30-Second Takeaway
- EVAR and open AAA repair yield similar survival, but EVAR carries about double the reintervention risk.
- Thoracic branch endografts in zones 0–2 show good early outcomes and outperform TEVAR+LSAB in zone 2.
- Immune checkpoint inhibitors are strongly associated with incident PAD and limb loss, especially in high-risk patients.
- Nonheparin anticoagulants, especially bivalirudin and LMWH, appear safe for carotid interventions when UFH is contraindicated.
- Socioeconomic and perioperative factors—from amputation rehab access to ARHD and PE pathways—now materially influence vascular outcomes.
Week ending February 21, 2026
EVAR durability, arch endografts, oncologic PAD, and perioperative nuances shaping contemporary vascular practice
EVAR and open AAA repair have equivalent survival but higher reintervention after EVAR
This systematic review pooled four randomized trials comparing EVAR with open repair for intact AAA. Long-term overall survival was equivalent between approaches (HR 1.02; 95% CI 0.93-1.12). Reinterventions were significantly more frequent after EVAR (HR 2.14; 95% CI 1.70-2.70), favoring open repair for durability. Low heterogeneity and minimal bias support these estimates for counseling on repair choice and post-EVAR surveillance intensity.
Mitral repair for degenerative MR shows high 2-year durability with low reoperation and recurrent severe MR
This post hoc analysis evaluated 314 patients undergoing mitral repair for degenerative MR with concomitant tricuspid disease. Two-year mortality was 3.5%, and mitral reoperation occurred in 2.2% of patients. Recurrent moderate MR occurred in 9.2% and severe MR in 1.4% among survivors without reoperation. The composite of death, severe MR, or reoperation was 8.0%, with higher failure risk in anterior or bileaflet versus posterior leaflet pathology. These data provide a contemporary benchmark for surgical mitral repair durability in this population.
Thoracic branch endograft repair in zones 0–2 yields favorable outcomes and outperforms TEVAR+LSAB in zone 2
This single-center cohort included 75 patients undergoing zone 0–2 thoracic branch endoprosthesis (TBE) after FDA approval. At one year, overall survival was 80.4%, sac regression occurred in 60%, type IA endoleak was 1.3%, and branch patency was 100%. Zone 0 TBE had more 30-day permanent stroke and zone 1 more myocardial ischemia than other zones. Compared with zone 2 TEVAR+LSAB (n=94), zone 2 TBE had less acute kidney injury, less myocardial ischemia, shorter procedures, and shorter hospitalization. Zone 2 TBE also showed greater sac regression and lower reintervention risk, supporting it as a preferred strategy in suitable anatomy.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.