Journal of Endovascular Therapy最新文献

{"title":"Retrieval of Thrombosed Inferior Vena Cava Filter and Mechanical Thrombectomy of Associated Caval Thrombosis Using FlowTriever and ClotTriever Systems With the ClotTriever as Embolic Protection.","authors":"Samuel Edrei So, Dexter Yak Seng Chan, Jacky Siu Chung Tam, Skyi Yin Chun Pang, Alfred Chiu Cheuk Wong, Stephen Wing Keung Cheng","doi":"10.1177/15266028261497455","DOIUrl":"https://doi.org/10.1177/15266028261497455","url":null,"abstract":"<p><p>A 55-year-old Chinese male with anti-phospholipid syndrome presented with left lower limb deep venous thrombosis (DVT) on warfarin and had an inferior vena cava filter (IVCF) implanted before a radical resection of a perineal sarcoma. The inferior vena cava (IVC) filter removal was attempted 2 weeks after the surgery, but thrombus was found at the filter. It was decided to leave the filter and to continue with anticoagulation. He presented with progressive right lower limb swelling, erythema and pain, with a CT venogram showing caval thrombosis extending from the IVC filter to the right below-knee veins. In view of worsening symptoms, endovenous mechanical thrombectomy of the IVC and iliofemoral veins, as well as caval filter removal, was performed using the ClotTriever and FlowTriever devices (Inari Medical, US). The ClotTriever itself was then placed alongside a 16Fr internal jugular vein (IJV) sheath to remove the thrombosed filter. The FlowTriever disc was next deployed from jugular access as proximal embolic protection during the thrombectomy procedure. The procedure was successful with no symptoms of pulmonary embolism (PE). This report illustrates the alternative use of the ClotTriever BOLD as an intra-operative proximal embolic protection in the absence of alternative devices like a ProTrieve sheath, during caval thrombectomy and removal for caval thrombosis secondary to an IVC filter.Clinical ImpactThe ClotTriever BOLD catheter, deployed alongside a large retrograde sheath may be considered as an proximal embolic protection for removing thrombosed IVCFs, where there is patient with a suitably sized IVC and when alternative and appropriate devices are unavailable.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028261497455"},"PeriodicalIF":1.8,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217301","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":"Heart Failure Predicts Contralateral Limb Progression After Endovascular Therapy for Initial Unilateral Chronic Limb-Threatening Ischemia.","authors":"Yuki Shima, Eiji Karashima, Shingo Kurimoto, Takashi Shimonaga, Tomohiro Yoshino, Hironobu Toda, Kohei Kawamura, Akira Takashima, Yoji Urabe, Yasunori Arai, Yusuke Kobayashi, Takanobu Okazaki, Naoto Ohsawa, Gakuto Bando, Narumi Irie, Kazunori Mushiake, Naoya Inoue, Mitsuru Abe","doi":"10.1177/15266028261495914","DOIUrl":"https://doi.org/10.1177/15266028261495914","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is associated with adverse outcomes in patients with peripheral artery disease. However, its impact on contralateral limb progression after endovascular therapy (EVT) for chronic limb-threatening ischemia (CLTI) remains unclear. This study investigated the association between HF and contralateral major adverse limb events (MALE) after EVT for initial unilateral CLTI.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with initial unilateral CLTI from the multicenter registry. Patients with prior contralateral CLTI or contralateral major amputation were excluded. The primary outcome was contralateral MALE, defined as a composite of contralateral revascularization and major amputation. Secondary outcomes included recurrent contralateral CLTI, contralateral EVT, contralateral major amputation, and ipsilateral MALE. Kaplan-Meier analysis and Cox proportional hazards models were used.</p><p><strong>Results: </strong>Among 347 patients, 182 had HF. During follow-up, contralateral MALE occurred in 86 patients. Patients with HF had significantly lower freedom from contralateral MALE than those without HF (63.9% vs 80.3%, log-rank <i>P</i> = .002). In multivariable analysis adjusting for age, sex, diabetes mellitus, dialysis, albumin <3.0 g/dL, cerebrovascular disease, and coronary artery disease, HF remained independently associated with contralateral MALE (adjusted HR 2.08, 95% CI 1.29-3.35, <i>P</i> = .003). Heart failure was also independently associated with contralateral EVT (adjusted HR 2.06, 95% CI 1.29-3.28, <i>P</i> = .003), but not with ipsilateral MALE (adjusted HR 1.08, 95% CI 0.77-1.51, <i>P</i> = .66).</p><p><strong>Conclusions: </strong>In patients undergoing EVT for initial unilateral CLTI, HF independently predicted contralateral limb events but not ipsilateral limb failure. These findings suggest that HF may identify patients who warrant closer clinical assessment of the contralateral limb after EVT.Clinical ImpactHeart failure (HF) is a well-established predictor of mortality in patients with chronic limb-threatening ischemia (CLTI), but its association with subsequent limb events has remained unclear. In this multicenter study, HF was independently associated with contralateral major adverse limb events and contralateral revascularization after endovascular therapy, whereas no association was observed with ipsilateral MALE. These findings suggest that HF may help identify patients at increased risk for future contralateral limb events. Incorporating HF status into post-EVT risk assessment may support closer surveillance of the contralateral limb and facilitate earlier detection of clinically significant disease requiring intervention.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028261495914"},"PeriodicalIF":1.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139228","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":"Mechanical Thrombectomy for High-Risk Pulmonary Embolism in Pregnancy: A Case Report and a Systematic Review of the Literature.","authors":"Andrea Discalzi, Benedetta La Delfa, Floriana Nardelli, Jacopo Brino, Marinella Zanierato, Mariella Maio, Luca Marozio, Nicolò Montali, Marco Calandri","doi":"10.1177/15266028261494954","DOIUrl":"https://doi.org/10.1177/15266028261494954","url":null,"abstract":"<p><p>Pulmonary embolism (PE) in pregnancy is a major clinical challenge with potentially fatal maternal and fetal outcomes. Mechanical thrombectomy (MT) offers a promising alternative when thrombolysis is contraindicated, although evidence in pregnancy is limited. We describe a 26-year-old at 29 + 5 weeks' gestation with high-risk PE causing acute right heart failure, successfully treated, achieving rapid hemodynamic recovery, and minimal fetal radiation exposure. A systematic review identified 15 MT cases in pregnancy or peripartum (11 antepartum, 4 postpartum), reporting 100% maternal survival and favorable fetal outcomes in 87% (1 fetal death, 1 abortion). Complications occurred in 40%, including hemolysis, renal failure, and hemorrhagic shock. MT appears to be an effective, potentially life-saving option in selected obstetric patients when performed in experienced centers with multidisciplinary support.Clinical ImpactMechanical thrombectomy (MT) represents a valuable therapeutic option for high-risk pulmonary embolism in pregnancy when thrombolysis is contraindicated. In this setting, MT allows for rapid reperfusion and hemodynamic stabilization while avoiding the bleeding risks associated with systemic fibrinolysis. Early consideration of MT within a multidisciplinary framework might significantly improve maternal prognosis without compromising fetal safety.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028261494954"},"PeriodicalIF":1.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139225","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":"Stent-Graft Fracture 18 Years After Hybrid Repair of Thoracoabdominal Aortic Aneurysm: A Possible Risk of Retrograde Reconstruction.","authors":"Haoyue Xu, Chengxin Weng, Ding Yuan, Tinghui Zheng, Tiehao Wang","doi":"10.1177/15266028261494953","DOIUrl":"https://doi.org/10.1177/15266028261494953","url":null,"abstract":"<p><p>We report the case of a patient who underwent hybrid repair for a type V thoracoabdominal aortic aneurysm. The procedure ensured durable aneurysm exclusion and visceral perfusion for 18 years. Eighteen years after surgery, the stent-graft fractured occurred at the visceral artery segment. Fluid-structure interaction analysis revealed a progressive elevation of von Mises stress at the eventual fracture site. Compared with in situ reconstruction, retrograde reconstruction in hybrid repair may increase the risk of stent-related complications. Monitoring von Mises stress during follow-up may help predict fracture and allow early intervention.Clinical ImpactLate stent-graft fracture after hybrid repair can occur despite effective aneurysm exclusion and satisfactory visceral perfusion. This case highlights the importance of long-term surveillance of graft integrity and changes in aortic morphology. A gradual increase in tortuosity and progressive elongation of the aorta may warrant particular attention, even many years after surgery. Fluid-structure interaction analysis linked progressive elevation of von Mises stress to the eventual fracture site and suggested that retrograde reconstruction may increase localized stress compared with in situ reconstruction. Integrating longitudinal imaging with patient-specific stress analysis may help clinicians recognize graft segments that warrant closer follow-up.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028261494953"},"PeriodicalIF":1.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139194","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":"Early Outcomes of Physician-Modified Endurant Limbs vs Iliac Branch Devices in Narrow Common Iliac Arteries: A Retrospective Cohort Pilot Study.","authors":"Chayatorn Chansakaow, Termpong Reanpang, Saranat Orrapin, Supapong Arworn, Kritsada Phruksawatnon, Rungrujee Kaweewan, Kittipan Rerkasem, Jiraporn Khorana, Poon Apichartpiyakul","doi":"10.1177/15266028261495364","DOIUrl":"https://doi.org/10.1177/15266028261495364","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the feasibility and short-term outcomes of physician-modified Endurant limbs (PMEGs) for internal iliac artery (IIA) preservation in patients with narrow common iliac artery (CIA) anatomy, with descriptive comparison to commercially available iliac branch devices (IBDs).</p><p><strong>Methods: </strong>This retrospective multicenter pilot study included 20 consecutive patients with a CIA bifurcation diameter ≤18 mm who underwent endovascular aneurysm repair with preservation of at least 1IIA between January 2023 and December 2025. Ten patients were treated with PMEG and 10 with commercially available IBDs. Primary outcomes were technical success and IIA branch patency. Secondary outcomes included operative time, back-table modification time, endoleaks, reinterventions, and perioperative outcomes.</p><p><strong>Results: </strong>Technical success was achieved in all patients. Internal iliac artery branch patency was 100% at 1 and 3 months in both groups and remained 100% in the PMEG group vs 90% in the IBD group at 12 months. No type I/III endoleaks or iliac-related reinterventions occurred. Operative time was similar between groups, while mean PMEG modification time was 61.5 ± 26.4 minutes. No modification-related complications or procedure-related mortality occurred.</p><p><strong>Conclusions: </strong>The PMEG appears to be a feasible option for IIA preservation in patients with narrow iliac anatomy, demonstrating favorable early outcomes. Given the pilot design, small sample size, and limited follow-up, these findings should be interpreted cautiously and require validation in larger prospective studies.Clinical ImpactPMEGs may be a feasible option for IIA preservation in patients with narrow CIA anatomy when standard IBDs are limited by profile or availability. This approach may expand endovascular options in selected cases, emphasizing careful planning and technical flexibility. Given the small sample size, these findings warrant cautious interpretation and validation in larger studies.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028261495364"},"PeriodicalIF":1.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139122","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":"Low-Profile Versus Standard-Profile Endograft for Thoracoabdominal and Complex Abdominal Endovascular Aortic Treatment-Multicenter Cohort Study.","authors":"Tiago Magalhães, Ryan Gouveia E Melo, Jan Stana, Nikolaos Konstantinou, Ruy Fernandes E Fernandes, Luís Mendes Pedro, Nikolaos Tsilimparis","doi":"10.1177/15266028261489194","DOIUrl":"https://doi.org/10.1177/15266028261489194","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The introduction of low-profile stent grafts (LPSGs) has proven to be a useful option despite initial concerns. The aim of this study was to analyze and compare the outcomes of standard-profile stent grafts (SPSGs) versus LPSG in a cohort of patients treated for thoracoabdominal (TAAA) and complex abdominal (CAAA) aortic aneurysms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A multi-center cohort study based on a retrospective analysis of consecutive patients admitted for the treatment of TAAA and CAAA using fenestrated and/or branched endovascular aneurysm repair (FB-EVAR) was performed. Outcomes were compared in patients treated with LPSG versus SPSG including procedural metrics, technical success (TS), clinical complications, access-related complications, overall survival, stent-graft integrity issues, secondary interventions, sac enlargement, and primary patency of target vessels (TVs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 478 patients were included, with a mean age of 71.6 years (±8.96), and 80.3% were male. There were 227 TAAAs and 251 CAAAs, with a median of 4 (interquartile range [IQR]: 4-4) vessels catheterized per patient. Low-profile stent grafts were used in 137 (28.7%) patients and SPSGs in 341 (71.3%) patients. Low-profile stent grafts were more frequently used in patients with previous aortic surgery (44.9% vs 33.6%, &lt;i&gt;P&lt;/i&gt; = .022), and the number of TVs treated differed significantly between LPSG and SPSG (4, IQR: 4-4 vs 4, IQR: 3-4; &lt;i&gt;P&lt;/i&gt; &lt; .001). Moderate-to-severe iliac calcification was significantly more common in the LPSG group (29.9% [n = 40] vs 18.3% [n = 61], &lt;i&gt;P&lt;/i&gt; = .006). The tortuosity index was also higher in the LPSG group (1.35 ± 0.23) compared with in the SPSG group (1.29 ± 0.16, &lt;i&gt;P&lt;/i&gt; = .030). Patients treated with LPSG had a similar TS rate (92.7% vs 95.0%, &lt;i&gt;P&lt;/i&gt; = .33). There were no significant differences in postoperative complications. The median follow-up period was 6.9 months (IQR: 0.8-28.7). Regarding persistent or late endoleaks, no statistically significant differences were observed (&lt;i&gt;P&lt;/i&gt; = .36). Overall survival (hazard ratio [HR]: 1.06; 95% CI, 0.66-1.71; &lt;i&gt;P&lt;/i&gt; = .78) and freedom from reintervention (HR: 1.04; 95% CI, 0.64-1.70; &lt;i&gt;P&lt;/i&gt; = .86) were also similar between groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Fenestrated and/or branched endovascular aneurysm repair with LPSG and SPSG was performed with similar rates of TS and mortality. Low-profile stent grafts were more often used in complex cases with prior aortic repairs and challenging access. Early and mid-term outcomes were comparable, with both devices showing similar safety and effectiveness profiles.Clinical ImpactWe performed a retrospective, multicenter cohort study including 478 patients, comparing low-profile stent grafts with standard-profile grafts in the treatment of complex aortic aneurysms. Both types of stent grafts demonstrated similar technical success, safety, and effectiveness. Low","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028261489194"},"PeriodicalIF":1.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139210","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":"Circulating Metalloproteinase Inhibitors and Artificial Intelligence-Derived Radiomics Predict Persistent Endoleak After Endovascular Abdominal Aortic Aneurysm Repair: A Multimodal Biological-Imaging Model.","authors":"Antonio Bozzani, Edoardo Destefanis Gallo, Ilaria Salzillo, Vittorio Arici, Matteo Crippa, Giulia Maria Stella","doi":"10.1177/15266028261493859","DOIUrl":"https://doi.org/10.1177/15266028261493859","url":null,"abstract":"<p><strong>Objective: </strong>Persistent endoleak after endovascular abdominal aortic aneurysm repair (EVAR) reflects ongoing aneurysm sac biological activity and remains insufficiently predicted by anatomical surveillance alone. We aimed to evaluate whether integration of circulating matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs), and artificial intelligence (AI)-derived radiomic features from computed tomographic angiography (CTA) improves prediction of persistent endoleak.</p><p><strong>Methods: </strong>We conducted a retrospective observational study including 62 consecutive patients undergoing elective infrarenal EVAR between January 2020 and December 2024. Plasma levels of MMP-1, MMP-2, MMP-9, MMP-10, TIMP-1, and TIMP-2 were measured preoperatively and at 1 and 12 months post-EVAR. Computed tomography angiography data sets were analyzed using a standardized semi-automated radiomics pipeline with reproducibility testing and penalized feature selection. The primary endpoint was persistent endoleak at 12 months. Multivariable logistic regression was constructed with event-per-variable control and internally validated using bootstrap resampling.</p><p><strong>Results: </strong>Persistent endoleak occurred in 18 patients (29%). Patients with persistent endoleak exhibited significantly higher MMP-9 levels, lower TIMP-1 and TIMP-2 levels, and markedly elevated MMP-9/TIMP-1 ratios at 1 month (all <i>P</i> < .01). Radiomics demonstrated increased intraluminal thrombus (ILT) entropy and reduced ILT density in the endoleak group. A parsimonious model including MMP-9/TIMP-1 ratio and ILT entropy yielded an optimism-corrected area under the curve (AUC) of 0.81 with good calibration, outperforming sac diameter change alone (AUC = 0.62).</p><p><strong>Conclusions: </strong>Persistent endoleak is associated with systemic proteolytic imbalance and imaging-detectable thrombus heterogeneity. Integration of biological and radiomic markers improves risk stratification compared with morphological surveillance alone and warrants prospective validation.Clinical ImpactThis study proposes a novel multimodal approach to post-EVAR surveillance by integrating circulating metalloproteinase inhibitors with AI-derived CT radiomics. Combining biological biomarkers with quantitative analysis of peri-EVAR thrombus volume and density may improve identification of patients at risk of persistent endoleak beyond conventional imaging assessment. For clinicians, this approach could enable earlier risk stratification, support personalised surveillance intervals, and identify patients who may benefit from closer imaging follow-up or intervention. The innovation lies in integrating systemic biological activity with local imaging phenotypes within a predictive model, moving EVAR surveillance from a predominantly anatomical strategy towards a personalised, data-driven biological-imaging paradigm.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028261493859"},"PeriodicalIF":1.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139076","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":"The Removal of Intravascular Foreign Bodies by Intervention in Pediatrics.","authors":"Isabel C Sánchez-Escobar, Miguel Á Restrepo-Arboleda, María Isabel Palacio, Luis H Díaz-Medina, Rafael Correa-Velásquez, Rafael Lince-Varela","doi":"10.1177/15266028251344541","DOIUrl":"10.1177/15266028251344541","url":null,"abstract":"<p><strong>Introduction: </strong>The use of intravascular catheters has become increasingly widespread in children, due to their use in diagnostic procedures (such as coronary, intracardiac, cerebral, and renal angiography, as well as pressure monitoring) and for therapeutic purposes (including angioplasties, valvuloplasties, congenital defect closure, chemotherapy, among other uses). However, they are not free from complications, which may include catheter fracture and migration within the cardiovascular system, potentially leading to vascular or cavity perforation, arrhythmias, and even death.</p><p><strong>Objective: </strong>To define the clinical and hemodynamic characteristics of pediatric patients undergoing catheterization for the retrieval of intravascular foreign bodies.</p><p><strong>Materials and methods: </strong>A retrospective cohort study of all patients under 18 years of age who underwent endovascular extraction of foreign bodies at a cardiovascular reference center.</p><p><strong>Results: </strong>A high percentage of successful retrieval of intravascular foreign bodies was noted, with the most frequently retrieved catheter being the chemotherapy catheter, primarily located in the right atrium, between the pulmonary trunk and the right ventricle, and in the brachiocephalic vein. Few secondary complications were observed, occurring in only 2 patients.</p><p><strong>Conclusion: </strong>Endovascular retrieval of foreign bodies is a highly effective procedure, and complications are relatively low in pediatrics, even during the neonatal period and in low-birth-weight cases, making it a preferable alternative to surgical extraction.Clinical ImpactBy documenting favorable outcomes across a diverse group, it encourages clinicians to adopt catheter-based approaches more confidently. The use of tools like snare loops and balloon-tipped guidewires in this population reflects procedural innovation and adaptability. Early, minimally invasive intervention may reduce morbidity and hospital stay. These findings can influence clinical decision-making and protocol development in pediatric cardiovascular care, particularly in centers equipped for interventional procedures.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"2507-2510"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340565","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":"Effectiveness of Infrared Thermography Combined With Ankle-Brachial Index in the Assessment of Patients With Below-the-Knee Periphery Artery Diseases.","authors":"Zhenyu Guo, Benjamin Patterson, Xuyang Zhang, Zhenyu Shi, Daqiao Guo, Longhua Fan, Baolei Guo, Weiguo Fu","doi":"10.1177/15266028251356459","DOIUrl":"10.1177/15266028251356459","url":null,"abstract":"<p><strong>Objective: </strong>The prevalence of peripheral artery disease (PAD) is on the rise due to an aging population. This study aimed to gain insight into the clinical role of infrared thermography (IRT) as a diagnostic method and prognostic tool for below-the-knee (BTK) PAD patients.</p><p><strong>Materials and methods: </strong>The study prospectively recruited 64 patients who received lower limb revascularization for symptomatic BTK PAD (ChiCTR2400083847). IRT was used to detect lower limb skin temperature. Locations on the lower extremity sampled with IRT were dorsal areas, plantar areas, and medial and lateral areas of the calves.</p><p><strong>Results: </strong>One hundred twenty-eight limbs of 64 patients were divided into normal (n=35), mild (n=22), moderate (n=55), and severe (n=16) groups based on the ankle-brachial index (ABI) testing. Limbs in the moderate and severe groups showed an obvious decrease in surface temperature when compared to the normal baseline measurements, particularly in the dorsal areas (all p values <0.01). Further analysis revealed IRT increased the sensitivity of ABI from 75.8% (69/91) to 96.7% (88/91) in PAD diagnosis. In addition, our results showed maximum temperature variations (ΔTEMP) on treated limbs decreased significantly after endovascular treatment. Further analysis revealed showed a negative correlation between maximum ΔTEMP on treated limbs and walking distance.</p><p><strong>Conclusions: </strong>Our findings showed the use of IRT increased the diagnostic efficacy of ABI in BTK PAD patients. This noninvasive technique has the potential to be applied in PAD diagnosis, preoperative, and postoperative evaluation.Clinical ImpactAn ankle-brachial index (ABI) is the most commonly used diagnostic method for evaluating vascular disorders in the lower limb. The high prevalence of medial sclerosis, which can render arteries incompressible upon cuff inflation, may lead to falsely elevated ABI values (ABI>1.4) in patients with diabetes mellitus. Infrared thermography (IRT) is a novel potential diagnostic method that does not require physical contact. The use of IRT may increase the diagnostic efficacy of ABI in BTK PAD patients. This non-invasive technique has the potential to be applied in PAD diagnosis, preoperative, and postoperative evaluation.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"2545-2554"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621067","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":"Drug-Coated Balloon Versus Plain Balloon Angioplasty for the Treatment of Dysfunctional Dialysis Access: A Systematic Review and Meta-analysis.","authors":"Qianqian Zhang, Deshuang Zou, Wenqiong Mao, Xing Su, Jingzhen Li","doi":"10.1177/15266028251359499","DOIUrl":"10.1177/15266028251359499","url":null,"abstract":"<p><strong>Background: </strong>The optimal treatment for dysfunctional dialysis access between drug-coated balloon angioplasty (DCBA) and plain balloon angioplasty (PBA), including standard balloon angioplasty (SBA) and high-pressure balloon angioplasty (HPBA), remains unclear. This study aims to compare the efficacy and safety of DCBA and PBA.</p><p><strong>Materials and methods: </strong>A systematic review was conducted to identify randomized controlled trials (RCTs) comparing DCBA and PBA. Outcomes included target lesion primary patency (TLPP), access circuit primary patency (ACPP), target lesion revascularization (TLR), technical success, and all-cause mortality. A meta-analysis with a priori subgroup analysis (ie, DCBA vs HPBA and DCBA vs SBA) was performed using a random-effects model to calculate risk ratios (RRs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Twenty-five RCTs with a total of 2838 patients were included. DCBA showed higher TLPP at 6 months (RR: 1.27, 95% CI: 1.12-1.43, p<0.001) and 12 months (RR: 1.28, 95% CI: 1.13-1.45, p<0.001) than PBA. ACPP was also superior with DCBA at 6 months (RR: 1.25, 95% CI: 1.04-1.40, p=0.002) and 12 months (RR: 1.42, 95% CI: 1.23-1.65, p<0.001). However, no significant difference was found between DCBA and HPBA for TLPP (RR: 1.49, 95% CI: 0.83-2.67, p=0.181) and ACPP (RR: 1.30, 95% CI: 0.92-1.84, p=0.133) at 12 months. TLR was lower with DCBA at 6 months (RR: 0.60, 95% CI: 0.35-0.80, p=0.003) and 12 months (RR: 0.79, 95% CI: 0.68-0.93, p=0.005). No significant difference in the technical success rate and all-cause mortality was observed.</p><p><strong>Conclusions: </strong>DCBA improves TLPP and ACPP and reduces the TLR rate compared to PBA. However, it shows no significant advantage over HPBA in terms of TLPP and ACPP at 12 months. The technical success rate and all-cause mortality were similar between the 2 approaches.Clinical ImpactThis meta-analysis highlights the differential effectiveness of drug-coated balloon angioplasty (DCBA) compared with standard balloon angioplasty (SBA) and high-pressure balloon angioplasty (HPBA) in dysfunctional dialysis access. DCBA significantly improves primary patency and reduces revascularization rates compared to SBA, supporting its clinical utility. However, no clear advantage was found over HPBA at 12 months. These results suggest that while DCBA offers benefits over SBA, its added value over HPBA remains uncertain. Clinicians should consider individual patient factors and access characteristics when selecting the optimal angioplasty strategy.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"2291-2305"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856874","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}