Repaired coarctation of the aorta does not affect four-dimensional flow metrics in bicuspid aortic valve disease.

Objectives: The objective of this study was primarily to compare four-dimensional flow magnetic resonance imaging metrics in the ascending aorta (AA) of patients with right-left fusion type bicuspid aortic valve (RL-BAV) and repaired coarctation of the aorta (CoA) to RL-BAV without CoA. Metrics of patients with RL-BAV were also compared to the matched group of patients with common tricuspid aortic valve (TAV).

Methods: Eleven patients with RL-BAV and CoA, 11 patients with RL-BAV without CoA and 22 controls with TAV were investigated.

Long-term outcome after implementation of endovascular-first strategy to treat acute mesenteric ischemia.

Objective: To evaluate the rationale of an aggressive endovascular-first strategy to treat elderly patients with acute mesenteric ischemia (AMI) by studying long-term survival, readmissions, and patients' discharge to home vs nursing facility a decade after an episode of AMI.

Methods: The retrospective study cohort included 66 consecutive patients (all-comers) treated for arterial occlusive AMI between 2009 and 2013. Endovascular revascularization (EVR) was attempted in 50 patients (EVR+), whereas 16 patients were treated without attempted revascularization (EVR-).

Friendly Neck Anatomy Does Not Prevent Neck-Related Adverse Events After EVAR.

Background: Life-long follow-up after endovascular aneurysm repair (EVAR) is costly and burdensome to the patient. Follow-up should be stratified based on the risk of EVAR failure. Aneurysm neck is thought to be the single most important risk factor.

4D Flow 2D Phase Contrast MRI in Populations With Bi- and Tricuspid Aortic Valves.

Aim: To compare 4D flow magnetic resonance imaging (MRI) and 2D phase contrast (PC) MRI when evaluating bicuspid (BAV) and tricuspid (TAV) aortic valves.

Materials And Methods: A total of 83 subjects (35 BAV, 48 TAV) were explored with 4D flow and 2D PC MRI. Systolic peak velocity, peak flow and regurgitation fraction were analysed at two pre-defined aortic levels (aortic root, mid-tubular).

A modified candy-plug technique to occlude false lumen in aortic dissection.

Purpose: Aim of this technical note article is to introduce a modified, novel way to custom create a candy-plug (CP) device to endovascularly occlude false lumen. The technique is illustrated by a patient case with significant backflow to false lumen (FL). The patient had already undergone surgical repair of the ascending aorta, aortic arch and subsequent TEVAR procedure down to the ostium of the celiac trunk because of type A aortic dissection, but the descending thoracic aorta continued to dilate due to backflow to the FL from an uncovered tear at the level of the renal arteries.

Wall Shear Stress Predicts Media Degeneration and Biomechanical Changes in Thoracic Aorta.

In thoracic aortic aneurysm (TAA) of the ascending aorta (AA), AA is progressively dilating due to the weakening of the aortic wall. Predicting and preventing aortic dissections and ruptures in TAA continues to be challenging, and more accurate assessment of the AA dilatation, identification of high-risk patients, and timing of repair surgery are required. We investigated whether wall shear stress (WSS) predicts pathological and biomechanical changes in the aortic wall in TAA.

Use of paclitaxel-coated balloons in clinical setting is not associated with increased mortality compared with plain balloon angioplasty in femoropopliteal lesions.

Objective: To investigate mortality and causes of death associated with the use of paclitaxel-coated balloon (PCB) compared with plain balloon (PB) angioplasty in the treatment of femoropopliteal artery lesions in real-world clinical setting.

Methods: This retrospective, single-center study included patients who underwent percutaneous femoropopliteal artery angioplasty without stenting between years 2014 and 2020. Patients were stratified into PCB and PB groups according to the index procedure.

Radiographically quantified sarcopenia and traditional cardiovascular risk assessment in predicting long-term mortality after endovascular aortic repair.

Objective: This study evaluated radiographically quantified sarcopenia and the patient's comorbidity burden based on traditional cardiovascular risk assessment as potential predictors of long-term mortality after endovascular aortic repair (EVAR).

Methods: The study included 480 patients treated with standard EVAR for intact infrarenal abdominal aortic aneurysms. Patient characteristics, comorbidities, aneurysm dimensions, and other preoperative risk factors were collected retrospectively.

Long-term outcomes of transaxillary versus video-assisted first rib resection for neurogenic thoracic outlet syndrome.

Objectives: This study compared the long-term outcomes in terms of clinical examinations and patient-reported outcome measures, between transaxillary and video-assisted thoracoscopic techniques for first rib resection in patients with neurogenic thoracic outlet syndrome.

Methods: The study population comprised patients who underwent first rib resection for neurogenic thoracic outlet syndrome at our institution between 2009 and 2016. All patients were recruited in a follow-up assessment in 2019, and those who agreed to participate were included in this study.

Flow displacement and decreased wall shear stress might be associated with the growth rate of an ascending aortic dilatation.

Objectives: Our goal was to evaluate whether four-dimensional (4D) flow magnetic resonance imaging (MRI) can predict the growth rate of dilatation of the ascending aorta (AA) in patients with a tricuspid, normally functioning aortic valve.

Methods: In this prospective clinical study, aortic 4D flow MRI was performed at the Kuopio University Hospital on 30 patients diagnosed with AA dilatation (maximum diameter >40 mm) between August 2017 and July 2020. The MRI was repeated after a 1-year follow-up, with AA dimensions and 4D flow parameters analysed retrospectively at both time points.

Excess of visceral adipose tissue with or without aortic elongation leads to a steeper heart position.

Background: The heart's position determined as the heart-aorta angle (HAA) has been demonstrated to associate with ascending aortic (AA) dilatation. Visceral adipose tissue (VAT) and aortic elongation may shift the heart to the steeper position.

Purpose: To investigate whether VAT and aortic length influence the HAA.

Finnish flow diverter study: 8 years of experience in the treatment of acutely ruptured intracranial aneurysms.

Background: Flow diversion of acutely ruptured intracranial aneurysms (IAs) is controversial due to high treatment-related complication rates and a lack of supporting evidence. We present clinical and radiological results of the largest series to date.

Methods: This is a nationwide retrospective study of acutely ruptured IAs treated with flow diverters (FDs).

Long-term outcome over a decade after first rib resection for neurogenic thoracic outlet syndrome.

Objectives: The aim was to determine long-term outcomes over a decade after first rib resection (FRR) in patients with neurogenic thoracic outlet syndrome (NTOS). A secondary aim was to investigate correlation of residual rib stump with long-term symptoms.

Methods: This ambispective cohort included patients who underwent transaxillary FRRs for NTOS between 1998 and 2007.

Effect of Endovascular Treatment Rate on Population Level Outcomes and Survival After Intact Abdominal Aortic Aneurysm Repair.

Objectives: The aim was to study outcomes of endovascular aneurysm repair (EVAR) and open surgical repair (OSR) of abdominal aortic aneurysms (AAAs) in four geographically adjacent populations with identical demographics and variable EVAR rates.

Methods: This was a multicentre cohort study based on local and national registry data from an area of 815 000 inhabitants. The study involved 527 consecutive patients with an intact AAA treated with EVAR (n = 327) or OSR (n = 200) between 2010 and 2016.

High prevalence of ascending aortic dilatation in a consecutive coronary CT angiography patient population.

Objectives: To clarify the prevalence and risk factors of ascending aortic (AA) dilatation according to ESC 2014 guidelines.

Methods: This study included 1000 consecutive patients scheduled for diagnostic coronary artery computed tomographic angiography. AA diameter was retrospectively measured in 3 planes: sinus valsalva, sinotubular junction, and tubular part.

Aortic dilatation associates with flow displacement and increased circumferential wall shear stress in patients without aortic stenosis: A prospective clinical study.

Background: The relationship between blood flow characteristics and ascending aortic (AA) dilatation has not been studied in patients with a tricuspid aortic valve (TAV) without aortic stenosis.

Purpose: To evaluate whether 4D flow characteristics determined in MRI are related to AA dilatation by comparing dilated AA and nondilated AA subjects with TAV.

Study Type: Prospective.

Pharmacomechanical Thrombectomy in Paget-Schroetter Syndrome.

Purpose: The purpose of the study was to evaluate feasibility of pharmacomechanical thrombectomy (PMT) in the treatment of Paget-Schroetter syndrome (PSS) followed by thoracoscopic or open surgical decompression of the subclavian vein.

Methods: Twenty-two out of 27 consecutive patients with PSS received PMT using the Trellis-8 peripheral infusion system (Covidien) between 2010 and 2014. Subsequent surgery was performed in 18 of those patients, 9 patients were treated with thoracoscopic, 7 patients with subclavicular, and 2 patients with transaxillary first rib resection, 4 patients were treated with PMT and anticoagulation alone.

Endovascular Treatment of Degenerative Aneurysms Involving Only the Descending Thoracic Aorta: Systematic Review and Meta-analysis.

Purpose: To determine the efficacy of thoracic endovascular aortic repair (TEVAR) for degenerative aneurysm involving only the descending thoracic aorta (DTAA).

Methods: An English-language literature review was performed through PubMed, Scopus, and Google Scholar to identify any study evaluating the outcomes of TEVAR for DTAA. The main endpoints of this analysis were all-cause 30-day and late postoperative mortality.

Interpretation of Abdominal CT Findings in Patients Who Develop Acute on Chronic Mesenteric Ischemia.

Background: We studied whether ischemia-specific computed tomography (CT) findings are consistently detectable in patients who develop acute on chronic mesenteric ischemia (AOCMI), whereas absent in chronic mesenteric ischemia (CMI).

Methods: Consecutive patients with symptomatic angiography-verified atherosclerotic obstruction of the superior mesenteric artery (SMA) were categorized as AOCMI (n = 27) or CMI (n = 20). Three experienced radiologists blindly evaluated the contrast-enhanced CTs for vascular and intestinal findings.

Detecting acute mesenteric ischemia in CT of the acute abdomen is dependent on clinical suspicion: Review of 95 consecutive patients.

Objectives: (1) To evaluate the ability of emergency room radiologists to detect acute mesenteric ischemia (AMI) from computed tomography (CT) images in patients with acute abdominal pain. (2) To identify factors affecting radiologists' performance in the CT interpretation and patient outcome.

Materials And Methods: A retrospective study of 95 consecutive patients treated for 97 AMI events between 2009 and 2013 was carried out.

Endovascular Therapy as a Primary Revascularization Modality in Acute Mesenteric Ischemia.

Purpose: To evaluate endovascular therapy (EVT) as the primary revascularization method for acute mesenteric ischemia (AMI).

Methods: A retrospective review was performed on all consecutive patients treated for AMI during a 5-year period (January 2009 to December 2013). EVT was attempted in all patients referred for emergent revascularization.

Early and midterm outcomes after endovascular treatment of degenerative aneurysms of the descending thoracic aorta: a Finnish multicenter study.

Purpose: To evaluate results of endovascular stent-graft placement for aneurysms of the descending aorta in 3 Finnish university hospitals during 1998-2010.

Methods: Among 158 consecutive patients treated with stent-graft placement for disease of the descending thoracic aorta, all 69 patients (58 men; mean age 71.7 years, range 54-90) with an aneurysm were included in the analysis.

Antegrade in situ fenestration of aortic stent graft: in-vivo experiments using a pig model.

Background: Short proximal neck of an abdominal aortic aneurysm is associated with risk of treatment failure during abdominal aortic repair. Important side branches, such as renal arteries, cannot be covered without serious consequences.

Purpose: To test the feasibility of preoperative fenestration of abdominal aortic stent grafts with a re-entry catheter and steerable sheath to preserve the patency of renal arteries in an animal model.

Fenestration of aortic stent grafts-in vitro tests using various device combinations.

Purpose: To evaluate the response of various stent grafts after needle fenestration and sequential dilation with standard percutaneous transluminal angioplasty (PTA) and cutting balloons and sealing of the fenestration with a side branch stent graft.

Materials And Methods: Five commercially available aortic stent grafts (Endurant, Gore TAG, Talent, Valiant, and Zenith) were fenestrated with a needle. The fenestrations were sequentially dilated up to 10 mm with PTA balloons or cutting balloons.