Efficacy and Safety of Endovascular Therapy with Stent Implantation Versus Endarterectomy in Common Femoral Artery Atherosclerosis: A Systematic Review and Meta-Analysis.

To assess the feasibility, safety, and midterm outcomes of intravascular lithotripsy (IVL) in isolated heavily calcified lesions (HCLs) of the popliteal artery, a location historically regarded as a "no-stent zone". This retrospective monocentric cohort included 18 consecutive adult patients where IVL was used to treat a symptomatic isolated popliteal HCL-between November 2021 and September 2025. IVL was followed by interwoven stent implantation in case of residual stenosis ≥30%. In other cases, a drug-coated balloon was used. Technical success, primary and assisted patency, target lesion revascularization, and major adverse limb events (MALE) were recorded. Kaplan-Meier survival analysis was provided for patency and reintervention outcomes. Indication was a chronic limb-threatening ischemia in 39% of the cases. The median lesion length was 60 mm (interquartile range [IQR]: 55-100), and 39% were chronic total occlusions. The median degree of stenosis was 90% (IQR: 90-100). The median luminal gain achieved post-IVL was 60%. Bailout stenting was required in 39% of the cases. The technical success rate was 100%. Primary patency was 93% at 12 months and 73% at 24 months. During follow-up, MALE occurred in 22%, including 3 reinterventions that all occurred in patients treated without stenting. At last follow-up, 56% of the patients had received a stent in the target lesion. IVL is an effective and safe vessel preparation tool for isolated popliteal HCLs. Since most patients ultimately require stenting the benefit of IVL in a "nothing left behind" strategy remains questionable.

Coronary atherosclerosis disrupts blood flow, and stent implantation is a common revascularization strategy for this condition. While stent design influences outcomes, lesion-specific characteristics, such as plaque morphology and stenosis severity, also play a critical role. This study, through finite element analysis (FEA), evaluated stent-artery interactions (SAI) across symmetric (SYM) and asymmetric (ASYM) plaques at 40%, 60%, and 80% stenosis severity. Six computational models were developed and stent performance evaluated using standard mechanical metrics including radial recoil (RR), dog-boning (DB), foreshortening (FS), longitudinal recoil (LR), and lumen gain (LG). At maximum expansion, peak stent stresses were similar between SYM and ASYM lesions at each severity level, increasing only slightly (8-9%) with stenosis severity. However, after recoil, morphology significantly altered stress distribution: SYM plaques concentrated stress in the stent's central region, while ASYM lesions shifted high stress toward the proximal and distal rings, particularly at crown apexes and ring junctions, known as fatigue-prone sites. Arterial stress patterns also changed significantly. The SYM stenosis led to uniform circumferential stresses, whereas ASYM plaques produced eccentric stress peaks adjacent to the narrowed wall. This localization of mechanical stress explains the elevated risk of vessel injury in eccentric lesions, despite comparable global stress levels. DB increased substantially with severity (10-15% at 40%; 30-35% at 80%), RR rose from 20 to 50%, FS remained low (1-4%), and LG was higher in asymmetric geometries. These findings demonstrate that stenosis severity determines stress magnitude, while plaque morphology dictates its spatial distribution, guiding potential failure sites and informing strategies for lesion-specific stent design. This study presents a comparison of SAI across different morphologies and highlights the importance of plaque-aware procedural planning. Although based on idealized geometries and homogeneous materials, this work establishes a foundation for future patient-specific simulations incorporating anatomical and tissue heterogeneity.

Syndromic hereditary thoracic aortic disease (sHTAD), including Loeys-Dietz syndrome (LDS), often lead to aneurysmal disease with diffuse arterial involvement. Although open repair remains the gold standard in sHTAD, it carries significant morbidity. Herein, a hybrid approach for subclavian-axillary arterial aneurysm repair in patients with LDS is described. Two patients with prior aortic repair extending from the aortic root to the abdominal aorta were managed for extensive aneurysms involving the subclavian and proximal axillary artery. Via ipsilateral upper limb access, the prior proximal repair was extended with multiple self-expanding covered stents to the axillary artery, ensuring adequate overlap. The distal stent was exposed through a transverse arteriotomy, and an end-to-end anastomosis was created by incorporating the covered stent and arterial walls. In both cases, no salvage of the vertebral arteries was attempted; they were either covered or coiled. Mid-term follow-up showed no anastomotic pseudoaneurysms, kinking, or stenosis. One patient developed a persistent type II endoleak without sac enlargement and remains under surveillance. Hybrid repair with endovascular stent implantation, proximal non-native landing zone and open distal anastomosis may offer a safe and effective alternative for complex subclavian-axillary aneurysms in patients with LDS.Clinical ImpactSyndromic hereditary thoracic aortic disease can result in aneurysms with extensive arterial involvement, and open repair remains the gold standard in these patients. A hybrid technique, involving endovascular extension of a previously replaced proximal landing zone to a distal native arterial segment, followed by open exposure and creation of an end-to-end anastomosis, is described. This approach was successfully applied in 2 cases, both with prior open and endovascular management of the proximal landing zone. Mid-term postoperative outcomes demonstrated acceptable efficacy and confirmed the feasibility of the technique. This hybrid approach may significantly reduce postoperative morbidity compared with conventional open repair.

To evaluate whether XEN® Gel Stent position within the anterior chamber angle influences aqueous humor outflow and complication rates during the early postoperative period. 51 consecutive glaucomatous eyes of 51 patients (mean age 72.0 ± 11.4, 49.0% female) undergoing XEN®-63 Gel Stent implantation between 09/2024 and 07/2025 at Charité - Universitätsmedizin Berlin, Germany were included in this single-center, prospective cohort study. Eyes were categorized postoperatively according to stent position within the anterior chamber angle (Grades 0-4). Stent position was evaluated 12 weeks postoperatively through automated gonioscopy (GS-1, Nidek). Aqueous humor outflow was assessed using a standardized non-invasive stress test. Primary outcome was the intraocular pressure (IOP) reduction during stress test. Secondary outcomes included IOP reduction from baseline to 12 weeks postoperatively, number of glaucoma medications, complications and need for additional interventions. Mean IOP decreased significantly after XEN® Gel Stent implantation from 22.2 ± 7.5 mmHg to 12.1 ± 5.1 mmHg 12 weeks postoperatively measured with Goldmann applanation tonometry (p < 0.001, Z -5.6). Stress test induced IOP reduction increased from 14.8 ± 13.3% pre-implantation to 32.7 ± 19.7% at 12 weeks (p < 0.001, CI -24.1 to -11.8). Eyes with stent placement within the scleral spur or ciliary body band (Grading 3 + 4, n = 34) had greater aqueous humor outflow improvement compared with eyes graded 0-2 (stent above scleral spur, n = 12) (p = 0.010, 95% CI -28.6 to -4.2). Postoperative transient hypotony occurred in 85.3% vs. 61.5% of eyes in Grading group 3 + 4 vs. 0-2 (p = 0.08). 4 eyes were considered non-functional due to malposition (Grading x). Mean number of glaucoma medications decreased from 2.8 ± 1.3 preoperatively to 0.2 ± 0.9 postoperatively. The positioning of the XEN® Gel Stent within the scleral spur or ciliary body band (Grade 3 + 4) was associated with greater pressure reduction during stress testing, suggesting an increased aqueous humor outflow in this study cohort. Such placement was associated with high treatment success and no increase in major complications, except the risk of misplacement, while transient hypotony was common.

The effectiveness and safety of acute intracranial atherosclerotic disease-related large vessel occlusion (ICAD-LVO) stenting are still up for debate. We conducted a comparative analysis between patients who had successful mechanical thrombectomy(MT) and the group that rescue stent placement following MT failure. Our study included 1125 patients who underwent thrombectomy between January 2020 and December 2024 at 2 centres in Zhejiang, China. Among them, the number of ICAD-LVO patient cases was 430, which were divided into the group with MT alone group andthe group with rescue stent after failed thrombectomy. The two groups were balanced through the use of propensity score matching. The primary outcome was a modification of the Rankin Scale (mRS) at 90 days, which measured the change in disability. Wemeasured the secondary outcomes of symptomatic intracranial haemorrhage (sICH), 90-day mortality and good functioning and independence (defined as a 90-day mRS score of 0 to 2). Our results showed no statistical differences between the good 90-day mRS score, sICH incidence, and 90-day mortality between the rescue stent group and the successful MT group. In addition, we found that stent placement after multiple thrombectomies reduced the90-day good functional prognosis (mRS 0-2), which was statistically significant (aOR, 0.43 [95% CI, 0.22-0.85]; P = 0.02). Our study indicates rescue stenting after failed MT can yield outcomes similar to successful MT. In addition, our study showed that good outcome of placing a rescue stent after 1 failed thrombectomy is better than after multiple thrombectomies.

BACKGROUND Prolonged exposure to high altitude can increase the risk of coronary artery disease, acute coronary syndrome, and other ischemic cardiovascular events. This report describes the case of a 34-year-old man with exercise-induced ST-segment elevation myocardial infarction (STEMI) 36 hours after descent from high altitude. CASE REPORT A previously healthy 34-year-old man presented with 9 hours of crushing substernal chest pain. Electrocardiogram (ECG) demonstrated anteroseptal ST-segment elevation in leads V1-V3 with reciprocal changes in inferior leads. Emergency coronary angiography (CAG) revealed total occlusion with a high thrombus burden of the proximal left anterior descending (LAD) artery with TIMI 0 flow, accompanied by diffuse non-culprit coronary plaques (30-40% stenosis). Primary percutaneous coronary intervention (PCI) with drug-eluting stent implantation restored TIMI 3 flow. The event occurred 36 hours after descent from 4200 m altitude, immediately following intensive exercise, suggesting a temporal association between early de-acclimatization and acute coronary events. CONCLUSIONS Multiple factors, including dyslipidemia, residual hemorheological changes after high-altitude exposure, and vigorous exercise, may be associated with the occurrence of acute myocardial infarction (AMI) during high-altitude de-acclimatization. This report highlights the importance of recognizing that patients with a history of living at high altitude can be at increased risk of acute coronary syndromes, particularly ST-segment elevation myocardial infarction, when undertaking exercise.

Central venous occlusion is a prevalent cause of vascular access failure among hemodialysis patients, and endovascular treatment represents the preferred approach; however, intraoperative complications demand meticulous attention.1 We report a case of a 69-year-old male patient with end-stage diabetic nephropathy who had been undergoing maintenance hemodialysis via a left wrist arteriovenous fistula for 3 years. He presented with swelling of the left upper limb and face due to left brachiocephalic vein occlusion and underwent percutaneous transluminal angioplasty in conjunction with covered stent implantation under digital subtraction angiography guidance. After full stent deployment, the pull line became trapped during its withdrawal. We resolved the complication by stabilizing the stent with an angiographic catheter, preventing displacement and vascular injury. Unlike previously reported bailout techniques that require specialized balloon stabilization, this method utilizes a standard 5 F angiographic catheter-a readily available device in most interventional suites-to stabilize the stent edge and facilitate pull-line retrieval. This approach offers a simpler, more accessible alternative for managing this rare complication, particularly in resource-limited settings. In conclusion, Viabahn stent deployment with entrapment of the pull line is a rare complication. When pull line entrapment occurs, this technique can effectively resolve the complication while minimizing the risk of stent migration and vascular injury, provided that resistance is not excessive. Careful fluoroscopic monitoring and readiness to abort the procedure if significant resistance is encountered are essential.

Vascular diseases, particularly atherosclerosis, represent a leading cause of global morbidity and mortality. Endovascular stenting has emerged as a cornerstone of therapy to restore vessel patency, yet conventional stents remain obstructed by significant clinical limitations, including in-stent restenosis, thrombosis, and mechanical failure. These adverse outcomes are intrinsically linked to their fundamental structural design, which is characterized by a positive Poisson's ratio, leading to foreshortening and a biomechanical mismatch with the native vasculature. This review critically examines auxetic stents as a next-generation solution, engineered with a structure possessing a negative Poisson's ratio. This unique property allows them to expand axially upon radial deployment, thereby eliminating foreshortening, enhancing conformability to tortuous vessels, and distributing mechanical stress more uniformly onto the arterial wall. This paper synthesizes the robust body of in-silico/bench-top evidence from computational modeling and in-vitro experimentation that validates these superior biomechanical characteristics. Furthermore, it explores the profound and favorable biological implications, arguing that the optimized mechanical environment and improved hemodynamics are hypothesized to attenuate the primary triggers for neointimal hyperplasia and foster rapid, complete endothelialization. The review concludes by outlining the translational pathway, including challenges in structure integration and discussing the vast future horizons for auxetic structured stents in complex peripheral, carotid, and non-vascular applications. Auxetic design represents a paradigm shift from material-centric iteration to structure-driven innovation, holding the promise to significantly improve the long-term safety and efficacy of endovascular stent implants.

Novel stent technologies offer early intravascular treatment options for coarctation (COA). Mid-to-long-term cardiovascular responses to early COA stent interventions are undefined. We studied a porcine model of COA, with and without early stent implantation with serial dilation to adult aortic diameters, aiming to define longitudinal cardiovascular changes. In total, 18 swine were studied: 6 shams, 6 COA controls (CC), and 6 COA stents (CS). Surgical COA was induced at 2 weeks (4.5 kg) followed by stent implant at 6 weeks, with serial dilations at 12 and 20 weeks (80 kg). All animals were terminally studied at 20 weeks. Successful stent implantation with serial dilation matching somatic growth occurred in all CS animals with predictable stent performance and elimination of COA. No in-stent stenosis observed. Final stent dimensions equaled the proximal descending aorta (DAo) of shams (16.8 ± 1.5 vs. 17.5 ± 0.8, p = 0.3); however, DAo narrowing (13.3 ± 1.1 mm) just distal to the stent without gradient was created because of stent shortening, and this DAo segment demonstrated decreased vessel wall collagen content. Four of 6 animals developed peri-stent aneurysms treated with covered stents. CS prevented post stenotic dilation and collateralization and resulted in near normalization of catheter-derived hemodynamics. Cardiac MRI documented similar ventricular function, cardiac index, and myocardial tissue characterization between groups. Early COA stenting was associated with increased systemic arterial elastin content. In this swine COA model, early stent implants effectively dilated to adult aortic dimensions, prevented blood pressure gradients, collateralization, and adverse myocardial remodeling. Early stenting with serial dilations altered systemic arterial elastin content, and additional stents may be necessary to enlarge the adjacent DAo. Aneurysm formation frequently occurred.

ABSTRACT Introduction Based on the principles of DRG, this study aimed to analyze the current status and existing problems in the clinical use of high-value medical consumables for certain specialized diseases in orthopedics and cardiovascular medicine, and propose application standards and targeted management strategies. Methods DRGs involving the use of high-value medical consumables in orthopedic total hip replacement and cardiovascular percutaneous coronary drug-eluting stent implantation were selected. Data from all patients within these groups were extracted, and the total hospitalization costs and high-value medical consumable costs were calculated for each patient. The cost structure of consumables was analyzed in relation to DRGs payment standards, and the related differences were evaluated. Results Within the same DRGs, the average proportion of high-value medical consumable costs in orthopedics and cardiovascular medicine were 43.12% and 62.02%, respectively. Compared to the DRG payment standards, a high percentage of cases in orthopedics and cardiovascular medicine exceeded the total cost, that rates of 81.56% and 77.41%, respectively, and were the main drivers of total hospitalization costs. Conclusion DRG can be used to evaluate the use of high-value medical consumables, which would lay the foundation for establishing reasonable standards for the proportion of consumable costs in specialized diseases.

Despite the effectiveness of the surgical or percutaneous treatment of coarctation of the aorta, the presence of hypertension in these patients remains a common and concerning issue. This study was undertaken to explore the relation between the severity of coarctation of the aorta and renal perfusion and to evaluate the role of renal scintigraphy as a predictive tool for clinical outcomes after percutaneous treatment of coarctation of the aorta. Adult patients with coarctation of the aorta and concomitant arterial hypertension were enrolled in the study. Ambulatory 24-hour blood pressure monitoring, CT angiography, and a renal perfusion scan were performed, along with invasive pressure gradient measurements. Patients with invasive peak gradients ≥20mmHg and/or a difference of ≥50% in diameter between the isthmus and the descending aorta at the diaphragmatic level were selected for percutaneous stent implantation. The mean time to peak change in renal scintigraphy after captopril did not significantly differ between the Medical group (-1.01 ± 2.526 min. for the left kidney and -0.19 ± 1.46 min. for the right kidney) and the Stent group (-0.59 ± 1.188 min. for the left kidney and -0.17 ± 1.461 min. for the right kidney) (p-values > 0.05). No statistically significant changes in renal perfusion were observed between pre-and post-stent implantation measurements. In this pilot study, no clear association was found between the degree of aortic narrowing and renal perfusion, and no measurable reduction in renal perfusion was detected. Stent implantation did not result in significant short-term changes in blood pressure. These findings are exploratory and require confirmation in larger studies.

To examine how changes in Medicare payments and industry transfers of value (TOVs) are associated with changes microinvasive glaucoma surgery (MIGS) procedure rates. Retrospective, observational cohort study. Ophthalmologists who performed glaucoma surgery for Medicare beneficiaries from 2018-2023. A 20% nationally representative sample of Medicare Part B Carrier claims from 2018-2023 identified trabecular meshwork bypass stent implantation, goniotomy, canaloplasty, and trabeculectomy procedures using Current Procedural Terminology codes. Procedures were aggregated at the physician-year level using National Provider Identifiers. Medicare payment changes for trabecular bypass stents implantation implemented on January 1, 2022 were examined alongside contemporaneous industry stent-related TOV payments from trabecular meshwork bypass stent manufacturers (Alcon and Glaukos), obtained from the Centers for Medicare & Medicaid Services Open Payments database. Annual and quarterly procedure volumes were compared before (2018-2021) and after (2022-2023) the policy change. Trabeculectomy served as a control procedure. Annual procedure volumes for trabecular stents, goniotomy, canaloplasty, and trabeculectomy; mean number of procedures performed per physician; association of CMS payment rates and industry TOV payments with individual procedure rates. Following a Medicare payment reduction for trabecular stents from approximately $500 to $34 per procedure, national trabecular stent utilization stably declined by 33%. Over the same period, goniotomy utilization increased by 61% and canaloplasty utilization increased by 19%, Total MIGS volume remained relatively stable. Industry stent-related TOV payments to ophthalmologists increased substantially in 2022 but subsequently declined in 2023. Stratified analyses demonstrated that reductions in trabecular stent utilization occurred across all levels of industry TOV payment recipients, including among physicians receiving the highest payment amounts. A large Medicare payment reduction for trabecular meshwork bypass stent implantation was associated with rapid declines in stent utilization and increased performance of alternative MIGS procedures. Concurrent increases in industry TOV payments did not offset these shifts, suggesting that Medicare payment policy exerted a stronger influence on procedural selection than industry financial incentives. These findings highlight the sensitivity of surgical practice patterns to payment policy and suggest that even substantial industry payments may have limited influence when insurer payments change dramatically.

The purpose of this study was to develop and validate a predictive model to assessing the risk of side branch flow impairment (SBFI) following stent implantation in patients with non-left main coronary bifurcation lesions (CBLs). This model aims to provide preprocedural risk stratification and inform the selection of interventional strategies. Coronary artery bifurcation lesions constitute a particularly complex subtype of coronary artery disease that is frequently encountered in practice. Compared with non-bifurcation lesions, they are associated with greater procedural complexity and risk of procedure-related complications. Data from 830 patients with CBL who underwent percutaneous coronary intervention (PCI) in the Affiliated Hospital of Chengde Medical University from January 2022 to December 2023 were retrospectively collected. The least absolute shrinkage and selection operator regression methods were used to screen variables, and multivariate logistic regression was used to establish a predictive model. A nomogram was built based on these factors and internally verified using the bootstrap resampling method. The C-statistic was used to verify and evaluate the discriminative ability of the model; the calibration curve was drawn, and the decision curve analysis (DCA) was performed to evaluate the calibration degree, clinical net benefit, and practicability of the model. The primary endpoint was SBFI, defined as a transient or persistent reduction in thrombolysis in myocardial infarction (TIMI) flow grade in a branch vessel following stent implantation in a major non-left main coronary artery. A nomogram was constructed using the selected predictors of SBFI, which included age, plaque location ipsilateral to the SB, TIMI flow grade before main vessel (MV) stenting, and N-terminal pro-brain natriuretic peptide (NT-proBNP). The discriminatory ability of the model, as assessed by the area under the curve (AUC), was 0.651. The robustness of the model was evaluated through internal validation with 1000 bootstrap replicates, resulting in a corrected AUC of 0.641. The calibration curve, evaluated by the Hosmer-Lemeshow test, showed good agreement between predictions and observations (χ2 = 5.765, P = 0.674). Finally, DCA indicated that the model provided clinical net benefit over a threshold probability range of 0.19-0.45. We developed and validated a predictive model for SBFI after PCI in non-left main bifurcation lesions. The model exhibited modest discriminative ability, calibration, and a positive net benefit on DCA, suggesting that it may serve as a valuable risk stratification tool in clinical practice.

Coral reef aorta (CRA) is defined by the presence of heavily calcified exophytic plaques that protrude into the aortic lumen. Open surgery remains the standard treatment but is associated with substantial morbidity, particularly in high-risk patients. Endovascular approaches, including intravascular lithotripsy (IVL), have emerged as less invasive alternatives. This case series aimed to evaluate the feasibility, safety, and hemodynamic impact of IVL combined with fractional flow reserve (FFR) in the treatment of calcified aortic stenoses. We present a case series of three patients with severe calcified abdominal aortic stenosis treated with IVL under FFR guidance. Pre- and post-procedural FFR measurements were used to assess lesion hemodynamic significance and treatment efficacy. All procedures were technically successful, with significant improvement in FFR values following IVL, indicating restoration of hemodynamic flow. One case was complicated by an aortic dissection, successfully managed with stent placement. In the remaining cases, IVL achieved adequate luminal gain without the need for stenting. At follow-up (up to 12 months), all patients demonstrated sustained clinical improvement and maintained vessel patency. IVL combined with FFR appears to be a feasible and effective minimally invasive approach for the management of heavily calcified aortic lesions. This strategy allows both morphological plaque modification and objective physiological assessment, potentially reducing the need for stent implantation. Larger studies are required to validate these findings.

Chronic kidney disease is associated with an increased incidence of stent thrombosis (ST) following drug-eluting stent (DES) implantation, but the clinical outcomes after DES-ST in hemodialysis (HD) patients compared with non-HD patients have not been fully elucidated. From the REAL-ST registry, we evaluated 655 patients with DES-ST, divided into 2 groups: HD group (n=59) and non-HD group (n=596). The primary endpoint was the cumulative 3-year incidence of all-cause death after the index ST event. Late ST was more prevalent in the HD group, whereas early and very late ST were common in the non-HD group. Following the index ST event, the HD group showed significantly higher 3-year incidences of all-cause death (48.2% vs. 22.9%, P=0.0005), cardiac death (33.4% vs.15.8%, P=0.003) and target lesion revascularization (TLR: 36.2% vs. 17.5%, P=0.0002) compared with the non-HD group. The cumulative 3-year incidence of recurrent ST did not differ significantly between groups (7.3% vs. 5.9%, P=0.88). After multivariable adjustment, HD remained significantly associated with an increased risk of all-cause death (adjusted hazard ratio [aHR], 1.95; 95% confidence interval [CI], 1.25-3.04; P=0.003), cardiac death (aHR, 1.75; 95% CI, 1.02-2.99; P=0.04) and TLR (aHR, 2.63; 95% CI, 1.52-4.57; P<0.001). Compared with non-HD patients, HD patients experienced worse clinical outcomes following their index DES-ST event.

The application of the intracranial arterial drug-eluting stent DES-NOVA in intracranial atherosclerotic stenosis-related emergent large vessel occlusion.

Abstract Objective Visceral artery pseudoaneurysms (VAPAs) are a life-threatening complication of pancreatitis. This study aimed to evaluate the early outcomes of endovascular treatment (EVT), its effect on the reduction of VAPA sac volume, and the resolution of extrinsic compression (mass effect) caused by VAPAs within three months after the procedure. Patients and Methods We retrospectively analysed 20 patients who underwent endovascular treatment for pancreatitis-associated VAPAs between August 2006 and September 2025. Depending on the anatomical setting, various EVT techniques were used, including coil embolisation, application of n-butyl-2-cyanoacrylate tissue adhesive, and covered stent implantation. We assessed EVT success and related complications. In a subgroup of 11 patients, we evaluated changes in VAPA sac volume before and after endovascular therapy. In patients with VAPA-related mass effect, we analysed the post-EVT course of the clinical manifestations of extrinsic compression. Results Primary technical success was achieved in all 20 patients (100%); in one patient repeated embolisation was required (5%). One patient developed a large splenic infarction requiring splenectomy. Median regression of VAPA sac volume reached 69.4% within 1 month after EVT and 96.5% within 3 months ( P &lt; 0.0001). Symptomatic mass effect was observed in three patients, and clinical symptoms improved in all of them after EVT. Conclusions Endovascular treatment is an effective therapeutic modality for pancreatitis-associated VAPA and leads to a significant reduction in pseudoaneurysm sac volume. In patients with symptomatic mass effect, EVT may also be associated with regression of clinical symptoms.

PurposeTo evaluate the intraocular pressure (IOP)-lowering efficacy and adverse event profile of Xen63 gel stent compared to the Preserflo microshunt.MethodsRetrospective, multicenter, two-arm cohort study comparing 65 eyes undergoing standalone Xen63 implantation and 75 eyes undergoing standalone Preserflo implantation, all with intraoperative mitomycin C (MMC). Primary outcome was complete success, defined as all of the followings: 1) no two consecutive IOP readings >17mmHg, 2) ≥20% IOP reduction from baseline; 3) no clinical hypotony (IOP <6 mmHg associated with loss of ≥2 lines of vision); and 4) no use of glaucoma medications. Secondary outcomes included success at different IOP cut offs, qualified success (allowing medications), change in IOP, medications, complications, interventions, and re-operations.ResultsAt 12 months, complete success was achieved in 61.5% of eyes in the Xen63 group and 73.9% in the Preserflo group (p = 0.13). Postoperative complications were more frequent in the Xen63 group compared with the Preserflo group (61.5% vs. 29.3%, p = 0.0002). Postoperative interventions were required at similar rates between groups (Xen63 30.8% vs. Preserflo 28.0%, p = 0.85); however, reoperations were performed more frequently in the Xen63 group (16.9% vs. 4.0%, p = 0.01). Non-Caucasian ethnicity was associated with an increased risk of surgical failure (HR 2.57; 95% CI, 1.26–5.23).ConclusionBoth devices achieved comparable success rates, median IOP reduction, and postoperative medication burden; however, the Xen63 group experienced a higher rate of complications and reoperations.

Coarctation of the aorta (CoA) is a congenital obstructive anomaly that may remain undiagnosed until adulthood, often presenting with systemic hypertension. While percutaneous interventions, including balloon angioplasty and stent implantation, are increasingly utilized in adults, real-world data on procedural outcomes, complications, and long-term mortality remain limited. This study aimed to evaluate procedural outcomes, complication rates, and short- and long-term mortality associated with percutaneous interventions in adult patients with CoA. A single-center, retrospective observational study was conducted, including adult patients with CoA who underwent percutaneous intervention between July 2017 and July 2023. Procedural success was defined as a residual peak systolic gradient ≤20 mmHg without major complications. Patient demographics, comorbidities, procedural details, complications, and follow-up outcomes were analyzed. Twenty-nine patients (median age 40 [29-45] years; 31% female) were included. Endovascular stent placement was performed in 89.7% of patients, 74% of whom were covered stents (mean length 39 mm). Balloon angioplasty alone was used in 10.3% of cases. The procedure was associated with a marked reduction in the peak systolic gradient, decreasing from a median of 57.5 mmHg [50.0-68.8] before the procedure to 9.0 mmHg [1.2-11.8] after the procedure. Complications occurred in 6.9%, including 1 aortic rupture and 1 access site bleeding. Recoarctation developed in 14% of patients at a median of 17.5 months. No in-hospital deaths occurred; out-of-hospital mortality was 6.9%, including 1 death of unknown cause and 1 following posterior mediastinal hematoma after aortic rupture. Percutaneous interventions in adult CoA achieve favorable procedural success and low in-hospital mortality, while rare but serious complications underscore the necessity for meticulous management and lifelong follow-up.