European Journal of Vascular and Endovascular Surgery最新文献

{"title":"Long Term Real World Performance of the Gore Excluder AAA Endoprosthesis Featuring the C3 Delivery System: Ten Year Results from the European C3 Module of the GREAT Registry","authors":"Moritz S. Bischoff, Eric Verhoeven, Athanasios Katsargyris, Dittmar Böckler","doi":"10.1016/j.ejvs.2025.11.044","DOIUrl":"10.1016/j.ejvs.2025.11.044","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to report the ten year data for patients treated with the Gore Excluder AAA Endoprosthesis featuring the C3 Delivery System for infrarenal aortic disease, as recorded in the European C3 module of the Gore Global Registry for Endovascular Aortic Treatment.</div></div><div>This study aimed to report the ten year data for patients treated with the Gore Excluder AAA Endoprosthesis featuring the C3 Delivery System for infrarenal aortic disease, as recorded in the European C3 module of the Gore Global Registry for Endovascular Aortic Treatment.</div><div><h3>Methods</h3><div>The European C3 module included patients from 13 centres who underwent endovascular aortic aneurysm repair between August 2010 and December 2012. Outcomes were assessed using descriptive statistics and Kaplan–Meier survival analysis with 95% confidence intervals (CIs).</div></div><div>The European C3 module included patients from 13 centres who underwent endovascular aortic aneurysm repair between August 2010 and December 2012. Outcomes were assessed using descriptive statistics and Kaplan–Meier survival analysis with 95% confidence intervals (CIs).</div><div><h3>Results</h3><div>At module closure, 396 patients (87.1% men; mean age ± standard deviation 73.9 ± 7.8 years) were available for analysis, with a mean follow up duration ± standard deviation of 6.4 ± 3.2 years. Of these, 94.4% underwent elective endovascular aortic aneurysm repair for infrarenal aortic aneurysm, and 16.9% (67 of 396) were treated outside the instructions for use. At ten years, the all cause mortality rate was 46.0% with 182 deaths: five aortic related, 120 non-aortic related, and 57 of unknown cause. Freedom from aortic related death was 98.6% (95% CI 96.7 – 99.4%). Freedom from any re-intervention and device related re-intervention was 77.3% (95% CI 71.8 – 81.8%) and 80.6% (95% CI 75.3 – 84.9%), respectively. Freedom from type 1 endoleak was 95.4% (95% CI 92.3 – 97.5%), with type 2 endoleaks accounting for 82% (41 of 50) of all endoleaks. Structural complications were rare: two cases of migration (0.5%), one case of compression (0.3%), and no cases of device fractures. Nine patients (2.3%) required conversion, and secondary rupture occurred in three cases (0.8%).</div></div><div>At module closure, 396 patients (87.1% men; mean age ± standard deviation 73.9 ± 7.8 years) were available for analysis, with a mean follow up duration ± standard deviation of 6.4 ± 3.2 years. Of these, 94.4% underwent elective endovascular aortic aneurysm repair for infrarenal aortic aneurysm, and 16.9% (67 of 396) were treated outside the instructions for use. At ten years, the all cause mortality rate was 46.0% with 182 deaths: five aortic related, 120 non-aortic related, and 57 of unknown cause. Freedom from aortic related death was 98.6% (95% CI 96.7 – 99.4%). Freedom from any re-intervention and device related re-intervention was 77.3% (95% CI 71.8 – 81.8%) and 80.6% (95% CI 75.3 –","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"72 4","pages":"Pages 613-621"},"PeriodicalIF":8.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed Aetiology, Mixed Messages: Navigating Clinical Uncertainty in Compression Therapy in Patients with Venous Leg Ulcers and Peripheral Artery Disease","authors":"Athanasios D. Giannoukas, Christos Karathanos","doi":"10.1016/j.ejvs.2025.11.043","DOIUrl":"10.1016/j.ejvs.2025.11.043","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"72 4","pages":"Pages 698-699"},"PeriodicalIF":8.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long Term Target Vessel Outcomes in Patients Treated with Fenestrated Endovascular Aortic Repair","authors":"George Apostolidis, Petroula Nana, Giuseppe Panuccio, Daour Yousef al Sarhan, Jose I. Torrealba, Tilo Kölbel","doi":"10.1016/j.ejvs.2026.01.058","DOIUrl":"10.1016/j.ejvs.2026.01.058","url":null,"abstract":"<div><h3>Objective</h3><div>Fenestrated endovascular aortic repair (FEVAR) has been proposed as an alternative to open surgical repair (OSR) in complex aortic cases. Target vessel outcomes have shown good results, with re-interventions constituting an important FEVAR pitfall. This single centre, retrospective, observational cohort study presented the target vessel outcomes in patients treated with FEVAR in a high volume aortic centre.</div></div><div>Fenestrated endovascular aortic repair (FEVAR) has been proposed as an alternative to open surgical repair (OSR) in complex aortic cases. Target vessel outcomes have shown good results, with re-interventions constituting an important FEVAR pitfall. This single centre, retrospective, observational cohort study presented the target vessel outcomes in patients treated with FEVAR in a high volume aortic centre.</div><div><h3>Methods</h3><div>Consecutive patients managed with custom made FEVAR from 2010 to 2024 were included. Vessels targeted through scallops or intentionally unstented fenestrations were excluded from the main analysis. Primary outcomes were target vessel technical success and primary patency, along with freedom from target vessel instability (TVI), endoleak, and re-intervention during follow up, all assessed using Kaplan–Meier estimates. Regression analyses were performed.</div></div><div>Consecutive patients managed with custom made FEVAR from 2010 to 2024 were included. Vessels targeted through scallops or intentionally unstented fenestrations were excluded from the main analysis. Primary outcomes were target vessel technical success and primary patency, along with freedom from target vessel instability (TVI), endoleak, and re-intervention during follow up, all assessed using Kaplan–Meier estimates. Regression analyses were performed.</div><div><h3>Results</h3><div>The study included 340 patients and 1 181 target vessels. Technical success was 99.2%. The mean follow up was 41.5 ± 32 months. Freedom from TVI was 87.7% (standard error [SE] 1.6%) at 60 months. Previous endovascular aortic repair (hazard ratio [HR] 2.14, 95% confidence interval [CI] 1.18 – 3.87; <em>p</em> = .012) and thoraco-abdominal aortic aneurysm (TAAA) (HR 3.3, 95% CI 2.07 – 5.25; <em>p</em> < .001) were independently related to instability. Primary patency was 97.2% (SE 0.7%) at 60 months and was negatively associated with Lifestream use (HR 3.61, 95% CI 1.26 – 8.67; <em>p</em> = .019), while the presence of aortic dissection (HR 0.14, 95% CI 0.001 – 0.98; <em>p</em> = .047) was a positive prognostic factor. Freedom from target vessel endoleak was 90.4% (SE 1.5%) at 60 months. Endoleaks were associated with previous OSR (HR 2.59, 95% CI 1.20 – 5.59; <em>p</em> = .016), number of fenestrations per device (HR 1.69, 95% CI 1.06 – 2.71; <em>p</em> = .029), and TAAA (HR 3.66, 95% CI 2.10 – 6.38; <em>p</em> < .001). Freedom from re-intervention at 60 months was 88.5% (SE 1.6%); only TAAA presence was associated with","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"72 4","pages":"Pages 635-644"},"PeriodicalIF":8.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Outdoor Air Pollution, Noise Pollution, and Green Exposure on Abdominal Aortic Aneurysm Progression","authors":"Liam Musto, Corry Gellatly, Calvin Jephcote, Kathryn Adams, Sarah Finch, Sarah Johnson, Athanasios Saratzis, Matthew Bown, Anna L. Hansell","doi":"10.1016/j.ejvs.2026.01.031","DOIUrl":"10.1016/j.ejvs.2026.01.031","url":null,"abstract":"<div><h3>Objective</h3><div>Recent evidence suggests an association between air pollution exposure and abdominal aortic aneurysm (AAA) rupture. It is unclear whether environmental factors also influence the rate at which AAAs grow. This study aimed to determine how environmental factors contribute to aneurysm growth using a prospective cohort study design.</div></div><div>Recent evidence suggests an association between air pollution exposure and abdominal aortic aneurysm (AAA) rupture. It is unclear whether environmental factors also influence the rate at which AAAs grow. This study aimed to determine how environmental factors contribute to aneurysm growth using a prospective cohort study design.</div><div><h3>Methods</h3><div>This study used data from the UK Aneurysm Growth Study (UKAGS), a national cohort of men with AAA representative of the UK population in AAA surveillance. Participant records were linked with environmental exposure data from a validated land use regression model, including nitrogen dioxide (NO<sub>2</sub>) concentrations (μg/m<sup>3</sup>), particles with an aerodynamic diameter < 2.5 μm (PM<sub>2.5</sub>) concentrations (μg/m<sup>3</sup>), satellite measures of greenness (normalised difference vegetation index, enhanced vegetation index, and tree cover density), Ordnance Survey derived greenspace, and noise pollution exposure (dB) from three sources (aircraft, railway, and road), over a ten year period (2010 – 2019) with a 25 × 25 m grid cell resolution. Linear mixed effect growth modelling was used to explore the association with AAA growth.</div></div><div>This study used data from the UK Aneurysm Growth Study (UKAGS), a national cohort of men with AAA representative of the UK population in AAA surveillance. Participant records were linked with environmental exposure data from a validated land use regression model, including nitrogen dioxide (NO<sub>2</sub>) concentrations (μg/m<sup>3</sup>), particles with an aerodynamic diameter < 2.5 μm (PM<sub>2.5</sub>) concentrations (μg/m<sup>3</sup>), satellite measures of greenness (normalised difference vegetation index, enhanced vegetation index, and tree cover density), Ordnance Survey derived greenspace, and noise pollution exposure (dB) from three sources (aircraft, railway, and road), over a ten year period (2010 – 2019) with a 25 × 25 m grid cell resolution. Linear mixed effect growth modelling was used to explore the association with AAA growth.</div><div><h3>Results</h3><div>Environmental data were available for 3 360 (86.0%) participants. Mean follow up ± standard deviation was 5.64 ± 2.47 years. There were no statistically significant associations between NO<sub>2</sub>, PM<sub>2.5</sub>, and transport noise pollution with AAA growth in adjusted models, whereas relationships with greenspace measures were inconsistent.</div></div><div>Environmental data were available for 3 360 (86.0%) participants. Mean follow up ± standard deviation was 5.64 ± 2.47 years. There","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"72 4","pages":"Pages 624-633"},"PeriodicalIF":8.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motor Evoked Potential Monitoring: An Imperative during Open Thoraco-Abdominal Aortic Aneurysm Repair","authors":"Jürg Schmidli, Salome Weiss","doi":"10.1016/j.ejvs.2026.01.046","DOIUrl":"10.1016/j.ejvs.2026.01.046","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"72 4","pages":"Page 688"},"PeriodicalIF":8.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Malignant Neoplasms on Limb Prognosis in Patients with Peripheral Arterial Disease: A Real World Analysis Based on a Nationwide Database","authors":"Noriyuki Miyama, Kimihiro Komori, Arata Takahashi, Hiroyoshi Komai","doi":"10.1016/j.ejvs.2026.01.037","DOIUrl":"10.1016/j.ejvs.2026.01.037","url":null,"abstract":"<div><h3>Objective</h3><div>It is unclear how malignant neoplasms affect limb prognosis in patients with peripheral arterial disease (PAD). The purpose of this study was to clarify the association between malignant neoplasms and limb outcomes in patients with PAD complicated by chronic limb threatening ischaemia (CLTI).</div></div><div>It is unclear how malignant neoplasms affect limb prognosis in patients with peripheral arterial disease (PAD). The purpose of this study was to clarify the association between malignant neoplasms and limb outcomes in patients with PAD complicated by chronic limb threatening ischaemia (CLTI).</div><div><h3>Methods</h3><div>Data for patients who underwent revascularisation between 2013 – 2015 were collected from the JAPAN Chronic Limb Threatening Ischaemia Database (JCLIMB), established as a part of the National Clinical Database. All patients included in this study had PAD with CLTI and were followed for two years. The prevalence of malignant neoplasms at the time of revascularisation was examined. Overall survival, cardiovascular death, primary patency, and major adverse limb events (MALEs) were also investigated.</div></div><div>Data for patients who underwent revascularisation between 2013 – 2015 were collected from the JAPAN Chronic Limb Threatening Ischaemia Database (JCLIMB), established as a part of the National Clinical Database. All patients included in this study had PAD with CLTI and were followed for two years. The prevalence of malignant neoplasms at the time of revascularisation was examined. Overall survival, cardiovascular death, primary patency, and major adverse limb events (MALEs) were also investigated.</div><div><h3>Results</h3><div>The 2 891 patients included in the study underwent surgical revascularisation (including hybrid treatment) in 1 709 cases and endovascular treatment in 1 182 cases. Overall, 62 patients (2.1%) had malignant neoplasms at the time of revascularisation (malignancy bearing group). Primary patency and MALE free rates did not differ between patients with and without malignant neoplasms, regardless of treatment type. Overall survival was statistically significantly poorer in the malignancy bearing than in the malignancy free group. The cardiovascular mortality rate was not statistically significantly different between the malignancy bearing and malignancy free groups, regardless of treatment modality.</div></div><div>The 2 891 patients included in the study underwent surgical revascularisation (including hybrid treatment) in 1 709 cases and endovascular treatment in 1 182 cases. Overall, 62 patients (2.1%) had malignant neoplasms at the time of revascularisation (malignancy bearing group). Primary patency and MALE free rates did not differ between patients with and without malignant neoplasms, regardless of treatment type. Overall survival was statistically significantly poorer in the malignancy bearing than in the malignancy free group. The cardiovascular mortality rate w","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"72 4","pages":"Pages 582-588"},"PeriodicalIF":8.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Diagnostic Reference Levels for Endovascular Aneurysm Repair in Sweden","authors":"Erna Markusdottir, Alice Lindén, Catharina Cicek, Joachim Starck, Kristian Smidfelt, Magnus Jonsson, Mari Holsti, Sofia Strömberg, Sara Bruce, Talha Butt, Kevin Mani","doi":"10.1016/j.ejvs.2026.03.009","DOIUrl":"10.1016/j.ejvs.2026.03.009","url":null,"abstract":"<div><h3>Objective</h3><div>The 2023 European Society for Vascular Surgery (ESVS) guidelines on radiation safety recommended establishment of national diagnostic reference levels (DRLs) for endovascular procedures, which indicate an expected radiation dose for any given procedure for the average sized patient. The aim of this study was to propose a national DRL for Sweden for standard endovascular aortic repair (EVAR).</div></div><div>The 2023 European Society for Vascular Surgery (ESVS) guidelines on radiation safety recommended establishment of national diagnostic reference levels (DRLs) for endovascular procedures, which indicate an expected radiation dose for any given procedure for the average sized patient. The aim of this study was to propose a national DRL for Sweden for standard endovascular aortic repair (EVAR).</div><div><h3>Methods</h3><div>This was a national registry based study where all EVARs performed in Sweden over a two year period (2021 – 2022) were identified in the Swedish vascular registry, Swedvasc. Patient demographics were extracted from Swedvasc and radiation related parameters were collected at centre level. Multivariable analyses were performed to assess which factors affected fluoroscopy time, total dose area product (DAP), and cumulative air kerma (CAK). The national DRL was defined as the third quartile of all centre specific median values for DAP total.</div></div><div>This was a national registry based study where all EVARs performed in Sweden over a two year period (2021 – 2022) were identified in the Swedish vascular registry, Swedvasc. Patient demographics were extracted from Swedvasc and radiation related parameters were collected at centre level. Multivariable analyses were performed to assess which factors affected fluoroscopy time, total dose area product (DAP), and cumulative air kerma (CAK). The national DRL was defined as the third quartile of all centre specific median values for DAP total.</div><div><h3>Results</h3><div>Nine hundred and thirty-three procedures at 23 centres were included; 831 (89.1%) intact abdominal aortic aneurysms (AAAs) and 102 (10.9%) ruptured AAAs. The median (interquartile range [IQR]) DAP for EVAR at centre level varied from 28.3 Gy·cm<sup>2</sup> (IQR 14.1, 76.1) to 212.7 Gy·cm<sup>2</sup> (IQR 196.8, 275.0). Overall, the third quartile of the DAP radiation dose for EVAR in Sweden was 152.6 Gy·cm<sup>2</sup>. The DAP was a median 81.1  Gy·cm<sup>2</sup> and 116.5 Gy·cm<sup>2</sup> for intact and ruptured EVARs, respectively (<em>p</em> < .001). The DRL was 147.7 Gy·cm<sup>2</sup> and 213.8 Gy·cm<sup>2</sup> for intact and ruptured EVARs, respectively. In a multivariable linear regression analysis, rupture, iliac branched repair, access complication, obesity, low centre volume and larger aneurysm were predictors for higher DAP during EVAR.</div></div><div>Nine hundred and thirty-three procedures at 23 centres were included; 831 (89.1%) intact abdominal aortic aneurysms (AAA","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"72 4","pages":"Pages 602-608"},"PeriodicalIF":8.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Cause of Lower Gastrointestinal Bleeding: Mesenteric Arteriovenous Malformation","authors":"Zhongjie Zeng, Binglin Lai","doi":"10.1016/j.ejvs.2026.04.007","DOIUrl":"10.1016/j.ejvs.2026.04.007","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"72 4","pages":"Page 623"},"PeriodicalIF":8.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midterm Outcomes of the Knickerbocker Technique following Thoracic Endovascular Aortic Repair for Chronic Post-dissection Thoracic Aortic Aneurysms: A Single Centre Experience☆","authors":"Anastasia Dean, Kelly Feng, Summer Hassan, Abdelaziz Marzoug, David Lindstrom, Andrew Holden","doi":"10.1016/j.ejvs.2026.02.003","DOIUrl":"10.1016/j.ejvs.2026.02.003","url":null,"abstract":"<div><h3>Objective</h3><div>The Knickerbocker (KB) technique selectively manages the thoracic false lumen (FL) following thoracic endovascular aortic repair (TEVAR). This single centre case series evaluated midterm outcomes of KB in patients with post-dissection thoracic aortic aneurysms (TAA).</div></div><div>The Knickerbocker (KB) technique selectively manages the thoracic false lumen (FL) following thoracic endovascular aortic repair (TEVAR). This single centre case series evaluated midterm outcomes of KB in patients with post-dissection thoracic aortic aneurysms (TAA).</div><div><h3>Methods</h3><div>This study analysed a retrospective cohort including all TEVARs with the KB technique at an aortic centre between July 2014 and April 2024. Data were obtained from a prospective aortic database and electronic records. The primary outcome was technical KB success with intimal flap disruption and endograft expansion, without any KB related adverse events of aortic rupture, extension of aortic dissection, or distal stent graft induced new entry (dSINE). Secondary outcomes were positive aortic remodelling, FL thrombosis, true lumen (TL) expansion on surveillance imaging, and freedom from aortic re-intervention and aortic related death.</div></div><div>This study analysed a retrospective cohort including all TEVARs with the KB technique at an aortic centre between July 2014 and April 2024. Data were obtained from a prospective aortic database and electronic records. The primary outcome was technical KB success with intimal flap disruption and endograft expansion, without any KB related adverse events of aortic rupture, extension of aortic dissection, or distal stent graft induced new entry (dSINE). Secondary outcomes were positive aortic remodelling, FL thrombosis, true lumen (TL) expansion on surveillance imaging, and freedom from aortic re-intervention and aortic related death.</div><div><h3>Results</h3><div>Twenty-one patients were included (median age 63 years, interquartile range [IQR] 55, 70; 81% men), with TAA following type B (14; 67%) and repaired type A (7; 33%) aortic dissections. The majority (90%) were elective and performed during the chronic period (median time from index dissection 58 months [IQR 22, 108]). The primary outcome was achieved in all cases. There were three peri-operative adverse events (one minor stroke, one retrograde type A dissection, and one iliac rupture). Positive aortic remodelling was achieved in all patients: at 12 months, the median maximum aortic diameter reduced from 60 mm (IQR 55, 64) to 48 mm (IQR 43.5, 53.5) (<em>p</em> < .001), the median FL diameter reduced from 40 mm (IQR 32, 44) to 14 mm (IQR 2.5, 21.5) (<em>p</em> < .001), and the median TL increased from 20 mm (IQR 14, 22) to 35 mm (IQR 32.5, 36) (<em>p</em> < .001). Seventeen patients (81%) had FL thrombosis, with a median time to thrombosis detection of three months. The aortic diameter at the KB site and distally remained stable, and there ","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"72 4","pages":"Pages 647-656"},"PeriodicalIF":8.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's Choice – Open versus Endovascular Revascularisation for Femoropopliteal Disease in Patients with Chronic Limb Threatening Ischaemia","authors":"Michael S. Conte, Alik Farber, Iris H. Liu, Robert W. Chang, Gheorghe Doros, Christine R. Herman, Jade S. Hiramoto, Katharine L. McGinigle, Jeffrey J. Siracuse, Michael Strong, Matthew T. Menard","doi":"10.1016/j.ejvs.2026.02.018","DOIUrl":"10.1016/j.ejvs.2026.02.018","url":null,"abstract":"<div><h3>Objective</h3><div>Multiple options exist for the treatment of femoropopliteal (FP) disease, including endovascular interventions (ENDOs) and bypass surgery (OPEN). There are limited data directly comparing ENDO and OPEN strategies for FP disease in chronic limb threatening ischaemia (CLTI).</div></div><div>Multiple options exist for the treatment of femoropopliteal (FP) disease, including endovascular interventions (ENDOs) and bypass surgery (OPEN). There are limited data directly comparing ENDO and OPEN strategies for FP disease in chronic limb threatening ischaemia (CLTI).</div><div><h3>Methods</h3><div>Outcomes of patients in the Best Endovascular <em>vs.</em> Best Surgical Therapy in Patients with CLTI (BEST-CLI) trial who underwent revascularisation for FP disease were examined. ENDO and OPEN were compared using single segment great saphenous vein (SSGSV) or alternative conduits (ACs). The primary outcome was major adverse limb event (MALE) or death; secondary outcomes included major amputation (MA); major re-intervention; amputation free survival; any re-intervention, MA, or death (RAD); and any re-intervention.</div></div><div>Outcomes of patients in the Best Endovascular <em>vs.</em> Best Surgical Therapy in Patients with CLTI (BEST-CLI) trial who underwent revascularisation for FP disease were examined. ENDO and OPEN were compared using single segment great saphenous vein (SSGSV) or alternative conduits (ACs). The primary outcome was major adverse limb event (MALE) or death; secondary outcomes included major amputation (MA); major re-intervention; amputation free survival; any re-intervention, MA, or death (RAD); and any re-intervention.</div><div><h3>Results</h3><div>Seven hundred and sixty-four patients underwent ENDO (378), OPEN with SSGSV (265), or OPEN with AC (121) procedures for FP disease. Patients had a mean age of 67 years; 66.6% were men, and 75.9% were White. Comorbidities included hypertension (85.5%), hyperlipidaemia (75.4%), diabetes mellitus (59.5%), smoking (47.2%), coronary artery disease (40.4%), and end-stage renal disease (7.6%); 68.4% of patients had tissue loss. Wound, Ischemia, and foot Infection (WIfI) stages were stage 1 (7.3%), stage 2 (35.2%), stage 3 (28.4%), and stage 4 (29.1%). TASC II classification of the FP disease was A and B (24.0%), C (25.4%), D (34.8%), or not scored (15.8%). Associated (untreated) infrapopliteal disease was present in 42.5%. ENDO treatments included plain balloon angioplasty (9.3%), drug coated balloons (32%), drug eluting stents (24.9%), bare metal stents (55.6%), stent grafts (17.5%), and atherectomy (11.1%). Cox models demonstrated superior MALE and death, MA, RAD, major re-intervention, and any re-intervention for OPEN SSGSV <em>vs.</em> ENDO. OPEN SSGSV also demonstrated superior freedom from MALE and death, and greater amputation free survival <em>vs.</em> OPEN AC. Presence of infrapopliteal disease, tissue loss, TASC classification, and diabetes mellitus were signif","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"72 4","pages":"Pages 561-568"},"PeriodicalIF":8.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}