Pub Date : 2025-06-18DOI: 10.1016/j.avsurg.2025.100393
Pietro Modugno , Mario Nocerino , Francesco Maria Modugno , Veronica Picone , Lucia Scurto , Alessandra Paolini , Carmen Pediliggieri , Corrado Cirielli
We present a series of three cases of symptomatic pseudoaneurysms of the superficial temporal artery (STA) following non-concussive head trauma. All patients developed a superficial hematoma associated with a pulsatile swelling, painful on both palpation and spontaneously. Diagnosis was promptly made with color Doppler ultrasound, supplemented by a non-contrast head computed tomography (CT) scan to rule out cranial fractures or cerebral hemorrhages. Management involved ligating the STA both upstream and downstream of the pseudoaneurysm, followed by its excision. This approach effectively resolved the local and regional symptoms through a quick, safe, and minimally invasive procedure.
{"title":"Symptomatic pseudoaneurysm of the superficial temporal artery: three case reports","authors":"Pietro Modugno , Mario Nocerino , Francesco Maria Modugno , Veronica Picone , Lucia Scurto , Alessandra Paolini , Carmen Pediliggieri , Corrado Cirielli","doi":"10.1016/j.avsurg.2025.100393","DOIUrl":"10.1016/j.avsurg.2025.100393","url":null,"abstract":"<div><div>We present a series of three cases of symptomatic pseudoaneurysms of the superficial temporal artery (STA) following non-concussive head trauma. All patients developed a superficial hematoma associated with a pulsatile swelling, painful on both palpation and spontaneously. Diagnosis was promptly made with color Doppler ultrasound, supplemented by a non-contrast head computed tomography (CT) scan to rule out cranial fractures or cerebral hemorrhages. Management involved ligating the STA both upstream and downstream of the pseudoaneurysm, followed by its excision. This approach effectively resolved the local and regional symptoms through a quick, safe, and minimally invasive procedure.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 3","pages":"Article 100393"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502270","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 : 2025-06-18DOI: 10.1016/j.avsurg.2025.100390
Claudiomar Zardo de Oliveira, Júlia Scussiato de Oliveira, Éverton Macedo
We present a unique case of a 72-year-old man who underwent endovascular repair of a ruptured abdominal aneurysm. This patient has received a unilateral left lung transplant for cystic fibrosis 14 months prior to this event. He was being treated with cyclosporine, azathioprine and prednisone as immunosuppressive therapy. Among the studies published to date, this is the first case of a ruptured abdominal aortic aneurysm treated endovascularly after lung transplantation. We noted that prior to the transplant the patient had a small abdominal aortic aneurysm, but that after the transplant the aneurysm evolved rapidly, culminating in rupture.
{"title":"Abdominal aortic aneurysm endovascular repair in a patient after lung transplantation","authors":"Claudiomar Zardo de Oliveira, Júlia Scussiato de Oliveira, Éverton Macedo","doi":"10.1016/j.avsurg.2025.100390","DOIUrl":"10.1016/j.avsurg.2025.100390","url":null,"abstract":"<div><div>We present a unique case of a 72-year-old man who underwent endovascular repair of a ruptured abdominal aneurysm. This patient has received a unilateral left lung transplant for cystic fibrosis 14 months prior to this event. He was being treated with cyclosporine, azathioprine and prednisone as immunosuppressive therapy. Among the studies published to date, this is the first case of a ruptured abdominal aortic aneurysm treated endovascularly after lung transplantation. We noted that prior to the transplant the patient had a small abdominal aortic aneurysm, but that after the transplant the aneurysm evolved rapidly, culminating in rupture.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 3","pages":"Article 100390"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306508","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 : 2025-06-17DOI: 10.1016/j.avsurg.2025.100394
Giulia Maria Piermarini , Corrado Cirielli , Gennaro Restaino , Massimiliano Missere , Mario Nocerino , Luca Mascellari , Pietro Modugno
Introduction
Aneurysms of the dorsalis pedis artery (DPA) are a rare condition but their management is essential to prevent significant complications, such as rupture or foot ischemia2,3,4. Despite the evolution of therapeutic techniques in recent decades, the current literature shows a predominant use of surgical treatments, with limited recourse to endovascular options. This study presents a clinical case of DPA pseudoaneurysm and offers a review of current therapeutic approaches.
Methods
We performed a systematic review of the literature using PubMed and Scopus, analyzing articles published from 1955 to the present. We focused on studies that addressed etiology, clinical presentation, diagnostic methods, and treatment outcomes.
Results
In our review, trauma (25 %) and iatrogenic causes (18.75 %) were the most frequent etiologies of DPA aneurysms. The typical clinical presentation was a pulsatile mass, and Doppler ultrasound was the most common diagnostic tool. Surgery, especially resection and ligation of feeding vessels (50 %), was the most frequently used treatment. Endovascular treatments, including embolization, were rare. No significant complications were reported 44.
Discussion
Surgical treatment remains the primary approach for DPA aneurysms, resulting in good outcomes when performed promptly. Despite the advancements in endovascular techniques, their application to DPA aneurysms remains limited, with only one case reported in the literature.44
Conclusions
Despite the rarity of DPA aneurysms, surgical treatment remains effective and safe when promptly applied.
{"title":"A rare case of dorsalis pedis artery pseudoaneurysm: Surgical management and review of the literature","authors":"Giulia Maria Piermarini , Corrado Cirielli , Gennaro Restaino , Massimiliano Missere , Mario Nocerino , Luca Mascellari , Pietro Modugno","doi":"10.1016/j.avsurg.2025.100394","DOIUrl":"10.1016/j.avsurg.2025.100394","url":null,"abstract":"<div><h3>Introduction</h3><div>Aneurysms of the dorsalis pedis artery (DPA) are a rare condition but their management is essential to prevent significant complications, such as rupture or foot ischemia<sup>2,3,4</sup>. Despite the evolution of therapeutic techniques in recent decades, the current literature shows a predominant use of surgical treatments, with limited recourse to endovascular options. This study presents a clinical case of DPA pseudoaneurysm and offers a review of current therapeutic approaches.</div></div><div><h3>Methods</h3><div>We performed a systematic review of the literature using PubMed and Scopus, analyzing articles published from 1955 to the present. We focused on studies that addressed etiology, clinical presentation, diagnostic methods, and treatment outcomes.</div></div><div><h3>Results</h3><div>In our review, trauma (25 %) and iatrogenic causes (18.75 %) were the most frequent etiologies of DPA aneurysms. The typical clinical presentation was a pulsatile mass, and Doppler ultrasound was the most common diagnostic tool. Surgery, especially resection and ligation of feeding vessels (50 %), was the most frequently used treatment. Endovascular treatments, including embolization, were rare. No significant complications were reported <sup>44</sup>.</div></div><div><h3>Discussion</h3><div>Surgical treatment remains the primary approach for DPA aneurysms, resulting in good outcomes when performed promptly. Despite the advancements in endovascular techniques, their application to DPA aneurysms remains limited, with only one case reported in the literature.<sup>44</sup></div></div><div><h3>Conclusions</h3><div>Despite the rarity of DPA aneurysms, surgical treatment remains effective and safe when promptly applied.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 3","pages":"Article 100394"},"PeriodicalIF":0.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513997","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 : 2025-06-11DOI: 10.1016/j.avsurg.2025.100392
Jonathan Sexton, Kennedy Nye
Free floating carotid thrombus (FFCT) is an infrequent but dangerous finding of symptomatic carotid stenosis. Definitive management for FFCT is not well defined and the risk of stroke after endarterectomy comes with almost a threefold increase in stroke risk. Initial anticoagulation will usually resolve the thrombus on its own and allow for traditional management. In those that persist, there remains a low chance of recurrent stroke at 30 days with continued anticoagulation. For patients who have persistent disease, or recurrent symptoms, Transcarotid Artery Revascularization (TCAR) with Percutaneous Mechanical Thrombectomy (PMT) appears to be a safer alternative option to Carotid Endarterectomy.
{"title":"Evolution of the management of symptomatic carotid artery stenosis with free floating thrombus","authors":"Jonathan Sexton, Kennedy Nye","doi":"10.1016/j.avsurg.2025.100392","DOIUrl":"10.1016/j.avsurg.2025.100392","url":null,"abstract":"<div><div>Free floating carotid thrombus (FFCT) is an infrequent but dangerous finding of symptomatic carotid stenosis. Definitive management for FFCT is not well defined and the risk of stroke after endarterectomy comes with almost a threefold increase in stroke risk. Initial anticoagulation will usually resolve the thrombus on its own and allow for traditional management. In those that persist, there remains a low chance of recurrent stroke at 30 days with continued anticoagulation. For patients who have persistent disease, or recurrent symptoms, Transcarotid Artery Revascularization (TCAR) with Percutaneous Mechanical Thrombectomy (PMT) appears to be a safer alternative option to Carotid Endarterectomy.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 3","pages":"Article 100392"},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306509","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}
Pseudoaneurysms involving the internal mammary artery/internal thoracic artery (IMA/ITA) are rare occurrences, and the presentation and treatment approaches for such cases can be variable. Due to the potentially life-threatening risk of rupture, leading to conditions like haemothorax, it is important to have a comprehensive understanding of safe and effective diagnostic and therapeutic techniques. We present a case of IMA/ITA artery pseudoaneurysm complicated with fistula formation with the vein.
Case presentation
A 36-year-old male presented to the surgical casualty after one week with bleeding from the laceration he had in left chest following a motor vehicle accident. CT angiogram of the chest revealed a pseudoaneurysm formation in the internal mammary artery and a fistula to the internal mammary vein.
Intervention and Outcome
He underwent coil embolization, and subsequent post-procedure angiograms confirmed the effective occlusion of the left IMA/ITA, with no further visualization of the pseudoaneurysm.
Conclusion
Targeted coil embolization is favoured over surgical repair due to its lower complication rates and favourable outcomes.
{"title":"Traumatic pseudoaneurysm of internal mammary artery with fistula of internal mammary vein treated minimally invasive: A case report","authors":"Kasilingam Kiritharan, Srikumaran Sivamainthan, Vengadasalam Sutharshan, Murugavel Mayuran, Satchithanantham Vinojan","doi":"10.1016/j.avsurg.2025.100391","DOIUrl":"10.1016/j.avsurg.2025.100391","url":null,"abstract":"<div><h3>Background</h3><div>Pseudoaneurysms involving the internal mammary artery/internal thoracic artery (IMA/ITA) are rare occurrences, and the presentation and treatment approaches for such cases can be variable. Due to the potentially life-threatening risk of rupture, leading to conditions like haemothorax, it is important to have a comprehensive understanding of safe and effective diagnostic and therapeutic techniques. We present a case of IMA/ITA artery pseudoaneurysm complicated with fistula formation with the vein.</div></div><div><h3>Case presentation</h3><div>A 36-year-old male presented to the surgical casualty after one week with bleeding from the laceration he had in left chest following a motor vehicle accident. CT angiogram of the chest revealed a pseudoaneurysm formation in the internal mammary artery and a fistula to the internal mammary vein.</div></div><div><h3>Intervention and Outcome</h3><div>He underwent coil embolization, and subsequent post-procedure angiograms confirmed the effective occlusion of the left IMA/ITA, with no further visualization of the pseudoaneurysm.</div></div><div><h3>Conclusion</h3><div>Targeted coil embolization is favoured over surgical repair due to its lower complication rates and favourable outcomes.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 3","pages":"Article 100391"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144331074","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 : 2025-06-03DOI: 10.1016/j.avsurg.2025.100389
Eden Z Gebreselassie , Virgile Omnes , Karima Houasli , Gwenaelle Duchemin , Eva Madeleine , Marine Gaudry
Popliteal artery entrapment syndrome (PAES) is a rare but significant cause of lower limb claudication in young, otherwise healthy individuals. This case describes a 16-year-old athletic patient presenting with bilateral calf pain, initially evaluated by cardiology. While initial arterial Doppler ultrasound was unremarkable, calf contraction elicited a complete interruption of arterial flow. Angio-CT confirmed dynamic compression of the popliteal artery, consistent with functional popliteal entrapment syndrome. Surgical intervention was performed, involving resection of the medial gastrocnemius muscle and tendon release. The patient experienced full symptom resolution postoperatively. This report highlights the importance of considering PAES in the differential diagnosis of claudication in young patients, underscores the role of dynamic imaging and surgical management, and addresses postoperative recurrence risk.
{"title":"Functional popliteal artery entrapment syndrome in an athletic adolescent: a case report and surgical insights","authors":"Eden Z Gebreselassie , Virgile Omnes , Karima Houasli , Gwenaelle Duchemin , Eva Madeleine , Marine Gaudry","doi":"10.1016/j.avsurg.2025.100389","DOIUrl":"10.1016/j.avsurg.2025.100389","url":null,"abstract":"<div><div>Popliteal artery entrapment syndrome (PAES) is a rare but significant cause of lower limb claudication in young, otherwise healthy individuals. This case describes a 16-year-old athletic patient presenting with bilateral calf pain, initially evaluated by cardiology. While initial arterial Doppler ultrasound was unremarkable, calf contraction elicited a complete interruption of arterial flow. Angio-CT confirmed dynamic compression of the popliteal artery, consistent with functional popliteal entrapment syndrome. Surgical intervention was performed, involving resection of the medial gastrocnemius muscle and tendon release. The patient experienced full symptom resolution postoperatively. This report highlights the importance of considering PAES in the differential diagnosis of claudication in young patients, underscores the role of dynamic imaging and surgical management, and addresses postoperative recurrence risk.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 3","pages":"Article 100389"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280426","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 : 2025-06-01DOI: 10.1016/j.avsurg.2025.100385
Ivo Petrov, Zoran Stankov, Petar Polomski
Concerns exist whether the mesh of previously implanted multilayer stents can be crossed with existing interventional devices to treat endovascularly de novo stenotic lesions in covered aortic side branches. We describe the endovascular procedures used to treat three symptomatic patients (two male, one female; mean age: 69 years) who had undergone treatment for thoracoabdominal aortic aneurysms with multilayer stents a mean of 40 months earlier. The procedure involved six general steps: 1) using a brachial approach to navigate a 6 Fr Judkins Right guiding catheter close to the target branch ostium; 2) crossing the stent’s mesh covering the targeted side-branch ostium with a high-torque soft-tip guidewire; 3) advancing a low-profile, semicompliant 2-mm coronary balloon across the mesh and dilating it; 4) exchanging the 2-mm for a 3- or 4-mm noncompliant coronary balloon, and applying the balloon anchor technique to advance the guiding catheter across the mesh to engage it in the branch artery; 5) treating the stenotic lesion with balloon predilatation; and 6) implanting a low-profile, high-radial force stent through the mesh with the side branch stent protruding into the aorta. All target lesions were successfully treated without complications and patent at six-month follow-up. This case series demonstrates that the mesh of previously implanted multilayer stents can be crossed safely with readily available interventional devices using the balloon anchor technique. Endovascular treatment of multilayer stent-covered visceral and renal arteries is possible without the need for open surgery. These findings should be validated in larger studies with longer follow-up.
{"title":"Crossing the mesh of multilayer stents to treat ostial stenosis in aortic side branches","authors":"Ivo Petrov, Zoran Stankov, Petar Polomski","doi":"10.1016/j.avsurg.2025.100385","DOIUrl":"10.1016/j.avsurg.2025.100385","url":null,"abstract":"<div><div>Concerns exist whether the mesh of previously implanted multilayer stents can be crossed with existing interventional devices to treat endovascularly de novo stenotic lesions in covered aortic side branches. We describe the endovascular procedures used to treat three symptomatic patients (two male, one female; mean age: 69 years) who had undergone treatment for thoracoabdominal aortic aneurysms with multilayer stents a mean of 40 months earlier. The procedure involved six general steps: 1) using a brachial approach to navigate a 6 Fr Judkins Right guiding catheter close to the target branch ostium; 2) crossing the stent’s mesh covering the targeted side-branch ostium with a high-torque soft-tip guidewire; 3) advancing a low-profile, semicompliant 2-mm coronary balloon across the mesh and dilating it; 4) exchanging the 2-mm for a 3- or 4-mm noncompliant coronary balloon, and applying the balloon anchor technique to advance the guiding catheter across the mesh to engage it in the branch artery; 5) treating the stenotic lesion with balloon predilatation; and 6) implanting a low-profile, high-radial force stent through the mesh with the side branch stent protruding into the aorta. All target lesions were successfully treated without complications and patent at six-month follow-up. This case series demonstrates that the mesh of previously implanted multilayer stents can be crossed safely with readily available interventional devices using the balloon anchor technique. Endovascular treatment of multilayer stent-covered visceral and renal arteries is possible without the need for open surgery. These findings should be validated in larger studies with longer follow-up.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 2","pages":"Article 100385"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211912","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 : 2025-06-01DOI: 10.1016/j.avsurg.2025.100386
Sujay Edavalapati , Charles Hamilton , Steve I. Curtiss
Background
True brachial artery aneurysms (BAA) are considerably rare dilatations of the brachial artery, including all three layers of the vessel wall, which can have potentially devastating limb-threatening complications.4 The gold standard of treatment remains as open surgical resection, oftentimes requiring the utilization of autogenous or prosthetic conduit. We present a case of idiopathic true left brachial aneurysm in a 28-year-old female treated with excision and primary repair.
Methods
A 28-year-old female initially presents with an incidentally found pulsatile mass in her left arm. She was asymptomatic and incidentally noticed a lump which was found to be the aneurysm on further imaging workup. There was no other abnormal pulsatility noticed concerning aneurysms of other sites i.e., femoral, popliteal, abdominal, contra brachial. She denied a history of trauma to the area and injection and denied a family history of connective tissue disorder. Further workup, including duplex ultrasound and MRA, confirmed a true brachial artery aneurysm without evidence of aneurysms in the remainder of the body. The aneurysm was treated with surgical excision and primary repair with pathology negative for any connective tissue disorder.
Results
Postoperatively, the patient recovered well and was discharged on post-op day 2. Pathology report was negative for any connective tissue abnormalities and genetic testing without causative factors. On follow-up, the patient has been doing well on an aspirin with palpable distal pulses.
Conclusions
True brachial artery aneurysms are estimated to have an incidence of 0.17 %5 and represent an exceedingly uncommon cause of limb-threatening sequelae if not treated. Those identified should undergo thorough investigation, including genetic testing and imaging for other aneurysms. Surgical excision and repair with or without a conduit (autogenous or prosthetic) remain the gold standard of treatment with documented good outcomes.
{"title":"Idiopathic brachial artery true aneurysm in 28-year-old female","authors":"Sujay Edavalapati , Charles Hamilton , Steve I. Curtiss","doi":"10.1016/j.avsurg.2025.100386","DOIUrl":"10.1016/j.avsurg.2025.100386","url":null,"abstract":"<div><h3>Background</h3><div>True brachial artery aneurysms (BAA) are considerably rare dilatations of the brachial artery, including all three layers of the vessel wall, which can have potentially devastating limb-threatening complications.<sup>4</sup> The gold standard of treatment remains as open surgical resection, oftentimes requiring the utilization of autogenous or prosthetic conduit. We present a case of idiopathic true left brachial aneurysm in a 28-year-old female treated with excision and primary repair.</div></div><div><h3>Methods</h3><div>A 28-year-old female initially presents with an incidentally found pulsatile mass in her left arm. She was asymptomatic and incidentally noticed a lump which was found to be the aneurysm on further imaging workup. There was no other abnormal pulsatility noticed concerning aneurysms of other sites i.e., femoral, popliteal, abdominal, contra brachial. She denied a history of trauma to the area and injection and denied a family history of connective tissue disorder. Further workup, including duplex ultrasound and MRA, confirmed a true brachial artery aneurysm without evidence of aneurysms in the remainder of the body. The aneurysm was treated with surgical excision and primary repair with pathology negative for any connective tissue disorder.</div></div><div><h3>Results</h3><div>Postoperatively, the patient recovered well and was discharged on post-op day 2. Pathology report was negative for any connective tissue abnormalities and genetic testing without causative factors. On follow-up, the patient has been doing well on an aspirin with palpable distal pulses.</div></div><div><h3>Conclusions</h3><div>True brachial artery aneurysms are estimated to have an incidence of 0.17 %<sup>5</sup> and represent an exceedingly uncommon cause of limb-threatening sequelae if not treated. Those identified should undergo thorough investigation, including genetic testing and imaging for other aneurysms. Surgical excision and repair with or without a conduit (autogenous or prosthetic) remain the gold standard of treatment with documented good outcomes.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 2","pages":"Article 100386"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194459","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 : 2025-06-01DOI: 10.1016/j.avsurg.2025.100388
Hoi Yee Annie Lo , Pouria Parsa
The COVID-19 pandemic has affected over 60 million individuals globally, resulting in >15 million deaths. While the virus predominantly targets the respiratory system, it can also affect other organ systems, including the cardiovascular system. There have been limited reports on COVID-19-associated aortic pathology. We aim to contribute to the current literature by presenting the case of a 70-year-old female from Southern California with post-COVID-19 inflammatory aortitis.
The patient, who had been diagnosed with COVID-19 without respiratory symptoms, initially presented with failure to thrive. A comprehensive workup revealed rapidly progressing penetrating aortic ulcers involving the ascending and descending thoracic aorta as well as the infrarenal abdominal aorta. Within two weeks, these ulcers evolved into saccular aneurysms measuring up to 4 cm. After evaluating surgical repair versus medical therapy, the patient and family collectively elected to pursue nonoperative management with high-dose pulse corticosteroids with close observation. Under this regimen, the aneurysms showed slight growth but remained below 6 cm, with no immediate need for surgical intervention.
This case underscores the potential for life-threatening vascular complications of COVID-19 and highlights the importance of early recognition and individualized treatment strategies. As our understanding of COVID-19-associated vascular inflammation evolves, further studies are needed to refine management approaches and improve outcomes for affected patients.
{"title":"A rare presentation of post COVID-19 inflammatory aortitis","authors":"Hoi Yee Annie Lo , Pouria Parsa","doi":"10.1016/j.avsurg.2025.100388","DOIUrl":"10.1016/j.avsurg.2025.100388","url":null,"abstract":"<div><div>The COVID-19 pandemic has affected over 60 million individuals globally, resulting in >15 million deaths. While the virus predominantly targets the respiratory system, it can also affect other organ systems, including the cardiovascular system. There have been limited reports on COVID-19-associated aortic pathology. We aim to contribute to the current literature by presenting the case of a 70-year-old female from Southern California with post-COVID-19 inflammatory aortitis.</div><div>The patient, who had been diagnosed with COVID-19 without respiratory symptoms, initially presented with failure to thrive. A comprehensive workup revealed rapidly progressing penetrating aortic ulcers involving the ascending and descending thoracic aorta as well as the infrarenal abdominal aorta. Within two weeks, these ulcers evolved into saccular aneurysms measuring up to 4 cm. After evaluating surgical repair versus medical therapy, the patient and family collectively elected to pursue nonoperative management with high-dose pulse corticosteroids with close observation. Under this regimen, the aneurysms showed slight growth but remained below 6 cm, with no immediate need for surgical intervention.</div><div>This case underscores the potential for life-threatening vascular complications of COVID-19 and highlights the importance of early recognition and individualized treatment strategies. As our understanding of COVID-19-associated vascular inflammation evolves, further studies are needed to refine management approaches and improve outcomes for affected patients.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 2","pages":"Article 100388"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144231700","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}
Finding suitable vascular access for dialysis is a significant challenge in advanced kidney failure. Patients with end-stage renal disease (ESRD) need urgent lower extremity vascular access. This study compares the outcomes of Femoral vein transposition (FVT) and Arterovenous Grafts (AVG) in patients without viable upper limb access, in alignment with KDOQI guidelines and individualized Life Plan strategies.
Materials and Methods
A retrospective study involving 52 patients with end-stage renal disease (ESRD) and no suitable upper extremity access, including those with suitable femoral veins or adequate lower extremity vasculature, analyzed either FVT (n = 26) or lower extremity AVG (n = 26) over a one-year period. The procedure involved freeing the femoral vein, transferring it to a subcutaneous tunnel in the thigh, and connecting it to the femoral artery. Outcomes measured were success rate, complications, and primary and secondary patency rates over nine months.
Results
In our study, 26 patients were evaluated, comprising 14 (53.8 %) males and 12 (46.2 %) females. The mean age of the patients was 60.32 years. At the 9-month follow-up, successful dialysis was achieved in 92.3 % of FVT cases compared to 53.8 % of AVG cases (p = 0.001). Primary patency was significantly higher in FVT (84.6 %) than AVG (50 %) (p = 0.01). Notably, no thrombosis or infection occurred in FVT patients, whereas the AVG group experienced 26.9 % thrombosis and 11.5 % infection. Wound healing complications were more frequent in the FVT group (42.3 % vs. 15.4 %, p = 0.032), though all resolved with conservative
Discussion
The FVT procedure has shown a high success rate and low complication rate, making it a viable option for patients lacking upper extremity vascular access. However, its complexity and limited familiarity among practitioners have hindered broader adoption. Our findings confirm that with proper training, FVT can significantly benefit patients with advanced chronic kidney disease (CKD) who need reliable dialysis access, highlighting its potential to the medical community.
Conclusion
Our study demonstrated that AVG remains a viable option when FVT is contraindicated. FVT is a low-complication and reliable method for establishing dialysis access in patients with no upper extremity vascular access.
{"title":"Comparing the outcomes of femoral vein transposition versus lower extremity arteriovenous graft in dialysis patients with exhausted upper extremity access","authors":"Hossein Hemmati , Mohammad Taghi Ashoobi , Seyyed Mostafa Zia Ziabari , Habib Eslami Kenarsari , Mohaya Farzin , Sepideh Atef Rad","doi":"10.1016/j.avsurg.2025.100387","DOIUrl":"10.1016/j.avsurg.2025.100387","url":null,"abstract":"<div><h3>Introduction</h3><div>Finding suitable vascular access for dialysis is a significant challenge in advanced kidney failure. Patients with end-stage renal disease (ESRD) need urgent lower extremity vascular access. This study compares the outcomes of Femoral vein transposition (FVT) and Arterovenous Grafts (AVG) in patients without viable upper limb access, in alignment with KDOQI guidelines and individualized Life Plan strategies.</div></div><div><h3>Materials and Methods</h3><div>A retrospective study involving 52 patients with end-stage renal disease (ESRD) and no suitable upper extremity access, including those with suitable femoral veins or adequate lower extremity vasculature, analyzed either FVT (<em>n</em> = 26) or lower extremity AVG (<em>n</em> = 26) over a one-year period. The procedure involved freeing the femoral vein, transferring it to a subcutaneous tunnel in the thigh, and connecting it to the femoral artery. Outcomes measured were success rate, complications, and primary and secondary patency rates over nine months.</div></div><div><h3>Results</h3><div>In our study, 26 patients were evaluated, comprising 14 (53.8 %) males and 12 (46.2 %) females. The mean age of the patients was 60.32 years. At the 9-month follow-up, successful dialysis was achieved in 92.3 % of FVT cases compared to 53.8 % of AVG cases (<em>p</em> = 0.001). Primary patency was significantly higher in FVT (84.6 %) than AVG (50 %) (<em>p</em> = 0.01). Notably, no thrombosis or infection occurred in FVT patients, whereas the AVG group experienced 26.9 % thrombosis and 11.5 % infection. Wound healing complications were more frequent in the FVT group (42.3 % vs. 15.4 %, <em>p</em> = 0.032), though all resolved with conservative</div></div><div><h3>Discussion</h3><div>The FVT procedure has shown a high success rate and low complication rate, making it a viable option for patients lacking upper extremity vascular access. However, its complexity and limited familiarity among practitioners have hindered broader adoption. Our findings confirm that with proper training, FVT can significantly benefit patients with advanced chronic kidney disease (CKD) who need reliable dialysis access, highlighting its potential to the medical community.</div></div><div><h3>Conclusion</h3><div>Our study demonstrated that AVG remains a viable option when FVT is contraindicated. FVT is a low-complication and reliable method for establishing dialysis access in patients with no upper extremity vascular access.</div></div>","PeriodicalId":72235,"journal":{"name":"Annals of vascular surgery. Brief reports and innovations","volume":"5 2","pages":"Article 100387"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144239693","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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