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Annals of Vascular Diseases

Fumiya Yoneyama, Motoo Osaka, Fujio Sato, Hiroaki Sakamoto, Yuji Hiramatsu
Two-dimensional perfusion angiography (2DPA) is utilized in hybrid operating rooms. 2DPA produces color map images and functional parameters to provide more robust visual and quantitative evaluations than conventional angiography. Its efficacy was suggested in five patients following bypass surgery; unexpected results were obtained in one patient, leading to a decision to perform surgical re-anastomosis. Furthermore, we found that the general anesthesia eliminates body movements that tend to disrupt 2DPA results...
June 25, 2018: Annals of Vascular Diseases
Takashi Ando, Hiroshi Goto, Kazuma Date, Makoto Takeda
Primary leiomyosarcoma of the left common iliac artery with development of an arteriovenous fistula is extremely rare. Here we report the case of a 78-year-old woman with primary vascular leiomyosarcoma that presented as acute heart failure involving an arteriovenous fistula. She underwent surgery; however, after the diagnosis of leiomyosarcoma, she did not seek active treatment. She died 8 months after the surgery. This case report supports the need to document and follow-up a primary leiomyosarcoma of the iliac artery, especially when a case includes the presentation of an arteriovenous fistula (AVF)...
June 25, 2018: Annals of Vascular Diseases
Yohsuke Yanase, Akihito Ohkawa, Satomi Inoue, Yukihiro Niida
A 69-year-old man presented with abdominal pain. Enhanced computed tomography (ECT) showed abdominal aortic aneurysm (AAA) with vessel wall thickening. Follow-up ECT on day 3 of admission showed expansion of the AAA. Endovascular abdominal aortic repair (EVAR) was urgently performed. Since preoperative blood cultures revealed Campylobacter jejuni infection, the antibiotics imipenem/cilastatin were administered for five weeks, followed orally by Clarithromycin. The patient was discharged on postoperative day 45...
June 25, 2018: Annals of Vascular Diseases
Yoshitaka Yamane, Toshifumi Hiraoka, Shingo Mochizuki, Tomokuni Furukawa, Kazunori Yamada
We present a case of ruptured thoracic aortic aneurysm (TAA) with type B aortic dissection in which hybrid repair, namely, the frozen elephant trunk (FET) technique with thoracic endovascular aortic repair (TEVAR), was performed. The TAA extended to the proximal descending aorta at the level of the pulmonary trunk bifurcation. We thus employed the FET technique to control the blood flow into the TAA. After performing the FET technique, intraoperative catheter aortography revealed slight type 1B endoleak. We therefore performed additional TEVAR to control the blood flow into the TAA...
June 25, 2018: Annals of Vascular Diseases
Masaki Yamamoto, Hitoshi Ninomiya, Miwa Tashiro, Hideaki Nishimori, Keiji Inoue, Takayuki Sato, Kazuhiro Hanazaki, Kazumasa Orihashi
We report the case of a 75-year-old man who underwent right femoral-popliteal bypass surgery. Anastomotic stenosis was overlooked in indocyanine green (ICG) angiography due to opacification on the bypass graft. X-ray angiography revealed slit-shaped stenosis in the distal graft anastomosis that required revision. Although blood flow may be maintained despite of anastomotic stenosis, small decreases in blood flow cannot be detected in ICG angiography. We describe and discuss the pitfalls of qualitative graft assessment using ICG angiography, and compare ICG fluorescence luminance intensity between primary and revised grafts...
June 25, 2018: Annals of Vascular Diseases
Ken Okamoto, Ayumi Koga, Hirokazu Tazume, Ryo Noguchi, Sayahito Kumamoto, Hiroo Satoh, Takanao Sueyoshi, Toshihiro Fukui
Objective : To evaluate limb-salvage surgery including vascular resection for lower-extremity soft-tissue sarcomas and carcinomas for adult patients. Materials and Methods : Eight consecutive patients (median age, 59 years) who underwent vascular replacement during surgery for malignant tumors in the lower limbs between November 2006 and March 2018 were evaluated. Patient data were retrospectively obtained in a computerized database. Arterial and venous reconstructions were performed for seven patients, with one additional patient receiving venous reconstruction only...
June 25, 2018: Annals of Vascular Diseases
Benjamin Dk Leong, Ariffin A Zainal, Hussein Hanif, Hafizan M Tajri, Naresh Govindarajantran, Kumaraguru Pillay, Kia L Tan, Ahmad Faidzal Othman
Objective : Native fistula creation for hemodialysis in patients who have exhausted all their superficial veins presents a challenge to vascular practice. We review our experience in transposed basilic vein fistula (BVT) creation and its usage for hemodialysis. Materials and Methods : We analyzed the hospital operative registry from January 2009 till June 2012 to identify the total number of BVT created in our center. Medical records of all patients were traced, and patients were interviewed using a standard proforma...
June 25, 2018: Annals of Vascular Diseases
Noriyuki Miyama, Hiroyoshi Komai, Takashi Nakamura, Masahiro Iwahashi, Nobuhiko Mukobara, Masato Yoshida, Hironobu Fujimura, Takaki Sugimoto, Hidenori Asada, Nobuhiro Tanimura, Takashi Azami, Masatoshi Kawata, Yoshihiko Tsuji, Noboru Wakita, Hitoshi Ogino, Shunya Shindo, Atsutoshi Hatada, Takanori Oka
Objective: The aim of this study was to elucidate the long-term results of crossover bypass (CB) for iliac atherosclerotic lesions in the era of endovascular treatment (EVT). Methods: A retrospective multicenter cohort study was performed. CB was performed in 242 patients between 2003 and 2014 by vascular surgeons at multiple medical centers in Japan. Results: Perioperative mortality was 1.7%. Primary patency rates were 86% at 5 years and 82% at 8 years. Univariate analysis showed that critical limb ischemia (Rutherford class 4-6), vein graft, and superficial femoral artery occlusion were significantly associated with low primary patency...
June 25, 2018: Annals of Vascular Diseases
Ming Ngan Aloysius Tan, Zhiwen Joseph Lo, Soon Hong Lee, Rui Ming Teo, Wei Leong Glenn Tan, Sadhana Chandrasekar
Objective : To evaluate outcomes after transmetatarsal amputation (TMA) in peripheral arterial disease (PAD) limb salvage in an Asian population and identify risk factors associated with TMA failure. Methodology : A retrospective review of 147 patients with PAD, who had undergone TMA between 2008 and 2014, was carried out. Univariate and multivariate analysis were used to identify predictors of TMA failure. Kaplan-Meier survival analysis was used to calculate major amputation and all-cause mortality rates. Results : The mean age was 66 years...
June 25, 2018: Annals of Vascular Diseases
Takehisa Nojima, Yasuki Motomiya
Objective : Flow reduction is required to preserve vascular access in cases with high flow access (HFA). We report a new flow reduction procedure, the graft inclusion technique (GIT). Methods : The GIT procedure developed by us involves the intraluminal placement and suturing of a 4-mm polytetrafluoroethylene graft to the anastomosis and outflow tract to plicate the enlarged anastomosis and maintain lower flow volumes. Flow reduction for HFA was retrospectively assessed in a series of 25 patients (age 65±12 years; 17 males and 8 females) to evaluate flow volume and patency rate, wherein 10 patients underwent conventional methods of flow reduction and 15 underwent GIT...
June 25, 2018: Annals of Vascular Diseases
Kei Aizawa, Shinichi Ohki, Yoshio Misawa
Objective : This study was performed to determine whether open surgical decompression (OSD) decreased the mortality associated with abdominal compartment syndrome (ACS) following open repair (OR) of ruptured abdominal aortic aneurysm and iliac aneurysm (rAAA), and to investigate the risk factors associated with OSD. Material and Methods : Total 113 consecutive patients with rAAA underwent OR in our institution. Ninety patients underwent primary abdominal closure; however, three of them developed ACS and required OSD...
June 25, 2018: Annals of Vascular Diseases
Takuya Miyahara, Katsuyuki Hoshina, Masahiko Ozaki, Masanori Ogiwara
Objective : We aimed to assess the efficacy of preoperative antibiotic therapy for the treatment of prosthetic graft infection. Materials and Methods : We retrospectively analyzed the treatment strategies used for managing patients with prosthetic vascular graft infections between 2000 and 2016. The patients were divided into two groups: early antibiotic (EA) group, those who were administered with antibiotics ≥2 weeks preoperatively and late antibiotic (LA) group, those who were administered with antibiotics <2 weeks preoperatively...
June 25, 2018: Annals of Vascular Diseases
Juno Deguchi, Osamu Sato
As more than 320,000 patients are currently receiving hemodialysis treatment in Japan, the creation and maintenance of hemodialysis access is a major concern. The national guidelines recommend autogenous arteriovenous hemodialysis, and the brachial-basilic arteriovenous fistula has been the focus of attention, because the need for secondary, tertiary, or even more vascular access is growing. Although favorable results have been reported in terms of patency and access-related complication, this fistula involves various unsolved or controversial issues, with limitations including complex procedures, which might contribute to the lower prevalence at this point in Japan...
June 25, 2018: Annals of Vascular Diseases
Kyoko Imanaka-Yoshida, Ken-Ichi Matsumoto
Tenascins are a family of large extracellular matrix (ECM) glycoproteins. Four family members (tenascin-C, -R, -X, and -W) have been identified to date. Each member consists of the same types of structural domains and exhibits time- and tissue-specific expression patterns, suggesting their specific roles in embryonic development and tissue remodeling. Among them, the significant involvement of tenascin-C (TNC) and tenascin-X (TNX) in the progression of vascular diseases has been examined in detail. TNC is strongly up-regulated under pathological conditions, induced by a number of inflammatory mediators and mechanical stress...
June 25, 2018: Annals of Vascular Diseases
Hirona Kugo, Hiroki Tanaka, Tatsuya Moriyama, Nobuhiro Zaima
Abdominal aortic aneurysm (AAA) is a vascular disease that involves the gradual dilation of the abdominal aorta followed by its rupture. AAA is closely associated with weakening of the vascular wall due to oxidative stress, chronic inflammation, and degradation of the extracellular matrix. No effective drug therapy is currently available for preventing aneurysm progression or rupture. Adipocytes in the vascular wall are reportedly closely associated with AAA development and rupture. Fiber degradation in the aneurysm wall is enhanced by increased numbers of adipocytes, and rupture risk may increase as well...
June 25, 2018: Annals of Vascular Diseases
Akira Murata, Koji Amaya, Kentaro Mochizuki, Masami Sotokawa, Shingo Otaka, Kazuhiro Tani, Shota Nakagaki, Tetsuyuki Ueda
We report a case of an aneurysm of the inferior pancreaticoduodenal artery (IPDA), with chronic occlusion of the celiac axis. Both surgical aneurysmectomy and endovascular coil embolization were anticipated to sacrifice IPDA, which could lead to severe acute ischemia in the celiac region. The treatment involved surgical ligation of the aneurysm after bypass grafting from the superior mesenteric artery to the anterior IPDA. A postoperative computed tomography revealed no enhancement of the aneurysm and sufficient collateral blood supply by the patent bypass graft...
March 25, 2018: Annals of Vascular Diseases
Miyako Tanaka, Fukashi Serizawa, Yohei Nagaoka, Takuya Jimbo, Kazuki Kawashima, Takeshi Asakura, Hiroshi Otomo, Kenichi Yokota
We report our experience of two cases of refractory cellulitis caused by peripheral micro-arteriovenous fistulas (AVFs) in the lower extremity. The micro-AVFs were so small that they could not be located accurately; further, the patients' symptoms differed markedly from those previously reported for AVF. AVF is known to cause ischemic symptoms. In contrast, micro-AVF causes congestive symptoms and remains undetected in the majority of patients. Identification of this pathology is crucial to enable effective treatment by the ligation of the incompetent perforator vein that increases venous hypertension, leading to congestive symptoms...
March 25, 2018: Annals of Vascular Diseases
Minami Taki, Takashi Miura, Takahiro Kobayashi, Toshio Kasai, Takahisa Maruyama, Minako Hayakawa, Yu Matsumura, Fumitaka Yamaki, Uichi Ikeda
Primary iliac venous aneurysm is an exceedingly rare abnormality that can be complicated by pulmonary embolism, thrombosis, and rupture. Here we report the case of an otherwise healthy 40-year-old man with a unilateral external iliac vein aneurysm without any evidence of an arteriovenous fistula, proximal stenosis, or obstruction, as reported on computed tomography. Pulmonary embolism was diagnosed using 99m Tc-macroaggregated albumin scintigraphy. To prevent life-threatening complications, we treated the patient with anticoagulant therapy and performed aneurysmectomy with reconstruction using a saphenous vein graft patch...
March 25, 2018: Annals of Vascular Diseases
Katsuaki Tsukioka, Tetsuya Kono, Kohei Takahashi, Hiromu Kehara, Shuichi Urashita, Kazunori Komatsu
A 75-year-old woman was involved in a traffic accident and suffered retrograde type A aortic dissection, multiple rib fractures, and grade II hepatic injury accompanied by intraperitoneal bleeding. We performed total arch replacement using an open stent graft with cardiopulmonary bypass and circulatory arrest. This procedure requires anticoagulation and hypothermia, which are principally contraindicated in severe trauma patients. However, this situation was resolved by managing the patient non-operatively for 7 days, confirming the stabilization of other injured organs, and then performing the surgery...
March 25, 2018: Annals of Vascular Diseases
Hiroshi Sato, Syuichi Naraoka
An axillary arterial aneurysm is a rare disorder, with few surgical cases reported to date. Here we report the case of a left axillary arterial aneurysm associated with Marfan syndrome. A 44-year-old female with Marfan syndrome presented with numbness of the left upper limb and a pulsatile mass on the left chest. A computed tomography scan revealed a highly enlarged and tortuous left axillary arterial aneurysm. We performed a graft replacement and resection of the aneurysm with two skin incisions. After the surgery, the blood flow to the patient's left upper limb was confirmed, and the neurological symptoms improved significantly...
March 25, 2018: Annals of Vascular Diseases
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