30-Second Takeaway
- Rupture at open conversion after EVAR drives a several-fold increase in 30-day mortality.
- Drug-coated balloons and drug-eluting stents show broadly similar 1-year outcomes for SFA disease, but noninferiority is not robust.
- PCD-CT monoenergetic reconstructions around 55–60 keV optimize detection of small endoleaks after EVAR.
- Pedal medial arterial calcification on plain foot x-ray stratifies cardiovascular and mortality risk in diabetic foot ulcer patients.
- Emerging cerebrovascular data on DCB, EVT prediction tools, and MT in pregnancy can inform collaboration with stroke teams.
Week ending January 24, 2026
Key updates in aneurysm conversion, femoropopliteal devices, and neurovascular interventions relevant to vascular surgeons
Outcomes and indications for open conversion after EVAR in a 208-patient multicenter series
Among 208 Japanese patients undergoing open surgical conversion (OSC) after EVAR, median age was 78 years and median sac diameter 62 mm. Type 2 endoleak with sac expansion was the leading indication (47%), followed by type 1, type 5, infection, and type 3 endoleaks. Thirty-day mortality was 4.3% overall, 2.4% in nonruptured cases, and 13.2% when conversion occurred for rupture. Rupture at OSC increased 30-day mortality nearly sixfold (HR 5.93; 95% CI 1.59–22.1). At 10 years, overall survival was 58.4%, aneurysm-related mortality 14.8%, and freedom from retreatment 87.5%, suggesting durable aneurysm control after OSC.
Drug-coated balloon versus drug-eluting stent for SFA disease: broadly similar 12-month outcomes
In 170 propensity-matched pairs with superficial femoral artery disease, drug-coated balloons (DCB) were compared with drug-eluting stents (DES). The 12-month composite endpoint (restenosis, death, target vessel revascularization, major amputation, acute limb ischemia) occurred in 32.4% with DCB and 32.9% with DES. This met a prespecified 10% noninferiority margin (one-sided p=0.02), but sensitivity analyses did not consistently support noninferiority. A secondary composite endpoint excluding restenosis showed similar event-free survival between DCB and DES before and after matching. Clinically, DCB and DES appear comparable at 1 year, yet definitive lesion-specific superiority or robust noninferiority remains unproven.
References
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Additional Reads
Optional additional studies from this edition.