We have developed a non-obstructive general angioscopy (NOGA) applied for any vessel size. Frequent spontaneously ruptured aortic plaques in the aorta are implicated in organ dysfunction leading to aging. We demonstrated the progression and rupture of plaques via innate immune response involving cholesterol crystals by in situ NOGA studies. Furthermore, NOGA has advanced the identification of detailed endothelial injuries in acute aortic dissections and their application in treatment. NOGA is valuable for the assessment and new therapies for atherosclerotic disease.

Although some vascular malformation lesions are localized, various lesions invade the surrounding tissue extensively and are considered difficult to resect. Usually, endovascular treatment such as sclerotherapy and embolization tend to be employed for such lesions, but resection is highly effective in reducing the size of the lesion, so resection is still preferred as one of available treatment. In this report, we review our recent techniques in resection of lymphatic malformations, venous malformations, and arteriovenous malformations.

An 87-year old man with a history of graft replacement for abdominal aortic aneurysm over 20 years previously was admitted to our hospital with a diagnosis of non-anastomotic aneurysm of Dacron graft. 4-dimentional computed tomography (CT) revealed extravasation from the previously replaced Dacron graft. Endovascular aneurysm repair (EVAR) was performed with ENDURANT Aorto-uni iliac graft. Postoperative CT at 3 months revealed shrinkage of the aneurysm without extravasation. Non-anastomotic Pseudoaneurysm treated with EVAR was rare and 4-dimentional CT was effective for the diagnosis of this disease.