Objective: This study aimed to investigate the relationship between thrombus localization, sac volume shrinkage, and the number of patent lumbar arteries following endovascular aortic aneurysm repair (EVAR). Methods: A total of 143 patients who underwent elective EVAR were included in the study. Preoperative and postoperative thrombus volume and localization were assessed, along with lumbar artery counts. Thrombus was categorized as either anterior, posterior, circular, or absent. A postoperative sac volume reduction ≥10% was considered positive remodeling. Results: Results demonstrated that patients with a posteriorly localized thrombus exhibited significantly more significant sac volume shrinkage (p=0.017) and fewer patent lumbar arteries (mean: 3.1±1.6; p=0.002). In contrast, circular thrombus localization was associated with less sac shrinkage and a higher number of patent lumbar arteries, which likely impeded effective remodeling. The presence of more than three patent lumbar arteries (p<0.001) and thrombus occupying ≥25% of the neck (p=0.049) were negatively correlated with sac shrinkage, suggesting an increased risk of secondary interventions. Conclusion: These findings highlight the critical role of thrombus localization and lumbar artery count in determining sac remodeling outcomes after EVAR. Posterior thrombus placement may promote effective sac shrinkage by reducing blood flow through lumbar arteries, thus potentially lowering the need for secondary interventions.

We report the case of a male patient with limited cutaneous systemic sclerosis (SSc) that was complicated with severe digital ischemia, resistant to medical treatment. Due to the lack of treatment response, further laboratory and imaging studies were conducted. Findings were compatible with antiphospholipid syndrome and oral warfarin was added to the treatment regimen. After successful anticoagulation no further recurrences of digital ischemia were seen. An underlying etiology in SSc patients with treatment resistant digital ischemic necrosis should be suspected for accompanying antiphospholipid syndrome (APS).

The optimal timing and expected postoperative course of coronary artery bypass grafting (CABG) after asymptomatic coronavirus disease 2019 (COVID-19) remai

Background/Objectives. To compare clinical and angiographic outcomes after staged bilateral ovarian and parauterine vein embolization using coils or vascular plugs in women with pelvic congestion syndrome. Methods. We retrospectively compared 97 coil-treated and 103 plug-treated premenopausal women with complete six-month follow-up after staged bilateral ovarian and parauterine embolization at two centres from February 2025 to March 2026. Device selection reflected anatomy, availability, and operator preference. Left-sided treatment preceded right-sided treatment by approximately one month. Before right-sided embolization, venography assessed filling of previously treated left parauterine veins. Pain was assessed with a continuous-line visual analogue scale (VAS), scored 0–10, at baseline and six months after bilateral completion. Comparisons were unadjusted. Results. Six-month VAS was 1.4 ± 0.7 with coils and 4.2 ± 1.1 with plugs (mean difference, −2.80 points; 95% confidence interval, −3.06 to −2.54; P < .001). Parauterine opacification occurred in 15/97 (15.5%) versus 77/103 (74.8%; risk difference, −59.3 percentage points; 95% confidence interval, −68.7 to −46.8; P < .001). Immediate technical success was reported in all patients. Combined angiographic intervals were 18.0 ± 2.5 versus 22.0 ± 3.7 minutes. Transient increased pelvic pain occurred in 33.0% versus 37.9%. No migration, ovarian vein rupture, or unplanned repeat embolization was reported through six months. Conclusions. Coil treatment was associated with lower six-month pain scores and less parauterine opacification during contralateral venography. Nonrandom device selection and unadjusted comparisons prevent conclusions about causal device superiority.