Sequential Combination of Balloon Pulmonary Angioplasty for Distal Lesions in the Left Pulmonary Artery Followed by Pulmonary Endarterectomy for Central Lesions in the Right Pulmonary Artery: A Case Report.

Pulmonary endarterectomy (PEA) is the gold standard treatment for chronic thromboembolic pulmonary hypertension (CTEPH). While balloon pulmonary angioplasty (BPA) is an emerging treatment for distal CTEPH, a standard therapeutic strategy for CTEPH with unilateral central lesions has yet to be established. Herein, we describe the successful treatment of a patient with CTEPH who underwent BPA for left distal lesions, followed by PEA for unilateral right central lesions, without serious complications.

Endovascular Aneurysm Repair for a Sac Enlargement Caused by Type IIIb Endoleak Diagnosed Using Four-Dimensional Computed Tomography.

Purpose: We describe a case in which 4-dimensional computed tomography (4D-CT) was used to detect a type IIIb endoleak after endovascular aneurysm repair (EVAR).

Case Report: The patient was a 75-year-old man who underwent EVAR for abdominal aortic aneurysm at our institute 13 years before presentation. The patient had been aortic event-free for 10 years postoperation.

Resection of hilar renal artery aneurysm after coil embolization in 10-year-old girl.

Coil embolization is a common treatment for visceral artery aneurysms. However, it is unknown whether it is effective or not for hilar renal artery aneurysms, and the coil itself can cause imaging artifacts, complicating the diagnosis of sac re-expansion. This report describes a 10-year-old girl who underwent open surgical repair for a left hilar renal artery aneurysm that reexpanded up to 50 mm 5 years after embolization.

A Case of Surgery for a Giant Popliteal Venous Aneurysm Positive for Heparin-Induced Thrombocytopenia Antibodies with Repeated Acute Pulmonary Embolism.

A 56-year-old woman with recurrent acute pulmonary embolism was diagnosed with a left popliteal venous aneurysm (PVA) by venous echocardiography. During anticoagulation therapy with heparin for acute pulmonary embolism, she was found to be positive for heparin-induced thrombocytopenia (HIT) antibodies. Surgery was performed with argatroban for anticoagulation, removal of the thrombus in the PVA, and suturing of the vein.

Current Status of Diagnostic Process in Asymptomatic Abdominal Aortic Aneurysm in Japan.

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. 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.

Survival trends in patients with chronic thromboembolic pulmonary hypertension: an observational study.

Background: Treatment options for patients with chronic thromboembolic hypertension (CTEPH) have increased over the past decade. However, it is unknown whether the outcomes of patients with CTEPH have changed as well.

Methods: This retrospective study analysed the data of 834 patients with CTEPH, categorised into early (April 1980-December 1999), middle (January 2000-September 2010) and current (October 2010-December 2023) eras.

Surgical Outcomes Stratified by Type of Transportation and Presence of Coronary Reperfusion in Patients with Coronary Malperfusion Caused by Type A Aortic Dissection.

Purpose: Owing to the time-sensitive nature of myocardial ischemia, challenging clinical scenarios should be considered in patients with type A acute aortic dissection (AAAD) complicated by coronary malperfusion. In clinical settings, the diagnosis and reperfusion strategies for coronary malperfusion often depend on institutional resources. This study evaluated early surgical outcomes in such patients, focusing on transportation type and clinical management.

Outcomes of thoracic endovascular aortic repair for complicated type B acute aortic dissection from a multicenter Japanese post-market surveillance study.

Objectives: A primary goal of thoracic endovascular aortic repair (TEVAR) for type B acute aortic dissection (BAAD) is exclusion of the primary entry tear with a suitable stent graft (SG) to reestablish true lumen flow and promote aortic remodeling. This study aimed to determine the safety and efficacy of a conformable thoracic SG in a Japanese population with complicated BAAD.

Methods: Between 2016 and 2017, 43 patients with complicated BAAD were enrolled in this prospective, nonrandomized, multicenter post-market surveillance study at 27 sites in Japan.

Early surgical outcomes in the composite-valve root replacement with bioprosthesis after surgery for acute type A aortic dissection.

Objectives: This study aimed to evaluate the surgical outcomes of composite-valve root replacement with bioprosthesis (b-CVRR) after acute type A aortic dissection (AAAD) repair.

Methods: We included 41 patients who underwent b-CVRR after surgery for AAAD from 2007 to 2022. We excluded seven patients with VSRR, three with mechanical valve use, one with mycotic aneurysm, and one with cardiopulmonary resuscitation.

Covering the intercostal artery branching of the Adamkiewicz artery during endovascular aortic repair increases the risk of spinal cord ischemia.

Objectives: This study aimed to determine the relationship between covering the intercostal artery branching of the Adamkiewicz artery (ICA-AKA) and spinal cord ischemia (SCI) during thoracic endovascular aortic repair (TEVAR).

Methods: Patients who underwent TEVAR from 2008 to 2022 were enrolled. Stent grafts covered the ICA-AKA in 108 patients (covered AKA group) and stent grafts didn't cover the ICA-AKA in 114 patients (uncovered AKA group).

Prognosis after non-surgical therapy for acute type A aortic dissection.

Background: Immediate surgery to save life is the recommended treatment for Stanford type A acute aortic dissection (AAAD).

Method: The present study comprised 35 patients admitted with AAAD who were considered inappropriate candidates for surgery or declined surgery. The mean age was 84.

The open-first strategy is acceptable for ruptured abdominal aortic aneurysm even in the endovascular era.

Purpose: To examine the surgical findings of ruptured abdominal aortic aneurysm (RAAA) based on the open-first strategy in the last decade, and to analyze the predictors of in-hospital mortality for RAAA in the endovascular era.

Methods: The subjects of this retrospective study were 116 patients who underwent RAAA repair, for whom sufficient data were available [25% female, median age 76 (70-85) years]. Sixteen (13.

Lower-profile stent graft reduces the risk of embolism during thoracic endovascular aortic repair in shaggy aorta.

Objectives: This study aimed to reveal the association between lower-profile stent graft (LPSG) and embolism during thoracic endovascular aortic repair for non-dissecting distal arch and descending thoracic aortic aneurysm.

Methods: This study reviewed data of 35 patients who underwent thoracic endovascular aortic repair with LPSG (27 males; age: 77 ± 9.2 years) and 312 who underwent thoracic endovascular aortic repair with conventional-sized stent graft (CSSG) (247 males; age: 77 ± 7.

Role of initial medical treatment and effectiveness of thoracic endovascular aortic repair for acute type A aortic dissection with thrombosed false lumen.

Objectives: The optimal treatment for acute type A aortic dissection (AAAD) with thrombosed false lumen (T-FL) of the ascending aorta remains controversial. The goal of this study was to evaluate clinical outcomes of initial medical treatment (IMT) and the effectiveness of thoracic endovascular aortic repair (TEVAR) for AAAD with T-FL.

Methods: We retrospectively analysed 60 patients with AAAD with T-FL.

Surgical outcomes of thoracic endovascular aortic repair for retrograde Stanford type a dissection.

Objectives: The optimal indications and contraindications for thoracic endovascular aortic repair of retrograde Stanford type A acute aortic dissection (R-AAAD) are not well known. The goal of this study was to determine the outcomes of thoracic endovascular aortic repair for R-AAAD at our institution and to discuss optimal indications.

Methods: The medical records of 359 patients admitted to our institution for R-AAAD between December 2016 and December 2022 were reviewed, and 83 patients were finally diagnosed with R-AAAD.

Thoracic endovascular aortic repair with collateral vessels from the femoral artery to Adamkiewicz's artery.

Identification of the Adamkiewicz's artery (AKA) prior to the operation is one of the spinal cord ischaemia preventive measures. A 75-year-old man presented with the rapid expansion of thoracic aortic aneurysm. Collateral vessels from the right common femoral artery to the AKA were observed on preoperative computed tomography angiography.

Aggressive use of prophylactic cerebrospinal fluid drainage to prevent spinal cord ischemia during thoracic endovascular aortic repair is not supportive.

Objectives: We investigated whether prophylactic preoperative cerebrospinal fluid drainage (CSFD) was effective in preventing spinal cord ischemia (SCI) during thoracic endovascular aortic repair of degenerative descending thoracic aortic aneurysms, excluding dissecting aneurysms.

Methods: We retrospectively reviewed the medical records of patients who underwent thoracic endovascular aortic repair involving proximal landing zones 3 and 4 between 2009 and 2020.

Results: Eighty-nine patients with preemptive CSFD [68 men; median (range) age, 76.

Differences of mid-term outcomes in debranching thoracic endovascular aortic repair between zone 0 and zone 1-2 landing.

Objective: Debranching thoracic endovascular aortic repair (d-TEVAR) for zone 0 landing (Z0-TEVAR) remained challenging in aortic arch aneurysms. This study aimed to compare the mid-term outcomes between Z0-TEVAR and Z1/2-TEVAR to assess the appropriateness of Z0-TEVAR as the first-line therapy for aortic arch aneurysms in high-risk patients.

Methods: Medical records of 200 patients who underwent d-TEVAR from 2007 to 2019 were retrospectively reviewed.

Case report: Vascular graft infection due to Aspergillus species presenting with recurrent vascular occlusion.

Background: An aortic graft implantation is an effective therapeutic method for various aortic diseases. However, it is known that sometimes these implanted grafts can be the foci of infections. Here we report a rare case of graft infection that presented multiple embolisms of aortic branches and peripheral organs.

Novel brain computed tomography perfusion for cerebral malperfusion secondary to acute type A aortic dissection.

Objectives: The management of acute type A aortic dissection with malperfusion syndrome remains challenging. To evaluate preoperative condition, symptoms might be subjective and objective evaluation of cerebral artery has not yet been established. For quantitative evaluation, this study focused on brain computed tomography perfusion (CTP), which has been recommended by several guidelines of acute ischaemic stroke.

Long-term durability of a reimplantation valve-sparing aortic root replacement can be expected in both Marfan syndrome and Loeys-Dietz syndrome.

Objectives: The goal of this study was to evaluate the surgical outcomes of a valve-sparing root replacement using the reimplantation technique for annuloaortic ectasia in patients with Marfan syndrome (MFS) and in those with Loeys-Dietz syndrome (LDS).

Methods: We reviewed 103 patients with MSF with mutations in the fibrillin-1 gene and 28 patients with LDS with mutations in the transforming growth factor-beta receptor and 2, SMAD3 and transforming growth factor beta-2 from 1988 to 2020.

Results: Forty-four (42.