Journal of Endovascular Therapy最新文献

{"title":"The Removal of Intravascular Foreign Bodies by Intervention in Pediatrics.","authors":"Isabel C Sánchez-Escobar, Miguel Á Restrepo-Arboleda, María Isabel Palacio, Luis H Díaz-Medina, Rafael Correa-Velásquez, Rafael Lince-Varela","doi":"10.1177/15266028251344541","DOIUrl":"10.1177/15266028251344541","url":null,"abstract":"<p><strong>Introduction: </strong>The use of intravascular catheters has become increasingly widespread in children, due to their use in diagnostic procedures (such as coronary, intracardiac, cerebral, and renal angiography, as well as pressure monitoring) and for therapeutic purposes (including angioplasties, valvuloplasties, congenital defect closure, chemotherapy, among other uses). However, they are not free from complications, which may include catheter fracture and migration within the cardiovascular system, potentially leading to vascular or cavity perforation, arrhythmias, and even death.</p><p><strong>Objective: </strong>To define the clinical and hemodynamic characteristics of pediatric patients undergoing catheterization for the retrieval of intravascular foreign bodies.</p><p><strong>Materials and methods: </strong>A retrospective cohort study of all patients under 18 years of age who underwent endovascular extraction of foreign bodies at a cardiovascular reference center.</p><p><strong>Results: </strong>A high percentage of successful retrieval of intravascular foreign bodies was noted, with the most frequently retrieved catheter being the chemotherapy catheter, primarily located in the right atrium, between the pulmonary trunk and the right ventricle, and in the brachiocephalic vein. Few secondary complications were observed, occurring in only 2 patients.</p><p><strong>Conclusion: </strong>Endovascular retrieval of foreign bodies is a highly effective procedure, and complications are relatively low in pediatrics, even during the neonatal period and in low-birth-weight cases, making it a preferable alternative to surgical extraction.Clinical ImpactBy documenting favorable outcomes across a diverse group, it encourages clinicians to adopt catheter-based approaches more confidently. The use of tools like snare loops and balloon-tipped guidewires in this population reflects procedural innovation and adaptability. Early, minimally invasive intervention may reduce morbidity and hospital stay. These findings can influence clinical decision-making and protocol development in pediatric cardiovascular care, particularly in centers equipped for interventional procedures.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251344541"},"PeriodicalIF":1.7,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review and Meta-Analysis of Outcome After Repeat Revascularization for Primary Carotid Artery Restenosis.","authors":"Mert Kök, Franziska Röder, Reinoud P H Bokkers, Maarten Uyttenboogaart, Barzi Gareb, Clark J Zeebregts","doi":"10.1177/15266028251325054","DOIUrl":"10.1177/15266028251325054","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Carotid artery restenosis can occur after both carotid artery stenting (CAS) and carotid endarterectomy (CEA). This systematic review and meta-analysis aim to determine which revascularization technique, CAS, or CEA, is superior for treating primary carotid restenosis, irrespective of the initial revascularization method used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Systematic review and meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRALs) databases were searched for eligible studies on December 19th, 2023. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed. Primary endpoint was the occurrence of transient ischemic attack (TIA) or any stroke. Secondary endpoints were technical success, death within 30 days, myocardial infarction (MI), local complications, cerebral hyperperfusion syndrome (CHS), cranial nerve injury (CNI), dys-/arrythmia, secondary restenosis, repeat revascularization, and long-term survival. Results were adjusted for symptomatic status and primary treatment strategy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nineteen studies comprising 10,171 procedures in 10,041 patients were included. Baseline characteristics were comparable between groups. Main findings were (1) No difference in primary outcome; however, if adjusted for symptomatic status the rate of TIA/any stroke is higher (OR: 2.05, 95% CI: 1.29-3.27, p &lt; 0.01) after CEA compared to CAS; (2) Significant higher rate of MI (OR: 1.85, 95% CI: 1.19-2.86, p &lt; 0.01) after CEA; (3) Besides CNI, which appears to be commonly temporary and occurred only after CEA (7.56%, 95% CI: 4.21%-13.22%), no significant differences in other secondary endpoints were observed between groups. Long-term risk of secondary restenosis was similar between CEA compared to CAS (OR: 0.98, 95% CI: 0.39-2.49, p = 0.95); (4) Correction for the index procedure did not affect conclusions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Based on limited-quality studies, mostly retrospective and nonrandomized in design, both CAS and CEA represent feasible treatment approaches for patients with primary restenosis, with comparable primary outcome between the two groups. However, based on the obtained results, CAS appears to be preferable. Patients should be critically evaluated in a multidisciplinary team and further research is desirable.Clinical ImpactThis review expands on previous studies by incorporating a larger patient cohort and more recent literature while offering new insights into restenosis. Unlike earlier research, this study uniquely evaluates first repeat revascularization outcomes (CAS and CEA) independently of the initial procedure, suggesting that patient and plaque characteristics might be more influential than the primary technique. Sensitivity analysis confirmed this, as stratification by index procedure did not alter conclusions. Although lower TIA/stroke and mortality ra","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251325054"},"PeriodicalIF":1.7,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340564","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":"Tibioperoneal Trunk Aneurysm in a Patient With Type IV Ehlers-Danlos Syndrome: A Diagnostic-Therapeutic Challenge.","authors":"Diego Caicedo Valdés, Christos D Karkos, Rita Calviño López-Villalta","doi":"10.1177/15266028251319726","DOIUrl":"10.1177/15266028251319726","url":null,"abstract":"","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251319726"},"PeriodicalIF":1.7,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340566","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":"Preloaded Physician-Modified Thoracic Endovascular Aortic Repair to Achieve Left Subclavian Artery Fenestration Alignment in Zone 2.","authors":"Emiel W M Huistra, Wajdi Alrawi, Ignace F J Tielliu, Samuel Saers, Clark J Zeebregts, Artai Pirouzram, Robert C Lind","doi":"10.1177/15266028251344882","DOIUrl":"https://doi.org/10.1177/15266028251344882","url":null,"abstract":"<p><strong>Purpose: </strong>This report describes the use of a physician-modified endovascular graft (PMEG) with a preloaded fenestration for the left subclavian artery (LSA) and diameter-reducing ties to facilitate alignment between the fenestration and LSA.</p><p><strong>Technique: </strong>Thoracic endovascular aortic repair (TEVAR) was performed to treat an intramural aortic hematoma originating at the level of the LSA. A Relay Plus endograft was modified with a fenestration for the LSA. Diameter-reducing ties were added, and the fenestration was preloaded. The preloaded guidewire was introduced at the femoral access and externalized at the brachial artery. The PMEG was then introduced via the common femoral artery with the through-and-through guidewire assisting in the orientation of the endograft. Before releasing the diameter-reducing ties, a 12 mm balloon was inflated within the fenestration and LSA. The diameter-reducing ties were released while the balloon was inflated, ensuring precise alignment of the fenestration with the LSA. The LSA was stented using a balloon-expandable covered stent. Completion angiography and computerized tomography angiography at follow-up demonstrated technical success.</p><p><strong>Conclusion: </strong>Constructing a PMEG with diameter-reducing ties and a preloaded LSA fenestration to establish a through-and-through wire could facilitate precise alignment, improving procedural consistency over time of fenestrated TEVAR in zone 2.Clinical ImpactEndovascular methods for left subclavian artery (LSA) preservation during thoracic endovascular aortic repair (TEVAR) in zone 2 are gaining in popularity. One promising endovascular treatment option is construction of a fenestrated physician-modified endovascular graft (PMEG). Achieving precise alignment between the fenestration and LSA can be challenging. The current report demonstrates a technique to preload the LSA fenestration to establish a through-and-through wire, which, in combination with diameter reducing ties, can potentially aid in achieving consistent results by obtaining a perfect alignment in a quick manner.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251344882"},"PeriodicalIF":1.7,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327611","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":"Detecting Mitochondrial Oxygen Tension as a Measure of Local Tissue Oxygenation in Patients With Peripheral Arterial Disease Before and After Endovascular Therapy.","authors":"Abdallah H A Zaid Al-Kaylani, Richte C L Schuurmann, Riemer H J A Slart, Reinoud P H Bokkers, Jean-Paul P M de Vries","doi":"10.1177/15266028251344791","DOIUrl":"https://doi.org/10.1177/15266028251344791","url":null,"abstract":"<p><strong>Introduction: </strong>Assessment of mitochondrial oxygen tension (mitoPO₂) is a novel technique for measuring skin perfusion. It is based on the oxygen-dependent quenching of delayed fluorescence of 5-aminolevulinic acid (5-ALA), known as the protoporphyrin IX-triple state lifetime technique. This study aimed to determine the tolerability and feasibility of measuring mitoPO₂ in the lower limbs of patients with peripheral arterial disease (PAD) undergoing endovascular therapy. In addition, the study investigated the changes in mitoPO₂ pre- and postoperatively.</p><p><strong>Materials and methods: </strong>This prospective single-center study included patients with Rutherford stage 4 to 6 scheduled for endovascular therapy. Plasters containing 5-ALA were placed over the tibia and at the lower lateral leg 12 hours before the operation. 5-ALA tolerability was assessed by noting the occurrence of related side effects during application, measurements, and in the 48 hours after removal of the plaster. MitoPO₂ was measured immediately before and after the operation over the tibia at the anterior tibialis muscle and the lateral side of the lower leg, and was followed by transcutaneous oxygen pressure and ankle-brachial index measurements.</p><p><strong>Results: </strong>Ten patients were included in this study. No side effects or adverse events related to 5-ALA were observed. One patient reported weak itching within 48 hours after removing the 5-ALA plaster. MitoPO₂ measurements were feasible in all patients at the tibia and lower leg, but were not feasible on the dorsum of the foot. Postoperatively, a significant drop in mitoPO₂ was detected at the tibia. No significant difference was found in mitoPO₂ levels pre- and postoperative at the lower lateral leg. For transcutaneous oxygen pressure, no significant differences were detected postoperatively.</p><p><strong>Conclusions: </strong>5-ALA is tolerable and safe in patients with PAD. MitPO₂ measurements at the tibia and lower lateral leg are feasible and capable of detecting changes in perfusion following endovascular therapy. Further research is needed with larger cohorts and longer follow-up to investigate the relationship between mitoPO₂, oxygen supply, and tissue regeneration.Clinical ImpactThis study demonstrated the feasibility and safety of mitochondrial oxygen tension (mitoPO₂) measurement using 5-aminolevulinic acid (5-ALA) for assessing local skin perfusion in patients with peripheral arterial disease (PAD) undergoing endovascular therapy. Changes in mitoPO₂ post-intervention suggest sensitivity to real-time microvascular and physiological alterations. This technique could potenitally improve overall patient outcomes and wound healing by enhancing patient stratification, treatment planning, perioperative monitoring, and postoperative follow-up.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251344791"},"PeriodicalIF":1.7,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318548","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":"Aortic Coarctation With Type B Aortic Dissection: A Systematic Review and Report of 2 Cases.","authors":"Mauricio Gonzalez-Urquijo, Leopoldo Marine, Jose Francisco Vargas, Gabriel Seguel, Diego Soto V, Michel Bergoeing, Francisco Valdes","doi":"10.1177/15266028251344799","DOIUrl":"https://doi.org/10.1177/15266028251344799","url":null,"abstract":"<p><strong>Purpose: </strong>A systematic review of patients with aortic coarctation (CoA) and concomitant type B aortic dissection (TBAD) is presented; additionally, 2 cases of our own experience are reported.</p><p><strong>Materials and methods: </strong>Following the PRISMA guidelines, databases were search for all articles or abstracts written in English published until May 2024. Mesh terms used included \"aortic coarctation\" in combination with \"aortic dissection,\" \"type B aortic dissection,\" and \"TBAD.\"</p><p><strong>Results: </strong>A total of 121 studies were screened, 19 full-length articles, and 1 abstract were included for analysis. Adding our own 2, a total of 22 cases were analyzed. The median age was 39 years (range: 25-64 years). Eighteen (81.8%) patients were male. Fourteen (63.6%) patients underwent open surgery. One (4.5%) patient underwent hybrid repair. Five (22.7%) patients underwent endovascular repair, including these 2 cases. Two (9%) patients were managed conservatively. The complication rate was 9% (n=2). There were no reported deaths, and the median follow-up period was 11.5 months (range: 6-48 months).</p><p><strong>Conclusion: </strong>The most comprehensive data on patients with CoA and TBAD is presented. The pathophysiology of this disorder remains uncertain. Both endovascular and open surgery have proven effective in treating these conditions with low complication rates. However, long-term outcomes remain undefined.Clinical ImpactThis systematic review provides the most comprehensive analysis of patients with concomitant aortic coarctation and type B aortic dissection to date, offering valuable insights into the demographics, treatment strategies, and outcomes of this rare condition. The findings suggest that both open and endovascular repair are viable treatment options with low complication rates. The absence of mortality in the analyzed cases highlights the feasibility of surgical intervention. However, with limited long-term follow-up, the durability of these treatments remains uncertain, emphasizing the need for further research to guide optimal management and improve long-term patient outcomes.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251344799"},"PeriodicalIF":1.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Ultralow-Dose CT With Deep-Learning Reconstruction for Aneurysm Diameter Measurement in Post-EVAR Follow-Up: A Prospective Comparative Study With Conventional CT.","authors":"Keigo Matsushiro, Takuya Okada, Koji Sasaki, Tomoyuki Gentsu, Eisuke Ueshima, Keitaro Sofue, Katsuhiro Yamanaka, Masatoshi Hori, Masato Yamaguchi, Koji Sugimoto, Kenji Okada, Takamichi Murakami","doi":"10.1177/15266028251339345","DOIUrl":"https://doi.org/10.1177/15266028251339345","url":null,"abstract":"<p><strong>Purpose: </strong>We conducted a prospective study to evaluate the usefulness of ultralow-dose computed tomography (ULD-CT) with deep-learning reconstruction (DLR) compared with conventional standard-dose CT (SD-CT) for post-endovascular aneurysm repair (EVAR) surveillance.</p><p><strong>Materials and methods: </strong>We prospectively performed post-EVAR surveillance using ULD-CT at a single center in 44 patients after they had received SD-CT. The ULD-CT images underwent DLR, whereas the SD-CT images underwent iterative reconstruction. Three radiologists blinded to the patient information and CT conditions independently measured the aneurysmal sac diameter and evaluated the overall image quality. Bland-Altman analysis and a linear mixed-effects model were used to assess and compare the measurement accuracy between SD-CT and ULD-CT.</p><p><strong>Results: </strong>The mean CT dose index volume and dose-length product were significantly lower for ULD-CT (1.0 ± 0.3 mGy and 71.4 ± 26.5 mGy•cm) than that for SD-CT (6.9 ± 0.9 mGy and 500.9 ± 96.0 mGy•cm; p<0.001). The mean short diameters of the aneurysmal sac measured by the 3 observers were 46.7 ± 10.8 mm on SD-CT and 46.3 ± 10.8 mm on ULD-CT. The mean difference in the short diameter of the aneurysmal sac between ULD-CT and SD-CT was -0.37 mm (95% confidence interval, -0.6 to -0.12 mm). The intraobserver limits of agreement (LOA) for measurements by ULD-CT and SD-CT were -3.5 to 2.6, -2.8 to 1.9, and -2.9 to 2.3 for Observers 1, 2, and 3, respectively. The pairwise LOAs for assessing interobserver agreement, such as for the differences between Observers 1 and 2 measurements in SD-CT, were mostly within the predetermined acceptable range. The mean image-quality score was lower for ULD-CT (3.3 ± 0.6) than that for SD-CT (4.5 ± 0.5; p<0.001).</p><p><strong>Conclusion: </strong>Aneurysmal sac diameter measurements by ULD-CT with DLR were sufficiently accurate for post-EVAR surveillance, with substantial radiation reduction versus SD-CT.Clinical ImpactDeep-learning reconstruction (DLR) is implemented as a software-based algorithm rather than requiring dedicated hardware. As such, it is expected to be integrated into standard computed tomography (CT) systems in the near future. The ultralow-dose CT (ULD-CT) with DLR evaluated in this study has the potential to become widely accessible across various institutions. This advancement could substantially reduce radiation exposure in post-endovascular aneurysm repair (EVAR) CT imaging, thereby facilitating its adoption as a standard modality for post-EVAR surveillance.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251339345"},"PeriodicalIF":1.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Fate of False Lumen in Type B and Residual Type A Aortic Dissection Using the Candy-Plug Technique: A Systematic Review and Meta-Analysis.","authors":"Georgios I Karaolanis, Konstantinos Kotopoulos, Rosalinda D'Amico, Drosos Kotelis, Edin Mujagic, Vladimir Makaloski","doi":"10.1177/15266028251344808","DOIUrl":"https://doi.org/10.1177/15266028251344808","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We performed a systematic review and meta-analysis to evaluate the technical and clinical success of false lumen occlusion with the Candy-plug (CP) technique in patients with type B and residual type A aortic dissection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A systematic search of all the literature reported until November 2024 was performed according to the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. The pooled technical and clinical success and corresponding 95% confidence intervals (CIs) were estimated using fixed or random effect methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 106 study titles were identified by the initial search strategy, of which 6 were considered eligible for inclusion in the meta-analysis. A total of 128 patients (83% male) were identified among the eligible studies. The pooled technical and clinical success rate among the studies were 96% (95% CI, 88-98) and 76% (95% CI, 58-88) respectively. The technical success for custom-made manufacturing device (CMD) was 98.5% (95% CI, 92-99; &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=0%; p=0.78, 2 studies) while for the physician modified CP technique (pmCP) technique was 92.7% (95% CI, 77-98; &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=0%; p=0.79, 4 studies). Overall, false lumen thrombosis rate was 71% (95% CI, 55-83): 80% (95% CI, 57-92; &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=0%; p=0.90, 2 studies) for CMD while for the pmCP technique was 63% (95% CI, 27-88; &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=0%; p=0.99, 4 studies). The pooled aortic remodeling rate was 50% (95% CI, 33-66): 63.2% (95% CI, 52.7-72.5; &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=69%; p=0.68, 2 studies) for CMD, while for the pmCP technique was 35.9% (95% CI, 17-54%; &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=39%; p=0.17, 4 studies). The incidence of CP related reinterventions were 7.1% [11.5% for CMD (95% CI, 0.3-8.4; &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=0%; p=0.09, 2 studies) and 5.1% for pmCP (95% CI, 1.3-18; &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=0%; p=0.96, 4 studies)] and 12.8% [4.5% for CMD (95% CI, 0.3-39; &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=69%; p=0.68, 2 studies), while for the pmCP technique was 4.6% (95% CI, 0.9-19; &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=0%; p=0.90, 4 studies)] in the early and late period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;CP technique appears to be a promising solution demonstrating high technical success, false lumen thrombosis, and aortic remodeling rate. However, the clinical success rate tends to be lower. Life-long and strict follow-up of these patients may be necessary to monitor CP-related complications, given the limited data on the long-term durability of these devices.Clinical ImpactThis study provides detailed information on a physician-modified candy plug technique in patients with patent False lumen in Type B or residual Type A aortic dissection. As the custom-made candy plug devices have been developed, the delivery time for them varies between countries and vascular surgery services, making the planning of the procedure difficult, especially in symptomatic patients or ","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251344808"},"PeriodicalIF":1.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Terumo Aortic Global Endovascular Registry: A Multiarm, Multicenter, Open Label, Prospective Observational Registry to Obtain Safety and Performance Data on off-the-Shelf and Custom-Made Stent-Grafts.","authors":"Michel M P J Reijnen, Bartosz Rylski, Antoine Millon, Robert H Geelkerken, Alexander Hyhlik-Dürr, Arjan W J Hoksbergen, Pierfrancesco Veroux, Ernst Weigang, Jörg Tessarek, Vincent Riambau","doi":"10.1177/15266028251344790","DOIUrl":"https://doi.org/10.1177/15266028251344790","url":null,"abstract":"<p><strong>Background: </strong>Approval of medical devices is typically based on data from relatively small clinical studies with a highly selected patient population. Postmarket surveillance is required by regulatory bodies after approval to collect and evaluate experience gained from real world use in larger and unselected populations. Terumo Aortic is a manufacturer of off-the-shelf and custom-made stent-grafts for endovascular repair of thoracic and abdominal aortic pathologies and is assessing device performance in a large registry.</p><p><strong>Methods: </strong>A multiarm, multicenter, open label, prospective observational registry designed to obtain both short- and long-term safety and performance data on the use of standard and custom-made Terumo Aortic endovascular devices in patients with thoracic and abdominal aortic pathologies. Eligibility requirements are minimal, and a standard-of-care protocol will ensure real-world evidence is collected as far as 10 years.</p><p><strong>Discussion: </strong>Challenges to this research reflect its real-world nature such as differences in standard of care between centers and geographies, varying levels of experience and expertise with the devices or techniques, all-comer populations that may not always be comparable, and a design specifically limited to a single manufacturer. Advantages of this registry design include long-term follow-up, different modules to collect standardized outcomes across pathologies and global reach to reflect practice in many different geographies with a wide range of latest-generation endovascular devices.</p><p><strong>Conclusion: </strong>This protocol is a large endovascular registry of all aortic pathologies that are treated by both off-the-shelf and custom-made Terumo Aortic products. It is ambitious in scope and projection and will be part of an overall response involving patients, physicians, and manufacturers to answer the remaining questions of endovascular aortic repair, contribute to continuing improvement of the techniques and technologies, and present an accurate picture of outcomes with latest generation stent-graft devices.Clinical ImpactThis large, long-term registry will generate robust real-world evidence on the safety and performance of both standard and custom-made Terumo Aortic endovascular devices in treating thoracic and abdominal aortic pathologies. By including a broad, minimally selected patient population across diverse global centers, the study mirrors everyday clinical practice and helps bridge the gap between clinical trials and real-world outcomes. Its findings will inform clinical decision-making, support regulatory compliance, and guide ongoing device development. Ultimately, the registry aims to enhance patient care by improving the understanding of endovascular treatment effectiveness and long-term durability in heterogeneous populations.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251344790"},"PeriodicalIF":1.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303469","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":"Primary Drug-Coated Balloon Versus Drug-Eluting Stent for Native Atherosclerotic Femoropopliteal Lesions: An Updated Systematic Review and Meta-Analysis.","authors":"Alessio Mario Cosacco, Gladiol Zenunaj, Pierfilippo Acciarri, Aaron Thomas Fargion","doi":"10.1177/15266028251344877","DOIUrl":"https://doi.org/10.1177/15266028251344877","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical outcomes after endovascular treatment of native femoropopliteal lesions with a drug-coated balloon (DCB) and drug-eluting stent (DES) as a primary option in patients with symptomatic peripheral artery disease.</p><p><strong>Materials and methods: </strong>A comprehensive literature search was performed through PubMed and Embase databases. Studies written in the English language and reporting a direct comparison of the outcomes between primary angioplasty with DCB and primary stenting with DES were included. The endpoints were considered the primary patency (PP), clinical-driven target lesion revascularization (cdTLR), major adverse limb events (free-MALE), and freedom from all-cause mortality.</p><p><strong>Results: </strong>Eleven studies were considered eligible for the metanalysis (3 randomized clinical trials and 8 cohort studies). Overall, 3231 femoropopliteal lesions in 3137 patients were included, with DCB and DES performed in 1951 and 1280 lesions, respectively. No differences were found in demographics, clinical limb presentation, lesions length [173.9±80.2 mm DES vs 195.1±103.3 mm DCB; odds ratio (OR) -2.44; 95% confidence interval (CI) -11.26 to 6.38; p=0.59] and total occlusions (OR 1.41; 95% CI 0.87-2.27; p=0.16). In the DCB group, there was a significant rate of adjunctive procedures such as atherectomy and bailout stenting OR 0.13 (95% CI 0.09-0.18; p<0.001). No differences among PP, cdTLR, free-MALE and freedom from all-cause mortality at 1 year for DCB and DES: OR 1.11 (95% CI 0.74-1.66, p=0.61); OR 1.01 (95% CI 0.72-1.41, p=0.97); OR 1.08 (95% CI 0.69-1.69, p=0.74) and OR 1.85 (95% CI 0.82-4.17, p=0.14) respectively. No differences were found at 2 years: OR 0.89 (95% CI 0.64-1.23, p=0.47); OR 0.79 (95% CI 0.49-1.27, p=0.32); OR 0.74 (95% CI 0.49-1.10, p=0.14); OR 1.21 (95% CI 0.75-1.96, p=0.44) respectively.</p><p><strong>Conclusions: </strong>Both approaches proved to be effective and safe for treating complex femoropopliteal lesions, with comparable clinical outcomes between the 2 groups. In the DCB arm, adjunctive procedures such as atherectomy and bailout stenting were required to optimize the results.Clinical ImpactThe introduction of drug-coated technologies, such as drug-coated balloons (DCBs) and drug-eluting stents (DESs), has significantly improved clinical outcomes for native femoropopliteal lesions. However, despite ongoing advancements in drug-coated device technology, the optimal treatment approach remains unclear due to limited comparative data in the literature. This meta-analysis aims to bridge this gap by reviewing current evidence, highlighting the latest developments, and providing valuable insights that may aid clinical decision-making in the management of native femoropopliteal lesions.</p>","PeriodicalId":50210,"journal":{"name":"Journal of Endovascular Therapy","volume":" ","pages":"15266028251344877"},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286993","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}