Annals of Vascular Diseases

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Volume 6 (2013) Issue 4 Pages 687-693

Visceral Artery Aneurysms and Pseudoaneurysms—Should They All be Managed by Endovascular Techniques?

Alfredo C. Cordova, Bauer E. Sumpio

Visceral artery aneurysms (VAA) and pseudoaneurysms (VAPA) can be life-threatening conditions with high incidence of rupture and hemorrhage. Greater availability and increased use of advanced imaging technology has led to the increased incidental detection of asymptomatic visceral aneurysms. In addition, increased percutaneous endovascular interventions have raised the incidence of iatrogenic pseudoaneurysms. Due to this, both VAA and VAPA have become an increasingly frequent diagnosis confronting the vascular surgeon. Over the past decade, there has been steady increase in the utilization of minimally invasive, non-operative interventions, for vascular occlusive and aneurysmal disease. All VAA and VAPA can technically be fixed by endovascular techniques but that does not mean they should. These catheter-based techniques constitute an excellent approach in the elective setting, particularly in patients who are poor surgical candidates due to their comorbidities or who present a hostile abdomen. However, in the emergent setting it may carry a higher morbidity and mortality. We review the literature about open and endovascular approach for the treatment of VAA and VAPA both in the elective and emergent setting.

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Volume 5 (2012) Issue 4 Pages 416-422

Compression Therapy: Clinical and Experimental Evidence

Hugo Partsch

Aim: A review is given on the different tools of compression therapy and their mode of action.Methods: Interface pressure and stiffness of compression devices, alone or in combination can be measured in vivo. Hemodynamic effects have been demonstrated by measuring venous volume and flow velocity using MRI, Duplex and radioisotopes, venous reflux and venous pumping function using plethysmography and phlebodynamometry. Oedema reduction can be measured by limb volumetry.Results: Compression stockings exerting a pressure of ~20 mmHg on the distal leg are able to increase venous blood flow velocity in the supine position and to prevent leg swelling after prolonged sitting and standing. In the upright position, an interface pressure of more than 50 mmHg is needed for intermittent occlusion of incompetent veins and for a reduction of ambulatory venous hypertension during walking. Such high intermittent interface pressure peaks exerting a “massaging effect” may rather be achieved by short stretch multilayer bandages than by elastic stockings.Conclusion: Compression is a cornerstone in the management of venous and lymphatic insufficiency. However, this treatment modality is still underestimated and deserves better understanding and improved educational programs, both for patients and medical staff.

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Volume 6 (2013) Issue 2 Pages 180-188

Significance of Ultrasound Examination of Skin and Subcutaneous Tissue in Secondary Lower Extremity Lymphedema

Kotaro Suehiro, Noriyasu Morikage, Masanori Murakami, Osamu Yamashita, Makoto Samura, Kimikazu Hamano

Objectives: To clarify whether ultrasound findings of skin and subcutaneous tissue represent the severity of lymphedema.
Materials and Methods: Thirty-five patients with secondary lower extremity lymphedema caused by intrapelvic lymph node dissection during cancer surgery, who first visited our clinic between April 2009 and March 2012, were studied retrospectively. At their first visit, skin thickness, subcutaneous tissue thickness, and subcutaneous echogenicity were assessed at 8 points on the thigh and leg of both legs using an 11-MHz ultrasound transducer. These findings correlated with the International Society of Lymphology (ISL) clinical stage.
Results: Skin thickness, subcutaneous tissue thickness, and subcutaneous echogenicity all showed significant positive correlation with the ISL stage. However, measuring skin and subcutaneous tissue thicknesses was not feasible in 29%-71% of scanning points in stage III legs because of poor delineation of boundaries at the dermo-hypodermal junction and the upper boundary of the muscular fascia. However, subcutaneous echogenicity was assessable at all scanning points and was linearly correlated with ISL stage.
Conclusion: Evaluating subcutaneous echogenicity is feasible even with low-resolution ultrasound and reflects the ISL stage. These findings may thus be valuable to objectively represent the severity of extremity lymphedema.

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Volume 12 (2019) Issue 1 Pages 109-135

2016 JAPAN Critical Limb Ischemia Database (JCLIMB) Annual Report

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), is created on the National Clinical Database (NCD) and collects data of patients’ background, therapeutic measures, early results, and long term prognosis as long as five years after the initial treatment. The limbs managed conservatively are also registered in JCLIMB, together with those treated by surgery and/or EVT. In 2016, 1,092 CLI limbs (male 755 limbs: 70%) were registered by 91 facilities. ASO has accounted for 98% of the pathogenesis of these limbs. In this manuscript, the background data, the early prognosis, and 6-months’ prognosis of the registered limbs are reported. (This is a translation of Jpn J Vasc Surg 2019; 28: 1–27.)

Volume 11 (2018) Issue 3 Pages 398-426

2015 JAPAN Critical Limb Ischemia Database (JCLIMB) Annual Report

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. The limbs managed conservatively are also registered in JCLIMB, together with those treated by surgery and/or endovascular treatment. In 2015, 1138 CLI limbs (male, 796 limbs [70%]) were registered by 92 facilities. Arteriosclerosis obliterans has accounted for 98% of the pathogenesis of these limbs. In this manuscript, the background data and the early prognosis of the registered limbs are reported. (This is a translation of Jpn J Vasc Surg 2018; 27: 155–185.)

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2021 Volume 14 Issue 1

Type B Acute Aortic Dissection as a Perioperative Complication after an Endovascular Abdominal Aortic Repair Kayoko Natsume, Tsunehiro Shintani, Masanori Hayahi, Kazuhiro Ohkura, Yuto Hasegawa, Takumi Ariya
A Case of Isolated Infragenicular Arterial Lesions Successfully Treated with Open Endarterectomy Hiroko Okuda, Shinsuke Kikuchi, Atsuhiro Koya, Hidehiro Takei, Nobuyoshi Azuma
Lipoprotein Profiles before Heparin Administration in Patients with or without Coronary Thrombosis Following Atherosclerosis Tomomi Koizumi, Hideaki Kaneda, Nobuyuki Komiyama, Ikuo Inoue, Toshihiro Muramatsu, Katsuyuki Nakajima
Use of Sponge-Foam Inserts in Compression Bandaging of Non-Healing Venous Leg Ulcers Rica Tanaka, Hideaki Inoue, Takeru Ishikawa, Yuichi Ichikawa, Rumiko Sato, Azusa Shimizu, Hiroshi Mizuno

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