Annals of Vascular Diseases (AVD) is an international, peer-reviewed, open access journal publishing articles on vascular disease. Published continuously online, the journal is fully indexed in J-STAGE and PubMed Central. AVD welcomes submissions from around the world.
Announcements
The licensing policy for our journal has been updated. Starting from January 1, 2025, newly published articles will generally be licensed under the CC BY (Attribution) license.
– Articles published on or after January 1, 2025: Licensed under CC BY (Attribution).
– Articles published before January 1, 2025: Retain their original license, CC BY-NC-SA (Attribution-NonCommercial-ShareAlike).
– Secondary publications (e.g., translations) may follow the licensing terms of the primary publication.
For more details, please refer to the “Copyright, Open Access and Fees” section of the Instructions to Authors.
About the journal
AVD is an official journal of Asian Society for Vascular Surgery (ASVS) and Asian Venous Forum, sponsored by Japanese College of Angiology, Japanese Society for Vascular Surgery and the Japanese Society of Phlebology.
Contact
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Editorial Committee of Annals of Vascular Diseases
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E-mail: avd-edit[at]je.bunken.co.jp
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Latest articles
Case ReportDecember 17, 2025
Hybrid Repair of a True Brachiocephalic Artery Aneurysm: A Case Report
Takahiro Mizoguchi, Hiroshi Ito, Hiroshi Kurazumi, Masaya Takahashi, Yoshitaka Ikeda, Noriyasu Morikage, Kimikazu Hamano
A 74-year-old man with hypertension and hyperuricemia was incidentally diagnosed with a 39-mm brachiocephalic artery aneurysm. Because of a sufficient proximal sealing zone, a hybrid repair was performed, consisting of a right common carotid–axillary bypass with a prosthetic graft, followed by endovascular exclusion using covered stents, a vascular plug, and coils. Completion angiography confirmed complete aneurysm exclusion without endoleak and satisfactory bypass flow. The postoperative course was uneventful. Computed tomography (CT) angiography demonstrated persistent aneurysm exclusion without endoleak and a patent bypass. At 12 months, plain CT confirmed no aneurysm enlargement.
Original ArticleDecember 17, 2025
Revascularization of the Superficialized Brachial Artery
Shunichiro Fujioka, Kenjiro Sakaki
Objectives: The superficialized brachial artery (SBA) is an important alternative vascular access for hemodialysis patients when autogenous vein fistula creation is not feasible. However, repeated puncture of the SBA can lead to severe complications such as aneurysm formation, pseudoaneurysm, and infection. This study aimed to review surgical strategies for revascularization and infection control in SBA aneurysms.
Methods: We retrospectively analyzed 8 cases of SBA aneurysms treated at our institution between November 2020 and June 2025. Patient demographics, comorbidities, surgical procedures, and outcomes were evaluated based on medical records and follow-up data.
Results: Patients ranged in age from 43 to 81 years and had been on dialysis for an average of 19 years. Six aneurysms were ruptured, and 5 were associated with infection. Brachial artery bypass was the most common procedure, performed in 6 patients using autologous veins or prosthetic grafts. One patient underwent fistula closure with a bovine pericardial patch, and another received direct arterial anastomosis. In infected cases, autologous vein bypass or aneurysm resection with direct anastomosis was performed after thorough debridement. All patients maintained adequate dialysis access postoperatively.
Conclusions: Revascularization of the SBA using autologous vein bypass is effective for managing aneurysms, especially in infected cases. Careful infection control and individualized surgical planning are essential for maintaining safe dialysis access and preserving limb function.
Case ReportDecember 11, 2025
Challenges in Identifying and Interpreting Intercostal Branches of the Adamkiewicz Artery
Satoru Tomita, Yoshimasa Seike, Tatsuya Nishii, Kazufumi Yoshida, Yojiro Koda, Takayuki Shijo, Yosuke Inoue, Tetsuya Fukuda, Hitoshi Matsuda
An 82-year-old woman underwent zone 4 thoracic endovascular aortic repair (TEVAR) for a descending aortic aneurysm. Four years later, an additional TEVAR was performed for a type Ib endoleak. Preoperative computed tomography angiography (CTA) initially identified the intercostal artery branching of the Adamkiewicz artery (ICA-AKA) at the left 10th thoracic level, which was covered by a stent graft. Prior to the second TEVAR, CTA showed the ICA-AKA via the left first lumbar artery. Reevaluation of the ICA-AKA is important, particularly after coverage. Surgeons should interpret CTA findings carefully, as other arteries or veins may resemble the AKA.
Case ReportDecember 9, 2025
Progressive Stenosis of Thoraflex Hybrid Prosthesis after Total Arch Replacement Leading to a Fatal Outcome: A Case Report
Norimasa Haijima, Mikihiko Kudo, Satoru Murata, Takuya Ono, Hideyuki Shimizu
The Thoraflex Hybrid prosthesis (Terumo Aortic, Inchinnan, UK) is widely used for total arch replacement, but postoperative stenosis or pseudo-coarctation is rare and potentially fatal. We report an 83-year-old man who underwent a Bentall procedure and total arch replacement with a 36-mm Thoraflex Hybrid graft (Terumo Aortic). Postoperative imaging showed mild stenosis, but distal perfusion was maintained. Eighteen hours later, his cardiac index dropped to 1.4 L/min/m2 and lactate rose to 11.2 mmol/L. Computed tomography (CT) revealed severe graft stenosis. Although rescue thoracic endovascular aortic repair (TEVAR) transiently improved hemodynamics, the patient succumbed to multiorgan failure despite veno-arterial extracorporeal membrane oxygenation (VA ECMO). This case underscores the need for early recognition and prompt intervention.
Original ArticleNovember 22, 2025
Thoracic Endovascular Aortic Repair for Kommerell’s Diverticulum
Masato Hayama, Go Kuwahara, Hiromitsu Teratani, Mau Amako, Hiroyuki Ito, Hideichi Wada
Objectives: Thoracic endovascular aortic repair (TEVAR) has recently emerged as a less invasive alternative to open thoracotomy for the treatment of Kommerell’s diverticulum (KD). However, anatomical challenges, including an acute aortic arch and an aberrant subclavian artery, often limit its feasibility. This study aimed to evaluate the outcomes of TEVAR for KD.
Methods: Between February 2012 and July 2023, 6 patients with KD underwent TEVAR at 3 institutions. Subclavian artery embolization or reconstruction was performed when necessary. Morphological parameters, including the Kommerell’s diverticulum diameter (KDd) and the distance to the opposite aortic wall (DAW), were assessed.
Results: Four patients underwent subclavian artery embolization, including 1 requiring bilateral embolization. Subclavian artery reconstruction was performed in 2 cases. Intraoperative type 1a endoleaks were observed in 3 cases and were successfully managed with additional stent grafts. During a follow-up period ranging from 13 to 83 months, 1 patient required open surgical conversion due to graft infection. No other severe complications or aneurysmal progression were noted.
Conclusions: Despite the limited follow-up period and lack of long-term data, TEVAR for KD demonstrated favorable short- to mid-term outcomes and may represent an effective treatment option in selected patients.
Case ReportNovember 15, 2025
True Digital Artery Aneurysm: A Case Report
Hiroki Nakabori, Hideyasu Ueda, Kenji Iino
True aneurysms of the digital artery are extremely rare, and only several dozen cases have been reported worldwide. A 29-year-old man presented with a pulsatile, tender nodule in his left index finger. Angiography revealed a 7-mm saccular aneurysm of the proper palmar digital artery with well-developed distal collaterals. Under local anesthesia, the aneurysm was excised following proximal and distal ligation. It was histopathologically confirmed as a true aneurysm. Postoperatively, symptoms resolved without ischemic or neurological complications and without recurrence after 1 year. Thus, simple ligation and excision are effective when collateral circulation is sufficient.
Featured articles
GuidelineJune 6, 2025
Supplement of Clinical Practice Guidelines for Endovenous Thermal Ablation for Varicose Veins 2019: Laser Ablation of Varicose Tributaries
Masayuki Hirokawa, Junichi Utoh, Satoru Sugiyama, Osamu Suzuki, Takashi Yamamoto, Tomohiro Ogawa, Makoto Mo, on behalf of the Guideline Committee, Japanese Society of Phlebology
In the treatment of saphenous varicose veins with endovenous laser ablation, simultaneous treatment of varicose tributaries using stab avulsion or sclerotherapy is commonly performed. To address the limitations of these conventional treatments, laser ablation for varicose tributaries has recently gained widespread acceptance. This guideline, developed by the Japanese Society of Phlebology, outlines appropriate treatment protocols for laser ablation of varicose tributaries. Indications include primary varicose veins requiring concurrent treatment of the saphenous trunk and varicose tributaries. The procedure utilizes slim radial fibers, with puncture and ablation performed using either short- or long-axis approaches. Although rare, adverse events such as skin burns, nerve injury, and fiber breakage have been reported. A learning curve is necessary to ensure the safe execution of the procedure. Further clinical studies are essential to enhance the safety and efficacy of laser ablation for varicose tributaries. (This is a secondary publication from Jpn J Phlebol 2025; 36: 51–58.)
Overview of type 2 endoleak following endovascular aneurysm repairMarch 25, 2023
Surgical Treatment of Sac Enlargement Due to Type II Endoleaks Following Endovascular Aneurysm Repair
Seiji Onitsuka, Hiroyuki Ito
An aneurysm sac enlargement caused by type II endoleak (T2EL) following endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms may cause serious complications such as rupture. Consequently, methods that preoperatively prevent or postoperatively treat T2EL have been employed.
Therapeutic Angiogenes UpdateDecember 25, 2022
Therapeutic Angiogenesis Using Autologous CD34-Positive Cells for Vascular Diseases
Yasuyuki Fujita, Atsuhiko Kawamoto
CD34 is a cell surface marker, which is expressed in various somatic stem/progenitor cells such as bone marrow (BM)-derived hematopoietic stem cells and endothelial progenitor cells (EPCs), skeletal muscle satellite cells, epithelial hair follicle stem cells, and adipose tissue mesenchymal stem cells. CD34+ cells in BM and peripheral blood are known as a rich source of EPCs.
Updates on Image Diagnosis in Aortic DiseaseDecember 25, 2018
Update on Cardiovascular Echo in Aortic Aneurysm and Dissection
Kazuhiro Nishigami
The majority of aortic aneurysms comorbid with atherosclerosis can be asymptomatic and are discovered incidentally on routine physical examination or on imaging studies for other indications. Transthoracic echocardiography is a basic modality to assess patients with coronary artery disease and can be used for the screening of aortic aneurysm. Acute aortic dissection is a highly lethal cardiovascular emergency and requires prompt recognition. Although cardiovascular echo has a suboptimal accuracy rate for detecting aortic dissection, it is noninvasive, readily available, and easy to use. Recently, the concept of point-of-care ultrasound (POCUS) refers to ...
Updates on Image Diagnosis in Aortic DiseaseSeptember 25, 2019
Updates on Ultrasonography Imaging in Abdominal Aortic Aneurysm
Shinichi Iwakoshi, Toshiko Hirai, Kimihiko Kichikawa
Abdominal aortic aneurysms (AAAs) are life-threatening and are associated with >80% mortality when they rupture. Therefore, detecting these aneurysms before they rupture is critical. Ultrasonography is a non-invasive tool that is used for screening AAAs by measuring abdominal aorta diameter. A recent meta-analysis demonstrated the positive effects of ultrasonography. To date, aneurysm diameter is the most reliable predictor for aneurysm rupture and is used as a criterion for surgical intervention. However, some AAAs rupture at small diameters. Therefore, a better predictor for AAA rupture that is independent of aneurysm diameter is needed. Recently, an aortic wall strain examined using ultrasonography has been reported to have a potential in predicting AAA rupture....
Updates on Image Diagnosis in Aortic DiseaseMarch 25, 2020
Updates on Computed Tomography Imaging in Aortic Aneurysms and Dissection
Ryoichi Tanaka, Kunihiro Yoshioka, Akihiko Abiko
Computed tomography (CT) is a primary imaging modality for the diagnosis of aortic diseases, because of its minimal invasiveness and agility. Prompt and accurate diagnosis is crucial especially for acute aortic diseases, and the guidelines for acute aortic dissection recommend the use of CT for initial diagnosis. For the follow-up observation of longstanding aortic diseases, the strategy of imaging management by CT must be different from that for emergency and acute phases. In this review, we document the differences in characteristics and clinical course between aortic aneurysm and aortic dissection and explain the use of recent CT techniques in diagnosing short- and longstanding aortic diseases.