endograft, between the visceral and the bifurcated components. Given the perpendicular configuration of the dissociated stent grafts, no endovascular salvage was feasible, and open explantation was indicated. His preoperative evaluation was significant for a positive cardiac stress test warranting coronary artery stenting. The patient underwent subsequent open graft explantation and aortic repair, and was ultimately discharged home after an uncomplicated hospital course.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 1","pages":"Article 102065"},"PeriodicalIF":0.7,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736323","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}
Pub Date : 2025-11-20DOI: 10.1016/j.jvscit.2025.102064
Pharis B. Sasa MD , Naiem Nassiri MD
The aim of this study was to demonstrate a novel, office-based treatment of life-threatening hand arteriovenous malformations (AVMs) via Venaseal cyanoacrylate embolization. Two adult male patients with debilitating Yakes II hand AVMs underwent staged, transarterial, and direct-stick Venaseal embolization in an office-based setting over a period of 12 (7 sessions) and 8 (4 sessions) months. Technical success was 100% with no complications. Clinical success was achieved with ulcer and cardiopulmonary overload alleviation, nonrestricted restoration of hand function, and reduction in lesion volume confirmed by Doppler flow rate measurements. Interim results after 9-month follow-up revealed sustained relief with no recurrence clinically or ultrasonographically. We present a novel, office-based approach to safe, effective, and durable embolization of advanced hand AVMs using Venaseal cyanoacrylate and have found AVM nidal flow rate measurements on Doppler useful for objective assessment of AVM hemodynamics and response to treatment.
{"title":"Staged, office-based treatment of debilitating, limb-threatening hand arteriovenous malformations with a Venaseal cyanoacrylate-based embolization strategy","authors":"Pharis B. Sasa MD , Naiem Nassiri MD","doi":"10.1016/j.jvscit.2025.102064","DOIUrl":"10.1016/j.jvscit.2025.102064","url":null,"abstract":"<div><div>The aim of this study was to demonstrate a novel, office-based treatment of life-threatening hand arteriovenous malformations (AVMs) via Venaseal cyanoacrylate embolization. Two adult male patients with debilitating Yakes II hand AVMs underwent staged, transarterial, and direct-stick Venaseal embolization in an office-based setting over a period of 12 (7 sessions) and 8 (4 sessions) months. Technical success was 100% with no complications. Clinical success was achieved with ulcer and cardiopulmonary overload alleviation, nonrestricted restoration of hand function, and reduction in lesion volume confirmed by Doppler flow rate measurements. Interim results after 9-month follow-up revealed sustained relief with no recurrence clinically or ultrasonographically. We present a novel, office-based approach to safe, effective, and durable embolization of advanced hand AVMs using Venaseal cyanoacrylate and have found AVM nidal flow rate measurements on Doppler useful for objective assessment of AVM hemodynamics and response to treatment.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 1","pages":"Article 102064"},"PeriodicalIF":0.7,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790012","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}
Pub Date : 2025-11-19DOI: 10.1016/j.jvscit.2025.102067
Mark S. Zemela MD , Benjamin Feng MD , Abigail Clark MD , Katherine McMackin MD , Joseph V. Lombardi MD, MBA
A 72-year-old female presented to an outside hospital after her legs gave out and she fell at home. Computed tomography angiography revealed an aortoenteric fistula. Given her extensive and complex revascularization history, including an aortobifemoral bypass, femoral-femoral bypass, and multiple lower extremity revascularizations, she was transferred to our facility for further management and definitive repair. She underwent staged endovascular exclusion of the aortoenteric fistula followed by definitive open aortic repair and lower extremity revascularization 3 days later. Her postoperative course was uneventful, and she was discharged on hospital day 10.
{"title":"Staged endovascular and open surgical repair of an aortoenteric fistula with complex autologous lower extremity revascularization","authors":"Mark S. Zemela MD , Benjamin Feng MD , Abigail Clark MD , Katherine McMackin MD , Joseph V. Lombardi MD, MBA","doi":"10.1016/j.jvscit.2025.102067","DOIUrl":"10.1016/j.jvscit.2025.102067","url":null,"abstract":"<div><div>A 72-year-old female presented to an outside hospital after her legs gave out and she fell at home. Computed tomography angiography revealed an aortoenteric fistula. Given her extensive and complex revascularization history, including an aortobifemoral bypass, femoral-femoral bypass, and multiple lower extremity revascularizations, she was transferred to our facility for further management and definitive repair. She underwent staged endovascular exclusion of the aortoenteric fistula followed by definitive open aortic repair and lower extremity revascularization 3 days later. Her postoperative course was uneventful, and she was discharged on hospital day 10.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 1","pages":"Article 102067"},"PeriodicalIF":0.7,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736326","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}
We describe a technique for repairing Crawford type IV thoracoabdominal aortic aneurysms using a midline abdominal incision with left transverse extension, performed in the supine position without thoracotomy. Six patients (median age, 73 years) underwent this approach for true aneurysms, chronic dissection, or aortoduodenal fistula. Aortic reconstruction was performed with four-branched or bifurcated grafts under selective visceral perfusion. All patients were discharged home; one required reoperation for bleeding, and one developed an abdominal wall incisional hernia. This approach provided sufficient exposure for proximal and distal anastomoses and facilitated concurrent abdominal procedures while minimizing respiratory complications.
{"title":"Midline abdominal incision with left transverse extension for type IV thoracoabdominal aortic aneurysm repair","authors":"Yorihiko Matsumoto MD, PhD , Tsutomu Ito MD, PhD , Norimasa Haijima MD, PhD , Hirofumi Kasahara MD, PhD , Motohiko Osako MD, PhD , Hideyuki Shimizu MD, PhD","doi":"10.1016/j.jvscit.2025.102062","DOIUrl":"10.1016/j.jvscit.2025.102062","url":null,"abstract":"<div><div>We describe a technique for repairing Crawford type IV thoracoabdominal aortic aneurysms using a midline abdominal incision with left transverse extension, performed in the supine position without thoracotomy. Six patients (median age, 73 years) underwent this approach for true aneurysms, chronic dissection, or aortoduodenal fistula. Aortic reconstruction was performed with four-branched or bifurcated grafts under selective visceral perfusion. All patients were discharged home; one required reoperation for bleeding, and one developed an abdominal wall incisional hernia. This approach provided sufficient exposure for proximal and distal anastomoses and facilitated concurrent abdominal procedures while minimizing respiratory complications.</div></div>","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"12 1","pages":"Article 102062"},"PeriodicalIF":0.7,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736327","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}
Pub Date : 2025-11-18DOI: 10.1016/S2468-4287(25)00330-2
{"title":"Information for Readers","authors":"","doi":"10.1016/S2468-4287(25)00330-2","DOIUrl":"10.1016/S2468-4287(25)00330-2","url":null,"abstract":"","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 6","pages":"Article 102048"},"PeriodicalIF":0.7,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578525","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}
Pub Date : 2025-11-18DOI: 10.1016/S2468-4287(25)00331-4
Peter Gloviczki, Peter F. Lawrence (Editors)
{"title":"Info for Authors","authors":"Peter Gloviczki, Peter F. Lawrence (Editors)","doi":"10.1016/S2468-4287(25)00331-4","DOIUrl":"10.1016/S2468-4287(25)00331-4","url":null,"abstract":"","PeriodicalId":45071,"journal":{"name":"Journal of Vascular Surgery Cases Innovations and Techniques","volume":"11 6","pages":"Article 102049"},"PeriodicalIF":0.7,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578526","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}
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