Journal of Vascular Surgery最新文献

{"title":"Early revascularization in symptomatic carotid artery disease leads to better outcomes: A 10-year multicenter cohort analysis.","authors":"Diego Sanchez-Calderin, James F Meschia, Gyanendra Kumar, Robert D Brown, Bernard R Bendok, Kevin Barrett, W Chris Fox, David A Miller, Camilo Polania-Sandoval, Ekin Inal, Camila Esquetini-Vernon, Sukhwinder S J Sandhu, Richard D Beegle, Houssam Farres, Giuseppe Lanzino, Young Erben","doi":"10.1016/j.jvs.2026.07.086","DOIUrl":"10.1016/j.jvs.2026.07.086","url":null,"abstract":"<p><strong>Objective: </strong>Randomized trials and meta-analyses have suggested that earlier intervention for symptomatic carotid artery disease may benefit patients, yet the optimal timing window remains debated. This study evaluated the impact of timing of revascularization on perioperative and long-term outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective review of 821 carotid revascularization procedures for carotid artery disease from 2016 to 2026, excluding patients with previous neck radiation. Procedures were stratified by time from symptom onset to intervention into urgent (0-2 days), early (3-14 days), and delayed (≥15 days) groups. Perioperative end points included 30-day mortality, ipsilateral stroke, transient ischemic attack (TIA), myocardial infarction (MI), and a composite of these events. Long-term outcome end points included all-cause mortality, ipsilateral stroke, TIA, MI, restenosis, and reintervention. Univariable and multivariable Cox proportional hazards regression analyses were performed to identify independent predictors of the 30-day composite outcome and long-term reintervention. Sensitivity analyses were also included excluding patients who underwent thrombolysis or thrombectomy to adjust for factors related to adjunct procedures at the time of initial neurovascular event presentation.</p><p><strong>Results: </strong>The study cohort had a median age of 74.2 years (interquartile range, 66.7-80.5) and was predominantly composed of male patients (69.4%), with high rates of hypertension (86.1%), hyperlipidemia (84.4%), and coronary artery disease (35.6%). The most common presentation was stroke (48.4%), followed by TIA (31.8%) and amaurosis fugax (19.9%). The 30-day composite outcome of stroke, TIA, MI, or death was significantly lower in the early group (2.8%) than in the delayed (4.0%) and urgent (8.0%) groups (P = .03). Thirty-day mortality was significantly higher in the urgent group (2.9%) than in the early (0.3%) and delayed (0.3%) groups (P = .01). On multivariable Cox regression, urgent timing [hazard ratio (HR), 2.50; 95% confidence interval, 1.02-6.12; P = .044] and absence of preoperative antithrombotic therapy (HR, 3.75; 95% confidence interval, 1.46-9.64; P = .006) were independent predictors of the 30-day composite outcome. At a median follow-up of 2.8 years (interquartile range, 1.1-5.3), all-cause mortality was comparable across groups (urgent, 20.4% vs early, 18.5% vs delayed, 16.5%; P = .57). Long-term MI was more frequent in the early group (4.7%) than in the urgent (1.5%) and delayed (1.6%) groups (P = .03), confined entirely to those initially presenting with TIA on subgroup analysis. Long-term restenosis was highest in the urgent group (9.5%), followed by delayed (5.3%) and early groups (3.9%; P = .05). Reintervention rates followed the same pattern (urgent, 6.6% vs delayed, 3.1% vs early, 1.1%; P < .01), with a 3-year reintervention-free survival of 97.9% for early, 76.3% for urg","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017185","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":"Preoperative risk stratification for sac enlargement and reintervention using inferior mesenteric artery patency and lumbar artery burden after endovascular aneurysm repair.","authors":"Kaichiro Manabe, Hidetake Kawajiri, Takuma Kobayashi, Mitsuko Nakata, Tatsuro Gondai, Shinichiro Oda","doi":"10.1016/j.jvs.2026.09.017","DOIUrl":"10.1016/j.jvs.2026.09.017","url":null,"abstract":"<p><strong>Objective: </strong>To determine the optimal number of residual lumbar arteries (LAs) based on inferior mesenteric artery (IMA) patency and assess their associations with sac enlargement and reintervention after endovascular aneurysm repair (EVAR).</p><p><strong>Methods: </strong>This retrospective single-center study included 335 patients who underwent EVAR for abdominal aortic aneurysm. Patients were stratified by postoperative IMA patency and residual LA count. Kaplan-Meier analyses with three prespecified dichotomizations were used to determine optimal risk-stratification cutoffs.</p><p><strong>Results: </strong>Among 335 included patients, type II endoleak incidence increased with greater residual LA burden and was consistently higher in those with a patent IMA than those with a nonpatent IMA (P < .001 for all comparisons). Based on previously reported long-term open repair outcomes, patients with a nonpatent IMA and ≥3 residual LAs or a patent IMA and ≥2 residual LAs were classified as high risk. Kaplan-Meier analysis showed significantly lower 10-year freedom from sac enlargement >5 mm and reintervention in the high-risk than in the low-risk group (35% vs 92% and 70% vs 98%, respectively, both; P < .0001). In multivariable Cox regression, each additional residual LA was independently associated with increased risks of sac enlargement >5 mm (hazard ratio, 1.83; 95% confidence interval, 1.59-2.12; P < .001) and reintervention (hazard ratio, 1.79; 95% confidence interval, 1.39-2.32; P < .001), whereas patent IMA was independently associated with sac enlargement but not with reintervention.</p><p><strong>Conclusions: </strong>Following EVAR, fewer residual LAs were associated with improved outcomes; optimal thresholds differed by IMA patency and may aid risk stratification and treatment planning.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017216","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":"Changes in quality of life and the impact of frailty after fenestrated-branched endovascular repair of pararenal and thoracoabdominal aortic aneurysms.","authors":"Jay P Natarajan, Shivam Patel, Janelle Barrera Ikan, Eric Johnson, Sanjay V Wunnava, Rahul Mhaskar, Jean Bismuth, Ulka Sachdev-Ost, Dean J Arnaoutakis","doi":"10.1016/j.jvs.2026.08.043","DOIUrl":"10.1016/j.jvs.2026.08.043","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Quality-of-life (QOL) metrics following infrarenal endovascular aortic aneurysm repair (EVAR) have been extensively studied and suggest that endovascular aortic aneurysm repair is more favorable than open repair. With the development of complex endovascular aortic repair, understanding postoperative health status is critically important for care delivery. As such, QOL outcomes are poorly understood for patients undergoing fenestrated-branched endovascular aortic aneurysm repair (F/BEVAR) for pararenal aortic aneurysms or thoracoabdominal aortic aneurysms (TAAA). This study aimed to determine changes in QOL measures over time and delineate which variables influence this outcome measure in patients undergoing F/BEVAR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Consecutive patients enrolled in a prospective, nonrandomized, single-center clinical trial using physician-modified F/BEVAR were included (June 2023-July 2024). QOL was evaluated using the EuroQol 5-dimension (EQ-5D) instrument, which measures five dimensions (such as mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) using five severity scores and rates overall health. Patient responses were collected at baseline preoperatively and 1-, 6-, and 12-months postoperatively. Preoperative characteristics including the 5-factor modified frailty index (mFI-5), operative variables, and postoperative outcomes were analyzed. The primary outcome measure was changes in EQ-5D scores over time. Generalized linear modeling was used to identify factors that influenced overall QOL over time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Sixty-four patients were treated during the study period, 56 of whom had EQ-5D measurements at all time points. Patients were predominantly elderly (74 ± 6.1 years), Caucasian (n = 57, 89%) men (n = 45, 70%) who suffered from hypertension (n = 58, 91%), coronary artery disease (n = 28, 44%), chronic obstructive pulmonary disease (n = 24, 38%), and chronic renal insufficiency (n = 12, 19%). The mean mFI-5 score was 0.34 ± 0.16. Mean aneurysm size was 65 ± 15.5 mm with 27 (42%) patients classified as pararenal aortic aneurysms, 24 (38%) extent IV TAAA, and 13 (20%) extent I, II, or V TAAA. Mean number of target arteries incorporated per patient was 3.9 ± 0.5. Overall technical success was 100%; procedure time was 193 ± 81 minutes; contrast volume was 98 ± 25 mL; and cumulative air kerma was 2877 ± 1528 mGy. Postoperative complications developed in 13 (20%) patients and four (6%) patients died within 30-days. The 2-year overall survival was 88%. All 5 EQ-5D dimensions declined 1 month after surgery, with some returning to baseline 6 months postoperatively. The EQ-5D overall health score also declined after surgery, rebounded with time, and surpassed baseline levels. On generalized linear modeling, higher mFI-5 score (P = .009) negatively impacted EQ-5D overall health score across all time points. On estimated marginal means analysis, those pati","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017170","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":"Outcomes of lower-extremity hemodialysis vascular access: A systematic review and meta-analysis.","authors":"Nahar Alanezi, Yazeed Alofisan","doi":"10.1016/j.jvs.2026.07.085","DOIUrl":"10.1016/j.jvs.2026.07.085","url":null,"abstract":"<p><strong>Background: </strong>Lower-extremity vascular access is used when conventional upper-extremity options for hemodialysis (HD) have failed or are anatomically unsuitable; however, its durability and complication profile remain uncertain. This systematic review and meta-analysis evaluated patency, graft survival, complications, mortality, and differences by access class after lower-extremity HD access creation.</p><p><strong>Methods: </strong>PubMed, Scopus, Web of Science, and MEDLINE were searched from inception to April 30, 2026. Studies of surgically created lower-extremity HD access in adults were included. Random-effects proportional meta-analyses were performed using logit transformation and inverse-variance weighting. Outcomes were stratified by follow-up duration and access class where feasible.</p><p><strong>Results: </strong>Forty-five studies, corresponding to 47 reports, were included. Pooled primary patency declined from 69% at 6 months [95% confidence interval (CI), 45%-86%; I² = 85.5%] to 62% at 12 months (95% CI, 53%-70%; I² = 85.0%), and 35% at 24 months (95% CI, 22%-43%; I² = 86.1%). Secondary patency was higher, with pooled estimates of 80% at 6 months (95% CI, 63%-90%; I² = 78.6%), 81% at 12 months (95% CI, 75%-87%; I² = 82.5%), and 67% at 24 months (95% CI, 51%-80%; I² = 90.0%). At 12 months, autogenous arteriovenous fistula (AVF)/femoral vein transposition (FVT) had higher primary patency than prosthetic arteriovenous graft access (79% vs 53%; subgroup P = .0016), supported by direct comparison (risk ratio, 1.23; 95% CI, 1.08-1.39; P = .0011). Secondary patency was also higher with AVF/FVT (88% vs 77%; subgroup P = .0069; risk ratio, 1.19; 95% CI, 1.13-1.27; P < .0001). Pooled thrombosis, infection, leg ischemia, arterial steal, and all-cause mortality rates were 22%, 16%, 10%, 7%, and 17%, respectively. Infection was higher with prosthetic arteriovenous graft than AVF/FVT (19% vs 7%; P = .0054).</p><p><strong>Conclusions: </strong>Lower-extremity HD access provides a viable salvage option, with preserved secondary patency despite declining intervention-free patency. Autogenous AVF/FVT may provide superior 12-month patency and lower infection risk, although heterogeneity and observational evidence warrant cautious interpretation.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990584","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":"Comparative outcomes of open and endovascular left subclavian artery revascularization during zone 2 thoracic endovascular aortic repair.","authors":"Aidin Baghbani, Akiko Tanaka, Kourosh Keyhani, Arash Keyhani, Gordon H Martin, Anthony L Estrera, Naveed U Saqib, Shihuan Keisin Wang","doi":"10.1016/j.jvs.2026.08.042","DOIUrl":"10.1016/j.jvs.2026.08.042","url":null,"abstract":"<p><strong>Objective: </strong>To compare perioperative and follow-up outcomes of carotid-subclavian bypass (CSB)+thoracic endovascular aortic repair (TEVAR), branched TEVAR, and fenestrated TEVAR for left subclavian artery revascularization during zone 2 TEVAR.</p><p><strong>Methods: </strong>The Society for Vascular Surgery Vascular Quality Initiative TEVAR registry was queried from 2013 to 2026 to identify nontraumatic zone 2 TEVAR procedures with left subclavian artery revascularization. The outcomes were compared using omnibus testing and full-cohort multivariable-adjusted regression, with pairwise propensity score-matched sensitivity analysis also performed.</p><p><strong>Results: </strong>Among 723 patients from 113 centers, 406 (56.2%) underwent CSB+TEVAR, 205 (28.4%) underwent branched TEVAR, and 112 (15.5%) underwent fenestrated TEVAR. In-hospital mortality (3.2% vs 1.0% vs 3.6%; P = .212), cerebrovascular events (6.4% vs 3.4% vs 5.4%; P = .303), stroke (5.9% vs 2.9% vs 5.4%; P = .272), and spinal cord ischemia (3.0% vs 4.9% vs 0.9%; P = .143) did not differ significantly among the groups. CSB+TEVAR was associated with greater blood loss, longer procedure duration, more frequent staged treatment, lower technical success, and longer postoperative length of stay. In full-cohort multivariable-adjusted analyses, mortality, cerebrovascular events, stroke, myocardial infarction, most access complications, and intensive care unit stay did not differ significantly; however, side-arm branched TEVAR was associated with lower adjusted odds of aortic reintervention before discharge and shorter postoperative length of stay compared with CSB+TEVAR. Through log-rank testing, the overall survival and freedom from aortic reintervention did not differ significantly, whereas freedom from sac enlargement differed significantly. In pairwise propensity score-matched analyses, no significant differences were identified in most perioperative outcomes, although matched sample sizes were limited.</p><p><strong>Conclusions: </strong>The results demonstrated distinct procedural profiles for CSB+TEVAR, branched TEVAR, and fenestrated TEVAR during zone 2 TEVAR. After adjustment, most perioperative and follow-up outcomes did not differ significantly, supporting the individualized selection of left subclavian artery revascularization strategies based on anatomy, device availability, and institutional expertise.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990608","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":"One-year mortality, cardiovascular and limb events in the Best Endovascular versus Best Surgical Therapy for Patients with Critical Limb Ischemia Registry of patients with chronic limb-threatening ischemia.","authors":"E Hope Weissler, Shuang Li, Nishant P Shah, Alik Farber, Matthew Menard, Jennifer A Rymer, W Schuyler Jones, Dennis Narcisse, Vikram S Kashyap, Igor A Laskowski, Carlos Mena Hurtado, Samir K Shah, David J Dexter, Michael Strong, Kenneth Rosenfeld, Joshua Beckman, Manesh Patel, Sreekanth Vemullapalli","doi":"10.1016/j.jvs.2026.08.041","DOIUrl":"10.1016/j.jvs.2026.08.041","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic limb-threatening ischemia (CLTI) are at risk for cardiovascular events, amputations, hospitalizations, and death. We aimed to describe 1-year outcomes in a broader, nonclinical trial cohort of patients with CLTI at a subset of Best Endovascular vs Best Surgical Therapy for Patients with Critical Limb Ischemia (BEST-CLI) trial sites.</p><p><strong>Methods: </strong>The BEST-CLI Registry enrolled patients with CLTI from 40 BEST-CLI trial sites between 2019 and 2023. One-year rates of mortality, major adverse limb events (MALE), the composite of mortality or MALE, and major adverse cardiovascular events were reported and compared between key subgroups using multivariable analyses.</p><p><strong>Results: </strong>Of 1009 patients who enrolled in the BEST-CLI Registry, 34.5% were female and 28.1% were Black. Ischemic rest pain was present in 62.8% of patients, and tissue loss in 74.2%. Over the course of a year, 38.9% of patients [95% confidence interval (CI), 35.4%-42.7%] experienced the composite of MALE or mortality; MALE occurred in 17.0% (95% CI, 14.2%-20.4%) and 25.6% died (95% CI, 22.3%-29.1%). Major amputation occurred in 8.2% (95% CI, 6.3%-10.7%) and 20.6% had any revascularization (95% CI, 17.1%-24.8%). Major adverse cardiovascular events occurred in 27.3% of participants (95% CI, 23.9%-30.8%). There were no differences in outcomes between Black and White patients or female and male patients.</p><p><strong>Conclusions: </strong>In this large, diverse cohort of patients with CLTI, including those ineligible for revascularization, mortality, and limb events were common at 1 year and did not differ based on race or sex. Patients had higher clinical event rates compared with those published in the BEST-CLI trial. Further work is needed to understand the generalizability of BEST-CLI findings to real-world cohorts of patients with CLTI.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983004","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":"Vascular Quality Initiative-based risk score for mortality within 3 years of revascularization for chronic limb-threatening ischemia in end-stage renal disease patients on dialysis.","authors":"Paula Pinto Rodriguez, Jericho Hallare, Prachi Thakur, Shivani Maisuria, Pranav Akhand, Lilly Darman, Amy Liu, Trissa Babrowski, Bernadette Aulivola, Matthew Blecha","doi":"10.1016/j.jvs.2026.08.037","DOIUrl":"10.1016/j.jvs.2026.08.037","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The purpose of this study was to create a validated risk score for the outcome of mortality within 3 years of revascularization for chronic limb-threatening ischemia (CLTI) in end-stage renal disease (ESRD) patients on dialysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Querying the United States-based data in the Vascular Quality Initiative identified 38,144 patients with ESRD undergoing open surgical or endovascular revascularization for CLTI. Two-thirds and one-third of the patients were divided into a risk score creation testing cohort and a validation cohort, respectively. Time-dependent multivariable Cox regression was performed utilizing variables associated with the outcome in the univariable analysis (P &lt; .05). Variables with a P value of ≤.05 in the multivariable regression were included in the risk score and weighted based on their respective regression beta-coefficients on a point scale. Variables with a beta-coefficient of &lt;.2 were assigned 1 point; then, a point was added for each increase in beta-coefficient at .2 intervals. A total score was then established for each patient based on the individual prevalence of the significant covariates. The mean 3-year mortality rate at each risk score bundle was calculated. The risk score was then applied to the validation cohort, who were not utilized for risk score creation, and event rates were compared between the testing and validation cohorts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Multivariable significance toward the primary outcome was noted in the testing cohort for (P &lt; .01 for all): suprainguinal bypass procedure (hazard ratio [HR] reference); suprainguinal bypass in combination with infrainguinal artery bypass (HR, 1.86); body mass index (BMI) &lt; 20 kg/m&lt;sup&gt;2&lt;/sup&gt; (HR, 1.32); BMI &gt; 35 kg/m&lt;sup&gt;2&lt;/sup&gt; (protective) (HR, 0.873); advancing age with each decade over the age of 50 years (P &lt; .001 at each decade); history (Hx) of coronary artery disease (CAD; HR, 1.09); Hx of CAD revascularization over 5 years ago (HR, 1.12); CAD revascularization less than 5 years ago (HR, 1.12); congestive heart failure (CHF) class I (HR, 1.20); CHF class II (HR, 1.25); CHF class III (HR, 1.41); CHF class IV (HR, 1.86); no medicines in chronic obstructive pulmonary disease (COPD) (HR, 1.10); medicine use in COPD (HR, 1.18); oxygen use in COPD (HR, 1.406); nursing home status (HR, 1.11); prior carotid endarterectomy or stenting (HR, 1.18); absence of preoperative statin (protective HR, 0.611); dual antiplatelet at post-procedure discharge (protective HR, 0.910); absence of post-procedure antiplatelet (HR, 1.67), statin (HR, 2.12), and angiotensin-converting enzyme inhibitor (HR, 1.26); Asian race (HR, 1.25); White race (HR, 1.28); and unidentified race (HR, 1.12). Race HR was calculated with reference to the Black race HR. The mortality rate markedly increased, with event rates of 25% at the risk scores of ≤0 that increased to a 3-year mortality rate over 90% at the total risk score of 1","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977252","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":"Bailout balloon-expandable bare-metal stent placement after device migration during zone 0 branched thoracic endovascular aortic repair.","authors":"Giuseppe Panuccio, Song Xue, Petroula Nana, Jose I Torrealba, Daour Yousef Al Sarhan, Tilo Kölbel","doi":"10.1016/j.jvs.2026.09.009","DOIUrl":"10.1016/j.jvs.2026.09.009","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148969654","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":"Left subclavian artery management strategies during thoracic endovascular aortic repair for blunt thoracic aortic injury: Do branched endografts offer a clinical advantage?","authors":"Aidin Baghbani, Gabriel Dominguez, Margaret L Jackson, Akiko Tanaka, Anthony L Estrera, Naveed U Saqib, S Keisin Wang","doi":"10.1016/j.jvs.2026.07.084","DOIUrl":"10.1016/j.jvs.2026.07.084","url":null,"abstract":"<p><strong>Objective: </strong>To compare outcomes of left subclavian artery (LSA) management strategies during thoracic endovascular aortic repair (TEVAR) for blunt thoracic aortic injury (BTAI) using a national registry.</p><p><strong>Methods: </strong>The Society for Vascular Surgery Vascular Quality Initiative TEVAR registry was queried for patients undergoing zone 2 TEVAR for BTAI from 2013 through April 2026. Patients were stratified into LSA coverage without revascularization, TEVAR with branched endograft (TBE), or carotid-subclavian bypass with TEVAR (CSB+TEVAR). Primary outcomes were 30-day mortality and arm ischemia. Secondary outcomes included stroke, spinal cord ischemia, and reintervention. Kaplan-Meier survival analysis and adjusted TBE vs coverage sensitivity analyses were performed.</p><p><strong>Results: </strong>A total of 416 patients were included (LSA coverage, n = 327; TBE, n = 74; CSB+TEVAR, n = 15). Patients undergoing LSA coverage were younger and more frequently presented with rupture. Thirty-day mortality was 11.6%, 5.4%, and 0%, respectively (P = .113). Stroke (5.2% vs 5.4% vs 6.7%) and arm ischemia (2.4% vs 1.4% vs 6.7%) were not significantly different across groups. Spinal cord ischemia was rare (1.8%, 0%, and 6.7%). Aortic- or arm ischemia-related reintervention was more frequent after CSB+TEVAR (13.3% vs 2.7% vs 1.5%; P = .044). Overall reintervention and survival did not differ significantly among groups.</p><p><strong>Conclusions: </strong>In patients undergoing zone 2 TEVAR for BTAI, no statistically significant differences were detected in major neurologic or ischemic complications among LSA management strategies. These findings suggest a pragmatic, damage-control approach favoring rapid TEVAR with selective delayed revascularization rather than routine prophylactic LSA intervention.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920115","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":"A prominent glomic artery in a carotid body tumor: An overlooked arterial feeder of surgical significance.","authors":"Devender Singh, Shalini Aryala","doi":"10.1016/j.jvs.2026.08.029","DOIUrl":"10.1016/j.jvs.2026.08.029","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920133","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}