This study was to analyze the outcomes of left subclavian artery (LSA) revascularization during thoracic endovascular repair (TEVAR) for type B aortic dissections (TBAD). From 2011 to 2017, TBAD patients who underwent LSA revascularization during TEVAR were enrolled. Technical success, endoleaks, mortality, complication, reintervention, and patency of target vessels were analyzed. 38 patients were included, 14 underwent carotid-subclavian bypass (CSB), and 24 underwent chimney graft (CG) implantation. Technical success rates were 92.9% and 100% in CSB and CG group. Eleven immediate type I endoleak (EL-I) was detected, including one from CSB group and ten from CG group. Three immediate type II endoleak (EL-II) was detected in CSB group. Perioperative complications showed no difference, but CSB group had longer intensive care unit (ICU) stay time. Median follow-up time was 26.2 months, and overall mortality was 14.3% and 0% in each group. Three EL-I and one EL-II underwent reintervention. All the LSA showed good patency, except one suffered from CG collapse. Both CSB and CG were feasible strategies to preserve the antegrade blood flow of LSA, and each strategy had its advantages and disadvantages. Based on our current experience, we preferred CG for high-risk patients. However, the evidence was still not strong enough, further well-designed studies are necessary to identify the criteria for LSA revascularization strategy during TEVAR.

Background: This cohort study aimed to evaluate the short- and long-term outcomes of open repair (OR) and endovascular repair (ER) and identify the most suitable graft and approach for treating popliteal artery aneurysm (PAA) patients. Methods: The data of PAA patients from January 2000 to August 2020 were retrospectively collected and analyzed. The primary endpoints were 30-day mortality, peri-operative complication morbidity, post-operative type II endoleak, and sac- enlargement. The secondary endpoints were primary graft patency, secondary graft patency, the reintervention rate, and overall mortality. Results: A total of 213 PAAs of 186 patients were surgically repaired. The ER group had a significantly lower mean length of hospital stay, blood loss volume, and aneurysm diameter than the OR group. There were no significant differences between the ER and OR groups in terms of average surgery time, 30-day mortality, peri-operative complication morbidity, post-operative type II endoleak, sac enlargement, primary and secondary graft patency, reintervention rate, and overall mortality. However, in the sub-group analysis, autologous vein grafts had significantly higher primary and secondary graft patency rates than expanded polytetrafluoroethylene (ePTFE) vascular grafts and stent grafts. Type II endoleaks and post-operative sac enlargements were less likely to occur in OR patients when the posterior approach was adopted. Conclusions: We failed to establish any difference in superiority between OR or ER. However, we found that autologous vein grafts have better graft patency and the posterior approach is less likely to lead to type II endoleaks and sac enlargements after the initial PAA surgical procedure. However, more high-quality, large-scale randomized controlled trials need to be conducted.

The aim of this study was to compare the vascular complications of ProGlide and Prostar in percutaneous transfemoral transcatheter aortic valve replacement. Electronic databases were searched in July 2022 for studies that compared the vascular complications of ProGlide and Prostar for percutaneous closure in transcatheter aortic valve replacement. The primary outcome was major vascular complications and the secondary outcomes were minor vascular complications, types of access-site vascular complications, device failure, and additional intervention. Estimates of relative effects were pooled to generate ORs and their 95 per cent c.i. using a random-effects model. The risk of bias in non-randomized comparative studies was assessed using the Risk Of Bias In Non-randomized Studies - of Interventions (‘ROBINS-I’) tool. Nine studies were identified and a total of 7529 patients were included. Among them, 4144 patients received ProGlide and 3385 received Prostar. The pooled data showed that the risk of major vascular complications was significantly lower with ProGlide versus Prostar (OR 0.50, 95 per cent c.i. 0.32 to 0.78). Regarding the types of vascular complications, vascular trauma was the most common complication and the risk was similar between groups (OR 1.02, 95 per cent c.i. 0.55 to 1.91). ProGlide had a lower risk of bleeding complications (OR 0.46, 95 per cent c.i. 0.22 to 0.94), but a higher risk of ischaemia complications (OR 1.90, 95 per cent c.i. 1.10 to 3.27). The risk of device failure was lower in the ProGlide group (OR 0.45, 95 per cent c.i. 0.21 to 0.95). Both groups had a similar risk of having additional interventions for vascular complications (OR 1.02, 95 per cent c.i. 0.75 to 1.39). The use of ProGlide was associated with a lower risk of additional surgical treatments (OR 0.52, 95 per cent c.i. 0.34 to 0.80), but a higher risk of endovascular treatments (OR 2.69, 95 per cent c.i. 1.29 to 5.63). In percutaneous transfemoral transcatheter aortic valve replacement procedures, ProGlide has superior safety and efficacy when compared with Prostar; it is associated with fewer major vascular complications and device failures. The vascular complications of ProGlide are more likely to be dealt with using endovascular treatments than surgical treatments.