Vasc Endovascular Surg [JOURNAL]
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200 papers
Pulmonary Aneurysmal Arteriovenous Malformation Treated With a Vascular Plug.
Gonzalez-Urquijo M, Marchesini M, Marine L … +4 more , Vargas JF, Bergoeing M, Mertens R, Valdes F
Vasc Endovascular Surg · 2025 Feb · PMID 39311420 · Publisher ↗
PURPOSE: To report a case of an asymptomatic patient with a pulmonary aneurysmal arterio-venous malformation successfully treated with a vascular plug. CASE REPORT: An active 30-year-old male patient, residing at 3000 ft...
PURPOSE: To report a case of an asymptomatic patient with a pulmonary aneurysmal arterio-venous malformation successfully treated with a vascular plug. CASE REPORT: An active 30-year-old male patient, residing at 3000 ft above sea level was referred due to an incidental finding on a CT scan of a 37 mm vascular mass localized in the lower lobe of the right lung, which corresponded to a pulmonary arteriovenous malformation with a single feeding artery. The patient was treated with an Amplatzer vascular plug, which effectively excluded the afferent vessel. An angio CT at 19 months follow-up revealed a hypodense residual mass of 9.0 mm in diameter with no arterial filling or venous drainage. The patient is fully active and remains asymptomatic at 24 months follow-up. CONCLUSION: An unusual case of a pulmonary aneurysmal arteriovenous malformation successfully treated with a vascular plug is presented, highlighting the efficiency of this procedure.
The Efficiency of Preoperative Embolization in the Management of Shamblin Type III Carotid Body Tumor: A Single-Center Retrospective Study.
Lu H, Wu Z, Wei W … +1 more , Lu X
Vasc Endovascular Surg · 2025 Feb · PMID 39308096 · Publisher ↗
BACKGROUND: This study aims to determine the efficacy and safety of preoperative embolization in the management of Shamblin type III carotid body tumors (CBT). METHOD: In this retrospective study, patients with Shamblin...
BACKGROUND: This study aims to determine the efficacy and safety of preoperative embolization in the management of Shamblin type III carotid body tumors (CBT). METHOD: In this retrospective study, patients with Shamblin type III CBT were included between January 2005 and January 2017. A total of 48 Patients were divided into preoperative embolization (SRE, n = 25) and non-preoperative embolization group (SR, n = 23). RESULT: Mean surgical time (145.24 ± 19.86 min vs 186.91 ± 17.808 min, < 0.05) and intraoperative blood loss (271.4 ± 73.001 mL vs 380.36 ± 39.822 mL, < 0.05) were markedly reduced in the SRE group compared with SR group. The preoperative tumor volume in the SRE group was larger than that in the SR group, but the volume was similar between the two groups after surgery. The number of tumor residual cases was higher in the SR group. The incidence of complications and duration of hospitalization were comparable between the two groups. CONCLUSION: This study demonstrates the efficacy of preoperative embolization in reducing the duration of surgery and volume of blood loss during the process of CBT resection. More prospective, well-designed studies are urgently needed to validate the current findings.
Study Protocol for a Focus Group Discussion About the Patients' Perspective on Carotid Endarterectomy.
Marsman MS, Koning GG, Jansen BPW … +3 more , Reijnen MMPJ, Habibovic M, Vriens PWHE
Vasc Endovascular Surg · 2025 Apr · PMID 39305507 · Full text
INTRODUCTION: The outcomes of carotid surgery are commonly evaluated using parameters such as mortality and stroke. The importance of these parameters is based on doctors' and scientific perspectives. Presently, patient...
INTRODUCTION: The outcomes of carotid surgery are commonly evaluated using parameters such as mortality and stroke. The importance of these parameters is based on doctors' and scientific perspectives. Presently, patient centered health care aims to value the evaluation from patients' perspective, mostly using Patient-Reported Outcomes (PROs). The true significance of outcomes of carotid surgery that matter most to the patients is largely unknown. The aim of this study is to identify and verify the patients' perspective on carotid surgery for patients with a symptomatic and significant carotid stenosis. METHODS AND OUTCOMES: An exploratory semi-structured focus group discussion will be used, as a quality research method. Three groups consisting of 8 patients ( = 24), who underwent the carotid endarterectomy because of a significant and symptomatic stenosis of the internal carotid artery, will be enrolled. If data saturation is not reached, the sample size will be expanded. An expert medical psychologist will lead the focus group discussions. The interviews will be recorded, transcribed 'verbatim' and analyzed after each session. Items valuable to patients regarding their surgery and recovery will be discussed. This protocol will be published prior to the start of the Focus Group Discussion. DISCUSSION: Patients' perspective on outcomes regarding their carotid surgery will be explored and tried to be identified. The results of the focus group discussions may fuel the ongoing global discussion on improving evidence based and patient reported outcome measures and will help the clinical physician to 'understand' their patients better. Focus group discussions may aid in the purpose of verification of PROs and PROMs.
Axillary to Lateral Above Knee Popliteal Artery Bypass: An Alternative Approach to Lower Extremity Revascularization.
Nguyen T, Tenewitz P, Shames M … +1 more , Parikh R
Vasc Endovascular Surg · 2025 Feb · PMID 39305280 · Publisher ↗
OBJECTIVE: Management of limb ischemia in the setting of malignancy with history of resection and/or radiation presents a unique challenge. Radiation arteritis contributing to limb ischemia may not respond to endovascula...
OBJECTIVE: Management of limb ischemia in the setting of malignancy with history of resection and/or radiation presents a unique challenge. Radiation arteritis contributing to limb ischemia may not respond to endovascular intervention. Furthermore, significant tissue scarring from extensive resection and/or radiation can increase the risk of complications with open intervention and limit revascularization options. Utilization of an axillary to popliteal artery bypass using a lateral approach to the popliteal artery has been described as a reasonable alternative in these challenging cases. CASE REPORT: The patient is a 68-year-old male with history of liposarcoma of the left groin, scrotum, and medial thigh for which he underwent multiple resections, flap reconstruction, and skin graft. He had a recurrence 2 years later and underwent repeat resection, placement of brachytherapy catheters, vertical rectus abdominal flap, and external beam radiation. He now presents with Rutherford 2B acute limb ischemia with associated left foot drop. Computed tomography angiography was performed and revealed an occluded left common femoral artery stent, proximal left superficial and deep femoral artery occlusion, and thrombosis of the left femoral vein. An attempt was made at endovascular recanalization without success. He subsequently underwent left axillary-to-lateral above knee popliteal artery bypass with a 6 mm ringed polytetrafluoroethylene graft, tibial thrombectomy, and 4 compartment fasciotomy. RESULTS: Post-operatively, his pain resolved. He continued to have left foot drop but recovered his ability to ambulate with a walker. He was ultimately discharged on post-operative day 11 to an inpatient rehabilitation facility on aspirin and apixaban. CONCLUSION: Hostile groin secondary to infection, malignancy requiring resection/radiation presents a unique challenge for revascularization. When endovascular revascularization or obturator bypass are not feasible options, axillary-to-lateral above knee popliteal artery bypass is a described, feasible alternative approach to restore blood flow in this challenging patient population.
Endovascular Embolization of Aneurysmal Renal Arteriovenous Malformation.
Ghahremani JS, Chapek MA, Singh Rana SS … +4 more , Lee J, Safran BA, Lau DL, Brewer MB
Vasc Endovascular Surg · 2025 Feb · PMID 39302121 · Publisher ↗
Renal arteriovenous malformations (AVM) represent an uncommon vascular condition characterized by an abnormal direct communication between an intrarenal artery and vein. Though asymptomatic in many individuals, treatment...
Renal arteriovenous malformations (AVM) represent an uncommon vascular condition characterized by an abnormal direct communication between an intrarenal artery and vein. Though asymptomatic in many individuals, treatment is often indicated if the AVM causes flank pain, hematuria, or medically refractory hypertension, or if there is an associated renal artery aneurysm. We present a case of a large right renal AVM with associated renal artery aneurysm and large varix which was incidentally found on magnetic resonance imaging of the spine. Endovascular and open surgical options were considered, including ex-vivo renal vascular reconstruction and nephrectomy. The patient was successfully treated with endovascular embolization of the AVM with coil packing of the arterial aneurysm and inflow artery. The patient recovered uneventfully with well-maintained renal function and blood pressure control. We review and discuss the literature on the etiology and treatment options for renal AVM.
Endovascular Recanalization in Patients With Vertebral Artery Stump Syndrome: A Single-Center Experience.
Ji R, Chen H, Xu Z … +1 more , Luo B
Vasc Endovascular Surg · 2025 Feb · PMID 39300718 · Publisher ↗
BACKGROUND: To evaluate the feasibility, success rate, and safety of endovascular revascularization of patients with vertebral artery stump syndrome (VASS). METHODS: This single-center retrospective study analyzed clinic...
BACKGROUND: To evaluate the feasibility, success rate, and safety of endovascular revascularization of patients with vertebral artery stump syndrome (VASS). METHODS: This single-center retrospective study analyzed clinical and imaging data from consecutive patients with VASS who underwent endovascular recanalization from January 2020 until June 2023. RESULTS: Our study enrolled 30 patients [mean age 69 (range 51-84) years; 26 men]. The rate of successful technical revascularization was 96.7% (n = 29), and the rate of complications was 3.3% (n = 1). At the 6-month follow-up, the patients with successful endovascular revascularization of VASS did not have any neurological symptoms, and computed tomography angiography showed 3/29 (10.3%) re-occlusions and 4/29 (13.8%) restenosis of the stent, which was confirmed by digital subtraction angiography. CONCLUSIONS: Endovascular recanalization in patients with VASS is feasible in selected patients and has a high procedural success rate and low rate of complications. A large, multicenter, randomized study is warranted to confirm these findings.
Persistent Sciatic Artery Aneurysm With Distal Embolization Treated Endovascular - A Case Report.
Rasmussen ATN, Duvnjak S
Vasc Endovascular Surg · 2025 Apr · PMID 39293066 · Publisher ↗
Persistent sciatic artery (PSA) is a rare embryologic remnant of the internal iliac artery variant with an estimated incidence of 0.03-0.06 %. Aneurysmatic formation can give rise to neurological sciatic nerve compressio...
Persistent sciatic artery (PSA) is a rare embryologic remnant of the internal iliac artery variant with an estimated incidence of 0.03-0.06 %. Aneurysmatic formation can give rise to neurological sciatic nerve compression symptoms or thromboembolic and ischemic symptoms. The present is a case with recurrent thromboembolic symptoms and PSA aneurysm, successfully treated endovascularly.
A Prosthetic Conduit can be Used Safely for TransCarotid Artery Revascularization Under Local Anesthesia in High-Risk Patients.
Lu J, McCabe K, Drucker C … +3 more , Blitzer D, Nagarsheth K, Toursavadkohi S
Vasc Endovascular Surg · 2025 Feb · PMID 39292960 · Publisher ↗
Surgical management of carotid stenosis has evolved from open carotid endarterectomy (CEA) to include multiple alternative procedures including transfemoral carotid artery stenting (tfCAS) and transcarotid artery stentin...
Surgical management of carotid stenosis has evolved from open carotid endarterectomy (CEA) to include multiple alternative procedures including transfemoral carotid artery stenting (tfCAS) and transcarotid artery stenting. In recent years, Transcarotid Artery Revascularization (TCAR) has emerged as a third option, combining open cut down to the common carotid artery (CCA) with endovascular stenting and neuroprotection via reversal of cerebral blood flow. In this case series, a modified TCAR procedure using a prosthetic conduit was successfully performed exclusively under local anesthesia in a total of 10 patients with carotid artery stenosis, high cardiac risk, and anatomical contraindications to a traditional TCAR.
A Rare Case of Pulmonary Artery Trunk Aneurysm.
De Jesus Ferreira H, Ferreira Borges JA, Simões Galini Schwarz De Andrade N … +3 more , De Castro JT, Reis F, Daruich De Souza C
Vasc Endovascular Surg · 2025 Feb · PMID 39291664 · Publisher ↗
BACKGROUND: Pulmonary artery trunk aneurysm (PATA) is a rare and complex vascular anomaly characterized by the abnormal dilation of the initial portion of the pulmonary artery, posing significant diagnostic and therapeut...
BACKGROUND: Pulmonary artery trunk aneurysm (PATA) is a rare and complex vascular anomaly characterized by the abnormal dilation of the initial portion of the pulmonary artery, posing significant diagnostic and therapeutic challenges. PURPOSE: This clinical case report aims to describe the follow-up of a patient with PATA, emphasizing the role of imaging in diagnosis and monitoring, as well as discussing potential associations with other conditions. RESEARCH DESIGN: The study is designed as a clinical case report, detailing the longitudinal follow-up of a single patient with PATA. STUDY SAMPLE: The subject of this study is a 48-year-old female patient with a history of idiopathic hypertension who developed a PATA. Since 2010, the patient underwent various imaging exams, including echocardiography, computed tomography, and catheter angiography, to detect and evaluate the aneurysm at different stages. RESULTS: The imaging results indicated a progression of the aneurysm over time, underscoring the importance of imaging in the early identification and monitoring of PATA. The report also explores the possible association of PATA with conditions such as pulmonary hypertension, Behçet's disease, and Hughes-Stovin syndrome, highlighting the diagnostic complexity. CONCLUSIONS: Imaging diagnosis is crucial for the detection, characterization, and monitoring of PATA, providing essential information for selecting appropriate treatment options and achieving a satisfactory prognosis. An individualized treatment approach, considering both medical and surgical options, is necessary based on the clinical characteristics of each patient.
Surgical Treatment of Superior Vena Cava Syndrome in a Preterm Neonate.
Alpat S, Alma M
Vasc Endovascular Surg · 2025 Feb · PMID 39283806 · Publisher ↗
Superior vena cava syndrome is rare and challenging clinical entity in neonates. Medical treatment options are usually effective. However, when failed, surgery is warranted. Herein, we present a preterm neonate with SVC...
Superior vena cava syndrome is rare and challenging clinical entity in neonates. Medical treatment options are usually effective. However, when failed, surgery is warranted. Herein, we present a preterm neonate with SVC syndrome and associated chylothorax. When 2 weeks old, he underwent successful open thrombectomy and SVC reconstruction under cardiopulmonary bypass. Immediately after the operation findings of SVC syndrome and chylotorax were completely resolved. To our knowledge, this patient is the smallest baby underwent open SVC reconstruction with cardiopulmonary bypass.
Bow Hunter Phenomenon From Advanced Cerebrovascular Disease Treated With Subclavian Artery Stenting and Carotid Endarterectomy.
Dong HW, Ghahremani JS, Singh Rana SS … +3 more , Safran BA, Lau DL, Brewer MB
Vasc Endovascular Surg · 2025 Feb · PMID 39269683 · Publisher ↗
Bow Hunter syndrome (BHS) is a rare disorder characterized by mechanical occlusion of the vertebral artery (VA) during neck rotation, resulting in symptomatic, transient, and positional vertebrobasilar insufficiency. We...
Bow Hunter syndrome (BHS) is a rare disorder characterized by mechanical occlusion of the vertebral artery (VA) during neck rotation, resulting in symptomatic, transient, and positional vertebrobasilar insufficiency. We describe a case of a 76-year-old female who presented with dizziness and right ear tinnitus triggered by right head rotation. Her symptoms would immediately resolve upon returning her head to the neutral position. CT angiogram showed 80% stenosis of the left subclavian artery origin, 50%-70% stenosis of the proximal right internal carotid artery (ICA), and near occlusive stenoses of the origins of the bilateral VAs. After failing conservative management, the patient was treated with left subclavian artery stenting, followed by a right carotid endarterectomy (CEA) 6 weeks later. Follow-up at 1 month showed resolution of paroxysmal symptoms and no neurological sequelae. To our knowledge, there have not yet been reported cases of patients with concurrent BHS, subclavian artery stenosis, and carotid artery stenosis. We suggest that global revascularization via subclavian artery stenting and CEA may be considered as treatment for patients with BHS complicated by other cerebrovascular disease secondary to stenoses of the ICA and subclavian artery. This approach obviates the need for more complex surgery or endovascular intervention of the VA.
The Efficacy of Radiofrequency Ablation for the Treatment of Symptomatic Varicose Veins of Lower Limbs.
Butt MA, Avabde D, Cheema MU … +4 more , Raza T, Latif A, Leechong P, Miah MMR
Vasc Endovascular Surg · 2025 Feb · PMID 39264598 · Publisher ↗
BACKGROUND: Radiofrequency ablation (RFA) is a minimally invasive treatment for lower limb varicose veins. Studies indicate that RFA results in immediate occlusion of 90%-100% of treated long saphenous veins. Evidence su...
BACKGROUND: Radiofrequency ablation (RFA) is a minimally invasive treatment for lower limb varicose veins. Studies indicate that RFA results in immediate occlusion of 90%-100% of treated long saphenous veins. Evidence suggests that post-operative scans rarely alter patient management or outcomes. OBJECTIVE: The aim of this study was to assess the potential necessity of routine postoperative scanning in the treatment of varicose veins. METHOD: Retrospective data were collected for the patients who had RFA under a single consultant from November 2015 to June 2018. Descriptive statistics were calculated to summarize patient demographics, procedural details, and outcome measures. RESULTS: A total of 124 patients underwent radiofrequency ablation (RFA). Most of the patients (n = 114, 92%) demonstrated complete ablation, indicating a high success rate for the procedure. CONCLUSION: This study suggested that routine postoperative scanning should be discontinued as this did not alter patient management in over 99% of cases. The resources currently used for postoperative scans could be redirected towards other critical areas.
Abernethy Malformation and Gastrointestinal Bleeding: A Case Report and Literature Review.
Li W, Liu B, Feng H
Vasc Endovascular Surg · 2025 Feb · PMID 39262296 · Publisher ↗
Congenital extrahepatic portosystemic shunt (CEPS), also termed Abernethy malformation (AF) is a rare anomaly of the splanchnic venous system. Several approaches, including shunt closures through surgical or radiological...
Congenital extrahepatic portosystemic shunt (CEPS), also termed Abernethy malformation (AF) is a rare anomaly of the splanchnic venous system. Several approaches, including shunt closures through surgical or radiological interventions and liver transplantations, have been proposed, but clear comparisons among different treatment strategies are still unavailable. We report a case in which an unusual portosystemic shunt was present between the dilated inferior mesenteric vein (IMV) to the right ovarian vein. A mini literature review of AF patients presented with gastrointestinal (GI) tract bleeding. Research design: Case report and literature review. An electronic search of PubMed was performed from inception to December 2023. 34 AF patients presented with GI tract bleeding were identified published in the literature. The proportion of type II AF patients presenting with GI bleeding is greater (79%). We regard that both surgical ligation and endovascular closure of the shunt are effective and safe treatments for these patients, but coils embolization alone may not be sufficient to completely close the shunt when the shunt flow is high.
Clinical Efficiency and Safety of Radiofrequency Ablation for Treating Incompetent Great Saphenous Veins in Aged Patients.
Chen Y, Zhou L, Gu Y … +2 more , Wang X, Sun J
Vasc Endovascular Surg · 2025 Feb · PMID 39259821 · Publisher ↗
INTRODUCTION: Few studies have focused on the safety and efficacy of radiofrequency ablation (RFA) in treating incompetent great saphenous vein (GSV) in aged population. This study was designed to investigate the clinica...
INTRODUCTION: Few studies have focused on the safety and efficacy of radiofrequency ablation (RFA) in treating incompetent great saphenous vein (GSV) in aged population. This study was designed to investigate the clinical efficacy of RFA in treating incompetent GSV in the aged patients. METHODS: In this retrospective study, we included 138 consecutive patients (involving 194 limbs) with a mean age of 63.0 years who underwent RFA and microphlebectomy or sclerotherapy due to symptomatic incompetent GSV with saphenofemoral junction reflux. Based on their ages, patients were classified into young group and aged group. Then we compared the preoperative and postoperative Clinical, Etiology, Anatomic, Pathophysiology (CEAP) classification, venous clinical severity score (VCSS) and chronic venous insufficiency questionnaire 14 (CIVIQ-14) score between the 2 groups. RESULTS: In both the young and aged groups, patients underwent RFA showed significant decrease in the CEAP and VCSS at month 1, 3 and 6 compared with immediately after RFA (month 0) (all < .001). In addition, in both groups, significant increase was seen in the CIVIQ-14 score at month 1, 3 and 6 compared with month 0 (all < .001). Compared with the young group, the post-RFA CEAP, VCSS and CIVIQ-14 scores showed no statistical differences in the aged group at the designated time points, respectively (all > .05). CONCLUSIONS: RFA of GSV was effective for treating GSV in the aged population, which improved the CEAP, VCSS and CIVIQ-14.
Pulmonary Artery Endograft Implantation Using a Parallel Stent Grafting Technique to Enable the Treatment of a Bronchial Anastomosis Complication After Lung Transplantation.
Schmid BP, Scordamaglio PR, Samano MN … +5 more , Cunha MJS, Valle LGM, Galastri FL, Nasser F, Affonso BB
Vasc Endovascular Surg · 2025 Feb · PMID 39256060 · Publisher ↗
BACKGROUND: Bronchial stenosis associated with bronchial anastomosis dehiscence after lung transplantation is a catastrophic complication following lung transplantation with a paucity of therapeutic solutions. PURPOSE: T...
BACKGROUND: Bronchial stenosis associated with bronchial anastomosis dehiscence after lung transplantation is a catastrophic complication following lung transplantation with a paucity of therapeutic solutions. PURPOSE: To describe an adaptation of the parallel stent grafting technique in the pulmonary arterial territory to treat this challenging situation. RESEARCH DESIGN: This is a case report of a 52-year-old patient who presented bronchus stenosis and bronchial anastomosis dehiscence after lung transplantion. Bronchial stenting and lung retransplantation were contraindicated. Therefore, an endovascular approach using pulmonary artery endograft placement to prevent bleeding during repeated right bronchial balloon dilation was propposed. The technique consists of the deployment of an aortic extender endoprosthesis in the right main pulmonary artery and a balloon expandable stent in the upper lobe pulmonary artery (using a parallel graft configuration) through the common femoral and right internal jugular veins, respectively. Intraoperative transesophageal echocardiogram and one-lung ventilatory ventilation are needed. RESULTS: The patient underwent a new bronchoscopy 16 days after the procedure, that showed epithelization at the previous eroded zone, enabling bronchocopic balloon dialtion to be safely performed. A post-operative contrast-enhanced CT scan revealed an adequate positioning of the stent grafts. Despite all eforts, the patient succumbed to ventilator associated pneumonia on postoperative day 108. DATA ANALYSIS: The technique's advantages include its feasibility even in situations in which other techniques may be contraindicated and its potential use in emergencies. Its limitations include the need for experienced interventionists to perform it, and the potential risk of acute tricuspid regurgitation. CONCLUSION: This study illustrates the early feasibility of the parallel stent grafting technique applied to the pulmonary artery territory. However, it's safety profile regarding infectious risk was not demontrated.
Endovascular Treatment of Aortoiliac Aneurysms With the Bell-Bottom Technique: A Systematic Review and Meta-Analysis.
Volteas P, Giannopoulos S, Koudounas G … +4 more , Asencio A, Chandrashekar A, Karkos C, Virvilis D
Vasc Endovascular Surg · 2025 Feb · PMID 39254224 · Publisher ↗
OBJECTIVE: Aneurysmal degeneration of the common iliac artery (CIA) can pose a challenge to achieve distal landing zone sealing at the time of endovascular abdominal aortic aneurysm repair (EVAR). The aim of this study w...
OBJECTIVE: Aneurysmal degeneration of the common iliac artery (CIA) can pose a challenge to achieve distal landing zone sealing at the time of endovascular abdominal aortic aneurysm repair (EVAR). The aim of this study was to summarize the current literature regarding the bell-bottom technique (BBT) for ectatic CIAs during EVAR. METHODS: This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Eligible articles were identified through a comprehensive search of PubMed, Scopus, and Cochrane Central published until April 2023. A meta-analysis was conducted using the random effects model and the I statistic was used to assess for heterogeneity. The primary endpoints were type Ib/III endoleak, graft occlusion/limb embolization, and reintervention rate. Secondary endpoints included perioperative adverse events and mortality. RESULTS: Overall, twenty-six studies and 4332 patients with flared limbs were included. The pooled estimate for type Ib/III endoleak was 4% (95% CI: 2-6, I = 85.6%), for reintervention rate was 9% (95% CI: 6-12, I = 90.4%), and for overall mortality was 10% (95% CI: 4-19, I = 97.3%). No aneurysm related deaths were recorded. Comparative analysis showed similar type Ib/III endoleak, graft occlusion, and reintervention rates between the EVAR BBT, iliac branch endoprosthesis (IBE), and embolization of the internal iliac artery followed by extension of the iliac limb to the external iliac artery (EIE) groups. CONCLUSIONS: The use of flared limbs could be considered a reasonable first line choice for EVAR cases with CIA ectasia as it is simpler, allows for future IBE or EIE and does not increase the risk for type Ib/III endoleak or graft occlusion. Further comparative studies with longer follow-up are needed.
Open Surgical Repair in a Patient With Loeys-Dietz Syndrome and Extensive Vascular Compromise: A Case Report and Literature Review.
Polania-Sandoval CA, Farres H, Lanka SP … +1 more , Erben Y
Vasc Endovascular Surg · 2025 Jan · PMID 39254110 · Publisher ↗
Loeys-Dietz syndrome (LDS) has been associated with multiple vascular abnormalities involving the entire arterial tree. However, limited reports regarding compromise in the aortoiliac and femoral bifurcation are availabl...
Loeys-Dietz syndrome (LDS) has been associated with multiple vascular abnormalities involving the entire arterial tree. However, limited reports regarding compromise in the aortoiliac and femoral bifurcation are available. Further, recommendations for optimal approach, thresholds for diameter at the time of surgery, and surveillance are also limited. We present a case of a 67-year-old male patient with LDS and aneurysmal aortoiliac and enlarging common femoral arteries aneurysms, who underwent open surgical repair. His past surgical history included multiple vascular interventions for lower extremity claudication and bilateral hip replacements. The right hip arthroplasty was previously removed due to infection. From the vascular standpoint, the patient underwent staged endovascular left hypogastric artery embolization and open aorto-bi-profunda bypass with a Rifampin-soaked Dacron graft. At 5-month follow-up, he remains asymptomatic with healed incisions and patent bypasses. This case highlights the challenges in managing peripheral aneurysms in LDS patients, emphasizing the need for tailored treatment strategies. While open repair is preferred, endovascular options may be considered in selected cases. Surveillance remains critical with annual cross-sectional imaging. Surgical planning is intricate due to comorbidities, anatomical complexities, and previous surgical infection. Surveillance of these patients must be strict as multiple vascular and non-vascular complications may arise. Therefore, collaborative decision-making is essential for optimal outcomes in this known high-risk population with connective tissue disorders.
Short-Term and Long-Term Fluvastatin Inhibit Effects of Thrombospondin-1 on Human Vascular Smooth Muscle Cells.
Maier K, Helkin A, Stein JJ … +5 more , Yuan HL, Seymour K, Ryabtsev B, Iwuchukwu C, Gahtan V
Vasc Endovascular Surg · 2025 Jan · PMID 39235354 · Publisher ↗
INTRODUCTION: Vascular smooth muscle cells are important in intimal hyperplasia. Thrombospondin-1 is a matricellular protein involved in the vascular injury response. Statins are cholesterol lowering drugs that have bene...
INTRODUCTION: Vascular smooth muscle cells are important in intimal hyperplasia. Thrombospondin-1 is a matricellular protein involved in the vascular injury response. Statins are cholesterol lowering drugs that have beneficial cardiovascular effects. Statis have been shown to inhibit smooth muscle migration through the mevalonate pathway. This effect is thought to be mediated by small G protein Ras and Rho turnover which requires many hours. While many patients undergoing treatment for vascular disease are on statins, many are not. Thus immediate pretreatment with statins before surgery may be beneficial. We hypothesized that statins have effects independent of the mevalonate pathway and thus have an immediate effect. METHODS: Human vascular smooth muscle cells were pretreated for 20 h (long-term) or 20 min (short-term) with fluvastatin, or mevalonolactone plus fluvastatin. Thrombospondin-1-induced migration, activation of p42/p44 extracellular signal-regulated kinase, c-Src, focal adhesion kinase and PI3 kinase was determined. The effect of fluvastatin on thrombospondin-1-induced expression of , , and was examined. RESULTS: Both treatments inhibited thrombospondin-1-induced chemotaxis back to the control group. Mevalonolactone reversed the long-term statin effect by increasing migration but had no effect on the short-term statin response. p42/p44 extracellular signal-regulated kinase was activated by thrombospondin-1 and both treatments augmented activation. Neither treatment affected c-Src activity, but both inhibited focal adhesion kinase and PI3 kinase activity. Only long-term statin treatment inhibited expression while both treatments inhibited and expression. Neither treatment affected . knockdown inhibited thrombospondin-1-induced but not gene expression. CONCLUSION: Long-term fluvastatin inhibited thrombospondin-1-induced chemotaxis through the mevalonate pathway while short-term fluvastatin inhibited chemotaxis through an alternate mechanism. Short-term stains have immediate effects independent of the mevalonate pathway. Acute local treatment with statins followed by longer term therapy may limit the vascular response to injury.
Progressive Acute Lower Extremity Ischemia Resulting From Cardiac Myxoma Embolization: A Case Report.
Boada-Sandoval PM, Bizueto-Rosas H, Martínez-Bravo LE
Vasc Endovascular Surg · 2025 Jan · PMID 39228028 · Publisher ↗
Cardiac myxomas are the most common primary benign tumors of the heart. The occlusion of peripheral arteries and complete obstruction of the abdominal aorta by a tumor embolus presents with distinct clinical manifestatio...
Cardiac myxomas are the most common primary benign tumors of the heart. The occlusion of peripheral arteries and complete obstruction of the abdominal aorta by a tumor embolus presents with distinct clinical manifestations. Herein, we present the case of a 38-year-old male with acute paresthesia, muscle weakness, erythematous, and violaceous changes in skin color localized to the dorsum of the left forefoot initially treated as cutaneous vasculitis. Further studies revealed the total occlusion of the terminal abdominal aorta by a saddle embolus from a cardiac myxoma. A multidisciplinary team consisting of cardiothoracic and vascular surgeons were involved in treating the patient, which resulted in full resolution of the case. This paper details the progression of acute bilateral limb ischemia to chronic limb threatening ischemia resulting from the total occlusion of the terminal abdominal aorta by a saddle embolus.
Prospective Multi-Center Longitudinal Study to Validate Accuracy of the Global Anatomic Staging System (GLASS) Score in Predicting Major Acute Limb Events in Patients With Chronic Limb Threatening Ischemia Undergoing Endovascular Intervention: The PROMOTE-GLASS Study Protocol.
Darwish M, D'Oria M, Croo A … +3 more , Melo RG, Meecham L, European Vascular Research Collaborative (EVRC)
Vasc Endovascular Surg · 2025 Jan · PMID 39226237 · Publisher ↗
INTRODUCTION: Developed by the Global Vascular Guidelines committee, the Global Limb Anatomic Staging System (GLASS) is an angiographic scoring system used for quantifying infrainguinal disease extent and predicting trea...
INTRODUCTION: Developed by the Global Vascular Guidelines committee, the Global Limb Anatomic Staging System (GLASS) is an angiographic scoring system used for quantifying infrainguinal disease extent and predicting treatment success with endovascular techniques (EVT). Currently, no other risk prediction model is available for patients with chronic limb threatening ischemia (CLTI) undergoing EVT. GLASS' validation and adoption outside academic institutions for research are limited. Thus, this longitudinal multicenter prospective study aims to examine GLASS' validity and reliability in predicting major acute limb events and overall survival (OS) in patients with CLTI undergoing EVT. METHODS AND ANALYSIS: This prospective, international, multicenter, observational study will include patients with CLTI undergoing EVT (PROMOTE-GLASS) (ClinicalTrials.gov; ID: NCT06186544) identified through routine clinical referrals and emergency visits to vascular units in participating centers. Only patients who are referred for EVT will be recruited. The primary outcomes are immediate technical success, immediate technical failure, and 1-year limb base patency. The secondary outcomes are major adverse limb events, major lower limb amputation, and OS in patients presenting with CLTI who undergo EVT up to 1 year after the procedure. Clinical and imaging data will be analyzed at the end of follow-up to validate risk prediction. This protocol outlines our approach for identifying cases, GLASS score calculation, outcome measures assessment, and a statistical analysis plan. ANTICIPATED IMPLICATIONS: PROMOTE-GLASS holds significant implications and can potentially revolutionize clinical decision-making by assisting clinicians in identifying patients who are likely to benefit from EVT. Ultimately, reduce the need for more invasive procedures and improve patient outcomes. Furthermore, PROMOTE-GLASS can provide useful information, including patient selection, for future randomized controlled trials (RCTs) investigating EVT for CLTI. PROMOTE-GLASS anticipated implications on the vascular community are rooted in its potential to improve patient care, inform future research, and address limitations in existing literature regarding CLTI treatment outcomes.
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