Successful orthognathic therapies are characterised by aphysiologically configured occlusion whose long-term clinical stability is mainly assessed through occlusal parameters. In the present study, long-term treatment outcomes were assessed based on occlusal changes after 5years using digital occlusion and masticatory efficiency analysis. This study examined 33adult patients after treatment of skeletal classII (n = 18; 12women, median age 28.15 years; interquartile range [IQR] = 15.10) and classIII malformations (n = 15; 7women, median age 23.90 years; IQR = 4.80) 9months (T1) and 5years (T2) postorthognathic therapy. A total of 20patients with neutral skeletal relation (10women; median age 30.50 years; IQR = 7.50) served as acontrol group. Skeletal classification was based on sagittal jaw configuration (Wits) and habitual intercuspation was recorded using the T‑Scan Novus® (Tekscan Inc., South Boston, MA, USA) for digital occlusion analysis with the following variables: total tooth contact (TTC), occlusion time (TOC), occlusion asymmetry (OAS), anterior and posterior antagonism (ATC and PTC). In addition, masticatory performance was assessed using astandardized two-colour chewing gum bolus analysis. Five years after surgery (T2), none of the occlusal parameters differed significantly between the groups, indicating functional approximation to the control group. Longitudinal analysis revealed significant improvements within both surgical groups (T1 to T2). In classII patients, TTC, ATC and PTC increased, while TOC decreased significantly. ClassIII patients also showed significant increases in TTC, ATC and PTC with TOC and OAS remaining unchanged. Overall, both treatment groups demonstrated substantial recovery and long-term stabilization of occlusal function. Bolus homogeneity analysis showed no significant difference between control and treatment patients 5years after surgery. The 5‑year observation of orthognathic treatment for sagittal jaw malformations showed significant improvements in occlusal parameters. Both masticatory efficiency and occlusal parameters measured at 5years postoperatively did not differ significantly from the control group, indicating that the functional improvements achieved by the therapy were stable in the long term.

Lubiak, SM, Howard, MA, Schmidt, JT, Shah, NM, Patel, NN, Prajapati, AJ, Herring, EK, and Hill, EC. Ischemic preconditioning does not attenuate reductions in rate of torque development after fatiguing resistance exercise. J Strength Cond Res 40(7): e676-e683, 2026-The purpose of this investigation was to examine the acute effects of ischemic preconditioning (IPC) on indices of rate of torque development (RTD) and peak torque (PT) after fatiguing resistance exercise. Twelve college-aged females randomly completed 3 cycles of IPC at low (20 mmHg [IPCSHAM]), moderate (80% of total arterial occlusion pressure [IPC80]), and high (220 mmHg [IPC220]) pressures. Each cycle consisted of 5 minutes at the assigned pressure followed by 5 minutes of zero pressure. After IPC, subjects performed one-set to volitional failure of unilateral, isotonic, concentric-only leg extension muscle actions at 30% of 1-repetition maximum. Two maximal voluntary isometric contractions (MVICs) were performed before and immediately after the fatiguing exercise protocol to derive RTD at early (0-100 ms; RTD100), late (0-200 ms; RTD200), and peak (0-peak; RTDPK), as well as PT from the highest pretest and post-test MVIC. Separate 2-way, 3 (Pressure [IPCSHAM, IPC80, and IPC220]) × 2 (Time [Pretest, Post-test]), repeated-measures analysis of variance were performed to examine mean differences. Collapsed across Pressure, RTD100 (-113.9 Nm·s-1; p = 0.045), RTD200 (-94.5 Nm·s-1; p = 0.008), RTDPK (-157.0 Nm·s-1; p = 0.028), and PT (-15.2 Nm; p = 0.002) decreased from pretest to post-test. There were no significant interactions (p = 0.463-0.934) or main effects of Pressure (p = 0.235-0.581). Applying IPC at various pressures did not attenuate reductions in RTD or PT after fatiguing resistance exercise. Thus, coaches and practitioners may consider alternative exercise adjuncts or strategies to attenuate resistance exercise fatigue-induced performance reductions.

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.

Comparative validation of risk scores for in-hospital complications following chronic total occlusion percutaneous coronary intervention.

To determine the effects of dentin infiltration with polymeric nanoparticles (NPs) doped with parathyroid hormone (PTH) (PTH-NPs) on hydroxyapatite formation, crystallinity, energy dissipation and viscoelasticity of resin-dentin interfaces. Etched dentin surfaces were infiltrated with NPs or PTH-NPs. Bonded interfaces were obtained, 24 h stored and submitted to thermal or mechanical challenging. Resin-dentin interfaces were evaluated through nano-DMA/complex-loss-storage moduli-tan delta assessment, atomic force microscopy (AFM)/topographical mapping-collagen fibril diameter, X-ray diffraction (XRD)/refined XRD2 profile-Debye-Scherrer rings and transmission electron microscopy (TEM)/Bright field-selected area electron diffraction -Fast Fourier Transforms. Load cycling of specimens infiltrated with PTH-NPs achieved the highest complex modulus and the lowest tan (δ), at the hybrid layer, promoting intratubular mineral precipitation, total occlusion of the dentinal tubules and thick platforms of mineral in dentin. Bridges of slipped mineralized dentin appeared close to peritubular structures, and the collagen fibrils width significantly augmented. PTH-NPS facilitated the highest crystallinity, crystallite size and microstrain in the longitudinal and perpendicular directions of the c-axis, with a right defined lineation. Undoped NPs and load cycling did not totally occlude the dentin tubules, and provoked microcracking and breakdown of the unfilled tubules. New crystals, with a low calcium and phosphorous percentage, were amorphous in absence of PTH. PTH-NPs dentin infiltration ensured intrafibrillar mineralization and advanced crystallinity, that resulted associated to high mechanical performance. The new crystals were hydroxyapatite in nature and showed the strongest chemical stability of the created nano-rods. Thermocycling of samples treated with PTH-NPs showed lower resistance to deformation and limited dentin mineralization. The mineral precipitates obtained with undoped NPs had scarce crystallinity, high grade of impurities and elevated biodegradability.

Chronic mesenteric ischemia (CMI) with multivessel occlusive disease remains challenging when endovascular therapy fails. We describe sequential antegrade reconstruction of the superior mesenteric artery (SMA) and celiac artery using a single 8-mm Dacron conduit originating from the supraceliac aorta. A 59-year-old man with severe malnutrition presented with progressive postprandial abdominal pain and substantial weight loss. Computed tomography angiography revealed flush occlusion of the celiac trunk, heavily calcified chronic total occlusion of the proximal SMA, patent distal target vessels, and limited collateralization through a diminutive inferior mesenteric artery. After two unsuccessful endovascular attempts, open revascularization was performed. The distal SMA was selected beyond the occluded segment, and the celiac trunk was reimplanted onto the same graft to preserve antegrade physiologic inflow while avoiding additional conduits. The patient recovered uneventfully and remained asymptomatic with patent graft at 3 months. This report outlines considerations for conduit configuration in CMI after failed endovascular therapy.

To evaluate the efficacy and periprocedural safety of distal puncture-assisted bidirectional endovascular therapy (EVT) for de novo femoropopliteal chronic total occlusion (FP-CTO). This multicenter retrospective study included 5 institutions and was conducted between 2019 and 2022. Outcomes and complications were analyzed per procedure (94 procedures); major amputation and mortality were assessed per patient based on the index procedure (87 patients). Major complications were defined as the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) classification grade ≥3. Wire-crossing success was 98.9%, and technical success was 84.0%. Complications occurred in 23.4% of procedures, including major complications in 8.5% and distal access-site complications in 10.6%, with no major distal access-site complications observed. Distal embolization occurred in 6.4% of procedures and was uniformly graded as CIRSE grade 1. At 1 year, freedom from target lesion revascularization was 82.0%, whereas limb salvage and overall survival were 97.0% and 85.6%, respectively. In this selected multicenter cohort, distal puncture-assisted bidirectional EVT achieved a high wire-crossing success rate, with no adjudicated major distal access-site complication identified using the CIRSE classification. However, these safety findings should be interpreted with caution, as failed distal puncture attempts were not captured and the temporal attribution of distal embolization could not be fully established.Clinical ImpactDistal puncture-assisted bidirectional endovascular therapy may be a useful bailout or planned strategy for complex femoropopliteal chronic total occlusions when conventional antegrade crossing is difficult. This multicenter study provides contemporary procedural outcomes and Cardiovascular and Interventional Radiological Society of Europe-graded complication profiles, allowing clinicians to interpret not only technical success but also the severity and clinical relevance of complications. The findings may help operators discuss procedural risk, select appropriate access strategies, and standardize complication reporting in femoropopliteal CTO interventions. Further studies including attempted but unsuccessful distal puncture cases are needed to define the overall risk-benefit profile of this approach.

Preterm birth remains a leading cause of neonatal morbidity and mortality worldwide. Despite medical advances, effective prevention remains challenging. Surgical interventions like total cervix occlusion (TCO) show promise in high-risk groups. This was a retrospective study including patients with singleton pregnancies who had undergone Saling's TCO at the Medical School of Hannover from 2011 to 2021. Data on maternal characteristics, obstetric history, intervention details, and outcomes were collected. Patients were stratified into two groups: classic Saling indication (≥2 late miscarriages or preterm births <32weeks) and extended indication (1 such event). Primary outcomes were live birth and preterm birth after 28+0weeks. The analysis is based on a sample of 99 pregnant women, pregnancy and outcome data was available of 67 patients. The median delivery time was 36weeks. 92.5 % of the neonates were born alive, with 88.1 % of these births occurring after the 28th week of gestation. Patients with extended indication showed longer gestation than those with classic indication. Maternal age, BMI, and conception mode had no impact. Higher parity increased chances of live birth, prior preterm birth lowered it. Previous late abortions raised the risk of delivery before 28weeks. TCO may prolong gestation and improve outcomes, independent of maternal factors. Women with extended indications appear to benefit as well. Given the lack of prospective data and varied international practices, further randomized, multicenter trials are urgently needed to better define indications and assess efficacy.

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.

Coronary computed tomography angiography (CCTA) can be used beyond diagnostic purposes to support the preprocedural planning of percutaneous coronary intervention (PCI). Advances in scanner technology, software platforms, and physiology- and plaque-based visualization tools have expanded the role of CCTA-guided PCI. CCTA provides detailed assessment of coronary anatomy, plaque and calcium morphology, lesion length, vessel size, and noninvasive physiology, offering opportunities to anticipate procedural complexity, optimize resource utilization, and individualize PCI strategy. Emerging data, including randomized studies in chronic total occlusions and ongoing multicenter trials, support the feasibility and potential clinical value of this approach. In April 2024, the first CCTA-guided PCI summit in the United States convened interventional cardiologists and cardiac imagers, as well as industry stakeholders, to discuss the evidence, technical considerations, clinical applications, and unmet needs related to CCTA-guided PCI. This manuscript summarizes the key discussions and conclusions specific to this meeting, with a focus on the transition of CCTA from a diagnostic to a therapeutic planning tool, emerging artificial intelligence applications, its complementary role with intravascular imaging, and opportunities to enhance procedural planning and decision-making. While early experience is promising, broader adoption will require broader educational efforts, access to purpose-built visualization software tools designed for interventional cardiologists, multidisciplinary collaboration, and additional randomized and real-world studies to define its impact on clinical outcomes and procedural efficiency.

To examine the impact of angiographic markers on endovascular therapy (EVT) outcomes in patients with lateral sinus dural arteriovenous fistulas (LSDAVFs). We analyzed the data of 81 patients who completed their first EVT session for LSDAVFs between December 2011 and February 2025 at our institute. Angiograms obtained before EVT were evaluated for LSDAVF characteristics. Shunt patterns were categorized as direct sinus fistula type, compartmental sinus channel type, mural channel type, and bridging vein shunt type. Sinovenous outflow patency was evaluated using the combined conduit score (CCS), a 9-point scoring system with scores ranging from 0 (total occlusion) to 8 (full patency). Multivariate logistic regression and Cox regression were used to identify key parameters associated with complete LSDAVF obliteration after EVT. Of the 81 patients, 46 (56.8%) achieved immediate obliteration after EVT. Multivariate logistic regression revealed that a CCS <4, jugular bulb involvement, and ipsilateral meningohypophyseal trunk supply were independent parameters associated with immediate obliteration. After a median imaging follow-up duration of 11.4 months, 36 out of 60 patients (60%) achieved complete obliteration without further treatment. Multivariate Cox regression revealed that a CCS <4 was independently associated with complete obliteration (HR 3.061, P=0.006). LSDAVFs with sinovenous outflow restriction, indicated by a CCS <4, were more likely to be obliterated after EVT compared with those without outflow restriction. In patients with LSDAVFs, the CCS may assist in outcome prediction and therapeutic decision-making.

Drug-coated balloon (DCB) therapy has emerged as an alternative to stent-based treatment in coronary artery disease (CAD), particularly in patients where a "leave-nothing-behind" approach may be advantageous. This systematic review aimed to evaluate the current evidence on DCB-only therapy in complex CAD and at assessing its potential role in clinical practice. We performed a systematic review searching PubMed, CENTRAL, SCOPUS, and ICTRP from inception to 24th March 2025 to identify studies investigating a DCB-only strategy in complex CAD, defined as bifurcation and calcified lesions, chronic total occlusions (CTO), three-vessel disease, or left main disease. The main inclusion criteria were (i) studies including patients with complex CAD and (ii) the use of DCB-only therapy as the main treatment strategy. Risk of bias was systematically assessed. A total of 3120 records were identified. After duplicate removal, screening, and full-text review, 34 studies met our inclusion criteria (32 non-randomized, 2 randomized). Seven studies investigated bifurcation lesions (n = 660), nine evaluated CTOs (n = 870), six assessed calcified lesions (n = 455), and 12 included all-comer cohorts with complex lesions (n = 7079). Most studies were conducted in Asia. Overall, DCB-only therapy showed acceptable outcomes in patients with complex CAD. However, 47% (16/34) of studies lacked a control group and the overall risk of bias was high. DCB-only therapy may be feasible in selected patients with complex CAD, but current evidence remains scarce, heterogeneous, and of limited methodological quality. Randomized controlled trials comparing DCB-only with DES-based strategies in complex CAD are warranted.

Intravascular Lithotripsy-Assisted Femoropopliteal Revascularization for Heavily Calcified Chronic Limb-Threatening Ischemia: Midterm Outcomes From a Single-Center Retrospective Study.

The uric acid-to-albumin ratio (UAR) is a novel cardiovascular biomarker, but its prognostic value in patients undergoing percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) remains unknown. This retrospective study enrolled 1513 consecutive patients who underwent successful CTO-PCI at a single center from February 2011 to December 2023. Patients were stratified by baseline UAR tertiles. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), and the secondary endpoint was all-cause mortality. Multivariable Cox regression and restricted cubic spline (RCS) analyses were performed. During a median follow-up of 810 days, patients in the highest UAR tertile had significantly higher rates of MACCE (18.5%, 10.1%, and 7.5% across tertiles; p < 0.001) and all-cause mortality (10.7%, 3.8%, and 2.0%; p < 0.001). After multivariable adjustment, each one-unit increase in UAR was associated with a 6% higher risk of MACCE (HR 1.06; 95% CI 1.02-1.10; p = 0.002) and a 9% higher risk of all-cause mortality (HR 1.09; 95% CI 1.04-1.14; p < 0.001). Patients in the highest UAR tertile had significantly increased risks of MACCE (HR 1.90; 95% CI 1.25-2.90; p = 0.003) and all-cause mortality (HR 3.40; 95% CI 1.62-7.12; p = 0.001) compared with those in the lowest UAR tertile. RCS analysis showed significant overall associations between UAR and both MACCE and all-cause mortality, with no significant evidence of nonlinearity. Elevated baseline UAR was independently associated with long-term MACCE and all-cause mortality after successful CTO-PCI. These findings support UAR as a readily available prognostic marker but do not establish causality or support UAR-guided therapeutic decision-making. Prospective studies are needed for validation.

What the electrocardiogram is being asked to detect in acute myocardial infarction: The case for the OMI/NOMI paradigm.

Percutaneous Recanalization of Chronic Total Inferior Vena Cava Occlusion During ASD Closure.

There is a lack of data available on the feasibility of rotational atherectomy (RA) in chronic total occlusion (CTO) lesions compared to RA in non-CTO lesions. So, we aimed to study the safety and feasibility of RA in patients with CTO lesions compared to non-CTO lesions. We searched PubMed, Scopus, Web of Science (WOS), and Ovid until March 2024. We included all relevant studies assessing RA in CTO lesions versus non-CTO lesions. The primary outcome of interest was major adverse cardiovascular events (MACE), while secondary outcomes were all-cause death, cardiac death, myocardial infarction (MI), and target-vessel revascularization (TVR). Other studied angiographic outcomes were vessel perforation, technical success, and procedural success. The pooled data was analyzed using odds ratio (OR) with its 95% CI in using a random-effect model. Four studies comprising 1925 patients were included in the analysis. The pooled analysis showed that RA in CTO lesions was associated with higher rates of vessel perforation (OR = 3.56, 95% CI: 1.59-7.98, p < 0.001) compared to the non-CTO lesions. On the other hand, no significant differences were observed regarding studied clinical outcomes and angiographic outcomes between CTO and non-CTO lesions. RA for CTO lesions was associated with comparable clinical and angiographic outcomes. RA is a safe and feasible approach in CTO lesions, despite a higher incidence of vessel perforation. More investigations on the severity of each case should be guided in further studies.

The retrograde approach improves the procedural success rate of chronic total occlusion percutaneous coronary interventions (CTO-PCIs). However, it remains unclear whether the primary retrograde approach (PRA) offers benefits in terms of procedural success and burden/resource use in challenging cases. Therefore, we compared efficacy between the primary antegrade approach (PAA) and PRA in complex CTO-PCIs. This single-center retrospective cohort study included all patients undergoing coronary CTO-PCI attempted by experienced high-volume operators between January 2016 and July 2023. The difficulty of the antegrade approach was determined using the Japanese CTO score, and the feasibility of interventional collaterals was determined using the collateral channel score. In 698 patients undergoing CTO-PCI, the overall technical and initial guidewire success rates were 91.4% and 83.8%, respectively. Of 380 patients with a Japanese CTO score ≥3 and a collateral channel score ≥2, PAA and PRA were performed in 161 (42.4%) and 219 (57.6%) patients, respectively. Initial guidewire success was higher with PRA than PAA (88.1% vs. 78.9%; P=0.01), and bail-out success was higher for a retrograde than antegrade approach (91.2% vs. 56%; P=0.0019). PRA was associated with longer guidewire crossing time, longer fluoroscopy time, and greater contrast use. In patients with challenging CTO, poor antegrade conditions, and feasible interventional collaterals, PRA achieved higher initial guidewire success at the expense of higher procedural burden/resource use.

To describe early and midterm outcomes of Viabahn stenting for extensive aortoiliac occlusive disease involving the external iliac artery (EIA). In this single-center retrospective study, all consecutive patients in whom a covered self-expanding (SE) Viabahn stent was implanted (W.L. Gore & Associates, Inc, Flagstaff, Arizona) in the EIA for symptomatic Trans-Atlantic Intersociety Consensus (TASC) II C and D lesions between 2012 and 2020 were included. Lesions limited to the iliac artery were treated percutaneously. Iliac lesions extending down to the common femoral artery (CFA) were treated with a hybrid approach. Patency, major adverse limb events (MALEs), target lesion revascularization (TLR), and limb salvage rates were estimated using Kaplan-Meier curves. Of 118 limbs, 48 (41%) were treated for claudication, 33 (28%) for rest pain, and 37 (31%) for tissue loss. Lesions were TASC C (n = 43 limbs, 36%) or TASC D (n = 75 limbs, 64%). Chronic total iliac occlusions were identified in 26 limbs (22%). Concomitant CFA lesions were recorded in 97 limbs (82%). All lesions involved the EIA. Technical success was achieved in 100% of cases. Six (5.7%) perioperative major adverse cardiovascular events occurred, including 4 (3.8%) deaths. Eleven (7.6%) early MALEs were recorded. Two-year primary patency, assisted primary patency, and secondary patency were 85%, 88%, and 95%, respectively. After multivariate analysis, small-diameter stents (<8 mm) were associated with lower primary patency rates (hazard ratio [HR] 3.20, 95% confidence interval [CI]: 1.26-8.13, P = .014) and lower freedom from TLR rates (HR 2.61, 95% CI: 1.02-6.66, P = .045). Adjunctive CFA endarterectomy was significantly associated with higher primary patency rates (HR 0.38, 95% CI: 0.15-0.95, P = .038). The use of Viabahn SE covered stents for extensive aortoiliac disease involving the EIA provided acceptable postoperative morbidity and high rates of midterm secondary patency, similar to those usually reported with aortobifemoral bypass. Adjunctive CFA endarterectomy was a major determinant of patency and should be considered an essential component of the treatment strategy. Additional long-term data are necessary to evaluate the role of SE covered stents for the treatment of such lesions.Clinical ImpactThe endovascular management of extensive aortoiliac occlusive disease involving the external iliac artery remains challenging. This study represents one of the largest series dedicated to the treatment of TASC II C and D lesions involving the external iliac artery with self-expanding covered stents. The results suggest mid-term secondary patency rates comparable to those commonly reported after aortobifemoral bypass. Notably, concomitant common femoral bifurcation treatment and the use of ≥8-mm diameter stents were associated with improved patency rates, suggesting that aggressive management of common femoral artery lesions and the use of larger-diameter stents may contribute to optimizing long-term outcomes.

Background: To report long-term outcomes following stenting for aortoiliac occlusive disease, focusing on covered stents (CS) versus bare metal stents (BMS) in a real-world, multicentre European cohort. Design: Multicentre retrospective cohort study. Patients and methods: Prospectively maintained data from nine European vascular centres (2012-2020) were analysed. Two cohorts were evaluated: aortic-only stenting and aortoiliac stenting (stratified as CS/CS, CS/BMS, BMS/CS, and BMS/BMS). Primary outcomes were target lesion revascularisation (TLR), major amputation, and mortality, with median follow-up of 75 months. Cox regression and propensity score matching were performed to adjust for baseline anatomical and procedural differences between stent types. Results: A total of 201 patients were included (50% male, mean age 65 years, 34% with chronic limb-threatening ischaemia). In the aortic-only subgroup (n = 46), outcomes were comparable between CS and BMS. Among aortoiliac reconstructions (n = 155), patients treated with CS/CS had greater anatomical complexity, including higher prevalence of iliac chronic total occlusions, longer lesions, and heavier calcification. Independent predictors of TLR included iliac chronic total occlusion, subintimal aortic recanalization, and concomitant common femoral endarterectomy. After propensity score adjustment, there remained no significant difference in TLR (28/155), major amputation (4/155), or mortality (30/155) between CS/CS and BMS/BMS groups. Conclusions: CS was preferentially employed in more complex aortoiliac occlusive disease and achieved outcomes equivalent to BMS after adjustment for lesion severity using propensity score methods. These findings reinforce that operator selection patterns and lesion complexity, rather than stent type alone, influence the clinical outcomes, underscoring the need for individualised stent selection strategies in advanced aortoiliac disease.