Anatomical and clinical factors associated with infrapopliteal arterial bypass outcomes in patients with chronic limb-threatening ischemia.

The aim of this study was to identify anatomical and clinical factors associated with limb-based patency (LBP) loss, major adverse limb events (MALEs), and poor amputation-free survival (AFS) after an infrapopliteal arterial bypass (IAB) surgery according to the Global Limb Anatomic Staging System. A retrospective analysis of patients undergoing IAB surgery between January 2010 and December 2021 at a single institution was performed. Two-year AFS, freedom from LBP loss, and freedom from MALEs were assessed using the Kaplan-Meier method.

Prediction Models for Two Year Overall Survival and Amputation Free Survival After Revascularisation for Chronic Limb Threatening Ischaemia.

Objective: The aim of this study was to create prediction models for two year overall survival (OS) and amputation free survival (AFS) after revascularisation in patients with chronic limb threatening ischaemia (CLTI).

Methods: This was a retrospective analysis of prospectively collected multicentre registry data (JAPAN Critical Limb Ischaemia Database; JCLIMB). Data from 3 505 unique patients with CLTI who had undergone revascularisation from 2013 to 2017 were extracted from the JCLIMB for the analysis.

Efficacy of Fusion Imaging in Endovascular Revascularization of the Superficial Femoral Artery.

Background: The demand for endovascular revascularization (ER) to treat peripheral artery disease (PAD) has steadily increased. However, ER comes at the cost of increased contrast and radiation exposure, particularly in more complex cases. Fusion imaging is a new technology that may address these issues.

Early evaluation of the infrainguinal revascularization strategy selection tool of the Global Vascular Guidelines for chronic limb-threatening ischemia patients.

Objective: The Global Vascular Guidelines (GVG) propose a novel Global Anatomic Staging System (GLASS) with the Wound, Ischemia, and foot Infection (WIfI) classification system as a clinical decision-making tool for interventions in chronic limb-threatening ischemia (CLTI). We assessed the validity of clinical staging and the relationship between the treatments recommended by the GVG and the outcomes of the actual procedures.

Methods: This retrospective, single-center, observational study included 117 patients with CLTI undergoing infrainguinal revascularization in our hospital between 2015 and 2019.

Treatment of prosthetic vascular graft infection in the groin with ultrasound debridement: A case report.

Introduction: Prosthetic graft infection (PGI) is associated with low patient survival rates. The effectiveness of ultrasound debridement in chronic wound healing has been previously reported; however, data on the use of ultrasound technology and its effect on the treatment of PGI are still lacking. We report a case in which PGI in the groin was managed by graft removal using ultrasound debridement.

A modified loop snare technique for the retrieval of a dislodged central venous catheter.

A dislodged central venous port catheter is typically retrieved using an endovascular approach; however, the retrieval procedure poses a challenge for vascular specialists. The desired outcomes can be successfully achieved with the loop snare technique, an endovascular treatment method for the retrieval of a dislodged central venous port catheter. Herein, we present a case wherein the modified loop snare technique was used for successfully retrieving a dislodged central venous port catheter by reversing the tip of the guidewire inside the right ventricle and advancing it back into the snare.

Three cases of fusion imaging in endovascular treatment of occlusive peripheral artery disease.

Endovascular treatment of peripheral artery disease has dramatically improved in the past decades; however, occlusive or stenotic lesions of the femoral-popliteal artery segment remain a significant challenge for vascular specialists. Real-time guidance based on vessel visualization might be helpful for successful recanalization. Herein, we present three successful cases of fusion imaging during endovascular treatment of the femoral-popliteal artery segments.

Deep Circumflex Iliac Artery as an Inflow Alternative for Surgical Revascularization: A Case Report.

The common femoral artery (CFA) is the most widely used inflow in all types of surgical revascularization in patients with peripheral artery disease. However, the CFA cannot always be used because of calcification, obstruction, or previous dissection. Here, we report a rare case of selecting the deep circumflex iliac artery (DCIA) as a source of inflow to perform a surgical revascularization in a patient with chronic limb-threatening ischemia.

A Double-Blind Randomized Controlled Trial to Determine the Preventive Effect of Hangekobokuto on Aspiration Pneumonia in Patients Undergoing Cardiovascular Surgery.

Purpose: This study aimed to assess whether hangekobokuto (HKT) can prevent aspiration pneumonia in patients undergoing cardiovascular surgery.

Methods: We performed a single-center, double-blinded, randomized, placebo-controlled study of HKT in patients undergoing cardiovascular surgery. JPS HKT extract granule (JPS-16) was used as HKT.

Increased Incidence of Cancer in Japanese Patients with Critical Limb Ischemia.

: This multicenter observational study was conducted in order to investigate the incidence of cancer in patients with critical limb ischemia. : We prospectively investigated the incidence of cancer in 68 patients with critical limb ischemia over a two-year period. Patients underwent an intensive examination at enrollment, which included tumor marker levels and chest and abdominal computed tomography, as well as one- and two-year follow-up examinations.

Coil Embolisation for Endovascular Treatment of Proper Hepatic Artery Aneurysm Using the Balloon Occlusion Technique.

Introduction: Endovascular repair (ER) as a minimally invasive approach can be effective for treating hepatic artery aneurysm (HAA) with gratifying results. Microcoil embolisation is the main technique used in ER. However, the coil embolisation of a large proper HAA (PHAA) with a very wide neck tends to be extremely troublesome owing to the limited length of the inflow and outflow artery.

Achieving LDL cholesterol target levels <1.81 mmol/L may provide extra cardiovascular protection in patients at high risk: Exploratory analysis of the Standard Versus Intensive Statin Therapy for Patients with Hypercholesterolaemia and Diabetic Retinopathy study.

Aims: To assess the benefits of intensive statin therapy on reducing cardiovascular (CV) events in patients with type 2 diabetes complicated with hyperlipidaemia and retinopathy in a primary prevention setting in Japan. In the intension-to-treat population, intensive therapy [targeting LDL cholesterol <1.81 mmol/L (<70 mg/dL)] was no more effective than standard therapy [LDL cholesterol ≥2.

Long-Term Results of Crossover Bypass for Iliac Atherosclerotic Lesions in the Era of Endovascular Treatment: The Re-ACTION Study (trospective ssessment of rossover Bypass as a reatment for liac Lesis).

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). 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.

Intensive Treat-to-Target Statin Therapy in High-Risk Japanese Patients With Hypercholesterolemia and Diabetic Retinopathy: Report of a Randomized Study.

Objective: Diabetes is associated with high risk of cardiovascular (CV) events, particularly in patients with dyslipidemia and diabetic complications. We investigated the incidence of CV events with intensive or standard lipid-lowering therapy in patients with hypercholesterolemia, diabetic retinopathy, and no history of coronary artery disease (treat-to-target approach).

Research Design And Methods: In this multicenter, prospective, randomized, open-label, blinded end point study, eligible patients were randomly assigned (1:1) to intensive statin therapy targeting LDL cholesterol (LDL-C) <70 mg/dL ( = 2,518) or standard statin therapy targeting LDL-C 100-120 mg/dL ( = 2,524).

Clinical Significance of the Serotonin Release Assay and Platelet Count Monitoring After Cardiac Surgery.

Heparin-induced thrombocytopenia (HIT) is one of the serious complications in patients who undergo cardiac surgery. However, there remains a major problem in diagnosing HIT because the current immunological assays for detection of HIT antibody have limitations. Furthermore, the clinical course of thrombocytopenia in this surgery makes it increasingly difficult to diagnose HIT.

Spontaneous Evacuation of a Vascular Metallic Stent through a Graft-Duodenal Fistula with Concomitant Non-Surgical Fistula Closure.

We report a patient who developed ileus caused by vascular stent migration into the duodenum with periprosthetic retroperitoneal abscess. The patient previously underwent removal of an infected abdominal aortic aneurysm with concomitant axillobifemoral arterial reconstruction. An occlusion of the graft leg was treated by a unilateral aortoiliac bypass where endovascular surgery with a metallic stent was later needed.

The Effect of Hachimi-Jio-Gan (Ba-Wei-Di-Huang-Wan) on the Quality of Life in Patients with Peripheral Arterial Disease - A Prospective Study Using Kampo Medicine.

To assess whether Hachimi-jio-gan (HJG), a preparation of Kampo medicine (traditional Japanese medicine), improves quality of life (QOL) in patients with peripheral arterial disease (PAD). Among the patients with PAD being followed in the Department of Cardiovascular Surgery at Tokyo Medical University Hachioji Medical Center, those with intermittent claudication (IC) and in stable condition regarding PAD severity were registered. We registered the patients from April 2014 to March 2015.

Reduced Protein C Activity Might be Associated With Progression of Peripheral Arterial Disease.

We evaluated the effect of reduced activities of protein C (PC) and protein S (PS) on the progression of peripheral arterial disease (PAD). We measured PC and PS activities in 106 patients with PAD and 44 patients with abdominal aortic aneurysm (AAA) in the same period. The incidences of PC deficiency in PAD and AAA were 4.

Splenic artery aneurysm of the hepatosplenomesenteric trunk.

We herein report the case of a splenic artery aneurysm with a hepatosplenomesenteric trunk that presented in a pregnant woman. Catheter embolization was not performed due to the wide neck of the aneurysm and its close location to the trunk indicates a high risk of mesenteric trunk thrombosis. We instead performed surgical resection of the aneurysm after successful delivery of the infant by Caesarian section.

Contained rupture of an inflammatory abdominal aortic aneurysm into the iliopsoas muscle: report of a case.

A 72-year-old man with a history of old myocardial infarction was admitted to our hospital for surgical treatment of a ruptured abdominal aortic aneurysm. His hemodynamics was stable. He had left lumbar pain on moving his left leg and constipation for ten days without abdominal pain and high fever.

Recovery of cardiomegaly after treatment of traumatic popliteal arteriovenous fistula.

Circulatory distress can occur in the long term after the formation of a traumatic arteriovenous fistula (AVF), but cardiac failure rarely occurs in a patient with an AVF in the lower extremity. The present patient underwent surgery to treat a traumatic popliteal AVF 9 years after sustaining the injury. Although the patient was asymptomatic with regard to cardiac circulation, cardiomegaly was noted and it resolved promptly after the surgical treatment.

Recurrent mediastinal liposarcoma twenty years after the initial operation: case report.

We report a case of mediastinal liposarcoma, recurrent after 20 years. A 58-year-old man who presented with dyspnea on exertion was found to have a large mediastinal tumor in chest computed tomography (CT), and he was referred to our hospital. He had undergone an extirpation of a mediastinal liposarcoma about 20 years earlier, and we suspected its recurrence.