Vascular and endovascular surgery最新文献

{"title":"Secondary Prevention after Carotid Stenting in Patients With Atrial Fibrillation.","authors":"Alex D Hanson, Diedo J Ojeda, Arshaq Saleem, Elena Sagues, Andres Gudino, Randall Krug, Edgar A Samaniego","doi":"10.1177/15385744251387547","DOIUrl":"https://doi.org/10.1177/15385744251387547","url":null,"abstract":"<p><p>IntroductionThere is no consensus on the optimal secondary stroke prevention regimen for patients with atrial fibrillation undergoing carotid artery stenting (CAS). Our objective is to compare the long-term efficacy and safety of different medical regimens after CAS.MethodsThis retrospective observational study included patients with pre-existing atrial fibrillation who underwent CAS from 2011 to 2024. Patients were divided into three treatment groups: dual antiplatelet therapy (DAPT), single antiplatelet therapy plus oral anticoagulation (AA), and triple therapy (dual antiplatelet therapy plus oral anticoagulation, TT). The primary outcome was the incidence of major bleeding. Secondary outcomes included the incidence of clinically relevant minor bleeding, recurrent stroke, and stent thrombosis.ResultsOf the 1047 patients who underwent CAS, 129 met the inclusion criteria: 31 in the DAPT group, 46 in the AA group, and 52 in the TT group. At 3 months, major bleeding events occurred in 3.2% (1/31) of patients in the DAPT group, 6.5% (3/46) in the AA group, and 7.7% (4/52) in the TT group (<i>P</i> = 0.71). Ischemic stroke after stent placement occurred in 6.4% (2/31) of cases in the DAPT group, compared to 4.3% (2/46) in the AA group and 1.9% (1/52) in the TT group (<i>P</i> = 0.57). Stent thrombosis occurred in 3.2% (1/31) of patients in the DAPT group, 6.5% (3/46) in the AA group, and 1.9% (1/52) in the TT group (<i>P</i> = 0.32).ConclusionOur findings suggest no significant differences in bleeding events or ischemic outcomes among the different antiplatelet and anticoagulation regimens in patients with atrial fibrillation who underwent CAS.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251387547"},"PeriodicalIF":0.7,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early and Mid-term Results From a Tertiary Care Center for Total Aortic Arch Replacement Using the Thoraflex Hybrid Graft.","authors":"Louise Koskas, Steeve Doizi, Mohammad Zagzoog, Jean-Michel Davaine, Fabien Koskas","doi":"10.1177/15385744251387766","DOIUrl":"https://doi.org/10.1177/15385744251387766","url":null,"abstract":"<p><p>ObjectiveTo report the outcomes of the frozen elephant trunk (FET) technique for patients with chronic aortic dissection and thoracic aortic aneurysm.MethodsPatients undergoing the FET technique using the Vascutek Thoraflex hybrid graft for chronic aortic dissection and thoracic aortic aneurysm from 2013 to 2021 were included. Outcomes included mortality rates, peri-operative complications and aortic related re-interventions. Patients were categorised into aortic dissection and thoracic aortic aneurysm groups.Results39 patients were identified, of whom 56% (n = 22) had a thoracic aortic aneurysm and 44% (n = 17) chronic aortic dissection. Patients with aneurysm had a significantly higher rate of peripheral artery disease at baseline. A significant difference was found in in-hospital mortality rate (27% in patients presenting with aneurysm (n = 6) vs 0% (n = 0) in patients with dissection). Peri-operative complications were 2 (5%) post-operative strokes, 1 (3%) symptomatic spinal cord ischemia, 2 (5%) lower limb ischemia and 4 (10%) ischemic colitis. The median follow-up was 14.8 (2.9-46.5) months. During follow up, mortality from all cause was 18% (n = 7), and aortic re-intervention rate 18% (n = 7) after 39.4 (19.8-45.5) months.ConclusionsThe FET technique is a good therapeutic option for aortic disease of the aortic arch and proximal descending aorta. While the postoperative outcome was acceptable given the high mortality rates of such disease and their treatment, outcomes were better among patients presenting with aortic dissection, particularly in terms of peri-operative mortality.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251387766"},"PeriodicalIF":0.7,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Predictive Role of BUN/Creatinine Ratio and Inflammatory Markers in Determining Amputation Risk in Acute Limb Ischemia Patients.","authors":"Alper Yasar, Mustafa Selcuk Ayar, Fatih Caliskan, Semih Murat Yucel","doi":"10.1177/15385744251387753","DOIUrl":"https://doi.org/10.1177/15385744251387753","url":null,"abstract":"<p><p>ObjectiveAcute limb ischemia (ALI) is a time-sensitive vascular emergency that often presents to the emergency department and can result in limb loss or mortality if not managed promptly. Identifying simple, cost-effective biomarkers at the time of initial emergency department evaluation could facilitate early risk stratification and guide timely intervention, particularly in resource-limited settings. This study aimed to evaluate the predictive value of three readily available laboratory markers-neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and blood urea nitrogen (BUN)/creatinine ratio-for assessing amputation risk in patients with ALI.MethodsWe conducted a single-center, retrospective cross-sectional study of 138 patients diagnosed with ALI who presented to the emergency department between January 2020 and January 2023. Demographic and laboratory data were collected. ROC analysis was performed to evaluate the predictive performance of NLR, PLR, and BUN/creatinine ratio for amputation risk, and multivariate logistic regression identified independent predictors.ResultsAmong the biomarkers analyzed, the BUN/creatinine ratio demonstrated the highest predictive performance for amputation risk (AUC: 0.727, sensitivity: 69.0%, specificity: 68.8%), although the discriminative ability was only moderate. NLR (AUC: 0.666) and PLR (AUC: 0.647) also showed associations with amputation risk, though with lower predictive values. Female gender emerged as an additional independent predictor of amputation risk (OR: 4.16, 95% CI: 1.47-11.81, <i>P</i> = .007).ConclusionsOur findings suggest that the BUN/creatinine ratio may serve as an accessible biomarker with moderate predictive performance, whose main utility may lie in helping to exclude patients at low risk of amputation. While NLR and PLR also showed potential value, further prospective multicenter studies are required to validate their clinical applicability.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251387753"},"PeriodicalIF":0.7,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational Attainment and Outcomes of Hemodialysis Access Creation.","authors":"Nyah Patel, Anna Schneider, Thomas W Cheng, Andrea Alonso, Thomas McNamara, Khuaten Maaneb De Macedo, Elizabeth King, Alik Farber, Jeffrey J Siracuse","doi":"10.1177/15385744251387567","DOIUrl":"https://doi.org/10.1177/15385744251387567","url":null,"abstract":"<p><p>ObjectiveHigher education has historically correlated with improved health outcomes, yet its impacts on end-stage renal disease (ESRD) patients undergoing hemodialysis are not well understood. The goal of this study was to characterize patient factors and outcomes associated with initial arteriovenous (AV) access creation by patient education level.MethodsWe performed a single-center retrospective review of patients who underwent initial AV access creation from 2014-2021. Education groups were defined as primary (elementary school), secondary (middle/high school equivalent), and tertiary (college or higher). Univariable, multivariable, and Kaplan-Meier analyses were performed.ResultsWe identified 480 patients with primary (20.2%), secondary (54.6%), or tertiary education levels (25.2%). Patients with primary education were more likely to be of Hispanic ethnicity (58.8% primary vs 17.9% secondary vs 9.9% tertiary; <i>P</i> < 0.0001) or underinsured (Medicaid/uninsured) (62.9% vs 46.2% vs 39.7%; <i>P</i> < .001), but less likely to have English proficiency (27.1% vs 79.4% vs 77.5% tertiary; <i>P</i> < .001).Univariable analysis showed no significant differences in access-related steal or 30-day readmission. On Kaplan-Meier analysis, 2-year survival was 89.5% (primary education), 89.1% (secondary education), and 89.7% (tertiary education) (<i>P</i> = .99). Maturation at 180 days was 80.8%, 75.4%, and 75.3%, respectively (<i>P</i> = .4). On multivariable analysis, neither 30-day index readmission nor loss of primary patency were significantly associated with education level.ConclusionsAlthough education level was not associated with adverse outcomes once patients were undergoing hemodialysis, many of our patients only have primary school education. Earlier attempts at improving healthcare literacy and preventative care should be examined before the deterioration of kidney function.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251387567"},"PeriodicalIF":0.7,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medium Term Outcomes of Bypass Surgery for Recurrent Superficial Femoral Artery Lesions After Endovascular Treatment.","authors":"Hitoshi Tachibana, Taira Kobayashi, Takanobu Okazaki, Shingo Mochizuki, Kazuki Maeda, Hiroshi Kodama, Mayo Oshita, Miwa Arakawa, Akira Katayama, Shinya Takahashi","doi":"10.1177/15385744251387657","DOIUrl":"https://doi.org/10.1177/15385744251387657","url":null,"abstract":"<p><p>ObjectiveThe study was performed to examine clinical outcomes of bypass surgery for recurrent superficial femoral artery (SFA) occlusive lesions after endovascular treatment (EVT).MethodPatients who underwent bypass surgery for a recurrent SFA lesion after EVT at 4 Japanese vascular centers from 2015 to 2020 were analyzed retrospectively. The primary endpoint was graft patency (primary, assisted primary, and secondary).ResultsA total of 46 patients were included in the study. The patients had high rates of hypertension (85%), diabetes (70%), and chronic kidney disease (63%). Clinical presentation before EVT was intermittent claudication in 16 cases (35%) and chronic limb-threatening ischemia in 30 cases (65%). Initial EVT was performed for complex SFA lesions (lesion length, 200 [125-260] mm; reference vessel diameter, 5.3 [4.7-6.0] mm; chronic total occlusion, 50%; poor below-the-knee runoff vessel, 60%). The final device was a bare-nitinol stent in 26 cases (56%), stent graft in 9 (20%), and drug-eluting stent in 7 (15%). A total of 46 surgical reconstructions (above-the-knee femoropopliteal bypass, 15 (33%); below-the-knee femoropopliteal bypass, 7 (15%); tibial bypass, 24 (52%)) were performed using autologous vein grafts (72%) and prosthesis grafts (28%) in a median period of 300 [145-556] days from initial EVT. The median procedure time was 201 [159-299] min. No case had early graft occlusion or hospital death within 30 days. The median follow-up period was 27 (12.7-49.2) months. The 3-year primary, assisted primary, and secondary graft patencies were 57%, 70%, and 77%, respectively; the 3-year limb salvage was 84%; and the 3-year survival was 66%.ConclusionMedium term outcomes were acceptable in patients with bypass surgery for a recurrent SFA lesion after EVT.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251387657"},"PeriodicalIF":0.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Vascular Surgery Readmission Data in Commonly Used Quality Metric Programs.","authors":"Ahmad Aljobeh, Alisa Khomutova, Ian Winkeler, Sery Pak, Jasper Murphy, Stefanos Giannopoulos, Apostolos Tassiopoulos","doi":"10.1177/15385744251387569","DOIUrl":"https://doi.org/10.1177/15385744251387569","url":null,"abstract":"<p><p>BackgroundThirty-day hospital readmissions are a critical healthcare quality metric used to evaluate hospital performance and patient outcomes. Vascular surgery readmission rates are among the highest and most costly. Accurate data on patient readmissions is essential for improving care quality and reimbursement processes. The accuracy of readmission data, often derived from quality metric programs like NSQIP and Vizient, is challenged by misclassification or improper capture of readmissions.MethodsWe conducted a single-institution retrospective analysis using the NSQIP and Vizient registries to identify patients who underwent vascular surgery between 2018 and 2023 and were subsequently readmitted to our institution within 30 days. Demographic, procedural, and readmission data were reviewed to identify factors associated with procedure-related vs non-procedure related readmissions. Logistic regression was employed to determine variables that significantly predicted procedure-related readmissions.ResultsAmong 2375 vascular surgery operations captured by NSQIP and Vizient during the study period, 219 patients (9.2%) were readmitted within 30 days. Of these, 89 (40.6%) were procedure-related and 130 (59.4%) were non-procedure-related. Baseline demographics, comorbidities, and perioperative characteristics were largely similar between groups, although patients with non-procedure-related readmissions were more likely to be functionally dependent (39.2% vs 22.5%, <i>P</i> = 0.009) and current smokers (30.8% vs 20.2%, <i>P</i> = 0.08). In multivariable logistic regression, functional dependence (OR 0.41, 95% CI 0.19-0.88, <i>P</i> = 0.022) and current smoking within 1 year (OR 0.48, 95% CI 0.23-0.99, <i>P</i> = 0.047) were independently associated with lower odds of procedure-related readmission, suggesting that these patients are more likely to return for medical decompensation rather than surgical complications.ConclusionsVascular surgery readmissions are frequent and costly, and factors such as functional health status and pre-existing complications should be considered in prevention strategies. Accurate documentation and coding, combined with targeted transitional care interventions, will be essential to reduce unnecessary readmissions and to ensure fair institutional benchmarking under current quality metric programs.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251387569"},"PeriodicalIF":0.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patch Angioplasty for the Treatment of Hemodialysis Access Dysfunction.","authors":"Xiang Li, Qianling Ye, Li Zhang, Weikang Guan, Huanhuan Song, Cunliang Zeng, Chaoyang Li, Ming Xie, Bin Zhao, Huaping Wu","doi":"10.1177/15385744251387751","DOIUrl":"https://doi.org/10.1177/15385744251387751","url":null,"abstract":"<p><p>BackgroundThe treatment of hemodialysis access dysfunction include creating a new fistula, balloon dilation, or stent implantation. However, these options are not suitable for all patients. We adopted patch angioplasty to reconstruct the hemodialysis access and observed this group of cases to evaluate the feasibility, effectiveness, and safety of this surgical method.MethodsBetween 2021 and 2024, we performed 14 cases of patch angioplasty using PTFE patch material. We recorded the time of fistula establishment, time of patch angioplasty, surgical site, transitional dialysis status using central venous catheter, complications, and patency of the fistula in this group of cases.ResultsAll 14 patients successfully underwent patch angioplasty, with a technical success rate of 100%. During follow-up, 3 patients died respectively 2, 8, 9 months post-operation. The longest follow-up time was 38 months. The primary patency rates for target lesions were as follows: 92.3% at 3 months (12/13), 81.8% at 6 months (9/11), 77.8% at 12 months (7/9), and 57.1% at 24 months (4/7). The cumulative patency rates were: 3 months 100% (13/13), 6 months 90.9% (10/11), 12 months 88.9% (8/9), and 24 months 71.4% (5/7). No cases experienced infection, bleeding, pseudoaneurysm, or steal syndrome.ConclusionsPTFE patch angioplasty for hemodialysis access reconstruction yields a high technical success rate and serves as an effective solution after hemodialysis access dysfunction. It has high safety and good patency rates, making it a recommended method for access reconstruction.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251387751"},"PeriodicalIF":0.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Management of Aortic Injuries Caused by Pedicle Screws: A Two-Case Series With a Proposed Decision-Making Framework.","authors":"Santiago Rosales, Andres Rodriguez-Buitrago, Marcos Tarazona, Yessid Araque-Puello, Juan Alarcon-Palomino, Juan F Ramon, Fernando Alvarado-Gomez","doi":"10.1177/15385744251387781","DOIUrl":"https://doi.org/10.1177/15385744251387781","url":null,"abstract":"<p><p>IntroductionPedicle screw-related aortic injuries are rare but potentially life-threatening complications of spinal instrumentation. While some cases remain asymptomatic for extended periods, delayed recognition increases the risk of catastrophic vascular events. Early diagnosis and appropriate management are critical to prevent severe morbidity and mortality. Traditional open vascular repair carries significant risks, whereas thoracic endovascular aortic repair (TEVAR) has emerged as a minimally invasive alternative. However, clear guidelines for diagnosis and treatment in spine surgery remain lacking.MethodsWe present 2 cases of aortic injury caused by pedicle screws following spinal instrumentation. Both patients underwent multidisciplinary management, including intravascular ultrasound (IVUS) for vascular assessment, TEVAR for aortic repair, and pedicle screw removal/repositioning. A review of the literature was conducted to contextualize these cases within existing management strategies.ResultsBoth patients were successfully treated with TEVAR and pedicle screw revision, without perioperative complications. IVUS played a crucial role in confirming the extent of vascular involvement and guiding intervention. At 18-month and 24-month follow-up, both patients remained asymptomatic, with no evidence of graft migration, endoleak, or spinal instability.ConclusionsPedicle screw-related aortic injuries, though uncommon, pose a serious risk in spine surgery. Multidisciplinary management involving spine and vascular surgery is essential for optimal outcomes. IVUS enhances diagnostic accuracy, allowing for precise treatment planning. Endovascular stent placement, combined with appropriate pedicle screw revision, is an effective and safe management strategy. Given the lack of standardized guidelines, we propose a structured decision-making approach for spine surgeons encountering vascular complications. Future research should focus on risk stratification, screening protocols, and long-term outcomes of endovascular management in spinal instrumentation.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251387781"},"PeriodicalIF":0.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic Pleomorphic Sarcoma Presenting With Claudication: A Rare Diagnostic Challenge.","authors":"Zehra Ünlü, Sedat Karaca, Aysen Yaprak Kapkin, Fatih Islamoglu","doi":"10.1177/15385744251387625","DOIUrl":"https://doi.org/10.1177/15385744251387625","url":null,"abstract":"<p><p>Aortic pleomorphic sarcomas are rare, aggressive vascular tumors often presenting with nonspecific symptoms that delay diagnosis. We describe a 53-year-old male who presented with isolated lower extremity claudication. Examination revealed absent pulses in the left leg, and duplex vascular ultrasound showed monophasic flow. CT angiography demonstrated a 48 mm infrarenal abdominal aortic aneurysm extending to the iliac bifurcation, a bulge in the left common iliac artery, and high-grade stenosis in a short segment. The patient underwent surgical repair with a Y-graft. Histopathological analysis confirmed undifferentiated pleomorphic sarcoma with a high Ki67 index (65%) and absence of specific immunohistochemical markers. Postoperative PET-CT revealed metastatic disease involving lungs, liver, and bones. The patient subsequently received systemic chemotherapy. This case highlights the diagnostic challenges of undifferentiated pleomorphic sarcoma when they present with isolated ischemic symptoms rather than signs of malignancy Early recognition through imaging and histopathology is essential, as surgical resection remains the cornerstone of treatment despite poor prognosis.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251387625"},"PeriodicalIF":0.7,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Management of Common Femoral Artery Occlusion Caused by Suture-mediated Vascular Closure Devices: A Single-Center Experience.","authors":"Young Ha Kim, Lee Hwangbo, Jun Kyeung Ko","doi":"10.1177/15385744251387755","DOIUrl":"https://doi.org/10.1177/15385744251387755","url":null,"abstract":"<p><p>ObjectiveVascular closure devices (VCDs) are frequently employed to achieve hemostasis at the femoral puncture site, offering an alternative to traditional manual compression. However, a rare yet significant complication is common femoral artery (CFA) occlusion caused by suture-mediated VCDs. The optimal management of this complication remains unclear, with open surgical repair traditionally regarded as the standard of care. This paper aims to share our clinical experience in managing CFA occlusions caused by suture-mediated VCDs and to introduce our preferred endovascular treatment strategy.MethodsAt our institution, approximately 250 femoral artery hemostasis procedures using suture-mediated VCDs are performed annually. Over the past 10 years, we encountered 6 cases of CFA occlusion following the use of such devices. This corresponds to an incidence rate of approximately 0.24%. In all cases, endovascular management was selected as the primary treatment modality over open surgical intervention. Our endovascular approach consisted of initial balloon angioplasty, with adjunctive stenting performed when residual stenosis exceeded 50%.ResultsEndovascular treatment was technically successful in all 6 cases, with no major procedural complications. The mean degree of stenosis prior to balloon angioplasty was 91.9%, including 3 cases of long segmental occlusion. Balloon angioplasty alone was sufficient in 4 cases, while the remaining 2 required additional stenting to address significant residual stenosis. Final angiography demonstrated an average residual stenosis of 25.1%. During the follow-up period (mean duration: 37.8 months), no patients reported symptoms of lower extremity ischemia.ConclusionThis case series highlights the feasibility and efficacy of endovascular management as a first-line approach for CFA occlusion caused by suture-mediated VCDs. When diagnosis is delayed, long segmental occlusion with considerable thrombus burden may limit the effectiveness of balloon angioplasty alone, necessitating adjunctive stenting. Therefore, timely diagnosis and intervention are essential to optimize outcomes in these cases.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251387755"},"PeriodicalIF":0.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}