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Endovascular Surgery: State of the Art and Clinical Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Vascular Medicine".

Deadline for manuscript submissions: 9 October 2025 | Viewed by 433

Special Issue Editors


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Guest Editor
Vascular and Endovascular Surgery Unit, “San Bortolo” Hospital, AULSS8 Berica, 36100 Vicenza, Italy
Interests: complex aortic endovascular repair; endoleaks; F/BEVAR

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Guest Editor
Vascular and Endovascular Surgery Division, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padua University, Padua, Italy
Interests: complex aortic endovascular repair; endoleaks; F/BEVAR

Special Issue Information

Dear Colleagues,

Endovascular surgery has transformed the management of aortic pathologies, offering less invasive alternatives to traditional open surgical methods, particularly for thoracic, thoracoabdominal, and aortic arch pathologies.

However, the increasing complexity of cases is highlighting the need for continued innovation.

Endoleaks continue to represent a significant clinical challenge, requiring advanced imaging and treatment strategies.

In the case of aortic arch endovascular surgery, the development of branched and fenestrated endografts has greatly improved the possibilities for treating these complex lesions without the need for open surgery, although neurological complications still prove to be the Achilles' heel in these procedures.

Similarly, spinal cord ischemia still poses a problem when we are dealing with pathologies involving the thoracic and thoracoabdominal aorta, highlighting the need for new strategies to mitigate these risks.

Despite these advances, new safety concerns have emerged, from the well-known problem of exposure to ionizing radiation in patients and surgeons to the possible release of micro- and nanoplastics from the graft materials, which could pose potential health risks.

In addition, legal and ethical challenges related to physician-modified endografts have raised questions about patient safety and regulatory oversights, underscoring the need for rigorous standards in endovascular surgery.

The future of aortic endovascular surgery lies in refining these techniques while addressing clinical and regulatory challenges.

We look forward to receiving your contributions.

Dr. Andrea Xodo
Dr. Francesco Squizzato
Guest Editors

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Keywords

  • complex aortic endovascular repair
  • aortic arch endovascular surgery
  • endoleaks
  • PMEG
  • spinal cord ischemia
  • endograft-related adverse events

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Published Papers (1 paper)

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Research

13 pages, 1477 KiB  
Article
Technical Considerations and Preliminary Experience of Intraprocedural Aneurysm Sac Embolization During Fenestrated and Branched EVAR (Embo F/BEVAR Technique): A Case Series
by Andrea Xodo, Fabio Pilon, Alessandro Gregio, Giulia Ongaro, Alessandro Desole, Federico Barbui, Giovanni Romagnoni and Domenico Milite
J. Clin. Med. 2025, 14(8), 2709; https://doi.org/10.3390/jcm14082709 - 15 Apr 2025
Viewed by 267
Abstract
Background: The aim of this case series is to describe technical considerations and preliminary outcomes of preventive aneurysm sac embolization during fenestrated or branched EVAR (embo F/BEVAR technique). Methods: Five male patients suffering from juxtarenal or pararenal abdominal aortic aneurysms, preoperatively identified as [...] Read more.
Background: The aim of this case series is to describe technical considerations and preliminary outcomes of preventive aneurysm sac embolization during fenestrated or branched EVAR (embo F/BEVAR technique). Methods: Five male patients suffering from juxtarenal or pararenal abdominal aortic aneurysms, preoperatively identified as being at “high risk” of type 2 endoleak (EL2) development, were treated with embo F/BEVAR. The patients presented at least two of these risk factors: patent inferior mesenteric artery (IMA) > 3 mm; more than three pairs of patent lumbar arteries (LAAs); more than two pairs of LAAs, associated with an accessory efferent artery or at least a pair of intercostal arteries; aneurysm thrombus volume < 40%; aneurysm sac diameter > 65 mm. Embo F/BEVAR was performed with 15 × 20 mm MReye Inconel coils (Cook Medical, Limerick, Ireland), using different aortic endografts. Results: Technical success was 100%, with no complications related to perioperative or postoperative coils implantation. An average number of 11 ± 4.4 coils/patient was deployed. No reinterventions were observed during the follow-up (12.4 ± 3.6 months). One case of EL2 (20%) was detected during the follow-up, without aneurysm sac enlargement. Conclusions: According to this preliminary experience, embo F/BEVAR technique with Inconel coils seems a feasible adjunctive procedure to manage the risk of EL2 after FEVAR or BEVAR, allowing a simple follow-up with low levels of scatter artifacts, and ensuring limited additional procedural costs. Moreover, embo F/BEVAR can be used with different endografts, requiring minimal increases in operating times. Further studies with larger cohorts of patients and longer follow-up periods are mandatory to better define the potential of this technique and its limitations. Full article
(This article belongs to the Special Issue Endovascular Surgery: State of the Art and Clinical Perspectives)
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