{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T03:59:42Z","timestamp":1760587182731,"version":"3.41.2"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T00:00:00Z","timestamp":1698019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Vascular Ehlers-Danlos Syndrome (vEDS) is a rare connective tissue disorder associated with <jats:italic>COL3A1<\/jats:italic> gene mutation encoding type III collagen. Given the possible fatal prognosis if not treated timely, it is important to suspect and diagnose as soon as possible. Despite advances in endovascular technique, access point complications remain a serious challenge in patients with vEDS. Here, we describe a 30-year-old male patient who was diagnosed with vEDS after consecutive events of bilateral iliac vessels at an interval of 3 months: (1) spontaneous dissecting aneurysm of right iliac artery and (2) arteriovenous fistula between left internal iliac artery (IIA) and left common iliac vein. This patient was treated with iliac stent-grafts and overlapping femoral interposition graft (Dacron) in the 1st operation and access artery repair with surgical dissection after coil embolization of IIA and stent-graft insertion into left common to external iliac arteries in the 2nd operation. The patient has been treated with beta-blockers and anticoagulants for the management of vEDS and postoperative deep vein thrombosis, respectively. The stent-grafts in both iliac arteries and the access sites have been well-tolerated without any adverse effects for 14 months following the 2nd operation. In conclusion, given the vascular fragility and the potential for future events, additional vascular manipulation should be avoided unless it is in a life-threatening condition. In particular, meticulous hybrid interventions can be effective treatments.<\/jats:p>","DOI":"10.3389\/fsurg.2023.1268671","type":"journal-article","created":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T21:13:31Z","timestamp":1698095611000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Hybrid approach as a Rescue Treatment in a patient with vascular Ehlers\u2013Danlos Syndrome"],"prefix":"10.3389","volume":"10","author":[{"given":"Suehyun","family":"Park","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deokbi","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woo-Sung","family":"Yun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyung-Kee","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung","family":"Huh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"w20379","DOI":"10.4414\/smw.2020.20379","article-title":"Surgical management of vascular Ehlers-Danlos syndrome and its challenges: a case report","volume":"150","author":"da Rocha de Sousa","year":"2020","journal-title":"Swiss Med Wkly"},{"key":"B2","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1002\/ajmg.c.31553","article-title":"Diagnosis, natural history, and management in vascular Ehlers-Danlos syndrome","volume":"175","author":"Byers","year":"2017","journal-title":"Am J Med Genet C Semin Med Genet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1056\/NEJM200003093421001","article-title":"Clinical and genetic features of Ehlers-Danlos syndrome type IV, the vascular type","volume":"342","author":"Pepin","year":"2000","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"975.e1","DOI":"10.1016\/j.avsg.2013.01.004","article-title":"Successful endovascular treatment of a ruptured superior mesenteric artery in a patient with Ehlers-Danlos syndrome","volume":"27","author":"Yasuda","year":"2013","journal-title":"Ann Vasc Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1007\/s00270-007-9135-1","article-title":"Endovascular treatment of a carotid dissecting pseudoaneurysm in a patient with Ehlers-Danlos syndrome type IV with fatal outcome","volume":"31","author":"Lim","year":"2008","journal-title":"Cardiovasc Intervent Radiol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.jvs.2006.08.071","article-title":"Endovascular repair of an iliac artery aneurysm in a patient with Ehlers-Danlos syndrome type IV","volume":"45","author":"Tonnessen","year":"2007","journal-title":"J Vasc Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"3090","DOI":"10.1002\/ajmg.a.34332","article-title":"Vascular Ehlers-Danlos syndrome presenting as rapidly progressive multiple arterial aneurysms and dissections","author":"Barbosa","year":"2011","journal-title":"Am J Med Genet A"},{"key":"B8","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1007\/s00270-010-9929-4","article-title":"Metachronous bilateral posterior tibial artery aneurysms in Ehlers-Danlos syndrome type IV","volume":"34","author":"Hagspiel","year":"2011","journal-title":"Cardiovasc Intervent Radiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.3171\/jns.2003.99.6.1077","article-title":"Successful stent placement for cervical artery dissection associated with the Ehlers-Danlos syndrome. 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