Vascular Surgery

Bypass versus repeat endovascular therapy after prior revascularization in CLTI

This VQI analysis included 53,793 CLTI patients undergoing infrainguinal revascularization after prior bypass or endovascular therapy (ET). Propensity-matched cohorts were constructed separately for prior bypass (1,047 pairs) and prior ET (5,603 pairs). After prior bypass, 1-year mortality, major amputation, reintervention, and MALE did not differ between repeat bypass and ET. After prior ET, bypass was associated with lower 1-year mortality, reintervention, and MALE/death hazards than repeat ET. These findings support preferential consideration of open bypass after failed ET, with either strategy reasonable after failed bypass. 1

False lumen occluders drive favorable remodeling in chronic type B dissection

This single-center study evaluated 71 chronic type B dissection patients treated with TEVAR or F/BEVAR plus third-generation false lumen occluders (FLOs). Across 268 imaging exams, total aortic and false lumen volumes decreased significantly, while true lumen volume expanded over time. Aortic remodeling, defined as ≥10% false lumen regression, occurred in 83.1% of patients; enlargement was infrequent. Adjunctive false lumen embolization enhanced true lumen expansion and FLO remodeling without added mortality or morbidity. No spinal cord ischemia occurred, and FLO size or position did not materially influence outcomes. FLO remodeling strongly correlated with false lumen reduction, offering a practical radiologic success marker. 2

2026 ACC/AHA PAD performance and quality measures

This ACC/AHA document defines 2026 clinical performance and quality measures for patients with peripheral artery disease (PAD). Measures emphasize evidence-based pharmacotherapy and appropriate follow-up testing to quantify treatment effects on PAD outcomes. They are intended for clinicians, researchers, quality personnel, payers, and regulators across varied practice environments. Adoption should standardize PAD care delivery and enable reproducible quality benchmarking for vascular programs. 3

Cilostazol and prognosis in Korean diabetics with lower extremity PAD

This nationwide Korean cohort included 14,768 diabetic patients with lower extremity PAD, 5,382 receiving cilostazol and 9,386 controls. Cilostazol therapy was associated with significantly lower all-cause mortality compared with no cilostazol use. Antiplatelet therapy overall reduced mortality versus no antiplatelet treatment, with no major mortality differences between agents. Cilostazol alone or with other antiplatelets reduced recurrent MALEs without increasing major bleeding risk. Cilostazol did not reduce MACCE, indicating primarily limb- and survival-focused benefits rather than cardiocerebral protection. 4