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.
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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This site is operated by Editorial Committee of Annals of Vascular Diseases.
Editorial Committee of Annals of Vascular Diseases
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Latest articles
Review ArticleSeptember 25, 2024
Infrapopliteal revascularization is generally performed for patients with chronic limb-threatening ischemia. As with revascularization in other fields, the indications for endovascular treatment (EVT) have expanded in recent years due to advances in endovascular devices and techniques. However, the optimal revascularization method must be selected based on (1) patient risk, (2) limb severity, and (3) anatomical pattern of disease. Therefore, vascular surgeons need to understand the characteristics of EVT and surgical treatment and improve their technical skills in both procedures. Here is an overview of the current methods of revascularization. (This is a translation of Jpn J Vasc Surg 2024; 33: 61–65)
Review ArticleSeptember 25, 2024
Revascularization of the Femoropopliteal Artery Region
Atsushi Guntani
In recent years, endovascular therapy (EVT) has come to play an important role in the revascularization of the femoropopliteal artery region; however, the number of cases that cannot be treated with EVT is increasing, and the importance of bypass surgery has been reaffirmed. We will provide an overview of the revascularization of the femoropopliteal artery region in accordance with the JCS/JSVS 2022 Guideline on the Management of Peripheral Arterial Disease. (This is a translation of Jpn J Vasc Surg 2024; 33: 57–59).
Original ArticleSeptember 25, 2024
Mid-Term Outcomes Following TEVAR for Chronic Type B Aortic Dissection
Masato Ohno, Nobuya Zempo, Yuki Jinzai, Hideki Sakashita, Tomohiko Uetsuki, Takayuki Okada
Objective: To evaluate the mid-term outcomes following thoracic endovascular aortic repair (TEVAR) for chronic type B aortic dissection (TBD), especially to know which re-entry closure affects the thoracic false lumen remodeling in the late chronic TBD.
Methods: From April 2017 to April 2022, 25 patients with chronic TBD underwent TEVAR. The late chronic TBD received the re-entry closure including stent-graft deployment in the renal artery, infrarenal aorta, and unilateral or bilateral iliac artery.
Results: Complete shrinkage of the thoracic false lumen was accomplished in 67% of the early chronic cases but only 13% of the late chronic cases. The thoracic false lumen shrinkage over 5 mm in diameter was obtained in 78% of the early chronic cases and 69% of the late chronic cases. Univariate and multiple logistic regression analyses revealed the re-entry closure of common or external iliac artery affects the thoracic false lumen remodeling.
Conclusion: The re-entry closure in the common or external iliac artery could affect the thoracic false lumen remodeling following TEVAR for the late chronic TBD. (This is a translation of Jpn J Vasc Surg 2023; 32: 351–356)
Original ArticleSeptember 25, 2024
Ultrasonographic Study of the Corkscrew Arterial Image in Buerger Disease Patients
Kaori Homma, Tomoko Kagayama, Takehisa Iwai, Hiroko Kume, Shinya Koizumi, Kenichi Sakurazawa
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 these 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. (This is a translation of Jpn J Vasc Surg 2023; 32: 345–350.)
Original ArticleSeptember 25, 2024
Major Lower Limb Amputation for Chronic Limb-Threatening Ischemia Is Associated with Poor Long-Term Survival: 4-Year Follow-Up of a Single-Center Experience
Thushan Gooneratne, Rezni Cassim, Mandika Wijeyaratne
Objective: Despite advances in medicine, 30% of patients with chronic limb-threatening ischemia (CLTI) require major lower limb amputation (MLLA). The long-term outcome of this cohort is poorly described.
Methods: In all, 154 patients undergoing MLLA for CLTI during 2018–2020 were analyzed for short-term and long-term outcomes and prosthesis use.
Results: In total, 106 below-knee amputations and 48 above-knee amputations were followed up for a mean duration of 50 months (37–78). The mean age of the cohort was 63 years. The majority were male (60%) with multiple comorbidities, including diabetes (83.8%), hypertension (49.4%), ischemic heart disease (20%), and smoking (32.5%). An equal proportion underwent MLLA as primary (45%) or secondary (55%). 30-day mortality was 6%. The mean length of in-hospital stay was 18 days (3–56). Overall survival rates at 1st, 2nd, and 4th year were 73%, 64%, and 35%, respectively. On a multivariate regression analysis, a higher level of amputation had a significant impact on mortality (p = 0.015). 54% of amputees had a prosthetic limb. However, the primary use of prosthesis was for cosmesis, with only 12% mobile independently.
Conclusions: MLLA for CLTI is associated with poor early and long-term survival. Prosthesis use and mobility are extremely poor in the Sri Lankan context.
Original ArticleSeptember 25, 2024
Spinal Cord Injury Risk in Open Repair for Descending Thoracic and Thoracoabdominal Aneurysm
Masato Furui, Hitoshi Matsumura, Yoshio Hayashida, Go Kuwahara, Mitsuru Fujii, Masayuki Shimizu, Yuichi Morita, Chihaya Ito, Masato Hayama, Kayo Wakamatsu, Hideichi Wada
Objective: In open repair for descending thoracic aortic aneurysm (DTAA) or thoracoabdominal aortic aneurysm (TAAA), the influence of re-interventions on spinal cord injury (SCI) remains unclear. This study evaluated the relationships between re-interventions, atherosclerosis, and SCI.
Methods: We retrospectively reviewed 78 patients who underwent open surgical repair for DTAA or TAAA between April 2011 and May 2023. The associations of SCI with (i) re-interventions with a history of endovascular therapy and graft replacement and (ii) atherosclerotic factors, including monocyte count, triglyceride levels (TG), and intra-aortic plaques, were examined.
Results: The rates of SCI complications and 30-day mortality were both 3.8% (3/78). There was no significant difference between the incidence of SCI in the re-intervention and first-time intervention groups (p >0.90). However, patients with protruding plaque on computed tomography (CT) were more affected by SCI than those without (13.3% vs. 1.6%, p = 0.034). Univariate analysis revealed that SCI was associated with increased monocyte count, TG, protruding plaques on CT, and intraoperative blood loss.
Conclusion: Re-interventions for DTAA and TAAA showed no association with the development of SCI under appropriate protective measures. The implicated risk factors may be atherosclerosis factors such as elevated monocyte count, TG, and protruding plaques on CT.
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.