We performed a comparative study of surgical outcomes and venous functions between endovenous laser ablation with a 980-nm diode laser (EV group) and thigh stripping (ST group). There were no severe complications and initial success rates were 100% in both groups. In the EV group, preoperative symptoms improved in 94.3% of cases, the venous occlusion rate was 98%, and endovenous heat induced thrombosis had occurred in 11.9% (Class 3: 0.7%) at 12 months after the operation. Although comparative study of postoperative venous function by air plethysmography showed significant improvement in both groups, there was less recovery of postoperative venous function in the EV than in the ST group.
Diagnostic criteria of Ex-ABI test is not known in hemodialysis (HD) patients. Results of Ex-ABI test were compared with computed tomographic angiography findings in 25 HD patients (50 limbs) who were suspected of peripheral arterial disease. The sensitivity of the Ex-ABI test was the highest (100%) but its specificity was the lowest (48.3%) using the conventional diagnostic criteria (−15.0%) as the cut-off value. On the other hand, the diagnostic accuracy improved using a cut-off value of −35.0% (sensitivity, 90.5%; specificity, 86.2%). In the case of HD patients, it is difficult to use the conventional diagnostic criteria on Ex-ABI test.
We report a case of a 77-year-old female with type II endoleakage due to recanalization of a coil-embolized internal iliac artery. The patient had undergone endovascular aneurysmal repair (EVAR) for an abdominal aortic aneurysm (5.0 cm in diameter) 4 years back. Because of the right common iliac artery aneurysm, coil embolization to the right internal iliac artery had been simultaneously performed. The diameter of the aneurysm had increased annually after EVAR, and reached 5.7 cm at the time of presentation. Contrast-enhanced computed tomography revealed a moderate amount of type II endoleakage from the right internal iliac artery. Selective angiogram showed the recanalization of the right internal iliac artery, which was once embolized completely. Repetitive coil embolization seemed difficult, because the recanalized artery was fed with multiple narrow, curved collateral vessels. We, therefore, ligated the orifice of the right internal iliac artery via the retroperitoneal approach. No endoleakage from the right internal iliac artery was detected in the final angiogram.