JVS-vascular insights最新文献

{"title":"A qualitative investigation of interventionalists’ views and experiences on clinical decision-making in claudication","authors":"Chloé A. Powell MD, MS ,&nbsp;Lauren A. Szczygiel PhD ,&nbsp;Mary E. Byrnes PhD, MUP ,&nbsp;Nicholas H. Osborne MD, MS","doi":"10.1016/j.jvsvi.2025.100327","DOIUrl":"10.1016/j.jvsvi.2025.100327","url":null,"abstract":"<div><h3>Background</h3><div>Claudication, pain with walking, is a common presentation of peripheral artery disease, which can significantly impact quality of life. Recent appropriate use criteria from the Society of Vascular Surgery provide a framework for management, particularly considerations for revascularization; however, consensus on the indications for revascularization remain elusive. This study seeks to understand the interventionalist perspective on decision making around intermittent claudication.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with 30 interventionalists including interventional cardiologists, interventional radiologists, and vascular surgeons. Transcripts were iteratively analyzed through steps informed by inductive thematic analysis.</div></div><div><h3>Results</h3><div>Three key thematic patterns were identified regarding interventionalists’ perspectives on management, particularly procedural intervention, for patients with claudication: (1) periprocedural risk for complications and long-term durability of interventions for claudication was a persistent consideration in decision making; (2) despite the risks, there were opportunities to improve the patient’s quality of life, in other words, there were “good reasons” to be risky; (3) interventionalists’ expectations of the patient regarding adherence to medical management and indication influence providers’ decisions to pursue intervention.</div></div><div><h3>Conclusions</h3><div>Although there are recommendations to guide an interventionalists’ decision-making to pursue revascularization for a patient with claudication, in practice, there is heterogeneity in the factors that influence the decision to intervene. Interventionalists contend with not only the risks of a procedure but must interpret patients’ treatment goals and subjectivity of symptoms when determining benefit of revascularization. Interventionalists’ value judgements are frequently incorporated into the decision-making process, which may introduce bias. As such, there are opportunities to improve shared decision-making.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"4 ","pages":"Article 100327"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022899","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 supra-versus infra-renal clamping in elective open aortic aneurysm repair in a tertiary vascular center","authors":"Daniel Becker MD ,&nbsp;Ahmed Ali MD ,&nbsp;Anja Lehmann MD ,&nbsp;Christian Zielasek MD ,&nbsp;Michel J. Bosiers MD ,&nbsp;Juerg Schmidli MD ,&nbsp;Drosos Kotelis MD ,&nbsp;Vladimir Makaloski MD","doi":"10.1016/j.jvsvi.2025.100322","DOIUrl":"10.1016/j.jvsvi.2025.100322","url":null,"abstract":"<div><h3>Objective</h3><div>Juxtarenal abdominal aortic aneurysms (AAAs), pose a greater surgical challenge than infrarenal AAAs and often require suprarenal aortic clamping during open repair. This study aims to assess the impact of suprarenal vs infrarenal clamping on short- and long-term renal outcomes, mortality, and reintervention rates.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was conducted on 1250 patients undergoing open AAA repair between 2000 and 2020 at a tertiary vascular center. Patients were stratified into suprarenal and infrarenal clamping groups. Outcomes included 30-day mortality, major adverse events, acute kidney injury, new-onset dialysis, chronic kidney disease (CKD), long-term mortality, and reintervention. Propensity score matching and multivariate analysis were used to adjust for confounders.</div></div><div><h3>Results</h3><div>Of the cohort, 492 underwent suprarenal and 758 infrarenal clamping. The suprarenal group experienced higher 30-day major adverse events (20.9% vs 16.2%; <em>P</em> = .036), acute kidney injury (37.6% vs 22.0%; <em>P</em> &lt; .001), and new-onset dialysis (4.5% vs 1.8%; <em>P</em> = .009). At a median follow-up of 8.6 years, CKD incidence was significantly higher in the suprarenal group (28.5% vs 21.1%; <em>P</em> = .004), as was all-cause mortality (41.3% vs 32.4%; <em>P</em> &lt; .001). We found no difference in reintervention rates between groups. In the propensity-matched cohort, CKD remained significantly more common with suprarenal clamping (<em>P</em> &lt; .001), whereas differences in mortality were not statistically significant.</div></div><div><h3>Conclusions</h3><div>Suprarenal clamping during open AAA repair is associated with increased postoperative renal complications and long-term CKD and mortality, despite similar reintervention and short-term mortality rates. These findings support the need for individualized surgical planning.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"4 ","pages":"Article 100322"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022900","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 lasting value of single-center experiences","authors":"Mauricio Gonzalez-Urquijo MD, PhD,&nbsp;Francisco Valdes MD","doi":"10.1016/j.jvsvi.2025.100333","DOIUrl":"10.1016/j.jvsvi.2025.100333","url":null,"abstract":"","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"4 ","pages":"Article 100333"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976588","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":"Incidence, risk factors, and short-term outcomes of groin infections after femoral bovine patch angioplasty and concomitant procedures","authors":"Ryan Lee BA ,&nbsp;Rajbir Singh DO ,&nbsp;Calogero DiMaggio DO ,&nbsp;Sharvil Sheth MD ,&nbsp;Maggie Lin MD","doi":"10.1016/j.jvsvi.2025.100338","DOIUrl":"10.1016/j.jvsvi.2025.100338","url":null,"abstract":"<div><h3>Objective</h3><div>Bovine pericardial patches are widely used in femoral artery reconstruction following femoral endarterectomy due to presumed resistance to infection compared with prosthetic materials, but literature on the management of groin infection in the setting of femoral endarterectomy (FEA) with bovine patch angioplasty remains limited. This study aims to evaluate risk factors for groin infection and need for bovine patch explant (BPE).</div></div><div><h3>Methods</h3><div>This is a single-center, retrospective, case-control study of all consecutive groins undergoing FEA with bovine patch angioplasty between January 2020 through July 2024. Risk factors for groin infection and BPE were assessed in a multivariate model. Secondary outcomes included wound infection bacteriology, 30-day mortality, and 1-year amputation rates for groin infections with and without BPE.</div></div><div><h3>Results</h3><div>A total of 313 groins from 288 patients underwent FEA with bovine patch angioplasty, 60 of whom (19.2%) developed groin infections. Of these groin infections, 20 were deep infections (33.3%). Risk factors for groin infection on multivariate analysis included diabetes mellitus (relative risk [RR], 1.67; <em>P</em> = .043) and overweight body mass index (RR, 1.04; <em>P</em> = .024). Patients developing groin infections were less likely to be current smokers (RR, 0.52; <em>P</em> = .038). All deep groin infections were managed with washout with negative pressure wound therapy. BPE was performed in nine of 20 patients (45%) with deep infections, and none of the superficial infections. BPE was pursued in all patients developing pseudoaneurysm, and patch preservation was successful in all patients with seromas. On multivariate analysis, female gender was associated with increased risk of BPE (RR, 7.87; <em>P</em> = .047). Hypertension was associated with decreased risk of BPE (RR, 0.11; <em>P</em> = .005), as was current smoking status (RR, 0.13; <em>P</em> = .039). None of the other comorbidities, indications for FEA, and concomitant procedures increased risk of BPE in our study. Wound culture bacteriology did not significantly differ between patients managed with and without BPE. Compared with patch preservation, BPE was associated with significantly higher 1-year amputation rate (33.3% vs 5.9%; <em>P</em> = .011) and higher 30-day mortality rates (22.2% vs 3.9%; <em>P</em> = .045).</div></div><div><h3>Conclusions</h3><div>Bovine patch preservation is reasonable for patients with superficial groin infections and postoperative seroma. Patch preservation is reasonable in select patients with deep groin infections, although a lower threshold for patch explant is necessary. Female gender and deep infection are associated with a higher rate of patch explant. Groin infection bacteriology did not alter risk of BPE. Patch explant is associated with a high perioperative mortality rate and 1-year major limb loss.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"4 ","pages":"Article 100338"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976590","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":"Aortic remodeling predicts long-term survival and freedom from reintervention after thoracic endovascular aortic repair for chronic type B aortic dissection including residual type A dissection","authors":"Sadanari Sawaki MD, PhD ,&nbsp;Mika Kumagai MA ,&nbsp;Kazuki Nomura MD ,&nbsp;Shogo Maeda MD ,&nbsp;Riku Kato MD ,&nbsp;Tsubasa Yazawa MD ,&nbsp;Masayoshi Tokoro MD, PhD ,&nbsp;Ayumi Shintani MPH, PhD ,&nbsp;Toshiaki Ito MD, PhD","doi":"10.1016/j.jvsvi.2025.100352","DOIUrl":"10.1016/j.jvsvi.2025.100352","url":null,"abstract":"<div><h3>Background</h3><div>The optimal timing for thoracic endovascular aortic repair in chronic type B aortic dissection is controversial, largely because the long-term impact of aortic remodeling on clinical outcomes remains unclear. This study investigates the prognostic value of aortic remodeling and identifies its key determinants.</div></div><div><h3>Methods</h3><div>In a retrospective analysis of 95 patients treated with thoracic endovascular aortic repair for chronic type B aortic dissection, we defined aortic remodeling as a ≥5 mm decrease in aortic diameter. We then assessed its association with 5-year survival and freedom from reintervention and identified preoperative predictors for its occurrence.</div></div><div><h3>Results</h3><div>Achieving aortic remodeling was associated with a dramatic improvement in long-term outcomes. Patients in the remodeling group (n = 57) had the estimated 5-year survival rate of 98.0%, compared with 80.0% in the non-remodeling group (n = 38; <em>P</em> = .003). Freedom from reintervention was also substantially higher at 91.3% in the remodeling group vs 50.0% in the non-remodeling group (<em>P</em> &lt; .0001). This favorable remodeling was most likely to occur in patients treated sooner after the initial dissection (median, 12 months vs 78 months; <em>P</em> &lt; .001) and in those with a smaller preoperative aortic diameter at the diaphragmatic level (median, 34 mm vs 42 mm; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Favorable aortic remodeling is a strong and independent predictor of long-term survival and freedom from reintervention after thoracic endovascular aortic repair for chronic type B aortic dissection. These findings suggest that intervening earlier in the chronic phase, before substantial aortic dilatation develops, may be beneficial for improving clinical outcomes.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"4 ","pages":"Article 100352"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022901","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":"Biopsychosocial predictors of long-term major amputation following peripheral vascular intervention in chronic limb-threatening ischemia using a machine learning algorithm approach","authors":"Golsa Joodi MD ,&nbsp;Gaëlle Romain PhD ,&nbsp;Jacob Cleman MD ,&nbsp;Iliana Hurtado Rendon MD ,&nbsp;Rabih Tabet MD ,&nbsp;Lindsey Scierka MD, MPH ,&nbsp;Mufti Mushfiqur Rahman MD, MPH ,&nbsp;Aseem Vashist MD ,&nbsp;Eman Mubarak MD ,&nbsp;Christiany Tapia MD ,&nbsp;Kim G. Smolderen PhD ,&nbsp;Carlos Mena-Hurtado MD","doi":"10.1016/j.jvsvi.2025.100348","DOIUrl":"10.1016/j.jvsvi.2025.100348","url":null,"abstract":"<div><h3>Background</h3><div>Patients with chronic limb-threatening ischemia (CLTI) remain at high risk of major amputation following revascularization. Although traditional clinical risk factors are well-established, the role of biopsychosocial factors in amputation risk remains unclear. This study aimed to identify the most important biopsychosocial clinical factors that predict the 3-year risk of major amputation following peripheral vascular intervention (PVI).</div></div><div><h3>Methods</h3><div>Patients who underwent PVI for CLTI between January 2017 and December 2018 were identified from the PVI module of the Vascular Quality Initiative, which is linked to Medicare outcomes data. We evaluated 63 pre-procedural variables, including peripheral arterial disease (PAD)/CLTI-related, demographic, functional, and behavioral characteristics. A random survival forest algorithm accounting for the competing risk of death (RSF-CR) was developed to rank pre-procedural variables based on their importance in predicting the 3-year major amputation risk. The relative importance [RI] of each predictor was calculated using the Breiman-Cutler importance approach. A sensitivity analysis was conducted using the minimal depth approach, which measures the importance of each variable in the decision-making process. We assessed the RSF-CR’s accuracy and discriminative ability using the out-of-bag error rate and the Harrell C-index, respectively.</div></div><div><h3>Results</h3><div>A total of 7848 patients with CLTI were included (mean age, 76.5 ± 7.6 years; 57.2% male; 77.9% White). At 3-year follow-up, 40.9% died, and 13.8% underwent major amputation. A non-null RI was calculated for 52 of 63 preprocedural variables. Advanced chronic kidney disease (stage 5) was the most important predictor of 3-year major amputation risk (RI = 100%), followed by below-the-knee disease, prior major amputation, and diabetes (RI = 78%, 71%, and 57%, respectively). Beyond these medical history and PAD/CLTI-related factors, the key demographic, functional status, and behavioral factors were female sex, ambulation with wheelchair, and pain (RI = 28%, 28%, and 3%, respectively). Model demonstrated good performance (out-of-bag error rate = 32.7%; C-index = 0.67).</div></div><div><h3>Conclusions</h3><div>Long-term limb outcomes are affected by a multitude of factors including traditional cardiovascular risk factors as well as functional and behavioral patient characteristics. A multidimensional risk assessment framework, incorporating both traditional clinical and biopsychosocial factors, is essential to shared decision-making and delivery of individualized care with multidisciplinary involvement.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"4 ","pages":"Article 100348"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022897","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":"Vascular surgery training in Brazil: Gaps and opportunities","authors":"Mauricio Gonzalez-Urquijo MD, PhD,&nbsp;Lara Lopes MD","doi":"10.1016/j.jvsvi.2025.100334","DOIUrl":"10.1016/j.jvsvi.2025.100334","url":null,"abstract":"","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"4 ","pages":"Article 100334"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977850","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":"Exploring the awareness of artificial intelligence among vascular surgeons in the Middle East","authors":"Yalnaz Mohasin MB, BCh, BaO ,&nbsp;Ali Mohamed Omar Mohamed MB, BCh ,&nbsp;Jamal Hashem MB, BCh, BaO ,&nbsp;Martin Maresch MD","doi":"10.1016/j.jvsvi.2025.100347","DOIUrl":"10.1016/j.jvsvi.2025.100347","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) and machine learning (ML) are transforming health care, with significant potential to enhance diagnosis, prognosis, and treatment. In vascular surgery, AI/ML has demonstrated promise not only in predicting outcomes and aiding imaging diagnostics but also in optimizing patient selection and procedural planning. However, clinical adoption remains limited, necessitating an understanding of clinician perspectives to identify facilitators and barriers. This study aims to assess the knowledge, attitudes, and perceptions of vascular surgeons in the Middle East regarding AI/ML, identify key barriers and facilitators for adoption, and explore their clinical applicability in vascular surgery.</div></div><div><h3>Methods</h3><div>A survey was conducted among vascular surgeons practicing in Bahrain, Egypt, Kuwait, Jordan, Oman, Saudi Arabia, Syria, and the United Arab Emirates to assess their demographics, knowledge, attitudes, and perceptions regarding AI/ML.The survey explored self-assessed knowledge, formal training in AI, perceived applications, confidence in integrating AI/ML tools, and concerns regarding errors, bias, and ethical implications. A total of 65 vascular surgeons participated in the survey, with a response rate of 16.5%.</div></div><div><h3>Results</h3><div>Respondents (median age, 41 years; mean age, 43.9 years) were predominantly male (70%), with 45% having less than 10 years of practice experience. Although most (44%) rated their AI/ML knowledge as “fair,” 90% reported no formal training in AI, indicating a substantial knowledge gap. Despite this, 74% expressed moderate to high excitement about AI/ML, with 61% believing it could significantly or extremely improve patient outcomes. The primary areas of interest included image analysis, clinical decision support, and patient selection. Concerns centered on errors leading to patient harm (47%) and data security/privacy issues (42%), and 67% of clinicians reported moderate to high levels of ethical concern.</div></div><div><h3>Conclusions</h3><div>Middle Eastern vascular surgeons acknowledge the potential of AI/ML to improve patient care but face significant barriers to adoption, including limited knowledge, training deficits in AI, and ethical concerns. Addressing these challenges through targeted education, transparent AI/ML tools, and ethical oversight is critical for successful integration into clinical practice. These findings highlight the need for tailored strategies to bridge the gap between AI/ML innovation and its practical utility in vascular surgery.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"4 ","pages":"Article 100347"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077721","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":"Comparison of patient outcomes following endovascular vs surgical management of infrainguinal autogenous bypass stenosis","authors":"Meghan McGillivray MD ,&nbsp;Ningzhi Gu MD ,&nbsp;Mark Tatangelo PhD, MBA, BA ,&nbsp;Jason Faulds MD, MHSc, FRCSC ,&nbsp;Jonathan Misskey MD, MHPE, FRCSC","doi":"10.1016/j.jvsvi.2025.100341","DOIUrl":"10.1016/j.jvsvi.2025.100341","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to evaluate outcomes of open vs endovascular intervention for infrainguinal bypass stenosis.</div></div><div><h3>Methods</h3><div>A single-institution retrospective review of infrainguinal bypass stenosis cases from January 1, 2010, to December 31, 2020, was conducted. Data collected included index bypass operation, lesion characteristics, reintervention, and patient outcomes.</div></div><div><h3>Results</h3><div>Of the 146 patients included, 40% underwent open intervention, whereas 60% underwent endovascular intervention. There were no significant differences between the index bypasses of each cohort with respect to inflow, outflow, conduit, or primary patency. The severity of stenotic lesions in open and endovascular cohorts was &gt;70% severity on duplex ultrasound in 76% and 78% of patients, respectively (<em>P</em> = .02). Lesion location was not significantly different between cohorts with 48% proximal, 27% distal, 8% midgraft, 3% venovenostomy, and 14% multiple stenotic lesions. There was no significant difference in primary revision patency in open vs endovascular intervention (1109 vs 809 days; <em>P</em> = .09). The average number of repeat interventions was not significantly different (0.47 vs 0.58 times; <em>P</em> = .48); however, the average cumulative hospital length of stay was significantly shorter for patients who underwent endovascular intervention (8.21 vs 5.22 days; <em>P</em> = .02). During the study period, a comparable portion of patients in open and endovascular cohorts went on to have failed bypass grafts (17% vs 18%) with no significant difference in the total time to graft failure in these subgroups (860 vs 1144 days; <em>P</em> = .47). There were no significant differences in major adverse limb events (12% vs 8%; <em>P</em> = .59) or mortality (47% vs 40%; <em>P</em> = .52).</div></div><div><h3>Conclusions</h3><div>Open and endovascular interventions for infrainguinal bypass stenosis showed no significant differences in primary revision patency, graft failure rates, major adverse limb events, or mortality. Endovascular intervention was associated with shorter cumulative hospital stays for reintervention.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"4 ","pages":"Article 100341"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977853","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":"Retrograde tibiopedal access as an alternative procedural technique for genicular artery embolization","authors":"Nishanth Konduru,&nbsp;Anton Hnatov BS,&nbsp;Siddhartha Rao MD","doi":"10.1016/j.jvsvi.2025.100339","DOIUrl":"10.1016/j.jvsvi.2025.100339","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study is to assess the feasibility, safety, and technical outcomes of genicular artery embolization (GAE) performed via retrograde tibiopedal access.</div></div><div><h3>Materials and Methods</h3><div>GAE was performed in 357 patients utilizing tibiopedal access. Patient eligibility was determined through a comprehensive clinical evaluation and radiographic imaging. Embolic agents were delivered through a microcatheter to the targeted arteries by an interventional cardiologist with an additional 1 year of fellowship training in endovascular medicine and certification from the American Board of Vascular Medicine. Technical success was defined as successful embolization of at least two genicular arteries, with subsequent resolution of arterial blush. Peri and post-procedural data and complications related to the access site were assessed.</div></div><div><h3>Results</h3><div>Technical success was obtained in 96.6% of cases. Patient ages ranged from 38 to 98 years, with body mass index ranging from 18.01 to 63.23 kg/m². Across this study cohort, 3.7 ± 1.0 genicular arteries were embolized, with a mean procedure time of 51.3 ± 13.0 minutes. Procedure time was measured from initial injection of lidocaine to application of hemostatic device. Results also show 25% improvement in average procedure duration after 50 cases, suggesting a brief learning curve for GAE. Post-procedural complications occurred in 4.5% of cases (n = 16) and were associated only with minor, transient side effects.</div></div><div><h3>Conclusions</h3><div>GAE via tibiopedal access offers a viable alternative to the conventional femoral approach reported in recent literature. In this study, retrograde access consistently enabled successful completion of GAE without notable discrepancies in treatment efficacy or safety. This approach resulted in a high technical success rate with no significant complications. Study findings support the potential for widespread adoption of the retrograde approach for treating osteoarthritis with GAE, particularly in patients in whom an antegrade approach may pose a higher risk of complications.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"4 ","pages":"Article 100339"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977849","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}