Primary aortoduodenal fistula with a history of distal gastrectomy.

Case: A 69-year-old man was transferred to our hospital because of an aortoduodenal fistula with hematemesis and pre-shock vital signs. He had a history of alcoholism, malnutrition, and distal gastrectomy and Billroth I reconstruction. Endovascular aneurysm repair was successfully carried out; however, the presence of comorbidities affected further radical treatment.

Raison d'etre of Tibial Artery Bypass for Intermittent Claudication in the Era of Endovascular Therapy.

Background: There is currently no positive opinion regarding infrapopliteal revascularization for intermittent claudication (IC) in any guidelines. The aim of this study was to analyze the outcomes of infragenicular bypass and verify the adequacy of tibial artery bypass for IC.

Methods and results: Over a 21-year period, 58 below-knee popliteal artery (BKPOP) bypasses and 35 tibial artery bypasses were performed for IC caused by arteriosclerosis obliterans.

Long-Term Results of a Hybrid Revascularization Procedure for Peripheral Arterial Disease.

Objective: To evaluate the efficacy of hybrid procedure for peripheral arterial disease (PAD), we compared the cases treated using the hybrid procedure with those treated using open revascularization (bypass alone) in our facilities.

Materials And Methods: We retrospectively reviewed 204 patients who underwent revascularization for PAD between 2007 and 2013. We divided the patients into two groups based on the type of procedure.

Ultrasound-guided percutaneous thrombin injection for post-catheterization pseudoaneurysm.

Background: The efficacy and safety of ultrasound-guided thrombin injection (UGTI) for the treatment of post-catheterization femoral and brachial artery pseudoaneurysms (PSA) is unclear in Japan.

Methods And Results: A retrospective study of 32 consecutive patients undergoing percutaneous UGTI of post-catheterization PSA between February 2011 and February 2014 was performed. There were 23 femoral PSA and 9 brachial PSA treated with UGTI.

Thoracic endovascular aortic repair and coil embolization of the pulmonary artery for primary racemose hemangioma of the bronchial artery with a bronchial-pulmonary artery fistula.

A 69-year-old male visited a doctor with dyspnea. A bronchial-pulmonary artery fistula, which is called racemose hemangioma, and dilated pulmonary artery were detected by a computed tomography (CT) scan. The bronchial-pulmonary artery fistula can cause lethal hemoptysis, therefore, we performed thoracic endovascular aortic repair (TEVAR) to seal the bronchial artery and coil embolization of the pulmonary artery.

Midterm outcomes of endovascular repair for abdominal aortic aneurysms with the on-label use compared with the off-label use of an endoprosthesis.

Purpose: Endovascular repair of an abdominal aortic aneurysm (EVAR) is sometimes not performed in accordance with the instructions for use (IFU) of the endoprosthesis ("off-label use"). We investigated whether the off-label use of the endograft affected the outcomes of EVAR.

Methods: Demographic, anatomical, intraoperative and follow-up data on 100 patients in whom the endograft was used on-label in EVAR were compared retrospectively with the corresponding data of 50 patients with off-label endograft use.

Thoracic stent graft with distal fenestration for the superior mesenteric artery for treatment of thoracic aortic aneurysm.

An 86-year-old man with a 75-mm TAA that terminated just above the celiac artery was treated with a customized Zenith stent graft that had a distal fenestration for the superior mesenteric artery (SMA). Because angiography demonstrated a type IB endoleak, an additional extension stent graft was deployed, and coil embolization of the aneurysmal sac was performed. Three months later, there was no endoleak and good visceral blood flow.

Successful treatment of an abdominal aortic aneurysm with a severely angulated and large aortic neck using a modified Zenith.

This report presents the case of an abdominal aortic aneurysm (AAA), in which the aortic neck was severely angulated. Furthermore, there was moderate stenosis and a severe angle with calcification of the suprarenal aorta. EVAR was performed with a commercial Zenith stent-graft, with a slight modification, because an open aneurysm repair was risky in general condition.

Clinical Results of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Renal Insufficiency without Hemodialysis.

Objective: Chronic renal insufficiency may be a relative contraindication to endovascular aneurysm repair (EVAR) for the use of contrast enhanced mediums. It is thought that more contrast enhanced media are needed in patients who are not anatomically suitable for EVAR, because of procedural difficulties. We reviewed a 2 year EVAR experience at our institution to determine whether the procedure and use of contrast enhanced mediums has any deleterious effect on renal function in patients with pre-existing chronic renal insufficiency.

Delayed closure technique for a ruptured abdominal aortic aneurysm: report of three cases.

This report describes three cases of a delayed closure to prevent the occurrence of abdominal compartment syndrome (ACS) in patients presenting with ruptured abdominal aortic aneurysms (rAAA). The delayed closure technique is useful for rAAA in order to prevent ACS.

Long-term Results of Reconstructive Surgery for the Unilateral Aortoiliac Occlusive Disease and Future Risks of Contralateral Iliac Events.

Objective: Our experience with unilateral iliac reconstructive surgery was retrospectively reviewed, and the long-term patency and the morphological information was disclosed. In addition, the prognosis of contralateral iliac artery was examined, because future contralateral iliac events seem to be important for durability of unilateral iliac revascularizations.

Materials And Methods: 148 patients (mean age, 66.

A New Extra-anatomical Bypass for Atypical Aortic Coarctation with Porcelain Aorta: Reno-iliac Arterial Bypass.

We report a case of atypical aortic coarctation with severe calcification of the proximal aorta treated by a new extra-anatomical bypass. This 58-year-old woman with coarctation of the infrarenal aorta had thick circular calcifications of the thoracic aorta and stenosis of the subclavian arteries. To control the progressive claudication, we performed a bypass with an externally supported PTFE graft 6mm in diameter between the right renal artery and the right common iliac artery.

Upregulation of proteinase-activated receptors and hypercontractile responses precede development of arterial lesions after balloon injury.

Thrombin and other proteinases exert vascular effects by activating the proteinase-activated receptors (PARs). The expression of PARs has been shown to be upregulated after balloon injury and in human arteriosclerosis. However, the relationship between the receptor upregulation and the alteration of vasomotor function remains to be elucidated.

[Occlusion of endovascular stent-graft for abdominal aortic aneurysm three years after surgery].

A 79-year old man was admitted to our department with complaints of bilateral foot coldness, numbness and intermittent claudication. He underwent endovascular repair for abdominal aortic aneurysm three years before. An abdominal X-ray showed highly kinked endovascular stent-graft which indicated graft migration, and aortography showed occlusion of stent-graft and infrarenal aorta.