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Annals of Vascular Diseases

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September 25, 2018: Annals of Vascular Diseases
The Japanese Society For Vascular Surgery Jclimb Committee, Ncd Jclimb Analytical Team
Since 2013, the Japanese Society for Vascular Surgery has started the project of nationwide registration and tracking database for patients with critical limb ischemia (CLI) who are treated by vascular surgeons. The purpose of this project is to clarify the current status of the medical practice for the patients with CLI to contribute to the improvement of the quality of medical care. This database, called JAPAN Critical Limb Ischemia Database (JCLIMB), was created on the National Clinical Database and collects data of patients' background, therapeutic measures, early results, and long term prognosis as long as five years after the initial treatment...
September 25, 2018: Annals of Vascular Diseases
The Japanese Society For Vascular Surgery Database Management Committee Member, Ncd Vascular Surgery Data Analysis Team
This is an annual report indicating the number and early clinical results of annual vascular treatments performed by vascular surgeons in Japan during 2011, as analyzed by database management committee (DBC) members of the Japanese Society for Vascular Surgery (JSVS). Materials and Methods : To survey the current status of vascular treatments performed by vascular surgeons in Japan, the DBC members of the JSVS analyzed the vascular treatment data provided from National Clinical Database (NCD), including the number of treatments and early clinical results such as operative and in-hospital mortality...
September 25, 2018: Annals of Vascular Diseases
Kuniyasu Ikeoka, Keita Okayama, Tetsuya Watanabe, Shinsuke Nanto, Yasushi Sakata, Shiro Hoshida
It is unclear whether arterial healing occurs beyond 1 year following paclitaxel-coated stent implantation in peripheral artery disease. An 81-year-old woman with superficial femoral artery disease underwent endovascular therapy with a paclitaxel-coated stent. An angiography 21 months later revealed peri-stent contrast staining in the superficial femoral artery, and optical frequency domain imaging demonstrated incomplete stent apposition with significant positive vascular remodeling. High-resolution angioscopy detected positive vascular wall remodeling and in-stent yellow plaque more clearly than conventional angioscopy...
September 25, 2018: Annals of Vascular Diseases
Daisuke Takeyoshi, Shinsuke Kikuchi, Keisuke Miyake, Takamitsu Tatsukawa, Daita Kobayashi, Daiki Uchida, Yuya Kitani, Hiroyuki Kamiya, Nobuyoshi Azuma
A 79-year-old man with a heavy smoking history presented with threatened lower limbs due to acute exacerbation of peripheral artery disease (PAD). He underwent emergent distal bypass surgery for the right leg and external iliac stenting for the left leg. Fatal coronary artery spasm (CAS) with ST segment changes on electrocardiography was observed 28 h after the procedures, resulting in cardiac arrest. Coronary angiography showed widespread CAS with improvement after intra-arterial nitroglycerin infusion. We should keep in mind that CAS may occur more frequently than expected in PAD patients, especially those who have not stopped smoking prior to revascularization...
September 25, 2018: Annals of Vascular Diseases
Ryo Kanamoto, Shinichi Hiromatsu, Shinichi Nata, Yusuke Shintani, Hiroyuki Otsuka, Seiji Onitsuka, Hidetoshi Akashi, Hiroyuki Tanaka
Fibromuscular dysplasia (FMD) mainly develops in medium-sized arteries, including renal, extracranial, and extremity arteries, but it rarely causes abdominal aortic aneurysm (AAA). A 69-year-old woman with AAA diagnosed on ultrasonography by a home doctor visited our hospital. Contrast-enhanced computed tomography revealed a saccular aneurysm of terminal abdominal aorta. We performed abdominal aortic replacement and resected the section with aneurysm. Pathological examination of the wall tissue of the resected aneurysm revealed findings that are consistent with FMD...
September 25, 2018: Annals of Vascular Diseases
Keisuke Miyake, Shinsuke Kikuchi, Yuya Kitani, Atsuhiro Koya, Toshiharu Takeuchi, Naoyuki Hasebe, Yoshiki Sawa, Nobuyoshi Azuma
Acute limb ischemia (ALI) is associated with high morbidity and mortality rates, even with the advent of technical advances. Although myocardial infarction is one of the causes of ALI along with intraventricular thrombus formation and subsequent embolism, ALI with concomitant acute myocardial infarction (AMI) is extremely rare. Here, we report a complicated ALI case with concurrent AMI and prolonged limb ischemic duration. The cause may be attributed to thrombosis with atherosclerotic disease of the coronary and peripheral arteries triggered by dehydration...
September 25, 2018: Annals of Vascular Diseases
Yasunori Iida, Akihiro Yoshitake, Hideyuki Shimizu
We report a case with aortic intimal sarcoma who presented with left upper limb arterial embolization from tumor. A 79-year-old female patient presented with paleness and left upper limb paralysis. A transesophageal echocardiogram revealed a mobile and fragile mass attached in the aortic arch. Contrast-enhanced computed tomography showed a massive irregular tumor in the aortic arch with left common carotid and subclavian artery occlusion. Total arch replacement was performed, and tumor was resected en bloc...
September 25, 2018: Annals of Vascular Diseases
Wongsakorn Chaochankit, Osaree Akaraborworn
Venous thromboembolism (VTE) is a major healthcare problem that results in significant mortality, morbidity, and expenditure of resources. It compounds with pulmonary embolism (PE) and deep vein thrombosis (DVT). Phlegmasia cerulea dolens (PCD) is an uncommon but potentially life-threatening complication of acute DVT characterized by marked swelling of the extremities with pain and cyanosis, which in turn may lead to arterial ischemia and ultimately gangrene with high amputation and mortality rates. The key in treating such patients is to provide quick and effective treatment to save the limbs and the patient...
September 25, 2018: Annals of Vascular Diseases
Takeshi Nishina, Yukiyo Yoshida, Akihiro Mizuno, Masashi Yada, Kazuo Yamanaka
Treatment by thoracic endovascular aortic repair (TEVAR) for type B dissection has improved outcomes. We tried the procedure named "Full Petticoat technique" in which the proximal entry tear was excluded with a covered stent and extended bare metal stents were placed to the aortic bifurcation for three complicated type B dissection cases with dynamic obstruction of the common iliac artery. Follow-up computed tomography revealed favorable aortic remodeling in which the true lumen was expanded. The short-term result of this procedure has shown acceptable aortic remodeling...
September 25, 2018: Annals of Vascular Diseases
Tsunehisa Yamamoto, Katsuhiko Oka, Keiichi Kanda, Osamu Sakai, Taiji Watanabe, Hitoshi Yaku
Listeria monocytogenes infection and rupture of the aneurysm sac, after endovascular aneurysm repair (EVAR), are both rare. We report the case of an 82-year-old man who presented with a ruptured aneurysm by infection with L. monocytogenes after EVAR. We successfully treated him by in situ reconstruction with a bifurcated expanded polytetrafluoroethylene (ePTFE) graft, with partial removal of the infected stent graft. At 30 months from the reoperation, the patient was in good health at home, with no symptoms of infection, and the gallium-67-citrate single-photon emission computed tomography/computed tomography (SPECT/CT) fusion images confirmed no fluid accumulation...
September 25, 2018: Annals of Vascular Diseases
Yoshitaka Yamane, Tomokuni Furukawa, Kazunori Yamada
We present here a case of Kommerell diverticulum (KD) with annuloaortic ectasia, in which single-stage surgical repair was performed via a median sternotomy using frozen elephant trunk (FET) technique. We used this technique for the following reasons: firstly, we could perform surgery only via a median sternotomy without thoracotomy; secondly, we were able to deliver the FET using a guidewire through the severely angulated aortic arch. We here investigate this technique as it could potentially be a good treatment option of KD...
September 25, 2018: Annals of Vascular Diseases
Takumi Yamaguchi, Akimitsu Tanaka, Hidekazu Aoyama, Masayuki Nakamura, Masao Tadakoshi, Ryosuke Kametani, Takeki Ohashi
Fistulas between an aneurysm branching off the abdominal aorta and the thoracic duct are rare. We report a case of aneurysmal-thoracic duct fistula diagnosed by angiography when aneurysm ruptured, and we successfully treated by catheter embolization. A 42-year-old man was referred to our hospital with a chief complaint of sudden back and chest pain. Computed tomography showed both post-mediastinal and retroperitoneal hematomas, with the aneurysm from the aorta being connected to the thoracic duct. After confirming the aneurysmal-thoracic duct fistula by angiography, we performed embolization of the aneurysm...
September 25, 2018: Annals of Vascular Diseases
Tsukasa Nakamura, Shuji Nobori, Kiyokazu Akioka, Koji Masuda, Shumpei Harada, Masafumi Osaka, Takehisa Matsuyama, Norio Yoshimura, Hidetaka Ushigome
Digital ischemia is a serious problem in peripheral artery diseases (PAD) patients. Case 1: A 60-year-old woman with large arteriovenous fistula (AVF) complained of digital ischemia symptoms. The patient underwent dissection of AVF and distal bypass to the palmar arch with successful repair. Case 2: A 47-year-old female, diagnosed with renal failure, and scleroderma, complained of a digital gangrene. A bypass was performed from the left brachial artery to the superficial palmar arch. The digital gangrene showed a complete recovery within 2 months after surgery...
September 25, 2018: Annals of Vascular Diseases
Masato Nakamura, Michael R Jaff, Richard A Settlage, Kimihiko Kichikawa
Objective : To assess the use of a nitinol stent to treat symptomatic stenoses or occlusions of the native superficial femoral artery (SFA). Materials and Methods : Seventy-four patients were treated at 12 Japanese sites. The primary endpoint, freedom from target-limb failure (TLF), was a composite of device- or procedure-related death, target-limb amputation, target-vessel revascularization (TVR), or restenosis compared to an objective performance goal (OPG) at 12 months. Secondary endpoints, including primary patency, freedom from TVR/target-lesion revascularization (TLR), improvements in clinical parameters, and major adverse events (MAEs) were evaluated through 36 months...
September 25, 2018: Annals of Vascular Diseases
Hongyan Yu, Baoxian Huang, Joachim Wen Kien Yau, Sadhana Chandrasekar, Glenn Wei Leong Tan, Zhiwen Joseph Lo
Objective : To compare patency rates between one- and two-stage (first-stage arteriovenous anastomosis followed by second-stage superficialization) creation of brachial-basilic transposition arteriovenous fistula (BBT-AVF) in an Asian population. Methods : A retrospective review of BBT-AVFs was conducted between July 2008 and March 2015. Kaplan-Meier survival analysis and log-rank test were used to evaluate patency. Results : In total, 103 BBT-AVFs were created in 86 patients (mean age, 61 years; men, 57%)...
September 25, 2018: Annals of Vascular Diseases
Rashid Usman, Muhammad Jamil, Muhammad Faheem Anwer
Objective : We aim to share our experience regarding the surgical management and outcome of extremity vascular trauma in level-1 trauma centres in Pakistan. Patients and methods : All consecutive patients with traumatic extremity vascular injury (TEVI) fulfilling the inclusion criteria; between June 2012 and June 2017 were included. The demographics, clinical presentation, management, and outcome measures were recorded. Results : The study included 81 patients. The mean age±standard deviation was 28.6±14...
September 25, 2018: Annals of Vascular Diseases
Atsushi Guntani, Shinsuke Mii, Sosei Kuma, Kiyoshi Tanaka, Akio Kodama, Eisuke Kawakubo
Objective : Although autologous veins are the first-choice conduit for femorotibial artery bypass, if there are no appropriate autologous veins, we perform femorotibial artery bypass using polytetrafluoroethylene (PTFE) with a distal vein cuff for patients with critical limb ischemia (CLI). This study examined the long-term outcomes of femorotibial artery bypass using PTFE with a Miller's cuff. Materials and Methods : Using prospectively collected data for 444 distal bypasses, a retrospective analysis was conducted for 32 femorotibial PTFE bypasses with a Miller's cuff (PTFE-Miller's cuff) performed for patients with CLI from April 1994 to December 2016...
September 25, 2018: Annals of Vascular Diseases
Takao Nonaka, Naoyuki Kimura, Daijiro Hori, Yusuke Sasabuchi, Mitsunori Nakano, Koichi Yuri, Masamitsu Sanui, Harunobu Matsumoto, Atsushi Yamaguchi
Objective : To investigate the predictors of acute kidney injury (AKI) following surgery for abdominal aortic aneurysm. Materials and Methods : Subjects were 642 non-hemodialysis patients (open aortic repair [OAR] group, n=453; endovascular aortic repair [EVAR] group, n=189) who underwent elective surgery between 2009 and 2015. AKI was assessed according to the Kidney Disease Improving Global Outcomes criteria. In-hospital mortality and incidence of AKI were compared between the OAR and EVAR groups. The effect of AKI on outcomes and predictors of AKI were examined in both groups...
September 25, 2018: Annals of Vascular Diseases
Gary Andrew Cuthbert, Zhiwen Joseph Lo, Justin Kwan, Sadhana Chandrasekar, Glenn Wei Long Tan
Objective : To review the outcomes of central venoplasty in the treatment of symptomatic central vein stenosis in patients undergoing haemodialysis via an ipsilateral arteriovenous fistula (AVF). Methods : Data were collected retrospectively, and included all the consecutive cases of central venoplasty between January 2008 and December 2015. Results : A total of 132 central venoplasties in 76 patients were performed, with incidence of symptomatic central vein stenosis at 7.4%. Of the patients, 66% were male and the mean age was 61 years...
September 25, 2018: Annals of Vascular Diseases
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