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 ReportFebruary 17, 2026
Staged Endovascular and Surgical Management of Pediatric Tracheo-Innominate Artery Fistula: A Case Report
Yuchen Cao, Masaaki Koide, Masafumi Yashima, Hisashi Sugiyama, Yasumi Nakashima, Arika Matsushita, Kotaro Ishida, Yusuke Okui
Tracheo-innominate artery fistula (TIF) is rare but potentially fatal, especially in pediatric patients. We present a case treated by emergency endovascular stenting followed by elective open surgery. Stent grafting achieved immediate hemostasis and served as a lifesaving bridge, but its limitations—including risks of infection, rebleeding, and graft mismatch due to somatic growth—made definitive surgery necessary. Laryngoscopic findings revealed intratracheal graft exposure, prompting timely graft removal and tracheal repair. This staged strategy highlights both the value of stenting as bridging therapy and the importance of early multidisciplinary planning in pediatric TIF.
Case ReportFebruary 17, 2026
Successful Treatment for a Huge Pulmonary Pseudoaneurysm in the Interlobar Segment with Coil Embolization: A Case Report
Masao Takahashi, Koichiro Matsuura, Ken Nakazawa, Yoko Usami, Shunsuke Yamada, Satoru Mochida, Cho Konjo, Kaiji Inoue, Eito Kozawa
A 62-year-old male with empyema underwent an attempted pleural drainage, which resulted in iatrogenic pseudoaneurysm formation of the right pulmonary artery in the interlobar segment. Endovascular treatment was favored over surgical intervention due to the presence of empyema. The pulmonary artery in the interlobar segment was embolized with metallic coils, with inevitable occlusion of blood perfusion in the middle and lower lobes. Despite the perfusion loss in a large lung territory, the patient eventually required no supplemental oxygenation. Coil embolization can be a favorable alternative to stent-grafting for pseudoaneurysm even in the interlobar segment, despite the potential risk of post-procedure hypoxemia.
Case ReportFebruary 17, 2026
Treatment of a Type II Endoleak from an Atypical Mediastinal Collateral Branch Following Total Arch Replacement with Frozen Elephant Trunk
Emiko Chiba, Kohei Hamamoto, Mamoru Arakawa, Satoshi Uesugi, Soichiro Kojima, Ryoma Kobayashi, Tatsuya Ogawa, Hiroyuki Fujii, Mitsuru Matsuki, Harushi Mori
We present a rare case of type II endoleak (T2EL) from an atypical mediastinal artery following total arch replacement with a frozen elephant trunk (FET) for chronic aortic dissection. A 63-year-old male with a history of multiple thoracic aortic surgeries, including FET, developed enlargement of an aortic arch aneurysm on follow-up. Computed tomography and diagnostic angiography revealed a T2EL due to a newly developed mediastinal collateral artery arising from the left subclavian artery feeding the sac. Selective transcatheter embolization with N-butyl-2-cyanoacrylate successfully eliminated the endoleak. Recognizing such atypical T2EL sources is crucial for managing post-FET aneurysm expansion.
Original ArticleFebruary 7, 2026
Cost Analysis of Abdominal Aortic Aneurysm Repair: The Economic Impact of Rising Surgical Material Costs on Public Health Insurance
Etsuji Umeda, Kiyoshi Doi, Osamu Sakai, Takayoshi Kato, Hiroki Ogura, Masayuki Sato
Objectives: We conducted a detailed comparison of inpatient medical costs between endovascular aneurysm repair (EVAR) and open aneurysm repair (OAR) for abdominal aortic aneurysms.
Methods: We evaluated 312 EVAR and 205 OAR cases performed at our institution between January 2007 and December 2017. Patient background characteristics were adjusted between the EVAR and OAR groups using propensity score matching (PSM). Surgical outcomes and inpatient medical costs were compared.
Results: After PSM, 161 cases were included in each group for comparison. Operative time, blood loss, intensive care unit (ICU) stay, and hospital stay were significantly lower in the EVAR group than in the OAR group. Total inpatient medical costs were significantly higher in the EVAR group (3111× 103 vs. 2156 × 103 JPY [Japanese yen], p <0.01). The surgical material costs in the EVAR group were significantly higher than those in the OAR group, accounting for 58% of total medical expenses. Other costs (diagnosis procedure combination, ICU management, surgical procedure, transfusion, intraoperative injection, and room) were all lower in the EVAR group than in the OAR group.
Conclusions: The cost-saving effects of EVAR, such as reduced transfusion costs and ICU stay fees, were offset by the significantly higher cost of surgical materials.
Review ArticleFebruary 7, 2026
Physician-Modified Endografts for Complex Aortic Aneurysms in Japan: Current Status, Clinical Outcomes, and Guideline Integration
Tsuyoshi Shibata, Yutaka Iba, Shingo Tsushima, Tomohiro Nakajima, Junji Nakazawa, Ayaka Arihara, Kenichi Kato, Shigeki Komatsu, Masato Yonemori, Kenta Yoshikawa, Shun Hayasaka, Hirokazu Sugiura, Hajime Maeda, Nobuyoshi Kawaharada
In Japan, the absence of commercially available fenestrated and/or branched endografts has necessitated widespread adoption of physician-modified endografts (PMEGs) for complex aortic aneurysms. This paper compares PMEG use in Western countries and Japan, summarizes multicenter outcome data, and highlights the gap between real-world practice and current Japanese aortic disease guidelines. Recent Japanese series report high technical success and acceptable mid-term outcomes, comparable to Western reports. While long-term durability remains uncertain, structured training, national registries, and standardized protocols are essential. Guideline acknowledgment of PMEGs could improve safety, consistency, and international alignment in complex endovascular therapy. Establishing structured training, national registries, and evidence-based policy recognition of PMEGs is essential to ensure safe and standardized practice in Japan.
Case ReportFebruary 6, 2026
Thoracic Endovascular Aortic Repair with Reverse Aortic Arch Debranching Technique for Ascending Aortic Pseudoaneurysm
Hiroki Tada, Keiwa Kin, Tsubasa Mikami, Kazuma Handa, Junya Yokoyama, Yukitoshi Shirakawa
Ascending aortic pseudoaneurysm is a rare but life-threatening complication after cardiac surgery, typically requiring redo open repair with substantial risk. We report a 58-year-old male with an incidental 85-mm ascending pseudoaneurysm discovered during evaluation for recurrent hepatocellular carcinoma. Due to prior sternotomy, cirrhosis, and urgent oncologic need, open surgery was deemed prohibitive. He successfully underwent thoracic endovascular repair with reverse extra-anatomical aortic arch debranching technique. He recovered uneventfully and proceeded to cancer treatment without delay. This case highlights the feasibility of hybrid endovascular strategies for ascending aortic pathology in high-risk patients.
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.