Background: Newer generation devices have attempted to accommodate a wider range of aortoiliac anatomies offering endovascular aneurysm repair (EVAR) to more patients with abdominal aortic aneurysms (AAAs). We aim to examine the anatomic suitability for the ultra-low profile Ovation endograft in our AAA patients and to compare them with other contemporary devices. Methods: 158 consecutive AAA patients treated with EVAR or open surgical repair (OSR) were tested for EVAR eligibility according to the most commonly used endografts’ instructions for use. Results: 106 patients underwent EVAR and 52 OSR. EVAR eligibility was higher for the Ovation system (72%) compared to the rest of the devices (Incraft: 63%, Nellix: 60%, Endurant-II: 59%, Excluder: 55%, Zenith-Flex: 36%, Aorfix: 35%, P-value<0.001). Non-suitable proximal neck anatomy followed by access vessel inadequacy were the primary reasons for ineligibility. Conclusion: New generation aortic endografts with innovative proximal sealing mechanisms and ultra-low profile delivery systems are increasing patient eligibility for EVAR.

Lower limb peripheral arterial disease (PAD) characterizes the impairment of blood flow to extremities caused by arterial stenoses or occlusions. Evaluation of PAD is based on clinical examination, calculation of ankle-brachial index and imaging studies such as ultrasound, CT, MRI and digital subtraction angiography. These modalities provide significant information about location, extension and severity of macrovasular lesions in lower extremity arterial system. However, they can be also used to evaluate limb perfusion, using appropriate techniques and protocols. This information may be valuable for assessment of the severity of ischemia and detection of hypoperfused areas. Moreover, they can be used for planning of revascularization strategy in patients with severe PAD and evaluation of therapeutic outcome. These techniques may also determine prognosis and amputation risk in patients with PAD. This review gives a basic overview of the perfusion techniques for lower limbs provided by imaging modalities such as ultrasound, CT, MRI, digital subtraction angiography and scintigraphy and their clinical applications for evaluation of PAD and revascularization outcome.

Endovascular therapy, including aspiration thrombectomy and local thrombolytic therapy, often associated with angioplasty and stent placement, has been described in the literature. The purpose of this study was to review case series of patients with acute mesenteric ischemia treated with endovascular therapy and evaluate their outcomes. An online review using PubMed was carried out to identify all English articles about this topic in the time interval from 2005 to 2016. number of patients, cause of occlusion, symptoms, arteries involved, number of sessions of treatment, technical success, clinical success, recurrence rate, complications, mortality rate, number of patients who underwent diagnostic laparoscopy or surgical resection of ischemic bowel. Eighteen papers met the inclusion criteria and were included. Among the patients with arterial mesenteric ischemia treated with endovascular approach, the technical success rate was high (up to 100%) and data regarding clinical success are encouraging, even though they are few and heterogeneous. Technical success rate and clinical success of patients with acute venous mesenteric ischemia approached with endovascular treatment was 74-100% and 87.5-100% respectively. Current advances in endovascular therapies have made these treatments feasible for mesenteric ischemia.

Obesity and sarcopenia have been reported to affect outcomes in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs). We analyzed prospective data from 52 patients with non-oncogene driven metastatic NSCLC treated with ICIs. Body tissue composition was calculated by measuring the fat and muscle densities at the level of 3^rd lumbar vertebra in each patient computed tomography scan before ICI initiation using sliceOmatic tomovision. We converted the densities to indices [Intramuscular Fat Index (IMFI), Visceral Fat Index (VFI), Subcutaneous Fat Index (SFI), Lumbar Skeletal Muscle Index (LSMI)] by dividing them by height in meters squared. Patients were dichotomized based on their baseline IMFI, VFI and SFI according to their gender-specific median value. The cut-offs that were set for LMSI values were 55 cm²/m² for males and 39 cm²/m² for females. SFI distribution was significantly higher (p = 0.040) in responders compared to non-responders. None of the other variables affected response rates. Low LSMI HR: 2.90 (95% CI: 1.261–6.667, p = 0.012) and low SFI: 2.20 (95% CI: 1.114–4.333, p = 0.023) values predicted for inferior OS. VFI and IMFI values did not affect survival. Subcutaneous adipose and skeletal muscle tissue composition significantly affected immunotherapy outcomes in our cohort.

Purpose: To compare results of simple coverage vs preemptive embolization to exclude the internal iliac artery (IIA) during endovascular repair of aortoiliac aneurysms. Methods: A systematic review of the literature was conducted by searching MEDLINE, CENTRAL, and OpenGray databases until March 2016. Primary outcome measures were safety and efficacy of the 2 strategies. Safety was determined by 30-day mortality and the minor and major complication rates. Efficacy was determined by absence of endoleak from the target IIA. Secondary outcomes of any endoleak, reintervention, operative time, fluoroscopy time, blood loss, contrast volume, and length of hospitalization were also examined. The random effects model was used to calculate combined overall effect sizes of pooled data. Data are presented as the odds ratio (OR) or mean difference (MD) with 95% confidence interval (CI). Forest plots and inconsistency ( I²) statistics were used to evaluate the heterogeneity of the included studies. Results: Eight observational studies were included in the analysis. Overall, 284 and 255 subjects underwent IIA coverage or embolization, respectively. IIA coverage resulted in a significantly lower major complication rate (6% vs 29%; OR 2.97, 95% CI 1.46 to 6.04, p=0.003; I²=0%) and shorter hospitalization (MD 0.48 days, 95% CI 0.08 to 0.89, p=0.02; I²=0%), while differences in all other outcomes were not statistically significant. Conclusion: In the presence of limited data, available evidence suggests that simple coverage of the IIA may result in significantly fewer major complications compared to preemptive embolization; at the same time, the rates of endoleaks and/or reinterventions are similar between groups.