Overcoming Resistance to Anti-Nectin-4 Antibody-Drug Conjugate.

Antibody-drug conjugates (ADC) represent a fast-growing drug class in oncology. However, ADCs are associated with resistance, and therapies able to overcome it are of utmost importance. Recently, enfortumab vedotin-ejfv (EV) was approved in nectin-4+ metastatic urothelial cancer.

Clinical Outcomes of Ambulatory Endovascular Treatment Using 4-French and 6-French Femoral Access Strategies: The Bio4amb Multicentre Trial.

Purpose: Ambulatory peripheral vascular interventions have been steadily increasing. In ambulatory procedures, 4F devices might be particularly useful having the potential to reduce access-site complications; however, further evidence on their safety and efficacy is needed.

Materials And Methods: BIO4AMB is a prospective, non-randomized mulitcentre, non-inferiority trial conducted in 35 centres in Europe and Australia comparing the use of 4F- and 6F-compatible devices.

Molecular imaging of endothelial activation and mineralization in a mouse model of accelerated atherosclerosis.

Purpose: Preclinical imaging of endothelial activation and mineralization using both positron emission tomography (PET) and magnetic resonance (MR) remains scarce.

Procedures: A group of uremic ApoE (Ur), non-uremic ApoE (NUr), and control C57Bl/6 J mice (Ctl) were investigated. Mineralization process was assessed using sodium fluoride ([18F]NaF) PET, and MR imaging combined with intravenous injection of MPIO-αVCAM-1 was used to evaluate endothelial activation.

Endovascular Treatment of Aortic Arch Vessel Stent Migration: Three Case Reports.

Percutaneous angioplasty and stenting is nowadays the treatment of choice for atherosclerotic stenotic lesions of the supraaortic trunks. Stent migration is a seldom published complication that can alter the short-term results of these procedures. Herein, we report three cases, from three different institutions, of secondary autoexpandable stent migration, after endovascular treatment of major arch vessel stenosis, and their subsequent endovascular management using three different retrieval techniques.

Performance Evaluation of a Dedicated Preclinical PET/CT System for the Assessment of Mineralization Process in a Mouse Model of Atherosclerosis.

Purpose: The purpose of this study was to assess the impact of positron emission tomography/X-ray computed tomography (PET/CT) acquisition and reconstruction parameters on the assessment of mineralization process in a mouse model of atherosclerosis.

Procedures: All experiments were performed on a dedicated preclinical PET/CT system. CT was evaluated using five acquisition configurations using both a tungsten wire phantom for in-plane resolution assessment and a bar pattern phantom for cross-plane resolution.

A targeted remifentanil administration protocol based on the analgesia nociception index during vascular surgery.

Background: The intraoperative modulation of opioids continues to be based on clinical signs. This may result in adverse events such as sympathetic reactivity or opioid-induced hyperalgesia. Recently, the Analgesia/Nociception Index (ANI), a non-invasive 0-100 index derived from heart rate variability analysis, has been proposed for nociception assessment.

True Brachial Artery Aneurysm after Arteriovenous Fistula for Hemodialysis: Five Cases and Literature Review.

Background: The donor artery after a long-standing arteriovenous fistula (AVF) for hemodialysis usually evolves exceptionally toward a true aneurysmal degeneration (AD). The purpose of this article was to describe true brachial artery AD in end-stage renal disease patients after AVF creation, as well as its influencing factors and treatment strategies.

Methods: We present a retrospective, observational, single-center study realized in Caen University Hospital's Vascular Surgery Department from May 1996 to November 2015.

Below-The-Knee Angioplasty for Critical Limb Ischemia: Results of a Series of 157 Procedures and Impact of the Angiosome Concept.

Background: To evaluate the long-term clinical results of below-the-knee percutaneous transluminal angioplasty (BTK-PTA) with or without stenting, in patients with critical limb ischemia (CLI), and to determine factors affecting clinical results including the role of the angiosome concept.

Methods: All patients undergoing primary BTK-PTA from January 2007 to December 2011 were included. Primary patency, assisted patency, limb salvage, survival, and wound healing were assessed using the Kaplan-Meier method.

Volume analysis of true and false lumens in acute complicated type B aortic dissections after thoracic endovascular aortic repair with stent grafts alone or with a composite device design.

Objective: This study compared the 12-month evolution of the aortic volume in patients who underwent thoracic endovascular aortic repair (TEVAR) with stent grafts alone or a composite device (Zenith TX2 stent graft and Zenith Dissection stent; Cook Medical, Bloomington, Ind) for acute (≤2 weeks from onset) complicated type B aortic dissection.

Methods: This was a retrospective analysis comparing prospectively collected data from 45 patients who underwent standard TEVAR repair at three European institutions (TEVAR group) and 39 patients in the Study of Thoracic Aortic type B Dissection using Endoluminal Repair (STABLE I) study who received a composite device (STABLE group). The analysis included consecutive patients treated for acute, complicated type B dissection and with available baseline and 12-month computed tomography imaging.

Influence of Obesity on Access-Related Complications During Anterior Lumbar Spine Interbody Fusion.

Objective: The anterior lumbar spine approach has gained in popularity in recent years, but the associated access-related complications for obese patients have not been clearly established. This study aimed to analyze the relationship between obesity or overweight and the safety of the anterior lumbar spine approach.

Methods: Eighty-four consecutive patients admitted for lumbar spine surgery by anterior approach between 2011 and 2014 were included.

Transradial versus transfemoral approach for percutaneous coronary intervention in cardiogenic shock: A radial-first centre experience and meta-analysis of published studies.

Background: The transradial approach for percutaneous coronary intervention (PCI) is associated with a better outcome in myocardial infarction (MI), but patients with cardiogenic shock (CS) were excluded from most trials.

Aims: To compare outcomes of PCI for MI-related CS via the transradial versus transfemoral approach.

Methods: A prospective cohort of 101 consecutive patients admitted for PCI for MI-related CS were treated via the transradial (n=74) or transfemoral (n=27) approach.

Periprocedural Myocardial Infarction After Carotid Endarterectomy and Stenting: Systematic Review and Meta-Analysis.

Background And Purpose: Carotid angioplasty and stenting (CAS) is associated with higher risk of periprocedural stroke and death when compared with carotid endarterectomy (CEA). By contrast, the risk of myocardial infarction (MI) was higher after CEA than after CAS in randomized trials. However, numbers were small, and risk factors are unknown.

Midterm results of type B intramural hematoma endovascular treatment.

Background: Recently, intramural hematoma (IMH) has been characterized as a rare variant of aortic dissection, falling within the acute aortic syndromes (AAS). Although aortic endovascular treatment seems to provide good results, no consensus has been established regarding the optimal management of IMH affecting the descending thoracic aorta (IMH B). The aim of this study was to assess long-term clinical and morphological results of IMH B treated with a stent graft.

Intimal angiosarcoma from the common femoral vein in a 27-year-old patient.

Intimal sarcoma is a rare and aggressive vascular pathology. The literature describes about 140 cases. Because of late diagnosis, the median survival time is only a few months.

Technique and results of femoral bifurcation endarterectomy by eversion.

Objective: This study evaluated, in a contemporary prospective series, the safety and efficacy of femoral endarterectomy using the eversion technique and compared our results with results obtained in the literature for the standard endarterectomy with patch closure.

Methods: Between 2010 and 2012, 121 patients (76% male; mean age, 68.7 years; diabetes, 28%; renal insufficiency, 20%) underwent 147 consecutive femoral bifurcation endarterectomies using the eversion technique, associating or not inflow or outflow concomitant revascularization.

Solitary kidney with renal artery aneurysm repaired by ex vivo reconstruction.

A 22-year-old pregnant female with pyelonephritis was found to have a 26-mm left renal artery aneurysm with unknown right kidney agenesis diagnosed by magnetic resonance imaging. Computed tomographic angiography with 3-dimensional reconstructions confirmed a saccular aneurysm localized at the bifurcation of the left posterior segmental artery. The patient ultimately underwent successful ex vivo left renal artery aneurysm repair with autotransplantation.

Calcified obstructive disease of the aortic arch.

Coral reef aorta is described as rock-hard calcifications usually localized in the visceral part of the aorta. Rare cases of acquired coarctation of the descending aorta due to coral reefs have been mentioned in the literature. A more uncommon entity is the coral reef of the aortic arch.

Ischemic stroke due to paradoxical embolism arising from a popliteal vein aneurysm.

Popliteal vein aneurysm (PVA) is a very uncommon cause of stroke. We present the case of a 63-year-old, right-handed man who presented to the emergency department with transitory ischemic accident (left superior extremity regressive monoplegia). Complete etiologic work-up led to the discovery of both a patent foramen ovale associated with an septum interauricular aneurysm, and of a PVA without mural thrombus.

Feasibility of ambulatory percutaneous femoral access without the use of arterial closure systems.

Background: To evaluate the feasibility of early ambulation in patients treated for peripheral occlusive lesions by femoral percutaneous access, without the use of closure systems and the application to ambulatory practice.

Methods: This single-center observational exploratory study was undertaken among 99 consecutive patients between August 1-December 31, 2011 (mean age: 72 years; 72 men) who were treated by percutaneous femoral route for peripheral arterial lesions. All the patients had a manual compression then pressure bandage.

Persistent type B aortic dissection treatment by renal artery reentry stent grafting as an alternative to open surgery.

Type B aortic dissections complicated by pain, malperfusion, or aneurysm expansion mandate surgical intervention. Success of this therapy is predicated on exclusion and thrombosis of the false lumen of the aneurysm. This report presents a case in which cessation of flow was achieved using a covered stent graft to close a renal reentry tear after a previous closing and overstenting of the main tear.

Gigantic clavicle osteochondroma with carotid compression as a rare cause of stroke.

We report the case of a 26-year-old woman who presented with embolic stroke from left common carotid artery compression by a gigantic clavicular osteochondroma. To our knowledge, this is the only such case described in the literature. The other particularity of this case is the delayed appearance of this childhood tumor.