Vascular and endovascular surgery最新文献

{"title":"Direct Carotid Puncture Mechanical Thrombectomy in Medium Vessel Occlusion (MEVO) Stroke Using Obtura Closure Device for Hemostasis.","authors":"Rasmiranjan Padhi, Virag Sanjay Shethna, Jagadeesan Dhanasekaran, Naci Kocer, Madhava Rao, Kiran Kumar Shetty","doi":"10.1177/15385744251360827","DOIUrl":"https://doi.org/10.1177/15385744251360827","url":null,"abstract":"<p><p>BackgroundMechanical thrombectomy (MT) is the gold standard treatment for acute ischemic stroke (AIS) patients with large vessel occlusion. Direct cervical carotid puncture is a recognized approach in unfavorable aortic arch anatomy. However, manual compression/ surgical closure of the access site can be challenging if the International Normalized Ratio (INR) is high and the patient is taking anticoagulation.Case SummaryWe present a case of Stanford type A (STA) aortic dissection (status post Bentall procedure) presenting with acute ischemic stroke (AIS) with left M2-MCA thrombotic occlusion. Conventional transfemoral or transradial approach for MT was deferred due to replaced ascending aorta & arch debranching and a residual thoraco-abdominal aortic dissection flap. Risk of soft tissue blood loss was high with open neck access (surgical cut down) due to high INR of 2.9. So, MT was performed through direct left common carotid artery (CCA) puncture achieving mTICI 3 flow. Due to high INR, manual compression was deferred, puncture site haemostasis was achieved with use of collagen based Obtura vascular closure device (VCD). Patient made substantial neurological recovery with no puncture site complications and MRS-0 at discharge.ConclusionObtura femoral VCD can be an alternative haemostatic device for direct carotid puncture mechanical thrombectomy for AIS.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251360827"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602728","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":"Drug Eluting Stents as a Management for Patients with Below the Knee Peripheral Artery Disease: A Systematic Review and Meta-Analysis.","authors":"Prakash Krishnan, Arthur Tarricone, Allen Gee, Dong Won Lee, Jayati Mehta, Lawrence A Lavery, Samin Sharma","doi":"10.1177/15385744251358129","DOIUrl":"https://doi.org/10.1177/15385744251358129","url":null,"abstract":"<p><p>PurposeThe purpose of this study was to compare the effectiveness and safety of drug eluting stents with percutaneous transluminal angioplasty and bare-metal stents in below the knee peripheral artery disease. <b>Methods</b>: The systematic review was registered in Research Registry. A literature search was performed across four databases: PubMed, Medline/Embase, Cochrane Review, and Web of Science for eligible comparative studies. The primary outcomes examined were mortality, major amputation (above the ankle), minor amputation (below the ankle), and clinically driven target lesion revascularization (CD-TLR). A random effects model was used when pooling outcomes to account for heterogeneity.Main FindingsA total of 7 studies were included in this systematic review and meta-analysis. All subjects were treated for below the knee lesions and CLTI was confirmed as Rutherford ≥4 in 669/955 (70.0%). Among the studies, 572 were treated with a drug eluting stents and 477 treated with non-DES modalities. Pooled analysis showed that DES significantly reduced minor amputations and CD-TLR, O.R = 0.56 [0.32, 0.96], and O.R = 0.38 [0.25, 0.60], respectively. In subgroup analysis, paclitaxel eluting stents were not associated with either survival or major amputation. Everolimus/sirolimus eluting stent use was associated with reduced CD-TLR, O.R = 0.36 [0.21, 0.61].ConclusionThis study suggests that Drug-Eluting Stents (DES), irrespective of type, provide protection against minor amputations and CD-TLR. However, they do not seem to have a significant impact on overall survival rates or the risk of major amputations.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251358129"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577504","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":"Systematic Review and Meta-Analysis of the Effect of Chronic Kidney Disease on Amputation and Mortality in Patients With Peripheral Artery Disease.","authors":"Yahui Zhang, Yuan Liao, Hongbao Guo","doi":"10.1177/15385744251355230","DOIUrl":"https://doi.org/10.1177/15385744251355230","url":null,"abstract":"<p><p>BackgroundThe influence of presence/absence chronic kidney disease (CKD) on the clinical course and outcomes of patients with peripheral artery disease (PAD) has not been extensively investigated. We aimed to measure the relative rates of amputation and mortality in individuals with different stages of CKD compared to those without CKD, and to assess whether revascularization treatments might reduce these risks for PAD patients.MethodsWe conducted a thorough search of the literature across multiple databases, including MEDLINE, EMBASE, the Cochrane Library, and Web of Science. The risk of bias assessment was assessed using the Newcastle-Ottawa Quality Assessment scale. All studies that reported relevant results in PAD patients were included. The statistical analysis involved the calculation of pooled prevalence estimates using a random-effects model, along with the performance of subgroup analyses and meta-regression to evaluate heterogeneity.ResultsWe included fourteen observational studies encompassing a total of 554,270 patients with PAD that met the predefined inclusion criteria. Eleven studies reported on amputation rates in patients with and without CKD. Our analysis showed that CKD patients faced nearly double the risk of amputation compared to those without CKD (1.94; 1.90 to 1.97; <i>P</i> < 0.001; I² = 96.8%, <i>P</i> < 0.001). Additionally, a significant rise in mortality risk among CKD patients was observed across 14 studies, in comparison to patients without CKD (OR 2.04; 95% CI 1.99 to 2.08; <i>P</i> < 0.001; I² = 78.6%, <i>P</i> < 0.001). Moreover, we observed a graded increase in both amputation and mortality rates with the progression of CKD severity. In terms of therapeutic interventions, the potential of revascularization procedures to lower mortality and amputation rates appeared to be attenuated in the presence of CKD in PAD patients. Meta-regression analysis revealed that only a baseline diabetic population exceeding 50% exhibited a borderline association with amputation rate (β 0.422; 95% CI [-0.189; 1.035]) after adjusting for other covariates, including sample size, percentage of patients with critical limb ischemia, and follow-up time.ConclusionThe significant association noted between CKD and risk of amputation and mortality with PAD, with this risk intensifying as renal insufficiency progresses. Furthermore, the effectiveness of revascularization procedures in reducing amputation and mortality rates is diminished in patients with PAD who also have CKD.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251355230"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562531","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":"Saphenous Bypass for Treating Anterior Nutcracker Syndrome After Failed Renal Vein Transposition: A Case Report.","authors":"Ahmed Azhar Ali, Mostafa M Abdelgawad, Mosaad A Soliman, Khalid A Mowafy","doi":"10.1177/15385744251355225","DOIUrl":"https://doi.org/10.1177/15385744251355225","url":null,"abstract":"<p><p>AimTo report on a case of renal vein anterior nutcracker syndrome (ANCS) that was treated using saphenous vein bypass after a failed attempt of renal vein transposition.CaseA 42-year-old female presented with gross hematuria and flank pain. Computed tomography revealed a left renal vein (LRV) anterior nutcracker syndrome. An attempt to perform LRV transposition failed due to short vein length. A saphenous bypass was then harvested to perform a bypass between the inferior vena cava and LRV. At 6-month follow-up, the patient remained symptom-free, and imaging confirmed graft patency.ConclusionSaphenous vein bypass presents a viable option in patients with short renal vein or failed renal vein transposition in cases of ANCS.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251355225"},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546751","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":"Post-Stent Vein Lumen Shape and Clinical Response in Patients Treated for Iliofemoral Venous Occlusive Disease.","authors":"Paul Gagne, Kayode O Kuku, Robert Mendes, Amy Griggs, Edem Segbefia, Lawrence V Hofmann, Anthony Comerota, Hector M Garcia-Garcia","doi":"10.1177/15385744251321900","DOIUrl":"10.1177/15385744251321900","url":null,"abstract":"<p><p>ObjectiveInterventionalists have noted significant venous luminal gain with nitinol venous stents although post-placement lumen shape differed from the circular shape observed with elgiloy stents. The goal of this study was to determine the characteristics of a stented vein lumen that correspond with clinical outcomes, and to identify metrics that might be relevant for stent design by assessing aspect ratio (AR), lumen diameter (LD), lumen area (LA), and stent shape (symmetry and eccentricity) post-implant.MethodsThis post-hoc analysis evaluated patients from the VIVO US Study (NCT01970007) with pre- and post-stent intravascular ultrasound (IVUS) imaging. Patient characteristics, Venous Clinical Severity Score (VCSS) and Venous Disability Score (VDS) were collected in the study. LD, LA, and stent geometry were measured by the core laboratory. Data were analyzed for linear association between core-laboratory assessed pre and post stent LD, LA, AR, stent eccentricity and symmetry index, and VCSS and VDS change.ResultsIVUS imaging was available for 29 patients (2 sites) enrolled in the VIVO US Study (55.2% women; mean age: 59.8 ± 17 years). The cohort had post-thrombotic (48.3%), nonthrombotic iliac vein lesion (44.8%) or acute deep vein thrombotic (6.9%) disease. Mean lesion length was 111.8 ± 60.9 mm. Eleven stents extended below the inguinal ligament. Median minimum LD and LA significantly increased after stent placement (<i>P</i> < 0.001); median lumen AR changed from 2.0 pre-stent to 1.4 post-stent (<i>P</i> < 0.001). Mean VCSS improved from baseline to 12 months (7.6 ± 4.3 to 3.7 ± 2.6). No statistically significant linear relationships were identified between VCSS / VDS change and a specific characteristic of LA, LD, or AR.ConclusionsMeasures of lumen change pre and post iliofemoral vein nitinol stent placement reflect disease and stent characteristics. After stent placement, minimum LD and LA increased and AR decreased. Stented lumen shape or size with Zilver Vena did not impact 1-year clinical improvement by VCSS.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"471-478"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451359","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 Alpha to Omega of Dialysis Access: Evaluation, Interventions, Innovations (Part 2).","authors":"Mohammad Ghasemi-Rad, Kelly Trinh, Mohadese Ahmadzade, Kevin Agahi, Xavier Jefferson, Carleigh Klusman, David Leon, David Wynne, Jie Cui","doi":"10.1177/15385744251326325","DOIUrl":"10.1177/15385744251326325","url":null,"abstract":"<p><p><b>Background:</b> End-stage kidney disease (ESKD) is a growing global health concern, significantly impacting patient morbidity and mortality, particularly among patients on hemodialysis. Vascular access remains a major challenge, often limiting the effectiveness of hemodialysis and requiring strategic planning to optimize outcomes. <b>Purpose:</b> This review examines the current evidence on vascular access for dialysis, with a focus on pre- and post-operative assessments, necessary interventions for complications, and innovations in vascular access materials and techniques. <b>Research Design:</b> This is a literature review analyzing existing studies, clinical trials and guidelines to evaluate the different vascular access options, interventions, and emerging technologies in dialysis access. <b>Results:</b> Findings highlight the importance of thorough preoperative assessment, including vascular imaging and patient-specific considerations, to optimize access placement. Postoperative assessments and early interventions are crucial in ensuring access longevity. Innovations such as drug-coated balloons, stent technologies, and biologically engineered grafts have improved patient outcomes and reduced complications. <b>Conclusion:</b> Strategic planning and advancements in vascular access technology play a critical role in improving dialysis efficiency and patient outcomes. Continued research and innovation are needed to refine vascular access techniques and address challenges associated with ESKD management.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"528-537"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635050","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":"Disparities in Aortic Aneurysm Mortality Trends: Revealing Sex and Racial Inequalities.","authors":"Masashi Azuma, Andrew Ramirez, G William Moser, Kenny J Oh, Mohammed Abul Kashem, Yoshiya Toyoda, Suyog Mokashi","doi":"10.1177/15385744251321621","DOIUrl":"10.1177/15385744251321621","url":null,"abstract":"<p><p>BackgroundAbdominal aortic dissection or aneurysm (AAA) is a significant health concern in developed nations often underdiagnosed with poor outcomes. Despite a decline in aortic dissection and aneurysm mortality rates in the US from 1999 to 2020, reported by the CDC, this improvement disproportionately favors males and Caucasians. This study aims to elucidate these disparities.MethodsData from the CDC Wonder database from 1999 to 2020 on aortic aneurysm, including abdominal, thoracic, and thoracoabdominal aneurysms and rupture related deaths in the US were analyzed. Mortality rates were compared across sex, race, and geographic location separated by state. Mortality was normalized based on population and analyzed with linear regression models with all plots showing goodness of fit.ResultsOverall, the mortality gap between male and female cohorts with aortic aneurysm-related deaths widened by 0.57 per 100,000 deaths per year (<i>P</i> < 0.001). Mortality between Caucasians with African American and Asian American cohorts showed reductions of 0.41 per 100,000 per year (<i>P</i> < 0.001). Caucasian and male cohorts started at higher mortality rates when compared to their competitive cohorts.ConclusionsDespite a reduction in mortality rates among individuals with aortic aneurysm in the US from 1999 to 2020, this decline disproportionately benefits males and Caucasians over African American and Asian populations. Although Caucasians and males had higher mortality in 1999, their decline is significantly greater. Following current trends, Caucasian and male mortalities will be lower than minority groups by 2026. Targeted interventions are needed to address these disparities effectively.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"464-470"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417129","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 Alpha to Omega of Dialysis Access: Arteriovenous Fistula and Graft (Part 1).","authors":"Mohammad Ghasemi-Rad, Kelly Trinh, Mohadese Ahmadzade, Kevin Agahi, Xavier Jefferson, Carleigh Klusman, David Leon, David Wynne, Jie Cui","doi":"10.1177/15385744251328396","DOIUrl":"10.1177/15385744251328396","url":null,"abstract":"<p><p><b>Background:</b> Vascular access is a critical determinant of hemodialysis efficacy in patients with end-stage kidney disease (ESKD). The choice between arteriovenous fistulas (AVFs) and arteriovenous grafts (AVGs) influences long-term dialysis outcomes, with AVFs offering superior patency but higher maturation failure rates and AVGs providing immediate usability at the expense of increased complications. Recent advancements in endovascular techniques and biomaterials have introduced novel approaches to optimizing vascular access. <b>Purpose:</b> This review examines the latest evidence on AVF and AVG creation, focusing on factors affecting maturation, long-term patency, and emerging minimally invasive techniques, such as percutaneous AVF creation, to enhance hemodialysis access outcomes. <b>Research Design:</b> A systematic review of current literature, clinical guidelines, and innovations in vascular access for dialysis patients was conducted. Emphasis was placed on comparative effectiveness studies, patency and complication rates, and new endovascular approaches. <b>Study Sample:</b> Data were sourced from clinical trials, registry reports, and systematic reviews evaluating AVF and AVG outcomes, as well as emerging endovascular fistula technologies. <b>Data Collection and/or Analysis:</b> Key parameters such as patency rates, infection rates, thrombosis incidence, and maturation success were analyzed. Particular attention was given to procedural innovations, including bioengineered grafts and percutaneous fistula creation, assessing their impact on long-term dialysis access viability. <b>Results:</b> AVFs maintain superior long-term patency but are hindered by primary failure rates, necessitating interventions for maturation. AVGs, while more prone to infection and thrombosis, offer a viable alternative when native vessels are unsuitable. Endovascular AVF creation has demonstrated high technical success and promising long-term outcomes, reducing the need for traditional surgical approaches. Advances in biomaterials and adjunctive pharmacologic therapies may further improve vascular access durability. <b>Conclusions:</b> Individualized vascular access planning remains essential to optimizing hemodialysis outcomes. The evolution of minimally invasive techniques, coupled with improved patient selection criteria and emerging biomaterials, offers new opportunities for enhancing dialysis access longevity. Future research should focus on refining endovascular approaches and integrating novel technologies to minimize complications and improve access patency.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"513-527"},"PeriodicalIF":0.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694979","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":"Three-Year Outcomes of Chronic Total Occlusion (CTO) versus Non-CTO Femoropopliteal Lesions Treated With Atherectomy Followed by Drug-Coated Balloon Angioplasty.","authors":"Haroon Kamran, Rohit Gokhale, Michael Halista, Anna Telegina, Zulfiya Bakirova, Anvar Babaev","doi":"10.1177/15385744251326976","DOIUrl":"10.1177/15385744251326976","url":null,"abstract":"<p><p>BackgroundEndovascular intervention of the femoropopliteal chronic total occlusions (CTOs) is technically challenging and associated with increased rates of treatment failure and complications. The long-term patency of CTOs of the femoropopliteal segment treated with contemporary tools, such as atherectomy and drug-eluting technology, is not well studied.MethodsWe performed a prospective, single-center analysis of 60 consecutive patients with femoropopliteal disease successfully treated with either directional or orbital atherectomy followed by paclitaxel drug-coated balloon (DCB). Endpoints of interest were freedom from restenosis and revascularization following atherectomy and DCB angioplasty. All patients underwent clinical and imaging evaluation for 3 years to identify evidence of target lesion restenosis (RS) and revascularization (TLR).ResultsThere were 26 patients with CTO and 34 patients with non-CTO lesions. Baseline demographic and clinical characteristics were similar between the CTO and non-CTO groups other than ankle-brachial indices (ABI, 0.73 ± 0.11 vs 0.88 ± 0.14, <i>P</i> < 0.001). Kaplan Meier (KM) analysis for freedom from RS and TLR at 3 years was similar among the 2 groups (log rank p; 0.42, 0.69 respectively). Post-procedure, all patients had improvement of claudication, normalization of ABI indexes and duplex ultrasound velocities.ConclusionFreedom from target lesion restenosis and revascularization at 3 years were similar between CTO and non-CTO lesions treated with atherectomy followed by DCB angioplasty. These findings underscore the importance of optimal vessel preparation to achieve improved patency regardless of lesion morphology.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"487-494"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627302","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 Use of Intravascular Ultrasound During Deep Venous Interventions in a Tertiary Care Center.","authors":"Sahar H Ali, Paula Pinto Rodriguez, Ehsan Abualanain, Ying Li, Mostafa S Khalil, Hesham Aboloyoun, Juan Carlos Perez Lozada, Edouard Aboian, Robert Attaran, Cassius Iyad Ochoa Chaar","doi":"10.1177/15385744251326989","DOIUrl":"10.1177/15385744251326989","url":null,"abstract":"<p><p>ObjectiveIntravascular ultrasound (IVUS) is the gold standard for diagnosing venous stenosis and sizing venous stents, yet its impact on thrombosis after deep venous interventions is not well-studied. This study evaluates the impact of IVUS on outcomes of lower extremity deep venous interventions, hypothesizing improved results with its use.MethodsThis retrospective study analyzed consecutive patients undergoing deep venous lower extremity interventions, dividing them into two groups based on IVUS use. Patient characteristics and outcomes, including primary patency and symptomatic improvement, were compared.ResultsAmong 185 patients (75.7% with IVUS), those without IVUS had higher rates of COPD (16% vs 5%; <i>P</i> = 0.045), chronic kidney disease (27% vs 5%; <i>P</i> < 0.001), and hypercoagulable state (47% vs 19%; <i>P</i> = 0.001). Non-IVUS patients more frequently presented with thrombotic disease (78% vs 40%; <i>P</i> < 0.001), while IVUS patients were more likely to have edema (41% vs 31%; <i>P</i> = 0.04) and receive stenting (92% vs 44%; <i>P</i> < 0.001). Wallstent was the most commonly used stent in both groups. IVUS patients achieved higher technical success (99% vs 82%; <i>P</i> < 0.001) and had fewer 30-day complications (7% vs 20%; <i>P</i> = 0.022). Over a mean follow-up of 3.5 years, IVUS use was associated with greater symptom relief (50% vs 41%; <i>P</i> < 0.001) and higher primary patency rates (83% vs 53%; <i>P</i> < 0.001). Regression analysis showed that age, prior anticoagulant use, and thrombolysis were significantly associated with loss of patency, while IVUS showed a trend toward decreased loss of patency (HR = 0.6; <i>P</i> = 0.244).ConclusionIVUS use during deep venous interventions is associated with fewer complications and improved primary patency rates, suggesting its utility in enhancing patient outcomes when complementing multiplanar venography.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"505-512"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653036","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}