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        <title>Frontiers in Surgery | Vascular Surgery section | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/surgery/sections/vascular-surgery</link>
        <description>RSS Feed for Vascular Surgery section in the Frontiers in Surgery journal | New and Recent Articles</description>
        <language>en-us</language>
        <generator>Frontiers Feed Generator,version:1</generator>
        <pubDate>2026-05-13T20:05:09.883+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1737663</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1737663</link>
        <title><![CDATA[Predictive factors for post-embolization infarction and long-term splenic remodeling in patients undergoing splenic artery aneurysm embolization]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Chang Hoon Oh</author><author>Kyoung Yeon Lee</author><author>Sang Yub Lee</author><author>Kwang Bo Park</author><author>Dongho Hyun</author><author>Yang-Jin Park</author><author>Shin-Seok Yang</author><author>Joon-Kee Park</author>
        <description><![CDATA[ObjectiveTo identify predictive factors for post-embolization splenic infarction and to assess long-term remodeling patterns of the spleen, including regeneration and atrophy, in patients undergoing embolization for splenic artery aneurysm (SAA).MethodsThis retrospective study included 64 patients (66 cases) with splenic artery aneurysms who underwent transcatheter arterial embolization between February 2007 and November 2023 at a single tertiary center. Embolization techniques included sac packing, trapping, combined approaches, and stent-graft placement.ResultsTechnical success was achieved in all 66 cases. Clinical success was obtained in 94.1% of evaluable patients, with two cases of recanalization and one new aneurysm detected during follow-up. Splenic infarction occurred in 24 patients (37.5%) and was associated with distal or hilar/intrasplenic location (p = 0.007), larger pre-embolization splenic volume (p = 0.018), and reduced splenic staining on angiography after embolization (p < 0.001). In multivariate analysis, only reduced splenic staining on angiography remained an independent predictor of infarction (HR = 0.939; p = 0.001). Among infarcted patients, 12 (50%) demonstrated regeneration and 12 (50%) progressed to atrophy, with regeneration associated with higher post-embolization splenic staining on angiography (p = 0.036), smaller infarcted volume (p = 0.003), and greater final splenic volume (p = 0.018). Overall complication rate was 39.1%, all of which resolved with conservative management. No major complications occurred.ConclusionEndovascular embolization for splenic artery aneurysms was safe and effective. Post-embolization splenic staining on angiography was the key predictor of infarction and was also associated with long-term splenic regeneration.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1750548</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1750548</link>
        <title><![CDATA[Experience in the diagnosis and treatment of venous adventitial cystic disease: a case series and literature review]]></title>
        <pubdate>2026-05-07T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Jianhuang Zhuang</author><author>Songlin Guo</author><author>Lei Wang</author><author>Longlong Zheng</author><author>Meilin Liu</author><author>Zhuohang Wu</author><author>Xiaoqiang Zhang</author><author>Zhang Zhang</author>
        <description><![CDATA[Venous adventitial cystic disease (VACD) is a rare condition. We describe two cases of unilateral lower-limb swelling due to a cystic mass compressing the common femoral vein (CFV) treated within a single vascular surgery unit. The first case was misdiagnosed as a lymphatic cyst preoperatively on both computed tomography and Doppler ultrasound. However, intraoperative findings suggested VACD, which was confirmed histopathologically. The second patient received the correct preoperative and postoperative VACD diagnoses. Both patients were successfully treated with surgical resection, with no complications during the postoperative follow-up.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1777076</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1777076</link>
        <title><![CDATA[Case Report: Spontaneous rupture of an internal thoracic artery aneurysm: a rare life-threatening emergency and Its therapeutic challenges]]></title>
        <pubdate>2026-04-29T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Xun Guo</author><author>Zhuohang Liu</author><author>Zheng Liu</author><author>Hongquan Fan</author>
        <description><![CDATA[Internal thoracic artery (ITA) aneurysms are exceedingly rare vascular anomalies that often remain asymptomatic until rupture. Rupture can precipitate acute hemothorax, hemorrhagic shock, and death if not rapidly diagnosed and managed. We report the case of a 42-year-old previously healthy female who presented to the emergency department with sudden-onset chest, abdominal, and back pain. Initial CT imaging elsewhere revealed pleural effusion, a non-specific finding. Upon transfer to our institution, emergency computed tomography angiography (CTA) demonstrated a ruptured left ITA pseudoaneurysm with active contrast extravasation and a large left hemothorax. Emergent transcatheter arterial embolization using microcoils achieved definitive hemostasis. Ultrasound-guided chest tube drainage was subsequently performed. The patient recovered uneventfully and was discharged without complications. This case highlights a critical diagnostic pitfall in emergency medicine—ruptured ITA aneurysm masquerading as simple pleural effusion—and underscores the pivotal role of CTA and endovascular therapy in optimizing outcomes. We also review the literature on etiology, diagnostic challenges, and evolving therapeutic strategies for this rare but fatal condition.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1795551</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1795551</link>
        <title><![CDATA[Popliteal artery aneurysm with popliteal artery entrapment syndrome: a case report and literature review]]></title>
        <pubdate>2026-03-30T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Yiming Ren</author><author>Lianrui Guo</author>
        <description><![CDATA[BackgroundPopliteal artery entrapment syndrome (PAES) is a rare anatomical anomaly that may rarely lead to secondary popliteal artery aneurysm (PAA). We present a case in which chronic extrinsic compression culminated in a giant PAA, highlighting the diagnostic workflow and surgical strategy.Case presentationA 50-year-old man presented with a 2-year history of exercise-induced pain and numbness in the right lower limb. On examination, popliteal and distal pulses were absent. Duplex ultrasound showed a 4.1 cm saccular popliteal artery aneurysm (PAA) containing a 15 mm mural thrombus; CT angiography revealed moderate-to-severe stenosis of the proximal popliteal artery. Intra-operatively, the popliteal artery was found compressed and occluded by the medial head of the gastrocnemius, confirming popliteal artery entrapment syndrome; after partial myotomy to release the vessel, only the eccentric aneurysmal sac wall was excised while the macroscopically normal-appearing arterial wall was preserved, and the artery was reconstructed with an autologous small-saphenous-vein patch angioplasty.DiscussionPAES-induced PAA is uncommon; failure to recognise the underlying entrapment risks could lead to incorrect endovascular treatment. Open decompression combined with venous bypass remains the gold standard when the artery is structurally damaged.ConclusionClinicians encountering an isolated PAA in a relatively young patient should actively exclude PAES. Timely surgical decompression and revascularisation can prevent thrombo-embolic complications and limb loss.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1752062</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1752062</link>
        <title><![CDATA[The structural and microbiological properties of human cadaveric iliac vessel grafts stored at a readily available standard freezer: a comprehensive analysis as a function of storage time]]></title>
        <pubdate>2026-03-12T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Abdullah Boga</author><author>Fuat Aksoy</author><author>Ercüment Gürlüler</author><author>Halit Ziya Dundar</author><author>Fatih Celik</author><author>Ozkan Balcin</author><author>Ceren Oy</author><author>Bilge Arıcan</author><author>Zehra Minbay</author><author>Feriha Ercan</author><author>Ekrem Kaya</author>
        <description><![CDATA[BackgroundVascular allografts are very important tool for transplantation procedures especially in living donor liver transplantation (LT). The aim of this study is to evaluate the histopathological and microbiological properties of human cadaveric iliac vessel grafts stored by a readily available method (freezing at −24 °C without using cryoprotectant solution) and to determine the impact of storage time on these parameters.MethodsDonor characteristics, histopathological changes on light microscopy [tunica intima, internal elastic lamina (IEL), tunica media in artery allografts], scanning electron microscopy (SEM) endothelial morphology grade and the microbiological results were recorded.ResultsA total of 54 cadaveric iliac vessel grafts (28 iliac arteries and 26 iliac veins) harvested from 28 donors were grouped based on the storage period as fresh control (0–24 h, n = 10) and 0–6 months (n = 10), 6–12 months (n = 10), 12–24 months (n = 12) and >24 months (n = 12) storage groups. Demographic data of the donors were similar along the groups. Some morphological changes were seen in graft stored for >24 months than those stored shorter time on the histopathological examinations and morphometric analysis. Endothelial structure damage was observed less in the grafts those stored shorter than 12 months than longer time in SEM examination. None of the graft samples showed bacterial growth after incubation.ConclusionsIn conclusion, our findings revealed that iliac vessel allografts stored for less than 12 months had the lower risk of morphological, structural and degenerative endothelial changes. Hence, this simple and readily available low cost storage method seems to offer a favorable alternative in allograft storage up to 12 months.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1732288</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1732288</link>
        <title><![CDATA[Case Report: Renal artery aneurysm rupture, axillary artery pseudoaneurysm, and catastrophic intraperitoneal hemorrhage caused by fibromuscular dysplasia with the involvement of multiple arterial beds]]></title>
        <pubdate>2026-03-11T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Haihua Zhou</author><author>Shi Sheng</author><author>Yun You</author><author>Jian Wang</author>
        <description><![CDATA[We report an unusual case of fibromuscular dysplasia (FMD) with multisite involvement into the intracranial, carotid, vertebral, internal mammary, visceral, renal, iliac, axillary, and upper extremity arteries in a 30-year-old woman. The patient presented with a spontaneous rupture of a renal artery aneurysm and an expanding axillary artery pseudoaneurysm. The diagnosis of the multifocal FMD was based mostly on the classical strings-of-beads angiographic appearance of the upper extremity, visceral, vertebral, carotid, and internal mammary arteries. A coil embolization procedure was successfully performed to treat the ruptured renal aneurysm. In addition, open surgical repair of the pseudoaneurysm was uneventfully achieved using direct arterial suture. Unfortunately, the patient suffered from recurrent intraperitoneal hemorrhage, declined further endovascular interventional or open surgical procedures, and eventually died from hemorrhagic shock and multiple organ failure. To our knowledge, this is the first case in the literature describing a rare and severe FMD involving multiple arterial beds in the regions of the head, neck, chest, abdomen, and pelvis, which adversely caused renal artery aneurysm rupture, axillary artery pseudoaneurysm, and catastrophic intraperitoneal hemorrhage.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1774257</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1774257</link>
        <title><![CDATA[Case Report: Unique presentation of iliac vein rupture in an elderly female patient: a multidisciplinary approach to diagnosis and management]]></title>
        <pubdate>2026-03-06T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Shixiang Dong</author><author>Dongdong Hu</author><author>Jing Li</author><author>Wen Feng</author><author>Weiwei Qian</author>
        <description><![CDATA[Iliac vein rupture (IVR) is a rare but critical clinical condition often presenting with nonspecific symptoms such as acute abdominal pain and hemorrhagic shock, leading to significant diagnostic challenges. This case report illustrates the complexity of IVR through the clinical course of an elderly female patient with multiple comorbidities, who was ultimately diagnosed with spontaneous IVR following surgical intervention. The case emphasizes the necessity of a multidisciplinary approach involving surgical, vascular, and critical care teams to facilitate timely diagnosis and management. The patient's presentation, characterized by severe pain and hypotension, was initially suggestive of retroperitoneal hemorrhage, yet definitive diagnosis was elusive until surgical exploration was conducted, highlighting the limitations of imaging modalities in certain instances. Furthermore, this case underscores the importance of considering individual risk factors, such as previous pelvic surgeries and underlying venous pathology, in formulating patient-specific care strategies. The successful management of this case not only contributes valuable insights to the existing literature but also advocates for heightened awareness and education among healthcare professionals regarding IVR. Although the rarity of IVR poses challenges to generalizability, it underscores the need for standardized diagnostic protocols and innovative management strategies tailored to high-risk populations. In conclusion, this case serves as a reminder of the critical role of prompt recognition and intervention in improving patient outcomes for those affected by iliac vein rupture.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1738033</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1738033</link>
        <title><![CDATA[Effects of rhythmic dumbbell upper limb rehabilitation training based on the multi-process action control framework on vascular access function and quality of life in hemodialysis patients]]></title>
        <pubdate>2026-03-02T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Jing Hu</author><author>Mingcong Cao</author><author>Rufu Jia</author><author>Keli Pan</author><author>Xuelian Jiang</author>
        <description><![CDATA[ObjectiveTo investigate the effects of rhythmic dumbbell upper limb rehabilitation exercise based on multi-process action control (M-PAC) theory on the function and quality of life of autogenous arteriovenous fistula in hemodialysis patients.MethodsA total of 72 patients who underwent autologous arteriovenous fistula (AVF) angioplasty and had stable and regular dialysis in the hemodialysis center of Cangzhou Central Hospital from January 2025 to April 2025 were selected as the research subjects, and were randomly divided into control group (n = 36) and intervention group (n = 36). Both groups were given routine rehabilitation management. The control group was given routine ball-holding rehabilitation exercise on the upper limb of the AVF side, and the intervention group was given rhythmic dumbbell rehabilitation exercise based on M-PAC theory. The intervention began 2 weeks after the operation, and the total intervention lasted for 3 months. Doppler ultrasound was used to measure the physiological maturation of AVF in both intervention and control groups, including cephalic venous blood flow, venous diameter, and skin-to-thickness distance. Clinical maturation outcomes were recorded and observed, including pump-controlled blood flow compliance rate, target values of pump-controlled blood flow, and single-needle puncture success rate. The Chinese version of the Kidney Disease Quality of Life Questionnaire (KDQOL-SFTM) was employed to evaluate patients’ quality of life before and after the intervention.ResultsPrior to the intervention, there were no significant differences between the two groups in general patient data, venous diameter, skin-to-thickness ratio, and various dimensions of quality of life, indicating balanced comparability (χ2/|t| ≤ 1.900, P ≥ 0.062). Regarding cephalic venous blood flow metrics, as preoperative values were extremely low and unstable, making measurement challenging, this study only compared post-intervention cephalic venous blood flow. For pump-controlled blood flow measurements, since patients lacked access to arteriovenous fistulas (AVF) prior to intervention, this study only analyzed post-intervention pump-controlled blood flow values. Post-intervention analysis revealed that the intervention group demonstrated significantly better outcomes in all metrics compared to the control group: superior cephalic venous blood flow, venous diameter, skin-to-vessel distance (STED), pump-controlled blood flow rate, single-needle puncture success rate, and quality of life dimensions (χ2/|t| ≥ 2.574, P ≤ 0.012). However, no significant difference was observed in the pump-controlled blood flow rate qualification rate (χ2 = 3.486, P = 0.507).ConclusionRhythmic dumbbell upper limb rehabilitation exercise based on M-PAC theory can promote the physiological and clinical maturity of AVF and improve the quality of life of patients.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1744615</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1744615</link>
        <title><![CDATA[Median arcuate ligament syndrome with anomalous origin of the right inferior phrenic artery from the celiac artery: a case report]]></title>
        <pubdate>2026-02-27T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Zhu Bin</author><author>Chen Jianfeng</author><author>Yang Zhipeng</author>
        <description><![CDATA[Median arcuate ligament syndrome (MALS) is a rare vascular disorder. We report the case of a 72-year-old man with MALS who was found to have an anomalous right inferior phrenic artery originating from the celiac artery (CA), which was not detected on preoperative computed tomography angiography. During laparoscopic decompression, this vessel was encountered unexpectedly. A temporary clamping test was performed, confirming no diaphragmatic or hepatic ischemia, after which the vessel was safely ligated. The CA was then fully decompressed. Postoperatively, the patient's symptoms resolved completely. This case underscores that significant vascular anomalies may only be revealed intraoperatively. The described clamping technique provides a simple and safe method for real-time functional assessment, aiding critical surgical decisions when managing unforeseen anatomical variations.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1743314</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1743314</link>
        <title><![CDATA[An interpretable nomogram with SHAP analysis predicts thrombotic failure of forearm arteriovenous fistulas]]></title>
        <pubdate>2026-02-26T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yilin Xu</author><author>Linsen Jiang</author><author>Haixia Zhang</author><author>Rong Ni</author><author>Peng Qian</author><author>Zhi Wang</author><author>Weiwei Li</author>
        <description><![CDATA[ObjectiveEnd-stage renal disease is an increasing global health problem. Arteriovenous fistula (AVF) thrombosis is a major cause of access failure in maintenance hemodialysis (MHD) patients. An interpretable nomogram, integrated with SHapley Additive exPlanations (SHAP) analysis is developed and validated for predicting thrombotic failure of forearm AVFs in MHD patients.MethodsA single-center retrospective cohort study enrolled 302 MHD patients with dysfunctional forearm AVFs undergoing percutaneous transluminal angioplasty. Patients were randomly allocated to training (70%) and validation (30%) sets. Univariable and multivariable logistic regression identified independent predictors for AVF thrombosis. A nomogram was constructed and its performance evaluated by the area under the receiver operating characteristic curve, calibration, and decision curve analysis. SHAP analysis was applied to quantify feature importance and directionality in the validation set.ResultsThe final model identified hypertension history, frequent intradialytic hypotension, body mass index, total cholesterol, C-reactive protein, and intact parathyroid hormone as independent predictors. The nomogram demonstrated good discrimination, with AUCs of 0.80 (95% CI: 0.73–0.86) in the training set and 0.71 (95% CI: 0.59–0.83) in the validation set, along with satisfactory calibration and clinical utility. SHAP analysis revealed red cell distribution width-standard deviation as the most influential predictor for individual risk, highlighting a distinction between statistical significance and predictive contribution.ConclusionThis study presents an interpretable nomogram with robust performance for predicting AVF thrombosis. The integration of SHAP analysis enhances model transparency and clinical trust, providing a valuable tool for personalized risk assessment and potential targeting of preventive strategies in MHD patients. Further external validation is warranted.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1754640</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1754640</link>
        <title><![CDATA[Case Report: Redo carotid endarterectomy with patch angioplasty for treatment of restenosis caused by excessive intimal hyperplasia following endarterectomy: illustrative case]]></title>
        <pubdate>2026-02-26T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Lu Zhao</author><author>Xinyu Wu</author><author>Wei Zhen</author><author>Fuyong Li</author>
        <description><![CDATA[IntroductionCarotid endarterectomy (CEA) is considered the surgical intervention of choice for symptomatic and asymptomatic carotid artery stenosis. Restenosis following CEA is not a rare condition. However, cases of restenosis resulting from short-term massive intimal hyperplasia of the carotid artery are relatively rare.Case descriptionWe present a case of a 69-year-old male patient who successively underwent carotid artery stenting (CAS), CEA and stent removal due to recurrent ischemic symptoms. Subsequently, the patient received redo carotid endarterectomy (reCEA) combined with patch angioplasty to address a third episode of carotid artery stenosis caused by extensive intimal hyperplasia. Based on a review of the relevant literature, the underlying pathological conditions and corresponding surgical strategies were analyzed and discussed.ConclusionSymptomatic restenosis caused by simple intimal hyperplasia shortly following CEA is relatively uncommon. In contrast to atherosclerotic plaques, this dense and fibrous tissue is more resistant to dissection and may lead to a reduction in vessel diameter. Neither standard CEA nor CAS alone can adequately prevent long-term restenosis. However, CEA combined with patch angioplasty has been shown to be an effective therapeutic option for this specific type of stenosis.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1735554</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1735554</link>
        <title><![CDATA[Is there a difference in catheter-related thrombosis between left- and right-sided arm ports and chest ports?]]></title>
        <pubdate>2026-02-20T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Yun Fan</author><author>Huarong Du</author><author>Yuanyuan Guan</author><author>Aili Zhang</author><author>Xiaolin Jiang</author>
        <description><![CDATA[BackgroundTotally Implantable Venous Access Ports (TIVAPs) are long-term subcutaneous venous infusion devices widely used in patients requiring prolonged venous therapy, particularly those with cancer. The choice of left- vs. right-sided implantation during TIVAP implantation is a key clinical decision, as anatomical and hemodynamic differences between sides may influence the risk of catheter-related thrombosis (CRT). However, existing literature remains controversial regarding the association between implantation side and CRT incidence. This meta-analysis aims to systematically evaluate the impact of left- vs. right-sided TIVAP implantation on CRT risk, providing evidence-based support for clinical prevention strategies.MethodsLiterature searches were conducted in PubMed, Web of Science, Embase, Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP Database to identify studies investigating the effect of left- vs. right-sided TIVAP implantation on CRT incidence. The search spanned from database inception to October 2025. Two independent researchers screened literature, extracted data, and assessed the risk of bias of the included studies. A meta-analysis was conducted using RevMan 5.3 software.ResultsA total of 21 studies involving 10,778 patients were included. Meta-analysis revealed no statistically significant difference in CRT incidence between left- and right-sided chest ports [OR = 1.28, 95%CI (0.97–1.68), P = 0.08] or arm port [OR = 1.19,95% CI (0.86–1.66), P = 0.29].ConclusionsCurrent evidence indicates no overall difference in CRT incidence between left- and right-sided TIVAPs. However, the observed sample size-dependent association suggests that left-sided implantation may carry a slightly higher CRT risk in large cohorts. Clinicians may select the implantation side based on individual patient characteristics. However, large-sample, multi-center randomized controlled trials are needed to further validate these findings, particularly given the observed sample size-dependent differences.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1785280</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1785280</link>
        <title><![CDATA[Editorial: Innovations and challenges in surgical education]]></title>
        <pubdate>2026-02-10T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Gabriel Sandblom</author><author>Marco Scarci</author><author>Gaetano Gallo</author><author>Stavros K. Kakkos</author><author>Philipp Taussky</author><author>Stefano Cianci</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1743595</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1743595</link>
        <title><![CDATA[Evolution of endovascular repair of complex aortic aneurysms in a German tertiary referral vascular center]]></title>
        <pubdate>2026-02-06T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Yannik Wanner</author><author>Shamsun Naher</author><author>Maria Del Pilar Ortega Carrillo</author><author>Michael Kallmayer</author><author>Felix Kirchhoff</author><author>Matthias Trenner</author><author>Christoph Knappich</author>
        <description><![CDATA[BackgroundFenestrated and/or branched endovascular aortic repair (f/bEVAR) has evolved a reliable alternative to treat complex aortic aneurysms. The aim of this study was to analyze the evolution of f/bEVAR in a large German vascular department by investigating temporal changes in patient selection, surgical strategies, and clinical outcomes.MethodsRetrospective cohort study of consecutive patients undergoing f/bEVAR between 2007 and 2023 at TUM University Hospital in Munich (Klinikum rechts der Isar, Technical University of Munich). To assess for temporal changes, the cohort was divided into three time periods (date of operation: 2007–2016; 2017–2020; 2021–2023). The primary outcome was in-hospital death. Statistical analyses included univariate analyses, Kaplan–Meier survival analyses, and Kruskal–Wallis tests for group comparisons.ResultsA total of 176 patients (median age 75 years; 80% male) were included. Over time (early phase vs. recent phase), an increase in the proportion of octogenarians was observed (14 vs. 31%; p = 0.042) and the mean number of incorporated vessels increased from 3.7 to 4.0 (p < 0.001). Mean operative time decreased from 321 to 241 min (p = 0.002) and intraoperative contrast volume was reduced (398 vs. 190 mL; p = 0.001). Length of intensive care unit stay (8.1 vs. 2.7 days; p < 0.001) and in-hospital rates of acute kidney injury (16 vs. 4.7%; p = 0.034) and respiratory failure (18 vs. 0%; p = 0.001) declined, while non-significant trends were found for in-hospital mortality (8.8% vs. 1.6%; p = 0.062) and the paraplegia rate (8.8% vs. 1.6%, p = 0.062). Longer operating time (per 10 min; OR 1.06; 95% CI 1.02–1.11; p = 0.003) and occurrence of a major adverse event (OR 37.4; 95% CI 4.52–4,869; p < 0.001) were associated with death until discharge. Kaplan–Meier analyses showed, that patients treated in the early phase had lower survival probability compared to those in the recent phase (p = 0.024).ConclusionThis retrospective analysis demonstrates a continuous improvement in clinical outcomes associated with f/bEVAR over the past two decades. The findings underscore the increasing reliability and effectiveness of endovascular treatment approaches.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2025.1715026</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2025.1715026</link>
        <title><![CDATA[Case Report: Challenges in the surgical treatment of Marfan-associated aortic aneurysms: a literature review starting from a clinical case]]></title>
        <pubdate>2026-01-30T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Ombretta Martinelli</author><author>Antonio Marzano</author><author>Valeria Gonta</author><author>Lucio Ferriero</author><author>Carola D’Amico</author><author>Simone Cuozzo</author><author>Maria Irene Bellini</author>
        <description><![CDATA[Marfan syndrome (MFS) is a systemic connective tissue disease severely affecting the cardiovascular system. We present the case of a MFS 55-year-old woman who arrived at the emergency department with increasing chest pain. Over the past 25 years, this patient had undergone mitral valve annuloplasty, subsequent open surgical repair of a ruptured infrarenal abdominal aortic aneurysm followed by open surgery for a type I thoracoabdominal aortic aneurysm. She was also operated for fenestrated endovascular repair of a visceral aortic aneurysm using a ‘graft-to-graft’ approach. Upon the urgent admission, a multislice computed tomography angiography demonstrated an aortic aneurysm sac with a maximum diameter of 11.8 cm that was fed by a type IIIB endoleak, due to complete branch stent disconnection of the right renal artery (RRA) and by type IIIB/IIIC endoleaks secondary to stent fracture and disconnection in the superior mesenteric artery (SMA) and celiac trunk (CT), respectively. A common hepatic artery aneurysm (diameter of 2.29 cm) was detected, too. Under general anaesthesia a relining of both RAA and SMA was performed with Ballon-expandable Gore Viabahn and VBX stent-grafts. Subsequently, a CT stenting was successfully carried out. The bridging stents were intentionally positioned to protrude into the fenestrations to get enough overlap with the previously placed stent at the target vessel level. There were no postoperative systemic complications and the patient was discharged after 3 days under dual anti-platelet therapy. At 12 months of follow-up, complete exclusion and shrinkage of the aneurysmal sac and the patency of the stented visceral vessels are demonstrated. This complex case serves as the starting point for a literature review on current trends and perspectives in the treatment of aortic pathology related to MFS. Since MFS patients often present with aortopathy at a young age, different surgical treatments could be combined over the years to provide durable results in in protection against aortic rupture, until more effective drugs can be implemented.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1788416</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1788416</link>
        <title><![CDATA[Editorial: Telehealth innovations in vascular care]]></title>
        <pubdate>2026-01-30T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Davide Costa</author><author>Umberto Marcello Bracale</author><author>Raffaele Serra</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2025.1667618</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2025.1667618</link>
        <title><![CDATA[The anatomic feasibility of thoracic branched endoprosthesis in the treatment of blunt thoracic aortic injury]]></title>
        <pubdate>2026-01-22T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Anna Rogalska</author><author>Ashley Flinn-Patterson</author><author>Maria Navarro</author><author>Stephanie Combs</author><author>Theodore Hart</author><author>Marlin Causey</author>
        <description><![CDATA[IntroductionBlunt thoracic aortic injury (BTAI) is one of the leading causes of death among trauma patients who sustain high impact thoracic trauma with rapid deceleration. Thoracic endovascular aortic repair (TEVAR) is indicated in high grade injuries and requires a management strategy for the left subclavian artery (LSA). Gore TAG thoracic branch endoprosthesis (TBE) is a newly approved TEVAR device for to maintain LSA patency utilizing a side branch with reported use in acute indications. The anatomic suitability of this device for a population of BTAI patients and optimal inventory for off-the-shelf emergent repairs has not been reported.MethodsA retrospective analysis of 66 patients admitted to a Level 1 Trauma Center who sustained BTAI between January 2011 and December 2023 and underwent TEVAR was performed. Computed tomography imaging was analyzed on all patients to determine the suitability for repair according to instructions for use (IFU) criteria of the manufacturer.ResultsThe distance between the LSA and the injury was less than 2 cm in 59% of patients, representing a possible indication for TBE. The average injury distance in this cohort was 9 mm from the LSA, with 82% of these patients meeting IFU requirements for TBE and 18% requiring standard TEVAR. For patients who met TBE graft requirements, 28 mm, 31 mm, and 34 mm aortic components fit 76% of patients and 10 mm and 12 mm subclavian branches fit 87% of patients. Patients who did not meet IFU requirements for TBE were sized for standard TEVAR with 26 mm, 31 mm, and 34 mm grafts treating 66% of patients.ConclusionsThis study demonstrates key anatomic considerations and models the suitability and optimal TBE inventory drawn from a real-world population of BTAI patients. Despite a vast device catalog for TEVAR, this study demonstrates that carrying three TBE aortic components, two TBE subclavian components, and three standard TEVAR sizes would treat 71% of BTAI patients.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2026.1674195</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2026.1674195</link>
        <title><![CDATA[Filter's retraction hook capture technique of pull-assisted method for endovascular retrieval of conical inferior vena cava filters whose hook attached to the wall]]></title>
        <pubdate>2026-01-22T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Xuan Tian</author><author>Jianlong Liu</author><author>Han Zheng</author><author>Jinyong Li</author><author>Xiao Liu</author><author>Mi Zhou</author><author>Chengjia Qu</author><author>Run Hua</author><author>Chenyang Tian</author>
        <description><![CDATA[BackgroundPermanent placement of venous filters can lead to numerous complications. When the risk of pulmonary embolism (PE) decreases, it is recommended to retrieve the filter. Inferior vena cava (IVC) filter retrieval is primarily performed intraluminally; however, the retrieval hook for conical filters may penetrate the venous wall, causing failure of the intraluminal retrieval: some filters are retrieved using the Loop-snare technique or its modified version, some are retrieved through open surgery, which causes more damage, and some are left permanently in place. For these patients, a filter's retraction hook capture technique of pull-assisted method can be used effectively to retrieve the filter. This study introduces a surgical method using the novel technique for the intraluminal removal of conical IVC filters whose retraction hook attached to the wall, along with the outcomes and a 3-month follow-up.MethodsFrom January 2021 to December 2024, patients with conical filters whose retraction hook attached to the wall were enrolled consecutively. Various advanced filter retrieval techniques were initially used to remove the filters, and those that were unsuccessful were subsequently treated with the new technology for filter retrieval. The patients were divided into a successful group and a failure group based on whether the filter retrieval was successful. Retrospective comparative analysis was performed to evaluate patient characteristics, filter retrieval rate, inclination, penetration distance, and IVC imaging.ResultsA total of 44 patients underwent filter retrieval using filter's retraction hook capture technique of pull-assisted method. Among these patients, 37 cases (84.1%) were successful in filter retrieval (successful group), with the penetration distance of cranial anchor vertex of 3.2 (2.5, 4.3) mm, and 12 (32.4%) filters were deformed. The other seven cases (failure group) were unsuccessful, with a penetration distance of cranial anchor vertex of 5.0 (4.3, 5.0) mm, and 6 (85.7%) filters were deformed. There was a statistically significant difference between the two groups (P < 0.05). One case (2.3%) had IVC injury, one case (2.3%) experienced filter fracture, and no symptomatic PE occurred. Logistic regression analysis was performed to identify factors that might affect filter retrieval, with an odds ratio (OR) of 0.069 (0.006, 0.828), suggesting a statistical difference between filter deformation and successful retrieval. Logistic regression analysis was also performed to determine factors influencing filter inclination, with the results indicating a statistically significant difference in the penetration distance and the transverse diameter of the IVC [OR = 0.667 (0.465, 0.958) and OR = 0.843 (0.712, 0.998), respectively], indicating a statistically significant difference in the penetration distance and the transverse diameter of the IVC, and affecting severe filter inclination.ConclusionFilter's retraction hook capture technique of pull-assisted method is effective in removing conical filters whose hook attached to the wall, with no symptomatic PE occurring. This method can be considered as a new adjuvant technique for filter retrieval.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2025.1730329</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2025.1730329</link>
        <title><![CDATA[Controlled venospasm-assisted foam sclerotherapy combined with high ligation—a novel minimally invasive approach for primary great saphenous vein varicosities]]></title>
        <pubdate>2026-01-20T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Chen Ya</author><author>Liu Zechao</author><author>Zhu Xuchang</author><author>Chen Boyu</author><author>Liu Zhengli</author><author>Kong Jie</author>
        <description><![CDATA[PurposeThis study aimed to evaluate the efficacy and safety of Controlled Venospasm-Assisted Foam Sclerotherapy (CVAFS) combined with high ligation (HL) for treating primary great saphenous vein (GSV) varicosities.Materials and methodsA retrospective cohort of 127 patients with primary GSV varicosities underwent CVAFS with high ligation between 1 Jan 2023 and 1 October 2023. Venospasm was induced by rotational mechanical stimulation of the catheter combined with external compression, resulting in a transient reduction of vessel diameter by 50%–70%, followed by DSA (Digital subtraction angiography)-guided foam injection (1:4 liquid-to-gas ratio). Technical success was defined as complete procedural execution under imaging guidance. Primary endpoints included 1-year GSV occlusion rate (assessed by duplex ultrasound) and reduction in Venous Clinical Severity Score (VCSS). Complications were recorded and managed conservatively.ResultsTechnical success was achieved in 100% of limbs (145/145). Among 127 enrolled patients, 109 patients (125 limbs) completed the 12-month follow-up, yielding a follow-up rate of 85.8% (109/127). At 12 months, 93.6% of great saphenous veins (117/125 limbs) maintained complete occlusion. The Venous Clinical Severity Score (VCSS) significantly decreased from 6.18 ± 3.90 preoperatively to 0.86 ± 0.90 postoperatively (V = 7,875, p < 0.001). Thrombophlebitis observed in 9.6% of limbs (12/125), all cases resolved spontaneously within 2 weeks with conservative management (warm compression and NSAIDs). Saphenous Junction Pain occurred in 32.8% of limbs (41/125), with complete resolution within 2 weeks without intervention. No deep venous thrombosis (DVT), pulmonary embolism, skin necrosis, or neurological injuries were documented.ConclusionCVAFS leverages controlled venospasm to enhance foam-endothelium contact, significantly improving occlusion rates and symptom relief with acceptable safety. This approach offers a promising minimally invasive alternative for GSV varicosities.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fsurg.2025.1682178</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fsurg.2025.1682178</link>
        <title><![CDATA[Development and validation of a frailty risk prediction model in patients with peripheral artery disease]]></title>
        <pubdate>2026-01-16T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Qingmei Fang</author><author>Fengwang Xue</author><author>Xueshuang Chen</author><author>Xia Qing</author><author>Feng Liu</author><author>Shengmin Guo</author>
        <description><![CDATA[ObjectiveTo investigate the current status and risk factors of frailty among patients with peripheral artery disease, and to develop a risk prediction model to inform targeted clinical interventions.MethodsPatients were consecutively recruited for this investigation from August 2024 to May 2025. The study included 499 individuals with peripheral artery disease who were hospitalized in the vascular surgery department of a tertiary hospital in Southwest China. Data were collected using a general information questionnaire, laboratory test results, the Barthel Index, and the Social Support Rating Scale. The Tilburg Frailty Indicator was used to classify patients into a non-frailty group and a frailty group. The dataset was randomly split in a 7:3 ratio into a training set and a validation set. Independent predictors of frailty were identified through univariate and multivariate logistic regression analyses. The risk prediction model was developed using R software. Discrimination of the model was evaluated by plotting receiver operating characteristic (ROC) curves and calculating the area under the curve (AUC), sensitivity, and specificity in both the training and validation sets. Model calibration was assessed using the Hosmer–Lemeshow goodness-of-fit test and calibration curves. Clinical utility was evaluated using decision curve analysis.ResultsAge, hemoglobin level, number of comorbidities, and activities of daily living were identified as independent risk factors for frailty. In the training set, the AUC was 0.771 (95% CI: 0.721–0.821), with a sensitivity of 0.788 and a specificity of 0.808. In the validation set, the AUC was 0.704 (95% CI: 0.620–0.788), with a sensitivity of 0.743 and a specificity of 0.682. The Hosmer–Lemeshow test indicated good calibration in both the training set (χ2 = 7.967, P = 0.435) and the validation set (χ2 = 9.642, P = 0.291). DCA showed that the model provided net clinical benefit within threshold probability ranges of 10%–80% in the training set and 20%–74% in the validation set.ConclusionThe developed risk prediction model exhibited predictive performance and can assist clinical healthcare providers in identifying populations at high risk of frailty among patients with PAD, thereby providing a reference for developing intervention strategies targeting relevant risk factors.]]></description>
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