Fusiform aneurysms elongate as they dilate, and WSS is lower as the diameter is larger. Saccular aneurysms dilate without proportionate elongation, and they, especially those occupying the inner curvature, have higher and variable sac depth/neck width ratio. When this ratio exceeds 0.8, WSS is low regardless of diameter, which may explain their malignant clinical behavior.

Our concept of spinal cord protection, which was based on selective intercostal reconstruction while maximizing spinal cord collateral blood flow, seems justified.

Type B aortic dissection (TBAD) is a rare but catastrophic complication of endovascular aneurysm repair (EVAR). We report two cases of TBAD occurring in the perioperative period of EVAR. The intraoperative and postoperative courses were unremarkable. Routine postoperative computed tomography angiography (CTA) revealed TBAD. Conservative treatment was successful, and no adverse aortic events occurred. TBAD that occurs in the perioperative period is likely to be iatrogenic in origin, uncomplicated, and managed with medical therapy: its prognosis is better than when the condition develops in the midterm postoperative period.

Carotid stenosis is a risk factor for perioperative stroke in on-pump surgery. Patients with large Stage 2 area (>10%) are at increased risk of perioperative stroke when on-pump surgery is performed.

Objective 18F-FDG PET/CT has been reported useful for diagnosing aortic graft infection. However, 18F-FDG uptake may depend upon various factors including open vs endovascular repair and time from surgery. We aimed to elucidate the factors influencing its uptake and the diagnostic value of 18F-FDG PET/CT after open and endovascular repair. Methods Hospital database of PET/CT (N = 14490) and our departmental database were cross-checked to identify those who underwent 18F-FDG PET/CT after aortic repair. Patient’s data were retrieved from the chart. Images were reviewed by two nuclear medicine specialists in consensus, and the presence of increased 18F-FDG uptake was recorded. The maximum standardized uptake value (SUV max) was measured. Results Among the 1112 patients who underwent aortic repair between 2011 and 2022, 71 patients were identified. Eighteen patients underwent 18F-FDG PET/CT for suspected graft infection and the remaining 53 patients for other purposes (malignancy etc.). Fourteen patients were treated as aortic graft infection. They had significantly higher SUV max than those without graft infection (mean 8.64 (SD2.78) vs 3.40 (SD0.84); p < 0.01). In the non-infected grafts, SUV max was higher early after open surgical repair, while it remained low after endovascular repair. Conclusion After endovascular aortic repair, a constant cut-off value of “SUV max = 4.5” seems appropriate for diagnosing graft infection, since it remains low and stable from the early postoperative period. After open surgical repair, it seems acceptable to have “stepwise cut-off value” depending on the time from surgery.