1,721,111 research outputs found
Arterial access for endovascular treatment of lower extremity peripheral arterial disease: A choice that matters and a matter of choice
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Atherosclerotic Renal Artery Stenosis in the Post-CORAL Trial Era. A Narrative Review
Full text linkAtherosclerotic renal artery stenosis (ARAS) represents a common manifestation of systemic atherosclerosis and remains an underrecognized cause of secondary hypertension, chronic kidney disease, and cardiovascular morbidity. Although often clinically silent, progressive narrowing of the renal artery may result in renovascular hypertension, ischemic nephropathy, or cardiac destabilization syndromes such as recurrent pulmonary edema. The pathophysiology of ARAS extends beyond simple flow limitation, involving renin-angiotensin-aldosterone system activation, oxidative stress, microvascular rarefaction, and parenchymal fibrosis, thereby explaining the limited reversibility of renal damage after revascularization. Over the past decades, management strategies have evolved considerably. While initial enthusiasm for surgical or endovascular revascularization was supported by observational reports of improved blood pressure and renal function, randomized controlled trials-including ASTRAL and CORAL-failed to demonstrate a consistent benefit of stenting over optimal medical therapy in unselected patients. These findings have shifted current practice toward medical therapy as the cornerstone of management, integrating renin-angiotensin system inhibitors, statins, antiplatelet agents, and, more recently, SGLT2 inhibitors. Nevertheless, accumulating evidence indicates that specific high-risk subsets-patients with resistant hypertension, recurrent pulmonary edema, or progressive ischemic nephropathy-may derive meaningful clinical benefit from timely revascularization. In the post-CORAL era, the central challenge is therefore accurate patient selection to identify the small group in whom revascularization remains appropriate, leveraging advanced imaging, physiological indices, and risk stratification
Nothing New Under the Sun of the European Society for Vascular Surgery Carotid Guidelines
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sj-tiff-1-jet-10.1177_15266028231179864 – Supplemental material for Total Transfemoral Branched Endovascular Thoracoabdominal Aortic Repair (TORCH2): Short-term and 1-Year Outcomes From a National Multicenter Registry
No full textSupplemental material, sj-tiff-1-jet-10.1177_15266028231179864 for Total Transfemoral Branched Endovascular Thoracoabdominal Aortic Repair (TORCH2): Short-term and 1-Year Outcomes From a National Multicenter Registry by D’Oria Mario, Grandi Alessandro, Pratesi Giovanni, Parlani Gianbattista, Giudice Rocco, Gargiulo Mauro, Mangialardi Nicola, Chiesa Roberto, Lepidi Sandro and Bertoglio Luca in Journal of Endovascular Therapy</p
Intraoperative rescue of a dislodged renal stent during fenestrated endovascular aortic repair for treatment of type 1A endoleak
Full text linkIn the past 15 years, fenestrated-branched endovascular aortic repair (F-BEVAR) has progressively become the first-line option for management of most complex abdominal aortic aneurysms (AAAs); with increasing experience, as well as persistent technological refinements, F-BEVAR indications have been expanded to include rescue of failures after prior EVAR. Despite the feasibility and effectiveness, F-BEVAR procedures in the presence of prior infrarenal endografts may come with higher technical complexity that should be properly anticipated, and several anatomical challenges can be expected. Among these, presence of suprarenal bare stents from prior EVAR device are certainly a frequent scenario and may sometimes make target vessel cannulation more difficult because of encroachment on the target vessel origins. In this manuscript, we report a case intraoperative rescue of a dislodged renal stent during FEVAR for treatment of type 1 endoleak with the aim of showing the culprit of the complication, how to recognize it, and the off-label solution that was devised to solve it
sj-pptx-2-jet-10.1177_15266028231179864 – Supplemental material for Total Transfemoral Branched Endovascular Thoracoabdominal Aortic Repair (TORCH2): Short-term and 1-Year Outcomes From a National Multicenter Registry
No full textSupplemental material, sj-pptx-2-jet-10.1177_15266028231179864 for Total Transfemoral Branched Endovascular Thoracoabdominal Aortic Repair (TORCH2): Short-term and 1-Year Outcomes From a National Multicenter Registry by D’Oria Mario, Grandi Alessandro, Pratesi Giovanni, Parlani Gianbattista, Giudice Rocco, Gargiulo Mauro, Mangialardi Nicola, Chiesa Roberto, Lepidi Sandro and Bertoglio Luca in Journal of Endovascular Therapy</p
Current expert-based opinions on endovascular treatment of blunt thoracic aortic injury: A state-of-the-art narrative review on indications, techniques, results, and challenges
No full textIntroduction: Blunt thoracic aortic injury (BTAI) represents one of the most devastating scenarios of vascular trauma which warrants prompt recognition with expedited management. Clinical manifestations of BTAI may not be straightforward to detect and may be misdiagnosed. Therefore, diagnosis of BTAI requires a high index of suspicion based on the mechanism of injury along with urgent transfer to centers with appropriate expertise and facilities. Methods: We provide an expert-based narrative review on endovascular treatment of BTAI highlighting indications, techniques, results, and challenges. Results: Multiple imaging modalities can be used including computed tomography angiography, transesophageal echocardiography, magnetic resonance imaging, and intravascular ultrasound. Whilst conservative pharmacological management can be a safe option in low-grade BTAI, thoracic endovascular aortic repair has become the gold-standard strategy in most cases, replacing open surgical repair. Nevertheless, it is important to account for patient demographics particularly age, severity of injury, choice of endograft including its type and size, and endovascular technique including landing zone and left subclavian artery revascularization. Conclusions: Overall, TEVAR in BTAI has been shown to be an efficacious strategy with favorable early outcomes. In contrast, less is known on the long-term clinical outcomes of TEVAR in BTAI. Hence, despite the optimal early technical and clinical success rates, concerns remain about the need for long-term surveillance. The exact timing of follow-up and the integration of different modalities that can also investigate potential downstream cardiovascular effects remain hot topics for future research. Finally, industry should focus on developing more compliant endografts to improve the stiffness mismatch between the endograft and the aorta to optimize results
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