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.
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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).
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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.
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Latest articles
Original ArticleMay 13, 2025
Clinical Management of Peri-Aortitis Following Endovascular Aortic Repair for Abdominal Aortic Aneurysm
Yuriko Takeuchi, Noriyasu Morikage, Ryunosuke Sakamoto, Takahiro Mizoguchi, Makoto Samura, Takasuke Harada, Hiroshi Kurazumi, Ryo Suzuki, Kotaro Suehiro, Kimikazu Hamano
Objectives: Peri-aortitis following endovascular aneurysm repair (EVAR) is a rare phenomenon with unclear pathogenesis. In this study, we investigated its clinical features and sac prognosis.
Methods: A retrospective analysis was conducted on 1369 EVAR. Peri-aortitis was defined using post-EVAR computed tomography. Clinical and imaging data were assessed.
Results: Peri-aortitis following EVAR was identified in 12 patients (0.89%) with a mean age of 74 ± 8.9 years; 83.3% were male, and 41.7% had allergic or autoimmune histories. There were eight symptomatic cases (66.7%), including seven with fever, three with back or abdominal pain, and one with hydronephrosis. Precautionary antibiotic treatment was administered in five febrile cases. Although persistent and recurrent inflammation was observed in two cases (16.7%) each, inflammation resolved spontaneously in seven patients (58.3%). One (8.3%) needed steroid therapy for severe back pain. Aneurysm shrinkage was observed in seven cases (58.3%), while enlargement was noted in one case (8.3%) with type II endoleak. No correlation was found between aneurysm growth and peri-aortitis development.
Conclusions: Peri-aortitis following EVAR may present significant challenges, including differentiation from infection, management of symptomatic cases requiring medical therapy, and addressing recurrences. Accurate diagnosis, individualized treatment, and meticulous follow-up are essential for favorable outcomes.
Original ArticleApril 17, 2025
Acute Effect of Two Different Hand Exercises on Vessel Size in Patients Undergoing Arteriovenous Fistula Creation
Yuthapong Wongmahisorn, Pong Kanchanasuttirak, Waigoon Stapanavatr, Yupadee Fusakul
Objectives: We primarily aimed to compare the acute effects of hand-squeezing exercises, with and without tourniquet-like compression, on vessel size 5 minutes post-exercise in patients after arteriovenous fistula (AVF) creation. The secondary aim was to assess differences in AVF blood flow rates between the 2 interventions.
Methods: A randomized study was conducted at a university hospital in Bangkok, Thailand, from October 2018 to September 2023. Seventy-eight participants, 2 weeks post-first-time autogenous AVF creation, were randomized into 2 groups: a non-compression group (n = 39) performing 5 minutes of hand-squeezing exercises and a compression group (n = 39) performing the same exercises with tourniquet-like compression. Ultrasound measured venous diameter and blood flow rates pre- and post-exercise.
Results: Both groups showed increased venous diameter, but the difference between the groups was not statistically significant (mean difference: 0.18 mm with compression vs. 0.12 mm without; P = 0.489). Blood flow rates increased significantly in the compression group compared to the non-compression group (mean difference: 171.49 vs. 24.44 mL/min; P = 0.002).
Conclusion: Hand-squeezing exercises with tourniquet-like compression significantly improved AVF blood flow rates acutely, supporting its potential to enhance AVF maturation. Further research is needed to assess long-term benefits.
Annual ReportApril 10, 2025
Vascular Surgery in Japan: 2019 Annual Report by the Japanese Society for Vascular Surgery
The Japanese Society for Vascular Surgery Database Management Committee Member, NCD Vascular Surgery Data Analysis Team
Objectives: This is an annual report indicating the number and early clinical results of annual vascular treatment performed by vascular surgeons in Japan in 2019, as analyzed by database management committee (DBC) members of the JSVS.
Materials and Methods: To survey the current status of vascular treatments performed by vascular surgeons in Japan, the DBC members of the JSVS analyzed the vascular treatment data provided by the National Clinical Database (NCD), including the number of treatments and early results such as operative and hospital mortality.
Results: In total 154,460 vascular treatments were registered by 1,082 institutions in 2019. This database is composed of 7 fields including treatment of aneurysms, chronic arterial occlusive disease, acute arterial occlusive disease, vascular injury, complication of previous vascular reconstruction, venous diseases, and other vascular treatments. The number of vascular treatments in each field was 23,826, 17,100, 4,947, 2,369, 674, 54,023, and 51,521, respectively. In the field of aneurysm treatment, 20,369 cases of abdominal aortic aneurysm (AAA) including common iliac aneurysm were registered, and 63.3% were treated by endovascular aneurysm repair (EVAR). Among AAA cases, 1,739 (8.5%) cases were registered as ruptured AAA. The operative mortality rates of ruptured and un-ruptured AAA were 15.0%, and 0.6%, respectively. 43.8% of ruptured AAA were treated by EVAR, and the EVAR ratio was gradually increasing, but the operative mortality rates of open repair and EVAR for ruptured AAA were 12.6%, and 15.4%, respectively. Regarding chronic arterial occlusive disease, open repair was performed in 8,026 cases, including 1,250 distal bypasses to the crural or pedal artery, whereas endovascular treatment (EVT) was performed in 8,879 cases. The EVT ratio was gradually increased at 51.9%. Varicose vein treatment was decreased in 42,313 cases (1.9% less than in 2018), and 79.8% of the cases were treated by endovenous thermal ablation (ETA) including endovenous laser ablation (EVLA) and radio-frequency ablation (RFA). Regarding other vascular operations, 47,605 cases of vascular access operations and 1,703 lower limb amputation surgeries were included.
Conclusions: The number of vascular treatments increased since 2011, and the proportion of endovascular procedures increased in almost all fields of vascular diseases, especially EVAR for AAA, EVT for chronic arterial occlusive disease, and ETA for varicose veins. (This is a translation of Jpn J Vasc Surg 2024; 33: 307–335.)
Case ReportApril 3, 2025
Common Femoral Artery Aneurysm: A Rare Manifestation of Immunoglobulin G4-Related Disease
Masaru Yoshikai, Hisashi Sato, Akito Kuwano, Naoyo Nishida
We present a case of a common femoral artery aneurysm as an extremely rare manifestation of immunoglobulin G4-related disease (IgG4-RD). A 79-year-old male, who underwent emergency abdominal aortic aneurysm repair at age 60 due to rupture, developed enlarging aneurysms of the right internal iliac artery, the right common femoral artery, and the left common femoral artery. Consequently, the right iliac artery was replaced with a graft extending to the right deep femoral artery, also reconstructing the right internal iliac artery. Histopathological examination of the resected common femoral artery wall confirmed the diagnosis of IgG4-RD.
Original ArticleApril 1, 2025
Risk Factors for Acute Hemorrhagic Rectal Ulcers after Bypass Surgery for Chronic Limb-Threatening Ischemia
Yohei Kawai, Masayuki Sugimoto, Takuya Osawa, Changi Lee, Shuta Ikeda, Kiyoaki Niimi, Hiroshi Banno
Objectives: Acute hemorrhagic rectal ulcer (AHRU) occurs with a sudden onset of painless bloody stools and is caused by impaired blood flow in the rectal mucosa due to arteriosclerosis or prolonged bedridden status. Little information is available about AHRU in patients with chronic limb-threatening ischemia (CLTI). This study aimed to identify factors related to AHRU among CLTI patients after bypass surgery.
Methods: Between 2019 and 2023, we enrolled 80 CLTI patients at our institution who underwent bypass surgery using autogenous veins. Data were collected prospectively and supplemented with retrospective medical record reviews. Information regarding demographic and clinical characteristics was collected. The outcomes of patients without AHRU (non-AHRU group) and those with AHRU (AHRU group) were compared. Logistic regression analysis was used to assess factors associated with AHRU after bypass surgery.
Results: During the study period, 6 of the 80 patients (7.5%) experienced AHRU after bypass surgery. There was no significant difference in the global limb anatomic staging system (GLASS) or wound ischemia and foot infection (WIfI) stage between the 2 groups. The percentage of patients taking oral steroids was significantly greater in the AHRU group. In addition, the AHRU group had a significantly greater percentage of postoperative ambulatory failure and a longer hospital stay. In the univariate analysis of factors associated with the incidence of AHRU after bypass surgery, steroid use (odds ratio [OR], 13.8; 95% confidence interval [CI], 2.19–86.9; P = 0.005) and nonambulatory status after surgery (OR, 7.22; 95% CI, 1.26–41.4; P = 0.026) were significant factors.
Conclusions: Steroid use and postoperative nonambulatory status were associated with AHRU after bypass surgery for CLTI.
Original ArticleMarch 28, 2025
Current Status of Diagnostic Process in Asymptomatic Abdominal Aortic Aneurysm in Japan
Yoshimasa Seike, Nobuyoshi Azuma, Takao Ohki, Noriyasu Morikage, Akio Kodama, Makoto Sumi, Koji Maeda, Hitoshi Matsuda
Objectives: This study aimed to investigate the actual detection process and diagnostic methods for asymptomatic abdominal aortic aneurysm (AAA) in a multicenter setting, and to plan an effective screening strategy for asymptomatic AAA.
Methods: The subjects of this multicenter study were collected in a retrospective manner at 7 facilities. A total of 1894 patients with AAA, including iliac artery aneurysms, who were considered asymptomatic with a confirmed initial diagnosis from January 2018 to December 2022, were collected and reviewed.
Results: A total of 1666 patients who were diagnosed with asymptomatic AAA were included [83.9% males, median age of 75 (69–81) years]. Asymptomatic AAAs were frequently diagnosed during examinations for other diseases in 1339 patients (80.4%), whereas health screenings accounted for only 313 (18.8%). Computed tomography (CT) was the most commonly used diagnostic method (n = 1352, 81.2%) compared to abdominal ultrasonography (n = 252, 15.2%).
Conclusions: Asymptomatic AAAs are detected incidentally during examinations for other diseases, and there is an urgent need to promote health screening. Most AAAs are diagnosed by CT; nevertheless, we consider that abdominal ultrasonography would be the most appropriate modality for AAA screening because of its reasonable accuracy, noninvasiveness, and low cost.
Featured articles
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.
Angiosome and RevascularizationJune 25, 2019
Angiosome and Tissue Healing
Miki Fujii, Hiroto Terashi
For the treatment of patients with critical limb ischemia (CLI), the angiosome concept is essential in revascularization and wound treatment. In this article, we describe how we use the angiosome concept for surgically treating CLI wounds and review some essential reports. For wounds in patients with CLI to heal, both successful revascularization and wound management are crucial. In order to preserve the blood supply as much as possible intraoperatively, surgeons should always consider the angiosome concept.