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.
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Editorial Committee of Annals of Vascular Diseases
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Latest articles
Case ReportDecember 11, 2025
Challenges in Identifying and Interpreting Intercostal Branches of the Adamkiewicz Artery
Satoru Tomita, Yoshimasa Seike, Tatsuya Nishii, Kazufumi Yoshida, Yojiro Koda, Takayuki Shijo, Yosuke Inoue, Tetsuya Fukuda, Hitoshi Matsuda
An 82-year-old woman underwent zone 4 thoracic endovascular aortic repair (TEVAR) for a descending aortic aneurysm. Four years later, an additional TEVAR was performed for a type Ib endoleak. Preoperative computed tomography angiography (CTA) initially identified the intercostal artery branching of the Adamkiewicz artery (ICA-AKA) at the left 10th thoracic level, which was covered by a stent graft. Prior to the second TEVAR, CTA showed the ICA-AKA via the left first lumbar artery. Reevaluation of the ICA-AKA is important, particularly after coverage. Surgeons should interpret CTA findings carefully, as other arteries or veins may resemble the AKA.
Case ReportDecember 9, 2025
Progressive Stenosis of Thoraflex Hybrid Prosthesis after Total Arch Replacement Leading to a Fatal Outcome: A Case Report
Norimasa Haijima, Mikihiko Kudo, Satoru Murata, Takuya Ono, Hideyuki Shimizu
The Thoraflex Hybrid prosthesis (Terumo Aortic, Inchinnan, UK) is widely used for total arch replacement, but postoperative stenosis or pseudo-coarctation is rare and potentially fatal. We report an 83-year-old man who underwent a Bentall procedure and total arch replacement with a 36-mm Thoraflex Hybrid graft (Terumo Aortic). Postoperative imaging showed mild stenosis, but distal perfusion was maintained. Eighteen hours later, his cardiac index dropped to 1.4 L/min/m2 and lactate rose to 11.2 mmol/L. Computed tomography (CT) revealed severe graft stenosis. Although rescue thoracic endovascular aortic repair (TEVAR) transiently improved hemodynamics, the patient succumbed to multiorgan failure despite veno-arterial extracorporeal membrane oxygenation (VA ECMO). This case underscores the need for early recognition and prompt intervention.
Original ArticleNovember 22, 2025
Thoracic Endovascular Aortic Repair for Kommerell’s Diverticulum
Masato Hayama, Go Kuwahara, Hiromitsu Teratani, Mau Amako, Hiroyuki Ito, Hideichi Wada
Objectives: Thoracic endovascular aortic repair (TEVAR) has recently emerged as a less invasive alternative to open thoracotomy for the treatment of Kommerell’s diverticulum (KD). However, anatomical challenges, including an acute aortic arch and an aberrant subclavian artery, often limit its feasibility. This study aimed to evaluate the outcomes of TEVAR for KD.
Methods: Between February 2012 and July 2023, 6 patients with KD underwent TEVAR at 3 institutions. Subclavian artery embolization or reconstruction was performed when necessary. Morphological parameters, including the Kommerell’s diverticulum diameter (KDd) and the distance to the opposite aortic wall (DAW), were assessed.
Results: Four patients underwent subclavian artery embolization, including 1 requiring bilateral embolization. Subclavian artery reconstruction was performed in 2 cases. Intraoperative type 1a endoleaks were observed in 3 cases and were successfully managed with additional stent grafts. During a follow-up period ranging from 13 to 83 months, 1 patient required open surgical conversion due to graft infection. No other severe complications or aneurysmal progression were noted.
Conclusions: Despite the limited follow-up period and lack of long-term data, TEVAR for KD demonstrated favorable short- to mid-term outcomes and may represent an effective treatment option in selected patients.
Case ReportNovember 15, 2025
True Digital Artery Aneurysm: A Case Report
Hiroki Nakabori, Hideyasu Ueda, Kenji Iino
True aneurysms of the digital artery are extremely rare, and only several dozen cases have been reported worldwide. A 29-year-old man presented with a pulsatile, tender nodule in his left index finger. Angiography revealed a 7-mm saccular aneurysm of the proper palmar digital artery with well-developed distal collaterals. Under local anesthesia, the aneurysm was excised following proximal and distal ligation. It was histopathologically confirmed as a true aneurysm. Postoperatively, symptoms resolved without ischemic or neurological complications and without recurrence after 1 year. Thus, simple ligation and excision are effective when collateral circulation is sufficient.
Case ReportNovember 14, 2025
Successful Surgical Treatment of a Spontaneous Rupture of the Left Iliac Vein: What Is the Optimal and Radical Treatment?
Kei Morioka, Masanori Hirota, Shingo Kasahara
Spontaneous rupture of the iliac vein (SRIV) requires surgical hemostasis and venous return restoration. We herein report a case treated with initial thrombus removal and direct venous repair. Because of early occlusion, a 2nd surgery was performed for iliac vein reconstruction using a 14-mm ringed Gore-Tex graft (W. L. Gore & Associates, Newark, DE, USA), and a 4-mm Gore-Tex arteriovenous shunt was created between the femoral artery and the femoral vein to prevent reocclusion. The patient had an uneventful recovery without recurrence. A single-stage procedure including hemostasis, vein replacement, and arteriovenous bypass may be ideal for radical SRIV treatment.
Review ArticleNovember 5, 2025
Role of Gut Microbes in Hypertension: A Systematic Review of Literature
Swapnil S Garde, Somesh Garde
Objectives: Hypertension is a metabolic disorder affecting a significant proportion of the global population. Growing evidence suggests the contribution of gut microbiota to blood pressure homeostasis and the effectiveness of antihypertensive interventions. This systematic review evaluates the role of gut microbiota in hypertension and identifies microbial taxa contributing to or alleviating the condition.
Methods: A systematic search was conducted in PubMed and Cochrane databases for non-randomized studies, randomized controlled trials, and registry studies published in English. Studies were classified according to microbial taxa involved in the improvement or worsening of hypertension.
Results: According to the inclusion criteria, 19 studies were included. Some bacterial genera, such as Lactobacillus paracasei, Akkermansia, and Veillonella, had potential protective effects against hypertension by regulating blood pressure through dietary interactions and microbial metabolites. On the other hand, Klebsiella sp., Streptococcus sp., and Parabacteroides merdae were more abundant in hypertensive patients and were involved in dysbiosis and inflammation. The fungal taxa Malassezia and Mortierella were also involved in the pathogenesis of hypertension.
Conclusions: Gut microbiota composition may play crucial roles in hypertension, with certain taxa potentially contributing to or alleviating the condition. Modulating gut microbes through probiotics and diet may offer new therapeutic approaches.
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.