For abdominal aortic aneurysms, “In cases with a life expectancy of more than 10 years, open repair may be considered rather than EVAR” is recommended in Class IIb, and for thoracic aortic aneurysms, TEVAR for descending aortic aneurysms that meet anatomic requirements is recommended in Class I. For type B aortic dissection, “Preemptive TEVAR for high-risk uncomplicated cases, such as those in which future expansion is anticipated” is recommended in Class IIa.

ANCA-associated vasculitis is a necrotizing small vessel vasculitis associated with myeloperoxidase (MPO)- or proteinase 3 (PR3)-ANCA and is a systemic disease that affects various organs, including the kidney, lung, and nerves. New drugs and therapies are being investigated for both induction and maintenance of remission to improve efficacy and reduce side effects compared with conventional combination therapy with glucocorticoid and cyclophosphamide. Rituximab, an antibody preparation against CD20 antigen-positive B cells, has been shown to be non-inferior to cyclophosphamide for induction of remission and superior to azathioprine for maintenance of remission. In terms of side effects, rituximab is considered easier to use than cyclophosphamide. On the other hand, avacopan, a selective C5a receptor antagonist, has been shown to be an alternative to glucocorticoid during induction of remission and to have superior efficacy in preventing relapse compared to glucocorticoid during maintenance of remission. As for the glucocorticoid dosage, a randomized controlled trial (PEXIVAS) of plasma exchange therapy and glucocorticoid administration for ANCA-associated vasculitis showed no difference in remission rates and a low incidence of serious infections, even at about half the conventional dose of glucocorticoid.

Vascular anomalies are classified as either a vascular tumor or a vascular malformation. Precise diagnosis of vascular anomalies requires careful correlation of clinical findings, diagnostic imaging, histopathology, and genetic analysis. Pathological diagnosis, in particular, is important especially for vascular tumors and malformations, following the International Society for the Study of Vascular Anomalies (ISSVA) classification. Herein, we present an overview of the updated classification scheme, and histological features emphasizing on vascular tumors (infantile hemangioma, congenital hemangioma and kaposiform hemangioendothelioma) and malformations.

A 77-year-old man was diagnosed with cardiac tamponade and underwent emergency pericardial drainage. A contrast-enhanced computed tomography (CT) scan detected the ruptured false lumen of acute Stanford type B aortic dissection with an entry in the distal arch. We performed an emergency thoracic endovascular aortic repair (TEVAR) for lifesaving, but the postoperative paraplegia was developed. The adamkiewicz artery at the 12th level of thoracic vartebra was patent on CT examination. Because there are few reports that the acute Stanford type B aortic dissection causes cardiac tamponade and the pathology requires urgent treatment, we will review the literature.

The patient is a 76-year-old woman. Coronary angiography showed significant stenosis, and she underwent percutaneous coronary intervention (PCI). After stenting from the left main trunk (LMT) to the left anterior descending branch (LAD), contrast-enhanced CT showed DeBakey type I acute aortic dissection and cardiac tamponade, and she underwent emergency coronary artery bypass surgery with ascending replacement. DeBakey type I acute aortic dissection with LMT as an entry point is rare and is reported here.