Pub Date : 2026-01-01DOI: 10.1016/j.ejvs.2025.06.079
Anne Lejay , Bernard Geny
{"title":"Remote Ischaemic Preconditioning and Intermittent Claudication: Is the Game Worth the Candle?","authors":"Anne Lejay , Bernard Geny","doi":"10.1016/j.ejvs.2025.06.079","DOIUrl":"10.1016/j.ejvs.2025.06.079","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"71 1","pages":"Page 124"},"PeriodicalIF":6.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdominal aortic aneurysm (AAA) sac shrinkage has been reported as a surrogate marker of treatment success after endovascular aneurysm repair (EVAR). This study aimed to compare sac shrinkage after treatment with the Aorfix stent graft with that of Endurant and Excluder devices.
Methods
This retrospective, multicentre cohort study analysed data for 444 patients with AAA after EVAR who were treated with Aorfix, Endurant, or Excluder devices between 2014 and 2021. Sac shrinkage was defined as a decrease in the maximum aneurysm diameter of ≥ 5 mm. Primary endpoints included sac shrinkage and factors related to sac shrinkage within one year after EVAR. Secondary endpoints included re-intervention, type Ia endoleak (T1aEL), aneurysm related death (ARD), and overall survival.
Results
Of the 444 patients, 88 were treated with Aorfix, 191 with Endurant, and 165 with the Excluder. Sac shrinkage rates within one year in the Aorfix, Endurant, and Excluder groups were 52.1%, 32.8%, and 34.0%, respectively (p = .003). Multivariable analysis revealed that Aorfix device (ref. Endurant, p < .001; ref. Excluder, p= .010), smaller proximal neck diameter (p= .004), and number of patent lumbar arteries less than four (p= .033) were positive factors for sac shrinkage within one year. Re-intervention and T1aEL rates were lower in the sac shrinkage group within one year than in the group without sac shrinkage within one year. The ARD rate at ten years was 3.8% in the no shrinkage group and 0.7% in the shrinkage group (p= .29).
Conclusion
Sac shrinkage within one year was better in patients treated with the Aorfix device than in those treated with Endurant or Excluder devices, and sac shrinkage was a good surrogate marker for freedom from re-intervention and T1aEL after EVAR. However, the retrospective study design may have introduced.
{"title":"Sac Shrinkage after Endovascular Aneurysm Repair: Multicentre Comparative Data from Three Stent Grafts","authors":"Koichi Morisaki , Daisuke Matsuda , Ken Nakayama , Atsushi Guntani , Kazuomi Iwasa , Shinichiro Yoshino , Kentaro Inoue , Masazumi Kume , Terutoshi Yamaoka , Tomoharu Yoshizumi","doi":"10.1016/j.ejvs.2025.06.005","DOIUrl":"10.1016/j.ejvs.2025.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>Abdominal aortic aneurysm (AAA) sac shrinkage has been reported as a surrogate marker of treatment success after endovascular aneurysm repair (EVAR). This study aimed to compare sac shrinkage after treatment with the Aorfix stent graft with that of Endurant and Excluder devices.</div></div><div><h3>Methods</h3><div>This retrospective, multicentre cohort study analysed data for 444 patients with AAA after EVAR who were treated with Aorfix, Endurant, or Excluder devices between 2014 and 2021. Sac shrinkage was defined as a decrease in the maximum aneurysm diameter of ≥ 5 mm. Primary endpoints included sac shrinkage and factors related to sac shrinkage within one year after EVAR. Secondary endpoints included re-intervention, type Ia endoleak (T1aEL), aneurysm related death (ARD), and overall survival.</div></div><div><h3>Results</h3><div>Of the 444 patients, 88 were treated with Aorfix, 191 with Endurant, and 165 with the Excluder. Sac shrinkage rates within one year in the Aorfix, Endurant, and Excluder groups were 52.1%, 32.8%, and 34.0%, respectively (<em>p</em> = .003). Multivariable analysis revealed that Aorfix device (ref. Endurant, <em>p</em> < .001; ref. Excluder, <em>p</em>= .010), smaller proximal neck diameter (<em>p</em>= .004), and number of patent lumbar arteries less than four (<em>p</em>= .033) were positive factors for sac shrinkage within one year. Re-intervention and T1aEL rates were lower in the sac shrinkage group within one year than in the group without sac shrinkage within one year. The ARD rate at ten years was 3.8% in the no shrinkage group and 0.7% in the shrinkage group (<em>p</em>= .29).</div></div><div><h3>Conclusion</h3><div>Sac shrinkage within one year was better in patients treated with the Aorfix device than in those treated with Endurant or Excluder devices, and sac shrinkage was a good surrogate marker for freedom from re-intervention and T1aEL after EVAR. However, the retrospective study design may have introduced.</div></div>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"71 1","pages":"Pages 35-42"},"PeriodicalIF":6.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.ejvs.2025.06.063
Christina Powell , Anantha Narayanan , Manar Khashram
{"title":"Embarking on a Career in Vascular Surgery Starts at Medical School","authors":"Christina Powell , Anantha Narayanan , Manar Khashram","doi":"10.1016/j.ejvs.2025.06.063","DOIUrl":"10.1016/j.ejvs.2025.06.063","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"71 1","pages":"Pages 147-148"},"PeriodicalIF":6.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.ejvs.2025.05.047
Sharon Oud , Tamana Alozai , Faridi S. Jamaludin , Susan van Dieren , Michiel A. Schreve , Michael C. Mooij , Ron Balm , Çağdaş Ünlü
Objective
High quality comparative studies on treatments of the small saphenous vein (SSV) are lacking. Therefore, the primary aim of this study was to evaluate anatomic success across different SSV treatment modalities at short, mid, and long term follow up using a network meta-analysis (NMA) and pooled results from a meta-analysis.
Data Sources
MEDLINE and Embase.
Review Methods
Cohort studies (prospective and retrospective) and randomised controlled trials (RCTs) were included. Studies reported on the primary outcome of anatomic success (occlusion, absence of reflux) for all thermal, non-thermal, and surgical SSV treatment modalities. Secondary outcomes included complications, peri-procedural pain, time to return to daily activities or work, Venous Clinical Severity Score, and quality of life. Anatomic success was assessed at short term (up to and including three months), midterm (three months to one year), and long term (more than one year) follow up. A risk of bias and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evaluation were done.
Results
Sixty eight articles were included (28 retrospective studies, 26 prospective studies, four RCTs, and nine studies of unknown design), comprising a total of 6 793 limbs at baseline. The NMA ranked endovenous laser ablation (EVLA) as superior treatment at short term follow up, and radiofrequency ablation (RFA) at midterm follow up. Data were insufficient to perform a NMA for long term outcomes. The meta-analysis reported the highest anatomic success rates for RFA at short term follow up (98.4%) and for EVLA at both mid and long term follow up (96.1% and 94.3%, respectively). Of the secondary outcomes, only major complications could be pooled. Deep venous thrombosis was found in 0.2% of all patients and nerve injury in 3.0%. Although risk of bias in the NMA was low, most network estimates were of low or very low GRADE quality.
Conclusion
The limited number of high quality comparative studies on the SSV complicates ranking treatments based on anatomic success. However, RFA and EVLA showed the highest anatomic success.
{"title":"Anatomic Success of Treatment Modalities for Small Saphenous Vein Incompetence: A Systematic Review and Network Meta-analysis","authors":"Sharon Oud , Tamana Alozai , Faridi S. Jamaludin , Susan van Dieren , Michiel A. Schreve , Michael C. Mooij , Ron Balm , Çağdaş Ünlü","doi":"10.1016/j.ejvs.2025.05.047","DOIUrl":"10.1016/j.ejvs.2025.05.047","url":null,"abstract":"<div><h3>Objective</h3><div>High quality comparative studies on treatments of the small saphenous vein (SSV) are lacking. Therefore, the primary aim of this study was to evaluate anatomic success across different SSV treatment modalities at short, mid, and long term follow up using a network meta-analysis (NMA) and pooled results from a meta-analysis.</div></div><div><h3>Data Sources</h3><div>MEDLINE and Embase.</div></div><div><h3>Review Methods</h3><div>Cohort studies (prospective and retrospective) and randomised controlled trials (RCTs) were included. Studies reported on the primary outcome of anatomic success (occlusion, absence of reflux) for all thermal, non-thermal, and surgical SSV treatment modalities. Secondary outcomes included complications, peri-procedural pain, time to return to daily activities or work, Venous Clinical Severity Score, and quality of life. Anatomic success was assessed at short term (up to and including three months), midterm (three months to one year), and long term (more than one year) follow up. A risk of bias and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evaluation were done.</div></div><div><h3>Results</h3><div>Sixty eight articles were included (28 retrospective studies, 26 prospective studies, four RCTs, and nine studies of unknown design), comprising a total of 6 793 limbs at baseline. The NMA ranked endovenous laser ablation (EVLA) as superior treatment at short term follow up, and radiofrequency ablation (RFA) at midterm follow up. Data were insufficient to perform a NMA for long term outcomes. The meta-analysis reported the highest anatomic success rates for RFA at short term follow up (98.4%) and for EVLA at both mid and long term follow up (96.1% and 94.3%, respectively). Of the secondary outcomes, only major complications could be pooled. Deep venous thrombosis was found in 0.2% of all patients and nerve injury in 3.0%. Although risk of bias in the NMA was low, most network estimates were of low or very low GRADE quality.</div></div><div><h3>Conclusion</h3><div>The limited number of high quality comparative studies on the SSV complicates ranking treatments based on anatomic success. However, RFA and EVLA showed the highest anatomic success.</div></div>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"71 1","pages":"Pages 135-145"},"PeriodicalIF":6.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.ejvs.2025.06.024
Jean-Baptiste Ricco , Ryan Eduardo Costeloe De Gouvei Melo
{"title":"Ten Years after Endovascular Aneurysm Repair: The ENGAGE Registry Sheds Light, But Shadows Remain","authors":"Jean-Baptiste Ricco , Ryan Eduardo Costeloe De Gouvei Melo","doi":"10.1016/j.ejvs.2025.06.024","DOIUrl":"10.1016/j.ejvs.2025.06.024","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"71 1","pages":"Pages 32-33"},"PeriodicalIF":6.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.ejvs.2025.07.020
Chengkai Hu , Yuchong Zhang , Jue Yang , Yulong Huang , Wei Wang , Xiangchen Dai , Xinwu Lu , Hongpeng Zhang , Weiguo Fu , Lixin Wang
Objective
This study aimed to assess the five year follow up results from a prospective, single arm, multicentre study evaluating the efficacy of the Fabulous stent system (DiNovA Meditech, Hangzhou, China) in the treatment of complicated Stanford type B aortic dissection (cTBAD).
Methods
Between December 2017 and October 2019, 144 patients from 14 centres in China were prospectively enrolled. Primary outcomes were freedom from all cause death and long term aortic related adverse events. Secondary five year outcomes were the changes in the false lumen (FL) and true lumen (TL) in the bare stent and distal bare stent segments.
Results
The five year freedom from all cause death was 86.6%, and imaging follow up was completed by 64 patients (mean age 54.4 years; 89.1% male). From pre-procedure to the five year follow up there was a consistent increase in the minimum diameter of the TL (13.01 ± 6.52 mm pre-procedure; 23.16 ± 5.37 mm one year follow up; 24.68 ± 5.27 mm five year follow up) and a simultaneous reduction in the maximum diameter of the FL within the bare stent segment (28.69 ± 7.09 mm pre-procedure; 9.08 ± 12.84 mm one year follow up; 7.67 ± 12.51 mm five year follow up). The proportion of patients with complete FL thrombosis in the bare stent segment increased from 64% to 81%. During the five year follow up, three patients developed retrograde type A aortic dissection and three patients underwent a second intervention.
Conclusion
Following endovascular treatment using the Fabulous system, the five year cTBAD cohort outcomes demonstrated encouraging results regarding TL expansion and FL thrombosis. These results should enhance the understanding of the application of the Proximal ExTension To Induce COmplete ATtachment (PETTICOAT) technique in cTBAD.
{"title":"Editor's Choice – Five Year Outcomes of the Fabulous Stent System in the Management of Complicated Type B Aortic Dissection: A Prospective Multicentre Study","authors":"Chengkai Hu , Yuchong Zhang , Jue Yang , Yulong Huang , Wei Wang , Xiangchen Dai , Xinwu Lu , Hongpeng Zhang , Weiguo Fu , Lixin Wang","doi":"10.1016/j.ejvs.2025.07.020","DOIUrl":"10.1016/j.ejvs.2025.07.020","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the five year follow up results from a prospective, single arm, multicentre study evaluating the efficacy of the Fabulous stent system (DiNovA Meditech, Hangzhou, China) in the treatment of complicated Stanford type B aortic dissection (cTBAD).</div></div><div><h3>Methods</h3><div>Between December 2017 and October 2019, 144 patients from 14 centres in China were prospectively enrolled. Primary outcomes were freedom from all cause death and long term aortic related adverse events. Secondary five year outcomes were the changes in the false lumen (FL) and true lumen (TL) in the bare stent and distal bare stent segments.</div></div><div><h3>Results</h3><div>The five year freedom from all cause death was 86.6%, and imaging follow up was completed by 64 patients (mean age 54.4 years; 89.1% male). From pre-procedure to the five year follow up there was a consistent increase in the minimum diameter of the TL (13.01 ± 6.52 mm pre-procedure; 23.16 ± 5.37 mm one year follow up; 24.68 ± 5.27 mm five year follow up) and a simultaneous reduction in the maximum diameter of the FL within the bare stent segment (28.69 ± 7.09 mm pre-procedure; 9.08 ± 12.84 mm one year follow up; 7.67 ± 12.51 mm five year follow up). The proportion of patients with complete FL thrombosis in the bare stent segment increased from 64% to 81%. During the five year follow up, three patients developed retrograde type A aortic dissection and three patients underwent a second intervention.</div></div><div><h3>Conclusion</h3><div>Following endovascular treatment using the Fabulous system, the five year cTBAD cohort outcomes demonstrated encouraging results regarding TL expansion and FL thrombosis. These results should enhance the understanding of the application of the Proximal ExTension To Induce COmplete ATtachment (PETTICOAT) technique in cTBAD.</div></div>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"71 1","pages":"Pages 88-94"},"PeriodicalIF":6.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.ejvs.2025.04.035
Victor Mill, Johnny Steuer
{"title":"On Follow Up after Thoracic Endovascular Aortic Repair for Blunt Traumatic Aortic Injury","authors":"Victor Mill, Johnny Steuer","doi":"10.1016/j.ejvs.2025.04.035","DOIUrl":"10.1016/j.ejvs.2025.04.035","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"71 1","pages":"Page 157"},"PeriodicalIF":6.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.ejvs.2025.06.009
Chang Shu , Tun Wang , Kun Fang , Quanming Li , Mingyao Luo , Hao He , Xin Li , Yuanyuan Guo , Ming Li
Objective
Endovascular aortic arch repair with supra-aortic trunk (SAT) reconstruction is an alternative to open surgical replacement, but the ideal stent graft is still under investigation. This study describes the first experience and one year results of a novel, off the shelf, concave supra-arch triple branched stent graft system (CS system) for aortic arch diseases.
Methods
This was a prospective cohort study conducted in three hospitals, enrolling patients from March 2022 to June 2023, to evaluate use of the CS system for aortic arch pathologies. An interdisciplinary board assessed patients pre-operatively. All patients were treated using the CS system to cover the aortic arch pathologies and reconstruct all SATs. Follow up assessments were conducted with computed tomography scans at two weeks and six and 12 months.
Results
Ten patients (eight men) were treated using the CS system. The mean age was 65.3 years. Conditions included thoracic aortic aneurysm, non-A non-B aortic dissection, and penetrating aortic arch ulcer. Technical success was achieved in all patients, with one type III endoleak during the procedure. The mean procedure time was 160 ± 23 minutes and the mean fluoroscopy time was 63 ± 20 minutes. The in hospital mortality and stroke rates were both 0%. The mean follow up duration was 456.9 ± 93.6 days. All patients recovered well without complications. The CS system completely covered the aortic pathologies, and all reconstructed branches remained patent. The single endoleak sealed spontaneously within six months. Mild to moderate in stent stenosis was observed in three left common carotid arteries. No other morphological abnormalities were observed, and secondary interventions were not necessary.
Conclusion
The CS system for endovascular treatment of aortic arch pathologies demonstrated promising safety and efficacy in this study, with no deaths, strokes, retrograde type A aortic dissections, re-interventions, or significant endoleaks during one year follow up. Stenosis of the reconstructed SATs should be monitored closely.
{"title":"Concave Triple Branched Stent Graft System for Aortic Arch Pathologies: A First in Man Prospective Cohort Study","authors":"Chang Shu , Tun Wang , Kun Fang , Quanming Li , Mingyao Luo , Hao He , Xin Li , Yuanyuan Guo , Ming Li","doi":"10.1016/j.ejvs.2025.06.009","DOIUrl":"10.1016/j.ejvs.2025.06.009","url":null,"abstract":"<div><h3>Objective</h3><div>Endovascular aortic arch repair with supra-aortic trunk (SAT) reconstruction is an alternative to open surgical replacement, but the ideal stent graft is still under investigation. This study describes the first experience and one year results of a novel, off the shelf, concave supra-arch triple branched stent graft system (CS system) for aortic arch diseases.</div></div><div><h3>Methods</h3><div>This was a prospective cohort study conducted in three hospitals, enrolling patients from March 2022 to June 2023, to evaluate use of the CS system for aortic arch pathologies. An interdisciplinary board assessed patients pre-operatively. All patients were treated using the CS system to cover the aortic arch pathologies and reconstruct all SATs. Follow up assessments were conducted with computed tomography scans at two weeks and six and 12 months.</div></div><div><h3>Results</h3><div>Ten patients (eight men) were treated using the CS system. The mean age was 65.3 years. Conditions included thoracic aortic aneurysm, non-A non-B aortic dissection, and penetrating aortic arch ulcer. Technical success was achieved in all patients, with one type III endoleak during the procedure. The mean procedure time was 160 ± 23 minutes and the mean fluoroscopy time was 63 ± 20 minutes. The in hospital mortality and stroke rates were both 0%. The mean follow up duration was 456.9 ± 93.6 days. All patients recovered well without complications. The CS system completely covered the aortic pathologies, and all reconstructed branches remained patent. The single endoleak sealed spontaneously within six months. Mild to moderate in stent stenosis was observed in three left common carotid arteries. No other morphological abnormalities were observed, and secondary interventions were not necessary.</div></div><div><h3>Conclusion</h3><div>The CS system for endovascular treatment of aortic arch pathologies demonstrated promising safety and efficacy in this study, with no deaths, strokes, retrograde type A aortic dissections, re-interventions, or significant endoleaks during one year follow up. Stenosis of the reconstructed SATs should be monitored closely.</div></div>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"71 1","pages":"Pages 77-84"},"PeriodicalIF":6.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.ejvs.2025.06.067
Petroula Nana, Tilo Kölbel
{"title":"Off the Shelf Triple Branched Device For the Aortic Arch: Dream a Little Dream","authors":"Petroula Nana, Tilo Kölbel","doi":"10.1016/j.ejvs.2025.06.067","DOIUrl":"10.1016/j.ejvs.2025.06.067","url":null,"abstract":"","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"71 1","pages":"Pages 85-86"},"PeriodicalIF":6.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.ejvs.2025.06.070
Hence J.M. Verhagen , Joep A.W. Teijink , Adam H. Power , Michel M.P.J. Reijnen , Lee H. Bouwman , Frank E.G. Vermassen , Vincente Riambau , Philipp Erhart , Shuqiong Ling , Philippe W.M. Cuypers , Ian M. Loftus , ENGAGE Investigators
Objective
Long term performance of endovascular aneurysm repair has not been well studied. The Endurant Stent Graft Natural Selection Global Post-market Registry (ENGAGE) observational, multicentre, non-randomised, prospective global registry was used to assess long term outcomes in patients treated with the Endurant stent graft system (Medtronic, Santa Rosa, CA, USA).
Methods
Inclusion criteria were minimal and included patients who fell outside of the instructions for use guidance. Exclusion criteria were high probability of non-adherence to follow up requirements, or concurrent participation in another trial that could confound results. Clinical and imaging data were collected continuously to evaluate treatment efficacy through ten years.
Results
There were 1 263 patients enrolled in the ENGAGE registry, of whom 390 re-consented for follow up from more than five through ten years and constituted the extended follow up (FU) cohort. The other 873 patients made up the non-extended FU cohort. For the extended FU cohort from more than five through ten years, Kaplan–Meier rates with 95% confidence intervals (95% CIs) were 97.3% (95% CI 95.5 – 99.1%) for freedom from site reported all cause mortality, 75.7% (95% CI 70.4 – 81.0%) for freedom from Clinical Event Committee adjudicated aneurysm related mortality, and 99.4% (95% CI 98.6 – 100%) for freedom from conversion to open surgical repair. From zero through to ten years, these rates were 96.2% (95% CI 94.0 – 98.4%) for aneurysm rupture and 71.4% (95% CI 66.3 – 76.5%) for aneurysm related re-interventions. For the extended FU cohort in the first five years, freedom estimates were 99.2% (95% CI 98.4 – 100%) for aneurysm rupture and 83.6% (95% CI 79.9 – 87.3%) for aneurysm related re-interventions. Late re-interventions (n = 72) were associated with type Ia endoleaks (18/72), type II endoleaks (18/72), and type Ib endoleaks (16/72). At ten years, 64.1% of patients exhibited sac regression, 19.2% were sac stable, and 16.8% had sac expansion.
Conclusion
This is the first study to report long term outcomes in a real world, global cohort of patients with abdominal aortic aneurysm treated with the Endurant stent graft. Overall, long term efficacy and durability were observed in patients who survived beyond five years post-enrolment in the ENGAGE registry.
目的：血管内动脉瘤修复的远期疗效尚未得到很好的研究。耐力支架移植自然选择全球上市后注册（ENGAGE）观察性、多中心、非随机、前瞻性全球注册用于评估接受耐力支架移植系统治疗的患者的长期结果（美敦力，圣罗莎，CA， USA）。方法：纳入标准最小，纳入了不符合使用指南说明的患者。排除标准为极有可能不遵守随访要求，或同时参加另一项可能混淆结果的试验。持续收集临床及影像学资料，评估治疗效果。结果：1 263例患者入组ENGAGE登记，其中390例再次同意随访5 - 10年，构成延长随访（FU）队列。其他873例患者组成非扩展FU队列。对于超过5年至10年的扩展FU队列，Kaplan-Meier无现场自由率报告，95%置信区间（95% CI）的全因死亡率为97.3% (95% CI 95.5 - 99.1%)；75.7% （95% CI 70.4 - 81.0%）免于临床事件委员会判定的动脉瘤相关死亡率，99.4% （95% CI 98.6 - 100%）免于转换为开放式手术修复。从0到10年，动脉瘤破裂的发生率为96.2% (95% CI 94.0 - 98.4%)，动脉瘤相关再干预的发生率为71.4% （95% CI 66.3 - 76.5%）。对于前5年的扩展FU队列，动脉瘤破裂的自由度估计为99.2% (95% CI 98.4 - 100%)，动脉瘤相关再干预的自由度估计为83.6% （95% CI 79.9%, 87.3%）。晚期再干预（n = 72）与Ia型内漏（18/72）、II型内漏（18/72）和Ib型内漏（16/72）相关。10年时，64.1%的患者囊退化，19.2%的患者囊稳定，16.8%的患者囊扩张。结论：这是第一个报告现实世界中，全球腹主动脉瘤患者使用耐久支架移植的长期结果的研究。总体而言，在ENGAGE登记注册后存活超过5年的患者中观察到长期疗效和持久性。
{"title":"Editor's Choice – The ENGAGE Registry Ten Year Outcomes with the Endurant Stent Graft System for Endovascular Abdominal Aortic Aneurysm Repair","authors":"Hence J.M. Verhagen , Joep A.W. Teijink , Adam H. Power , Michel M.P.J. Reijnen , Lee H. Bouwman , Frank E.G. Vermassen , Vincente Riambau , Philipp Erhart , Shuqiong Ling , Philippe W.M. Cuypers , Ian M. Loftus , ENGAGE Investigators","doi":"10.1016/j.ejvs.2025.06.070","DOIUrl":"10.1016/j.ejvs.2025.06.070","url":null,"abstract":"<div><h3>Objective</h3><div>Long term performance of endovascular aneurysm repair has not been well studied. The Endurant Stent Graft Natural Selection Global Post-market Registry (ENGAGE) observational, multicentre, non-randomised, prospective global registry was used to assess long term outcomes in patients treated with the Endurant stent graft system (Medtronic, Santa Rosa, CA, USA).</div></div><div><h3>Methods</h3><div>Inclusion criteria were minimal and included patients who fell outside of the instructions for use guidance. Exclusion criteria were high probability of non-adherence to follow up requirements, or concurrent participation in another trial that could confound results. Clinical and imaging data were collected continuously to evaluate treatment efficacy through ten years.</div></div><div><h3>Results</h3><div>There were 1 263 patients enrolled in the ENGAGE registry, of whom 390 re-consented for follow up from more than five through ten years and constituted the extended follow up (FU) cohort. The other 873 patients made up the non-extended FU cohort. For the extended FU cohort from more than five through ten years, Kaplan–Meier rates with 95% confidence intervals (95% CIs) were 97.3% (95% CI 95.5 – 99.1%) for freedom from site reported all cause mortality, 75.7% (95% CI 70.4 – 81.0%) for freedom from Clinical Event Committee adjudicated aneurysm related mortality, and 99.4% (95% CI 98.6 – 100%) for freedom from conversion to open surgical repair. From zero through to ten years, these rates were 96.2% (95% CI 94.0 – 98.4%) for aneurysm rupture and 71.4% (95% CI 66.3 – 76.5%) for aneurysm related re-interventions. For the extended FU cohort in the first five years, freedom estimates were 99.2% (95% CI 98.4 – 100%) for aneurysm rupture and 83.6% (95% CI 79.9 – 87.3%) for aneurysm related re-interventions. Late re-interventions (<em>n</em> = 72) were associated with type Ia endoleaks (18/72), type II endoleaks (18/72), and type Ib endoleaks (16/72). At ten years, 64.1% of patients exhibited sac regression, 19.2% were sac stable, and 16.8% had sac expansion.</div></div><div><h3>Conclusion</h3><div>This is the first study to report long term outcomes in a real world, global cohort of patients with abdominal aortic aneurysm treated with the Endurant stent graft. Overall, long term efficacy and durability were observed in patients who survived beyond five years post-enrolment in the ENGAGE registry.</div></div>","PeriodicalId":55160,"journal":{"name":"European Journal of Vascular and Endovascular Surgery","volume":"71 1","pages":"Pages 22-31"},"PeriodicalIF":6.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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