Venous pseudoaneurysms combined with intramural thrombus are rare vascular malformations with few reported cases. Progression of aneurysms may lead to pulmonary embolism, requiring prophylactic measures including surgical resection or intervention. The indications for these treatment modalities, however, are controversial and the salient features supporting the choice of treatment are unclear. We report a case of venous pseudoaneurysm in the left brachiocephalic veincombined with an intratumoral thrombus, which was treated with endoluminal isolation with a laminating stent.
Case presentation
A 53-year-old woman was admitted after a physical examination had revealed a mediastinal mass 2 months earlier. CTV showed an irregular tumour-like dilatation at the confluence of the left brachiocephalic vein, with a maximal cross-sectional area of 40.9 mm × 45.3 mm. Intervention wasrecommended due to the risk of progression and rupture of the venous aneurysm. Endovascular surgery was performed, with good postoperative recovery. At 1 year follow-up, the patient was asymptomatic with no complications and the stent lumen remained patent.
Conclusion
Endovascular surgery may be a viable treatment option for cases such as the one described; however, its long-term efficacy requires further evaluation.
背景：静脉假性动脉瘤合并壁内血栓是一种罕见的血管畸形，报道病例很少。动脉瘤的发展可能导致肺栓塞，需要预防措施，包括手术切除或干预。然而，这些治疗方式的适应症是有争议的，支持治疗选择的显著特征尚不清楚。我们报告一例左头臂静脉假性动脉瘤合并瘤内血栓，采用腔内隔离和层压支架治疗。病例介绍一名53岁女性，2个月前体检发现纵隔肿块入院。CTV示左侧头臂静脉汇合处不规则肿瘤样扩张，最大横截面积40.9 mm × 45.3 mm。由于静脉动脉瘤进展和破裂的风险，建议进行干预。行血管内手术，术后恢复良好。随访1年，患者无症状，无并发症，支架管腔通畅。结论血管内手术可能是治疗此类病例的可行选择；但其长期疗效有待进一步评价。
{"title":"Endovascular exclusion for a left vein brachiocephalic pseudoaneurysm","authors":"Hao Zhao, Baoning Zhou, Gaopo Cai, Zhen Li, Zhaohui Hua","doi":"10.1016/j.avsurg.2025.100414","DOIUrl":"10.1016/j.avsurg.2025.100414","url":null,"abstract":"<div><h3>Background</h3><div>Venous pseudoaneurysms combined with intramural thrombus are rare vascular malformations with few reported cases. Progression of aneurysms may lead to pulmonary embolism, requiring prophylactic measures including surgical resection or intervention. The indications for these treatment modalities, however, are controversial and the salient features supporting the choice of treatment are unclear. We report a case of venous pseudoaneurysm in the left brachiocephalic veincombined with an intratumoral thrombus, which was treated with endoluminal isolation with a laminating stent.</div></div><div><h3>Case presentation</h3><div>A 53-year-old woman was admitted after a physical examination had revealed a mediastinal mass 2 months earlier. CTV showed an irregular tumour-like dilatation at the confluence of the left brachiocephalic vein, with a maximal cross-sectional area of 40.9 mm × 45.3 mm. Intervention wasrecommended due to the risk of progression and rupture of the venous aneurysm. Endovascular surgery was performed, with good postoperative recovery. At 1 year follow-up, the patient was asymptomatic with no complications and the stent lumen remained patent.</div></div><div><h3>Conclusion</h3><div>Endovascular surgery may be a viable treatment option for cases such as the one described; however, its long-term efficacy requires further evaluation.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100414"},"PeriodicalIF":0.0,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571364","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 : 2025-11-07DOI: 10.1016/j.avsurg.2025.100412
Elisa Bass , Phillip Pirgousis , Sukhwinder Johnny Singh Sandhu , David Miller , Richard D. Beegle , Young Erben
Introduction
Head and neck cancer recurrence in previously irradiated patients presents complex surgical challenges, particularly when compounded by asymptomatic carotid artery stenosis. Radiation therapy is a known risk factor for carotid stenosis, increasing the likelihood of cerebrovascular events during surgical intervention.
Case Presentation
We describe a 74-year-old man with a history of squamous cell carcinoma of the right tonsil treated with surgery and radiation 40 years prior, who presented with a recurrence involving the right oral cavity. Preoperative imaging revealed 90 % asymptomatic stenosis of the right internal carotid artery (ICA). Carotid angioplasty without stenting was performed prior to wide surgical resection to reduce perioperative stroke risk. One month later, the patient underwent oropharyngectomy with reconstruction. Postoperative recovery was uneventful aside from minor wound complications. Final pathology showed negative margins and no nodal involvement, and no adjuvant therapy was required. Angioplasty, lithotripsy, and stenting of the right ICA was performed 11 months after the initial angioplasty due to asymptomatic restenosis.
Discussion
This case illustrates the importance of screening for carotid artery stenosis in patients with prior head and neck radiation who are undergoing salvage surgery. Carotid angioplasty without stenting offers a viable preoperative strategy in select patients to mitigate cerebrovascular risk while avoiding complications associated with dual antiplatelet therapy.
Conclusion
Carotid angioplasty followed by resection can be safely and effectively performed in patients with recurrent head and neck cancer and radiation-induced carotid stenosis. This case underscores the need for multidisciplinary planning and vigilance in preoperative assessment.
{"title":"Carotid artery intervention for 90 % stenosis forty-years after radiation in a patient with squamous cell carcinoma recurrence: A case report","authors":"Elisa Bass , Phillip Pirgousis , Sukhwinder Johnny Singh Sandhu , David Miller , Richard D. Beegle , Young Erben","doi":"10.1016/j.avsurg.2025.100412","DOIUrl":"10.1016/j.avsurg.2025.100412","url":null,"abstract":"<div><h3>Introduction</h3><div>Head and neck cancer recurrence in previously irradiated patients presents complex surgical challenges, particularly when compounded by asymptomatic carotid artery stenosis. Radiation therapy is a known risk factor for carotid stenosis, increasing the likelihood of cerebrovascular events during surgical intervention.</div></div><div><h3>Case Presentation</h3><div>We describe a 74-year-old man with a history of squamous cell carcinoma of the right tonsil treated with surgery and radiation 40 years prior, who presented with a recurrence involving the right oral cavity. Preoperative imaging revealed 90 % asymptomatic stenosis of the right internal carotid artery (ICA). Carotid angioplasty without stenting was performed prior to wide surgical resection to reduce perioperative stroke risk. One month later, the patient underwent oropharyngectomy with reconstruction. Postoperative recovery was uneventful aside from minor wound complications. Final pathology showed negative margins and no nodal involvement, and no adjuvant therapy was required. Angioplasty, lithotripsy, and stenting of the right ICA was performed 11 months after the initial angioplasty due to asymptomatic restenosis.</div></div><div><h3>Discussion</h3><div>This case illustrates the importance of screening for carotid artery stenosis in patients with prior head and neck radiation who are undergoing salvage surgery. Carotid angioplasty without stenting offers a viable preoperative strategy in select patients to mitigate cerebrovascular risk while avoiding complications associated with dual antiplatelet therapy.</div></div><div><h3>Conclusion</h3><div>Carotid angioplasty followed by resection can be safely and effectively performed in patients with recurrent head and neck cancer and radiation-induced carotid stenosis. This case underscores the need for multidisciplinary planning and vigilance in preoperative assessment.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100412"},"PeriodicalIF":0.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519880","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}
Popliteal artery aneurysms require treatment in symptomatic cases or when the aneurysm diameter exceeds 20 mm, with graft replacement using the great saphenous vein being one of the most common treatment options. Although aneurysmal degeneration of great saphenous vein grafts has been reported, it is rare. We report the case of a 77-year-old woman who had undergone resection of a popliteal artery aneurysm and graft replacement with the left great saphenous vein three years previously. Two years after surgery, angiography revealed a 9.5-mm graft aneurysm, which was managed conservatively. She presented to our hospital with a 3-day history of intermittent claudication and coldness in her left lower limb. On examination, the left popliteal pulse was absent. Ultrasonography suggested acute arterial occlusion due to thrombosis extending from the origin of the superficial femoral artery through the graft to the anterior tibial artery. Emergency surgery was performed, revealing a 35-mm graft aneurysm. Thrombectomy was carried out, followed by aneurysm resection and graft replacement using a newly harvested great saphenous vein. This case highlights that although rare, saphenous vein graft aneurysms can lead to acute arterial occlusion, and early resection and replacement should be considered once detected.
{"title":"Acute arterial occlusion due to thrombotic occlusion of the great saphenous vein graft following popliteal artery aneurysm surgery: a case report","authors":"Kazuki Nagashima , Takahiro Toyofuku , Koji Yonekura , Takaki Sakoma , Norihide Sugano","doi":"10.1016/j.avsurg.2025.100413","DOIUrl":"10.1016/j.avsurg.2025.100413","url":null,"abstract":"<div><div>Popliteal artery aneurysms require treatment in symptomatic cases or when the aneurysm diameter exceeds 20 mm, with graft replacement using the great saphenous vein being one of the most common treatment options. Although aneurysmal degeneration of great saphenous vein grafts has been reported, it is rare. We report the case of a 77-year-old woman who had undergone resection of a popliteal artery aneurysm and graft replacement with the left great saphenous vein three years previously. Two years after surgery, angiography revealed a 9.5-mm graft aneurysm, which was managed conservatively. She presented to our hospital with a 3-day history of intermittent claudication and coldness in her left lower limb. On examination, the left popliteal pulse was absent. Ultrasonography suggested acute arterial occlusion due to thrombosis extending from the origin of the superficial femoral artery through the graft to the anterior tibial artery. Emergency surgery was performed, revealing a 35-mm graft aneurysm. Thrombectomy was carried out, followed by aneurysm resection and graft replacement using a newly harvested great saphenous vein. This case highlights that although rare, saphenous vein graft aneurysms can lead to acute arterial occlusion, and early resection and replacement should be considered once detected.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100413"},"PeriodicalIF":0.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571363","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 : 2025-10-10DOI: 10.1016/j.avsurg.2025.100411
Giuseppe Carpenzano , Maria Giuseppina Palmieri , Federica Novegno , Fabio Massimo Oddi , Fabrizio Cum , Andrea Ascoli Marchetti
Objective
In the extracranial carotidopaty the most frequent paragangliomas are chemodectomas; because of the complex anatomy of the surrounding structures, a lateral neck mass may arise by muscular, osseous, epithelial, mesenchymal or nervous tissues: a rare presentation is the vagus nerve neoplasia. The described technique compares the intraoperative neurological monitoring methods and their usefulness in avoiding neurological damage.
Methods
The surgical procedure was totally performed under neurophysiological monitoring with: A) Electroencephalogram. B) Transcranial electric motor evoked potential (MEP) with recording of left and right laryngeal and cricothyroid muscles. C) Somatosensory evoked potential (SEP) by the stimulation of the right and left median nerves. D) Free run registration from laryngeal and cricothyroid bilateral muscles. During the procedure was performed the direct stimulation (DNS) of the right vagus nerve and registration from the target muscles.
Results
The DNS of the neck mass was associated with finding of eloquent and non–eloquent nervous tissue allowing a safe gross total resection. The SEP and MEP did not show any significative changes during the surgical treatment.
Conclusions
Multidisciplinary approach is mandatory to perform perioperative evaluation and safe surgical treatment, which is the gold standard of Schwannoma treatment.
{"title":"Modern approach to the resection of carotid region schwannoma: The utility of continuous intraoperative neurophysiological monitoring","authors":"Giuseppe Carpenzano , Maria Giuseppina Palmieri , Federica Novegno , Fabio Massimo Oddi , Fabrizio Cum , Andrea Ascoli Marchetti","doi":"10.1016/j.avsurg.2025.100411","DOIUrl":"10.1016/j.avsurg.2025.100411","url":null,"abstract":"<div><h3>Objective</h3><div>In the extracranial carotidopaty the most frequent paragangliomas are chemodectomas; because of the complex anatomy of the surrounding structures, a lateral neck mass may arise by muscular, osseous, epithelial, mesenchymal or nervous tissues: a rare presentation is the vagus nerve neoplasia. The described technique compares the intraoperative neurological monitoring methods and their usefulness in avoiding neurological damage.</div></div><div><h3>Methods</h3><div>The surgical procedure was totally performed under neurophysiological monitoring with: A) Electroencephalogram. B) Transcranial electric motor evoked potential (MEP) with recording of left and right laryngeal and cricothyroid muscles. C) Somatosensory evoked potential (SEP) by the stimulation of the right and left median nerves. D) Free run registration from laryngeal and cricothyroid bilateral muscles. During the procedure was performed the direct stimulation (DNS) of the right vagus nerve and registration from the target muscles.</div></div><div><h3>Results</h3><div>The DNS of the neck mass was associated with finding of eloquent and non–eloquent nervous tissue allowing a safe gross total resection. The SEP and MEP did not show any significative changes during the surgical treatment.</div></div><div><h3>Conclusions</h3><div>Multidisciplinary approach is mandatory to perform perioperative evaluation and safe surgical treatment, which is the gold standard of Schwannoma treatment.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100411"},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417563","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}
Superficial arteriovenous malformations (sAVMs) are rare fast-flow vascular anomalies that can lead to both functional impairment and aesthetic deformities.
Methods
This retrospective study included seven patients treated surgically for sAVMs between 2021 and 2023. Diagnosis was confirmed by imaging, and preoperative embolization was selectively performed based on lesion characteristics.
Results
Surgical excision was carried out through healthy anatomical planes, avoiding direct manipulation of the nidus. Outcomes were favorable in most cases, with good scar quality and preserved function.
Conclusion
Imaging-guided surgical excision, supported by selective embolization, is a safe and effective strategy for managing sAVMs, minimizing complications and recurrence
{"title":"Surgical management of superficial arteriovenous malformations: resection through healthy tissue planes for safer outcomes","authors":"Doha AR-REYOUCHI , Ghita Cherkaoui Belmaati , Mustapha Maaroufi , Benzirar Adnane , Kamaoui Imane , Ayat Allah Oufkir","doi":"10.1016/j.avsurg.2025.100409","DOIUrl":"10.1016/j.avsurg.2025.100409","url":null,"abstract":"<div><h3>Background</h3><div>Superficial arteriovenous malformations (sAVMs) are rare fast-flow vascular anomalies that can lead to both functional impairment and aesthetic deformities.</div></div><div><h3>Methods</h3><div>This retrospective study included seven patients treated surgically for sAVMs between 2021 and 2023. Diagnosis was confirmed by imaging, and preoperative embolization was selectively performed based on lesion characteristics.</div></div><div><h3>Results</h3><div>Surgical excision was carried out through healthy anatomical planes, avoiding direct manipulation of the nidus. Outcomes were favorable in most cases, with good scar quality and preserved function.</div></div><div><h3>Conclusion</h3><div>Imaging-guided surgical excision, supported by selective embolization, is a safe and effective strategy for managing sAVMs, minimizing complications and recurrence</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100409"},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417564","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 : 2025-10-08DOI: 10.1016/j.avsurg.2025.100410
Aubrey Ding Rui Ng , Jing Hong Loo , Julene Hui Wun Ong , Kalpana Vijaykumar , Jia Sheng Tay
Objective
Digital subtraction angiography (DSA), the gold standard for endovascular imaging, has limitations in precision and safety. Intravascular ultrasound (IVUS) provides greater accuracy with detailed cross-sectional images, particularly useful for guiding percutaneous revascularisation. However, most IVUS data focuses on coronary interventions, with limited research on its application in lower limb procedures, especially in Asian populations.
Methods
A retrospective observational study of IVUS-guided lower limb angioplasty cases at Sengkang General Hospital, Singapore, analysed data from 65 Asian patients between January 2022 and June 2023. Assessing mean arterial diameters(MAD) and comparing them with reference vessel diameters (RVD) from European populations, locally derived RVDs, and post-intervention measurements. A multivariate analysis examined the relationships between arterial diameters and factors such as demographics and comorbidities.
Results
Significantly smaller artery diameters for below-the-knee (BTK) vessels in the study population than in Europe. The anterior tibial artery measured 3.25 mm vs. 3.37 mm (p = .031), the peroneal artery 2.74 mm vs. 3.03 mm (p = .001), and the posterior tibial artery 2.79 mm vs. 3.10 mm (p < .001). Above the knee, arteries were larger than local RVD, with the common femoral artery (CFA) at 7.8 mm vs. 6 mm (p < .001), the popliteal artery at 5.43 mm vs. 4 mm (p = .043) and the superficial femoral artery (SFA) at 6.38 mm vs. 5 mm (p = .145). Multivariate analysis revealed associations between arterial diameters and factors like race, gender, smoking status, coronary artery disease, diabetes, and hypertension.
Conclusion
Despite a small sample size, this study suggests that demographic factors may influence arterial size, impacting clinical decision-making and outcomes in peripheral arterial intervention. This highlights the importance of incorporating IVUS into routine practice for lower limb angioplasty in diverse populations. Further research with larger samples is needed to expand on these findings.
目的数字减影血管造影（DSA）作为血管内成像的金标准，在精度和安全性方面存在局限性。血管内超声（IVUS）提供更精确的详细横断面图像，特别有助于指导经皮血管重建。然而，大多数IVUS数据集中于冠状动脉介入治疗，对其在下肢手术中的应用研究有限，特别是在亚洲人群中。方法对新加坡圣康总医院ivus引导下下肢血管成形术病例进行回顾性观察研究，分析了2022年1月至2023年6月期间65例亚洲患者的数据。评估平均动脉直径（MAD），并将其与欧洲人群的参考血管直径（RVD）、当地衍生的RVD和干预后测量结果进行比较。多变量分析检查了动脉直径与人口统计学和合并症等因素之间的关系。结果研究人群的膝下血管（BTK）动脉直径明显小于欧洲。胫骨前动脉分别为3.25 mm和3.37 mm (p = 0.031)，腓骨动脉分别为2.74 mm和3.03 mm (p = 0.001)，胫骨后动脉分别为2.79 mm和3.10 mm （p < 0.001）。在膝关节以上，动脉比局部RVD大，股总动脉（CFA）为7.8 mm比6 mm (p < 0.001)，腘动脉为5.43 mm比4 mm (p = 0.043)，股浅动脉（SFA）为6.38 mm比5 mm （p = 0.145）。多变量分析显示，动脉直径与种族、性别、吸烟状况、冠状动脉疾病、糖尿病和高血压等因素有关。结论尽管样本量小，但本研究表明，人口统计学因素可能影响动脉大小，影响外周动脉介入治疗的临床决策和结果。这突出了将IVUS纳入不同人群下肢血管成形术常规实践的重要性。进一步的研究需要更大的样本来扩展这些发现。
{"title":"Use of intravascular ultrasound (IVUS) in lower limb angioplasty: A single centre experience","authors":"Aubrey Ding Rui Ng , Jing Hong Loo , Julene Hui Wun Ong , Kalpana Vijaykumar , Jia Sheng Tay","doi":"10.1016/j.avsurg.2025.100410","DOIUrl":"10.1016/j.avsurg.2025.100410","url":null,"abstract":"<div><h3>Objective</h3><div>Digital subtraction angiography (DSA), the gold standard for endovascular imaging, has limitations in precision and safety. Intravascular ultrasound (IVUS) provides greater accuracy with detailed cross-sectional images, particularly useful for guiding percutaneous revascularisation. However, most IVUS data focuses on coronary interventions, with limited research on its application in lower limb procedures, especially in Asian populations.</div></div><div><h3>Methods</h3><div>A retrospective observational study of IVUS-guided lower limb angioplasty cases at Sengkang General Hospital, Singapore, analysed data from 65 Asian patients between January 2022 and June 2023. Assessing mean arterial diameters(MAD) and comparing them with reference vessel diameters (RVD) from European populations, locally derived RVDs, and post-intervention measurements. A multivariate analysis examined the relationships between arterial diameters and factors such as demographics and comorbidities.</div></div><div><h3>Results</h3><div>Significantly smaller artery diameters for below-the-knee (BTK) vessels in the study population than in Europe. The anterior tibial artery measured 3.25 mm vs. 3.37 mm (<em>p</em> = .031), the peroneal artery 2.74 mm vs. 3.03 mm (<em>p</em> = .001), and the posterior tibial artery 2.79 mm vs. 3.10 mm (<em>p</em> < .001). Above the knee, arteries were larger than local RVD, with the common femoral artery (CFA) at 7.8 mm vs. 6 mm (<em>p</em> < .001), the popliteal artery at 5.43 mm vs. 4 mm (<em>p</em> = .043) and the superficial femoral artery (SFA) at 6.38 mm vs. 5 mm (<em>p</em> = .145). Multivariate analysis revealed associations between arterial diameters and factors like race, gender, smoking status, coronary artery disease, diabetes, and hypertension.</div></div><div><h3>Conclusion</h3><div>Despite a small sample size, this study suggests that demographic factors may influence arterial size, impacting clinical decision-making and outcomes in peripheral arterial intervention. This highlights the importance of incorporating IVUS into routine practice for lower limb angioplasty in diverse populations. Further research with larger samples is needed to expand on these findings.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100410"},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325425","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 : 2025-09-26DOI: 10.1016/j.avsurg.2025.100408
Tijen Alkan-Bozkaya , Halide Rengin Bilgen Akdeniz , Feyza Aksu , Gazanfer Ekinci , Zeynep Fırat , Murat Aydın Sav , Cemil Selim İsbir
Dolichoarteriopathy of the internal carotid artery (ICA) is characterized by abnormal elongation, kinking, and coiling of the extracranial segment of the ICA, leading to significant cerebrovascular events. This condition is increasingly recognized as a key cause of acute ischemic stroke with advances in clinical and radiological assessment. This report describes a surgical intervention performed on a 79-year-old woman admitted with acute ischemic stroke due to severe stenosis and bilateral dolichoarteriopathy of the ICAs. Following successful surgery, the patient demonstrated significant recovery. This case highlights the importance of early diagnosis and timely surgical intervention. The patient had significant comorbidities, including hypertension and a history of heavy smoking, which are commonly associated with severe bilateral dolichoarteriopathy.
{"title":"Surgical approach to symptomatic dolichoarteriopathy causing severe stenosis in a 79-year-old female patient","authors":"Tijen Alkan-Bozkaya , Halide Rengin Bilgen Akdeniz , Feyza Aksu , Gazanfer Ekinci , Zeynep Fırat , Murat Aydın Sav , Cemil Selim İsbir","doi":"10.1016/j.avsurg.2025.100408","DOIUrl":"10.1016/j.avsurg.2025.100408","url":null,"abstract":"<div><div>Dolichoarteriopathy of the internal carotid artery (ICA) is characterized by abnormal elongation, kinking, and coiling of the extracranial segment of the ICA, leading to significant cerebrovascular events. This condition is increasingly recognized as a key cause of acute ischemic stroke with advances in clinical and radiological assessment. This report describes a surgical intervention performed on a 79-year-old woman admitted with acute ischemic stroke due to severe stenosis and bilateral dolichoarteriopathy of the ICAs. Following successful surgery, the patient demonstrated significant recovery. This case highlights the importance of early diagnosis and timely surgical intervention. The patient had significant comorbidities, including hypertension and a history of heavy smoking, which are commonly associated with severe bilateral dolichoarteriopathy.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100408"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268329","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 : 2025-09-20DOI: 10.1016/j.avsurg.2025.100406
Hoi Yee Annie Lo , William Johnston , Jane J Keating , Allison E Berndtson , Ann C Gaffey
Background
Following executive order 13,767, the United States border wall height was nearly doubled to 30-feet (9.1 meters). Touted as “unclimbable,” the structure has led to an increase in fall-related trauma. Since 2019, our level 1 trauma center has noted a rise in blunt aortic injuries (BAI) from border wall falls. We aimed to characterize these injuries and their management.
Method
We performed a retrospective review of the University of California, San Diego level 1 trauma center registry, capturing patients from San Diego and Imperial Counties who sustained BAI due to border wall falls (2015–2024). Institutional review board exemption was granted.
Results
No BAIs were recorded from border wall falls before 2019. Since then, three cases have occurred. One patient sustained a grade I BAI and was managed non-operatively. Two patients had grade III BAI requiring emergent thoracic endovascular aortic repair (TEVAR). Both suffered multiple system injuries and required prolonged hospitalization and ultimate discharge to rehabilitation facilities.
Conclusions
BAIs from border wall falls emerged only after the wall height increase of 2019. The need for complex vascular intervention underscores the severe injury burden. Awareness of this mechanism is critical for timely diagnosis and intervention.
{"title":"Blunt thoracic aortic injuries from falls at the United States–Mexico Border: A case series","authors":"Hoi Yee Annie Lo , William Johnston , Jane J Keating , Allison E Berndtson , Ann C Gaffey","doi":"10.1016/j.avsurg.2025.100406","DOIUrl":"10.1016/j.avsurg.2025.100406","url":null,"abstract":"<div><h3>Background</h3><div>Following executive order 13,767, the United States border wall height was nearly doubled to 30-feet (9.1 meters). Touted as “unclimbable,” the structure has led to an increase in fall-related trauma. Since 2019, our level 1 trauma center has noted a rise in blunt aortic injuries (BAI) from border wall falls. We aimed to characterize these injuries and their management.</div></div><div><h3>Method</h3><div>We performed a retrospective review of the University of California, San Diego level 1 trauma center registry, capturing patients from San Diego and Imperial Counties who sustained BAI due to border wall falls (2015–2024). Institutional review board exemption was granted.</div></div><div><h3>Results</h3><div>No BAIs were recorded from border wall falls before 2019. Since then, three cases have occurred. One patient sustained a grade I BAI and was managed non-operatively. Two patients had grade III BAI requiring emergent thoracic endovascular aortic repair (TEVAR). Both suffered multiple system injuries and required prolonged hospitalization and ultimate discharge to rehabilitation facilities.</div></div><div><h3>Conclusions</h3><div>BAIs from border wall falls emerged only after the wall height increase of 2019. The need for complex vascular intervention underscores the severe injury burden. Awareness of this mechanism is critical for timely diagnosis and intervention.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100406"},"PeriodicalIF":0.0,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159152","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 : 2025-09-17DOI: 10.1016/j.avsurg.2025.100407
Amir R. Akhavan , Charles A. West Jr. , Jonathan S. Deitch , John L. Crawford
Primary aortoenteric fistulas (AEFs) are rare and life-threatening. We report the successful hybrid management of a 60-year-old man who presented in hemorrhagic shock from a primary aortoduodenal fistula arising from an unsuspected abdominal aortic aneurysm. The patient underwent emergent endovascular aneurysm repair (EVAR) followed by early, staged open aortoplasty and duodenal repair with omental flap reinforcement two days later. This case illustrates the successful use of a non-traditional approach to management of a primary AEF in an unstable patient. Few reports describing this technique have been found in the literature.
{"title":"Endovascular repair of a primary aortoenteric fistula with staged open aortoplasty and omentopexy with duodenal repair","authors":"Amir R. Akhavan , Charles A. West Jr. , Jonathan S. Deitch , John L. Crawford","doi":"10.1016/j.avsurg.2025.100407","DOIUrl":"10.1016/j.avsurg.2025.100407","url":null,"abstract":"<div><div>Primary aortoenteric fistulas (AEFs) are rare and life-threatening. We report the successful hybrid management of a 60-year-old man who presented in hemorrhagic shock from a primary aortoduodenal fistula arising from an unsuspected abdominal aortic aneurysm. The patient underwent emergent endovascular aneurysm repair (EVAR) followed by early, staged open aortoplasty and duodenal repair with omental flap reinforcement two days later. This case illustrates the successful use of a non-traditional approach to management of a primary AEF in an unstable patient. Few reports describing this technique have been found in the literature.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100407"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145121287","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 : 2025-09-10DOI: 10.1016/j.avsurg.2025.100404
Yusuke Nakata, Hikaru Uchiyama, Kazuyuki Miyamoto
Objectives
The aim of this study was to evaluate the early to mid-term outcomes of axillo-bifemoral bypass (AxBF) using T-shaped heparin-bonded expanded polytetrafluoroethylene (HB-ePTFE) grafts for bilateral aorto-iliac occlusive disease.
Materials and Methods
This was a retrospective, observational, and descriptive case series. Between February 2014 and October 2023, ten patients with abdominal aortic to iliac artery lesions underwent AxBF for bilateral aorto-iliac occlusive disease. Before June 2018, nine patients underwent aortic-bilateral femoral artery bypass (AoB) via the open abdomen approach for bilateral aorto-iliac occlusive disease. We investigated the reintervention rate, survival rate, and cause of death of the patients in the AxBF and AoB groups.
Results
During the observation period, reintervention was performed for other graft occlusions or residual lesions in more distal vessels in two patients in the AxBF group and for occlusion due to lower extremity thrombosis in one patient from the AoB group. These events were managed appropriately, with no procedure-related mortality.
Conclusion
AxBF using T-shaped HB-ePTFE grafts was technically feasible and performed safety, without procedure-related mortality, in this series of high-risk patients with bilateral aorto-iliac occlusive disease. These observations support the viability and perioperative safety of the approach. However, given the retrospective design, small sample size, and selective patient inclusion, these results should be interpreted as descriptive observations, and further prospective studies are warranted to confirm their clinical significance.
{"title":"Early to mid-term outcomes of axillo-bifemoral bypass using T-shaped heparin-bonded expanded polytetrafluoroethylene grafts","authors":"Yusuke Nakata, Hikaru Uchiyama, Kazuyuki Miyamoto","doi":"10.1016/j.avsurg.2025.100404","DOIUrl":"10.1016/j.avsurg.2025.100404","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to evaluate the early to mid-term outcomes of axillo-bifemoral bypass (AxBF) using T-shaped heparin-bonded expanded polytetrafluoroethylene (HB-ePTFE) grafts for bilateral aorto-iliac occlusive disease.</div></div><div><h3>Materials and Methods</h3><div>This was a retrospective, observational, and descriptive case series. Between February 2014 and October 2023, ten patients with abdominal aortic to iliac artery lesions underwent AxBF for bilateral aorto-iliac occlusive disease. Before June 2018, nine patients underwent aortic-bilateral femoral artery bypass (AoB) via the open abdomen approach for bilateral aorto-iliac occlusive disease. We investigated the reintervention rate, survival rate, and cause of death of the patients in the AxBF and AoB groups.</div></div><div><h3>Results</h3><div>During the observation period, reintervention was performed for other graft occlusions or residual lesions in more distal vessels in two patients in the AxBF group and for occlusion due to lower extremity thrombosis in one patient from the AoB group. These events were managed appropriately, with no procedure-related mortality.</div></div><div><h3>Conclusion</h3><div>AxBF using T-shaped HB-ePTFE grafts was technically feasible and performed safety, without procedure-related mortality, in this series of high-risk patients with bilateral aorto-iliac occlusive disease. These observations support the viability and perioperative safety of the approach. However, given the retrospective design, small sample size, and selective patient inclusion, these results should be interpreted as descriptive observations, and further prospective studies are warranted to confirm their clinical significance.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100404"},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145097897","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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