Recent innovations of CT have made great advances in imaging of vascular disease. This is because CT has made it possible to obtain wide areas with high speed and thin slice thickness. In addition, imaging options such as ECG-gated scan, subtraction technique and ultra-high-resolution CT have enhanced the diagnostic utility for vascular diseases. On the other hand, photon-counting CT, the newest type of CT equipment, is promising to be applied to the vascular imaging because of its high spatial resolution and high capability of material decomposition.

We have previously reported that spinal cord injury (SCI) after TEVAR for thoracic aortic aneurysm (TAA) is a micro embolism due to a vulnerable mural thrombus. Conversely, TEVAR in patients with aortic dissection (AD) develops SCI less frequently because of fewer mural thrombi. To prevent SCI after TEVAR for AD, attention should be paid to preserving blood flow towards the spinal cord, such as collateral circulation and steal phenomenon.

In Europe, herbal medicinal products containing horse chestnut seed extract as an active ingredient are widely used in patients with chronic venous insufficiency (CVI). In Japan, however, no clinical evidence for this drug has been established, and it has not been approved as a drug for CVI in Japan. Accordingly, we conducted a multicenter, open-label, single-arm study to confirm the efficacy and safety of ZO-SA0 (Belfemin) containing horse chestnut seed extract in seventy Japanese patients with mild CVI. After 12  weeks of treatment with the drug, a decrease in lower leg volume and improvement in subjective symptoms were suggested, as in overseas clinical studies, and no safety problems were observed.

A 43-year-old man visited a previous doctor with intermittent claudication of the left lower leg. He was referred to our hospital on the suspicion of left lower extremity arterial stenosis. CT and MRI showed that the left popliteal artery was compressed by a multilocular cystic structure, resulting in focal stenosis. He was diagnosed with left popliteal adventitial cystic disease. The stenotic lesion was surgically resected and replaced with the saphenous vein graft. Pathologically, the cystic lesion was located outside the arterial wall and was diagnosed as a ganglion.