The first issue of the Annals of Vascular Diseases was published in Japan, in April 2007.
The Journal publishes peer-reviewed original research articles, editorials, reviews, case reports, clinical trials, and how to do its in vascular research, vascular medicine, surgery, and allied fields. To aid in the development of the growing field of vascular medicine in Asia, the Japanese College of Angiology, the Japanese Society for Vascular Surgery and the Japanese Society of Phlebology collaborated to sponsor this new journal. Since October 2008, AVD is the official journal of Asian Society for Vascular Surgery, and since June 2010, the official journal of the Asian Venous Forum.
The Journal encourages and welcomes authors, particularly from Asian countries, to submit original, professional works on clinical and other investigations relating to vascular diseases and angiology.
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 and collects data of patients’ background, therapeutic measures, early results, and long-term prognosis as long as 5 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 2020, 1299 CLI limbs (male 890 limbs: 69%) were registered by 85 facilities. Arteriosclerosis obliterans has accounted for 99% 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 2023; 32: 363–391.)
Coronavirus disease 2019 (COVID-19) has become a huge threat worldwide as a pandemic, which could also cause venous thromboembolism (VTE), including pulmonary embolism (PE). On the basis of the concept of the high risk for VTE in patients with COVID-19, some studies reported the potential benefit of anticoagulation for the primary prevention of VTE. However, optimal strategies for the prevention of VTE in COVID-19 still remain unknown. Additionally, ethnic differences may have notable implications in the presentation of VTE. Very recently, in the Japanese Society of Phlebology and Japanese Society of Pulmonary Embolism Research, a questionnaire surveillance for COVID-19 and VTE was conducted, which revealed that the vast majority of the institutions did not have specific recommendations for the prevention of VTE with anticoagulation, the incidence rate of VTE was 0.6% (7/1243), and that of PE was 0.4% (5/1243). The current questionnaire surveillance has suggested that the management strategies for the prevention of VTE by anticoagulation in COVID-19 could widely vary according to institutions, and the number of patients diagnosed as VTE in COVID-19 in Japan was quite small compared with reports from other countries. Further studies, including cohort/registry-based studies, are warranted to confirm these results.
Objectives: Distal stent graft-induced new entry (dSINE), defined as a new tear caused by a stent graft, has been increasingly observed following total arch replacement using frozen elephant trunk (FET) for aortic dissection. We aimed to investigate the incidence and treatment of dSINE after the use of FET.
Methods: This retrospective study evaluated 70 patients who underwent total arch replacement using FET for aortic dissection between August 2014 and March 2020. They were followed up for at least 6 months postoperatively. Between-group comparisons were performed between those who did and did not develop dSINE. The risk factors for the development of dSINE and the treatment of dSINE were analyzed.
Results: dSINE occurred postoperatively in nine patients (12.9%) with a median time frame of 17.7±11.7 months. The incidence of dSINE did not differ significantly according to classification, phase of dissection, or oversizing. All patients in the dSINE group developed enlargement of the false lumen. dSINE closure was successfully achieved without complications via thoracic endovascular aortic repair (TEVAR) in all patients.
Conclusion: No independent factors predicting the development of dSINE were noted in this study. Additional TEVAR for dSINE provides good results and achieves false lumen thrombosis in the thoracic aorta, with no complications.
Takafumi Kayama, Masaki Sano, Kazunori Inuzuka, Kazuto Katahashi, Tatsuro Yata, Yuta Yamanaka, Ena Naruse, Naoto Yamamoto, Hiroya Takeuchi, Naoki Unno
Objective: To determine the prognostic value of regional tissue oxygenation saturation (rSO2) for ulcer healing after endovascular treatment (EVT) of peripheral arterial disease (PAD).
Materials and Methods: Among PAD patients, 34 patients with chronic limb-threatening ischemia underwent EVT for limb salvage. We retrospectively analyzed the cutoff rSO2 values on postoperative day 1 to predict ulcer healing and patient prognosis. Skin perfusion pressure (SPP) and transcutaneous oxygen pressure (TcPO2) were also used to assess wound healing.
Results: A finger-mounted tissue oximeter can easily measure rSO2 on the dorsal foot. Among the 34 patients, the ulcer healed in 25, and no changes were observed in 2 patients at 1 month after EVT. However, 7 patients needed major amputation at the same time. Wound healing was achieved in all patients with rSO2≥50%. With this cutoff, the sensitivity and specificity of the new device for wound healing were 100% and 64%, respectively. In all the wound healing cases, SPP was ≥45 mmHg, and TcPO2 was ≥40 mmHg.
Conclusion: To assess limb ischemia, rSO2 can be measured quickly and easily using this device. We suggest that an rSO2>50% shows good prognosis for ulcer healing.
There is a growing body of evidence that cumulative hyperglycemic exposure plays a central role in the development and progression of atherosclerotic cardiovascular disease in diabetic patients. Monosaccharides, such as glucose, fructose, and glyceraldehyde can react non-enzymatically with amino groups of proteins, lipids, nucleic acids to form senescent macromolecules termed advanced glycation end products (AGEs), whose formation and accumulation has been known to progress in diabetic patients, especially in those with a long history of disease. The sustained accumulation of AGEs could contribute to the phenomenon of metabolic memory or legacy effects observed in long-term follow-up clinical studies of diabetic patients. AGE modification alters the structural integrity and function of various types of macromolecules, and interaction of AGEs with a receptor for AGEs (RAGE) has been shown to evoke inflammatory and thrombotic reactions. Therefore, the AGE–RAGE axis is a novel therapeutic target of atherosclerotic cardiovascular disease in diabetic patients. In this paper, we briefly review the pathological role of AGEs and their receptor RAGE system in atherosclerotic cardiovascular disease, including peripheral artery disease and discuss the clinical utility of measuring AGEs in evaluating the severity of atherosclerosis in patients with diabetes.