Journal of Endovascular Therapy最新文献

{"title":"Differences in Pharmacokinetic and Histopathological Effects of Five Drug-Coated Balloons: An Experimental Study in Rabbit.","authors":"Chenlin Zeng, Zhaoxi Peng, Xiangxiang Li, Qun Huang, Zhijue Xu, Junchao Liu, Zhaoyu Wu, Jiahao Lei, Hongji Pu, Weiqing Wei, Weimin Li, Jinbao Qin, Xinwu Lu","doi":"10.1177/15266028251326848","DOIUrl":"https://doi.org/10.1177/15266028251326848","url":null,"abstract":"<p><strong>Background: </strong>The optimal design concept and the safety of drug-coated balloons (DCBs) have not been completely determined yet. Also, the optimal approach for DCB-based revascularization of peripheral artery diseases still remains undefined. This study was designed to explore the in vivo pharmacokinetic and histopathological effects of DCBs using Ranger and 4 Chinese DCBs after implantation and administration in New Zealand rabbits.</p><p><strong>Materials and methods: </strong>Fifty New Zealand rabbits were divided into 5 groups with 10 rabbits in each group according to the DCB used: Ranger (Boston Scientific), Orchid (Acotec), Reewarm (Endovastec), Ultrafree (Zylox), and Yaohang (Polyrey). After being guided to the lower segment of the abdominal aorta, the DCB was inflated for 3 minutes. Plasma, inflated infrarenal aorta, vastus lateralis muscle, anterior tibial muscle, and right toes were harvested for histological and paclitaxel concentration analyses 4 hours or 28 days after the angioplasty.</p><p><strong>Results: </strong>At 4 hours after aortic angioplasty, the overall paclitaxel concentrations in aortic wall were not statistically different (p = 0.050), but the paclitaxel concentrations in vastus lateralis muscle (p = 0.002), anterior tibial muscle (p = 0.006) and toe (p < 0.001) were not totally same according to the results of Kruskal-Wallis test. In toe, concentrations of paclitaxel were significantly lower for the Ranger (120.8 ng/g) DCB than for the Orchid (1880 ng/g; p = 0.008), Reewarm (347 ng/g; p = 0.016), and Ultrafree (261 ng/g; p = 0.016) DCBs. Concentrations of paclitaxel in the toe were not statistically different between Ranger and Yaohang DCBs (p = 0.421). Neointimal area (p < 0.001), neointimal thickness (p < 0.001), and percentage of luminal stenosis (p < 0.001) were less for Ranger DCB than for other DCBs 28 days after aortic angioplasty. The differences in paclitaxel concentrations in tissues 28 days after aortic angioplasty were not statistically significant.</p><p><strong>Conclusion: </strong>Different design concepts will make a difference in the in vivo pharmacokinetic and histopathological effects of DCBs. The Ranger DCB can achieve similar drug delivery efficiency as other higher-dose DCBs and fewer neointimal hyperplasia. Although clinical implications remain to be further investigated, the present results may provide implications for the design and use of DCBs.Clinical ImpactThe current preclinical study suggested that different design concepts would make a difference in the pharmacokinetic and histopathological effects of drug-coated balloons (DCBs). Though Ranger DCB had the lowest paclitaxel loading in this study, it still achieved similar drug delivery efficiency with other higher-dose DCBs. Also, neointimal hyperplasia was less for the Ranger DCB than for the other DCBs 28 days after aortic angioplasty. Although clinical implications remain to be further investigated, the present results","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251326848"},"PeriodicalIF":1.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651682","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":"Technical Approach to Rescuing a Previous Physician-Modified Endovascular Graft with a New Physician-Modified Endovascular Graft.","authors":"Emiel W M Huistra, Samuel Saers, Talje M Fokkema, Artai Pirouzram, Ignace F J Tielliu, Wajdi Alrawi, Clark J Zeebregts, Robert C Lind","doi":"10.1177/15266028251326844","DOIUrl":"https://doi.org/10.1177/15266028251326844","url":null,"abstract":"<p><strong>Purpose: </strong>To demonstrate the feasibility of the physician-modified endovascular graft (PMEG) technique in acute aorta disease, even in cases with a previous PMEG requiring a new repair.</p><p><strong>Technique: </strong>A 77-year-old man presented with an infectious native aortic aneurysm (INAA), which was treated with a PMEG containing fenestrations for the renal arteries and superior mesenteric artery (SMA). After 4 months, a new infectious aneurysm developed at the right renal hilum, which was treated by occluding the right renal artery with a vascular plug. At the 1-year follow-up, computerized tomography angiography (CTA) demonstrated a new suspected INAA at the level of the celiac trunk, just proximal to the previous PMEG. A new PMEG with fenestrations for the left renal artery and SMA was deployed within the previous PMEG, followed by a proximal extension of the PMEG with a thoracic stent graft. Completion angiography and CTA follow-up at 1 month showed successful exclusion of the aneurysm.</p><p><strong>Conclusion: </strong>Treatment with a PMEG may provide an endovascular solution for patients requiring urgent aneurysm repair even after a previous PMEG. This case also highlights the importance of anticipating a future proximal extension when planning a PMEGClinical ImpactThis article demonstrates the use of a physician-modified endovascular graft (PMEG) to reline and proximally extend a previously implanted PMEG requiring urgent repair. Although technically challenging, this approach provides a safe and effective endovascular solution for patients with a previous fenestrated endograft requiring urgent repair, thereby avoiding the need for open surgery. This case underscores the benefit of PMEGs to the vascular surgeon's armamentarium and emphasizes the importance of anticipating future reinterventions during primary procedures.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251326844"},"PeriodicalIF":1.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626710","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":"Association Between Bovine Aortic Arch Anatomy and Stroke After Thoracic Endovascular Aortic Repair.","authors":"Zeng-Rong Luo, Zhi-Sheng Wang, Yi-Xing Chen, Min-Cai, Zhong-Yao Huang, Liang-Wan Chen","doi":"10.1177/15266028251321284","DOIUrl":"https://doi.org/10.1177/15266028251321284","url":null,"abstract":"<p><strong>Objective: </strong>The link between bovine aortic arch (BAA) and stroke after thoracic endovascular aortic repair (TEVAR) was investigated.</p><p><strong>Methods: </strong>The multicenter retrospective study included consecutive Stanford type B aortic dissection patients undergoing TEVAR from January 2019 to December 2023. A multivariable logistic regression was utilized to assess the correlation between BAA and early stroke, while a multivariable Cox regression was employed to evaluate the association between BAA and overall stroke. Kaplan-Meier curves were used to compare the freedom from overall stroke rates.</p><p><strong>Results: </strong>In total, 138 (14.3%) had a BAA and 825 (85.7%) had a standard aortic arch (SAA). Patients with a BAA showed a greater early stroke incidence (11 [8.0%] vs 25 [3.0%]; p=0.005). An independent association was found between BAA and early stroke (odds ratio, 2.009 [95% confidence interval (CI), 1.491-2.684]; p=0.012). During follow-up, a greater incidence of overall stroke was seen in patients with a BAA (15 [10.9%] vs 42 [5.1%]) (hazard ratio, 2.310 [95% CI, 1.889-2.950]; p=0.006). Moreover, the freedom from the overall stroke rate was notably lower in the BAA group (80.42% vs 88.74%) (log-rank p=0.0068). Furthermore, patients with type A BAA showed significantly lower freedom from overall stroke rates (79.48%) relative to those with type B BAA (82.09%) (log-rank p=0.0431), and the freedom from overall stroke rate for patients with BAA ≥60 years was markedly lower (63.35%) than that in those <60 years (93.51%) (log-rank p=0.004).</p><p><strong>Conclusion: </strong>BAA was correlated with an increased risk of early and overall stroke following TEVAR, particularly among older and type A BAA patients.Clinical ImpactIndividualized stroke prevention protocols and efficient neuroprotective measures should be developed for patients with BAA and adequate anticoagulation should be ensured to reduce the risk of embolism during TEVAR. This population should also ensure proper needle alignment. For instance, minimize the contact between the guide wire and the aortic arch wall. Temporal-occlusion of the carotid dynamic pulse during stent release might prevent solid fragments from entering into the craniocerebral artery. Additionally, thorough CO₂ or saline flushing technique can be utilized for all the stentgrafts. Furthermore, distal cerebral embolic protection devices should be conducted in patients with a BAA during TEVAR.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251321284"},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626706","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":"Thirty-Day Endovascular Repair Outcomes of Stanford Type B Aortic Dissection in Patients With Diabetes Mellitus: A Propensity-Score-Matched Study From the ACS-NSQIP Database.","authors":"Renxi Li, Anton Sidawy, Bao-Ngoc Nguyen","doi":"10.1177/15266028251324823","DOIUrl":"https://doi.org/10.1177/15266028251324823","url":null,"abstract":"<p><strong>Background: </strong>The surgical intervention for Stanford type B aortic dissection (TBAD) has been revolutionized by thoracic endovascular aortic repair (TEVAR). While diabetes mellitus (DM) is associated with increased risks of short-term mortality and infectious complications after major surgeries, previous studies present conflicting findings regarding the outcomes of TEVAR in DM patients. This study aimed to assess the 30-day postoperative outcomes for DM patients who have undergone TEVAR for TBAD using a dataset from a multi-institutional national registry.</p><p><strong>Methods: </strong>Patients who underwent TEVAR for TBAD were selected from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2022. A 1:4 propensity-score matching was used to balance demographics and preoperative characteristics between patients with and without DM. Thirty-day postoperative outcomes were compared.</p><p><strong>Results: </strong>There were 160 (8.89%) DM and 1640 (91.11%) non-DM patients who underwent TEVAR for TBAD. After propensity-score matching, all DM patients were matched to 594 non-DM patients. DM patients had a higher rate of mortality that was trending toward significance (10.19% vs 5.89%, p = 0.07). All 30-day complications were comparable between DM and non-DM patients.</p><p><strong>Conclusion: </strong>TEVAR can generally be safe for DM patients in terms of short-term outcomes, but the potential for higher perioperative mortality rates in these patients may warrant careful consideration. Further large-scale studies may be necessary to fully understand the impact of DM on both short-term and long-term outcomes following TEVAR for TBAD.Clinical ImpactThis study assessed the 30-day postoperative outcomes for diabetes mellitus (DM) patients who have undergone thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection (TBAD) using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. After propensity-score matching, DM patients had a higher rate of mortality that was trending toward significance but all 30-day complications were comparable between DM and non-DM patients. Therefore, TEVAR can generally be safe for DM patients in terms of short-term outcomes, but the potential for higher perioperative mortality rates in these patients may warrant careful consideration. Further large-scale studies may be necessary to fully understand the impact of DM on both short-term and long-term outcomes following TEVAR for TBAD.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251324823"},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626711","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":"Endovascular Aneurysmal Repair With the INCRAFT Stent Graft System for Abdominal Aortic Aneurysms: A Combined Korean Multi-Center and Single-Center Registry Analysis.","authors":"In Tae Jin, Young-Guk Ko, Seung-Jun Lee, Chul-Min Ahn, Sang-Hyup Lee, Yong-Joon Lee, Sung-Jin Hong, Jung-Sun Kim, Byeong-Keuk Kim, Donghoon Choi, Myeong-Ki Hong, Ji Yong Jang, Cheol Woong Yu, Jae-Hwan Lee, Suk Won Song, Juhan Kim, In-Ho Chae, Woong-Chol Kang, Woong Kim","doi":"10.1177/15266028251320510","DOIUrl":"https://doi.org/10.1177/15266028251320510","url":null,"abstract":"<p><strong>Introduction: </strong>The INCRAFT™ Stent Graft System is a trimodular, bifurcated, ultra-low-profile endovascular device designed for endovascular aneurysm repair in patients with abdominal aortic aneurysm (AAA).</p><p><strong>Materials and methods: </strong>The study population comprised a prospective multi-center cohort (n = 85) and a single-center retrospective cohort (n = 61) of Korean AAA patients treated with INCRAFT. Postprocedural follow-up involved computed tomography (CT) imaging at 1 and 12 months post-procedure to monitor aneurysm dimensions and detect any endoleak.</p><p><strong>Results: </strong>The mean age of participants was 72.0 ± 7.1 years, with the majority being male (91.8%). The average maximal aortic sac diameter was 54.7 ± 8.6 mm. Technical success was achieved in 82.9%, primarily due to the relatively high incidence of type I endoleak (17.1%) observed on immediate angiographical assessment. The rate of 30-day major vascular complication was 0.7%. For the hemostasis of bilateral femoral access arteries, 57.5% required only 2 ProGlides. At the 30-day follow-up CT, the prevalence of endoleaks was 30.4% including type I (1.4%), type II (26.1%), and undermined type (2.8%). At the 12-month follow-up, the major adverse event rate was 6.2% attributed to noncardiovascular mortality. Aneurysm-related events included 3 cases (2.1%) of re-interventions due to graft occlusion (n = 2) and type II endoleak with sac expansion (n = 1). Aneurysm shrinkage and enlargement occurred in 37.8% and 3.4% of patients, respectively. At the 12-month follow-up, type II endoleak was the most frequent type, with a prevalence of 22.7%. Type I endoleak and undetermined type were found in 0.8% and 17.8% of cases, respectively, with no instances of type III endoleak.</p><p><strong>Conclusion: </strong>INCRAFT demonstrated favorable early and 12-month clinical efficacy and safety profiles for treating Korean patients with AAA.</p><p><strong>Trial registration: </strong>K-INCRAFT; www.</p><p><strong>Clinicaltrials: </strong>gov Identifier: NCT03952780Clinical ImpactEndovascular aneurysmal repair (EVAR) is effective treatment option for unruptured abdominal aortic aneurysm (AAA) in patients with high perioperative risk and suitable anatomy. The INCRAFT stent graft system is an ultra-low-profile endovascular graft designed for EVAR, and its efficacy and safety have been demonstrated in multi-center European and U.S.</p><p><strong>Trials: </strong>Our study found that the INCRAFT stent graft system has favorable early and 12-month clinical efficacy and safety profiles in treating AAAs within Korean population, with a 30-day major vascular complications rate of 0.7% and no cases of aneurysmal-related mortality or rupture.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251320510"},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626707","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":"Use of the Electrified Wire Technique for In Situ Fenestration Creation Within a Branch Bridging Stent.","authors":"Antonino Giordano, Petroula Nana, Giuseppe Panuccio, Kugarajah Arulrajah, José I Torrealba, Fiona Rohlffs, Tilo Kölbel","doi":"10.1177/15266028251324074","DOIUrl":"https://doi.org/10.1177/15266028251324074","url":null,"abstract":"<p><strong>Purpose: </strong>To present the use of the electrified wire technique as bailout for target vessel (TV) branch preservation after unintended coverage by a bridging stent during branched endovascular repair (bEVAR).</p><p><strong>Technique: </strong>A 73-year-old male, previously treated with thoracic endovascular aortic repair and Provisional Extension to Induce Complete Attachment Technique (PETTICOAT) for type B aortic dissection, presented with a 68 mm type V thoracoabdominal aortic aneurysm. The patient presented an anatomic variation with a common trunk for the superior mesenteric artery (SMA) and celiac artery (CA). After a previously failed open surgical attempt, a triple-branch custom-made device (2 renal branches and 1 for the SMA/CA trunk) was chosen. Endograft deployment and TV catheterization were uneventful, until an unintended coverage of the CA occurred, due to bridging stent unmount. Using the electrified wire technique, an in situ fenestration was created into the CA/SMA trunk covered bridging stent to preserve CA patency. A bare metal stent was used for CA revascularization. Renal arteries were catheterized and bridged as planned. The 6-month computed tomography angiography confirmed TV patency.</p><p><strong>Conclusion: </strong>The electrified wire technique may be used as bailout for in situ fenestration creation in unintended coverage of early TV side-branches.Clinical ImpactAnatomic variations may increase the technical complexity of branched endovascular aortic repair while technical pitfalls related to target vessel preservation may demand the application of bailout techniques. In this case, the electrified wire technique was used to create an in situ fenestration within the bridging stent of a celiac artery (CA) and superior mesenteric artery common trunk (anatomic variation), after bridging stent unmount during advancement and CA unintended coverage.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251324074"},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626713","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":"Use of Fenestrated/Branched Devices for Rescue of Proximal Endograft Failure After Endovascular Aneurysm Repair: A Systematic Review of the Literature and an Updated Meta-Analysis.","authors":"Spyridon N Mylonas, Vasileios Papavlasopoulos, Konstantinos G Moulakakis, John Kakisis","doi":"10.1177/15266028251325430","DOIUrl":"https://doi.org/10.1177/15266028251325430","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To present the current outcomes of fenestrated and branched endovascular aneurysm repair (F/BEVAR) for rescue of proximal endograft failure after endovascular aneurysm repair (EVAR). A systematic review of the currently published literature on F/BEVAR for failed EVAR is undertaken, and the eligible studies are combined into a meta-analysis with the intention of evaluating the safety, efficacy, and the durability of this treatment option.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A systematic review of the literature up to September 2024 was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (CRD42024590847). Studies were included in the meta-analysis if they reported ≥10 patients and at least one of the major outcomes was stated. Primary endpoint was technical success (efficacy). Secondary endpoints included 30-day/in-hospital mortality and morbidity (safety) and survival and reinterventions rate (durability). Methodological quality and robustness of the results of the eligible articles were assessed according to Joanna Briggs Institute (JBI's) critical appraisal tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 16 studies with overall 1079 patients were included. The pooled estimate for technical success was 94.4% (95% CI 92.5-95.8), whereas for the 30-day/in-hospital mortality 3.9% (95% CI 2.9-5.4). Permanent paraplegia was developed in a pooled rate of 1.6% (95% CI 0.8-3.0), whereas a cerebrovascular event in a pooled rate of 1.5% (95% CI 0.9-2.8). An acute renal function impairment requiring new onset dialysis occurred with a pooled rate of 4.4% (95% CI 3.2-6.1). Postoperative respiratory failure was observed with a pooled estimate of 7.2% (95% CI 5.5-9.4). The pooled estimate for 12-month overall survival was 88% (95% CI 83.4-91.4), and the pooled estimate for 24- and 36-month survival were 79.8% (95% CI 75.6-83.4) and 72.2% (95% CI 66.7-77.2), respectively. Freedom from reintervention was estimated at 83.7% (95% CI 79.9-86.9) for 12 months, 75.8% (95% CI 61.0-86.2) for 24 months and 59.3% (95% CI 36.5-78.7) for 36 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study showed that F/BEVAR is a feasible, safe, and reliable strategy for achieving proper proximal endograft sealing when previous EVAR has failed. The midterm survival of these patients is acceptable, whereas reinterventions are not negligible.Clinical ImpactThis work summarizes the current experience with fenestrated and branched endovascular aneurysm repair for the rescue of failed endovascular aneurysm repair in the most contemporary meta-analysis including 16 studies with a total of 1079 analyzed patients. Feasibility of the method is proven with a technical success of 94.4%, whereas a 30-day/in-hospital mortality of 3.9% was recorded. The compromised survival and freedom from reinterventions rates (72.2% and 59.3% for 36 months, respectively) pose, however, concerns regarding durability","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251325430"},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626712","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":"Inferior Vena Cava Filter Placed in Neurologic Intensive Care Unit: Effectiveness, Retrieval Rate, and Mortality.","authors":"Qian Yu, Patrick Tran, Monika Neale, Lauren Singer, Jonathan Fergus, Wesley Lim, Waseem Wahood, Rakesh Navuluri, Osman Ahmed, Thuong Van Ha","doi":"10.1177/15266028251325088","DOIUrl":"https://doi.org/10.1177/15266028251325088","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Patients in neurologic intensive care unit (NICU) often undergo inferior vena cava filter (IVCF) placement for venous thrombotic events. This study aims to determine the effectiveness of IVCF, filter retrieval, and mortality among patients that received IVCF in NICU.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;In this single institutional, noncomparative, retrospective study, all patients who were admitted to NICU and underwent IVCF placement from April 2015 to December 2020 were reviewed. IVCF was successfully deployed in all 175 patients [100%; median age 68 years, female 84/175 (48.0%)]. The 3 most common causes for NICU admission were intracranial hemorrhage (66/175, 37.7%), ischemic stroke (62/175, 35.4%), and traumatic brain injury (16/175, 9.1%). Deep vein thrombosis and pulmonary embolism (PE) were confirmed in 155 (88.6%) and 35 (20.0%) patients at the time of filter placement, respectively. Primary outcomes of interest were postfilter placement PE, filter retrieval, and inhospital mortality. Baseline characteristics were analyzed using &lt;i&gt;t&lt;/i&gt;-tests and chi-squared test for continuous and noncontinuous variables, respectively. Factors associated with primary outcomes were analyzed with a logistic regression model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Post-IVCF PE occurred in 3 patients (1.7%) with a median follow-up of 3 months. Excluding 26 inhospital deaths (14.9%, none was related to PE), filters were retrieved in 31 discharged patients (20.8%) with a median filter dwelling time of 9 months. Advanced filter retrieval required a higher fluoroscopy time (median 3.3 minutes vs 8.3 minutes, p = 0.016) and contrast volume use (median 35.0 ml vs 57.5 ml, p = 0.0028) than standard technique. No procedure-related complication occurred during filter placement and retrieval. Sequential Organ Failure Assessment (SOFA, p = 0.012) and Simplified Acute Physiology Scores (SAPS, p = 0.016) were independently associated with inhospital mortality. Modified Rankin Score (mRS) at discharge was an independent predictor for filter retrieval (p &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Despite safety and effectiveness, IVCF retrieval rate for NICU patients was low, particularly those with worse mRS at time of hospital discharge. Worse SOFA and SAPS scores were associated with inhospital mortality.Clinical ImpactInferior vena cava filter (IVCF) is effective preventing post-filter pulmonary embolism (PE) in neurologic intensive care unit (NICU) patients, with only 1.7% experiencing PE post-placement, underscoring its role in managing venous thrombotic events in this high-risk population; however, the low retrieval rate of IVCFs, particularly in patients with poorer functional outcomes (worse mRS at discharge), and the association of higher SOFA and SAPS scores with increased inhospital mortality, emphasize the need for improved strategies to optimize filter retrieval and patient selection in critically ill neurologic patients.&lt;/","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251325088"},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626708","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":"Portal Vein Thrombosis: Thrombectomy as a Treatment Option.","authors":"Cristina Mota, Carlos Senra, Filipa Sousa, Frederico Cavalheiro, Diogo Rocha, Teresa Dionísio, Pedro Sousa","doi":"10.1177/15266028251325432","DOIUrl":"https://doi.org/10.1177/15266028251325432","url":null,"abstract":"<p><strong>Purpose: </strong>Portal vein thrombosis (PVT) remains a significant clinical challenge with limited treatment options, particularly in patients at high risk of hemorrhage or intestinal infarction. In such cases, mechanical thrombectomy (MT) and catheter-directed thrombolysis (CDT), either as alternative treatments or in combination with systemic anticoagulation, may provide a more suitable approach.</p><p><strong>Case report: </strong>Here, we present 3 cases of symptomatic acute/subacute PVT with concurrent mesenteric vein thrombosis, in which patients underwent MT and CDT. The procedures were technically successful in all cases, and patients were discharged without complications.</p><p><strong>Conclusion: </strong>In this report, we give recognition to the key effect that the endovascular intervention had on the treatment of 3 different patients with PVT, highlighting the value that the endovascular approach may add to the therapeutic armamentarium and further supporting its inclusion in current treatment guidelines.Clinical ImpactThis study demonstrates the potential of endovascular interventions, such as MT and CDT, in treating PVT of high-risk patients. It offers a viable alternative to conventional treatments, enhancing clinical outcomes and supporting the inclusion of these techniques in updated treatment guidelines for PVT.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251325432"},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626709","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":"Corrigendum to \"ZILVERPASS Study: ZILVER PTX Stent vs Bypass Surgery in Femoropopliteal Lesions\".","authors":"","doi":"10.1177/15266028251329133","DOIUrl":"https://doi.org/10.1177/15266028251329133","url":null,"abstract":"","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251329133"},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617722","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}