Long term safety and effectiveness of the TREO stent graft for the endovascular treatment of infrarenal abdominal aortic aneurysms.

Objective: Report on the long-term safety and effectiveness of the TREO stent graft in endovascular repair of AAA from a US investigational device clinical study.

Methods: Data from a multicenter, nonrandomized, prospective, US investigational device exemption pivotal study (NCT02009644) were used. From November 2013 to February 2016, 150 patients were enrolled at 29 US centers.

The Association of Repair Timing on Outcomes following Thoracic Endovascular Aortic Repair for Intramural Hematoma.

Objective: Intramural hematoma (IMH) carries significant risk of morbidity and mortality, and although thoracic endovascular aortic repair (TEVAR) is increasingly utilized as a treatment, the optimal timing for its intervention remains uncertain. This study aims to compare outcomes between patients undergoing urgent TEVAR (within 24 hours of admission) and those receiving elective TEVAR (beyond 24 hours from admission).

Methods: Patients who underwent TEVAR between aortic zones 2 and 5 for IMH from 2013 to 2023 were included, excluding those with rupture.

Intra-aortic balloon pump rupture and metallic frame entrapment requiring complex retrieval and hybrid repair.

A 50-year-old woman required an emergent operative exploration after an unsuccessful attempt at bedside removal of a ruptured intra-aortic balloon pump (IABP). Initial fluoroscopy demonstrated that the IABP tip moved dynamically with blood flow, but retraction and advancement caused significant bowing of the proximal external iliac artery. After unsuccessful endovascular snaring and resheathing, an exploratory laparotomy was required to remove the entrapped IABP via a longitudinal external iliac arteriotomy.

Evaluation of Lipoprotein(a) as a Prognostic Marker of Extracoronary Atherosclerotic Vascular Disease Progression.

Background: Despite current treatment strategies for atherosclerotic vascular disease focusing on lifestyle modification and lowering cholesterol, a significant residual risk of major atherosclerotic complication remains, prompting investigation into lipoprotein(a) (Lp(a)) as a potential predictive biomarker. The objective of this study was to determine the usefulness of Lp(a) in identifying patients at high risk of incident extracoronary atherosclerotic vascular disease and complications.

Methods: Data from 460 544 participants in the UK Biobank with prospectively measured Lp(a) concentrations were included in this analysis.

A Novel FNDC1-NAMPT-NAD axis is Implicated in Small and Large-vessel Arterial Disease and Drives Vascular Calcification.

Vascular calcification represents a convergent pathological feature of diverse cardiovascular diseases, yet the upstream molecular programs orchestrating this process remain poorly defined. Here, we uncover 1 (FNDC1) as a previously unrecognized regulator of vascular calcification across both microvascular and macrovascular beds. Integrative transcriptomic profiling of human calciphylaxis lesions and atherosclerotic coronaries identified FNDC1 as one of the most significantly upregulated genes.

Aneurysm sac regression after fenestrated or branched endovascular aortic repair is associated with superior long-term survival.

Objective: Aneurysm sac behavior after fenestrated or branched endovascular repair (FB-EVAR) of thoracoabdominal aortic aneurysms (TAAAs) remains a key knowledge gap. The purpose of this study was to identify independent predictors of sac behavior after FB-EVAR and assess the relationship between sac behavior and long-term survival.

Methods: Patients undergoing FB-EVAR between 2005 and 2023, in 10 physician-sponsored investigational device exemption studies in the United States, were analyzed.

Outcomes following staged versus synchronous cervical debranching to optimize proximal landing zones for thoracic endovascular aortic repair of the aortic arch.

Objective: Cervical debranching was traditionally performed for occlusive disease of the proximal cervical branches of the aortic arch. However, as endovascular technology has evolved, cervical debranching is more commonly performed to optimize proximal landing zones for thoracic endovascular aortic repair (TEVAR). Cervical debranching and TEVAR can be performed in either a staged or synchronous fashion with little-to-no data regarding the optimal treatment strategy.

A case report of procedural management of an adult with morquio syndrome undergoing transcatheter aortic valve implantation.

Background: Morquio syndrome is an autosomal recessive deficiency of -acetylgalactosamine-6-sulphate, causing an accumulation of glycosaminoglycans that leads to musculoskeletal and cardiopulmonary abnormalities. We describe the management of aortic stenosis via a transcatheter aortic valve implantation (TAVI) in a patient with Morquio syndrome.

Case Summary: A 73-year-old woman with Morquio syndrome presented with one year of progressive dyspnoea and was found to have severe aortic stenosis on transthoracic echocardiogram.

Pilot study protocol for a novel perioperative mind-body intervention for peripheral vascular interventions.

Background: A novel mind-body intervention (MBI) targeting vascular surgery patients undergoing peripheral vascular interventions (PVIs) under procedural sedation and analgesia (PSA) was recently developed, but has yet to be clinically tested. An exploratory randomized controlled trial is planned to test the novel intervention in patients undergoing PVIs under PSA.

Methods: Patients undergoing PVIs under PSA by vascular surgeons across four hospitals in Massachusetts and New Hampshire will be screened for enrollment.

Multicenter Prospective Evaluation of Patient Radiation Exposure During Fenestrated-Branched Endovascular Aortic Repair: A Ten-year Experience.

Objective: To assess patient radiation exposure as reflected by cumulative air kerma (CAK) and dose area product (DAP) during fenestrated-branched endovascular aortic repair (FB-EVAR).

Summary Background Data: Patient radiation exposure during FB-EVAR has been reported inconsistently.

Methods: Data from 2,111 patients enrolled in 10 physician-sponsored investigational device exemption studies (2012-2022) were analyzed from the United States Aortic Research Consortium database.

Evolving practices of spinal drain use for branch/fenestrated endovascular aortic repair patients in the United States Aortic Research Consortium.

Objective: The use of cerebrospinal fluid drains (CSFDs) for the prevention or mitigation of spinal cord ischemia (SCI) is a subject of debate for patients undergoing branch/fenestrated endovascular aortic repair. We sought to evaluate the practices surrounding CSFD use concurrently with rates of SCI occurrence, recovery, and CSFD complications in the US Aortic Research Consortium.

Methods: We conducted a retrospective analysis of the US Aortic Research Consortium registry consisting of patients undergoing branch/fenestrated endovascular aortic repair under individual physician-sponsored investigational device exemptions from January 2011 to April 2024.

Trends and outcomes over time with fenestrated and branched endovascular aortic repair in the United States Aortic Research Consortium.

Objective: To characterize trends and outcomes with fenestrated and branched endovascular aortic repair (F/B-EVAR) performed at centers participating in the US Aortic Research Consortium.

Methods: F/B-EVARs performed in 10 prospective, nonrandomized, physician-sponsored investigative device exemption studies from 2015 to 2023 were studied retrospectively. Outcomes included 30-day major adverse event (MAE) and 1-year secondary reintervention.

Designing a Perioperative Mind-Body Intervention for Peripheral Vascular Interventions.

Background: Peripheral vascular interventions (PVIs) performed under procedural sedation and analgesia (PSA) can be associated with anxiety and poor compliance with patient instructions during surgery. Mind-body interventions (MBIs) such as meditation have demonstrated the potential to decrease perioperative anxiety, though this area is understudied, and no tailored interventions have been developed for the vascular surgical patient population.

Objectives: We aimed to design a perioperative MBI that specifically targeted vascular surgical patients undergoing PVIs under PSA.

Pilot Study to Improve Resident Experience on Vascular Surgery by Standardizing Dissemination of Operative Steps.

Objective: Many surgical residencies have passed along attendings preferences and procedural knowledge as a highly utilized but informal resource. The objective was to assess the effect of providing operative steps and attending preferences on surgical resident performance.

Design: This was a prospective observational study with a survey-based design.

Outcomes using inverted iliac limb bifurcate components in fenestrated/branched endografting.

Background: The use of standard bifurcate pieces in fenestrated/branched endovascular aortic repair (F/BEVAR) requires adequate length from the lowest branch or fenestration to the aortic bifurcation. In patients with prior aortic surgery, the aortic bifurcation is often artificially established in a more proximal position, compromising the infrarenal length, which hinders the placement of a standard bifurcate component below the fenestrated/branched component. Short bifurcate bodies using an inverted contralateral limb have been purpose-built to address this challenge.

Identifying risk factors for postoperative ileus following open abdominal aortic aneurysm repair.

Background: Postoperative ileus (POI) is a common complication following major abdominal surgery. The majority of the data available regarding POI after abdominal surgery is from the gastrointestinal and urological literature. These data have been extrapolated to vascular surgery, especially with regard to enhanced recovery programs for open abdominal aortic aneurysm (AAA) surgery.

Early and Late Aortic-Related Mortality and Rupture After Fenestrated-Branched Endovascular Aortic Repair of Thoracoabdominal Aortic Aneurysms: A Prospective Multicenter Cohort Study.

Background: Fenestrated-branched endovascular aortic repair (FB-EVAR) has been used as a minimally invasive alternative to open surgical repair to treat patients with thoracoabdominal aortic aneurysms (TAAAs). The aim of this study was to evaluate aortic-related mortality (ARM) and aortic aneurysm rupture after FB-EVAR of TAAAs.

Methods: Patients enrolled in 8 prospective, nonrandomized, physician-sponsored investigational device exemption studies between 2005 and 2020 who underwent elective FB-EVAR of asymptomatic intact TAAAs were analyzed.

Effect of fenestration configuration on renal artery outcomes during fenestrated-branched endovascular aortic repair.

Objective: The aim of this study was to evaluate the effect of fenestration configuration and fenestration gap on renal artery outcomes during fenestrated-branched endovascular aortic repair (F/BEVAR).

Methods: A retrospective multicenter analysis was performed, including patients with complex aortic aneurysms treated with F/BEVAR that incorporated at least one small fenestration to a renal artery. The renal fenestrations were divided into groups 1 (8 × 6 mm) and 2 (6 × 6 mm).

Complications of Carotid Interventions for Symptomatic Lesions after Systemic Thrombolysis.

Background: Series detailing complications after carotid endarterectomy (CEA) and transfemoral carotid stenting (tfCAS) for patients presenting with neurologic symptoms that are treated with systemic thrombolysis (ST) are sparse. We sought to determine if treatment with ST was associated with a higher rate of post-carotid intervention complications.

Methods: A multispecialty, institutional, prospectively maintained database was queried for symptomatic patients treated with CEA or tfCAS from 2007 to 2019.

Practice patterns of antiplatelet and anticoagulant therapy after fenestrated/branched endovascular aortic repair.

Objective: Antiplatelet and/or anticoagulant therapy are commonly prescribed after fenestrated/branched endovascular aortic repair (F/BEVAR). However, the optimal regimen remains unknown. We sought to characterize practice patterns and outcomes of antiplatelet and anticoagulant use in patients who underwent F/BEVAR.

Effect of EVAR on International Ruptured AAA Mortality-Sex and Geographic Disparities.

: We sought to investigate the differential impact of EVAR (endovascular aneurysm repair) vis-à-vis OSR (open surgical repair) on ruptured AAA (abdominal aortic aneurysm) mortality by sex and geographically. : We performed a retrospective study of administrative data on EVAR from state statistical agencies, vascular registries, and academic publications, as well as ruptured AAA mortality rates from the World Health Organization for 14 14 states across Australasia, East Asia, Europe, and North America. : Between 2011-2016, the proportion of treatment of ruptured AAAs by EVAR increased from 26.