Annals of vascular surgery最新文献

{"title":"Comparison of Cook Zenith and Relay plus Physician-Modified Endografts for Complex Abdominal and Thoracoabdominal Aortic Aneurysms","authors":"Samuel Saers ,&nbsp;Emiel W.M. Huistra ,&nbsp;Wajdi Alrawi ,&nbsp;Artai Pirouzram ,&nbsp;Clark J. Zeebregts ,&nbsp;Helene Zachrisson ,&nbsp;Robert C. Lind","doi":"10.1016/j.avsg.2025.11.142","DOIUrl":"10.1016/j.avsg.2025.11.142","url":null,"abstract":"<div><h3>Background</h3><div>Complex abdominal aortic aneurysms (CAAAs) or thoracoabdominal aneurysms (TAAs) often require urgent repair, but custom-made devices are unavailable in such settings. Physician-modified endografts (PMEGs) allow for rapid, patient-specific fenestrated or branched endografts. This study assessed clinical outcomes of CAAA and TAA PMEGs performed at a single Swedish center and compared results using the Cook Zenith and Relay Plus platforms.</div></div><div><h3>Methods</h3><div>A retrospective single-center review was conducted on all CAAA and TAA PMEG procedures at Linköping University Hospital between January 2012 and December 2023. Data were collected retrospectively. Primary outcomes included mortality and technical success; secondary outcomes were major adverse events (MAEs) within 30 days, reinterventions, and bridging stent-graft patency.</div></div><div><h3>Results</h3><div>All patients were treated using either the Zenith or Relay Plus systems. 42 patients were included (20 Zenith, 22 Relay Plus). Relay Plus was used more frequently in TAA (0% vs. 36%, <em>P</em> = 0.004). Median follow-up duration was 4.8 years (1.8–8.2 years). Technical success was 90% in both groups. Four-year all-cause survival was 64% in both subgroups (<em>P</em> = 0.49). MAEs within 30 days occurred in 12% (<em>n</em> = 5) without significant subgroup differences. Freedom from reintervention was 69% in the Zenith group and 59% in the Relay Plus group at 4 years (<em>P</em> = 0.34). Bridging stent-graft primary, primary assisted and secondary patencies were 91%, 97%, and 98%, respectively at 4 years.</div></div><div><h3>Conclusion</h3><div>PMEGs using both platforms offer favorable outcomes in mortality, technical success, MAEs, and target vessel patency. Despite Relay Plus being used in more complex anatomies, no significant outcome differences were observed. This study supports the use of both Zenith and Relay Plus in the construction of PMEGs.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"124 ","pages":"Pages 404-417"},"PeriodicalIF":1.6,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midterm Outcomes of Preemptive Side Branch Embolization Aimed for Total Branch Embolization During Endovascular Aneurysm Repair","authors":"Yu Nosaka,&nbsp;Masahiro Ikeda,&nbsp;Teruaki Ushijima,&nbsp;Hirofumi Takemura","doi":"10.1016/j.avsg.2025.12.009","DOIUrl":"10.1016/j.avsg.2025.12.009","url":null,"abstract":"<div><h3>Background</h3><div>We performed preemptive side branch embolization (PBE) during endovascular aneurysm repair (EVAR) to prevent type 2 endoleak (T2EL). Our aggressive PBE (A-PBE) strategy aims to embolize all patent side branches of abdominal aortic aneurysm (AAA) identified on preoperative computed tomography (CT). This study evaluated midterm clinical outcomes for that strategy.</div></div><div><h3>Methods</h3><div>Participants comprised 140 of 163 patients who underwent primary EVAR between 2015 and 2024. A total of 33 patients received A-PBE based on age, comorbidities, and activities of daily living (A-PBE group). The remaining 107 patients were assigned to the O group. Outcomes examined were changes in aneurysm sac diameter, reintervention rates, and T2EL incidence.</div></div><div><h3>Results</h3><div>The mean follow-up was 3.0 ± 2.3 years for the A-PBE group and 4.0 ± 2.6 years for the O group. The incidence of sac shrinkage was significantly higher in the A-PBE group (63.6% vs. 37.4%, <em>P</em> = 0.0078). The incidences of sac enlargement and T2EL were significantly lower in the A-PBE group (6.1% vs. 28.0%, <em>P</em> = 0.0086; 15.2% vs. 36.4%, <em>P</em> = 0.031, respectively). Sixteen patients in the O group (15.0%) required reintervention for sac enlargement, compared to none in the A-PBE group. Total embolization was achieved in 57.6% of A-PBE cases, with only one sac enlargement and T2EL due to incomplete embolization. Operative and fluoroscopy times and contrast agent usage were higher in the A-PBE group, but no postoperative complications or new dialysis occurred.</div></div><div><h3>Conclusion</h3><div>A-PBE effectively promotes sac shrinkage and reduces T2EL and sac enlargement, potentially improving long-term EVAR outcomes in selected patients.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"125 ","pages":"Pages 54-61"},"PeriodicalIF":1.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting High-Risk Populations for Abdominal Aortic Aneurysm Screening: A Sex-Stratified Analysis in an Ethnicity Diverse Cohort Incorporating Machine Learning Tools","authors":"Maysam Shehab ,&nbsp;Ziad Arow ,&nbsp;Lior Ben Hemo ,&nbsp;Adi R. Bachar ,&nbsp;Sharon Yalov-Handzel ,&nbsp;Tzipi Hornik-Lurie","doi":"10.1016/j.avsg.2025.12.010","DOIUrl":"10.1016/j.avsg.2025.12.010","url":null,"abstract":"<div><h3>Background</h3><div>Abdominal aortic aneurysm (AAA) is usually asymptomatic, but rupture carries up to 90% mortality. Ultrasound screening reduces rupture-related mortality in ever-smoking men older than 65. Women have 4-fold lower prevalence but worse outcomes and were markedly underrepresented in major AAA trials. We analyzed a nationwide database to identify high-risk subgroups.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed individuals aged ≥50 years who underwent ultrasound screening for AAA from the nationwide Clalit-Health-Services database (2013–2023). Sex-stratified logistic regression and machine learning models were applied to identify high-risk groups.</div></div><div><h3>Results</h3><div>A total of 70,149 individuals underwent screening, including 32,269 (46%) of Middle Eastern or North African descent and 24,776 (35.3%) women. AAA prevalence was 9.5% in men and 3.2% in women. In women, AAA was associated with age &gt;75 (odds ratio [OR]: 2.22, 95% confidence interval: 1.74–2.84, <em>P</em> &lt; 0.001), ever smoking (OR: 3.08, 2.63–3.60, <em>P</em> &lt; 0.001), and high CHA₂DS₂-VASc &gt;4 (OR: 3.27, 2.25–4.74, <em>P</em> &lt; 0.001). In men, age &gt;75 (OR: 1.93, 1.71–2.18, <em>P</em> &lt; 0.001), smoking (OR: 1.52, 1.38–1.67, <em>P</em> &lt; 0.001), and high CHA₂DS₂-VASc (OR: 1.84, 1.65–2.06, <em>P</em> &lt; 0.001) were significant. Ethnicity modestly increased AAA odds in men. Consistent with logistic regression, machine learning-based probability curves demonstrated higher predicted AAA risk with advancing age, higher CHA₂DS₂-VASc scores, smoking, and peripheral arterial disease, particularly among women &gt;75 years.</div></div><div><h3>Conclusion</h3><div>Our findings indicate that AAA screening should consider age, smoking status and cardiovascular risk factors, including in women, where higher ORs were observed.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"125 ","pages":"Pages 73-83"},"PeriodicalIF":1.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-Stage Open Ascending Aorta Replacement Followed by Total Aortic Arch Repair Using a Double-Fenestrated Physician-Modified Endograft for Patients with an Aortic Arch Aneurysm and an Aneurysmal Ascending Aorta","authors":"Christoph Bacri ,&nbsp;Baptiste Durant ,&nbsp;Kheira Hireche ,&nbsp;Pierre Alric ,&nbsp;Thomas Gandet ,&nbsp;Ludovic Canaud","doi":"10.1016/j.avsg.2025.11.143","DOIUrl":"10.1016/j.avsg.2025.11.143","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study is to report the feasibility and outcomes of a two-stage open ascending aorta replacement followed by total aortic arch repair using a double-fenestrated physician-modified endograft for aortic arch and ascending aorta aneurysm.</div></div><div><h3>Methods</h3><div>All consecutive patients presenting with an aortic arch aneurysm and treated between 2020 and 2024 were reviewed. Inclusion criteria included arch aneurysm with aneurysmal ascending aorta compromising the proximal landing zone. Study endpoints were technical success, 30-day outcomes, and mid-term follow-up analysis of mortality, morbidity, and reinterventions.</div></div><div><h3>Results</h3><div>Ten patients met the inclusion criteria. The median age was 68.5 years. Half had post-type B dissections, half had degenerative aneurysms. No patients died or experienced a stroke following open repair. All patients successfully underwent both procedures. The median interval between the two surgeries was 70 days. Technical success of the endovascular procedure was 100%. One patient required early reintervention after open surgery for hemostasis, and another required reintervention after the endovascular procedure for a false aneurysm at the brachial puncture site. One patient experienced a regressive stroke on postdischarge day 10 due to a sylvian artery occlusion. During mid-term follow-up, no patient died from aortic-related causes. One patient required a left subclavian artery stent extension for a type 1c endoleak 2 years after the procedure. No patients exhibited impaired renal function.</div></div><div><h3>Conclusion</h3><div>Two-staged open ascending aortic repair followed by endovascular arch repair using a double-fenestrated physician-modified endograft is a feasible, safe, and promising option that avoids the need for circulatory arrest.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"125 ","pages":"Pages 1-10"},"PeriodicalIF":1.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study Comparing the Outcomes of Ruptured Post-EVAR Aneurysms with Those Occurring Without Previous Treatment","authors":"Konstantinos G. Moulakakis ,&nbsp;Andreas M. Lazaris ,&nbsp;Constantine N. Antonopoulos ,&nbsp;George S. Sfyroeras ,&nbsp;Chris Klonaris ,&nbsp;Athanasios Katsargyris ,&nbsp;Natasha Hasemaki ,&nbsp;Stavros Kakkos ,&nbsp;Spyros I. Papadoulas ,&nbsp;Chrysostomos Maltezos ,&nbsp;Anastasios Papapetrou ,&nbsp;George C. Kopadis ,&nbsp;Spyridon N. Mylonas ,&nbsp;Konstantinos Papazoglou ,&nbsp;Ioannis Bountouris ,&nbsp;Theophanis T. Papas ,&nbsp;Konstantinos Seretis ,&nbsp;Christos V. Ioannou ,&nbsp;Nikolaos Kontopodis ,&nbsp;Michail Peroulis ,&nbsp;John D. Kakisis","doi":"10.1016/j.avsg.2025.11.141","DOIUrl":"10.1016/j.avsg.2025.11.141","url":null,"abstract":"<div><h3>Background</h3><div>Although endovascular aortic repair (EVAR) has been increasingly used for the treatment of abdominal aortic aneurysm (AAA), rupture is still a life-threatening event in 1–5% of those treated patients. We aimed to compare the characteristics, hemodynamic status at presentation, and outcomes between patients with previous EVAR (ruptured EVAR [rEVAR]) and those with no previous aortic intervention (rWPT group) who presented with AAA rupture.</div></div><div><h3>Methods</h3><div>Between January 2019 and November 2023, all consecutive patients who experienced a ruptured infrarenal/juxtarenal AAA, received endovascular or open intervention and prospectively recorded in the Hellenic Vascular Registry (Greek) were analyzed. The two groups of patients (rEVAR and rWPT) were compared.</div></div><div><h3>Results</h3><div>A total of 203 patients with AAA rupture were studied. Among them, 40 patients (19.7%) had previous EVAR for AAA (rEVAR group), while the remaining (163; 80.3%) were included in the rWPT group. Patients with rEVAR were on average 5.8 years significantly older (<em>P</em> &lt; 0.001). There was no significant difference regarding the hemodynamic status at presentation between rEVAR and rWPT groups. The overall mortality was 40.4% (82/203). Mortality for patients with rEVAR was 37.5% compared to 41.1% for the group of rWPT (<em>P</em> = 0.7). Among all patients, age (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 1.04–1.12; <em>P</em> &lt; 0.001), hemodynamic shock at initial presentation (OR: 6.57, 95% CI: 2.52–17.12; <em>P</em> &lt; 0.001), and open repair (OR: 5.31, 95% CI: (2.33–12.08; <em>P</em> &lt; 0.001) were significant prognostic factors of mortality.</div></div><div><h3>Conclusion</h3><div>Our study provides evidence that patients with post-EVAR rupture are equally hemodynamically unstable at presentation compared to patients with de novo ruptures. The mortality associated with post-EVAR rupture is high and not inferior compared to that observed for de novo ruptures. Significant risk factors for a dismal outcome in the whole cohort of patients who presented with AAA rupture were age, hemodynamic shock at initial presentation, and open repair.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"124 ","pages":"Pages 394-403"},"PeriodicalIF":1.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duration of Antimicrobial Treatment After Total Explantation of Infected Abdominal Aortic Vascular Grafts: A Systematic Review","authors":"K. Cremer ,&nbsp;M. Wouthuyzen-Bakker ,&nbsp;I.J.E. Kouijzer ,&nbsp;B.R. Saleem ,&nbsp;J.P.P.M. de Vries ,&nbsp;S.E. van Roeden","doi":"10.1016/j.avsg.2025.12.014","DOIUrl":"10.1016/j.avsg.2025.12.014","url":null,"abstract":"<div><h3>Background</h3><div>Vascular graft or endograft infection (VGEI) is a rare but severe complication of vascular surgery, associated with high mortality. In addition to surgical intervention, targeted antimicrobial treatment is essential. However, current guidelines lack consensus on the optimal postoperative treatment duration. This systematic review evaluates the optimal length of antimicrobial treatment in patients with abdominal VGEI after total graft explantation.</div></div><div><h3>Design</h3><div>Systematic review.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, Embase, and Cochrane Library databases up to December 19, 2024. Eligible studies reported on antimicrobial treatment following total explantation of infected abdominal vascular grafts, including cases with graft-related fistulas. Exclusion criteria comprised studies on partial graft explantation, specific microorganisms causing distinct clinical diseases (<em>Coxiella burnetii</em>, <em>Brucella</em> species), mycobacterial infections, infected native aortoiliac aneurysms, and thoracic and peripheral VGEI. The primary outcome was all-cause mortality; secondary outcomes included 30-day mortality, infection-free survival, infection recurrence, and graft patency. Risk of bias was assessed using the Newcastle-Ottawa Scale.</div></div><div><h3>Results</h3><div>Of 132 screened studies, 7 retrospective cohort studies comprising 776 patients met the inclusion criteria. Reported postoperative antimicrobial treatment durations ranged from 2 to 170 weeks (median 13 weeks), with some studies describing lifelong treatment. All-cause mortality varied between 23% and 57%. No association could be found between antimicrobial treatment duration and mortality.</div></div><div><h3>Discussion</h3><div>Limitations include the retrospective design, leading to confounding by indication and information bias. Patient populations were heterogeneous, and follow-up durations were often insufficient for long-term outcome assessment. This review underscores the limited quality of evidence available on this topic and underlines the importance of good quality research.</div></div><div><h3>Conclusion</h3><div>The optimal postoperative antimicrobial treatment duration following complete explantation of infected abdominal grafts remains uncertain.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"124 ","pages":"Pages 385-393"},"PeriodicalIF":1.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Equipoise to Evidence: Pre-Trial Setup of the European Uncomplicated Type B Aortic Repair Clinical Trial","authors":"Mohamad Bashir ,&nbsp;Matti Jubouri ,&nbsp;Abdelaziz O. Surkhi ,&nbsp;Yousif Jubouri ,&nbsp;Amr Abdelhaliem ,&nbsp;Ömer Tanyeli ,&nbsp;Murat Ugur ,&nbsp;Alberto Guagliano ,&nbsp;Mario D'Oria ,&nbsp;Raffaello Bellosta ,&nbsp;Luca Bertoglio ,&nbsp;Daniela Mazzaccaro ,&nbsp;Giovanni Nano ,&nbsp;Pasqualino Sirignano ,&nbsp;Giovanni Pratesi ,&nbsp;Stefano Bartoli ,&nbsp;Maria José Alcaraz García ,&nbsp;Joaquin Perez-Andreu ,&nbsp;Tomasz Hirnle ,&nbsp;Karin Pfister ,&nbsp;Gabriele Piffaretti","doi":"10.1016/j.avsg.2025.12.007","DOIUrl":"10.1016/j.avsg.2025.12.007","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Optimal management of uncomplicated type B aortic dissection (uTBAD) remains debated. While thoracic endovascular aortic repair (TEVAR) promotes false lumen thrombosis (FLT) and remodeling, the early clinical profile and long-term benefits in routine practice need further investigation. The pre-trial setup of the European Uncomplicated Type B Aortic Repair (EU-TBAR) program prospectively collated multicenter outcomes to evaluate real-world clinical outcomes of TEVAR for uTBAD across European centers, and to identify independent predictors of mortality, reintervention, and aortic remodeling to inform the design of a definitive randomized EU-TBAR trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Multicenter observational cohort of consecutive patients undergoing TEVAR for uTBAD and related descending thoracic pathology across European centers. Standardized electronic case-report forms captured demographics, presentation, imaging, procedural details, and outcomes. Primary outcomes were in-hospital and follow-up mortality; secondary outcomes included complications, reintervention, and aortic remodeling. Multivariable logistic regression identified predictors of mortality, reintervention, and remodeling.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We analyzed 263 patients (mean age 61.4 ± 13.4 years; 79.5% male) from six countries. In-hospital mortality was 9.9%, and mortality during follow-up was 14.1% (median follow-up time ≈ 1 year). Postoperative acute kidney injury (AKI) was the strongest independent predictor of death (odds ratio [OR] 9.93, &lt;em&gt;P&lt;/em&gt; &lt; 0.0001); additional predictors included AKI at presentation (OR 4.24, &lt;em&gt;P&lt;/em&gt; = 0.012), syncope (OR 3.15, &lt;em&gt;P&lt;/em&gt; &lt; 0.0001), and ventilation for &gt;48 hr (OR 2.69, &lt;em&gt;P&lt;/em&gt; = 0.024). Higher hemoglobin (OR 0.74 per g/dL, &lt;em&gt;P&lt;/em&gt; &lt; 0.0001) and estimated glomerular filtration rate (OR 0.79 per 10 units, &lt;em&gt;P&lt;/em&gt; &lt; 0.0001) were protective; reintervention was associated with lower mortality (OR 0.26, &lt;em&gt;P&lt;/em&gt; = 0.013). Reintervention occurred in 18.3% at a median of 168 days; discharge endoleak (present in 18.3%) tripled reintervention odds (OR 3.08, &lt;em&gt;P&lt;/em&gt; = 0.003). Imaging at discharge and follow-up was performed in 70.7% and 63.9%, respectively. At follow-up, FLT was complete in 42.1% and partial in 39.3%. Remodeling was associated with beta-blockers (descending aorta OR 3.58, &lt;em&gt;P&lt;/em&gt; = 0.009), prior thoracic surgery (suprarenal OR 5.47; infrarenal OR 8.33; both &lt;em&gt;P&lt;/em&gt; = 0.008), and targeted branch stenting (e.g., celiac OR 31.0, &lt;em&gt;P&lt;/em&gt; = 0.016). Female sex independently predicted FLT (OR 11.53, &lt;em&gt;P&lt;/em&gt; = 0.022). Survival was lower for emergent cases (65% vs 79–78%; &lt;em&gt;P&lt;/em&gt; = 0.039) and in patients with postoperative AKI (36% vs. 86%; &lt;em&gt;P&lt;/em&gt; &lt; 0.001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This pre-trial setup and analysis successfully confirm the feasibility and methodological foundation for the definitive EU-TBAR trial. Ther","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"125 ","pages":"Pages 230-247"},"PeriodicalIF":1.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polyurethane Peripheral Venous Catheter as a Permanent Microvascular Graft in a Rat Model: Potential Application as an Artificial Vascular Graft in Digital Replantation","authors":"Zeki Gunsoy ,&nbsp;Sevgi Vermisli Ciftci ,&nbsp;Mehmet Emre Topcu ,&nbsp;Fatih Golgelioglu ,&nbsp;Gokhan Sayer ,&nbsp;Sinan Oguzkaya","doi":"10.1016/j.avsg.2025.11.146","DOIUrl":"10.1016/j.avsg.2025.11.146","url":null,"abstract":"<div><h3>Background</h3><div>Restoring vascular continuity is crucial in digital replantation when direct anastomosis is not possible. Although autologous vein grafts are standard, they pose technical challenges and donor-site morbidity. This study evaluated the short-term patency and histopathological response of inexpensive and readily available polyurethane peripheral venous catheters (PPVC) grafts in a rat femoral artery model.</div></div><div><h3>Methods</h3><div>Twenty male Wistar Albino rats were randomly divided into 2 groups: PPVC graft (<em>n</em> = 10) and autologous vein graft (<em>n</em> = 10). A 5-mm femoral artery defect was repaired with either a 26G PPVC or a contralateral femoral vein segment. After 3 weeks, vascular patency was assessed by ultrasonography and histopathology. Thrombus formation, fibrosis, neovascularization, calcification, and inflammatory infiltration were semiquantitatively scored (0–3). Statistical analysis was performed using the Mann–Whitney U and Fisher exact tests, with <em>P</em> &lt; 0.05 considered significant.</div></div><div><h3>Results</h3><div>Compared with the autograft group, the PPVC group demonstrated significantly higher scores for thrombus formation (<em>P</em> &lt; 0.001), fibrosis (<em>P</em> = 0.002), neovascularization (<em>P</em> = 0.001), and inflammatory infiltration (<em>P</em> = 0.003). Calcification was not observed in either group. Severe thrombus formation occurred in one rat in the autograft group and 3 in the PPVC group. Despite these findings, no clinical signs of ischemia, including discoloration or gait impairment, were observed during follow-up.</div></div><div><h3>Conclusion</h3><div>PPVC grafts are technically feasible and show partial biological integration within 3 weeks. However, higher thrombosis, fibrosis, and inflammation indicate limited short-term patency compared with autologous grafts. Further studies with longer follow-up and surface modifications are needed.</div></div>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"124 ","pages":"Pages 376-384"},"PeriodicalIF":1.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Wound, Ischemia, and Foot Infection Classification Stratifies Amputation Risk but Not Patient Experience in Chronic Limb-Threatening Ischemia","authors":"Shiwen Song,&nbsp;Ping Li","doi":"10.1016/j.avsg.2025.12.004","DOIUrl":"10.1016/j.avsg.2025.12.004","url":null,"abstract":"","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"125 ","pages":"Pages 11-12"},"PeriodicalIF":1.6,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: “Medical Management of Patients With Symptomatic Carotid Artery Stenosis”","authors":"Edoardo Destefanis Gallo,&nbsp;Ilaria Salzillo,&nbsp;Vittorio Arici,&nbsp;Vittorio Danesino,&nbsp;Antonio Bozzani","doi":"10.1016/j.avsg.2025.12.002","DOIUrl":"10.1016/j.avsg.2025.12.002","url":null,"abstract":"","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":"124 ","pages":"Page 373"},"PeriodicalIF":1.6,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}