Annals of vascular surgery. Brief reports and innovations最新文献

{"title":"Left internal mammary artery supplying collateral circulation to the epigastric arteries is circumvented with axillofemoral bypass permitting coronary artery bypass grafting and mitral valve repair","authors":"Brady Antolick ,&nbsp;Andrew D. Vogel ,&nbsp;Schafer Paladichuk ,&nbsp;Melissa Obmann ,&nbsp;Christopher Demaioribus ,&nbsp;Tyler J. Wallen","doi":"10.1016/j.avsurg.2025.100405","DOIUrl":"10.1016/j.avsurg.2025.100405","url":null,"abstract":"<div><h3>Introduction</h3><div>Aortoiliac occlusive disease (AIOD) is a subset of peripheral artery disease (PAD) characterized by occlusion of the infrarenal aorta and iliac arteries. Patients with AIOD may develop collateral circulation through the internal thoracic artery–inferior epigastric artery (ITA-IEA) pathway to maintain lower extremity perfusion. Coronary artery disease (CAD) often necessitates coronary artery bypass grafting (CABG), where the left internal mammary artery (LIMA) is the preferred conduit for revascularizing the left anterior descending (LAD) artery. In patients with AIOD, disruption of ITA-IEA collaterals during CABG poses a risk of exacerbating lower extremity ischemia.</div></div><div><h3>Case description</h3><div>We report a case of a 65-year-old female with severe multivessel CAD, mitral valve regurgitation (MVR), and AIOD with ITA-IEA collaterals supplying the lower extremities. Preoperative imaging revealed an occluded distal aorta with inadequate venous conduits. To preserve lower extremity perfusion, the patient underwent axillary-femoral and femoral-femoral bypasses before CABG. A two-vessel CABG was performed using the LIMA to the LAD and the radial artery to the obtuse marginal artery, along with mitral valve replacement. The patient recovered well and was discharged 11 days postoperatively without complications.</div></div><div><h3>Discussion</h3><div>This case highlights the complexities of managing concurrent AIOD and CAD, emphasizing the importance of preserving collateral circulation. Preoperative imaging enabled strategic surgical planning to balance myocardial revascularization and lower extremity perfusion. The successful use of alternative conduits, such as the radial artery, underscores the necessity of flexibility in graft selection. Multidisciplinary collaboration and individualized surgical planning are crucial in managing patients with AIOD and CAD.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100405"},"PeriodicalIF":0.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145097896","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":"Iatrogenic femoral complex pseudoaneurysm: A case report","authors":"Rupendra Nath Saha ,&nbsp;Bhanu Duggal ,&nbsp;Raghuraj Chawla ,&nbsp;Shubham Rawat","doi":"10.1016/j.avsurg.2025.100403","DOIUrl":"10.1016/j.avsurg.2025.100403","url":null,"abstract":"<div><div>An iatrogenic complex femoral pseudoaneurysm, though rare, is associated with much comorbidity. We want to bring up a case of a complex pseudoaneurysm created after a percutaneous angioplasty, which was finally repaired using a surgical technique. The danger of rupture, embolisation, and infection are associated with complex femoral pseudoaneurysms. Though there are various ways of managing such a condition, an ideal approach should be tailored to each patient, considering their comorbidities. Surgical repair is still a practical and successful therapeutic option for these lesions, especially when endovascular or a conservative intervention is not advised or has not worked.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100403"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145121288","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":"Use of diverging buddy wires to aid in precise endovascular stent placement at an arterial branch point","authors":"Thane Gehring,&nbsp;Joshua Gierman","doi":"10.1016/j.avsurg.2025.100402","DOIUrl":"10.1016/j.avsurg.2025.100402","url":null,"abstract":"<div><div>Endovascular stent placement at or near arterial branch points requires precision to avoid complications, including stent jumping or mal-deployment, with potential jailing of adjacent branch ostia. Here we describe the novel use of diverging buddy wires to ensure precise endovascular stent deployment in the innominate artery in a bovine arch initially managed by surgical primary repair. The use of divergent buddy wires provided stability in the complex anatomy, facilitating precise deployment at the arterial branch point with embolic protection in the carotid artery.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100402"},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050769","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":"Stent occlusion after catheter-directed thrombolysis and iliac vein stenting in May-Thurner syndrome with iliofemoral deep vein thrombosis: A case report and literature review","authors":"Haijun Huang,&nbsp;Zuoyi Yao,&nbsp;Ke Guo,&nbsp;Yunping Liu,&nbsp;Qian Zhang,&nbsp;Wei Wei,&nbsp;Kan Zhao","doi":"10.1016/j.avsurg.2025.100401","DOIUrl":"10.1016/j.avsurg.2025.100401","url":null,"abstract":"<div><h3>Background</h3><div>Stent occlusion following endovascular management of May-Thurner syndrome (MTS) with iliofemoral deep vein thrombosis (DVT) remains a significant clinical challenge. This case report and literature review examines mechanical, procedural, and patient-specific determinants of stent failure in chronic venous disease.</div></div><div><h3>Case Presentation</h3><div>A 78-year-old female with acute left iliofemoral DVT post-hip arthroplasty underwent catheter-directed thrombolysis (CDT) and iliac vein stenting. Despite initial technical success and rivaroxaban therapy, stent occlusion occurred at 1-month follow-up, necessitating secondary stenting. Venography revealed residual thrombus at the inflow tract and incomplete coverage of the iliocaval confluence as likely contributors.</div></div><div><h3>Literature Review</h3><div>Analysis of 29 studies identified critical factors influencing stent patency:</div><div>Mechanical determinants: Larger stent diameter (≥16 mm) and optimized iliocaval confluence coverage reduced restenosis risk. In-stent shear rate &gt;100 s⁻¹ and inflow luminal area &gt;125 mm² correlated with patency.</div><div>Thrombotic risk: Chronic post-thrombotic lesions (residual thrombus &gt;30 %) and antiphospholipid syndrome increased occlusion risk.</div><div>Anticoagulation: Combined anticoagulant/antiplatelet regimens reduced stent malfunction by 72 % (HR=0.28), while extended anticoagulation (6–12 months) showed no superiority over shorter durations in recent cohorts.</div></div><div><h3>Conclusion</h3><div>This case highlights the multifactorial nature of venous stent failure. Key recommendations include:</div><div>Aggressive thrombus clearance during CDT (&lt;30 % residual burden)</div><div>IVUS-guided stent sizing to achieve optimal shear dynamics</div><div>Tailored anticoagulation incorporating thrombophilia screening</div><div>Anatomic precision in iliocaval confluence coverage</div><div>Prospective studies are needed to validate biomechanical thresholds and pharmacogenetic approaches in venous stent management.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 4","pages":"Article 100401"},"PeriodicalIF":0.0,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050768","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":"Measuring consistency: The reliability of pedal acceleration time measurements across and within raters","authors":"Odette Hart ,&nbsp;Philip Allan ,&nbsp;Bridget August ,&nbsp;Grant Abbott ,&nbsp;Catherine Evans ,&nbsp;Manar Khashram","doi":"10.1016/j.avsurg.2025.100400","DOIUrl":"10.1016/j.avsurg.2025.100400","url":null,"abstract":"<div><h3>Objectives</h3><div>Pedal acceleration time (PAT) is a novel non-invasive lower limb perfusion assessment tool. However, the test-retest reliability between and within raters has not been examined. The aim of this pilot study was to assess the inter- and intra-rater reliability of PAT measurements.</div></div><div><h3>Methods</h3><div>Ten patients with diabetic foot and/or chronic limb threatening ischaemia underwent three repeated PAT measurements across three pedal arteries in a single limb by three trained sonographers. Inter-rater reliability was assessed as the contribution to variance by patients, raters, and replicates. Intra-rater reliability was quantified by the within-subject coefficient of variation (CV). The effects of raters and repeat measures was summarised using the intraclass correlation coefficient (ICC).</div></div><div><h3>Results</h3><div>Inter-rater reliability showed little contribution to variance at only ≤0.4 %, with ≥88.1 % of variance being that driven by patient variability. Intra-rater reliability as assessed by CV ranged between 10.8 %-12.2 %. The combined effect of raters and repeat measures assessed by ICC was 0.88–0.99 (good-to-excellent reliability).</div></div><div><h3>Conclusions</h3><div>This pilot study suggests PAT can be reliably measured by trained sonographers with good-to-excellent inter- and intra-rater reliability.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 3","pages":"Article 100400"},"PeriodicalIF":0.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864112","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":"Aortoiliac graft occlusion presenting as lumbar plexopathy: a report of reversible neurological deficit","authors":"Andrea Muniz,&nbsp;Houssam Farres,&nbsp;Camilo Polania-Sandoval,&nbsp;Young Erben","doi":"10.1016/j.avsurg.2025.100399","DOIUrl":"10.1016/j.avsurg.2025.100399","url":null,"abstract":"<div><div>Ischemic lumbar plexopathy is a rare and challenging neurological complication resulting from vascular insufficiency. Its clinical presentation varies, making diagnosis difficult and often leading to it being overlooked. Although it has been documented following aortic reconstruction procedures, complete neurologic recovery after revascularization has not previously been reported. We present the case of a 79-year-old male patient with a history of EVAR for the treatment of an infrarenal abdominal aortic aneurysm utilizing an aortouniiliac endograft and a left-to-right femoral-femoral bypass, who presented with acute left lower extremity pain and progressive weakness of bilateral lower extremities. Evaluation revealed acute occlusion of both the endograft and femoral-femoral bypass. He underwent left external iliac artery thrombectomy and a left axillary-to-femoral artery bypass, a redo left-to-right femoral-femoral bypass, and a left common femoral to above-knee popliteal artery bypass. This revascularization resulted in immediate sensory and motor function improvement. A review of fifteen published cases involving lumbar plexopathy after aortic interventions revealed typical presentation in the early postoperative period. Management was predominantly conservative, with nearly all patients receiving physical therapy, and one was treated with surgical revascularization via bypass. Despite these efforts, most patients experienced persistent motor deficits, with only one patient achieving full neurologic recovery through physical therapy alone. Ischemic lumbar plexopathy secondary to aortic graft occlusion is extremely rare. This case highlights the need to consider ischemic lumbar plexopathy in patients with complex vascular histories. Timely revascularization, even in a high-risk patient, led to meaningful neurological recovery.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 3","pages":"Article 100399"},"PeriodicalIF":0.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694769","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":"Carotid body tumor presenting with acute internal carotid artery occlusion: Case report and review of the literature","authors":"Abdulrahman Saad Aldakkan","doi":"10.1016/j.avsurg.2025.100397","DOIUrl":"10.1016/j.avsurg.2025.100397","url":null,"abstract":"<div><div>Carotid body tumors are the most common paragangliomas of the head and neck. Although stroke is a known potential complication following surgical resection, it is a very unusual presenting symptom. We present the fourth case in the literature of a carotid body tumor presenting with a stroke. A 37 year old male with acute right internal carotid artery occlusion in the presence of ipsilateral carotid body tumor. He was managed with endovascular thrombectomy. The clinical presentation, imaging findings and management are presented.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 3","pages":"Article 100397"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723659","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":"Management of an infected native aortic aneurysm secondary to an extremely rare pathogen - Cutibacterium acnes infection","authors":"Drake Giese ,&nbsp;Buddhi P Hatharaliyadda ,&nbsp;Tiziano Tallarita ,&nbsp;Noora Jabeen ,&nbsp;Yasser Almadani ,&nbsp;Jason Beckermann ,&nbsp;Indrani Sen","doi":"10.1016/j.avsurg.2025.100398","DOIUrl":"10.1016/j.avsurg.2025.100398","url":null,"abstract":"<div><div>A 76-year-old male was treated for an incidentally diagnosed 6.6 cm infective native aortic aneurysm (INAA). He reported significant chronic back pain; but had no other clinical or radiological features of an infective or inflammatory aneurysm. He underwent open repair; aortic tissue culture was positive for <em>Cutibacterium acnes</em>. C. Acnes (previously known as Propionibacterium acnes) is an extremely rare etiology for INAA, there are no reports of long-term outcomes after open repair.^1-4 He was treated with 6 weeks of IV ceftriaxone and remains on oral amoxicillin for chronic suppression with no reinfection on imaging and improvement in back pain.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 3","pages":"Article 100398"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of midaortic syndrome in children with renovascular hypertension: Over a quarter of century experience","authors":"Afksendiyos Kalangos ,&nbsp;Murat Ugurlucan ,&nbsp;Didem Melis Oztas ,&nbsp;Panagiotis Sfyridis ,&nbsp;Gino Gemayel ,&nbsp;Yilmaz Zorman ,&nbsp;Nataliia Shatelen","doi":"10.1016/j.avsurg.2025.100396","DOIUrl":"10.1016/j.avsurg.2025.100396","url":null,"abstract":"<div><h3>Background</h3><div>If left untreated, mid-aortic syndrome with renovascular hypertension can lead to life-threatening complications due to refractory hypertension. We aimed to analyze the medium- and long-term outcomes in a pediatric population that underwent surgery over the past 25 years.</div></div><div><h3>Methods</h3><div>A review of eight children with mid-aortic syndrome resulting in renovascular hypertension due to renal arterial stenosis has been conducted over the past 25 years. Children diagnosed with Takayasu arteritis were excluded. Primary outcomes were survival, reoperations, and interventional procedures.</div></div><div><h3>Results</h3><div>Eight children, with a median age of 12.5 years (ranging from 4 to 17 years old), were included in the study period. One patient had Neurofibromatosis type I, while another was diagnosed with Williams-Beuren syndrome. Seven children had involvement of one or both renal arteries, and most of them were affected by visceral abdominal aortic branches: celiac trunk (<em>n</em> = 3) and/or superior mesenteric artery (<em>n</em> = 2), which required reimplantation. The procedure to alleviate the stenotic abdominal aortic segment employed a lateral-to-end aorto-aortic bypass tube graft, with or without renal or visceral arterial bypass. There were no early or late deaths during the follow-up period. One patient experienced a postoperative thrombosis of the venous graft between the aortic bypass graft and the right renal artery, necessitating a thrombectomy. One patient required dilation of the right renal artery due to stenosis in the reimplanted artery 18 months after the initial repair, while another patient needed dilation of the superior mesenteric artery at the anastomosis with the saphenous vein graft after 19 months. In the remaining patients, imaging revealed no significant residual stenosis, and all patients were tapered off anti-hypertensive medications by the last follow-up appointment.</div></div><div><h3>Conclusions</h3><div>Surgical repair of the mid-aortic syndrome can be performed with low operative and late morbidity in experienced hands. Long-term follow-up is associated with complete resolution of renal hypertension. Patients require regular follow-up because of the risk of visceral aortic branch and renal artery anastomotic restenosis. However, revascularization using short saphenous vein graft segments is durable, and if stenosis occurs, it can be easily managed percutaneously.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 3","pages":"Article 100396"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665867","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":"Aneurysmal degeneration after drug-eluting stent implantation in lower limb arteries: A systematic review and case reports","authors":"Angela Luongo ,&nbsp;Nicola Cantile ,&nbsp;Davide Turchino ,&nbsp;Abdul Karim Markabaoui ,&nbsp;Raffaele Serra ,&nbsp;Umberto Marcello Bracale","doi":"10.1016/j.avsurg.2025.100395","DOIUrl":"10.1016/j.avsurg.2025.100395","url":null,"abstract":"<div><h3>Background</h3><div>Paclitaxel-eluting stents (DES) are widely used in the treatment of femoropopliteal peripheral arterial disease (PAD) due to their ability to inhibit neointimal hyperplasia and reduce restenosis rates. However, recent observational data have raised concerns about delayed complications, particularly aneurysmal degeneration of the treated arterial segments.</div></div><div><h3>Objectives</h3><div>To systematically review the incidence, anatomical distribution, mechanisms, and clinical outcomes of aneurysmal degeneration following implantation of paclitaxel-eluting stents in lower limb arteries, define its incidence, anatomical distribution, proposed mechanisms, diagnostic criteria, and therapeutic approaches and to present a representative case requiring open surgical revision 12 months post-Eluvia implantation.</div></div><div><h3>Methods</h3><div>A PRISMA-compliant systematic review was performed including randomized trials, observational studies, and case reports describing aneurysmal degeneration after DES implantation. Data were extracted regarding stent type, lesion location, diagnostic methods, follow-up, and clinical outcomes. A clinical case of aneurysmal degeneration of the common femoral artery (CFA) following Eluvia implantation was integrated.</div></div><div><h3>Results</h3><div>Thirteen studies were included, comprising 1 randomized controlled trial, 6 observational cohorts, 1 case series, and 5 case reports. The incidence of aneurysmal degeneration ranged from 0 % to 15.7 %, with the superficial femoral artery (SFA) being the most affected site. Conservative management was common, although some cases required open surgical treatment. Our patient underwent aneurysmectomy and bypass for CFA degeneration 12 months after DES placement.</div></div><div><h3>Conclusions</h3><div>Aneurysmal degeneration after femoropopliteal DES implantation may be underdiagnosed and clinically relevant. Given the variability in diagnostic criteria and long-term risk, systematic surveillance and further investigation are warranted, particularly in off-label stent applications.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 3","pages":"Article 100395"},"PeriodicalIF":0.0,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633089","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}