Bankthornton8398

ck of objective criteria for diagnosis increase the chances of medical errors and makes it an area vulnerable to litigation. INTRODUCTION Post-implantation syndrome (PIS) is the clinical and biochemical expression of an inflammatory response following endovascular aneurysm repair, with a reported incidence ranging from 2-100%. Although generally benign, some studies report an association between PIS and post-operative major adverse cardiovascular events (MACE). Nonetheless, the role of PIS in post-operative myocardial injury (MINS) is unknown. This work aims to evaluate the relation between post-implantation syndrome and MINS in a subset of EVAR patients, as well as assess the impact of PIS in all-cause mortality. METHODS All patients undergoing elective standard EVAR between January 2008 and June 2017, and with at least one measurement of contemporary (cTnI) or high sensitivity troponin I (hSTnI) in the first 48h after surgery, were retrospectively analyzed. Post-implantation syndrome was defined as the presence of fever and leukocytosis in the postoperative period in the absence of infectious complications. MINS was defined as thS was found to be significantly associated with post-operative MACE (p=0.001), but not MINS. Survival analysis revealed no differences between patients with or without PIS regarding 30-day mortality as well as long-term all-cause mortality. ASA score (HR 2.157; 95% CI 1.07 - 4.33, P=0.031) and heart failure (HR 2.284; 95% CI 1.25 - 4.18, P=0.008) were found to be independently associated with increased long-term all-cause mortality in this cohort of patients. CONCLUSION PIS is a common complication after EVAR, occurring in 11.4% of the patients from this cohort. Graft type seems to significantly affect the risk of PIS, since all reported cases occurred when polyester grafts were used. learn more PIS did not influence 30-day or long-term survival and was found to be significantly associated with post-operative MACE but not MINS, suggesting the involvement of different pathophysiological mechanisms. OBJECTIVES The study purpose was to evaluate outcomes using drug-coated balloon (DCB) in comparison with uncoated balloon as adjunctive treatment after atherectomy for femoropopliteal artery lesions. METHODS This single-center retrospective and prospective study included 115 patients with 126 femoropopliteal artery lesions treated with endovascular treatment using atherectomy. Of these, 58 patients received adjunctive DCB after the atherectomy (group A) and 57 patients were managed with uncoated balloon after atherectomy (group B). Immediate and late clinical outcomes were compared. RESULTS Baseline clinical and lesion data were comparable between the two groups. However, group A included more uses of rotational atherectomy (43.9% vs. 1.7%, p less then 0.001) or embolization protection filter (53.0% vs. 6.7%, p=0.001), and fewer cases requiring provisional stenting (4.5% vs. 18.3%, p=0.014). Clinical primary patency at 1 year was significantly higher in group A than in group B (76.3% vs. 61.1%, p=0.039). There was a trend towards higher 1-year target lesion revascularization (TLR)-free survival in group A (89.8% vs. 77.9% at 1 year, p=0.275) without statistical significance. Proportional hazards regression analysis indicated that age (HR 0.94, 95% CI 0.90-0.99, p=0.016) and provisional stenting (HR 9.78, 95% CI 2.20-43.46, p=0.003) were independent factors associated with restenosis after combined treatment with atherectomy and DCB. CONCLUSIONS In femoropopliteal artery disease, the combination of atherectomy with adjunctive DCB achieved better clinical outcomes in terms of clinical primary patency compared to atherectomy plus uncoated balloon while TLR-free survival may also be improved. INTRODUCTION Transcarotid artery revascularization (TCAR) has been shown to have half the rates of transient ischemic attack (TIA), stroke and death compared to transfemoral carotid artery stenting (TFCAS). Successful outcomes of TFCAS requires careful patient selection. The aim of this study was to determine the outcomes of TFCAS versus TCAR in both simple (Type I) and complex (Type II and III) aortic arches. METHODS A retrospective cohort study was performed comparing the outcomes of patients undergoing TFCAS versus TCAR with simple and complex aortic arches using the Vascular Quality Initiative (VQI) registry from August 2011 to May 2019. The primary outcome was a composite of in-hospital TIA/stroke/death. RESULTS 6108 carotid artery interventions were analyzed, including 3536 (57.9%) patients with a Type I, 2013 (33.0%) Type II, and 559 (9.2%) with a Type III aortic arch. In 3535 patients with a simple arch, 1917 underwent TFCAS and 1619 had TCAR. Mean age was 70.6 (±9.5) years and 2382 (67.4%) patients w. Although the occurrence of in-hospital TIA was no different between the two approaches (P =0.6158), there were significantly fewer strokes in those treated with TCAR (P=0.0132). TCAR (P=0.0146) was associated with improved outcomes. A worse outcome was seen with advancing age (P=0.0003), prior strokes (P=0.01), and a left sided lesion (P=0.0176). CONCLUSION TCAR has improved outcomes of TIA/stroke/death compared to TFCAS in both simple and complex aortic arch anatomy. In simple aortic arches, there is no difference in neurological outcomes between both approaches. In complex arch anatomy TCAR has fewer strokes. OBJECTIVE To describe the occlusion rate and clinical response of a redo ablative procedure in symptomatic patients with recanalization of saphenous vein after endovascular thermal ablation (ETA). METHODS A retrospective cohort study was performed in a prospectively collected data of symptomatic patients with recanalization of great or small saphenous vein after ETA who underwent a secondary ablation (SA) from June 2015 to May 2018. RESULTS Ten patients (15 limbs) with recanalization of great or small saphenous vein were treated with SA. The median age was 67 years and 60% were men. The median time from the first ablation was 7.3 years (IQR 6.5 - 9.6). For SA, radiofrequency (RFA) was performed in 12 limbs (80%) and Ultrasound-guided foam sclerotherapy (UGFS) in 3 cases (20%). The Great Saphenous Vein was the treated vessel in 14 cases (93.3%). No complications were reported. Median follow-up was 13 months. Preoperative and 1 year follow-up VCSS was 9 (IQR 5-10) and 4 (IQR 2-8), respectively. Doppler Ultrasound evaluation after 1 year showed an occlusion rate of 93.