Journal of Vascular Surgery最新文献

{"title":"Outcomes following unilateral axillofemoral bypass versus crossover femorofemoral bypass in chronic limb-threatening ischemia patients","authors":"Sai Divya Yadavalli MD ,&nbsp;Elisa Caron MD ,&nbsp;Daniel Colome BS ,&nbsp;Lucas Souza-Mota MD ,&nbsp;Winona W. Wu MD ,&nbsp;Carla Moreira MD ,&nbsp;Jeffrey J. Siracuse MD ,&nbsp;Marc L. Schermerhorn MD ,&nbsp;Lars Stangenberg MD, PhD","doi":"10.1016/j.jvs.2025.10.025","DOIUrl":"10.1016/j.jvs.2025.10.025","url":null,"abstract":"<div><h3>Objective</h3><div>In patients with chronic limb-threatening ischemia (CLTI), extra-anatomical bypasses are viable options to establish inflow when aortic cross-clamping necessary for anatomical reconstruction cannot be tolerated or in those with a hostile abdomen. Given their infrequent use, direct comparisons between unilateral axillofemoral bypass (AxFB) vs cross-over femorofemoral bypass (FFB) for CLTI remain scarce. We evaluated postoperative and 5-year outcomes after AxFB vs FFB for CLTI.</div></div><div><h3>Methods</h3><div>Patients undergoing nonemergent unilateral AxFB and FFB in the Vascular Quality Initiative linked to Medicare claims between 2014 and 2019 were identified, excluding procedures with other concomitant bypasses/interventions. We performed 1:2 (AxFB:FFB) propensity score matching for baseline demographics, comorbidities, urgency, ipsilateral presentation, and contralateral symptoms (rest pain vs ulcer/gangrene), and prior interventions/bypass procedures. Perioperative and 5-year outcomes were analyzed using logistic regression and Cox regression models.</div></div><div><h3>Results</h3><div>We included 1185 patients (27% AxFB), of whom 224 AxFBs matched with 374 FFBs. After matching, perioperative mortality was comparable between the AxFB and FFB bypass groups (15% vs 10%; <em>P</em> = .12). However, AxFB patients had higher rates of any postoperative complication (30% vs 15%; <em>P</em> &lt; .01) as well as ipsilateral major amputations (below knee, 1.8% vs 0.5%; above knee, 5.4% vs 2.4%; <em>P</em> = .05), in-hospital reintervention (13% vs 7.2%; <em>P</em> = .04), and surgical site infections (5.8% vs 1.6%; <em>P</em> = .01). Patency rates at discharge were similar between the two groups. Postoperative length of stay was higher in the AxFB patients (6.9 ± 5.3 vs 6.2 ± 20; <em>P</em> &lt; .01), and rates for discharge to home were lower (57% vs 68%; <em>P</em> = .07). At 5 years, AxFB was associated with lower rates of 5-year overall survival (41% vs 46%; adjusted hazard ratio [aHR]. 1.3; 95% confidence interval [CI], 1.0-1.7; <em>P</em> = .046), and comparable reintervention free survival (49% vs 45%; aHR, 0.86; 95% CI, 0.59-1.2; <em>P</em> = .40). There was a suggestion of lower major amputation-free survival (69% vs 89%; aHR, 1.7; 95% CI, 0.92-3.1; <em>P</em> = .089), albeit not significantly.</div></div><div><h3>Conclusions</h3><div>Unilateral AxFB for CLTI was associated with lower 5-year survival rates and similar amputation-free survival and reintervention free-survival rates, alongside similar perioperative mortality and higher postoperative complication rates when compared with FFB. Our data confirm that, among the extra-anatomical bypass options, FFB remains first-line therapy and unilateral AxFB is an alternative option for the treatment of aortoiliac occlusive disease in select CLTI patients with acceptable outcomes.</div></div>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 3","pages":"Pages 793-802.e1"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145409222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous carotid access for endovascular arch repair: Can it simplify and minimize complication of the repair?","authors":"Thomas Lindsay MDCM, MSc, FRCS","doi":"10.1016/j.jvs.2025.10.042","DOIUrl":"10.1016/j.jvs.2025.10.042","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 3","pages":"Pages 662-663"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic Success of Treatment Modalities for Small Saphenous Vein Incompetence: A Systematic Review and Network Meta-analysis","authors":"S. Oud,&nbsp;T. Alozai,&nbsp;F.S. Jamaludin,&nbsp;S. van Dieren,&nbsp;M.A. Schreve,&nbsp;M.C. Mooij,&nbsp;R. Balm,&nbsp;Ç. Ünlü","doi":"10.1016/j.jvs.2025.12.168","DOIUrl":"10.1016/j.jvs.2025.12.168","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 3","pages":"Page 966"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse childhood experiences, adult hardships, and disease severity in peripheral artery disease","authors":"Natalie V. Hmeluk BS ,&nbsp;Martina Jelley MD, MSPH, FACP ,&nbsp;Juell Homco PhD, MPH ,&nbsp;Wato Nsa MD, PhD ,&nbsp;Peter R. Nelson MD, MS, FACS ,&nbsp;Julie Miller-Cribbs MSW, PhD ,&nbsp;Arad Abadi MD ,&nbsp;Kelly Kempe MD, MS, FACS","doi":"10.1016/j.jvs.2025.11.011","DOIUrl":"10.1016/j.jvs.2025.11.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Childhood abuse, neglect, and household dysfunction, collectively known as adverse childhood experiences (ACEs), are strongly associated with the development of severe outcomes from chronic diseases, including ischemic heart attacks and stroke. ACEs also contribute to a higher risk of adult hardships, which increases the risk of health risk behaviors, chronic disease, and social problems. In this study, we describe the period prevalence of ACEs in a patient population with peripheral artery disease (PAD) and explore the relationship between childhood adversity, adult hardships, and PAD severity, such as the need for surgical procedures, among patients with PAD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this survey-based, cross-sectional study, individuals with PAD were recruited at an academic outpatient vascular surgery clinic (2022-2025). The survey included five questions about adult hardships—self-reported financial, food, medical, and housing insecurity in the past year—and 10 questions based on the original Centers for Disease Control and Prevention-Kaiser Permanente ACE study. We collected cardiovascular disease-related and amputation surgical procedure data from patient charts. PAD severity was determined by minor (eg, peripheral stent) or major (eg, amputation) surgical procedures and ankle-brachial index and toe-brachial index scores. The Wilcoxon rank-sum test and Fisher exact and χ&lt;sup&gt;2&lt;/sup&gt; tests were used to assess differences in ACE or adult hardship scores as either continuous or categorical variables, respectively, in relation to cardiovascular disease-related surgical procedures.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 138 participants with PAD were included in the final analysis. Most respondents identified as male (55.8%, n = 77) and White (65.9%, n = 91). For childhood adversity, 37.0% (n = 51) reported experiencing no ACEs, 24.6% (n = 34) reported one ACE, 10.9% (n = 15) reported two ACEs, 10.1% (n = 14) reported three ACEs, and 17.4% (n = 24) reported at least four ACEs. The patient characteristics associated with a high number of ACEs included women, single individuals, Black individuals, and those living in poverty. The median ACE score was significantly higher for those who reported the following adult hardships compared with those who did not: not getting enough to eat (median, 3.0 vs 1.0; &lt;em&gt;P&lt;/em&gt; &lt; .001), being behind on bills (median, 2.0 vs 0.0; &lt;em&gt;P&lt;/em&gt; &lt; .001), and experiencing disconnected utilities (median, 3.0 vs 1.0; &lt;em&gt;P&lt;/em&gt; = .001). No statistically significant association was noted between reporting ACEs and PAD severity or adult hardships and PAD severity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Our findings suggest that a greater number of ACEs may indirectly contribute to an individual's risk for adult hardships in the PAD population, potentially placing these patients at higher risk of poor health outcomes. We did not find evidence to support a significa","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 3","pages":"Pages 848-858.e4"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of preprocedural ambulatory status on clinical outcomes after endovascular revascularization in patients with chronic limb-threatening ischemia","authors":"Yusuke Watanabe MD,&nbsp;Toru Naganuma PhD,&nbsp;Satoshi Matsuoka PhD,&nbsp;Koji Hozawa MD","doi":"10.1016/j.jvs.2025.09.049","DOIUrl":"10.1016/j.jvs.2025.09.049","url":null,"abstract":"<div><h3>Background</h3><div>It is reported that the preprocedural ambulatory status is an important factor of clinical outcomes after endovascular therapy (EVT) in chronic limb-threatening ischemia (CLTI). However, it is not completely understood the impact of preprocedural ambulatory status on clinical outcomes after EVT in patients with CLTI because there are available scarce papers directly comparing among the subgroups according to preprocedural ambulatory status using the data from the real world. This study aimed to evaluate the outcomes by directly comparing among the subgroups based on preprocedural ambulatory status.</div></div><div><h3>Methods</h3><div>We identified 690 consecutive patients with de novo (which means the first episode of CLTI) CLTI treated with EVT between January 2010 and December 2019 at the New Tokyo Hospital in Japan. The study population was divided into two groups: the ambulatory group (n = 356) and the nonambulatory group (n = 334). In addition, each ambulatory and nonambulatory group was divided into additional two groups. The ambulatory group was divided into ambulatory with and without assistance, and the nonambulatory group was divided into wheel chair users and bedridden patients. The primary end point was major adverse limb event (MALE) at 3 years after EVT. MALE was defined as the composite of all-cause death and major lower limb amputation.</div></div><div><h3>Results</h3><div>There was an increased risk of MALE in the nonambulatory group (adjusted hazard ratio [HR], 2.36; 95% confidence interval [CI], 1.89-2.95; <em>P</em> &lt; .001). The worse the preprocedural ambulatory status, the higher the risk of MALE for bedridden patients (adjusted HR, 4.42; 95% CI, 3.03-6.46; <em>P</em> &lt; .001), wheel chair users (adjusted HR, 2.57; 95% CI, 1.92-3.44; <em>P</em> &lt; .001), and ambulatory patients with assistance (adjusted HR, 1.49; 95% CI, 1.07-2.08; <em>P</em> = .008) compared with those without assistance.</div></div><div><h3>Conclusions</h3><div>In patients with CLTI, the worse the preprocedural ambulatory status, the higher the risk of adverse events after EVT for bedridden patients, wheel chair users, and ambulatory patients with assistance compared with those without assistance.</div></div>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 3","pages":"Pages 775-783.e3"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"STRIDE study post hoc analysis shows first-line mechanical aspiration thrombectomy for either in-stent or in-graft versus native vessel thrombosis in lower extremity acute limb ischemia yields similar outcomes","authors":"Thomas S. Maldonado MD ,&nbsp;Alex Powell MD ,&nbsp;Heiko Wendorff MD ,&nbsp;Jarrad Rowse MD ,&nbsp;Khanjan H. Nagarsheth MD ,&nbsp;David J. Dexter MD ,&nbsp;Alan M. Dietzek MD ,&nbsp;Patrick E. Muck MD ,&nbsp;Frank R. Arko MD ,&nbsp;Jayer Chung MD ,&nbsp;STRIDE study group","doi":"10.1016/j.jvs.2025.10.038","DOIUrl":"10.1016/j.jvs.2025.10.038","url":null,"abstract":"<div><h3>Objective</h3><div>Lower extremity acute limb ischemia (LE-ALI) is a severe form of peripheral artery disease associated with high morbidity and mortality rates. Thrombus in previously placed stents or grafts may present treatment challenges when compared with treatment of thrombus in native vessels, and data evaluating first-line treatment with mechanical aspiration thrombectomy are lacking. This post hoc analysis of STRIDE (A study of patients with lower extremity acute limb ischemia to remove thrombus with the Indigo Aspiration System) examines outcomes for first-line mechanical aspiration thrombectomy with the Indigo Aspiration System for LE-ALI in patients with either in-stent or in-graft thrombosis as compared with native vessel thrombosis.</div></div><div><h3>Methods</h3><div>STRIDE was a prospective, single-arm study that enrolled 119 adult patients across 16 sites in the United States and Europe who were treated first-line with the Indigo Aspiration System for LE-ALI. The primary outcome was target limb salvage at 30 days post procedure. Secondary outcomes included device-related serious adverse events, technical success (postprocedure Thrombolysis in Myocardial Infarction flow grades 2/3), and patency at 30 days. Outcomes for the in-stent thrombosis group vs the native vessel thrombosis group, and for the in-graft thrombosis group vs the native vessel thrombosis group, were compared.</div></div><div><h3>Results</h3><div>Of the 119 STRIDE patients, 29 had in-stent thrombosis, 19 had in-graft thrombosis, and 71 had native vessel thrombosis. For both the in-stent vs native vessel thrombosis and the in-graft vs native vessel thrombosis group comparisons, there were no significant differences for any of the primary or secondary outcomes. Overnight adjunctive thrombolytics use was higher for the in-graft vs native vessel groups (52.6% [10/19]) and 11.3% [8/71], respectively; <em>P</em> &lt; .001). In a combined multivariate Cox model, when adjusted for age and sex among US patients, in-stent thrombosis was associated with time to retreatment within 30 days (hazard ratio, 3.8; 95% confidence interval, 1.1-13.3; <em>P</em> = .040).</div></div><div><h3>Conclusions</h3><div>Although in-stent and in-graft thrombosis may represent more challenging treatment settings for LE-ALI, high technical success and high target limb salvage rates at 30 days were observed for both groups, similar to the favorable results seen in the native vessel group. Additionally, there were no device-related serious adverse events in either the in-stent or in-graft groups. In-stent thrombosis is associated with an increased risk of retreatment, which is unrelated to the device or procedure and may be expected owing to known complications of stenting. This STRIDE subgroup analysis shows that first-line mechanical aspiration thrombectomy using Indigo is safe and effective for LE-ALI patients in presentations of acute thrombosis in a stent or graft.</div></div>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 3","pages":"Pages 839-847.e1"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor’s Choice – The ENGAGE Registry Ten Year Outcomes with the Endurant Stent Graft System for Endovascular Abdominal Aortic Aneurysm Repair","authors":"H.J.M. Verhagen,&nbsp;J.A.W. Teijink,&nbsp;A.H. Power,&nbsp;M.M.P.J. Reijnen,&nbsp;L.H. Bouwman,&nbsp;F.E.G. Vermassen,&nbsp;V. Riambau,&nbsp;P. Erhart,&nbsp;S. Ling,&nbsp;P.W.M. Cuypers,&nbsp;I.M. Loftus,&nbsp;ENGAGE Investigators","doi":"10.1016/j.jvs.2025.12.162","DOIUrl":"10.1016/j.jvs.2025.12.162","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 3","pages":"Page 965"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk profiles and long-term mortality in premature and nonpremature peripheral artery disease from two prospective cohorts","authors":"Xiaoqi Ye MD, PhD ,&nbsp;Yan Li MD, PhD ,&nbsp;Siyu Chen MD, PhD ,&nbsp;Lihong Chen MD, PhD ,&nbsp;Yebei Liang MD, PhD ,&nbsp;Feiyan Shi MD ,&nbsp;Xingwu Ran MD","doi":"10.1016/j.jvs.2025.11.001","DOIUrl":"10.1016/j.jvs.2025.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral artery disease (PAD), particularly premature PAD, remains understudied. It is still unclear whether premature PAD exhibits distinct risk profiles and survival outcomes compared with nonpremature PAD. We aimed to compare risk factors and long-term mortality between premature and nonpremature PAD using two large cohorts.</div></div><div><h3>Methods</h3><div>In this study, we analyzed data from the UK Biobank (N = 348,766) and the U.S. National Health and Nutrition Examination Survey (NHANES; N = 6539). Premature PAD was defined using a sex-specific age cutoff (men &lt;55 years, women &lt;65 years), with sensitivity analyses using a 50-year cutoff. Participants were classified into three groups: no PAD, premature PAD, and nonpremature PAD groups. Multinomial logistic regression assessed associations between risk factors and PAD subtypes. Cox proportional hazards models estimated associations of PAD subtypes with all-cause and cardiovascular mortality risks.</div></div><div><h3>Results</h3><div>Patients with premature PAD were predominantly female with fewer cardiometabolic comorbidities. Peripheral neuropathy was a strong risk factor specifically for premature PAD (UK Biobank: odds ratio [OR] = 3.96, 95% confidence interval [CI]: 2.73-5.73; NHANES: OR = 2.01, 95% CI: 1.28-3.17), whereas nonpremature PAD showed no significant association (UK Biobank: OR = 1.32, 95% CI: 0.66-2.65; NHANES: OR = 0.87, 95% CI: 0.65-1.16). Over a mean follow-up period of 13.2 (UK Biobank) and 14.9 (NHANES) years, unadjusted analyses showed the highest mortality in nonpremature PAD among the three groups. However, after full adjustment for potential confounders, the patterns of mortality shifted. Premature PAD had a higher all-cause mortality risk (UK Biobank: hazard ratio [HR] = 2.15, 95% CI: 1.93-2.39; NHANES: HR = 2.15, 95% CI: 1.41-3.29) than nonpremature PAD (UK Biobank: HR = 1.91, 95% CI: 1.75-2.09; NHANES: HR = 1.52, 95% CI: 1.28-1.80). Premature PAD also had a higher cardiovascular mortality risk (UK Biobank: HR = 3.10, 95% CI: 2.33-4.13; NHANES: HR = 4.33, 95% CI: 2.47-7.57) vs nonpremature PAD (UK Biobank: HR = 2.26, 95% CI: 1.76-2.88; NHANES: HR = 1.66, 95% CI: 1.34-2.07). This was further confirmed in a direct comparison among patients with PAD, which showed that premature PAD carried a significantly higher risk of cardiovascular mortality than nonpremature PAD.</div></div><div><h3>Conclusions</h3><div>Premature PAD exhibited distinct risk profiles and had higher adjusted long-term mortality than nonpremature PAD, particularly from cardiovascular causes. Future studies are needed to investigate the mechanisms underlying these differences.</div></div>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 3","pages":"Pages 814-825.e10"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eight-year single- center experience with double-layer carotid stent","authors":"Gianbattista Parlani MD ,&nbsp;Giacomo Isernia MD, PhD ,&nbsp;Lydia Romano MD ,&nbsp;Francesco Pio Del Mastro MD ,&nbsp;Piergiorgio Cao MD, FRCS ,&nbsp;Massimo Lenti MD, PhD ,&nbsp;Gioele Simonte MD, PhD","doi":"10.1016/j.jvs.2025.11.027","DOIUrl":"10.1016/j.jvs.2025.11.027","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to provide perioperative and mid-term evaluation, safety, and efficacy of CGuard (InspireMD) micromesh self-expanding stent with an embolic protection system during a carotid artery stenting (CAS) procedure.</div></div><div><h3>Methods</h3><div>All patients who underwent CAS with CGuard stent from January 2016 to June 2024 in a tertiary center were prospectively evaluated. The primary end points were technical success, combined risk of any stroke or death within 30 days (perioperative), and any ipsilateral stroke after the procedure. Secondary end points were stroke, death, transient ischemic attack, myocardial infarction (major adverse event), occurring within 30 days and the rate of stroke, death, and restenosis during the follow-up.</div></div><div><h3>Results</h3><div>A total of 218 consecutive patients underwent 226 CAS procedures with the CGuard stent during the study period. There were 142 male (63%) and mean age was 74.3 ± 8.0 years. Fifty-nine patients (26%) had a symptomatic stenosis. Technical success was 99.5%, because in 1 patient advancing the CGuard stent in a tight stenosis was impossible despite predilation. The mean procedural time was 33 minutes, the mean fluoroscopic time was 11 minutes, and the mean contrast media used was 41 mL. At 30 day, one patient had a transient ischemic attack (0.5%) and another patient experienced a minor stroke (0.5%). No patient died or developed myocardial infarction. The mean hospitalization duration after the procedure was 1.5 days. The 30-day rate of major adverse event was 0.5%. During a mean follow-up 35 months (range, 1-84 months), one patient had an asymptomatic stent occlusion and two patients experienced restenosis &gt;70% successfully treated with a secondary stenting procedure in one case and stent explantation with Dacron patch closure in the other. The estimate of freedom from restenosis was 99.4% at 1 year, 97.5% at 3 years, and 97.5% at 5 years. Freedom from ipsilateral stroke was estimated 99.6% at 1 year, 98.7% at 3 years, and 98.7% at 5 years. The actuarial survival rate was 97.4% at 1 year, 92.4% at 3 years, and 78.7% at 5 years.</div></div><div><h3>Conclusions</h3><div>Preliminary data suggest that the CGuard stent with embolic protection system is an effective and safe device for the treatment of carotid artery stenosis with acceptably low perioperative and mid-term neurological event and durable patency rate. Larger, multicenter, randomized studies are advocated to confirm these findings.</div></div>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 3","pages":"Pages 767-774"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter regarding “Prediction of arteriovenous fistula maturation”","authors":"Ning Zhuo MD","doi":"10.1016/j.jvs.2025.10.094","DOIUrl":"10.1016/j.jvs.2025.10.094","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 3","pages":"Pages 968-969"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146169995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}