Journal of Endovascular Therapy最新文献

{"title":"Angiographic Types of Palpebral Arteriovenous Malformations and Relevant Therapeutic Options Based on Ethanol Embolization: A Multicenter Study.","authors":"Yuchen Shen, Deming Wang, Mingzhe Wen, Lixin Su, Xindong Fan, Xitao Yang","doi":"10.1177/15266028231201534","DOIUrl":"10.1177/15266028231201534","url":null,"abstract":"<p><strong>Purpose: </strong>The present work aimed to determine the different angio-architectural types of palpebral arteriovenous malformations (pAVMs) and appropriate ethanol embolotherapy for each type.</p><p><strong>Materials and methods: </strong>This was a multi-center comparative effectiveness research retrospectively conducted from November 2012 to October 2021. A total of 70 patients with pAVMs were included, which was classified into cystic pAVMs (n=29) and diffuse pAVMs (n=41) based on the angio-architecture. Of the included patients, 17 with cystic pAVMs and 13 with diffuse pAVMs underwent ethanol embolization combined with coils (CE). The remaining participants underwent no-coil ethanol embolization (NCE). Participants had undergone 60 months of follow-up. Normality of data was tested by the D'Agostino and Pearson test. Correlation was tested by the Pearson χ<sup>2</sup> test. Deterioration-free survival (DFS) rate was estimated using the Kaplan-Meier survival analysis. Multivariate Cox regression models included variables that were significant at a p value<0.05 in the univariate analysis to screen the prognostic factor.</p><p><strong>Results: </strong>The local symptoms of pAVMs, including pulsation, warmth, red plaque, blepharoptosis, bleeding, and visual blurring, along with the devascularizational grade of angiography were recorded before and after the respective procedures. Post-treatment complications were either evaluated at the 3-month routine follow-up or were self-reported by patients. Cystic pAVMs presented with significantly different clinical and angiographic features compared with diffuse pAVMs. With CE, patients with cystic pAVMs obtained a higher devascularizational grade (p<0.0001) and better clinical outcomes (p=0.0009) than those with diffuse pAVMs. Contrarily, with NCE, patients with diffuse pAVM had better outcomes than those with cystic pAVMs (p=0.0248). Moreover, the overall DFS rate was higher in patients with cystic pAVMs (p=0.0006). Finally, the angio-architecture of pAVMs was found to independently influence its prognosis (p=0.02).</p><p><strong>Conclusions: </strong>In pAVMs, the angio-architectural type was associated with the relative prognostic status. Ethanol embolization combined with coils was an effective method to treat cystic pAVMs, whereas NCE was more suitable for the diffuse type, further emphasizing the importance of a type-based therapeutic strategy for pAVMs.Clinical ImpactPalpebral arteriovenous malformations (pAVMs) are rare and tricky in clinical practices. The present study has divided the pAVMs into cystic and diffuse types according to their angiographic characteristics. Ethanol embolization with (CE) or without coils (NCE) was performed on both types. CE was suitable for cystic pAVMs; whereas NCE was a better choice for diffuse pAVMs. The five-year survival analyses provided evidence of the safety and efficacy of ethanol application in pAVMs. Finally, our work demonstrated that both ","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"1056-1066"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41118444","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 Ratio Between Infrarenal and Suprarenal Aortic Diameters Corrects for Absolute Aortic Diameter Variations due to Patients' Sex and Body Size.","authors":"Gert Jan Boer, Nora Larbi, Joost A Bekken, Tjallingius M Kuijper, Dammis Vroegindeweij, Bram Fioole","doi":"10.1177/15266028231204812","DOIUrl":"10.1177/15266028231204812","url":null,"abstract":"<p><strong>Objectives: </strong>Aortic diameters may differ significantly between patients with different gender and body size. The aim of this study was to relate absolute aortic diameters to age, sex, height, and weight of the patients and to correct for these factors by calculating the ratio between the infrarenal and the suprarenal aortic diameters.</p><p><strong>Methods: </strong>A total of 458 patients who underwent elective endovascular aneurysm repair (EVAR) between 2004 and 2018 were included. The aortic anatomy in this group of elective EVAR patients was compared with a control group of 75 patients without an abdominal aortic aneurysm (AAA). The aortic diameter was measured at 4 suprarenal points and 4 infrarenal points. Ratios were calculated by dividing the mean infrarenal neck diameter by 4 suprarenal measurements.</p><p><strong>Results: </strong>Patients in the aneurysm group had significantly larger suprarenal and infrarenal aortic diameters. The ratios between the mean infrarenal neck diameter and all 4 suprarenal measurements were larger in the AAA group than in the control group. In both groups, there was a significant correlation between the mean infrarenal neck diameter and sex, height, weight, and body surface area (BSA). However, in both groups, all 4 ratios between the mean infrarenal neck diameter and suprarenal aortic diameters were not correlated with age, sex, height, weight, or BSA, except for the ratio between the mean infrarenal neck diameter and the aortic diameter measurement proximal to the upper renal artery, which was correlated to weight and BSA in the control group.</p><p><strong>Conclusion: </strong>The mean infrarenal neck diameter is correlated with sex, height, weight, and BSA. However, when the suprarenal aortic diameter was used as an internal control for the mean infrarenal neck diameter, we were able to correct for these variations in aortic diameters due to sex and body size. The clinical relevance of this ratio in patients treated by EVAR has yet to be assessed in future research.Clinical ImpactIn the assessment for EVAR suitability the absolute diameter of the aneurysm neck is taken into account. We believe that using absolute diameters is not the appropriate way to assess this suitability, but that patient characteristics such as age, gender and body size, should be factored into this assessment. In this paper, we show that suprarenal and infrarenal aortic diameters are both significantly increased in patients with an aneurysm compared with patients without an aneurysm. Besides, we found that mean infrarenal aortic diameter is correlated with sex, height, weight, and body surface area. Finally, we propose a new ratio system, using suprarenal diameters as an internal control, to correct for aortic diameter variations due to sex and body size.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"1095-1101"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240482","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":"Ascending Aorta Nose-Cone Loop Technique as Bail Out for Precise Branched Endovascular Aortic Arch Endograft Delivery Without Valve Re-Crossing.","authors":"Alessandro Grandi, Tilo Kölbel, Fiona Rohlffs, Daour Yousef Al Sarhan, Giuseppe Panuccio","doi":"10.1177/15266028231201532","DOIUrl":"10.1177/15266028231201532","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a right carotid-femoral through-and-through (T&T) guidewire technique during branched thoracic endovascular aortic arch repair (B-TEVAR) to facilitate endograft delivery in a very tortuous aortic anatomy for a type Ia endoleak (EL) of a previous aortic endograft implantation.</p><p><strong>Technique: </strong>AT&T guidewire was established between the right common carotid artery and the right common femoral artery to facilitate a difficult endograft delivery. Once in the aortic arch, a loop in the ascending aorta was formed to allow the endograft to reach the desired position without losing tension on the guidewire. This maneuver allowed the T&T guidewire to be kept in place until the desired position was reached. The nose-tip of the endograft was curved over the looped guidewire pointing toward the innominate artery without crossing the valve. After endograft deployment, the T&T guidewire was released, and the branches were bridged in a standard fashion. Completion angiography documented correct deployment of the endograft and no sign of type I/III EL. The 1-month computed tomography angiography confirmed the correct deployment.</p><p><strong>Conclusion: </strong>Carotid-femoral T&T guidewire to facilitate endograft delivery in difficult anatomies can be feasible even in B-TEVAR. Possible bailout maneuvers are available if the aortic valve needs to be crossed after endograft delivery.Clinical ImpactEndovascular arch repair gains popularity as a valuable alternative, especially in patients considered unfit for open repair. A through-and-through (T&T) guidewire for endovascular arch repair with a landing zone in zone 0 according to Ishimaru is usually performed through the externalization of the femoral guidewire through a transapical access, but this may not always be feasible in frail patients. A right carotid-femoral though-and-through guidewire with a loop formation in the ascending aorta is proposed to achieve the support of a T&T wire to pass tortuous aortoiliac anatomies and access the ascending aorta without the need for aortic valve crossing.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"989-993"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41219092","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":"A Systematic Review and Meta-analysis of Atherectomy Plus Balloon Angioplasty Versus Balloon Angioplasty Alone for Infrapopliteal Arterial Disease.","authors":"Haichao Wu, Dandan Zheng, Long Zhou, Qiang Wang, Tao Wang, Siyuan Liang","doi":"10.1177/15266028231209236","DOIUrl":"10.1177/15266028231209236","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The article aimed to compare the efficiency and safety of atherectomy plus balloon angioplasty (BA) with BA alone for the treatment of infrapopliteal arterial disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;According to the inclusion and exclusion criteria, PubMed, Embase, and Cochrane Library database were searched for studies comparing atherectomy plus angioplasty and angioplasty alone in treating infrapopliteal artery lesions until November 2022. The endpoints included technical success, primary patency, clinically-driven target lesion revascularization (CD-TLR), periprocedural complications, distal embolization, target limb major amputation, and all-cause mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Ten studies met the requirements of our meta-analysis, including 7723 patients in the atherectomy plus BA group and 2299 patients in the BA alone group. The meta-analysis showed that atherectomy plus BA was associated with reduced CD-TLR (odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.34, 0.78, p=0.002) and target limb major amputation (OR: 0.43, 95% CI: 0.19, 1.01, p=0.05) at 12-month follow-up. No statistically significant difference was found in technical success, primary patency, periprocedural complications, distal embolization, or all-cause mortality. Subgroup analysis found a higher rate of primary patency at 6 and 12 months (6 months: OR: 2.26, 95% CI: 1.11, 4.60, p=0.02; 12 months: OR: 2.38, 95% CI: 1.16, 4.86, p=0.02), and lower rates of CD-TLR (OR: 0.45, 95% CI: 0.25, 0.82, p=0.009) and target limb major amputation (OR: 0.43, 95% CI: 0.19, 1.01, p=0.05) at 12 months in patients treated with atherectomy plus drug-coated balloon (DCB) but not in patients treated with atherectomy plus plain old balloon angioplasty (POBA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This meta-analysis suggests that compared with BA alone, atherectomy plus BA may reduce the need for CD-TLR and the incidence of target limb major amputation at 12-month follow-up in the treatment of infrapopliteal artery occlusive lesions, even though there are no significant advantages in technical success, primary patency, periprocedural complications, distal embolization, or all-cause mortality. To go further, atherectomy plus DCB shows significant benefits in primary patency, CD-TLR, and target limb major amputation rate but atherectomy plus POBA does not'. However, due to the limitations of this article, more randomized controlled trials (RCTs) are needed to confirm these conclusions.Clinical ImpactAccording to our research, atherectomy combined with BA has the advantages of higher primary patency rate, lower CD-TLR and target limb significant amputation rate in treating infrapopliteal artery occlusive lesions, which may replace the current mainstream surgical method ---BA alone. For the clinician, although the surgery may take longer, it will significantly improve the prognosis and quality of life of patients and hold considerable significance for th","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"957-968"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488301","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 Percutaneous Access to the First Versus Third Segment of Axillary Artery During Aortic Procedures.","authors":"Andrea Melloni, Luca Bertoglio, Wouter Van den Eynde, Christopher J Agrusa, Gianbattista Parlani, Dominic P J Howard, Javier Rio, Stefano Fazzini, Wassim Mansour, Nuno V Dias, Sonia Ronchey, Daniela Branzan","doi":"10.1177/15266028231202456","DOIUrl":"10.1177/15266028231202456","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This article aims at investigating the outcomes of percutaneous access via the first versus third axillary artery (AXA) segments with closure devices during aortic procedures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;All patients receiving percutaneous AXA access closed with Perclose ProGlide device (Abbott, Santa Clara, California) from 2008 to 2021 were included in a retrospective multicenter registry (NCT: 04589962). Efficacy endpoint was the technically successful percutaneous procedure (no open conversion). Safety endpoints were stroke and access complications according to the Valve Academic Research Consortium-3 reporting standards. The first (AXA1) or third (AXA3) axillary puncture sites were compared.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 412 percutaneous AXA accesses were included: 172 (42%) in AXA1 and 240 (58%) in AXA3. Left AXA was catheterized in 363 cases (76% of AXA1 vs 97% of AXA3, p&lt;0.001) and 91% of fenestrated/branched endovascular repair (F/BEVAR) procedures were conducted from the left. A ≥12F internal diameter (ID) sheath was used in 49% of procedures. Open conversion rate was 1%, no major vascular complications occurred, and only one major non-vascular complication was recorded. Primary closure failure occurred in 18 AXA1 (11%) and 32 AXA3 accesses (13%), treated by covered (8.3%) or bare-metal (2.7%) stenting. Bailout stent patency was 100% at median follow-up of 12 months, with 6 of 6 stents still patent after &gt;36 months of follow-up. Stroke rate was 4.4%. An introducer sheath &gt;12F was independently associated with both access complications (p&lt;0.001) and stroke (p=0.005), while a right-side access was associated with stroke only (p=0.034). Even after adjustment for covariates, AXA1 versus AXA3 showed an equal success rate (odds ratio [OR]=0.537, 95% confidence interval [CI]=0.011-1.22 for AXA3, p=0.104). The combination of AXA3 and a &gt;10F introducer sheath provided worse outcomes compared with &gt;10F sheaths through AXA1 (OR for success=0.367, 95% CI=0.176-0.767, p=0.008). This was not confirmed for &gt;12F sheaths, associated with similar outcomes (p=0.31 AXA 1 vs AXA 3).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Major local complications with the percutaneous axillary approach and ≤12F sheaths are infrequent and solvable by complementary endovascular interventions. Stroke risk remains an issue. First and third AXA segments are both amenable for access with good results, but larger sheaths (12F) perform better in AXA1.Clinical ImpactPercutaneous access with vascular closure devices at the first or third axillary artery (AXA) segments during aortic procedures is burdened by a negligible risk of open conversion. Local complications with the percutaneous axillary approach are infrequent and solvable by complementary endovascular interventions. First and third AXA segments are both amenable to access with excellent results, but larger sheaths (12F) perform better in the wider first AXA segment. In ","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"1075-1082"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151359","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":"Perprocedural Heparinization in Non-cardiac Arterial Procedures: The Current Practice in the Netherlands.","authors":"Liliane C Roosendaal, Max Hoebink, Arno M Wiersema, Kak K Yeung, Jan D Blankensteijn, Vincent Jongkind","doi":"10.1177/15266028231199714","DOIUrl":"10.1177/15266028231199714","url":null,"abstract":"<p><strong>Purpose: </strong>Heparin is the most widely-used anticoagulant to prevent thrombo-embolic complications during non-cardiac arterial procedures (NCAP). Unfortunately, there is a lack of evidence and consequently non-uniformity in guidelines on perprocedural heparin management. Detailed insight into the current practice of antithrombotic strategies during NCAP in the Netherlands is important, aiming to identify potential optimal protocols and local differences concerning perprocedural heparinization.</p><p><strong>Materials and methods: </strong>A comprehensive online survey was distributed electronically to vascular surgeons of every hospital in the Netherlands in which NCAP were performed. Data were collected from September 2020 to October 2021.</p><p><strong>Results: </strong>The response rate was 90% (53/59 hospitals). During NCAP, all surgeons generally administered heparin before arterial clamping. In 74% (39/54) of hospitals, a single heparin dosing protocol was used for all types of patients and vascular procedures. In 40%, there was no uniformity in heparin dosing between vascular surgeons. Depending on the procedure, a fixed bolus heparin, predominantly 5000 IU, was administered in 73% to 93%. In the remaining hospitals (7%-27%), a bodyweight-based heparin protocol was used, with an initial dose of 70 or 100 IU/kg. A minority (28%) monitored the effect of heparin in patients using the activated clotting time add (ACT) after activated clotting time. Target values varied between 180 and 250 seconds or 2 times the baseline ACT.</p><p><strong>Conclusion: </strong>This survey demonstrates considerable variability in perprocedural heparinization during NCAP in the Netherlands. Future research on heparin dosing is needed to harmonize and optimize heparin dosage protocols and contemporary guidelines during NCAP, and thereby improve vascular surgical care and patient safety.Clinical ImpactThis survey demonstrated persisting intra- and inter-hospital variability in perprocedural heparinization during non-cardiac arterial procedures (NCAP) in the Netherlands. The observed variability in heparinization strategies highlights the need for high quality evidence on perprocedural anticoagulation strategies. This is needed in order to harmonize and optimize heparin dosage protocols and contemporary guidelines and thereby improve vascular surgical patient care. Based on the current results, an international survey will be conducted by the authors to gain additional insight into the antithrombotic strategies used during NCAP, aiming to harmonize anticoagulation protocols worldwide.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"1009-1017"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156713","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":"The Relationship Between the Global Limb Anatomic Staging System and Midterm Outcomes of Subintimal Angioplasty of Superficial Femoral Artery Atherosclerotic Disease in Chronic Limb Threatening Ischemia.","authors":"Mohammed Shahat, Khaled Atalla, Mostafa Abdelmonem, Ahmed Khairy","doi":"10.1177/15266028231200466","DOIUrl":"10.1177/15266028231200466","url":null,"abstract":"<p><strong>Background: </strong>Superficial femoral artery (SFA) is commonly affected with atherosclerotic peripheral arterial disease leading to chronic limb-threatening ischemia (CLTI). Subinitimal angioplasty (SIA) is a minimally invasive option. We aimed to examine the relationship between the Global Limb Anatomic Staging System and SIA midterm limb and survival-related outcomes.</p><p><strong>Method: </strong>A prospective observational study was conducted on all patients with CLTI (Rutherford 4-6 or WIFI stages 2-4), with diseased femoropopliteal segment underwent SIA from August 2020 to September 2021. Patients with non-atherosclerotic SFA occlusion and those requiring primary major amputation were excluded. Multivariable Cox proportional hazard regression was performed to assess possible predictors of midterm clinical outcomes. Kaplan-Meier survival curves were used to estimate limb-based patency (LBP), limb salvage, amputation-free survival (AFS), and overall survival.</p><p><strong>Results: </strong>The study included 138 patients with CLTI due to chronic total occlusion of the SFA and underwent SIA ± treatment of associated ipsilateral hemodynamically significant inflow/outflow disease. Primary technical success was achieved in 116 cases (84%), with primary patency at 1, 6, and 12 months being 100%, 84%, and 79% respectively, while the limb-salvage rate at 6 and 12 months was 100% and 94%, respectively. The result of the comparison between CLASS 1 and Global Limb Anatomic Staging System III (GLASS III) revealed significantly worse patency with GLASS III (p=0.005), and better overall survival (p=0.037), limb salvage (p=0.021), and AFS (p<0.001) with GLASS I.</p><p><strong>Conclusion: </strong>Subinitimal angioplasty is a safe, effective, and minimally invasive treatment option for lengthy SFA lesions by avoiding the patients' anesthesia and operative risk. Our study suggests that the GLASS stage may be a useful predictor of midterm limb and survival-related outcomes of this approach. GLASS III anatomy in comparison with GLASS I is associated with a statistically significantly worse LBP, limb salvage, AFS, and overall survival.Clinical ImpactThis study is discussing a very hot interesting challenging topic in vascular surgery and its management as SFA atherosclerotic lesion is the most common lesion faced by vascular surgeons subintimal angioplasty SIA is considered feasible and effective method in dealing with this lesion with accepted durability and lower rates of complications.The subintimal angioplasty is made by opening an extraluminal track behind the intimal layer and between the media and intima of the artery surrounding atherosclerotic plaque and thrombus. Hence, the track has a low thrombus or plaque burden content, making the SIA easier than intraluminal angioplasty and with comparable results. GLASS stage III was an independent predictor of loss of LBP, worse AFS, and major amputation.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"902-910"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41146315","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":"Comparing Predictors Influencing Restenosis Following High-Dose Drug-Coated Balloon Angioplasty and Fluoropolymer-Based Drug-Eluting Stenting in Femoropopliteal Artery Lesions.","authors":"Naoya Kurata, Osamu Iida, Mitusyoshi Takahara, Mitsutoshi Asai, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takuya Tsujimura, Yousuke Hata, Taku Toyoshima, Naoko Higashino, Sho Nakao, Toshiaki Mano","doi":"10.1177/15266028231209234","DOIUrl":"10.1177/15266028231209234","url":null,"abstract":"<p><strong>Purpose: </strong>Despite widespread use of anti-restenosis devices, drug-coated balloons (DCBs) and drug-eluting stents (DESs), their appropriate use for femoropopliteal (FP) lesions has not been well investigated and the risk factors for restenosis have not been compared. To investigate risk factors associated with restenosis after endovascular therapy using DCB and DES for contemporary FP lesions.</p><p><strong>Materials and methods: </strong>This single-center, retrospective, observational study evaluated 378 FP lesions in 273 patients treated with DCB (278 lesions in 193 patients) or DES (120 lesions in 106 patients). The DCB used was high-dose DCB (IN.PACT, Admiral. Medtronic, Inc.) and DES was fluoropolymer-based DES (ELUVIA, Boston Scientific). Vessel preparation failure was defined as a residual stenosis of ≥50% and a dissection grade of D or greater on pre-dilatation angiography. The outcome measure was restenosis, and factors associated with restenosis in the DCB and DES groups were assessed using a Cox proportional hazards model.</p><p><strong>Results: </strong>The 2-year restenosis rate was not significantly different between the DCB and DES groups (29%±4% vs. 24%±5%, p=0.42). Interaction analysis demonstrated that popliteal lesions and plaque burden of ≥50% were restenosis-related factors for DES but not for DCB, whereas vessel preparation failure was a factor for DCB but not for DES (p<0.05). Vessel diameter of <6 mm and nodular calcification were risk factors in both groups (p<0.05).</p><p><strong>Conclusion: </strong>In contemporary FP lesions, smaller vessels and nodular calcification were shared restenosis-related factors for high-dose DCB and fluoropolymer-based DES. Popliteal lesions and plaque burden of ≥50% were restenosis-related factors for fluoropolymer-based DES and vessel preparation failure for high-dose DCB.Clinical ImpactShared and differential restenosis-related factors after endovascular therapy using high-dose drug-coated balloons (DCBs) and fluoropolymer-based drug-eluting stents (DESs) in contemporary femoropopliteal (FP) lesions are unclear. This single-center retrospective study included 378 FP lesions in 273 patients with lower-extremity arterial disease (high-dose DCB, 278 lesions in 193 patients; fluoropolymer-based DES, 120 lesions in 106 patients). Smaller vessels and calcified nodules were shared restenosis-related factors for both high-dose DCB and fluoropolymer-based DES, whereas popliteal lesions and plaque burden of ≥50% were restenosis-related factors for fluoropolymer-based DES and vessel preparation failure for high-dose DCB.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"1194-1204"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488302","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":"Treatment Strategies for Subclavian Artery Occlusion: A Comparative Analysis of Endovascular Repair, Subclavian-Carotid Bypass, and Transposition.","authors":"Ke Zhang, Yuanrui Gu, Haorui Zhang, Yanxia Tu, Cuntao Yu, Chenxi Ouyang","doi":"10.1177/15266028251353408","DOIUrl":"https://doi.org/10.1177/15266028251353408","url":null,"abstract":"<p><strong>Background: </strong>We aimed to compare the technical success rates and long-term patency of endovascular repair, subclavian-carotid bypass (SCB), and subclavian-carotid transposition (SCT) for subclavian artery occlusion.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 181 patients at Fuwai Hospital (2015-2024). Primary endpoint was the primary patency rate. Secondary endpoints included technical success, secondary patency and freedom from target lesion revascularization (TLR) rates. Kaplan-Meier analyses were applied.</p><p><strong>Results: </strong>One hundred and eighty-one patients [median age: 60 years, interquartile range (IQR) 54.00-65.00; 76.2% male) underwent 192 procedures, with 111 endovascular repairs, 38 SCBs, and 43 SCTs. Indications included vertebrobasilar insufficiency (39.2%), arm ischemia (28.7%), both (29.3%), cardiac causes (2.2%), and combined arm and cardiac indications (0.6%). The endovascular group had a lower technical success rate than SCB and SCT (86.5% vs 97.4% vs 100.0%). SCT had the longest lesion-to-vertebral artery (VA) length among the 3 groups. Ostial occlusion was more frequent and lesion length was longer in failed cases compared to successful cases (33.3% vs 6.3%, 14.50 vs 22.00 mm). After a median follow-up of 44 months (IQR 22.00-70.00), SCT had the highest primary patency rate (100% at 1, 3, and 5 years) compared to endovascular repair (93.4%, 88.2%, 77.6%) and SCB (94.1%, 86.8%, 72.3%; p=0.12). Endovascular group had primary patency, secondary patency, and freedom from TLR rates comparable to open surgery (SCB and SCT). SCB had lower primary patency than SCT.</p><p><strong>Conclusions: </strong>Endovascular repair offers good long-term patency but requires careful patient selection due to higher technical failure rates. SCT is recommended for patients at high risk of endovascular failure, while SCB remains suitable for multi-segment, distal occlusions or lesions with a short lesion-to-VA length.Clinical ImpactTo our knowledge, this is the largest study comparing outcomes of endovascular repair, subclavian-carotid bypass (SCB), and transposition (SCT) for SA occlusion. We found that endovascular repair provides midterm patency comparable to open surgery and may serve as the preferred option in carefully selected patients-contrary to prior reports, possibly due to optimized antiplatelet therapy. Technical failure was more frequent in cases with ostial involvement or longer lesion length. Although SCB showed inferior patency to SCT, it remains preferable for complex, distal lesions, or those with short lesion-to-vertebral artery (VA) length. Our anatomical analysis may offer guidance for individualized treatment selection.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251353408"},"PeriodicalIF":1.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745865","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":"Erratum to 'Safety and Efficacy of Endovascular Treatment Modalities for Below-the-Knee Arterial Disease: A Systematic Review and Network Meta-analysis'.","authors":"","doi":"10.1177/15266028251361959","DOIUrl":"https://doi.org/10.1177/15266028251361959","url":null,"abstract":"","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251361959"},"PeriodicalIF":1.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683464","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}