Journal of Endovascular Therapy最新文献

{"title":"Corrigendum to \"Provisional Stenting Using the Zilver PTX Drug-Eluting Stent After Drug-Coated Balloon Angioplasty: Initial Experience From the Double Drug Dose \"3D\" Study\".","authors":"","doi":"10.1177/15266028251336612","DOIUrl":"https://doi.org/10.1177/15266028251336612","url":null,"abstract":"","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251336612"},"PeriodicalIF":1.7,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030581","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":"IVUS-Assisted Intravascular Lithotripsy for the Treatment of a Paravisceral Coral Reef Aorta With a New Large Diameter Balloon Catheter: Case Report.","authors":"Konstantinos P Donas, Apostolos G Pitoulias, Dimitrios Kapetanios, Ralf Lehmann, Konstantinos Avranas","doi":"10.1177/15266028251333680","DOIUrl":"https://doi.org/10.1177/15266028251333680","url":null,"abstract":"<p><strong>Background: </strong>Coral reef aorta (CRA) is a rare and complex form of atherosclerosis, characterized by heavily calcified plaques in the abdominal aorta mainly infrarenal. In case of affecting the orifice of the superior mesenteric artery and the celiac trunk, treatment harbors the high risk of aortic rupture and 2-cavity urgent repair, peripheral, and visceral embolization.</p><p><strong>Case summary: </strong>We report a novel endovascular treatment for a paravisceral CRA in a 78-year-old female patient with severe peripheral arterial disease, consisting of a combination of intravascular ultrasound (IVUS) and lithotripsy-assisted angioplasty with the new low-pressure large (L6, Shockwave^®) balloon catheter. The balloon catheter reached 12 mm diameter with a low pressure of only 2 atm, avoiding high pressure and the risk of aortic rupture in an area in which a thoracoabdominal urgent repair and clamping would be associated with high morbidity and mortality. This approach resulted in an increase of the luminal gain based on IVUS measurements and improved infrastenotic blood pressure of 30 mmHg. The patient experienced resolution of the clinical symptoms, pulpable peripheral pulses, and sustained primary patency at the 6-month follow-up. This first reported case illustrates the effectiveness and safety of IVUS-assisted intravascular lithotripsy for paravisceral CRA with a new low-pressure balloon.Clinical ImpactTreatment of coral reef aorta affecting the renovisceral segment could be complex as endarterectomy at this level requires 2-cavity surgery and an endovascular treatment with angioplasty/ stent implantation includes the risk of rupture. Endovascular treatment of such lesions with the use of the new L6 ultralow-pressure IVL balloon (Shockwave Medical) with IVUS assessment could be a significant minimally invasive treatment option due to luminal gain with the use of a large (up to 12mm) IVL Balloon, inflated at 2-4 atmosphares minimizing the risk of rupture.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251333680"},"PeriodicalIF":1.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057363","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":"Temporary Gutter Endoleak to Reduce Renovisceral Ischemia During Urgent In Situ Laser Fenestrated Paravisceral Aortic Aneurysm Repair: Technical Note.","authors":"Vaiva Dabravolskaite, Annarita Santoro, Giuseppe Asciutto, Anders Wanhainen, Marek Kuzniar, Kevin Mani","doi":"10.1177/15266028251333565","DOIUrl":"https://doi.org/10.1177/15266028251333565","url":null,"abstract":"<p><strong>Purpose: </strong>Emergent repair of paravisceral aortic aneurysms (pAAs) with in situ laser fenestration (ISLF) technique is associated with renovisceral ischemia. We describe two strategies of temporary gutter endoleak creation to ensure renovisceral perfusion during ISLF.</p><p><strong>Technique: </strong>Two patients (79- and 83-year-old) presented with symptomatic pAA. A Cook Zenith Alpha endograft (Cook Medical LLC, Bloomington, IN, USA) was used in both cases. All visceral vessels were prestented to serve as guide markers. Prior to the deployment of the endograft, a Cook Flexor 8F-sheath (Cook Medical LLC, Bloomington, IN, USA) was placed in the superior mesenteric artery (SMA) (patient #1), and a 5 mm × 200 mm angioplasty Armada balloon (Abbott, Green Oaks, Illinois, USA) was placed between the endograft and the aortic wall (patient #2). Angiograms after visceral coverage confirmed perfusion of the renovisceral arteries through the intentional gutter endoleaks. Thereafter, ISLF and bridging stenting for SMA and the renal arteries were performed before the removal of the sheath or balloon to stop the gutter endoleak. Both patients did not experience any kind of perioperative complications.</p><p><strong>Conclusions: </strong>The above-described techniques for gutter endoleak creation during emergent pAA repair with ISLF can potentially reduce reno visceral ischemia and increase the ISLF technique's safety.Clinical ImpactThe ISLF technique for pAA repair typically requires coverage of the visceral arteries with unpredictable ischemia time until laser fenestrations are established. The gutter endoleak technique reduces the renovisceral ischemia and potentially increases the safety of the ISLF repair.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251333565"},"PeriodicalIF":1.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054304","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":"Percutaneous Endovascular versus Open Non-Endovascular Treatment for Chronic Mesenteric Ischemia-A Meta-Analysis.","authors":"George Galyfos, Alexandros Chamzin, Ioannis Moisidis, Despoina Chatzopoulou, Ioanna Kravari, Maria-Christina Kapoutsi, Antonios Palaios, Frangiska Sigala, Konstantinos Filis","doi":"10.1177/15266028251333627","DOIUrl":"https://doi.org/10.1177/15266028251333627","url":null,"abstract":"<p><strong>Purpose: </strong>Aim of this review is to compare pooled data on early and late outcomes between endovascular and open treatment for chronic mesenteric ischemia (CMI).</p><p><strong>Materials and methods: </strong>The present systematic review and meta-analysis was conducted under the PRISMA guidelines. The following databases were utilized: Pubmed, Embase, Scopus, and Cochrane Library. All eligible studies published online up to April 2024 were investigated. Eligible studies should compare early and/or late outcomes between endovascular repair (ER) and open surgery (OS) for CMI. Early outcomes included 30-day mortality, myocardial infarction (MI), pulmonary, gastrointestinal, and renal complications. Late outcomes included all-cause survival, symptom recurrence, and re-intervention.</p><p><strong>Results: </strong>In total, 15 studies (published from 1995 to 2024) were evaluated (12,326 patients under ER versus 6008 patients under OS). Regarding 30-day outcomes, ER was associated with a lower 30-day mortality risk (pooled OR = 0.58; 95% CI [0.347-0.975]; p = 0.039), a lower 30-day MI risk (pooled OR = 0.59; 95% CI [0.351-0.989]; p=0.045), a lower pulmonary complications risk (pooled OR = 0.18; 95% CI [0.075-0.426]; p=0.0001), and a lower 30-day renal complications risk (pooled OR = 0.28; 95% CI [0.146-0.553]; p=.00002). Regarding late outcomes, ER was associated with a lower overall 5-year survival (pooled OR = 0.414; 95% CI [0.291-0.591]; p < 0.0001). ER was also associated with a higher 3-year symptom recurrence risk (pooled OR = 3.77; 95% CI [2.314-6.142]; p < 0.0001) and a higher 5-year re-intervention risk (pooled OR = 2.40; 95% CI [1.538-3.739]; p=0.0001).</p><p><strong>Conclusions: </strong>ER is associated with superior early outcomes and worse late outcomes compared to OS among patients treated for CMI.Clinical ImpactThis is the most updated meta-analysis comparing pooled data between percutaneous endovascular repair (ER) and open surgery (OS) for patients with chronic mesenteric ischemia. This review verifies the advantage of endovascular treatment regarding early outcomes. However, this benefit is lost in the long-term as far as mortality and re-interventions are concerned. These findings seem to further support the current endovascular-first approach. One should take into consideration that ER is probably selected for patients of worse clinical status. OS may be more suitable for fitter patients who are not candidates for ER.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251333627"},"PeriodicalIF":1.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006448","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":"Triple Arch Branch Repair Under Sedo-Analgesia.","authors":"Martina Bastianon, Jan Stana, Nikolaos Konstantinou, David Khangoli, Jan Abicht, Sven Peterss, Maximilian Pichlmaier, Nikolaos Tsilimparis","doi":"10.1177/15266028251333659","DOIUrl":"https://doi.org/10.1177/15266028251333659","url":null,"abstract":"<p><strong>Purpose: </strong>Triple arch branch repair has emerged as a feasible option for high-risk patients unsuitable for open surgery. In high-risk patients, severe pulmonary compromise of pulmonary function due to chronic obstructive pulmonary disease (COPD) can be found. This condition is associated with a higher risk of postoperative complications after general anesthesia and intubation.</p><p><strong>Clinical case: </strong>In this clinical case, we describe the technical aspects of triple arch branch repair under sedo-analgesia, in a patient with severe COPD, unsuitable for intubation. Precise graft deployment was obtained, and no postoperative complications occurred.</p><p><strong>Conclusion: </strong>Triple arch branch repair under sedo-analgesia emerges as a viable option for high-risk patients with severe pulmonary compromise, obviating the need for general anesthesia and intubation. This clinical case elucidates the procedure, accentuating both its advantages and limitations, while suggesting the necessity for further validation of its safety in future studies.Clinical ImpactThe execution of complex endovascular aortic arch repair under sedo-analgesia allows for the expanded applicability of these techniques even in high-risk patients who, due to respiratory issues, cannot undergo general anesthesia and intubation.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251333659"},"PeriodicalIF":1.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022708","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":"Short- and Mid-Term Efficacy and Safety of Novel Sirolimus-Coated Balloon for Treatment of Femoropopliteal Lesions: A Single-Arm Meta-Analysis.","authors":"Ayers Gilberth Ivano Kalaij, Melani Limenco Benly, Ruth Grace Aurora, Taofan, Suci Indriani, Iwan Dakota, Suko Adiarto","doi":"10.1177/15266028251328156","DOIUrl":"https://doi.org/10.1177/15266028251328156","url":null,"abstract":"<p><strong>Introduction: </strong>Over the years, paclitaxel-coated balloons (PCBs) have been considered a standard treatment for femoropopliteal (FP) lesions due to their higher efficacy compared to noncoated balloon angioplasty. However, some studies have raised concerns about a potential link between PCBs and increased long-term mortality. Although relatively new, sirolimus is studied as an alternative that could be safer and more efficacious.</p><p><strong>Objective: </strong>This study aims to analyze the efficacy and safety of novel sirolimus-coated balloons (SCBs) for the treatment of femoropopliteal lesions.</p><p><strong>Materials and methods: </strong>A literature search was conducted across PubMed, Scopus, Cochrane, Science Direct, and Google Scholar databases. Five single-arm trials met the predefined eligibility criteria for inclusion and were assessed using the ROBINS-I tool. Data extraction was followed by single-arm meta-analysis in RStudio with meta package software.</p><p><strong>Major findings: </strong>Overall, a total of 5 single-arm trials were included. During 6-month follow-ups, SCBs have proven to have a high primary patency rate (pooled: 92%) and high freedom to target lesion revascularization (TLR) rates (pooled: 96%) with no heterogeneity (<i>I</i>² = 0%). In terms of safety, the pooled incidence of clinically driven-target vessel revascularization (CD-TVR) is 1%, while pooled clinically driven-target lesion revascularization (CD-TLR) rate is 2%, pooled amputation rate is 3%, and pooled incidence of mortality was 1%. During 12-month follow-ups, SCBs have high primary patency rate (pooled: 87%), high freedom to TLR rates (pooled: 96%), low amputation rate (pooled: 3%), and pooled incidence of mortality was 4%.</p><p><strong>Conclusion: </strong>Novel SCB is efficacious and safe in treating femoropopliteal lesions and thus could be a prompt alternative in treating FP lesions, although further studies are still needed. Hopefully, this method could be a treatment option for FP disease in symptomatic patients.Clinical ImpactSirolimus-coated balloons (SCBs) offer a promising alternative to paclitaxel-coated balloons (PCBs) for femoropopliteal lesions, demonstrating high efficacy with superior primary patency and low target lesion revascularization rates. The findings suggest SCBs may mitigate safety concerns associated with PCBs, potentially reducing long-term mortality risks. For clinicians, this innovation provides a safer, effective endovascular option, enhancing patient outcomes while maintaining procedural simplicity. With further validation, SCBs could redefine the standard of care for peripheral artery disease, ensuring optimal long-term vascular health with minimal complications.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251328156"},"PeriodicalIF":1.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058848","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 Outcomes of Endovascular Repair of Non-Ruptured Thoracic Aneurysms in Patients with Chronic Obstructive Pulmonary Disease.","authors":"Renxi Li, Anton Sidawy, Bao-Ngoc Nguyen","doi":"10.1177/15266028251331776","DOIUrl":"https://doi.org/10.1177/15266028251331776","url":null,"abstract":"<p><strong>Background: </strong>Thoracic Endovascular Aortic Repair (TEVAR) is the preferred treatment for thoracic aneurysms for eligible patients. Chronic obstructive pulmonary disease (COPD) is a common comorbidity that shares common inflammatory pathways with atherosclerosis, the major cause of thoracic aneurysms. However, surgical outcomes of TEVAR among patients with COPD have not been thoroughly investigated. This study aimed to assess the 30-day postoperative outcomes for COPD patients who have undergone TEVAR for non-ruptured thoracic aortic aneurysms, using data from a multi-institutional national registry.</p><p><strong>Methods: </strong>Patients who underwent TEVAR for non-ruptured thoracic aneurysms were identified in the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2022. A 1:1 propensity-score matching was used to match demographics, preoperative characteristics, and anesthesia between COPD and non-COPD patients. Thirty-day mortality and other postoperative outcomes were compared.</p><p><strong>Results: </strong>There were 525 (20.2%) COPD and 2,071 (79.8%) non-COPD patients who underwent TEVAR for the non-ruptured thoracic aneurysm. COPD was significantly more prevalent among patients with thoracic aneurysms compared to its incidence in the general population, and COPD patients also exhibited a higher burden of comorbidities. After 1:1 propensity-score matching, COPD and non-COPD patients had comparable 30-day mortality (5.7% vs 4.8%, p = 0.58). All other 30-day outcomes were comparable in COPD patients.</p><p><strong>Conclusion: </strong>While COPD might be linked to the development of thoracic aneurysms through potentially shared pathophysiological pathways, COPD does not appear to be related to major adverse 30-day outcomes in TEVAR. Future studies should aim to explore the long-term outcomes in COPD patients undergoing TEVAR.Clinical ImpactCOPD was significantly more prevalent among patients with thoracic aneurysms compared to the general population, and COPD patients also exhibited a higher burden of comorbidities. However, after propensity-score matching, COPD patients demonstrated comparable risks across all 30-day outcomes. Therefore, while COPD might be linked to the development of thoracic aneurysms through potentially shared pathophysiological pathways, COPD does not appear to be related to major adverse 30-day outcomes in TEVAR.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251331776"},"PeriodicalIF":1.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047930","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 Repair of a Huge False Aneurysm From an Ascending Aortic Prosthesis: Off-Label Use of the New Gore^® Aortic Extender.","authors":"Kinsing Ko, Guillaume Geuzebroek, Tychon Geeraedts, Foeke Nauta, Vincent Kroeze, Robin Heijmen","doi":"10.1177/15266028251333688","DOIUrl":"https://doi.org/10.1177/15266028251333688","url":null,"abstract":"<p><p>In this case report, we describe the feasibility and technical considerations of an off-label use of the new Gore^® Aortic Extender (W.L. Gore & Associates), which is part of the Gore^® TAG^® Thoracic Branch Endoprosthesis (W.L. Gore & Associates), to repair a huge false aneurysm originating from an ascending aortic prosthesis. The patient's medical history reported an acute type A aortic dissection 10 years ago, for which he was treated with a Bentall procedure. This was complicated by obstruction of the left main coronary after it was reconstructed and thus a coronary artery bypass was also performed. During follow-up, a huge false aneurysm of 11 cm was found, caused by a dehiscent saphenous vein graft on the Bentall prosthesis. Since the patient was clearly not fit for redo surgery, we decided to treat this patient endovascularly with the Gore^® Aortic Extender (W.L. Gore & Associates). This cuff has recently been introduced and is off-the-shelf available and seemed to fit perfectly in this patient.Clinical impactWith the introduction of the new, Gore^® TAG^® Thoracic Branch Endoprosthesis (W.L. Gore & Associates), a very short endoprosthesis became available for proximal extension of the Thoracic Branch Endoprosthesis. This graft, the Gore^® Aortic Extender (W.L. Gore & Associates) seems to come in favorable sizes for the ascending aorta. As long as dedicated endoprosthesis for the ascending aorta are not off-the-shelf availabe, off-label use of such endovascular devices is an useful option whenever open surgery seems too high risk.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251333688"},"PeriodicalIF":1.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025201","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":"Predicting Outcomes Following Carotid Artery Stenting Using Machine Learning.","authors":"Ben Li, Badr Aljabri, Derek Beaton, Mohamad A Hussain, Douglas S Lee, Duminda N Wijeysundera, Ori D Rotstein, Charles de Mestral, Muhammad Mamdani, Graham Roche-Nagle, Mohammed Al-Omran","doi":"10.1177/15266028251333670","DOIUrl":"https://doi.org/10.1177/15266028251333670","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Carotid artery stenting (CAS) carries important perioperative risks. Outcome prediction tools may help guide clinical decision-making but remain limited. We developed machine learning (ML) algorithms that predict 30-day outcomes following transfemoral CAS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The National Surgical Quality Improvement Program (NSQIP) targeted vascular database was used to identify patients who underwent transfemoral CAS between 2011 and 2021. Input features included 36 preoperative demographic/clinical variables. The primary outcome was a 30-day major adverse cardiovascular event (MACE; composite of stroke, myocardial infarction [MI], or death). The secondary outcomes were 30-day stroke, MI, death, carotid-related morbidity, other morbidity, non-home discharge, and unplanned readmission. Our data were split into training (70%) and test (30%) sets. Using 10-fold cross-validation, we trained six ML models using preoperative features with logistic regression as the baseline comparator. The primary model evaluation metric was area under the receiver operating characteristic curve (AUROC). Model robustness was evaluated with calibration plot and Brier score. Variable importance scores were calculated to determine the top 10 predictive features. Performance was assessed on subgroups based on age, sex, race, ethnicity, symptom status, stent type, and urgency.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 2093 patients underwent CAS during the study period. Thirty-day MACE occurred in 130 (6.2%) patients. The best-performing prediction model for 30-day MACE was XGBoost, achieving an AUROC (95% CI) of 0.93 (0.92-0.94). In comparison, logistic regression had an AUROC (95% CI) of 0.67 (0.65-0.68), and existing tools in the literature demonstrate AUROCs ranging from 0.58 to 0.74. For secondary outcomes, XGBoost achieved AUROCs between 0.86 and 0.97. The calibration plot showed good agreement between predicted and observed event probabilities with a Brier score of 0.02. The top three predictive features in our algorithm were (1) symptomatic carotid stenosis, (2) age, and (3) American Society of Anesthesiologists classification. Model performance remained robust on all subgroup analyses of specific demographic and clinical populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our ML models accurately predict 30-day outcomes following transfemoral CAS using preoperative data. They have the potential for important utility in guiding risk-mitigation strategies for patients being considered for CAS to improve outcomes.Clinical ImpactTransfemoral carotid artery stenting (CAS) carries important perioperative risks. Outcome prediction tools may help guide clinical decision-making but remain limited. Using data from the National Surgical Quality Improvement Program (NSQIP) targeted vascular database, we developed machine learning (ML) models that accurately predict 30-day outcomes following transfemoral CAS using preoperative data, out","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251333670"},"PeriodicalIF":1.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013462","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":"Safety and Efficacy of Genicular Artery Embolization for Knee Joint Osteoarthritis Associated Pain: A Systematic Review.","authors":"Nader Ashraf, Muhammad Junaid Tahir, Tarek Ziad Arabi, Bader Abou Shaar, Nadine Osman, Belal Nedal Sabbah, Yusra Mashkoor, Faheemullah Khan, Ali Asad, Muhammad Sohaib Asghar, Abderrahman Ouban, Zohaib Yousaf","doi":"10.1177/15266028251326770","DOIUrl":"https://doi.org/10.1177/15266028251326770","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review the literature on the effectiveness, safety, and long-term outcomes of genicular artery embolization (GAE) for knee joint osteoarthritis (OA) associated pain.</p><p><strong>Materials and methods: </strong>After registering the protocol with the PROSPERO database, a search was conducted from inception until July 31, 2023, in MEDLINE, Cochrane Central Register of Controlled Trials, and ScienceDirect databases to gather studies evaluating GAE's safety and efficacy in knee OA. A total of 4979 studies were identified and evaluated against the inclusion criteria. Data on study characteristics, success parameters, and adverse events were collected and synthesized.</p><p><strong>Results: </strong>Twenty-three studies, primarily single-center prospective studies with a total of 657 patients, were included. Most studies reported a 100% technical success rates, except one study reporting a rate of 84.2%. Clinical success rates, defined variably across studies, ranged from 30% to 100%, depending on the study's follow-up period and outcome measures. The most frequent adverse events included skin discoloration without an ulcer (15.6%, n = 98) and transient post-procedural knee pain (10.2%, n = 64). Most studies were rated as fair in terms of quality, but the lack of robust randomized controlled trials highlighted the need for further comparative studies to standardize outcome reporting.</p><p><strong>Conclusion: </strong>GAE appears to be a promising option for knee OA pain, particularly for patients unresponsive to conservative treatments or ineligible for surgery. High-quality studies are needed to confirm long-term effectiveness and standardize outcome measures.Clinical ImpactThis study highlights the safety and efficacy of genicular artery embolization as a minimally invasive treatment for knee osteoarthritis, particularly in patients who are unresponsive to conservative treatments or unsuitable for surgery. By targeting neovascularization and reducing inflammation, genicular artery embolization provides pain relief and functional improvement. Clinicians can consider genicular artery embolization as an alternative to surgery for mild-to-moderate OA, offering a lower adverse event rate and faster recovery.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251326770"},"PeriodicalIF":1.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065050","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}