Although the safety and efficacy of the Indigo Aspiration Thrombectomy System (Penumbra Inc.) for lower extremity acute limb ischemia (LE-ALI) have been demonstrated, head-to-head comparative data with conventional treatment (CT) in real-world clinical settings remain limited. Therefore, this study compared the clinical outcomes of mechanical aspiration thrombectomy (MAT) versus CT in patients with LE-ALI.

Peripheral artery disease (PAD) is a critical vascular condition characterized by arterial occlusions, primarily in the lower extremities, leading to significant morbidity. The aim of this study is to investigate the clinical outcomes after directional atherectomy combined with drug-coated balloon angioplasty in lower extremity arterial disease.

To comprehensively clarify various treatment options for Trans-Atlantic Inter-Society Consensus (TASC) II C and D aorto-iliac occlusive disease (AIOD) through network meta-analysis (NMA), thus offering in-depth perspectives for clinical decision-making.

Starting patients on hemodialysis (HD) with an arteriovenous fistula (AVF) and minimizing catheter contact time are major unmet needs for end-stage renal disease (ESRD) patients. Percutaneous arteriovenous fistulas (pAVFs) could address these needs, but current devices often result in flow loss to the brachial vein, requiring reinterventions for target vein maturation and initial clinical use. This study evaluated the technical feasibility and safety of a novel implant-based pAVF, designed to replicate surgical AVF anatomy by directing flow exclusively into the superficial venous system of the upper arm.

To describe the use of a physician-modified endograft (PMEG) through the incorporation of an outer branch within a fenestrated custom-made device (CMD) originally designed for another patient with similar anatomy.

Prevertebral left subclavian artery (LSA) occlusion was traditionally performed using conventional coil embolization or vascular plugs. The Penumbra Occlusion Device (POD) is a hybrid coil specifically designed for embolizing high-flow vessels. This study aims to report the technical and clinical success of the POD for LSA embolization during Zone 2 Thoracic Endovascular Aortic Repair (TEVAR).

Percutaneous Fogarty thrombectomy is a novel and potentially less invasive alternative to surgical thrombectomy for the treatment of patients with acute limb ischemia (ALI). This study aimed to evaluate the effectiveness of percutaneous thrombectomy versus conventional surgical thrombectomy with respect to amputation-free survival (AFS) and periprocedural complications in patients with ALI.

To compare the efficacy of sac embolization (SACE) versus inferior mesenteric artery embolization (IMAE) in preventing persistent Type II endoleaks (pT2EL) and promoting aneurysmal sac shrinkage following endovascular aneurysm repair (EVAR) in high-risk patients.

To evaluate and compare outcomes of single- and double-fenestrated physician-modified endovascular grafts (PMEGs) for aortic arch pathologies treated in an emergent setting.

To evaluate the safety and efficacy of a strategy using the Anaconda Fenestrated endograft for treating thoracoabdominal aortic aneurysms (TAA) and supra-renal aortic aneurysms (SRAAs).

Fenestrated stent-grafts with proximal bare-metal fixation stent (BMFS) may provide better rotational movement to facilitate vessel catheterization, but novel designs with covered fixation stents (CFSs) have been increasingly utilized with lower profile fabric. This study aimed to evaluate procedural metrics and outcomes of fenestrated endovascular repair (FEVAR) using BMFS and CFS devices.

This case series investigates the use of the Penumbra Indigo thrombectomy system to treat acute occlusions of below-the-knee venous bypass grafts.

Fenestrated Endovascular Aortic Repair (F-EVAR) using Physician-Modified Endografts (PMEGs) has become an important option in the treatment of complex aortic aneurysms, particularly when custom-made devices are not available. However, difficult target vessel (TV) cannulations, notably with misalignment, often limit total transfemoral repair. To address this condition, we developed the Gap Steering (GPS) technique, which is a transfemoral-only adjunctive method using a steerable sheath to create a controlled gap between the stent graft and the aortic wall, enabling on-demand cannulation. In this study, we aimed to evaluate the technical feasibility and procedural features, outcomes, and risks associated with the GPS technique in difficult target vessel cannulation owing to fenestration misalignment.

Thoracic endovascular aortic repair (TEVAR) with fenestration technology for reconstruction of the aortic arch branches has been used in patients with aortic arch pathologies. However, the outcomes of comparisons between the 2 reconstruction methods are rarely reported. This study sought to compare and clarify the midterm outcomes between in situ and in vitro fenestrated stent-grafts for endovascular repair of aortic arch pathologies.

Dedicated dual- and triple-branched endografts represent a transformative innovation for achieving secure Zone 0 proximal landing in aortic arch reconstruction. Driven by the limitations of traditional open and hybrid approaches, these dedicated devices integrate advanced design features-such as customizable dual-inner branch configurations, mechanical interlock systems, pre-curved ascending aortic stents, and ultra-low-profile delivery systems to enhance fixation, minimize wall stress, and reduce procedural complications. Early clinical experiences have shown promising outcomes with high freedom from aorta-related mortality and low rates of endoleaks and reinterventions, although challenges related to device durability, anatomical variability, and long-term patency remain. As the field shifts from physician-modified prototypes to dedicated commercial platforms, ongoing research is focused on refining device adaptability and integrating advanced imaging and computational modeling to further personalize treatment strategies. These trends underscore an industry-wide move toward minimally invasive, endovascular solutions that aim to improve patient outcomes in the management of complex aortic arch pathologies.Clinical ImpactDedicated dual- and triple-branched endografts enable fully endovascular Zone 0 repair, reducing the need for open or hybrid surgery. For clinicians, they broaden treatment options for high-risk patients and simplify procedural planning. As designs and imaging integration evolve, these devices are expected to improve durability, predictability, and long-term outcomes-marking a major step toward a truly minimally invasive standard for aortic arch reconstruction.

The objective of this systematic review was to provide evidence-based data regarding the safety and efficacy of the low-profile endografts (LPEGs) for abdominal aortic aneurysms.

Drug-coated balloons (DCB) might improve the results of below the knee (BTK) angioplasty, but sufficient randomized data comparing DCB and conventional angioplasty in treating patients with chronic limb threatening ischemia (CLTI) are lacking. This study aimed to perform a randomized comparison between a paclitaxel-coated angioplasty balloon catheter and a conventional balloon angioplasty catheter in treating BTK arterial lesions.

The objective of this systematic review was to provide evidence-based data regarding the safety and efficacy of physician-modified endografts (PMEGs) for reno-visceral aortic pathologies.

While the benefits of carotid surgery for symptomatic carotid artery disease are well-established, the management of asymptomatic carotid lesions remains controversial, with wide variation in clinical practice. Recent studies suggest that plaque characteristics, such as thrombus versus calcium content, may predict cerebral events more accurately than the degree of stenosis alone. This study investigates the feasibility of segmenting carotid lesions on computed-tomography (CT) angiography using artificial intelligence (AI), and evaluates differences in plaque composition between symptomatic and asymptomatic patients.

Full-moon calcified plaque is difficult to treat in coronary arteries. Computed tomography (CT) is used to evaluate calcification, but severe plaque can be difficult to assess due to artifacts. Adjusting noncontrast CT window settings may improve plaque evaluation. This study aimed to assess true full-moon calcifications and their impact on procedural success in below-the-knee (BTK) endovascular therapy (EVT) and antegrade guidewire success in chronic total occlusion (CTO) cases.