Objectives: To evaluate the effect of drug-coated balloons (DCB) on symptomatic and recurrent central venous lesions (including in-stent restenosis and occlusion) in hemodialysis patients. Methods: Twenty-seven patients who used DCB for symptomatic central venous lesions between June 2021 and September 2025 were included to examine the efficacy of DCB, the effect of repeat use, and factors affecting patencies. Results: Target lesion patency before and after initial DCB use was significantly improved after DCB use, 30% vs 77% at 6 months (p<0.0001), and the effect of repeat DCB use was not significantly different between first vs. second use. In a subgroup analysis, there was a trend toward better patency rates in the group that used peripheral cutting balloons (PCBs) for pre-dilatation than in the group using conventional balloon, but the difference was not significant. Conclusion: The effect of DCB on recurrent central venous lesions was satisfactory, was similar efficacy with repeated use. A trend toward better patency rates was observed when PCBs were used for anterior dilatation.

Objective: We report the early and long-term results of hybrid endovascular repair of a thoracoabdominal aortic aneurysm (TAAA), perioperative disseminated intravascular coagulation (DIC), and hemorrhagic complications associated with postoperative DIC. Methods: We evaluated 15 patients (10 males and 5 females; median age 74.6 years) who underwent hybrid endovascular repair for TAAA and chronic thoracoabdominal aortic dissection between January 2011 and September 2022. Postoperative complications, survival, incidence of DIC, and risk factors for hemorrhagic complications associated with postoperative DIC were evaluated. DIC was diagnosed using the scoring system established by the Japanese Association for Acute Medicine. Results: Only one patient (6.7%) died within 30 days of treatment due to cerebral hemorrhage. The 5-year survival rate was 64.6% and aneurysm-related deaths were not detected. The 5-year rate of freedom from aneurysm-related complications is 70%. Preoperative DIC occurred in five patients (33%), while postoperative DIC increased in 11 patients (73%), and hemorrhagic complications were detected in 3 patients (20%). A univariate analysis identified preoperative FDP value, thrombus volume, and stent-graft treatment length as risk factors for bleeding complications. Conclusion: Hybrid endovascular repair for TAAA may be a good option for high-risk patients who are ill suited to conventional open repair. Postoperative DIC and hemorrhagic complications associated with extensive stent grafting occur with relatively high frequency and can be fatal. Therefore, risk assessments and appropriate therapeutic interventions for perioperative DIC are necessary.

Objective: Thromboangiitis obliterans (Buerger disease) is known as an intractable vascular disease that has been reported as thrombosis in distal arteries and occasional venous occlusion, as well as inflammatory changes in the thrombus and vascular wall. Patients often require limb amputation due to limb necrosis. Corkscrew (CS), a small arterial coiling, is an important diagnostic finding that was mainly found with angiography. Recently, however, it can also be identified using a modern ultrasonographic technique. Methods: In thease 22 cases, in 48 areas of study, we used the ultrasonographic technique to identify the CS, which allowed us to observe its relationship with the surrounding nerves and arteries. Results: In all cases, it was possible to identify the CS easily and it was confirmed that the CS and the nerve were carried down in their sheath. The sites of the CS existed in areas other than the area around the occluded main arteries and some CS that ran inside the nerve (16 areas) and some CS that accompanied the outside of the nerve (10 areas) were confirmed, suggesting the CS work as collateral blood supply vessels, with well-developed normal vessel-like anatomy. Conclusion: When we observe the CS, it is important to observe not only around the main trunk artery, but also areas where nerves mainly run, even if they do not accompany the main trunk artery.