Vascular and endovascular surgery最新文献

{"title":"Enhancing Routine Reporting of IVC Filters: An Interventionalist's Approach to Improving Patient Safety in an Underserved Urban Area.","authors":"Muhammad U Shahid, Vishaal Kondoor, Neel Nirgudkar, Owen Gantz, Paul Ippolito, Pratik Shukla, Abhishek Kumar","doi":"10.1177/15385744251330080","DOIUrl":"https://doi.org/10.1177/15385744251330080","url":null,"abstract":"<p><p>PurposeTo determine whether concurrent reporting and follow-up on diagnostic imaging could be used as an effective tool to raise IVC filter (IVCF) awareness in an underserved urban community. <b>Methods:</b> For this prospective study, radiologists at our institution flagged plain-film and cross-sectional imaging in which an IVCF was identified from October 2018 to October 2019. For consent, a phone survey was conducted to assess the patient's knowledge and understanding related to IVC filter placement. Key data points on the survey included patients' awareness of filter presence, placement date, location, difference between filters, satisfaction regarding peri-procedural education, and plan for filter removal. Patients desiring further information were scheduled for follow-up in the Vascular Interventional Radiology clinic. <b>Results:</b> 77 patients were identified with an IVC filter. 34 patients (15 males, 19 females; mean age 56y +/- 13.6 years) consented. 23.5% were unaware of their IVC filter. Of those aware, 61.5% were dissatisfied with their consultation/education during placement and 88% pursued further IR consultation indicating a desire to consult a clinician regarding their filter. During the study, 8 patients with IVCF (23.5%) were deemed no longer medically necessary; 6 underwent retrieval and 2 were pending at study conclusion. <b>Conclusion:</b> In underserved urban communities, patients with indwelling IVC filters may not have received appropriate follow-up instructions regarding filter retrieval or may be unaware they have one altogether. Diagnostic imaging is an effective tool to identify these patients, raise awareness, and improve retrieval of filters that are no longer indicated.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251330080"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712423","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":"https://doi.org/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":"15385744251328396"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","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":"Predicting Long-Term Survival after Endovascular Aneurysm Repair Using Machine Learning-Based Decision Tree Analysis.","authors":"Toshiya Nishibe, Tsuyoshi Iwasa, Masaki Kano, Shinobu Akiyama, Shoji Fukuda, Jun Koizumi, Masayasu Nishibe","doi":"10.1177/15385744251329673","DOIUrl":"https://doi.org/10.1177/15385744251329673","url":null,"abstract":"<p><p>ObjectiveEndovascular aneurysm repair (EVAR) has become a preferred method for treating abdominal aortic aneurysms (AAA) due to its minimally invasive approach. However, identifying factors that influence long-term patient outcomes is crucial for improving prognosis. This study investigates whether machine learning (ML)-based decision tree analysis (DTA) can predict long-term survival (over 5 years postoperatively) by uncovering complex patterns in patient data.MethodsWe retrospectively analyzed data from 142 patients who underwent elective EVAR for AAA at Tokyo Medical University Hospital between October 2013 and July 2018. The dataset comprised 24 variables, including age, gender, nutritional status, comorbidities, and surgical details. The decision tree classifier was developed and validated using Python 3.7 and the scikit-learn toolkit.ResultsDTA identified poor nutritional status as the most significant predictor, followed by compromised immunity, active cancer, octogenarians, chronic kidney disease, and chronic obstructive pulmonary disease. The decision tree identified 9 terminal nodes with probabilities of long-term survival. Four of these terminal nodes represented groups of patients with a high probability of long-term survival: 100%, 84%, 77%, and 60%, whereas the other 5 terminal nodes represented groups of patients with a low probability of long-term survival: 17%, 25%, 30%, 45%, and 47%. The model achieved a moderately high accuracy of 76.1%, specificity of 72.4%, sensitivity of 81.8%, precision of 65.2%, and area under the receiver operating characteristic curve of 0.84.ConclusionML-based DTA effectively predicts long-term survival after EVAR, highlighting the importance of comprehensive preoperative assessments and personalized management strategies to improve patient outcomes.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251329673"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694978","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":"Hospital Volume and Social Determinants of Health Do Not Impact Outcomes in Fenestrated Visceral Segment Endovascular Aortic Repair for Patients Treated at VQI Centers.","authors":"Ruojia Debbie Li, Rylie O'Meara, Priya Rao, Ian Kang, Michael C Soult, Carlos F Bechara, Matthew Blecha","doi":"10.1177/15385744251330017","DOIUrl":"https://doi.org/10.1177/15385744251330017","url":null,"abstract":"&lt;p&gt;&lt;p&gt;ObjectiveThe purpose of this study is to investigate the impact of social determinants of health on access to high volume centers and clinical outcomes in fenestrated abdominal aortic endografting. Further, the effect of center volume in fenestrated endografting on outcomes will be sought as this is ill defined. The data herein have the potential to affect referral patterns and locations of complex fenestrated aortic aneurysm care. If lower volume centers achieve equivalent outcomes to higher volume centers, then limiting access to a small number of centers may not be justified.MethodsVascular Quality Initiative (VQI) was utilized as the data source. Four adverse outcomes categories were investigated : (1) Lack of follow up data in the VQI database at 1 year postoperatively; (2) Thirty day operative mortality; (3) Composite perioperative adverse event outcome; and (4) Twelve month mortality. Social determinants of health exposure variables included rural status, non-metropolitan living area, highest and lowest decile and quintile area deprivation index, insurance status, and non-home living status. Designated categories were created for patients operated on in centers within the top 25% of case volume, centers in the bottom 25% of case volume, and in centers with less than 10 total fenestrated endograft cases. Univariable analyses were performed with Chi-squared testing for categorical variables and &lt;i&gt;t&lt;/i&gt; test for comparison of means. Multivariable binary logistic regression was performed to identify risks for the composite adverse perioperative event.ResultsThere was no statistically significant association with the composite adverse perioperative event category, 30-day mortality or 12-month mortality for any of the social determinants of health or center volume categories. Patients who live in rural areas (&lt;i&gt;P&lt;/i&gt; = .029) and patients with Military/VA insurance (&lt;i&gt;P&lt;/i&gt; &lt; .001) were significantly more likely to be lost to follow up at their index VQI center at 1 year. When accounting for all standard co-morbidities, none of the following variables had any significant association with the composite adverse perioperative event on multivariable analysis: absolute center volume as an ordinal variable (&lt;i&gt;P&lt;/i&gt; = .985); procedure at a bottom 25&lt;sup&gt;th&lt;/sup&gt; percentile volume center (&lt;i&gt;P&lt;/i&gt; = .214); procedure at a center with less than 10 total fenestrated cases in the database (&lt;i&gt;P&lt;/i&gt; = .521); rural home status (&lt;i&gt;P&lt;/i&gt; = .622); remote from metropolitan home status (&lt;i&gt;P&lt;/i&gt; = .619); highest 10% ADI (&lt;i&gt;P&lt;/i&gt; = .903); highest 20% ADI (&lt;i&gt;P&lt;/i&gt; = .219); Lowest 10% of ADI (&lt;i&gt;P&lt;/i&gt; = .397). The variables that had a statistically significant multivariable association with the composite adverse event were 3 or 4 visceral vessels stented vs 2 vessels (&lt;i&gt;P&lt;/i&gt; &lt; .001), baseline renal insufficiency (&lt;i&gt;P&lt;/i&gt; &lt; .001), female sex (&lt;i&gt;P&lt;/i&gt; &lt; .001), ESRD on dialysis (&lt;i&gt;P&lt;/i&gt; = .002), and history of coronary revasculizaiton (&lt;i&gt;P&lt;/i&gt; = .047).","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251330017"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701530","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":"Iliac Artery Occlusion Following Iliac Vein Recanalization and Stenting in Two Patients.","authors":"Thomas Pennix, Zayed Metwalli, Peiman Habibollahi","doi":"10.1177/15385744251327018","DOIUrl":"https://doi.org/10.1177/15385744251327018","url":null,"abstract":"<p><p>Ileocaval venous thrombosis and outflow obstruction is a condition with many possible causes that typically presents with symptoms related to venous congestion or insufficiency. Recent device development and availability of endovascular stenting and venoplasty for lifestyle-limiting symptoms refractory to conservative management has led to increased interest in these procedures. While several common complications of venous stent placement have been well-described, 1 uncommon and emergent complication is nearby arterial compression or occlusion. Here we present 2 cases of iliac artery occlusion occurring after iliac venous recanalization and stenting, and discuss possible factors that may contribute to this uncommon complication.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251327018"},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675137","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":"Single Center Experience of Isolated Mechanical Thrombectomy and Thromboaspiration in Cancer-Related Acute Iliofemoral Deep Vein Thrombosis.","authors":"Görkem Yiğit","doi":"10.1177/15385744251329735","DOIUrl":"https://doi.org/10.1177/15385744251329735","url":null,"abstract":"<p><p>IntroductionIliofemoral deep vein thrombosis (IFDVT) and subsequent pulmonary embolism (PE) are an crucial cause of mortality in cancer patients. There is a lack of evidence on the results of mechanical thrombectomy and thromboaspiration (MTT) procedures performed on cancer patients. The aim of this research was to assess safety, efficacy, and clinical outcomes following MTT for cancer-related IFDVT patients.MethodsFrom July 2020 and April 2022, a total of 14 active cancer patients with symptomatic acute IFDVT were managed with MTT with Mantis device. Primary outcomes included overall survival, venous patency, major bleeding and minor bleeding. Secondary outcomes included duration in intensive care unit and hospital stay, complications, bleeding events, reocclusion and reintervention rates.ResultsIn twelve patients (85.7%), a significant early clinical improvement was found. Median intensive care unit (ICU) stay was 1 (range, 1-4) days, while the median hospital stay was 4 (range, 3-10) days. Recurrence of IFDVT was observed in 14.3% of cases (n = 2) in the study group. No re-intervention was performed in these patients. The overall survival for the study cohort was 85.7% at 6 months, and 71.4% at 12 months. Venous patency rate at 12-month follow-up control was 64.3%. There was a significant decrease in Villalta scores following the procedures (<i>P</i> < 0.0001). The overall procedural complication rate was 28.6%.ConclusionIn cancer patients, MTT promises to be a reliable and successful treatment for IFDVT considering the dramatic early symptomatic improvement, low reocclusion rates, acceptable procedure-related major complications, satisfactory patency rates, and improved patient quality of life.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251329735"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672160","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":"https://doi.org/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":"15385744251326989"},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","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}

{"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":"https://doi.org/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":"15385744251326325"},"PeriodicalIF":0.0,"publicationDate":"2025-03-15","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":"Endovenous Treatment for Great Saphenous Vein Insufficiency: A Comparative Study of Segmental Radiofrequency and 1470-nm Endovenous Laser.","authors":"Márcio Gomes Filippo, Leonardo de Oliveira Harduin, Thiago Almeida Barroso, Leonardo Cortizo de Almeida, Alberto Schanaider, Gaudencio Espinosa","doi":"10.1177/15385744251327014","DOIUrl":"https://doi.org/10.1177/15385744251327014","url":null,"abstract":"<p><p>PurposeThis study aims to evaluate recovery time, patient-centric postoperative outcomes, and the efficacy of endovenous laser ablation (LA) and radiofrequency ablation (RFA) in treating venous insufficiency associated with great saphenous vein (GSV) reflux.MethodsIn this single-center, self-paired, randomized trial, 16 limbs from 8 patients with symptomatic bilateral GSV insufficiency were treated. LA was performed on one lower limb, and after 40 days, the contralateral limb was treated with RFA. For LA, we used a 1470-nm endolaser with radial fiber, and for RFA, the VNUS ClosureFast™ system. All patients were followed with clinical, radiological, and laboratory evaluations for 6 months postoperatively.ResultsBoth techniques showed similar postoperative pain scores, number of complications, time to return to work, and patient satisfaction scores. LA and RFA decreased the mean Venous Clinical Severity Score by the end of the study and achieved a 100% vein occlusion rate, along with a reduction in GSV size. Procedure time was significantly shorter with LA.ConclusionLA and RFA demonstrated similar recovery profiles, pain levels, and patient satisfaction outcomes, maintaining high efficacy in resolving venous insufficiency associated with GSV reflux.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"15385744251327014"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617943","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":"https://doi.org/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":"15385744251326976"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","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}