Annals of vascular surgery最新文献

{"title":"Sex-Based Disparities in Statin Use and Intensity Among Women With Peripheral Artery Disease: A Systematic Review.","authors":"Amta Azeem, Cindy Huynh","doi":"10.1016/j.avsg.2026.09.042","DOIUrl":"https://doi.org/10.1016/j.avsg.2026.09.042","url":null,"abstract":"<p><strong>Background: </strong>Peripheral artery disease (PAD) is a manifestation of systemic atherosclerotic cardiovascular disease and is associated with substantial cardiovascular and limb-related morbidity. High-intensity statin therapy is recommended for patients with PAD, yet statin treatment remains underused, and sex-based differences in lipid-lowering therapy may further contribute to inequities in secondary prevention. This systematic review evaluated sex-based disparities in statin use and statin intensity among adults with PAD.</p><p><strong>Methods: </strong>A systematic search of PubMed/MEDLINE and Cochrane CENTRAL was performed from database inception through June 6, 2026. Eligible studies included adults with PAD, reported PAD-specific statin or lipid-lowering outcomes, and compared outcomes by sex. The primary outcome was high-intensity statin use among women versus men with PAD. Secondary outcomes included any statin use, no statin therapy, guideline-concordant lipid-lowering or vascular-protective therapy, and LDL-C goal achievement. Findings were synthesized narratively because of heterogeneity in study design, PAD definition, clinical setting, and outcome reporting.</p><p><strong>Results: </strong>Eleven observational studies met inclusion criteria. Only two studies reported high-intensity statin use by sex, and both found lower use among women than men. In the Medicare cohort of patients with critical limb ischemia, high-intensity statin use was lower among women than men. Similarly, in the Veterans Affairs cohort, women with PAD had lower rates of high-intensity statin use, any statin use, and statin adherence. Across studies reporting secondary lipid-lowering outcomes, women were generally less likely than men to receive statins or guideline-concordant vascular-protective therapy, including in primary care, hospital discharge, revascularization, administrative claims, and vascular registry settings. LDL-C goal achievement was not reported in the included studies.</p><p><strong>Conclusion: </strong>Women with PAD are less likely than men to receive statin therapy and guideline-concordant vascular-protective treatment, and the limited available evidence suggests lower use of high-intensity statins among women when statin intensity is reported. These findings highlight a persistent sex-based gap in secondary prevention for PAD. Future studies should report statin intensity, adherence, LDL-C goal achievement, treatment escalation, and standardized measures of statin tolerance or intolerance separately by sex. Quality-improvement efforts should also focus on improving statin prescribing for women with PAD.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restenosis after Carotid Artery Stenting in Radiation-induced versus Atherosclerotic Carotid Stenosis: 25-year experience from a tertiary hospital.","authors":"Jacky Siu-Chung Tam, Ngo-Yeung Fung, Pei-Zhi Ling, Stephen W K Cheng","doi":"10.1016/j.avsg.2026.09.046","DOIUrl":"https://doi.org/10.1016/j.avsg.2026.09.046","url":null,"abstract":"<p><strong>Objective: </strong>To compare the long-term in-stent restenosis (ISR) rate following carotid artery stenting (CAS) in patients with carotid stenosis secondary to atherosclerosis (AS) and radiation-induced stenosis (RIS).</p><p><strong>Methods: </strong>A retrospective review was conducted on 140 CAS procedures in 126 patients at our institution over a 25-year period. Patients with prior neck irradiation were classified as RIS, while the remaining were categorized as AS. Propensity score matching was employed to balance baseline characteristics between the groups. Restenosis was evaluated using specific duplex ultrasound velocity criteria validated for stented arteries. Rates of moderate (≥50%) and severe (≥70%) in-stent restenosis were compared, and long-term restenosis-free survival was estimated using Kaplan-Meier analysis. Multivariate logistic regression was used to determine independent risk factors for ISR.</p><p><strong>Results: </strong>After matching, 40 CAS procedures were included in each group (RIS and AS). Median follow-up duration was 72 months. The RIS group exhibited a significantly higher prevalence of ≥50% ISR (40% vs. 12.5%; p=0.005) and a composite endpoint of ≥50% ISR or new stenosis outside the stented segment (55% vs. 17.5%; p<0.001). The estimated 2-year ISR-free survival at ≥50% was 75.5% in RIS compared to 94.8% in AS (p=0.005). Multivariate analysis identified prior neck irradiation as the sole independent risk factor for ≥50% ISR (OR 7.05, 95% CI 1.26-39.45, p=0.026). No significant risk factors were found for ≥70% ISR. Era-based analysis demonstrated a significant decrease in the incidence of ≥50% and ≥70% ISR in the RIS group during the more recent period, accompanied by shifts in baseline characteristics such as prevalence of hyperlipidema and statin use. Reintervention rate and late ipsilateral neurological events were comparable between the groups.</p><p><strong>Conclusions: </strong>Radiation-induced carotid stenosis is associated with higher rates of long-term moderate (≥50%) in-stent restenosis following carotid artery stenting compared with atherosclerotic disease. However, reintervention and late ipsilateral neurological event rates remain comparable between groups. Recent temporal declines in restenosis coincide with increased statin use and optimized hyperlipidemia management.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Outcomes of Isolated Common Femoral Endarterectomy in the Endovascular Era.","authors":"João Marcelo Cabral, Luís Loureiro, Catarina Mesquita Guimarães, Vera Silva, Mónica Bandeira, Samuel Cardoso, Miguel Queirós, Henrique Almeida, Rui Machado","doi":"10.1016/j.avsg.2026.09.023","DOIUrl":"https://doi.org/10.1016/j.avsg.2026.09.023","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Common femoral endarterectomy remains the reference treatment for common femoral artery occlusive disease, yet contemporary real-world data focused specifically on isolated common femoral endarterectomy remain limited. This study aimed to evaluate the clinical profile, operative characteristics and outcomes of isolated common femoral endarterectomy performed in a tertiary vascular surgery center, with particular emphasis on postoperative complications, reintervention and occlusion, as well as the possible influence of wound closure technique and hemostatic adjunct use on local morbidity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective observational study was conducted including consecutive patients who underwent isolated common femoral endarterectomy between January 2013 and December 2023. Baseline characteristics, clinical presentation, lesion complexity, operative details, postoperative complications, reinterventions and postoperative occlusion were analyzed. Lesions were classified according to TASC II. Kaplan-Meier analysis was used to assess freedom from occlusion, while Cox regression was performed to explore factors associated with postoperative occlusion. Fisher's exact test was used to assess associations between wound closure technique, hemostatic adjunct use and postoperative complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 96 patients underwent 100 isolated common femoral endarterectomies. Mean age was 68.5 ± 9 years, 89% were male and 63% presented with chronic limb-threatening ischemia. Most lesions were classified as TASC A-B (68%). Median follow-up was 3.5 years (95% CI, 3.2-3.9). Early postoperative complications were predominantly local, including groin hematoma (4%), lymphatic leakage (4%), lymphocele (5%), pseudoaneurysm (2%) and infection (8%). Overall, 18% of procedures required reintervention, with 14% undergoing open and 4% endovascular reintervention. Nine occlusive events occurred during follow-up. Estimated freedom from occlusion was 100% at 30 days, 96% at 1 year and 86% at 5 years. TASC C-D lesions showed a numerically higher occlusion rate than TASC A-B lesions (12.5% vs. 7.4%; OR, 1.80), although this difference was not statistically significant (p = 0.462). In univariable Cox regression, aspirin therapy was the only variable significantly associated with lower risk of postoperative occlusion (HR, 0.20; p = 0.026). Neither intradermal wound closure nor hemostatic adjunct use was significantly associated with postoperative complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Isolated common femoral endarterectomy remains a safe and durable treatment for common femoral artery occlusive disease, with low rates of early local complications, acceptable reintervention rates and good freedom from occlusion during follow-up. These findings support the continued role of isolated common femoral endarterectomy as the reference treatment for common femoral artery disease in the endovascula","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Open and Endovascular Interventions in Octogenarians with Infrainguinal Chronic Limb-Threatening Ischemia.","authors":"Shima Rahgozar, Sina Zarrintan, Dong-Jin E Kang Sim, Rohini J Patel, Ann C Gaffey, Mahmoud B Malas","doi":"10.1016/j.avsg.2026.09.041","DOIUrl":"https://doi.org/10.1016/j.avsg.2026.09.041","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite prior studies showing that lower extremity revascularization in the elderly population could be performed safely, there continues to be significant debate regarding the outcomes in octogenarians with chronic limb-threatening ischemia (CLTI). The choice between bypass and endovascular therapy (ET) in this population is controversial. This study aimed to examine outcomes of bypass and ET in octogenarians presenting with CLTI using the Vascular Quality Initiative (VQI) database.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The VQI database was queried for all patients with infrainguinal CLTI that received bypass or ET between 2016 and 2023. Two cohorts, octogenarians (80-89 years old) and non-octogenarians (51 to 79 years old) were compared. Three types of revascularizations were compared within the age categories: bypass with a single-segment great saphenous vein (SSGSV), bypass with an alternative conduit (AC), and ET. Primary outcomes included postoperative myocardial infarction (MI) and 30-day mortality. Secondary outcomes included one-year rates of death, major amputation and major amputation/death. Multivariate logistic regression model was used for MI and 30-day mortality. Kaplan Meier survival and time-varying Cox regression analyses were used for one-year outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Data from a total of 134,808 limbs and 91,938 patients were analyzed (Octogenarian=25,547, 18.9%). Octogenarians had approximately two-fold higher 30-day mortality across all revascularization strategies compared to non-octogenarians. In octogenarians, the rates of SSGSV, AC, and ET were 6.3%, 7.4%, and 86.3%, respectively. After adjusting for potential confounders, ET was associated with lower odds of postoperative MI compared to SSGSV and AC bypasses, with no significant difference in 30-day mortality by revascularization type. At one year, AC bypass (aHR = 1.30 [95% CI: 1.20-1.41]; P &lt; 0.001) and ET (aHR = 1.18 [95% CI: 1.10-1.28]; P &lt; 0.001) were associated with higher hazards of major amputation/death compared to SSGSV bypass in octogenarians. ET had lower hazards of major amputation compared to SSGSV bypass (aHR = 0.78 [95% CI: 0.70-0.86]; P &lt; 0.001) and AC bypass (aHR = 0.64 [95% CI: 0.57-0.70]; P &lt; 0.001), as well as lower hazards of major amputation/death compared to AC bypass (aHR = 0.91 [95% CI: 0.85-0.97]; P = 0.004).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Octogenarians experience substantially higher perioperative mortality across all revascularization strategies. In octogenarians with CLTI, ET was the predominant approach and was associated with lower postoperative MI risk compared to bypass independent of the conduit. ET had higher hazards of combined major amputation/death compared to SSGSV bypass, driven solely by higher mortality. The higher mortality in ET may reflect these patients' higher overall risk profile. Moreover, ET was associated with lower hazards of combined major amputation/death compared to AC","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Mortality After Major Lower Extremity Amputation for Dysvascular or Infected Limbs.","authors":"Young Kim, Junette Yu, Joey Lew, Christina L Cui, Neena Pack, Lisa C Pickett, Kevin W Southerland, Tristen T Chun","doi":"10.1016/j.avsg.2026.09.028","DOIUrl":"https://doi.org/10.1016/j.avsg.2026.09.028","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies have reported poor survival rates after major amputation for dysvascular or infected limbs. In this study, we examined contemporary long-term survival rates and causes of death among patients undergoing major lower extremity amputation.</p><p><strong>Methods: </strong>Institutional medical records were queried for patients undergoing either above-knee (AKA) or below-knee amputation (BKA) for chronic limb-threatening ischemia (CLTI) or severe infection, from 2020-2023. Mortality rates were evaluated using Kaplan-Meier survival curves, and Cox proportional hazards models were constructed to identify risk factors.</p><p><strong>Results: </strong>A total of 747 patients underwent major amputation over the four-year period, with a median follow-up of 1.2 years. Median age was 65 years old and 62.7% were male sex. AKAs (n=371, 49.7%) and BKAs (n=376, 50.3%) were evenly distributed. The overall 30-day, one-year, and three-year survival rates were 91.9% (95% confidence interval [CI], 89.9-93.9%), 72.8% (95% CI, 69.4-76.2%), and 49.0% (44.3-53.7%), respectively. Amputation-related causes of death comprised 15.9% of all patient mortalities, with a median interval of 24 postoperative days (interquartile range, 8-64). Risk factors for overall mortality included patient age (hazard ratio [HR] 1.02 per year, 95% CI 1.01-1.03, p < .001), AKA (vs BKA; HR 1.76, 95% CI 1.39-2.25, p < .001), emergent amputation (versus elective; HR 8.59, 95% CI 3.12-17.84, p < .001), chronic kidney disease (HR 1.37, 95% CI 1.04-1.80, p = .026), end-stage renal disease (HR 1.41, 95% CI 1.00-1.98, p = .048), and coronary artery disease (HR 1.36, 95% CI 1.08-1.71, p = .010).</p><p><strong>Conclusion: </strong>Long-term mortality rates remain substantial among patients undergoing major lower extremity amputation. However, only a small fraction of these deaths are attributable to the amputation procedure or postoperative complications. Risk factors for overall mortality include advanced patient age, emergent operation, and the presence of significant medical comorbidities. These findings highlight the importance of comprehensive risk assessment and may aid in prognostication and shared decision-making for patients with CLTI or severe infection considering major amputation.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stenting of the Inferior Mesenteric Artery as a Single Vessel Treatment for Chronic Mesenteric Ischemia.","authors":"Khaled El-Qawaqzeh, Sateesh Babu, Arun Goyal, Nicholas Stafford, Zakiur Rahaman, Brandon Madris, Igor Laskowski, Romeo Mateo","doi":"10.1016/j.avsg.2026.09.043","DOIUrl":"https://doi.org/10.1016/j.avsg.2026.09.043","url":null,"abstract":"<p><strong>Purpose: </strong>Angioplasty and stenting of the mesenteric arteries have increasingly become the first therapeutic option for CMI. The superior mesenteric artery (SMA) and the celiac artery (CA) have been the usual targets for revascularization. However, published data on stenting of only the inferior mesenteric artery (IMA) for this disease are limited. This study evaluated the results in 10 patients treated at our institution.</p><p><strong>Study design: </strong>A retrospective review of 10 patients who underwent angioplasty and stenting of only the IMA for symptomatic CMI from 2005 to 2025. Patient demographics, angiographic findings, procedural details, and outcomes were recorded.</p><p><strong>Results: </strong>Four males and six females with a mean age of 68 years (range 50-85) underwent angioplasty and stenting of the IMA as a single vessel. Nine patients were treated with balloon expandable bare metal stents. One was treated with a drug eluting stent. All patients had critical IMA stenosis. Five patients had occlusions or critical stenosis of both the SMA and CA. Five patients had nonobstructive disease of the SMA and CA. Technical success was 100% and immediate clinical improvement of CMI symptoms occurred in all patients. The follow-up period ranged from 0 to 10 years after the procedure. At their last follow-up or at the time of death, all patients remained free of recurrent mesenteric ischemic symptoms.</p><p><strong>Conclusions: </strong>Under certain clinical and angiographic situations, angioplasty and stenting of the IMA as a single vessel treatment can be safely performed in patients with CMI with satisfactory short- and long-term outcomes.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multi-Institution Analysis Demonstrates that Intelligent Maps Improve Intraoperative Safety and Efficiency During Fenestrated/Branched Endovascular Repairs.","authors":"Dean J Arnaoutakis, Rohini J Patel, Mohammed Hamouda, Shivam Patel, Samantha M Pavlock, Murray Shames, Mahmoud B Malas","doi":"10.1016/j.avsg.2026.09.029","DOIUrl":"https://doi.org/10.1016/j.avsg.2026.09.029","url":null,"abstract":"<p><strong>Introduction: </strong>Augmented intelligence (AI) tools have become popular additions to medicine. AI can transform operating rooms with advanced visualization and aid surgeons with decision-making. The AI tool we are investigating in this study allows patient specific maps to be created with a cloud computing software based on preoperative CT scans which are superimposed with fluoroscopic images in the operating room. The image fusion arguably permits easier identification and cannulation of visceral vessels. A unique feature of this software is that the map can be manually moved and adjusted in the operating room as the aorta is manipulated. The goal of our study is to evaluate the impact of AI on the intraoperative outcomes of fenestrated/branched endovascular aortic repairs (F/BEVARs).</p><p><strong>Methods: </strong>This is a multi-institution review of patients who underwent a F/BEVAR at tertiary care centers from August 2015-December 2022. Patients were stratified based on the use of AI during F/BEVAR. Primary outcomes included operative time, radiation exposure, fluoroscopy time, and contrast use. Secondary outcomes included 30-day complications. Multivariate linear regression models were used to evaluate the association between AI and outcomes after adjustment for potential confounders.</p><p><strong>Results: </strong>There were 344 patients included in this analysis; 248 (72.1%) patients underwent procedures using AI, and 96 (27.9%) had procedures without AI. There were no significant differences in baseline characteristics between the two groups. There was a significant difference in aneurysm diameter at time of repair, 65.3mm in the AI group and 64.1mm in the non-AI group, p=0.047. On univariate analysis there was not a significant difference in operative time, fluoroscopy time or radiation exposure in the non-AI group compared to the AI group. After adjusting for potential confounders, we found that the AI group had a significant reduction in contrast use - 62.4cc (p<0.0001), radiation exposure - 916.4 mGy (p=0.002), and fluoroscopy time - 16.6 minutes (p=0.001). Additionally, no significant difference was found in 30-day events between the groups.</p><p><strong>Conclusion: </strong>Incorporating AI technology into the operating room during F/BEVAR can result in a significant reduction in contrast use, radiation exposure and fluoroscopy time. Therefore, AI can improve safety in the operating room for both patient and providers and should be considered as an adjunct to F/BEVAR cases. Additional studies are needed to confirm our findings and further extrapolate this benefit.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routinely Measured Serum Biomarkers and Peripheral Artery Disease in Patients Undergoing Maintenance Dialysis: A Systematic Review and Meta-Analysis.","authors":"Amirhossein Larijani, Aida Hasanzadi, Mokhtar Tazik, Amir Ahmad Sarhandi, Arash Bakhshi, Seyed Mohammad Hossein Mostafavi, Abolfazl Nikkhoy, Saeid Anvari, Mohammad Amin Ashoobi, Mohammad Taghi Ashoobi","doi":"10.1016/j.avsg.2026.09.036","DOIUrl":"https://doi.org/10.1016/j.avsg.2026.09.036","url":null,"abstract":"<p><strong>Background: </strong>Patients on maintenance dialysis have a markedly elevated prevalence of peripheral artery disease (PAD), which can be independently related to mortality and cardiovascular events. Although routine serum parameters are widely available in dialysis care, the studies comparing them between patients with and without PAD have demonstrated inconsistent results. This systematic review and meta-analysis aims to quantify biomarker differences and resolve the discrepancies.</p><p><strong>Methods: </strong>Following the PRISMA guidelines, unrestricted language searches were performed in PubMed, Scopus, and Web of Science for studies comparing routine serum biomarkers between dialysis patients with and without PAD. Random-effects meta-analyses were conducted for albumin, CRP, PTH, calcium, phosphate, total cholesterol, LDL, HDL, and triglycerides to calculate standardized mean difference (SMD) or means ratio. Heterogeneity was explored by meta-regression and sensitivity analyses.</p><p><strong>Results: </strong>Twenty-four studies (33,052 patients; 8,462 with PAD) were included. Serum albumin was significantly lower in PAD patients (SMD: -0.34; 95% CI: -0.48 to -0.20). CRP trended toward elevation without reaching significance. Also, PTH, calcium, phosphate, total cholesterol, LDL, and HDL showed no meaningful differences. Sensitivity analyses and meta-regression confirmed robustness of all estimates. No publication bias was detected.</p><p><strong>Conclusions: </strong>Among routinely measured serum biomarkers, only albumin was significantly associated with PAD in dialysis patients, consistent with the malnutrition-inflammation-atherosclerosis framework. As evidence is predominantly retrospective, these findings reflect correlates of established PAD rather than confirmed predictors of onset, supporting their use to prompt earlier clinical screening. Prospective studies with adjusted analyses are needed to clarify the roles of inflammatory and mineral metabolism markers.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Outcomes of Carotid Artery Stenting, Transcarotid Artery Revascularization, and Carotid Endarterectomy in Asymptomatic Carotid Stenosis: A Propensity-Matched Analysis.","authors":"Aman Singh, Omar I Sbaih, Stefan T Prvulovic, Jeffrey Breton, Qazi Ali, Matthew Bender","doi":"10.1016/j.avsg.2026.09.037","DOIUrl":"https://doi.org/10.1016/j.avsg.2026.09.037","url":null,"abstract":"<p><strong>Purpose: </strong>To compare myocardial infarction (MI), stroke, mortality, and major adverse events (MAE) after carotid artery stenting (CAS), transcarotid artery revascularization (TCAR), and carotid endarterectomy (CEA).</p><p><strong>Methods: </strong>Using TriNetX, adults undergoing CAS, TCAR, or CEA for asymptomatic carotid stenosis from 2015-2025 were identified using ICD-10-PCS codes. Asymptomatic status required no stroke or transient ischemic attack within 6 months before surgery. Propensity score matching was performed for CAS versus TCAR (5,558 pairs), TCAR versus CEA (9,666 pairs), and CAS versus CEA (13,707 pairs). Outcomes through 1 year were assessed using risk ratios and Kaplan-Meier analyses.</p><p><strong>Results: </strong>At 1 year, CAS was associated with higher stroke risk than TCAR (5.16% vs 3.74%; RR 1.31; p=0.002) and CEA (4.92% vs 3.47%; RR 1.44; p<0.001), whereas TCAR and CEA were similar (3.91% vs 3.79%; p=0.52). CAS had lower mortality than TCAR (3.78% vs 7.65%; RR 0.49; p<0.001), but mortality was similar in the other comparisons. MI was lower after CAS than TCAR (2.03% vs 2.95%; RR 0.63; p<0.001), with no differences otherwise. MAE was higher after CAS than CEA (7.66% vs 6.46%; RR 1.20; p<0.001), but similar between CAS and TCAR and between TCAR and CEA.</p><p><strong>Conclusions: </strong>Among patients selected for revascularization, CAS was associated with higher stroke risk than TCAR and CEA, lower MI and mortality than TCAR, and higher MAE than CEA. These observational findings complement randomized evidence and require cautious interpretation given residual confounding and unavailable anatomic data.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A STANDARDIZED 50-MM ANALYTICAL MODEL FOR REPRODUCIBLE ANEURYSM VOLUMETRY AFTER EVAR.","authors":"Ma Lourdes Del Río-Solá, Joan Roedan-Oliver, Manuel Diez-Martínez, Alfredo Redondo-Diéguez","doi":"10.1016/j.avsg.2026.09.031","DOIUrl":"https://doi.org/10.1016/j.avsg.2026.09.031","url":null,"abstract":"<p><strong>Background: </strong>Conventional volumetric assessment after endovascular aneurysm repair (EVAR) is limited by variability in anatomical landmark selection and inconsistent measurement regions, which may affect longitudinal reproducibility. This study evaluated the reproducibility and sensitivity of Volmax50, a standardized volumetric framework based on a patient-specific 50-mm analytical segment automatically identified within the region of maximal aneurysm dilatation, compared with conventional full-length volumetry.</p><p><strong>Methods: </strong>A prospective single-center study included 98 patients undergoing endovascular aneurysm repair (EVAR). Sac and thrombus volumes were obtained using semi-automated segmentation and analyzed with two approaches: traditional full-length volumetry and Volmax50, which evaluates a fixed 50-mm segment centered on maximal sac dilatation. Measurements were performed at baseline, 6, and 12 months. Agreement, intra- and interobserver reproducibility, and sensitivity for detecting sac enlargement ≥5 mL were assessed.</p><p><strong>Results: </strong>Baseline sac and thrombus volumes were comparable between methods. During follow-up, Volmax50 yielded slightly larger sac volumes (T6: 110 vs 105 mL, p=0.041; T12: 114 vs 107 mL, p=0.019) and thrombus volumes (T12: 52 vs 50 mL, p=0.044). Reproducibility was superior with Volmax50 (ICC 0.93, 95% CI 0.90-0.96) compared with the traditional method (ICC 0.82, 95% CI 0.76-0.87), with lower intra- and interobserver variability (2.8% and 3.4% vs 6.5% and 7.9%). Bland-Altman analyses confirmed smaller bias and narrower limits of agreement. Sensitivity for detecting sac enlargement ≥5 mL was significantly higher with Volmax50 (92% vs 68%, p<0.001).</p><p><strong>Conclusions: </strong>Volmax50 provides more reproducible and sensitive volumetric assessment than conventional volumetry for AAA surveillance after EVAR. By standardizing the analytical region and reducing observer-related variability, it improves the detection of sac volume changes and may represent a useful adjunct for routine postoperative monitoring.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}