Journal of Endovascular Therapy最新文献

{"title":"Aortic Coarctation With Type B Aortic Dissection: A Systematic Review and Report of 2 Cases.","authors":"Mauricio Gonzalez-Urquijo, Leopoldo Marine, Jose Francisco Vargas, Gabriel Seguel, Diego Soto V, Michel Bergoeing, Francisco Valdes","doi":"10.1177/15266028251344799","DOIUrl":"10.1177/15266028251344799","url":null,"abstract":"<p><strong>Purpose: </strong>A systematic review of patients with aortic coarctation (CoA) and concomitant type B aortic dissection (TBAD) is presented; additionally, 2 cases of our own experience are reported.</p><p><strong>Materials and methods: </strong>Following the PRISMA guidelines, databases were search for all articles or abstracts written in English published until May 2024. Mesh terms used included \"aortic coarctation\" in combination with \"aortic dissection,\" \"type B aortic dissection,\" and \"TBAD.\"</p><p><strong>Results: </strong>A total of 121 studies were screened, 19 full-length articles, and 1 abstract were included for analysis. Adding our own 2, a total of 22 cases were analyzed. The median age was 39 years (range: 25-64 years). Eighteen (81.8%) patients were male. Fourteen (63.6%) patients underwent open surgery. One (4.5%) patient underwent hybrid repair. Five (22.7%) patients underwent endovascular repair, including these 2 cases. Two (9%) patients were managed conservatively. The complication rate was 9% (n=2). There were no reported deaths, and the median follow-up period was 11.5 months (range: 6-48 months).</p><p><strong>Conclusion: </strong>The most comprehensive data on patients with CoA and TBAD is presented. The pathophysiology of this disorder remains uncertain. Both endovascular and open surgery have proven effective in treating these conditions with low complication rates. However, long-term outcomes remain undefined.Clinical ImpactThis systematic review provides the most comprehensive analysis of patients with concomitant aortic coarctation and type B aortic dissection to date, offering valuable insights into the demographics, treatment strategies, and outcomes of this rare condition. The findings suggest that both open and endovascular repair are viable treatment options with low complication rates. The absence of mortality in the analyzed cases highlights the feasibility of surgical intervention. However, with limited long-term follow-up, the durability of these treatments remains uncertain, emphasizing the need for further research to guide optimal management and improve long-term patient outcomes.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"2243-2253"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303466","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":"Long-Term Efficacy of Lutonix in a Real-World Femoropopliteal Patients With Peripheral Arterial Disease: Insights From the SAFE-DCB US Registry.","authors":"Nicolas W Shammas, Dion Franga, Erin Moore, George Mueller, Thomas P Davis, Edward Woo","doi":"10.1177/15266028261453224","DOIUrl":"10.1177/15266028261453224","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Several studies have demonstrated the efficacy of paclitaxel drug-coated balloons (DCBs) for the treatment of femoropopliteal (FP) lesions in patients with peripheral artery disease (PAD). Despite the available evidence, long-term real-world efficacy data are limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To report the 3-year outcomes of the prospective, multicenter, single-arm real-world registry conducted in the United States, assessing the clinical use of the Lutonix 035 DCB in arteries of the superficial femoral artery (SFA) and popliteal artery (PA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In the SAFE-DCB US Registry, a total of 1005 subjects at 74 investigational sites were treated with the Lutonix 035 DCB and were followed up to 36 months. The per protocol included 966 patients (mean age 69.1 years; 56.7% male). A total of 1237 target lesions were treated, in which 93.3% were de novo, 85.2% were located in the SFA, and 88% had mild-to-severe calcification. Forty-five percent of the patients were Rutherford 3, and 35.1% had critical limb-threatening ischemia. The primary efficacy endpoint is target lesion revascularization (TLR) at 12 months. Secondary endpoints included rate of primary patency at 12 months and freedom from TLR and freedom from target vessel revascularization (TVR) evaluated through 36 months. The safety endpoints evaluated through 36 months were freedom from the composite of device- and/or procedure-related perioperative (≤30 day) death, TVR, and freedom from major amputation of the target limb.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Primary patency at 12 months post-index procedure by Kaplan-Meier estimates was 83.7%. Freedom from TLR at 12 months was 88.6%, 75.7% at 24 months, and 74.4% at 36 months. At 36 months, freedom from TVR post-index procedure by Kaplan-Meier estimates was 69.5%. Freedom from primary safety events at 30 days was 98.2%. Freedom from composite of all-cause perioperative (≤30 day) death and from the following: index limb amputation, index limb reintervention, and index-limb-related death by Kaplan-Meier estimates at 12 months was 80.8%, at 24 months 67.4% and 58.4% at 36 months. Freedom from major amputation of the target limb at 36 months was 95.6%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The results from the SAFE-DCB US Registry for femoral popliteal (FP) disease demonstrated sustained safety and efficacy over 3 years following the Lutonix 035 DCB intervention.Clinical ImpactThis prospective real-world population study supports long-term clinical outcomes of Lutonix and provides meaningful insights into the sustained efficacy of drug-coated balloon (DCB) therapy in real-world femoropopliteal population. The low-bailout stenting rate (1.7%), and the 36-month sustained Freedom from target lesion revascularization rate (74.4%) supporting DCB usage when a \"leave nothing behind\" approach is favored. Furthermore, these results reinforce the effectiveness of DCBs in the endovascular treatment pe","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"2710-2718"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Endovascular Aortic Repair Durability in Patients Achieving Increased Shortest Apposition Length: A Multi-Centre Analysis.","authors":"Cas H F Hendricks, Richte C L Schuurmann, Bram Fioole, Rogier H J Kropman, Reinoud P H Bokkers, Lievay van Dam, Jan-Albert Vos, Jean-Paul P M de Vries","doi":"10.1177/15266028251338812","DOIUrl":"10.1177/15266028251338812","url":null,"abstract":"<p><strong>Objective: </strong>Endovascular aortic repair (EVAR) for an aneurysm of the abdominal aorta (AAA) is associated with long-term complications, such as endoleaks, resulting in a significant re-intervention rate. This study investigates the prognostic value of (change of) proximal seal length on post-EVAR computed tomography angiography (CTA) for predicting type 1a endoleak. It further proposes a risk-stratified imaging follow-up algorithm.</p><p><strong>Design: </strong>Multicentre, retrospective, observational study of consecutive patients who underwent elective EVAR for infrarenal AAA between 2015 and 2018 at 3 high-volume hospitals in the Netherlands.</p><p><strong>Materials and methods: </strong>Aorta morphology and endograft position analysis was performed. Shortest apposition length (SAL) was measured on the first post-EVAR CTA and, if available, on the last CTA. Change of SAL through time was categorized as increasing, stable, or decreasing and correlated with type 1a endoleak and secondary interventions for endoleak. Kaplan-Meier analysis was used to calculate type 1a endoleak free and re-intervention-free survival.</p><p><strong>Results: </strong>Three hundred ten AAA patients with a median follow-up of 51 (Q1, 17; Q3, 71) months were included. A median SAL of 22.8 mm (Q1, 15.9; Q1, 30.4) was measured on the first post-EVAR CTA. In 168 of 310 patients (54%), a second post-EVAR CTA was available, in which 71 (42%) showed increasing SAL over time. No type 1a endoleak developed in the increasing SAL group, whereas 1 of 43 (2%) in the stable group and 10 of 54 (19%) in the decreasing group developed type 1a endoleak. Five years post-EVAR, type 1a endoleak-free survival was 100% in the increasing SAL group versus 97.1% in the stable SAL group (p=0.195), and 81.6% in the decreasing SAL group (p<0.001). The re-intervention for all types of endoleak-free survival was 100% in the increasing SAL group versus 84.6% in the stable SAL group (p<0.001), and 60.7% (p<0.001) in the decreasing SAL group.</p><p><strong>Conclusion: </strong>Increasing SAL after EVAR for infrarenal degenerative AAA is an indicator of durable success without type 1a endoleak and endoleak-associated secondary intervention within 5 years. Decreasing SAL is associated with development of type 1a endoleak after EVAR. Evaluation of (change of) the proximal seal could be a valuable part of follow-up after EVAR.Clinical ImpactEvaluation of proximal seal length after endovascular aortic repair offers valuable prognostic information regarding the risk of type 1a endoleak. Implementation could refine current follow-up algorithms to better stratify patients who have a substantial risk of type Ia endoleak from patients who may benefit from limited image surveillance.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"2429-2438"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bifurcated In-Stent in Situ Technique for Creation of a Bifurcated Bridging Stent-Graft System to 2 Target Vessels Using a Single Directional Branch: A Report of 2 Cases.","authors":"Gustavo Paludetto, Lethicia Mesquita, Bruno Pagnin Schmid, Lucas Ruiter Kanamori, Dora Babocs, Thanila A Macedo, Gustavo S Oderich","doi":"10.1177/15266028251384906","DOIUrl":"10.1177/15266028251384906","url":null,"abstract":"<p><strong>Objective: </strong>The objective of the study is to describe a novel bifurcated in-stent in situ technique (BIS2T) for creation of a bifurcated bridging stent-graft system to target 2 vessels using a single directional branch during complex endovascular aortic aneurysm.</p><p><strong>Technique: </strong>The technique uses 3 balloon-expandable stent-grafts. The first supporting stent-graft is deployed from the directional branch into the first target vessel or aneurysm sac. A reentry catheter is used to create an in situ fenestration in the first stent-graft, which is predilatated with a 3 mm 0.014 inch angioplasty balloon. This is exchanged for a 0.035 inch 5 Fr catheter and guidewire which is used for catheterization of the second target vessel via the in situ fenestration. The docking area of the first stent-graft is predilated. The second stent-graft is deployed into the second target with >1 cm overlap into the first stent-graft, followed by a matching third stent-graft in a kissing stent fashion to reinforce the bifurcation and achieve a \"D shape\" stent-graft configuration.</p><p><strong>Results: </strong>The BIS2T was used to treat 2 patients. Neither experienced complications or endoleaks, and both had patent branches on follow-up computed tomography angiography.</p><p><strong>Conclusions: </strong>The BIS2T is a feasible option to incorporate 2 target vessels via a single directional branch.Clinical ImpactTarget vessel anatomy is a frequent limitation for successful endovascular incorporation using fenestrations or directional branches during complex endovascular aortic aneurysm repair. Numerous anatomical variations such as aberrant or accessory vessels, common celio-mesenteric trunks, or extension of the aneurysm/dissection into a target vessel may preclude successful incorporation using standard endovascular techniques. This technical note describes a novel bifurcated in-stent in situ technique (BIS2T) for the creation of a bifurcated bridging stent-graft system to target 2 vessels using a single directional branch. This approach may enable target vessel incorporation in challenging anatomical situations that might otherwise preclude endovascular treatment or require intentional artery coverage.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"2387-2396"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sirolimus-Eluting Resorbable Magnesium Scaffold for the Treatment of Patients With Infrapopliteal Arteries Disease: Three-Year Results.","authors":"Adeline Demierre, Rolf P Engelberger, Daniel Hayoz, Daniel Périard","doi":"10.1177/15266028251339356","DOIUrl":"10.1177/15266028251339356","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Symptomatic infrapopliteal arterial disease often requires challenging endovascular interventions. Percutaneous transluminal angioplasty with stent placement to settle residual stenosis or dissections remains the standard of care for infrapopliteal endovascular intervention. Concerns have been raised about permanent artery rigidification by stainless steel stents. Drug-eluting resorbable scaffolds combine the mechanical support in the acute phase and the delivery of an antirestenotic drug overtime, then fully resorb leaving the vessel free from permanent metallic implant. This study investigated the performance of the Magmaris sirolimus-eluting resorbable magnesium scaffold (RMS) in the management of infra-popliteal, severely diseased leg arteries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This investigator-initiated single-center retrospective study, analyzed all patients with symptomatic peripheral arterial occlusive disease (Rutherford class of symptoms 2-5) treated with the Magmaris RMS from 2016 to 2023, for the treatment of infrapopliteal arterial lesions with postangioplasty 50% or more residual stenosis. Technical success, degree of residual stenosis after scaffold implantation, incidences of target lesion primary patency, clinically driven target lesion revascularization (CDTLR), major limb amputation, and all-cause mortality are provided up to 36 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Hundred eleven patients (69.4% male, age 79 ± 10) were treated with 141 Magmaris RMS for infrapopliteal lesions (92.3% proximal third of leg). Target lesions had a mean degree of stenosis of 92%, with 52.2% of occlusion and 58.5% of moderate or severe calcification. The mean degree of stenosis after angioplasty remained 60.1% ± 15.8% and fell to 4.8% ± 9.6% after scaffold implantation. Freedom from CDTLR was 95.5%, 93.4%, 90.4%, and 87.9% at 6, 12, 24, and 36 months. Freedom from limb major amputation was 98.2%, 98.1%, 96.4%, and 95.5% and mortality was 7.6%, 10.6%, 24.2%, and 28.8% at 6, 12, 24, and 36 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study suggests that the Magmaris RMS has adequate mechanical properties, drug elution, and resorption time to be safely applied to atherosclerotic infrapopliteal arteries with promising clinical results. These data show that metallic resorbable scaffold may constitute a valuable addition to current option for infrapopliteal arteries management.Clinical ImpactResorbable magnesium scaffold (RMS) are an innovation in the treatment of residual stenoses or dissections after angioplasty in the infrapopliteal arteries. They offer mechanical support and drug elution during the healing phase of the artery wall; and then disappear, leaving the artery free of any rigid implant, once the resorption is completed. RMS thus allow the restoration of artery motion and endothelial function. This study provides efficacy and safety information up to 3 years after RMS implantation in severe l","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"2449-2457"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095471","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":"Urgent Relining of a Fenestrated Stent-Graft for Symptomatic Type V TAAA due to Late Type IIIB and IIIC Endoleaks in a Patient With Marfan Syndrome Case Report and Literature Review.","authors":"Simone Cuozzo, Jihad Jabbour, Carola D'Amico, Andrea Molinari, Maria Luisa De Cicco, Vincenzo Brizzi, Enrico Sbarigia","doi":"10.1177/15266028251351139","DOIUrl":"10.1177/15266028251351139","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Although open repair remains the standard of care for managing connective tissue disorders (CTDs), endovascular repair has emerged as an alternative, especially in patients with prior aortic surgery, using a \"graft-to-graft\" approach. Notwithstanding, long-term interaction between bridging stent-grafts and arterial wall of target vessels (TVs) remains under-investigated. We present a rare case of late-onset type IIIB/IIIC endoleaks in a symptomatic type V thoracoabdominal aortic aneurysm (TAAA) following fenestrated endovascular aneurysm repair (FEVAR) in a patient with Marfan syndrome (MFS), and a literature review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 55-year-old woman with MFS and a history of multiple cardiovascular surgeries, including previous FEVAR using a graft-to-graft approach, presented with chest pain secondary to a large type V TAAA. Computed tomography angiography revealed type IIIB/IIIC endoleaks due to stent disconnection, stent fracture, and fabric tears involving renal and visceral arteries' bridging stents. An urgent endovascular relining was performed with balloon-expandable stent-grafts, achieving enhanced stent protrusion and increased oversizing. The postoperative course was uneventful, with complete resolution of symptoms and no evidence of spinal cord ischemia. Follow-up imaging confirmed complete aneurysm exclusion and maintained patency of TVs. Additionally, a comprehensive literature review was conducted in accordance with PRISMA guidelines, using the search term \"MFS,\" \"type IIIB/IIIC endoleak,\" and \"Fenestrated stent-graft\" to investigate the rate of incident type III endoleak. Out of 43 identified reports, 8 studies met the inclusion criteria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Although infrequent (4%-5.9%), type IIIB/IIIC endoleaks after FEVAR in MFS patients may be underreported. These endoleaks may result from under-investigated interactions between bridging stents and TVs, especially due to the inherent fragility of the aortic wall in CTDs. In redo cases, adjunctive strategies, such as increased stent protrusion and greater oversizing, may be necessary to prevent further disconnections.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Endovascular therapy provides a viable option for managing MFS patients, particularly in challenging redo cases with prohibitive surgical risks. Lifelong aortic surveillance in specialized centers and extended and careful follow-up is essential to assess the risks and the true incidence of high-flow endoleaks, as well as the overall safety and durability of these interventions, especially given the progressive nature of CTDs.Clinical ImpactThis study demonstrated the feasibility, safety, and time- and cost-effectiveness of single-disc vascular plug embolization for directional branches during urgent or emergent branched endovascular aortic aneurysm repair using off-the-shelf devices, even without elongation with balloon-expandable stent-grafts. This approach is particul","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"2520-2528"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530808","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":"Respiration-Induced Displacements of Abdominal Aortic Branches-An MRI Study.","authors":"Hossam I Shaabi, Nicla Settembre, Jacques Felblinger, Maya Delbany, Damien Mandry, Serguei Malikov","doi":"10.1177/15266028251363487","DOIUrl":"10.1177/15266028251363487","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Introduction:&lt;/b&gt; The endovascular surgical approach provides a minimally invasive treatment of abdominal aortic aneurysms with less perioperative morbidity. This technique depends heavily on imaging to diagnose, plan surgical treatment, conduct the surgical procedure, and follow-up with patients. Image fusion technique was proposed to decrease radiation and injected contrast exposure; however, the accuracy of image fusion still needs to be improved. One of the major causes of this inaccuracy is the displacement of visceral arteries during respiration. &lt;b&gt;Objective:&lt;/b&gt; To analyze the physiological respiration-induced movements of the abdominal aortic side branches. &lt;b&gt;Materials and Methods:&lt;/b&gt; Thirty healthy volunteers were studied using noncontrast-enhanced MRI. Images were acquired in expiratory and inspiratory forced breath-holds. The displacements were studied by calculating 3-dimensional expiration-inspiration vectors of measured points; diaphragmatic domes, origins of the celiac trunk (CTA), superior mesenteric artery (SMA), right renal artery (RRA), and left renal artery (LRA) as well as the kidneys hila. &lt;b&gt;Results:&lt;/b&gt; For all measured points, the superior-inferior displacements were the most important component of movement vectors, and they were statistically significant. The right hemidiaphragm moved by 33.35 mm &lt;i&gt;P&lt;/i&gt; &lt; .001, the left hemidiaphragm by 32.4 mm &lt;i&gt;P&lt;/i&gt; &lt; .001, the right kidney moved by 19.56 mm &lt;i&gt;P&lt;/i&gt; &lt; .001, the left kidney moved by 23.64 mm &lt;i&gt;P&lt;/i&gt; &lt; .001, the origin of CTA moved by 3.41 mm &lt;i&gt;P&lt;/i&gt; &lt; .001, the origin of SMA moved by 3.54 mm &lt;i&gt;P&lt;/i&gt; &lt; .001, the origin of RRA moved by 3.03 mm &lt;i&gt;P&lt;/i&gt; &lt; .001, and the origin of moved LRA by 3.17 mm &lt;i&gt;P&lt;/i&gt; &lt; .001. &lt;b&gt;Conclusion:&lt;/b&gt; We found significant displacements of abdominal aortic branches from forced expiratory to forced inspiratory position. There is a positive correlation between diaphragmatic movement and all visceral arteries orifices displacements; however, this correlation is not high enough to be relayed upon for image fusion correction. Considering only the level of diaphragm to predict the level of abdominal branches origins is insufficient to correct image fusion inaccuracy. We suggest using a dynamic preoperative study as fusion model. Finally, this analysis protocol should be reapplied to a sample of patients with abdominal aneurysm to evaluate respiration-induced movements of the abdominal aortic side branches in pathological condition.Clinical ImpactAlthough it is known that visceral arteries move with respiration, the specific patterns and influencing factors remain unclear. No large-scale studies have quantified this motion under physiological conditions, and current understanding relies mainly on anatomical assumptions rather than detailed evidence.Understanding and predicting this movement has clear clinical implications. Accurate characterization of respiratory-induced arterial motion could improve image registration and fusi","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"2592-2599"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976944","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":"Outcome of Embolization of an Endoleak Type 2 After Placement of an Endoprosthesis for an Infrarenal Aorta Aneurysm.","authors":"Mattice Steenbeke, Nathalie Moreels, Frank Vermassen, Peter Vanlangenhove, Laurens Hermie, Elisabeth Dhondt, Lynn Huyck, Luc Defreyne","doi":"10.1177/15266028251363477","DOIUrl":"10.1177/15266028251363477","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to investigate the effect of transarterial (TA) and translumbar (TL) embolization of a type 2 endoleak (T2EL) after endovascular aneurysm repair (EVAR) of an infrarenal abdominal aortic aneurysm (AAA) on the evolution and rupture of the aneurysmal sac.</p><p><strong>Methods: </strong>A retrospective study was conducted including patients who underwent TA or TL embolization for a growing T2EL after EVAR from April 2001 to August 2022. Demographic data, used endograft, radiological data of the AAA and T2EL, embolization agents, techniques (TA or TL approach), and angiographical outcomes were collected from 48 patients with a total of 58 embolizations. The primary clinical outcome was rupture of the AAA. Secondary outcomes included T2EL recurrence, re-embolization of T2EL, aneurysm sac growth (≥5 mm), and mortality. Clinical success was defined as the absence of a 5 mm or greater increase in the aneurysm sac diameter.</p><p><strong>Results: </strong>After primary T2EL embolizations, an increase in aneurysm sac was seen in 56.5% (n = 26), stability in 30.4% (n = 14), and regression in 13.0% (n = 6). Recurrence of T2EL had a significant impact on clinical success. No difference in sac size or evolution after the TA and TL embolization was noted. Rupture was found in 4 patients, but in only 1 patient it was caused by an isolated T2EL. The effect of increase in aneurysm sac size on overall survival was not statistically significant. Additionally, no associations were observed between the outcome and clinical factors including gender, obesity, chronic obstructive pulmonary disease, diabetes, hypertension, hypercholesterolemia, smoking, technique, used embolic agents, and time from endoleak onset to embolization.</p><p><strong>Conclusion: </strong>In this retrospective study, 1 AAA rupture was attributable to an isolated T2EL out of 48 patients, with a clinical success rate of 43.5%.Clinical ImpactAlthough the impact of a type 2 endoleak (T2EL) on the outcome of an endovascular repaired abdominal aortic aneurysm is not yet clarified, in daily practice, the endovascular embolization is considered as a safe and effective option. Elimination or reduction of the volume of the endoleak can be obtained and can probably prevent aortic rupture, which is reassuring for the treating physician and the patient. The embolization of the T2EL reduces the need for extra imaging or hospitalizations, lowers the risk of complications and minimizes healthcare costs. This study contributes to the knowledge and treatment of T2EL, supporting clinicians in making better informed decisions, ultimately optimizing patient care. Moreover, this research found no outcome differences between the embolization techniques.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"2582-2591"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976928","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":"Mid-Term Outcomes of Hybrid Revascularisation of Symptomatic Multilevel Peripheral Arterial Disease Across Two Centres.","authors":"Gabriela Kaneta, Mishika Khandpur, Athanasios Saratzis, Hany Zayed","doi":"10.1177/15266028251363532","DOIUrl":"10.1177/15266028251363532","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined mid-term outcomes in symptomatic patients with peripheral arterial disease (PAD) undergoing hybrid revascularisation (HYR) involving common femoral artery endarterectomy (CFAE) with inflow and/or outflow endovascular procedure in 2 vascular centres.</p><p><strong>Results: </strong>A total of 366 consecutive patients (mean age 70.4 years, <i>SD</i>: 9.8 years; 271, 74% males) were identified. Overall, a total of 231 patients (63%) presented with chronic limb-threatening ischaemia. Patients were followed up for a median of 55 months (range 26-84 months). During follow-up, 105 patients (29%) required target lesion revascularisation (TLR). There were 33 patients (9%) who had a major amputation, and 37% (147) patients died resulting in an amputation-free survival (AFS) of 58% (213 patients) over the study period.</p><p><strong>Conclusion: </strong>HYR offers reasonable mid-term clinical and technical outcomes for multilevel PAD with diabetes adversely affecting outcomes such as AFS, primary patency (PP), and TLR, while patients on dual antiplatelet therapy post-operatively had favourable PP and TLR.Clinical ImpactHybrid lower limb arterial revascularization demonstrates acceptable mid-term outcomes and should be considered in patients with symptomatic multi-level PAD. By integrating open and endovascular techniques, it offers a practical solution for complex disease patterns. Given the paucity of contemporary data, this study provides meaningful evidence that may add to further studies and support the broader use of hybrid approaches in managing advanced PAD.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"2306-2313"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976900","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":"Geometrical Analysis and Initial Experience With Bentley's BeFlared Bridging Stent for Fenestrated Endovascular Aneurysm Repair.","authors":"Gian Franco Veraldi, Lorenzo Grosso, Marco Macrì, Mario D'Oria, Sandro Lepidi, Gabriele Piffaretti, Luca Mezzetto","doi":"10.1177/15266028251385460","DOIUrl":"10.1177/15266028251385460","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Endovascular treatment of juxtarenal aortic aneurysms is now widely accepted as a safe and effective alternative to open repair. Bridging stent-grafts (BSGs) are used to provide continuity between the main aortic graft and renovisceral target vessels (TVs) in fenestrated endovascular aneurysm repair (FEVAR). The BeFlared (Bentley InnoMed GmbH, Hechingen, Germany) represents the first dedicated BSG specifically designed for FEVAR, incorporating a novel flaring system that enables precise positioning and sealing in a single step. This study aims to evaluate the impact of BeFlared on procedural efficiency, radiation exposure, and deployment accuracy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A prospective registry of patients who underwent elective FEVAR at 3 Italian centers during February and March 2025 was retrospectively reviewed. Procedural parameters, including mean operative time, mean bridging time, and fluoroscopy duration, were recorded. Technical success was defined as successful stent deployment in all intended TVs. Cone-beam computed tomography (CBCT) was performed intraoperatively, and follow-up computed tomography angiography (CTA) was conducted 1 month post-procedure to assess geometric outcomes and complications. These parameters were compared with corresponding measurements obtained from a control cohort of patients who underwent FEVAR procedures, between 2020 and 2024 in the same 3 Italian centers, utilizing the Bentley BeGraft as BSG.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eight FEVAR procedures were performed, with a total of 31 TVs treated using BeFlared stents. The control cohort comprised 60 FEVAR procedures performed using the Bentley BeGraft as the BSG, involving a total of 185 renovisceral TVs. The BeFlared group demonstrated significantly improved intraoperative outcomes compared with the control group. Median operative time was 241 (interquartile range [IQR]=185-295) minutes vs 270.3 (IQR=207-365) minutes (p=0.022), mean bridging stent deployment time was 5 (IQR=4.25-6.15) minutes vs 7.6 (IQR=4.8-9.7) minutes (p&lt;0.001), and median fluoroscopy time was 72.2 (IQR=51-81) minutes vs 82.7 (IQR=49.5-113) minutes (p=0.064). Only 1 patient in the BeFlared cohort required brief intensive care unit admission. The average hospital stay was 5.1 (IQR=4-6) days compared with 5.7 (3-10) days in the control group (p=0.882). In the BeFlared cohort, technical success was achieved in 96.7% of TVs (30/31), no perioperative deaths or TV-related complications were observed. Geometric analysis showed that BeFlared stents had more uniform deployment, with lower variability regarding the landing zone of the BSG in the TV (16.4 mm, IQR=16-17.1 vs 15.4 mm, IQR=14.2-16.6; p&lt;0.001) and BSG aortic protrusion (4.2 mm, IQR=4.1-4.4 vs 5.1 mm, IQR=4.2-5.7; p&lt;0.001) compared with BeGraft. BeFlared also demonstrated a significantly larger proximal stent diameter (10.6 mm, IQR=10.4-11.4 vs 99.5 mm, IQR=8.7-10.2; p&lt;0.001), greater mean flari","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"2670-2676"},"PeriodicalIF":1.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402280","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}