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
This site is operated by Editorial Committee of Annals of Vascular Diseases.
Editorial Committee of Annals of Vascular Diseases
c/o Academy Center, Yamabuki-cho 358-5, Shinjuku-ku, Tokyo 162-0801, Japan
TEL: +81-3-6824-9399
E-mail: avd-edit[at]je.bunken.co.jp
(Note : change [at] to @ when typing in address.）
Latest articles
Original ArticleJune 13, 2025
Retrospective Study of 43 Cases of Visceral Artery Aneurysms: Evaluation of Surgical Indications Based on the 2020 Revised Guidelines of the Society for Vascular Surgery
Nozomu Ishikawa, Kazunori Inuzuka, Masaki Sano, Kazuto Katahashi, Hajime Tsuyuki, Yusuke Endo, Takaaki Saito, Hiroya Takeuchi, Naoki Unno
Objectives: Advancements in imaging technology have led to an increase in the incidental detection of visceral artery aneurysms (VAAs), which are associated with high mortality when ruptured. In 2020, the Society for Vascular Surgery (SVS) released updated guidelines, replacing the previous 2005 ACC/AHA recommendations. This study aimed to evaluate the impact of the new guidelines through a retrospective analysis of VAA cases treated at our department.
Methods: We retrospectively reviewed 43 cases of VAA treated between 2002 and 2024 at our department. Each case was re-evaluated to determine whether it met the treatment criteria defined in the 2020 SVS guidelines.
Results: Of the 43 cases, 23 (53.5%) met the new guideline criteria. Notably, treatment eligibility for renal and splenic artery aneurysms decreased significantly due to the revised aneurysm size threshold, raised from 2 to 3 cm. The remaining 20 cases were considered ineligible based solely on size, with the exception of cases involving young female patients, ruptured aneurysms, symptomatic lesions, or pseudoaneurysms.
Conclusions: The 2020 SVS guidelines impose stricter treatment indications for VAAs. However, clinical decisions should also consider aneurysm location, patient age, gender, symptoms, and rupture risk on an individual basis.
Case ReportJune 11, 2025
Renal Stent Graft Migration Following Chimney Endovascular Aneurysm Repair
Shun-ichi Kawarai, Yuichi Ono
A 78-year-old male presented with progressive enlargement of a pararenal abdominal aortic aneurysm following chimney endovascular aneurysm repair. The aneurysmal expansion was attributed to an endoleak secondary to migration of the left renal artery chimney stent graft, resulting in a 5-mm increase in aneurysm diameter over 6 months. Endovascular reintervention successfully induced aneurysm regression, with no recurrence of endoleak on annual imaging follow-up. While chimney endovascular aneurysm repair presents a minimally invasive alternative for managing complex aortic pathologies, including pararenal abdominal aortic aneurysms, vigilance regarding potential stent graft migration is essential.
Original ArticleJune 10, 2025
Improvement of Gait Biomechanics after Endovascular Therapy for Patients with Intermittent Claudication Associated with Aortoiliac Occlusive Disease
Norinobu Ogasawara, Takaaki Kakihana, Daijirou Akamatsu, Yuta Tajima, Michihisa Umetsu, Takanori Ishida, Michiaki Unno, Hitoshi Goto, Takashi Kamei, Masahiro Kohzuki
Objectives: Gait disturbances increase mortality rates in lower extremity artery disease. Changes in gait biomechanics after endovascular therapy for intermittent claudication associated with lower extremity artery disease remain unknown. This prospective study investigated the effect of endovascular therapy on gait biomechanics in intermittent claudication.
Methods: We recruited 10 patients (14 affected limbs) with intermittent claudication caused by isolated aortoiliac artery lesions who underwent endovascular therapy, and 10 healthy controls. Using 3-dimensional motion analysis, we measured biomechanical gait parameters preoperatively and over 6 months postoperatively, comparing them with those of healthy controls.
Results: One month after endovascular therapy, parameters improved significantly compared with preoperative values: step length (preoperative median 52.47 [interquartile range 47.11, 60.33]–postoperative 58.53 [54.63, 64.54] cm; P < 0.0037), walking speed (90.17 [73.98, 108.9]–103.49 [97.66, 117.94] cm/s; P = 0.0022), hip flexor moment (−0.75 [−1.04, −0.51] to −0.94 [−1.07, −0.74] Nm/kg; P = 0.04), and pull-off power generated by hip flexor muscles (H3, 0.68 [0.38, 1]–0.86 [0.72, 1.1] W/kg; P = 0.018). Preoperative joint power declined significantly compared to control parameters. However, 6 months postoperatively, no significant differences were observed.
Conclusions: Endovascular therapy for isolated aortoiliac artery lesions improved biomechanical gait parameters in patients with intermittent claudication.
Case ReportJune 5, 2025
Successful Treatment of Type 3b Endoleak after AFX Using TREO
Tobuhiro Nita, Hironori Baba, Yuji Hironaka, Gen Shinohara, Yoshie Ochiai, Shigehiko Tokunaga
Late postoperative type 3 endoleaks associated with the AFX (Endologix, Irvine, CA, USA) stent-graft are commonly reported. The AFX’s endoskeletal design raises concerns about wire entrapment between its frame and fabric, as well as a risk of type 1a endoleak. An 84-year-old man with prior EVAR using the AFX presented with a type 3b endoleak 4 years postoperatively. He underwent relining with the TREO stent-graft (Terumo Aortic, Sunrise, FL, USA), which enabled easy contralateral gate cannulation and secured a long proximal landing zone. The TREO appears to be a viable option for relining the AFX in type 3b endoleak cases.
Case ReportJune 3, 2025
Rupture of the Abdominal Aorta without Aneurysm Associated with Giant Cell Arteritis: A Case Report
Akito Kuwano, Masaru Yoshikai, Satoshi Ohtsubo, Kiyokazu Koga, Nozomi Yoshida, Naoyo Nishida
We report a case of an abdominal aortic rupture without aneurysm associated with giant cell arteritis. A 67-year-old woman presented with lower back pain. Contrast-enhanced computed tomography revealed a massive retroperitoneal hematoma with contrast leakage from the abdominal aorta, suggestive of abdominal aortic rupture. During emergency surgery, a rupture site was identified on the anterior wall of the abdominal aorta, while no aneurysmal changes or dilatation of the abdominal aorta were observed. Histopathological examination of the resected aortic wall revealed infiltration of giant cells positive for CD68, leading to the diagnosis of giant cell arteritis.
Original ArticleMay 30, 2025
Surgical Outcomes of the Boat-Form Vein Cuff Technique in Peripheral Artery Bypass Grafting
Shun-Ichiro Sakamoto, Anna Tsuji, Motohiro Maeda, Atsushi Hiromoto, Kenji Suzuki, Jiro Honda, Yosuke Ishii
Objectives: The venous cuff technique has been used primarily for arterial bypass using artificial grafts to the lower extremities. The boat-form vein cuff was designed to allow adjustment of the size and angle of the anastomosis at any anatomic site. We report our experience and outcomes of the original vein cuff technique in various peripheral artery bypass grafting procedures.
Methods: A total of 10 patients underwent arterial bypass grafting using a polytetrafluoroethylene (PTFE) graft with a boat-form venous cuff. The indications for the surgery consisted of peripheral artery disease (n = 4), acute limb ischemia (n = 4), chronic mesenteric ischemia (n = 1), and traumatic upper limb ischemia (n = 1). Five patients required emergency surgery. Surgical outcomes, such as mortality and morbidity, limb salvage rate, and graft patency, were examined using perioperative and postoperative follow-up data.
Results: There were no operative deaths or serious complications, including amputation of the lower extremity. During the follow-up period (44 ± 36.9 months), the PTFE graft remained patent in 9 patients (90%). In 1 patient, occlusion of the femoropopliteal bypass graft was observed 3 months after surgery.
Conclusions: The simple design and creation of the boat-form vein cuff are useful at any anatomical site in peripheral artery bypass grafting with a PTFE graft.
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.