Severe Atherosclerotic Stenosis Research Articles

Quantitative Measurement of Cerebral Blood Flow in Enhanced Psedo-continuous Arterial Spin Labeling Perfusion Imaging in Patients with Intracranial Atherosclerotic Stenosis.

Objective To acquire cerebral blood flow (CBF) in patients with severe intracranial atherosclerotic stenosis with enhanced pseudo-continuous arterial spin labeling (e-pCASL) and compare it with the findings of dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC PWI) and pseudo-continuous arterial spin labeling (pCASL). Methods A total of 39 consecutive patients with severe intracranial atherosclerotic stenosis were enrolled in this study. All these patients underwent e-pCASL, pCASL, and DSC PWI. Blood supply territory of the stenosed artery was outlined as region of interest (ROI) and a mirror ROI was applied. Ratios of CBF were calculated as value of ROI/value of mirror ROI. SNK variance analysis was conducted to compare the CBF values of three persufion methods. Factorial analysis of variance and Pearson were employed to analysis the difference and the correlation of e-pCASL CBF ratio, pCASL CBF ratio, and DSC PWI relative cerebral blood flow(rCBF) ratio. Results The e-pCASL CBF ratio, pCASL CBF ratio, and DSC PWI rCBF ratio were not significantly different (P=0.476). TTP showed the CBF ratios were not significantly different between the healthy side and diseased side in patients with severe intracranial atherosclerotic stenosis. ATT showed the correlations of pCASL CBF ratio and DSC PWI rCBF ratio were not affected by ATT. Conclusions e-pCASL with multiple-post labeling delay time and pCASL have good consistency with DSC PWI in the quantitative measurement of hypoperfusion pattern. As an accurate, simple, non-invasive, and repeatable technique, e-pCASL has good correlation with DSC PWI in the quantitative measurement of hypoperfusion pattern that is not affected by ATT.

Safety and Efficacy of Wingspan Stenting for Severe Symptomatic Atherosclerotic Stenosis of the Middle Cerebral Artery: Analysis of 278 Continuous Cases

Our objective is to investigate the safety and long-term efficacy of the Wingspan stent (Boston Scientific, Natick, MA, USA) for treating severe atherosclerotic stenosis of the middle cerebral artery (MCA). A total of 278 consecutive patients from our stroke database with clinical symptoms within the prior 90 days and intracranial atherosclerotic stenosis of 70% or above of the MCA were enrolled in this study between September 2012 and November 2014, and these patients were followed until the end of June 2015. The endpoint events included any stroke or death within 30 days after stenting and any subsequent ipsilateral ischemic stroke. Among the 278 enrolled patients, 277 patients (99.6%) successfully underwent stenting. The mean rate of stenosis decreased from 82.5 ± 7.9% to 9.0 ± 3.2% following treatment. Within 30 days after stenting, 12 patients (4.3%) experienced endpoint events, including 8 cases (2.9%) of hemorrhagic stroke and 4 cases (1.4%) of ischemic stroke; 2 perioperative deaths occurred. During 8-33 months of follow-up, 19 patients developed endpoint events. The 1- and 2-year endpoint event rates were 5.8% (95% confidence interval [CI], 5.0%-15.7%) and 7.2% (95% CI, 4.3%-10.1%), respectively. From this study, we can conclude that the treatment of severe symptomatic atherosclerotic stenosis of the MCA using the Wingspan stent was safe and effective and that the long-term stroke recurrence rate after stenting was low.

A long-term follow-up results of Enterprise stent in treatment of severe symptomatic basilar artery atherosclerotic stenosis

To evaluate the safety and efficacy of Enterprise stent in the treatment of severe symptomatic basilar artery atherosclerosis stenosis. All patients who underwent Enterprise stent for the treatment of symptomatic basilar artery atherosclerotic stenosis in our center from Nov. 2011 to Nov. 2014 were enrolled in the study. Preoperative and postoperative dual antiplatelet drugs and intensive lipid-lowering therapy were given to all the patients. Multi-modality imaging guiding for stent angioplasty was performed in all the patients, including head MRI or CT, CT or MRI perfusion, high resolution MRI for plaque analysis and angiography. Angiography after 6 months was recommended. The main outcome parameters were any stroke or death within 30 days, stroke recurrence in the basilar artery blood supply area during the follow-up period and in-stent restenosis. A total of 35 cases were enrolled in the study with operation technical success rate of 100%. The average preoperative and postoperative stenosis rate was (83.0±10.1)% and (28.1±8.9)%. The main perioperative complication and mortality rate was 0. The average follow-up period was (10.6±7.9) months. During follow-up period, only 2 cases (5.7%) of TIA related to the stented artery were observed. In patients with follow-up period more than 6 months, 17 cases (56.7%) underwent cerebral angiography. Restenosis rate was 17.6%. One patient with in-stent restenosis suffered from transient cerebral ischemia and received another Enterprise stenting successfully. Long term follow-up results show that Enterprise stent for the treatment of symptomatic basilar artery severe stenosis is safe and recurrence of stroke can be prevented effectively.

Tissue Kallikrein Prevents Restenosis After Stenting of Severe Atherosclerotic Stenosis of the Middle Cerebral Artery: A Randomized Controlled Trial.

In-stent restenosis (ISR) following intracranial artery stenting affects long-term clinical outcome. This randomized controlled trial sought to identify the long-term efficacy of exogenous tissue kallikrein (TK) for preventing ISR after intracranial stenting of symptomatic middle cerebral artery (MCA) atherosclerotic stenosis.Sixty-one patients successfully treated with intracranial stenting for symptomatic MCA M1 segment stenosis (>70%) were enrolled and randomized into 2 groups: control group and TK group. Patients in the TK group received human urinary kallidinogenase for 7 days, followed by maintenance therapy of pancreatic kallikrein for 6 months. The primary end point was angiographically verified ISR at 6 months, and secondary end points included vascular events and death within 12 months. Endogenous TK plasma concentrations of patients were measured before stenting and at the 6-month follow-up time-point.Patients in the TK group had lower occurrence rates of ISR and vascular events than patients in the control group. There was no difference in endogenous TK levels in plasma at 6 months postoperatively between the TK and control groups. Further subgroup analysis revealed that patients without ISR had higher endogenous TK levels at baseline and lower concentrations at 6 months postoperatively compared with patients who underwent ISR.Exogenous TK is effective for the prevention of ISR after intracranial stenting.

Wingspan stenting can effectively prevent long-term strokes for patients with severe symptomatic atherosclerotic basilar stenosis

To investigate the safety and long-term effect of using the Wingspan stent for severe symptomatic atherosclerotic basilar artery stenosis (≥70%). Between July 2007 and April 2013, we had 91 consecutive patients (age range 41-82 years old) with symptomatic severe basilar stenosis (70-99%) who underwent Wingspan stenting at our center. All patients had stenosis-related temporary ischemic attack or strokes. We analyzed the demographic data, pre- and post-procedural cerebral angiography, technical success rate, peri-procedural complications, and clinical and imaging follow-ups. The Wingspan stenting procedure was successful in all patients: The stenosis was reduced from 82.2% ± 5.8% pre-stenting to 15.9% ± 5.7% post-stenting. The 30-day peri-operative rate for stroke or death was 14.3%, which included ischemic stroke in 12 cases (12/91 = 13.2%) and subarachnoid hemorrhage in one case (1/91 = 1.1%), with a fatal or disabling stroke rate of 2.2%. Among the 77 patients with clinical follow-up assessment within 7-60 months (mean 31.3 ± 15.1 months) after stenting, four patients (5.2%) had posterior ischemia, including one patient with disabling ischemic stroke (1.3%) and three patients (3.9%) with temporary ischemic attack. The 2-year cumulative stroke rate was 16% (95% CI: 8.2-23.8%). Among 46 patients with imaging assessments at 3-45 months (mean, 9.5 ± 8.3) post-stenting, six (13.0%) patients had restenosis, including two (2/46 = 4.3%) with symptomatic restenosis. The benefit of stenting for patients with severe basilar artery stenosis (> 70%) may lie in lowering the long-term fatal and disabling stroke rate; and as long as the peri-operative stroke rate can be kept at a relatively lower level, patients with severe basilar stenosis can benefit from basilar artery stenting.

Use of the Smart nitinol stent system for the treatment of severe atherosclerotic carotid stenosis: study protocol for a retrospective, non-randomized, long-term parallel controlled trial

Background: The carotid artery should be stented in patients with 70-90% stenosis owing to the high risk of stroke. The self-expanding Smart nitinol stent system is a popular treatment for carotid artery stenosis, because it is easy to manipulate and deploy, and endothelialization is rapid. Methods/Design: We conducted a retrospective, single-center, non-randomized, parallel controlled trial at Beijing Jishuitan Hospital, China. A cohort of 103 patients with severe atherosclerotic carotid stenosis was included in the analysis. Treatment was undertaken according to each patient's wishes after weighing the options: a Smart nitinol stent system (Cordis Corporation, Miami, FL, USA) was used in 40 patients, while 63 were managed conservatively with antiplatelet drugs. The primary outcome is the degree of disability and dependence 2 years after treatment, assessed by the modified Rankin Scale (mRS). The secondary outcomes are mRS score 90 days and 1 year after treatment, recurrence of cerebrovascular events, and severity of neurologic deficit measured using the National Institutes of Health Stroke Scale 1 and 2 years after treatment. Discussion: Previous studies of the Smart nitinol stent system for the treatment of carotid stenosis are mostly self-controlled case series or small cohort studies with short follow-up periods. Consequently, the long-term influence of Smart nitinol stent deployment on the risk of cerebrovascular events and long-term outcomes are not known. This trial illuminates the therapeutic benefits of the Smart nitinol stent system in a 2-year follow-up study of a large cohort of patients with severe atherosclerotic carotid stenosis. Trial registration: This trial was registered at ClinicalTrial.gov (NCT02800174). Ethics: The study protocol was approved by the Ethics Committee of Beijing Jishuitan Hospital, China (approval number: 201605-01) and conducted in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Informed consent: Written informed consent was obtained from participants or their guardians.

Severe symptomatic intracranial internal carotid artery stenosis treated with intracranial stenting: a single center study with 58 patients.

We aimed to investigate the safety and effectiveness of intracranial stenting in a population with severe (≥ 70%) symptomatic intracranial internal carotid artery (ICA) atherosclerotic stenosis. Fifty-eight patients with severe intracranial ICA atherosclerotic stenosis were prospectively enrolled. The baseline data, cerebral angiography, success rate, perioperative complications, clinical and imaging follow-up were prospectively analyzed. All patients had successful intracranial stenting (100%), and the mean degree of stenosis was improved from 84.3% ± 7.5% to 23.5% ± 5.1% after the stent procedure. During the 30-day perioperative period, only one patient (1.7%) had ischemic stroke. Seven patients (12.1%) had headache and dysphoria. Thirty-six patients (62.1%) had clinical follow-up for 6-68 months after stenting. Five female patients (13.9%) had ipsilateral stroke including one death, but no disabling stroke, while three other patients (8.3%) had ipsilateral temporary ischemic attack (TIA). The recurrent stroke rate was higher in patients presenting with stroke (4/17, 23.5%) than in patients presenting with TIA (1/19, 5.3%), with no statistical significance (P = 0.33). Thirteen patients (22.4%) had imaging follow-up of 5-12 months following stenting, five of whom (38.5%) had in-stent restenosis. Intracranial stenting for patients with intracranial ICA atherosclerotic stenosis has a low perioperative stroke rate and decent outcome on long-term follow-up, despite a relatively high in-stent restenosis rate.

Intraplaque Expression of C-Reactive Protein Predicts Cardiovascular Events in Patients with Severe Atherosclerotic Carotid Artery Stenosis

Serum c-reactive protein (CRP) was suggested for the assessment of intermediate cardiovascular (CV) risk. Here, systemic or intraplaque CRP levels were investigated as predictors of major adverse cardiovascular events (MACEs) in patients with severe carotid stenosis. CRP levels were assessed in the serum and within different portions (upstream and downstream) of carotid plaques of 217 patients undergoing endarterectomy. The association between CRP and intraplaque lipids, collagen, neutrophils, smooth muscle cells (SMC), and macrophage subsets was determined. No correlation between serum CRP and intraplaque biomarkers was observed. In upstream portions, CRP content was directly correlated with intraplaque neutrophils, total macrophages, and M1 macrophages and inversely correlated with SMC content. In downstream portions, intraplaque CRP correlated with M1 and M2 macrophages. According to the cut-off point (CRP > 2.9%) identified by ROC analysis in upstream portions, Kaplan-Meier analysis showed that patients with high CRP levels had a greater rate of MACEs. This risk of MACEs increased independently of age, male gender, serum CRP, and statin use. In conclusion, in patients with severe carotid artery stenosis, high CRP levels within upstream portions of carotid plaques directly and positively correlate with intraplaque inflammatory cells and predict MACEs at an 18-month follow-up period.

Kronik Zeminde Akut Arter Týkanýklýðý ile Baþvuran Hastada Kateter Aracýlý Trombolitik Tedavi

Kronik Zeminde Akut Arter Týkanýklýðý ile Baþvuran Hastada Kateter Aracýlý Trombolitik Tedavi

Laboratory criteria of the risk of ischemic stroke in patients with severe atherosclerotic stenosis of the internal carotid artery

Laboratory criteria of the risk of ischemic stroke in patients with severe atherosclerotic stenosis of the internal carotid artery

Combined Use of Mechanical Thrombectomy with Angioplasty and Stenting for Acute Basilar Occlusions with Underlying Severe Intracranial Vertebrobasilar Stenosis: Preliminary Experience from a Single Chinese Center.

Acute basilar occlusions have a poor prognosis without recanalization. Many have underlying severe atherosclerotic intracranial stenosis coexisting with acute thrombosis, requiring treatment of both pathologies in the same session, though technical risks may be encountered. The purpose of this study was to evaluate the technical feasibility and safety of combined treatment by using stent retrievers for the thrombosis, together with angioplasty and stent placement for the underlying stenosis. This was a retrospective review of 13 patients with basilar occlusions treated with thrombectomy by the Solitaire stent retriever and angioplasty and intracranial stent placement for underlying severe vertebrobasilar stenosis in the same session. Reperfusion was assessed in terms of the TICI score. Perioperative complications were recorded. Clinical outcomes were assessed by the NIHSS at discharge and the mRS on follow-up at 90 days. Of the 30 patients with acute basilar artery occlusions treated with stent retrievers during the study period, 18 had coexisting severe intracranial stenosis. Thirteen patients meeting the criteria for our study received combined mechanical thrombectomy and angioplasty with stent placement. The successful recanalization rate was 100%. Distal vessel embolizations occurred in 3 patients. There were 2 mortalities. On discharge, 10 patients (77%) had an improvement in NIHSS of ≥10 points. At 90 days, 6 patients (46%) had a good functional outcome with an mRS of ≤2. The combined use of mechanical thrombectomy with angioplasty and stent placement for acute basilar occlusions with underlying severe intracranial atherosclerotic stenosis is technically feasible and safe.

Symptomatic intracranial vertebral artery atherosclerotic stenosis (≥70%) with concurrent contralateral vertebral atherosclerotic diseases in 88 patients treated with the intracranial stenting

PurposeTo investigate the safety, effect and instent restenosis rate of Wingspan stenting in treating patients with intracranial vertebral artery atherosclerotic stenosis (70–99%) concurrent with contralateral vertebral artery atherosclerotic diseases. Materials and methodsEighty-eight patients with severe symptomatic intracranial vertebral artery atherosclerotic stenosis (≥70%) combined with contralateral vertebral artery atherosclerotic diseases were treated with the Wingpsan stent. All the baseline, cerebral angiography, success rate, perioperative complications, clinical and imaging follow-up data were prospectively analyzed. ResultsThe success rate of stenting was 100%, and the mean stenotic rate was reduced from prestenting (84.9±6.8)% to poststenting (17.2±5.9)%. The perioperative stroke rate was 1.1%. Among eighty patients (90.9%) with clinical follow-up 8-62 months (mean 29.3±17.2) poststenting, five (6.3%) had posterior circulation TIA only, three (3.8%) had mild stroke in the posterior circulation but recovered completely, and another five patients greater than 70 years old died of non-ischemic stroke. Imaging follow-up in 46 patients (52.3%) 5–54 months (mean 9.9±9.9) following stenting revealed instent restenosis in 12 patients (26.1%) including 7 (58.3%) symptomatic restenosis. Age and residual stenosis were the two factors to significantly (P<0.05) affect instent restenosis. ConclusionWingspan stenting in the intracranial vertebral artery atherosclerotic stenosis combined with contralateral vertebral artery atherosclerotic diseases has a low perioperative stroke rate and a good preventive effect on long-term ischemic stroke, but the instent restenosis rate is a little high.

Detecting intracranial atherosclerotic plaques with high-resolution MR angiography for predicting ischemic cerebrovascular disease

Objective To investigate the Contrast enhancement of intracranial atherosclerotic plaque for prediction of ischemic cerebrovascular events with high-resolution MR angiography (HRMRA). Methods The moderate to severe stenosis patients with symptomatic intracranial atherosclerosis admitted to Chinese PLA General Hospital and Beijing Tiantan Hospital, Capital Medical University from May 2008 to October 2012 were enrolled prospectively. All patients performed HRMRA after grouping, and the enhanced features of guilty vascular plaques were assessed. The occurrence of ischemic cerebrovascular disease was observed after one year regular medical treatment. Results Forty-two patients were enrolled in the study, including 20 (47.6%) basilar artery stenoses and 22 (52.4%) middle cerebral artery stenoses, 23 (54.8%) cerebral infarction, and 19 (45.2%) transient ischemic attack (TIA). Four patients had TIA and 4 had cerebral infarction (event group) in one year. There were 34 patients in a non-event group. There were no significant differences in age, gender, risk factors for atherosclerosis, lesion vessels, and last event between the two groups (P>0.05). The time from the last symptom onset to HRMRA was 39.1±16.4 d and 25.0±15.6 d for the event group and the non-event group respectively (P=0.000). HRMRA revealed that 36 patients had plaque enhancement in guilty vessels in both groups, including 7 (87.5%) in the event group and 29 (85.3%) in the non-event group. There was no significant difference in the incidence of plaque enhancement between the two groups (OR, 1.00, 95% CI 0.07-13.87, P=1.00). Five patients had moderate enhancement and 2 had severe enhancement in the event group; 19 had moderate enhancement and 10 had severe enhancement in the non-event group. There was no significant difference in the comparison of enhancement degree between the two groups (OR, 1.32, 95 CI 0.22-8.04, P=0.77). Conclusion The plaque enhancement features in patients with moderate to severe intracranial atherosclerotic stenosis may not be the factors of influencing cerebrovascular events for a period of 1 year. Key words: Stroke; Brain ischemia; Plaque, atherosclerotic; Magnetic resonance angiography; High-resolution

Protective and Indicating Effect of Indirect Bilirubin in Intracranial or Extracranial Artery Atherosclerotic Stenosis Progresses

Background: Bilirubin is the metabolic end-product of heme degradation by heme oxy-genase (HO), which has recently been shown to act as an antioxidant which can protect against atherosclerosis. This study explored the relationship between serum bilirubin levels and different degrees of atherosclerotic stenosis in intracranial or extracranial arteries. Methods: The study included 189 patients undergoing digital subtraction angiography (DSA) diagnosed as being normal or having been confirmed as atherosc lerotic stenosis in the intracranial or extracranial arteries. The patients were allocated to normal, mild (Results: Indirect bilirubin (Ibil) concentrations increased in parallel with the increasing severity of atherosclerotic stenosis in the intracranial or extracranial arteries, but decreased in patients with occluded cranial vessels. Multivariate analysis showed that Ibil levels were significantly higher in patients with severe stenosis group than in those with mild stenosis (OR, 1.464; 95% CI, 1.050 - 2.042; P = 0.024). However, Ibil levels were significantly lower in patients with occlusion than in those with severe stenosis (OR, 0.790; 95% CI, 0.684 - 0.913; P = 0.001). Conclusions: Ibil appears to have a protective effect against the development of atherosclerotic stenosis in intracranial or extracranial arteries. The biosynthesis of Ibil increases with stenosis progresses but decreases once occlusion occurs.

Clinical significance of the circle of Willis in intracranial atherosclerotic stenosis

IntroductionThe effectiveness of a scoring system based on the circle of Willis for evaluations of collateral circulation was studied in patients with intracranial atherosclerotic stenosis.MethodsEighty-three patients who underwent medical or...

Arterial remodeling in middle cerebral artery atherosclerotic stenosis:a high-resolution MRI study

To investigate remodeling mode of moderate or severe atherosclerotic stenosis of the middle cerebral artery (MCA) using high resolution MRI. Thirty-seven consecutive symptomatic patients with atherosclerotic MCA stenosis were imaged with a 3.0-T magnetic resonance scanner. The HR-MRI protocol included four different scans: T1-weighted black blood imaging, T2-weighted MR, proton density (PD)-weighted MR, and 3D-SPACE. The wall area (VA), lumen area (LA) and plaque area (PA) were calculated. The characterization of the plaque on HR-MRI was analysed. And the difference between positive remodeling (PR) and non-postive remodeling (non-PR) was explored. Thirty-four patients imaging was appropriate for analyse. Positive remodeling was found in 19 lesions. Compared with the non-PR group, the PR group had greater WA [(10.9 ± 2.5) mm² and (9.2 ± 1.9) mm², P = 0.039)] and greater PA [(6.4 ± 1.9) mm² and (3.9 ± 1.1) mm², P = 0]. High intensity on DWI and irregularity of plaque surface were more frequently observed in PR than non-PR. In patients with MCA atherosclerosis, PR lesions contain larger plaques than non-PR lesions and are probably with high risk for plaque rupture and subsequent stroke.

Protocol for a prospective, multicentre registry study of stenting for symptomatic intracranial artery stenosis in China

IntroductionThe SAMMPRIS trial suggested that aggressive treatment was superior to endovascular stenting in patients with severe symptomatic intracranial atherosclerotic stenosis (ICAS) due to high complication rates in patients in the...

Basilar Artery Thrombosis in the Setting of Antiphospholipid Syndrome

Antiphospholipid syndrome is an autoimmune disorder characterized by arterial or venous thrombosis, recurrent first-trimester pregnancy loss, and multiple additional clinical manifestations. We describe a man with severe atherosclerotic basilar artery stenosis and superimposed in situ thrombus who was found to have antiphospholipid syndrome.

Incidental findings in computed tomographic angiography for planning percutaneous aortic valve replacement: advanced age, increased cancer prevalence?

Increased age is linked with a higher cancer risk according to model calculations. Patients with severe atherosclerotic aortic stenosis are of old age, therefore, a high incidence of malignancies should be found. To evaluate the prevalence of clinically significant and potentially malignant incidental findings at computed tomographic angiography (CTA) performed in patients with severe aortic stenosis being assessed as to their suitability for transcatheter aortic valve replacement (TAVR). Between August 2008 and April 2010, CTA of the thoraco-abdominal aorta and the pelvic arterial vessels was performed in 131 patients. There were 62 women (47%) and 69 men (53%); the mean age was 81.6 years (range, 64-91 years). Incidental findings were recorded and categorized as potentially malignant, clinically significant, and clinically insignificant. Clinically significant findings were defined as those requiring immediate therapy, intervention or imaging, or follow-up examination. Of the 131 study patients, 31 (23.7%) presented significant extravascular incidental findings, 19 (14.5%) in the thorax, and 12 (9.2%) in the abdomen. Five lesions (3.8%) were considered potentially malignant, three of them (2.3%) were new and highly suspicious for malignancies (two renal cell carcinomas and one hepatocellular carcinoma). In two patients (1.5%) mediastinal lymphadenopathy was found (recurrent malignant lymphoma und new metastases from known bladder cancer). The prevalence of highly suspicious malignant incidental findings in patients undergoing TAVR is 3.8% with an average age of 81.6 years which is not high compared to prevalence in the literature dealing with patients aged <70 years.

Use of a novel hybrid vascular graft for sutureless revascularization of the renal arteries during open thoracoabdominal aortic aneurysm repair

The aim of this study was to assess the safety and short-term effectiveness of a novel hybrid vascular graft used to address renal revascularization during open thoracoabdominal aortic aneurysm (TAAA) repair, performing a sutureless distal anastomosis. Between 2012 and 2013, 25 patients (16 men; mean age, 66 ± 8 years) underwent revascularization of one (24 patients) or both (one patient) renal arteries with the Gore Hybrid Vascular Graft (GHVG; W. L. Gore and Associates, Flagstaff, Ariz) during open TAAA repair. Specific indications included remote location of the ostium of the renal artery, severe atherosclerotic wall degeneration, focal dissection, and stenosis. All surviving patients underwent computed tomography angiography and follow-up visit at 1 month. Preoperative characteristics, intraoperative data, and short-term results were compared with those of 49 concurrent TAAA patients operated on within the same period by standard renal revascularization (SRR) techniques. All GHVG target renal vessels (26 of 26) were successfully revascularized without technical concerns. No significant differences were found between GHVG and SRR groups in preoperative and intraoperative data, except for a relative prevalence of aortic dissection (28% vs 6%; P = .026) and renal artery stenosis (44% vs 12%; P = .003) in the GHVG group and for intraoperative renal bare stenting that was predominantly used in the SRR group (12% vs 28%; P = .036). The 30-day mortality was 4% in both groups. Postoperative acute renal failure (doubling of creatinine level and creatinine level >3.0 mg/dL) occurred in two GHVG patients (8%) and seven SRR patients (14%; P = NS). Perioperative peak decrease of estimated glomerular filtration rate was lower in the GHVG group (26 ± 18 mL/min/1.73 m(2) vs 37 ± 22 mL/min/1.73 m(2); P = .034). At 1-month computed tomography angiography, renal artery patency was 92% for the GHVG vessels, 91% for the contralateral to GHVG renal vessels, and 92% for the SRR group arteries. No GHVG-related complications requiring reintervention or cases of new-onset renal failure requiring dialysis were observed at follow-up. Renal revascularization during open TAAA repair by the GHVG with distal sutureless anastomosis is feasible, especially in cases of aortic dissection, remote location of the renal vessel, and severe atherosclerotic disease of the ostium. Short-term results are satisfactory, at least comparable to those of SRR. Larger series and longer follow-up are needed to assess clinical advantages and durability of this new device.