Early clinical outcomes of retrograde in situ branched stent grafting for complex aortic arch aneurysms.

Objective: To evaluate the early outcomes of retrograde in situ branched stent grafting (RIBS) using the gutter balloon technique for complex aortic arch aneurysms (CAAs).

Methods: The RIBS technique is an in situ needle fenestration procedure during thoracic endovascular aortic repair with the reconstruction of cervical branches. The double RIBS (D-RIBS) for the reconstruction of the left common carotid artery and the brachiocephalic artery using the gutter balloon technique was performed in 30 high-risk patients.

Long-term results of the Japanese multicenter Viabahn trial of heparin bonded endovascular stent grafts for long and complex lesions in the superficial femoral artery.

Objective: We assessed the long-term safety and efficacy of endovascular stent grafting to treat long, complex lesions in the superficial femoral artery (SFA).

Methods: The present prospective, multicenter study at 15 Japanese hospitals assessed heparin-bonded stent grafts used to treat long SFA lesions in patients with symptomatic peripheral arterial disease. The inclusion criteria were Rutherford category 2 to 5 symptoms (grade 5 without active infection), an ankle brachial index of ≤0.

Clinical Impact of Stent Graft Thrombosis in Femoropopliteal Arterial Lesions.

Objectives: This study sought to elucidate the clinical impact and prognosis of stent graft (SG) thrombosis.

Background: The VIABAHN SG offers a favorable outcome in long peripheral artery occlusive disease (PAOD) lesions in the femoropopliteal artery. One concern after SG deployment is the incidence of stent thrombosis and consequent acute limb ischemia (ALI).

Neural dysfunctions following experimental permanent occlusions of bilateral common carotid arteries cause an increase of rat voluntary alcohol drinking behavior.

We have previously reported that ischemic animal models treated with a respiratory inhibitor, rotenon, show an increased voluntary alcohol intake. Although it is clear that ischemic brain, as a result of reduced-blood flow, shows pathological events and/or neuro-degenerations apparently, little is known of causal relationship between the mechanism of neural dysfunction and voluntary alcohol consumption. Authors have investigated effects of permanent two-vessel occlusion (p2VO) on rat voluntary alcohol drinking behavior.

Evaluation of heparin-bonded ePTFE grafts for forearm loop vascular access: Comparison between Gore PROPATEN vascular graft and ACUSEAL vascular graft.

Background: This retrospective study evaluates the clinical outcomes of two heparin-bonded expanded polytetrafluoroethylene grafts, PROPATEN and ACUSEAL (W. L. Gore & Associates, Flagstaff, AZ, USA), for forearm loop vascular access.

Endovascular treatment with an iliac branch endoprosthesis for a right subclavian artery aneurysm.

Subclavian artery aneurysms are rare peripheral artery aneurysms, and open surgical repair is the reference standard treatment. We have reported the case a patient with a right subclavian artery aneurysm who was not indicated for open surgical repair because of comorbidities. Thus, endovascular treatment using the Gore Excluder Iliac Branch Endoprosthesis (WL Gore and Associates, Flagstaff, Ariz) was performed, leading to complete aneurysmal exclusion without perioperative complications.

A Novel Shaggy Aorta Scoring System to Predict Embolic Complications Following Thoracic Endovascular Aneurysm Repair.

Objective: The aim of this study was to investigate the correlation between shaggy aorta and embolic complications during thoracic endovascular aneurysm repair (TEVAR), based on a shaggy aorta scoring system.

Methods: The entire aorta was assessed based on 5 mm slice computed tomography (CT) from the sinotubular junction to the aortic bifurcation using a three dimensional workstation. One shaggy point (shaggy score) was given when the following conditions were met: 1) ulcer like thrombus, 2) maximum thrombus thickness ≥ 5 mm, and 3) mural thrombus occupies more than two thirds of the circumference of the aortic diameter on reconstructed CT of the axial statue.

Current status of endovascular treatment for thoracoabdominal aortic aneurysms.

Open surgical repair (OSR) for thoracoabdominal aortic aneurysms (TAAAs) is maximally invasive and associated with high rates of operative mortality and perioperative complications including spinal cord ischemia (SCI), despite improvements in surgical techniques and perioperative care. Elderly patients, patients with a history of aortic surgery, and patients with severe comorbidities are often considered ineligible for this surgery and endovascular treatment may be their only treatment option. Total endovascular aneurysm repair (t-EVAR) without debranching surgery does not require thoracotomy and laparotomy and could improve the outcomes of these patients.

Bidirectional loop-snare technique for adherent inferior vena cava filter retrieval.

Placement of a Günther Tulip Inferior Vena Cava (IVC) Filter™ (Cook, Bloomington, IN, USA) is an alternative treatment option to prevent pulmonary embolism in patients in whom anticoagulation therapy is contraindicated. Most patients require filter placement for only short periods, after which it can be retrieved. IVC filter retrieval becomes more difficult as the indwelling time increases.

Hybrid Surgery for Multiple Visceral Artery Aneurysms: A Case Report.

Background: We present a case with multiple visceral artery aneurysms that were treated with a hybrid approach involving both surgical and endovascular treatment.

Case Report: The patient was a 48-year-old female. She was diagnosed with multiple visceral artery aneurysms including 2 splenic artery aneurysms, celiac artery aneurysm, and bilateral renal artery aneurysms during an examination for loss of appetite.

Outcomes of Chimney Thoracic Endovascular Aortic Repair for an Aortic Arch Aneurysm.

Background: Chimney thoracic endovascular aneurysm repair (TEVAR) has advantages that include no requirements for special devices; however, problems have been identified such as gutter leaks. The aim of this study is to evaluate the short- and mid-term results of TEVAR with chimney technique including the safety, efficacy, and risk factors for occurrence of gutter endoleak in this technique.

Methods: A retrospective single-center study was conducted on 55 consecutive patients who underwent first-time chimney TEVAR for arch aneurysms in the past 7 years.

Risk factors and treatment outcomes for stent graft infection after endovascular aortic aneurysm repair.

Objective: We aimed to retrospectively analyze incidence, risk factors, and management of postoperative stent graft (SG) infection after endovascular aneurysm repair (EVAR).

Methods: We evaluated patients who underwent EVAR for infrarenal abdominal aortic aneurysm at our institution between July 2006 and December 2014. The primary end point was SG infection.

Risk Factor Analyses of Abdominal Aortic Aneurysms Growth in Japanese Patients.

Background: This study aimed to retrospectively demonstrate the growth rate (mm/year) of abdominal aortic aneurysm (AAA) diameters (ADs) and to analyze risk factors for AAA expansion.

Methods: We retrospectively investigated the clinical data of 319 patients with AAAs who were followed up as outpatients for >2 years after their initial visit and who underwent computed tomography >4 times.

Results: The mean follow-up period was 3.

Early and midterm outcomes of endovascular treatment for chronic aneurysmal aortic dissection: a retrospective study.

Background: The aim of this study was to evaluate endovascular treatment for enlarged Stanford type B chronic aneurysmal aortic dissection (CAAD). The conventional treatment for CAAD is open repair; however, the operative mortality is high in extensive prosthetic graft replacements.

Methods: A retrospective single-center study was conducted on 74 consecutive patients who underwent endovascular treatment for CAAD in the past 8.

Endovascular Treatment of Various Aortic Pathologies: Review of the Latest Data and Technologies.

The technologies and innovations applicable to endovascular treatment for complex aortic pathologies have progressed rapidly over the last two decades. Although the initial outcomes of an endovascular aortic repair have been excellent, as long-term data became available, complications including endoleaks, endograft migration, and endograft infection have become apparent and are of concern. Previously, the indication for endovascular therapy was restricted to descending thoracic aortic aneurysms and abdominal aortic aneurysms.

Clinical Outcomes of Total Endovascular Aneurysm Repair for Aortic Aneurysms Involving the Proximal Anastomotic Aneurysm following Initial Open Repair for Infrarenal Abdominal Aortic Aneurysm.

Background: To evaluate initial and midterm clinical outcomes of aortic aneurysms involving the proximal anastomotic aneurysm (AAPAAs) following initial open repair for infrarenal abdominal aortic aneurysm.

Methods: Between July 2006 and August 2015, 24 patients underwent elective endovascular repair for the treatment of AAPAAs at our institution. AAPAA classification has been categorized as 3 types.

Result of Thoracic Endovascular Aortic Repair for Patients with Esophageal Cancer.

Background: Bleeding from the thoracic aorta is potentially fatal in patients with advanced esophageal cancer. Thoracic endovascular aortic repair (TEVAR) was recently applied for aortic invasion by esophageal cancer. However, only a few case reports have been published.

Outcomes of mini-incision eversion carotid endarterectomy combined with nontouch isolation technique of the internal carotid artery.

Objective: We developed a mini-incision eversion carotid endarterectomy (CEA) procedure (the Jikei method CEA) to prevent perioperative embolic stroke. The aim of this study was to retrospectively analyze perioperative and midterm outcomes after the Jikei method CEA.

Methods: We evaluated patients with the Jikei method CEA at our institution between January 2006 and June 2014.

Concomitant Coil Embolization for Gutter Leak during Endovascular Aortic Repair with the Snorkel Technique.

Snorkel endovascular aortic repair (SEVAR) is reported to be effective for the treatment of pararenal or juxtarenal aortic aneurysms. SEVAR can be performed with an off-the-self device, which is applied for emergency cases. However, there is a concern that SEVAR lead to gutter leak due to insertion of multiple stents.

Clinical Outcomes of Spinal Cord Ischemia after Fenestrated and Branched Endovascular Stent Grafting during Total Endovascular Aortic Repair for Thoracoabdominal Aortic Aneurysms.

Background: In this single-center study, we assessed the clinical outcomes of fenestrated endovascular aortic repair (f-EVAR) and branched EVAR on morbidity and mortality during total endovascular aortic repair for thoracoabdominal aortic aneurysms (TAAAs).

Methods: Between July 2006 and June 2015, elective f-EVAR and multibranched EVAR (t-Branch) for TAAAs were performed in 99 patients at our institution (Crawford classification types I [7], II [13], III [6], IV [55], and V [18]). We retrospectively analyzed 44 patients, excluding those with Crawford type IV TAAAs, and compared 30 patients treated with f-EVAR and 14 treated with t-Branch.

Outcomes of the Japanese multicenter Viabahn trial of endovascular stent grafting for superficial femoral artery lesions.

Objective: The objective of this study was to assess 1-year safety, efficacy, and invasiveness outcomes of endovascular stent grafting of symptomatic long lesions (≥10 cm) in the superficial femoral artery (SFA) as a substitute for above-knee open bypass surgery.

Methods: This prospective, multicenter (15 hospitals) study assessed heparin-coated stent grafts for the treatment of long SFA lesions in Japanese subjects with peripheral arterial disease. Inclusion criteria were Rutherford category 2 to 5 symptoms (grade 5 without active infection), ankle-brachial index ≤0.

Utility of the Ginza forceps for superficial phlebectomy during endovenous laser ablation of the great saphenous vein.

Purpose: To evaluate the efficiency of using the Ginza forceps (DVx, Tokyo, Japan), which have a long shaft and strong grip, for superficial phlebectomy with the stab avulsion technique, during simultaneous endovenous laser ablation (EVLA) of the great saphenous vein (GSV).

Methods: The subjects were patients treated with EVLA performed by a single operator at one institution. All patients had a GSV diameter of 4-10 mm and an EVLA length of the GSV of >20 cm.

Comparison between Open and Endovascular Repair for the Treatment of Juxtarenal Abdominal Aortic Aneurysms: A Single-Center Experience with Midterm Results.

Background: To evaluate the optimal treatment for juxtarenal abdominal aortic aneurysm (JAAA), we compared the outcomes of open surgical repair (OSR) with endovascular aortic repair (EVAR) using a variety of fenestrated and snorkel EVARs.

Methods: We evaluated overall survival, aneurysm-related death, reintervention, and renal impairment in 152 JAAAs retrospectively, excluding cases of aortic dissection and rupture. Cox models were used to assess survival and assessed postoperative dialysis rates following surgery.

Open arterial reconstruction of multiple hepatic artery aneurysms in a patient with hereditary hemorrhagic telangiectasia: A case report.

Background: Hereditary hemorrhagic telangiectasia (HHT) is characterized by mucocutaneous telangiectasia and visceral vascular malformations (VMs). Liver involvement with VMs may lead to high-output cardiac failure, portal hypertension, and biliary disease. There is no curative treatment for the disease, and liver transplantation is indicated for life-threatening complications.