Daniel Westby, Sara Gasior, Mark Twyford, Megan Power Foley, Aoife Lowery, Stewart R Walsh
OBJECTIVE: Endovenous ablation has revolutionized treatment of varicose vein surgery but is associated with a risk of venous thromboembolism. There is no consensus regarding anticoagulation protocols for these patients. This network meta-analysis (NMA) aims to identify which anticoagulant is optimal in this cohort for clot prevention with minimal risk of adverse bleeding events. METHODS: Library databases were searched for studies where patients were treated with one or more anticoagulants following endovenous ablation for varicose veins...
April 12, 2024: Vascular and Endovascular Surgery
Mauricio Gonzalez-Urquijo, Gerardo Alejandro Fumagal González, Héctor Manuel Cárdenas Castro, Arnulfo Alejandro Morales Guzman, Alan Alejandro Guzman Valladares, Danielle Catherine MacDonald, Marcos David Moya Bencomo, Israel Botello Arredondo, Mario Alejandro Fabiani
OBJECTIVE: The objective of this study was to investigate the flow effects in different degrees of thoracic aortic stent graft protrusion extension by creating bird beak effect simulations using accurate 3D geometry and a realistic, nonlinear, elastic biomechanical model using computer-aided software SolidWorks. METHODS: Segmentation in 3D of an aortic arch from a computed tomography (CT) scan of a real-life patient was performed using SolidWorks. A parametric analysis of three models was performed: (A) Aortic arch with no stent, (B) 3 mm bird-beak configuration, and (C) 6...
April 12, 2024: Vascular and Endovascular Surgery
Raja GnanaDev, Aldin Malkoc, Jeffrey Hsu, Jason Behseresht, Majid Tayyarah, Trung D Vo, Iden Andacheh
INTRODUCTION: Patients with complex aortic anatomy require meticulous surgical planning to optimize intraoperative and postoperative outcomes. The GORE Excluder Conformable Abdominal Aortic Aneurysm Endoprosthesis (CEXC Device, WL Gore and Associates, Flagstaff, AZ) allows for endovascular treatment of highly angulated and short proximal neck abdominal aortic aneurysms (AAA). Owing to its recent approval, short-term clinical outcomes of this device remain scarce. REPORT: In this report, we present a case series of 3 patients who underwent endovascular aortic repair using the GORE Excluder Conformable device with highly angulated (>70°) aortic neck anatomy...
March 25, 2024: Vascular and Endovascular Surgery
Renxi Li, Adham Qurashi, Anton Sidawy, Bao-Ngoc Nguyen
In this letter, we discussed the selection of patients undergoing Transcarotid Artery Revascularization (TCAR) using the Current Procedural Terminology (CPT) codes. We examined a previous study using CPT code 37215 to identify TCAR cases using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. As an ACS-NSQIP participating site, we have complete access to the ACS-NSQIP database, and we performed a more in-depth examination of the method. We found significant discrepancies in the method described and conclude that it is methodologically flawed to use CPT code 37215 to differentiate TCAR cases...
March 25, 2024: Vascular and Endovascular Surgery
Mickael Palmier, Myriam Cherel, Didier Plissonnier
The purpose of this article is to highlight an innovative technique in the surgical management of aortic aneurysms in the presence of a horseshoe kidney. The technique involves an anterograde aortic bypass from the distal thoracic aorta to the major renal artery with the primary advantage to a significant reduction in renal ischemia time.
March 20, 2024: Vascular and Endovascular Surgery
Patrick J Kato, Jesse Kato, Jarred A Napier, Rhami Khorfan, Abdulhameed Aziz
We present a case of an unvaccinated, 43-year-old African American female patient with COVID-19 infection and clinical evidence of a left hemispheric stroke. A non-occlusive thrombus with a radiographic target lesion was identified on computed tomography angiography (CTA). A multi-disciplinary discussion regarding concern for embolization was provided due to its unstable nature, as well as evidence of recent stroke. Given her acute COVID-19 infection, symptomatology, and radiographic findings, it was concluded that the etiology of her stroke appeared most consistent with a hypercoagulable-related embolism rather than an atheroembolic event...
March 18, 2024: Vascular and Endovascular Surgery
Kensuke Fujioka, Yuji Nishida, Yuya Eguchi, Takashi Fujita, Katsuharu Uchiyama, Manabu Fujimoto
BACKGROUND: Vascular graft infection is a very complex disease. Although complete excision of the infected grafts with extra-anatomic bypass or in situ reconstruction is a general treatment strategy, some concerns including reinfection in the new graft remain. CASE REPORT: An 88 year-old man presented to the hospital with abdominal swelling and bleeding. The patient had undergone revascularization for aorto-iliac occlusive disease twice in the past. The first procedure had been performed 15 years previously, with right ilio-femoral bypass grafting for right iliac artery occlusion and stent implantation for left iliac artery stenosis...
March 16, 2024: Vascular and Endovascular Surgery
Yu-Ying Lu, Ying-Chang Tung, Ming-Yun Ho, Jih-Kai Yeh, Cheng-Hung Lee, Hsin-Fu Lee, Shing-Hsien Chou, Chao-Yung Wang, Chun-Chi Chen, Ming-Lung Tsai
OBJECTIVES: Manual compression (MC) or vascular closure devices (VCDs) are used to achieve hemostasis after percutaneous transluminal angioplasty (PTA). However, limited data on the comparative safety and effectiveness of VCDs vs MC in patients with end-stage renal disease (ESRD) undergoing PTA are available. Accordingly, this study compared the safety and effectiveness of VCD and MC in patients with ESRD undergoing PTA. METHODS: This single-center retrospective cohort study included the data of patients with ESRD undergoing peripheral intervention at Chang Gung Memorial Hospital, Taiwan, from January 1, 2019, to June 30, 2022...
March 13, 2024: Vascular and Endovascular Surgery
Panagiotis Theodoridis, Aouatif E El Kanty, Islam Kourampi, Nikolaos Iatrou, Christos Dimopoulos, Theodosios Bisdas
Arteriovenous fistulas (AVFs) of the lower extremity are uncommon. The main causes are traumatic or iatrogenic, with 15% of traumatic AVFs occurring in the popliteal vessels. Herein, we present a 60-year-old female with a traumatic AVF caused after a car accident 40 years ago. The patient presented with right leg venous claudication and symptoms of congestive heart failure. Duplex ultrasound of lower limb vessels revealed an AVF at the distal part of the tibiofibular trunk. The patient was successfully managed with an endovascular approach using a coil-assisted covered endovascular repair technique of the tibiofibular bifurcation (CERTIFIB) with excellent results and distal vessels patency...
February 28, 2024: Vascular and Endovascular Surgery
Stefano Bonvini, Igor Raunig, Libertario Demi, Nicola Spadoni, Sebastiano Tasselli
OBJECTIVE: Static 3-dimensional (3D) printing became attractive for operative planning in cases that involve difficult anatomy. An interactive (low cost, fast) 3D print allowing deliberate surgical practice can be used to improve interventional simulation and planning. BACKGROUND: Endovascular treatment of complex aortic aneurysms is technically challenging, especially in case of narrow aortic lumen or significant aortic angulation (hostile anatomy). The risk of complications such as graft kinking and target vessel occlusion is difficult to assess based solely on traditional software measuring methods and remain highly dependent on surgeon skills and expertise...
February 9, 2024: Vascular and Endovascular Surgery
Sellers Boudreau, Jessica Schucht, Abindra Sigdel, Amit J Dwivedi, Erik J Wayne
OBJECTIVE: Traumatic axillary and subclavian artery injuries are uncommon. Limited data are available regarding patient and injury characteristics, as well as management strategies and outcomes. METHODS: Retrospective chart review was performed on patients presenting to University of Louisville Hospital, an urban Level One Trauma Center, with traumatic axillary and subclavian artery injuries from 2015-2021. Patients were identified using University of Louisville trauma, radiology, and billing database searches based on ICD9/10 codes for axillary and subclavian artery injuries...
January 29, 2024: Vascular and Endovascular Surgery
Dipesh M Patel, John F Di Capua, Mohammad Reza Rouhezamin, Raul N Uppot, Sanjeeva P Kalva
Inferior vena cava (IVC) filters are used to prevent fatal and nonfatal pulmonary embolism in patients who otherwise cannot receive anticoagulation for venous thrombosis. While generally safe and effective, complications can arise, especially after prolonged implantation. Timely retrieval is essential once the indication for insertion has resolved. However, encountering patients with long-standing embedded filters is not uncommon. This case report discusses the successful retrieval of a permanent Greenfield IVC filter after 29 years...
January 27, 2024: Vascular and Endovascular Surgery
Eleftherios Karanasios, Zeyad Ragab, Harry Cavenagh, Philip Stather, Tariq Ali
Introduction: Median Arcuate Ligament Syndrome (MALS) is associated with true aneurysms, mainly of both the pancreaticoduodenal artery (PDA) and gastroduodenal artery (GDA). Although rare, their potential for rupture and adverse clinical outcomes warrants analysis. Prior studies suggest high rupture rates even for smaller aneurysms under 2 cm in this setting. We performed a systematic literature review, synthesising the evidence on visceral artery aneurysms related to MAL syndrome, with a focus on descriptive analyses of aneurysm size, presentation, rupture rates, and management...
January 25, 2024: Vascular and Endovascular Surgery
Kiyomitsu Yasuhara, Tamiyuki Obayashi, Satoshi Ohki, Shuichi Okonogi, Ayako Nagasawa, Ryo Yamaguchi, Yusuke Kato, Takao Miki, Tomonobu Abe
INTRODUCTION: We sought to examine midterm results and remodeling effect of false-lumen occlusion treatment using AFX VELA in case of chronic dissection repair. MATERIAL AND METHODS: From June 2019 to May 2022, we performed false lumen occlusion treatment using a modified Candy-Plug technique with AFX VELA on 8 chronic aortic dissection patients with a patent false lumen. We collected operative data, short-term clinical outcomes, mid-term clinical outcomes and imaging test results...
January 23, 2024: Vascular and Endovascular Surgery
Kai Zhang, Shuqin Cheng, Yunxiao Zhi, Lin Lu, Mingsheng Yi, Shihong Cui
OBJECTIVE: To evaluate the application of different uterine artery embolization procedures under balloon occlusion of the abdominal aorta in patients with Placenta Accreta Spectrum (PAS) undergoing cesarean section. MATERIALS AND METHODS: A retrospective analysis was performed on clinical data from 72 patients who underwent uterine artery embolization for hemostasis during cesarean section with PAS. The patients were divided into two groups according to the embolization method used during surgery: group A (n = 43) underwent uterine artery embolization by withdrawing the balloon and inserting a Cobra catheter into the uterine artery for embolization, while group B (n = 29) underwent uterine artery embolization with a Cobra catheter inserted via contralateral puncture of the femoral artery and balloon occlusion...
January 22, 2024: Vascular and Endovascular Surgery
Mirte Langeveld, Romy Bosman, Caroline A Hundepool, Liron S Duraku, Christopher McGhee, J Michiel Zuidam, Tom Barker, Maciej Juszczak, Dominic M Power
BACKGROUND: Phantom limb pain (PLP) and symptomatic neuroma can be debilitating and significantly impact the quality of life of amputees. However, the prevalence of PLP and symptomatic neuromas in patients following dysvascular lower limb amputation (LLA) has not been reliably established. This systematic review and meta-analysis evaluates the prevalence and incidence of phantom limb pain and symptomatic neuroma after dysvascular LLA. METHODS: Four databases (Embase, MEDLINE, Cochrane Central, and Web of Science) were searched on October 5th , 2022...
February 2024: Vascular and Endovascular Surgery
Taylor Beal, Conrad Say, Mohammad Ghasemi Rad, David Leon
Coil migration during endovascular embolization is a complication that can result in thromboembolic occlusion leading to potentially large infarcts if not removed. Microsnares are commonly used to remove migrated coils. Current techniques, however, struggle in cases where the microsnare is unable to loop over and secure a free end of the coil. We present a case in which a microsnare combined with a microwire successfully removed a migrated coil in a patient with a bleeding hepatic pseudoaneurysm post-embolization...
January 19, 2024: Vascular and Endovascular Surgery
Anjali Bachetta, Simon Cheung, Emma R Moore, Danny Nguyen, Melissa J Kiely, Mark S Whiteley
AIMS: Endovenous microwave ablation (EMWA) is an endovenous thermoablation (EVTA) system to ablate incompetent truncal veins. Early results suggest that EMWA uses more power than endovenous laser ablation (EVLA) to get the same results. We aimed to define the parameters for EMWA, which give the same tissue ablation as EVLA, using the validated porcine liver model. METHODS: EVLA (1470 nm 600 micron radial fibre) treatments were performed at 6 W, 8 W and 10 W, at pullback speeds of 6, 7, 8 and 9 s/cm, giving Linear Endovenous Energy Densities (LEEDs) between 36 - 90 J/cm...
January 19, 2024: Vascular and Endovascular Surgery
Christopher Montoya, Jorge Rey, Camilo A Polania-Sandoval, Arash Bornak, Tony Shao, Stefan Kenel-Pierre
INTRODUCTION AND IMPORTANCE: Long-term mechanical complications after inferior vena cava (IVC) filter placement include embedded or tilted filters, erosion of the vena cava, filter thrombosis. In the setting of caval thrombosis, patients may subsequently develop venous hypertension and post-thrombotic syndrome (PTS). Here we present three unique cases of IVC filter complications and surgical management. CASE PRESENTATION: A 30-year-old female presented with acute abdominal pain, revealing a duodenal perforation caused by an IVC filter eroding into her duodenum...
January 9, 2024: Vascular and Endovascular Surgery
Hana Shafique, Kofi Quaye, Mitchell W Cox, Chandler A Long, Zachary F Williams
Aortic graft and endograft infections remain a significant source of morbidity and mortality after abdominal aortic aneurysm repair. With graft excision and extra-anatomic bypass, an infrarenal aortic stump remains which can have suture line dehiscence and catastrophic stump blowout. Treatment of this is extremely challenging, especially for severely co-morbid patients who cannot undergo major surgery, or in patients with a hostile abdomen. We present a case study of a 74-year-old male found to have an aortoenteric fistula (AEF)...
January 2, 2024: Vascular and Endovascular Surgery
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