Vascular and endovascular surgery最新文献

{"title":"A Systematic Review of Interventions Designed to Reduce Surgical Site Infection in Patients Who Undergo Transmetatarsal Amputation.","authors":"Rebecca Jess, Kieran Das, Lakna Harindi Alawattegama, Nina Al-Saadi, David Bosanquet, Ian Chetter, Ismay Fabre, Andrew Garnham, Brenig Gwilym, Louise Hitchman, Terry Hughes, Judith Long, Laura Magill, Thomas Pinkney, Matthew Popplewell, Michael Wall","doi":"10.1177/15385744261421787","DOIUrl":"10.1177/15385744261421787","url":null,"abstract":"<p><p>IntroductionSurgical site infection (SSI) following transmetatarsal amputation (TMA) is thought to be common. In patients who have peripheral arterial disease (PAD) or diabetes related foot complications, little is known regarding the effectiveness of interventions designed to reduce SSI following TMA. Our aim was to perform a systematic review of the literature to inform practice and highlight areas that warrant further research to reduce SSI post TMA.MethodsThis review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance and was prospectively registered with the International Prospective Register of Systematic Reviews (CRD4202454958). MEDLINE, EMBASE and Cochrane databases were searched using a predefined search strategy, without date restriction. All randomised controlled trials (RCTs) and observational studies including patients that underwent TMA due to PAD or complications of diabetes related foot disease, with at least 1 intervention designed to promote wound healing or reduce SSI were included. Bias was assessed using the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale.ResultsThe initial search identified 445 papers. Two RCTs and three observational studies, reporting on 378 TMAs and four interventions, were included. The effect of post-operative antibiotic use on the incidence of SSI differed between the studies. The use of antibiotic-impregnated beads embedded within the soft tissues prior to wound closure were associated with a reduction in SSI rate. The use of Negative Pressure Wound Therapy (NPWT) was associated with a reduction in SSI incidence and faster wound healing. No significant difference was identified in the incidence of SSI between different skin preparations.ConclusionData regarding interventions to prevent SSI following TMA are sparse in the current literature. Prolonged post-operative antibiotic use could reduce SSI, while NPWT and antibiotic beads may be beneficial to wound healing. However, larger more robust RCTs are required to confirm these findings.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"411-419"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146095433","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":"Outcomes of In-Situ Reconstruction of Secondary Aorto-Enteric Fistulas.","authors":"Josip Figl, Dino Papes","doi":"10.1177/15385744261428765","DOIUrl":"10.1177/15385744261428765","url":null,"abstract":"<p><p>Background and PurposeSecondary aorto-enteric fistulas (SAEF) are the most severe form of aortic graft infection, with a mortality of over 50% during the first year after diagnosis.Materials and MethodsA retrospective review of patients treated for SAEF from 2015 to 2021 in University Hospital Centre Zagreb was done to analyze factors that determine the outcome. There were 7 cases of SAEF among 400 cases of open aortic surgery. Mean patient age was 69 years (range 63-88).ResultsFive patients underwent graft removal and in-situ aortic reconstruction using a cryopreserved homograft or a prosthetic Dacron silver graft (Vascutec Gelsoft Plus, Terumo, Tokyo, Japan). In 1 patient direct suture repair of the fistula was done, and the patient underwent recurrent SAEF reconstruction with cryopreserved homograft a year later. There were 3 recurrences of SAEF in 2 patients, 1 case of disruption of the duodenal suture line, and 1 case of cryopreserved graft necrosis and rupture necessitating emergency extra-anatomic bypass. Overall, 1 patient died during surgery (in-hospital mortality 1/7, 15%), and 3 patients are currently alive (follow-up 4-5 years). Overall 1-month survival, 1-year survival and 3-year-survival were 6/7 (85%). All patients received antibiotics for 6 weeks postoperatively.ConclusionThere is no unique, the best, treatment modality proven in the literature for SAEF, so every case should be analyzed for itself. Prolonged antibiotic therapy, complications and re-interventions are common among these patients, so meticulous follow-up is necessary.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"429-434"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222664","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":"From Scores to Scholarship: Evolving Metrics in Vascular Surgery Residency Admissions.","authors":"Ismail Zazay, James R Burmeister, Jose I Ortiz De Elguea-Lizarraga, Lily Cormier, Annie Cherner, Mitchell Cox","doi":"10.1177/15385744251410008","DOIUrl":"10.1177/15385744251410008","url":null,"abstract":"<p><p>BackgroundIn 2022, the United States Medical Licensing Examination (USMLE) Step 1 transitioned to a pass/fail format, removing a long-standing objective measure from residency applications. This shift led applicants and/or residency program directors to place increased emphasis on alternative metrics such as research output (RO), though how much programs value this remains unclear. This study explores RO trends among vascular surgery applicants from 2014-2024 and compares them by applicant type and across other competitive surgical specialties.MethodsNRMP Charting Outcomes in the Match reports (2014-2024) were reviewed. The mean number of abstracts, presentations, and peer-reviewed publications (RO) was collected for matched and unmatched U.S. MD seniors applying to vascular surgery. RO data for Doctor of Osteopathic Medicine (DO) and non-U.S. international medical graduate (IMG) applicants were also reviewed for completeness.ResultsRO among matched U.S. MD vascular surgery applicants rose by 54.7%, from 7.0 in 2014 to 12.8 in 2024. The most marked increase occurred between 2018 and 2022 (8.3 to 12.4; +67%), with growth plateauing thereafter after 2022. In contrast, RO among matched DO and IMG applicants declined: DO applicants dropped from 21.3 in 2022 to 9.0 in 2024, and IMG applicants from 60.3 in 2020 to 38.3 in 2024. However, 2024 sample sizes were small, 137 matched U.S. MDs vs only 3 DOs and 6 IMGs, limiting direct comparisons.ConclusionWhile RO among vascular surgery applicants surged after Step 1 became pass/fail, the recent plateau suggests a transient response rather than ongoing growth, differing from trends in other surgical subspecialties. These findings raise concerns about equity and added pressure on underrepresented applicants. Further research is needed to clarify RO's actual role in residency selection and inform fairer evaluation practices.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"462-466"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Different Machine Learning Methods in Prediction of Long-Term Survival After Endovascular Aneurysm Repair.","authors":"Toshiya Nishibe, Tsuyoshi Iwasa, Namie Toda, Shinobu Akiyama, Masaki Kano, Akinari Iwahori, Shoji Fukuda, Jun Koizumi, Masayasu Nishibe","doi":"10.1177/15385744251410022","DOIUrl":"10.1177/15385744251410022","url":null,"abstract":"<p><p>PurposeLong-term survival after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm remains a clinical concern, particularly in elderly patients with comorbidities. This study aimed to compare different machine learning (ML) models that capture complex, nonlinear relationships among clinical variables to predict 5-year all-cause mortality following EVAR.MethodsWe retrospectively analyzed 142 patients who underwent elective EVAR between 2013 and 2018. Predictive models for 5-year mortality were developed using 3 supervised ML algorithms: Random Forest (RF), Extreme Gradient Boosting (XGBoost), and Support Vector Classification (SVC). Each model was trained on the entire dataset and internally validated through 5-fold cross-validation. Model performance was evaluated using accuracy, sensitivity, specificity, precision, F1 score, and area under the curve (AUC) based on the training set and 5-fold cross-validation. Feature importance was assessed for RF and XGBoost.ResultsThe RF demonstrated the most consistent performance (training AUC 0.80; cross-validation AUC 0.77 ± 0.07). XGBoost achieved the highest training accuracy (0.85) but had lower cross-validation AUC (0.68 ± 0.05). SVC showed stable but modest performance. Key predictors identified by RF and XGBoost included poor nutritional status, octogenarian status, compromised immunity, and active cancer.ConclusionsTree-based ML models, especially RF, may effectively predict long-term survival after EVAR. Incorporating key clinical predictors into preoperative assessment may enhance risk stratification. Future studies should explore external validation and integration with time-to-event models such as Cox proportional hazards, to enhance prognostic accuracy.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"404-410"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812610","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":"A New Technique Using a Stent and a Plug for the Management of Persistent Type IIIc Endoleak Following Fenestrated Endovascular Aortic Repair (FEVAR).","authors":"Mohammad Alsarayreh, Mark A Farber, Federico Ezequiel Parodi","doi":"10.1177/15385744261424745","DOIUrl":"10.1177/15385744261424745","url":null,"abstract":"<p><p>Fenestrated endovascular repair (FEVAR) has become a safe and effective option for the treatment of complex aortic aneurysms (CAA). Complications can occur, including endoleaks like type IIIc endoleak, characterized by flow between a fenestration and its bridging stent. Although some endoleaks may resolve spontaneously, most require secondary interventions to prevent further expansion of the aneurysmal sac and other complications. We describe a percutaneous \"stent-and-plug\" rescue maneuver performed in 5 consecutive patients with refractory type IIIc endoleaks after company-manufactured FEVAR grafts. Under moderate sedation and bilateral femoral access, the target-vessel stent was balloon-protected while the free space of the fenestration causing the endoleak was catheterized contralaterally; a 5 × 16 mm iCast™ stent was deployed within the fenestration, and an Amplatzer vascular plug was positioned inside the new stent. Then, the renal-stent balloon was re-inflated to crush the stent-plug complex and achieve a seal in the fenestration. Endoleaks emerged at a mean of 2.47 months (range 1.10-7.1) after the index repair, persisting despite one (n = 3) or 2 (n = 2) prior angioplasty or re-stenting attempts. The stent-and-plug technique achieved technical success in 4 of the 5 cases; the remaining case required one additional procedure to achieve complete sealing. No renal branch occlusion, dialysis-requiring renal injury, or procedure-related mortality occurred. The mean follow-up after rescue was 8.96 months (range 1.4-15.3), with no sac growth observed. Stenting and plugging the fenestration-free space offers a feasible option for treating persistent type IIIc endoleaks when conventional secondary interventions fail; extended surveillance is necessary to confirm long-term durability.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"457-461"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Outcomes of Carotid Endarterectomy and Carotid Artery Stenting: A Single-Center Experience.","authors":"Muhammet Cihat Çelik, Ayla Ece Çelikten, Abdullah Kadir Dolu, Görkem Yiğit, Ufuk Türkmen, Ömer Burak Çelik, Ceren Yağmur Doğru Yılmaz, Macit Kalçık, Mücahit Yetim, Lütfü Bekar, Yusuf Karavelioğlu","doi":"10.1177/15385744261423761","DOIUrl":"10.1177/15385744261423761","url":null,"abstract":"<p><p>BackgroundCarotid endarterectomy (CEA) is recommended as the standard revascularization strategy for patients with carotid stenosis, whereas carotid artery stenting (CAS) is generally reserved for high-risk surgical candidates. However, evidence comparing the safety and efficacy of both approaches in real-world practice remains heterogeneous.MethodsWe retrospectively analyzed 202 patients (mean age: 71.1 ± 8.5 years; 152 males, 75.2%) who underwent carotid revascularization at a single center between October 2016 and April 2025. Patients with symptomatic moderate-to-severe stenosis (50-99%) and asymptomatic severe stenosis (70-99%) were included. Based on the revascularization strategy, patients were divided into CEA (n = 67) and CAS (n = 135) groups. Periprocedural (30-day), 1 and 3-year outcomes including stroke, myocardial infarction (MI), and all-cause mortality were evaluated.ResultsAmong patients, periprocedural stroke occurred in 4.5% of CEA patients and 2.2% of CAS patients (<i>P</i> = 0.653), MI in 1.5% and 0%, (<i>P</i> = 0.720), and all-cause mortality in 4.5% and 0.7% (<i>P</i> = 0.208) respectively. At 1-year follow-up, MI was significantly more frequent after CEA compared with CAS (8.6% vs 1.5%, <i>P</i> = 0.029), whereas stroke (8.6% vs 5.3%, <i>P</i> = 0.387) and all-cause mortality (10.3% vs 12.9%, <i>P</i> = 0.622) did not differ significantly. At 3 years, rates of stroke (12.3% vs 5.3%), MI (10.3% vs 3.8%), and all-cause mortality (22.4% vs 15.9%) were numerically higher in the CEA group, although these differences were not statistically significant. Subgroup analyses according to symptomatic status demonstrated no significant differences in 30-day, 1 or 3-year rates of stroke, MI, or all-cause mortality between the CEA and CAS groups.ConclusionIn this single-center experience, CAS achieved peri-procedural and short-term outcomes comparable to CEA, despite being performed in a more frail and comorbid patient population. These findings suggest that CAS may represent a safe and effective alternative to CEA in high-risk surgical candidates when performed by experienced operators within a multidisciplinary framework.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"420-428"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146128108","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":"Novel Use of Lysis-Assisted Covered Endovascular Reconstruction of the Aortic Bifurcation (LA CERAB) in Acute Aortobiiliac Graft Thrombosis: A Case Report.","authors":"Ajibola O Anifowose, Aneet Mann, Harneil Sidhu, Matt Cwinn","doi":"10.1177/15385744251409967","DOIUrl":"10.1177/15385744251409967","url":null,"abstract":"<p><p>IntroductionAcute aortic occlusion (AAO) is a rare, life-threatening condition presenting with severe ischemia and requiring urgent intervention. While traditional open surgical approaches, including aortobifemoral and axillobifemoral bypasses, are well-established, endovascular techniques such as Covered Endovascular Reconstruction of the Aortic Bifurcation (CERAB) have emerged as promising alternatives in select cases. This case introduces a novel modification termed Lysis Assisted CERAB (LA CERAB), combining thrombolysis and CERAB to manage acute graft occlusions.MethodsSingle-institution case report highlighting the utility of the LA CERAB technique in select patients.ResultsA 67-year-old male presented two years post-open aortobiiliac aneurysm repair with acute abdominal pain and bilateral limb ischemia without motor impairment. Initial CTA demonstrated complete thrombosis of his graft. He underwent percutaneous bilateral transfemoral catheter-directed thrombolysis. Post-thrombolysis angiography showed graft patency but significant residual thrombus. Subsequent LA CERAB successfully re-lined the graft, secured residual thrombus, and restored perfusion. The patient had an uneventful recovery, discharged home on therapeutic anticoagulation. Follow-up CTA at 2 months demonstrated sustained graft patency. This case highlights its applicability to acute presentations and adds to a growing body of literature on acute aortic graft occlusion interventions.ConclusionThe LA CERAB technique can serve as a novel, minimally invasive approach for select AAO patients presenting with high morbidity risks for transition open surgery. This case underscores patient-specific considerations in treatment strategy selection, illustrating how individualized surgical approaches can achieve favorable immediate and sustained clinical outcomes for future patients.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"435-441"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors of Poststroke Cognitive Impairment: A Meta-Analysis.","authors":"Jinyu Wang, Guangyu Cheng, Yuanyuan Yang, Weiping Cheng","doi":"10.1177/15385744241259700","DOIUrl":"10.1177/15385744241259700","url":null,"abstract":"<p><p>ObjectiveTo explore the potential risk factors of post stroke cognitive impairment (PSCI) by conducting a meta-analysis.MethodsLiterature search was performed in databases (PubMed, Embase, Web of Science, CNKI) using keywords of PSCI. Cochrane ROB tool was adopted for evaluating the quality of the included studies. Afterwards, data was independently extracted by 2 investigators. Heterogeneity was quantified across studies by Chi-squared-based Q statistic test and I² statistic. The random-effects model or fixed-effects model was employed to compute the pooled estimates depends on whether the heterogeneity was significant (I² > 50% or <i>P</i> < .05) or not. Publication bias was evaluated by the funnel plot and Egger's test. Sensitivity analysis was accomplished through eliminating studies 1 at a time to evaluate the stability of the pooled estimates.Results23 high-quality studies with 13322 patients were included. Compared with patients with no cognitive impairment, PSCI was more likely to develop in the elderly (pooled MD = 3.58, 95% CI = [1.82, 5.34]), female (pooled RR = 1.23, 95% CI = [1.07, 1.41]), or less-educated (pooled MD = -1.63, 95% CI = [-2.96, -.31]) patients with a history of hypertension (pooled RR = 1.07, 95% CI = [1.03, 1.11]), diabetes mellitus (pooled RR = 1.10, 95% CI = [1.03, 1.17]), atrial fibrillation (pooled RR = 1.38, 95% CI = [1.10, 1.74]), or stroke (pooled RR = 1.36, 95% CI = [1.09, 1.70]). Smoking did not affect the development of PSCI in patients (pooled RR = .96, 95% CI = [.78, 1.19]). Ischemic heart disease and region represented the sources of significant heterogeneity across studies. The pooled estimates were robust, and no publication bias was seen.ConclusionAge, gender, education, hypertension, diabetes mellitus, atrial fibrillation, and stroke were the risk factors of PSCI. Controlling these risk factors can help prevent PSCI.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"389-396"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736273","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":"Long Term Outcomes of TEVAR for Blunt Thoracic Aortic Injury.","authors":"Mohineesh Kumar, Mackenzie Madison, Tara Zielke, Robert Brenner, Hanaa Aridi, Joel Corvera, Andres Fajardo, Raghu L Motaganahalli","doi":"10.1177/15385744251409962","DOIUrl":"10.1177/15385744251409962","url":null,"abstract":"<p><p>ObjectivesThoracic Endovascular Aortic Repair (TEVAR) is now the standard of care for management of aortic injury from trauma. Long term outcomes stratified by the severity of the aortic injury are limited.MethodsThis is a single center retrospective analysis of all patients undergoing TEVAR for trauma between January 2008-November 2023. Long term outcomes of mortality and re-intervention were stratified and compared based on the blunt thoracic aortic injury score. Kaplan Meier analysis was used to compute one year and 5-year survival.ResultsA total of 104 patients (age 42 ± 15 years; 72 males; 69%) underwent TEVAR for trauma. Most repairs were for grade 3 (59 patients, 57%) or grade 4 (30 patients, 29%) blunt aortic injuries. The remaining patients included grade 1 (1 patient, 1%), grade 2 (14 patients; 13%). Grade 4 injuries were not associated with higher rate of concomitant neurologic injuries (<i>P</i> = 0.33) or death (<i>P</i> = 0.74). Eighty-seven percent patients had a mean follow up of 4.2 ± 3.3 years. Two patients died due to aortic related causes within 30 days (intra-operative hemorrhage in one patient, graft collapse in one patient who had an unsuccessful exploratory thoracotomy). Overall, one year survival was 92%, and 5-year survival was 88% by Kaplan Meier analysis. Patients with neurologic injury trended toward higher mortality in Kaplan Meier analysis but this was not statistically significant (log rank = 0.22). The grade of injury was not significant for long term survival (log rank = 0.81). Early reintervention was required in 2% patients with none required in long-term. Age>40 (<i>P</i> = 0.17), female sex (<i>P</i> = 0.34) and graft diameter>26 mm (<i>P</i> = 0.41) were not significant for re-intervention. None of the patients experienced endoleaks or spinal cord ischemia.ConclusionsTEVAR is a durable repair for patients with BTAI requiring no re-intervention after one year follow-up. CT surveillance of TEVAR in setting of trauma should be limited to 1 and 5 years after surgery. Long term survival is not related to severity of BTAI.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"397-403"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145859708","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":"Staged Fenestrated Endovascular Aneurysm Repair Using Femoral Conduits in a Patient with Aortoiliac Occlusive Disease and Contemporary Literature Review.","authors":"David L Coffman, Houssam Farres, Biraaj M Mahajan, Yaman Alsabbagh, Christopher Jacobs, Camilo Polania-Sandoval, Young M Erben","doi":"10.1177/15385744251409992","DOIUrl":"10.1177/15385744251409992","url":null,"abstract":"<p><p><b>Background:</b> Patients with abdominal aortic aneurysms (AAA) often have comorbidities that make them poor candidates for open surgical repair (OSR). Endovascular aortic aneurysm repair (EVAR) circumvents the morbidity associated with OSR of AAA. Candidacy for EVAR is impacted by multiple factors, including the quality and size of vascular access vessels and involvement of visceral arteries, as seen in paravisceral abdominal aortic aneurysms (PVAAA). Additional challenges, such as obesity, can complicate vascular access during EVAR. PVAAA may be better suited for fenestrated EVAR (FEVAR) using a physician-modified endograft (PMEG).<b>Materials and Methods:</b> In this report, we describe the case of a 64-year-old female patient with a complex PVAAA in the setting of significant aortoiliac occlusive disease (AIOD) with intermittent claudication. We describe a successful staged FEVAR technique in which vascular access challenges were first addressed by recanalization of the iliac system with femoral conduit (FC) creation, followed by successful FEVAR using bilateral FC for deployment of the PMEG.<b>Conclusion:</b> Patients with PAAA have unique and complex pathology that are clinically challenging to address. It is not uncommon that these patients also have co-morbid conditions that make them less-than ideal candidates for open repair. Patients may also have other conditions such as AIOD which make EVAR complex. Staged approach with iliac recanalization and femoral conduit creation followed by FEVAR with PMEG is an effective treatment option for high-risk complex patients and can help avoid common complications such as groin infection and delay in FEVAR which may result in a catastrophic event such as interval AAA rupture.</p>","PeriodicalId":94265,"journal":{"name":"Vascular and endovascular surgery","volume":" ","pages":"442-449"},"PeriodicalIF":0.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812584","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}