Search Results (2,074)

Background/Objectives: Ascending thoracic aortic aneurysms (aTAAs) pose a high risk of dissection and rupture. Though more prevalent in males, females may experience worse outcomes. Growth rate is considered a part of risk assessment, yet data in non-syndromic females without valve abnormalities remain limited. This study aims to assess whether aTAA growth differs between non-syndromic females and males with normal aortic valve morphology. Methods: The systematic review followed the PRISMA 2020 guideline. The final search was completed in April 2025, with guidance from a certified librarian. Included studies were RCTs or observational studies of non-syndromic adults with aTAA reporting sex-specific data and included ≥10 females. Prior dissection, valve replacement, or surgery were excluded. In addition to the original search, 11 articles were identified as likely to contain sex-specific data, and the corresponding authors were contacted. The protocol is registered in PROSPERO (CRD420251025890). Meta-analysis was not performed due to high heterogeneity and limited study numbers. Results: Of 2629 identified studies, 73 studies were screened in full-text, and only three met the inclusion criteria. The most common exclusion reason was lack of appropriately sex-stratified data. Two authors out of the 11 contacted replied with additional datasets, resulting in a total of five studies being included. Of the five included studies, three found faster growth rates in females. Reported growth rates in females varied notably, ranging from −0.7–1.74 mm/year. Conclusions: Evidence on sex differences in aTAA growth among non-syndromic patients with normal aortic valves remains inconclusive. Three of the five studies reported faster growth in females. Standardization in future research is needed. Full article

Background: The management of bone defects in pediatric oncology represents a major challenge in orthopedics, as it requires preserving both joint function and skeletal growth. Traditional reconstructive approaches, such as autografts and allografts, are limited by availability, complications, and incomplete biological integration. In this context, xeno-hybrid bone substitutes have emerged as a promising alternative. The aim of this study was to evaluate the safety and effectiveness of SmartBone^® ORTHO in the reconstruction of post-oncological bone defects in children. Methods: Twelve pediatric patients treated at the Centro Traumatologico Ortopedico (CTO) and OIRM Hospital, AOU Città della Salute e della Scienza of Turin (Italy), between 2016 and 2019 were retrospectively analyzed. Lesions included simple and aneurysmal bone cysts, non-ossifying fibroma, chondroblastoma, and other benign conditions. All patients underwent curettage followed by defect filling with SmartBone^® ORTHO. Results: At clinical and radiological follow-up, nine patients (75%) showed stable graft integration and complete functional recovery. Three patients (25%) developed local recurrence, which was managed with revision surgery and re-implantation of SmartBone^®, with all achieving stable outcomes. Radiographs demonstrated progressive increases in bone density and trabecular thickness, reaching values comparable to those of native bone within 6–12 months. Conclusions: SmartBone^® ORTHO proved to be a safe and effective biomaterial for pediatric post-oncological bone reconstruction, promoting rapid osteointegration and physiological bone remodeling without infection or intolerance. Full article

Background and Clinical Significance: Subvalvular aortic stenosis (SAS) is the second most common form of aortic stenosis after valvular disease and predominantly affects male patients. It is frequently associated with other congenital cardiac anomalies, such as ventricular septal defect, and is rarely diagnosed during infancy. Instead, SAS typically manifests during childhood or adulthood as a progressive left ventricular outflow tract obstruction, leading to left ventricular hypertrophy and, in many cases, aortic regurgitation. Case Presentation: The first patient was a 61-year-old man presenting with progressive dyspnea, in whom echocardiography revealed severe subaortic stenosis and computed tomography demonstrated aneurysmal dilatation of the ascending aorta. Intraoperatively, the aortic valve was found to be dystrophic with mixed stenotic and regurgitant disease; therefore, subaortic membrane resection, mechanical aortic valve replacement, and ascending aortic replacement with a synthetic graft were performed. The second patient was a 31-year-old man with exertional dyspnea and a discrete subaortic membrane associated with mild ascending aortic dilatation. Surgical treatment consisted of complete membrane resection and aortic valve repair, while the ascending aorta was preserved. Both patients had an uneventful postoperative course and were discharged on the fourth postoperative day. At 3-month follow-up, both were asymptomatic, in normal sinus rhythm, and demonstrated satisfactory echocardiographic findings without residual left ventricular outflow tract obstruction. Conclusions: Surgical intervention remains the definitive treatment for subvalvular aortic stenosis when clinically indicated. Concomitant cardiac or aortic pathology should be addressed during the same procedure to optimize outcomes. When performed with meticulous technique and appropriate patient selection, surgical correction is associated with excellent early recovery and favorable mid-term results, although long-term follow-up remains essential due to the risk of recurrence. Full article

Background: Plasma cell granuloma is generally considered a pseudotumor formed by reactive, polyclonal plasma cells. Although most cases can show polyclonal gammaglobulin production, quite a minority may exhibit monoclonal gammopathy, which mimics plasma cell neoplasms such as multiple myeloma or plasmacytoma. Because of this overlap, distinguishing reactive monoclonal proliferation from true malignancy is clinically essential. Case report: A 79-year-old man was presented with an anterior chest wall mass that had grown during investigation for fever of unknown origin. ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) revealed a sternal bone mass (SUVmax 9.04), aortic uptake of bifurcation (SUVmax 7.08), and Th7/8 soft tissue mass (SUVmax 5.32). Results from the FDG-PET revealed infectious reactions. A chest wall biopsy revealed high degree proliferation of plasma cells. Hematologists suspected plasmacytoma. The pathologist did not diagnose plasmacytoma; thus, there remains a possibility of reactive granuloma lesion. Lastly, the patient’s vertebral soft tissue mass culture yielded Staphylococcus aureus. The patient was treated with antimicrobials and responded well. Discussion: In the presented case, FDG-PET revealed an aortic mass with an aortic aneurysm, a sternal mass, and a vertebral mass, as multiple lesions. The abscess lesions that initially resembled multiple plasmacytomas were identified as plasma cell granuloma. The final diagnosis required demonstrating biopsy and definitive monoclonality. Light-chain restriction or monoclonal protein should be considered in the clinical context. Ultimately, this case highlights the diagnostic value of FDG-PET and the importance of differentiating reactive plasma cell granuloma from true plasma cell neoplasm to guide appropriate management. In conclusion, a reactive plasma cell granuloma associated with infectious aortitis can exhibit monoclonal gammopathy, mimicking plasma cell neoplasm. Careful pathological and clinical evaluation is essential to avoid misdiagnosis and ensure proper treatment. Full article

Background: Anatomical variations in visceral arteries are not so uncommon (up to 20% of cases in general population), with splenic and hepatic artery anomalies being the most frequently reported. Aberrant arteries may be affected with aneurysmal lesions that are rare but potentially fatal conditions. In their treatment, a comprehensive understanding and knowledge of the underlining anatomical variation are pivotal to prevent potential ischemic complications for the end organ. Methods: A comprehensive literature search on the PubMed, Cochrane and Scopus databases was done using the terms: “anomalous visceral artery aneurysm”, “Aberrant visceral arteries”, and “anomalous origin visceral vessels”. Eligible studies published from inception to 30 June 2024 were identified. Only those that had included the adopted treatment strategies (open, endovascular or hybrid repair) and the related outcomes (mortality, bleeding, end-organ ischemia, lesions of the surrounding organ, need for reintervention) were analyzed to evaluate the safety and efficacy of each approach. A narrative analysis of the indications informing the selection of each interventional treatment, based on individual procedural risks, was also presented. Results: A total of 30 publications describing 36 patients (mean age 48.9 ± 12.8 years, range 22–73 years) with aneurysms involving aberrant visceral arteries were included. Most patients were female (25/36, 69.4%). True aneurysms predominated (with a mean size of 30.5 ± 11.5 mm, range 6–60 mm), being reported in 33/36 (91.7%) patients. Most lesions involved a splenic artery arising from the superior mesenteric artery (27/36, 75.0%). Overall, 26/36 (72.2%) patients were symptomatic upon presentation, most commonly with abdominal or epigastric pain, often associated with nausea or vomiting, back pain or shortness of breath. All patients underwent preoperative Computed angiotomography or subtraction angiography to define the operative strategy. Most cases were managed electively (31/36, 86.1%), but 11.1% (4/36) of cases required urgent intervention (in one case the urgency status was not specified). Overall, 19/36 (52.8%) patients underwent purely endovascular repair, 15/36 (41.7%) were treated with open surgery, and 2/36 (5.6%) had hybrid procedures combining endovascular coiling with laparoscopic splenic artery ligation. Indication for treatment was based on vessel tortuosity, landing zones, and the presence of side branches supplying end organs. Early outcomes were favorable regardless of treatment strategies. A single organ-related complication was reported (1/36, 2.8%) following open/endovascular repair, consisting of mild pancreatitis, which resolved with conservative management. No perioperative or aneurysm-related deaths were reported in any of the included cases. No recurrent aneurysms or late aneurysm-related complications were described during the reported follow-up intervals (mean ≈ 10.5 months, range 1.5–42 months). Conclusions: Aneurysms arising from aberrant visceral arteries present unique challenges because their origin, course, and collateral networks deviate from standard anatomy. Patient selection and detailed anatomic mapping preoperatively are decisive as inadequate imaging or failure to recognize an aberrant origin can lead to the incomplete exclusion or inadvertent sacrifice of critical branches. Understanding the anatomy of visceral arteries and their variations is paramount in clinical practice, particularly when planning interventions for minimizing procedural risks, optimizing outcomes, and preventing potential complications. Contemporary practice favors endovascular repair due to lower perioperative morbidity, but success depends on vessel tortuosity, landing zones, and the presence of important side branches that supply end organs. Full article

Ascending thoracic aortic aneurysm (ATAA) pathogenesis varies with aortic valve morphology, yet regional heterogeneity between inner curvature (IC) and outer curvature (OC) remains incompletely characterized. We hypothesized that regional differences between the outer and inner curvature of the ascending aorta are valve-morphology dependent and reflect distinct remodeling mechanisms in bicuspid versus tricuspid aortic valve-associated aortopathy. Ascending aortic tissue from 155 patients (69 tricuspid aortic valve [TAV], 68 bicuspid aortic valve [BAV], 18 non-aneurysmal heart transplantation [HTx] controls) underwent uniaxial tensile testing (n = 66), histological analysis, hydroxyproline assay, and reverse transcription quantitative PCR (RT-qPCR) for collagen (COL1A1, COL3A1, COL4A1, COL5A1, COL11A1) and elastin (ELN) genes. The OC was thinner than the IC in both TAV and BAV (p < 0.001), with no regional differences in HTx. TAV demonstrated increased OC stiffness (E-modulus 0.60 ± 0.31 vs. 0.43 ± 0.24 MPa, p = 0.004) with reduced failure strain (p = 0.013). BAV showed preserved stiffness but reduced OC extensibility (ε_max 56.5 ± 15.1% vs. 72.4 ± 21.7%, p < 0.001). BAV exhibited elevated OC collagen content (hydroxyproline OC/IC ratio 1.42, p = 0.048), whereas TAV showed reduced OC elastin area (p < 0.01). All collagen genes were upregulated at the OC in both TAV (all p < 0.001) and BAV (all p < 0.05), with COL11A1 showing the highest fold change (3.4-fold in TAV). ELN was reduced at the OC in TAV (p < 0.001) but unchanged in BAV. ATAAs exhibit distinct valve-dependent regional heterogeneities. The discordance between collagen gene expression and protein content suggests valve-specific differences in collagen regulation. These findings support distinct pathomechanisms and highlight the limitations of diameter-based risk stratification, motivating further investigation of regional wall assessment as a complement to current size criteria for surgical decision-making. Full article

Point-of-care ultrasound (POCUS) is portable and radiation-free, but its clinical reliability is constrained by operator-dependent image acquisition and the limited scalability of expert quality assurance (QA) review. As handheld devices proliferate faster than mentorship capacity, trainees increasingly rely on heterogeneous free open access medical education (FOAMed) resources that rarely provide real-time psychomotor feedback. We conducted a structured narrative review (MEDLINE, Embase, Scopus, and Web of Science; last searched on 23 February 2026), with searches performed by H.H. and independently checked by J.J.P. (both POCUS-trained clinicians). After screening, 31 studies were included. We synthesized evidence on artificial intelligence (AI) systems that support bedside image acquisition and automate QA. The primary synthesis centered on key prospective or comparative clinical evaluations of AI-guided acquisition across echocardiography, focused assessment with sonography in trauma, abdominal aortic aneurysm screening, and lung ultrasound, complemented by peer-reviewed studies of FOAMed appraisal tools and online resource quality. These evaluations suggest that real-time probe guidance, view recognition, anatomy labeling, and automated capture may enable novices, after brief training, to acquire diagnostically adequate images for narrowly defined tasks. Early reports of automated QA scoring and program-level triage for expert review suggest potential to reduce expert workload and shorten feedback cycles, but external validation, generalizability across devices and patient habitus, and patient-centered outcomes remain limited. Acquisition-focused AI may therefore serve as an upstream “digital mentor” to improve novice image acquisition. We propose a practical pathway that integrates curated FOAMed resources and simulation with AI-guided bedside acquisition and continuous QA governance for safe deployment. Full article

Cerebral aneurysms and arteriovenous malformations are life-threatening hemodynamic pathologies of the brain. While surgical intervention is often essential to prevent fatal outcomes, it carries significant risks both during the procedure and in the postoperative period, making the management of these conditions highly challenging. Parameters of cerebral blood flow, routinely monitored during medical interventions or with modern noninvasive high-resolution imaging methods, could potentially be utilized in machine-learning-assisted protocols for risk assessment and therapeutic prognosis. To this end, we developed a linear oscillatory model of blood velocity and pressure for clinical data acquired from neurosurgical operations. Using the method of Sparse Identification of Nonlinear Dynamics (SINDy), the parameters of our model can be reconstructed online within milliseconds from a short time series of the hemodynamic variables. The identified parameter values enable automated classification of the blood-flow pathologies by means of logistic regression, achieving a balanced accuracy of 74%. Our results demonstrate the potential of this model for both diagnostic and prognostic applications, providing a robust and interpretable framework for assessing cerebral blood vessel conditions. Full article

Background: Aorto-esophageal fistula is a rare but life-threatening condition most often linked to thoracic aortic aneurysms and significant upper gastrointestinal bleeding. Thoracic endovascular aortic repair (TEVAR) is a crucial, life-saving procedure, but delayed complications, such as secondary esophageal fistulas caused by endograft erosion, can develop. Prompt recognition and multidisciplinary management are vital for survival. Case Presentation: We describe a 57-year-old patient with cardiovascular comorbidities and a saccular thoracic aortic aneurysm, who initially presented with massive hematemesis, melena, and hemodynamic instability. Imaging showed an aorto-esophageal fistula. Emergency treatment included placing a fully covered esophageal stent followed by TEVAR. Three weeks later, he experienced fever, chest pain, and worsening dysphagia. Laboratory tests indicated elevated inflammatory markers and hypoalbuminemia. Computed tomography revealed a new retrocardial esophageal fistula at T9, caused by mechanical erosion from the thoracic endograft. Endoluminal vacuum-assisted closure (EndoVAC) therapy was performed, leading to clinical improvement and the return of esophageal function. Conclusions: This case highlights a rare instance of a delayed secondary esophageal fistula after TEVAR beneath a preexisting stent, likely due to chronic contact between the endograft and esophagus. Despite advancements in endoscopic therapy, secondary fistulas after TEVAR are associated with high morbidity. Early diagnosis, aggressive infection management, structured nutritional support, and a multidisciplinary approach are essential. Extraluminal or intraluminal vacuum-assisted closure offers a promising minimally invasive option for managing complex esophageal defects. Full article

Background: Abdominal aortic aneurysm (AAA) is a vascular disease with a high mortality rate upon rupture (85–90%). Surgical repair remains the most effective intervention, whereas pharmacological treatments to prevent aneurysm expansion or rupture are limited. Vascular smooth muscle cells (VSMCs) play a crucial role in AAA pathogenesis, and metabolic dysregulation is increasingly recognized as a contributor to disease progression. This study investigated metabolic changes in VSMCs and their association with AAA pathology using untargeted metabolomics. Methods: Angiotensin II (Ang II) was used to stimulate rat VSMCs and induce AAA in ApoE−/− mice. Untargeted metabolomic analysis was performed using liquid chromatography–tandem mass spectrometry to detect metabolite changes. Differential metabolites were identified using orthogonal partial least squares discriminant analysis, and metabolic pathways were analyzed using Kyoto Encyclopedia of Genes and Genomes and metabolic set enrichment analysis. Results: In Ang II-treated VSMCs, 54 differential metabolites (24 upregulated; 30 downregulated) were identified, whereas 470 differential metabolites (206 upregulated; 264 downregulated) were detected in mouse aortas. Three metabolites—carnitine, lysophosphatidylcholine (0:0/20:4), and 5-hydroxyeicosatetraenoic acid—were common in both models and were enriched in bile secretion and tryptophan metabolism pathways. The carnitine–FXR signaling axis emerged as a potential therapeutic target. Conclusions: This study revealed Ang II-induced metabolic changes in VSMCs and their association with AAA pathology. The carnitine–FXR signaling axis may contribute to AAA development, providing new directions for diagnostic biomarkers and therapeutic targets. Future studies should validate these findings in human AAA samples to determine their clinical relevance. Full article

Background/Objectives: Aneurysms develop secondary to progressive weakening of arterial walls and remain a major cause of morbidity and mortality worldwide. Collagen, particularly fibrillar types I and III, is the primary tensile load-bearing component of arteries, yet its specific role in aneurysm formation, progression, and rupture is incompletely defined. This narrative review synthesizes current evidence on collagen structure, regulation, and degradation in aneurysm pathophysiology, highlighting cerebral aneurysms within the broader context of aneurysms as a whole. Methods: Searches of PubMed, MEDLINE, Embase, and Google Scholar were performed to identify all English-language studies published prior to January 2026. Search terms included “cerebral aneurysm”, “collagen”, “extracellular matrix”, “vascular remodeling”, and “aneurysm rupture”. Included studies evaluated collagen structure or content, extracellular matrix remodeling, matrix metalloproteinases, or biomechanical properties of the aneurysm wall in experimental or human models. Results: The literature search identified 348 records, of which 87 studies published between 1999 and 2025 met the inclusion criteria and were synthesized in this review. Collagen types I and III form the primary tensile scaffold of intracranial arteries, while basement membrane and regulatory collagens (e.g., types IV, V, and VI) modulate fibril organization, endothelial stability, and mechanical homeostasis. Research demonstrates that endothelial dysfunction, nitric oxide dysregulation, oxidative stress, and matrix metalloproteinase activation are key pathways driving collagen fragmentation and degradation. Genetic and epigenetic disturbances in collagen and related extracellular matrix pathways further increase aneurysm susceptibility. Conclusions: Collagen dysregulation appears to be a final common pathway through which hemodynamic, inflammatory, hormonal, and genetic insults converge to weaken intracranial arterial walls. However, existing evidence is dominated by animal and aortic models, and in vivo tools, such as Magnetic Resonance Imaging with collagen-sensitive sequences and Positron Emission Tomography Tracers, to quantify collagen integrity in cerebral aneurysms are lacking. Future efforts should prioritize human-focused studies, advanced collagen-sensitive imaging, biomarker development, and targeted strategies to preserve or restore collagen structure as potential means to improve aneurysm risk stratification, prevention, and treatment. Full article

Background: Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high early mortality and long-term disability. Prognostic assessment relies mainly on neurological grading scales, which may incompletely capture the systemic metabolic response to acute brain injury. Non-thyroidal illness syndrome (NTIS), particularly low triiodothyronine syndrome (LT3S), is common in critical illness, but its prognostic relevance in aSAH remains unclear. Objectives: To evaluate the prognostic impact of early thyroid hormone alterations on 30-day mortality and early clinical outcomes including delayed cerebral ischemia (DCI) in patients with aSAH, with particular emphasis on the magnitude of triiodothyronine (T3) deficiency. Methods: We conducted a retrospective single-center observational cohort study of 157 consecutive adult patients admitted with confirmed aSAH between 2014 and 2025. Serum free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH) were measured within 72 h of admission. Hormone values were normalized to contemporaneous reference intervals to generate continuous reference-adjusted metrics (FT3_level, TSH_level). Associations with 30-day in-hospital mortality were analyzed using logistic regression and Cox proportional hazards models adjusted for admission variables including age, sex, APACHE II score, World Federation of Neurosurgical Societies grade, Fisher grade, and treatment modality. Results: Binary LT3S classification was frequent but not independently associated with 30-day mortality. In contrast, lower FT3_level values were significantly associated with increased mortality and shorter survival time. In logistic regression analyses, each 0.1 increase in FT3_level was associated with an 18% lower odds of death (adjusted OR 0.82, 95% CI 0.69–0.97). This association persisted after adjustment for established clinical severity measures and was concordant with time-to-event analyses. FT3_level was not correlated with TSH_level, consistent with NTIS. Endovascular coiling was associated with more pronounced peripheral fT3 deficiency (p < 0.05) but was not independently associated with mortality. FT3_level was not independently associated with early neurological status or functional outcome at hospital discharge. Conclusions: Lower FT3_level values were independently associated with higher 30-day mortality, indicating that early peripheral T3 reduction reflects clinically relevant metabolic vulnerability in aSAH. Full article

Background/Objectives: Operator experience, the implementation of low frame rates during both fluoroscopy and digital subtraction angiography (DSA), and the use of modern angiographic systems are essential for maintaining diagnostic image quality while minimizing ionizing radiation exposure during stent-assisted endovascular treatment of intracranial aneurysms. At the study center, a low-dose protocol is employed, using the lowest available fluoroscopy frame rate (3.125 frames per second) and a nominal acquisition rate of 2 frames per second for DSA, three-dimensional (3D) rotational angiography, 2D/3D mapping, and roadmapping. Methods: A retrospective analysis was performed on 132 stent-assisted procedures conducted at a single tertiary center between 2018 and 2024. For each procedure, data were collected for dose-area product (DAP), reference air kerma (Ka,r), fluoroscopy time (FT), and the total number of DSA frames. Local diagnostic reference levels (DRLs; 75th percentile [P75]) and typical values (50th percentile [P50]) were established and compared with values reported in the literature. Results: For all patients the P75 values, representing DRLs, were 19.89 Gy·cm² for DAP, 332 mGy for Ka,r, 25 min 32 s for FT, and 354 DSA frames. The P50 values were 13.71 Gy·cm² for DAP, 219.5 mGy for Ka,r, 20 min 36 s for FT, and 277 DSA frames. Conclusions: In this single-center cohort, dose metrics for stent-assisted coil embolization were within the lower range of published values. Cross-study comparisons remain descriptive and require cautious interpretation. The proposed local DRLs may support quality assurance, dose optimization, and patient safety in similar clinical settings. Further multicenter and multi-operator studies are necessary to assess transferability and applicability beyond coil-only procedures. Limitations include the retrospective single-center design (single operator) and the lack of a contemporaneous control group and formal image-quality/outcome assessment. Full article

Cardiovascular diseases (CVDs) remain the leading cause of global mortality, with aortic pathologies such as atherosclerosis and thoracic aortic aneurysm posing significant risks due to their asymptomatic nature and potential fatal complications. This study investigates molecular mechanisms underlying CVDs by examining key cellular components of the aortic wall—vascular smooth muscle cells (VSMCs), fibroblasts, and macrophages—and their responses to low-density lipoproteins (LDLs). Using in vitro models, we analyzed phenotypic characteristics, LDL internalization capacity, and secretion/expression of pro-inflammatory mediators (IL-6, IL-8, IL-1β, CCL2) in primary VSMCs (from tunica intima and media), fibroblasts (977hTERT), and THP-1 macrophages. Fluorescence staining with BDP 630/650 revealed that all cell types internalize LDLs, with macrophages showing the highest lipid accumulation. ELISA and RT-qPCR demonstrated cell-specific patterns of cytokine secretion and gene expression, both in control conditions and after LDL exposure. The results indicate that VSMCs and fibroblasts, normally involved in vascular tone maintenance and extracellular matrix (ECM) synthesis, acquire pro-inflammatory features under pathological conditions, including increased secretion of IL-6, IL-8, and CCL2. Macrophages exhibited enhanced expression of the scavenger receptor CD36 and pro-inflammatory cytokines (especially IL-1β) after LDL treatment. Full article

Neutrophils and their extracellular traps (NETs) are pivotal elements of the immune response. This study investigates the dynamics of neutrophil-related markers during the perioperative period of branched endovascular aortic repair (BEVAR) in patients with thoracoabdominal aortic aneurysms (TAAAs) and evaluates their association with one-year clinical outcomes. A prospective, single-center study was conducted on 20 TAAA patients treated with T-branch devices. The analysis focused on surrogate markers associated with NETosis, including double-stranded DNA (dsDNA), single-stranded DNA (ssDNA), and citrullinated histone H3 (citH3). Peripheral venous blood was collected 24 h before BEVAR, and on the third and fifth postoperative days. Patients were monitored for one year to evaluate mortality and hospitalization risks, with predictors identified using Cox regression analysis. Increased postoperative levels of inflammatory markers were significantly associated with higher risks of mortality and hospital readmission. On the third postoperative day, key parameters emerged as predictors of adverse outcomes: dsDNA (HR = 1.000; 95% CI 1.000–1.000; p = 0.027), ssDNA (HR = 1.000; 95% CI 1.000–1.000; p = 0.022), and NLR (HR = 1.226; 95% CI 1.043–1.440; p = 0.013). Markers assessed in the early postoperative period (the third postopearive day) demonstrated superior predictive utility compared to those measured on the fifth postoperative day. CitH3 levels did not show statistical significance as a prognostic factor. Early postoperative evaluation of NET-associated markers, particularly dsDNA and ssDNA, offers prognostic value for predicting mortality and hospitalization risks in TAAA patients undergoing BEVAR. These markers may provide superior predictive accuracy compared to conventional post-implantation syndrome criteria. Enhanced postoperative monitoring of these markers could help identify high-risk patients who may benefit from intensified follow-up. Full article