1
|
Menard MT, Farber A, Powell RJ, Rosenfield K, Conte MS, Hamza TH, Kaufman JA, Cziraky MJ, Creager MA, Dake MD, Jaff MR, Reid D, Sopko G, White CJ, Strong MB, van Over M, Chisci E, Goodney PP, Gray B, Kayssi A, Siracuse JJ, Choudhry NK. Quality of Life in Patients With Chronic Limb-Threatening Ischemia Treated With Revascularization. Circulation 2024; 149:1241-1253. [PMID: 38597097 DOI: 10.1161/circulationaha.123.065277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 02/20/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND In the BEST-CLI trial (Best Endovascular Versus Best Surgical Therapy for Patients With Chronic Limb-Threatening Ischemia), a prespecified secondary objective was to assess the effects of revascularization strategy on health-related quality of life (HRQoL). METHODS Patients with chronic limb-threatening ischemia were randomized to surgical bypass (Bypass) or endovascular intervention (Endo) in 2 parallel trials. Cohort 1 included patients with single-segment great saphenous vein; cohort 2 included those lacking suitable single-segment great saphenous vein. HRQoL was assessed over the trial duration using Vascular Quality-of-Life (VascuQoL), European Quality-of-Life-5D (EQ-5D), the Short Form-12 (SF-12) Physical Component Summary (SF-12 PCS), SF-12 Mental Component Summary (SF-12 MCS), Utility Index Score (SF-6D R2), and numeric rating scales of pain. HRQoL was summarized by cohort and compared within and between groups using mixed-model linear regression. RESULTS A total of 1193 and 335 patients in cohorts 1 and 2 with a mean follow-up of 2.9 and 2.0 years, respectively, were analyzed. In cohort 1, HRQoL significantly improved from baseline to follow-up for both groups across all measures. For example, mean (SD) VascuQoL scores were 3.0 (1.3) and 3.0 (1.2) for Bypass and Endo at baseline and 4.7 (1.4) and 4.8 (1.5) over follow-up. There were significant group differences favoring Endo when assessed with VascuQoL (difference, -0.14 [95% CI, -0.25 to -0.02]; P=0.02), SF-12 MCS (difference, -1.03 [95% CI, -1.89 to -0.18]; P=0.02), SF-6D R2 (difference, -0.01 [95% CI, -0.02 to -0.001]; P=0.03), numeric rating scale pain at present (difference, 0.26 [95% CI, 0.03 to 0.49]; P=0.03), usual level during previous week (difference, 0.26 [95% CI, 0.04 to 0.48]; P=0.02), and worst level during previous week (difference, 0.29 [95% CI, 0.02 to 0.56]; P=0.04). There was no difference between treatment arms on the basis of EQ-5D (difference, -0.01 [95% CI, -0.03 to 0.004]; P=0.12) or SF-12 PCS (difference, -0.41 [95% CI, -1.2 to 0.37]; P=0.31). In cohort 2, HRQoL also significantly improved from baseline to the end of follow-up for both groups based on all measures, but there were no differences between Bypass and Endo on any measure. CONCLUSIONS Among patients with chronic limb-threatening ischemia deemed eligible for either Bypass or Endo, revascularization resulted in significant and clinically meaningful improvements in HRQoL. In patients with an available single-segment great saphenous vein for bypass, but not among those without one, Endo was statistically superior on some HRQoL measures; however, these differences were below the threshold of clinically meaningful difference.
Collapse
Affiliation(s)
- Matthew T Menard
- Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.), Harvard Medical School, Boston, MA
| | - Alik Farber
- Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA (A.F., J.J.S.)
| | - Richard J Powell
- Division of Vascular and Endovascular Surgery, Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH (R.J.P., M.A.C., P.P.G.)
| | - Kenneth Rosenfield
- Brigham and Women's Hospital, Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Harvard Medical School, Boston, MA
| | - Michael S Conte
- Division of Vascular and Endovascular Surgery, University of California, San Francisco (M.S.C.)
| | - Taye H Hamza
- HealthCore, Inc, Watertown, MA (T.H.H., M.J.C., M.v.O.)
| | - John A Kaufman
- Department of Interventional Radiology, Human Performance Laboratory, Oregon Health and Science University, Portland (J.A.K.)
| | | | - Mark A Creager
- Division of Vascular and Endovascular Surgery, Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH (R.J.P., M.A.C., P.P.G.)
| | - Michael D Dake
- Department of Medical Imaging, University of Arizona Health System, University of Arizona, Tucson (M.D.D.)
| | - Michael R Jaff
- Professor of Medicine, Harvard Medical School (retired), Cambridge, MA (M.R.J.)
| | - Diane Reid
- National Heart, Lung & Blood Institute, Division of Cardiovascular Sciences, National Institutes of Health, Bethesda, MD (D.R., G.S.)
| | - George Sopko
- National Heart, Lung & Blood Institute, Division of Cardiovascular Sciences, National Institutes of Health, Bethesda, MD (D.R., G.S.)
| | - Christopher J White
- Department of Cardiovascular Diseases, The Ochsner Clinical School, University of Queensland, Australia (C.J.W.)
| | - Michael B Strong
- Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.), Harvard Medical School, Boston, MA
| | - Max van Over
- HealthCore, Inc, Watertown, MA (T.H.H., M.J.C., M.v.O.)
| | - Emiliano Chisci
- Division of Vascular Surgery, Ospedale San Giovanni di Dio, Florence, Italy (E.C.)
| | - Philip P Goodney
- Division of Vascular and Endovascular Surgery, Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH (R.J.P., M.A.C., P.P.G.)
| | - Bruce Gray
- Division of Vascular Medicine, Prisma Health, Greenville, SC (B.G.)
| | - Ahmed Kayssi
- Division of Vascular Surgery, University of Toronto, Canada (A.K.)
| | - Jeffrey J Siracuse
- Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA (A.F., J.J.S.)
| | | |
Collapse
|
2
|
Chou EL, Lu E, Dake MD, Fischbein MP, Bavaria JE, Oderich G, Makaroun MS, Charlton-Ouw KM, Naslund T, Suckow BD, Matsumura JS, Patel HJ, Azizzadeh A. Initial Outcomes of the Gore TAG Thoracic Branch Endoprosthesis for Endovascular Repair of Blunt Thoracic Aortic Injury. Ann Vasc Surg 2024:S0890-5096(24)00097-9. [PMID: 38492730 DOI: 10.1016/j.avsg.2023.12.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 03/18/2024]
Abstract
OBJECTIVE Endovascular repair of blunt thoracic aortic injury (BTAI) has dramatically reduced the morbidity and mortality of intervention. Injuries requiring zone 2 coverage of the aorta traditionally require left subclavian artery (LSA) sacrifice or open revascularization. Furthermore, these injuries are associated with increased risk of in-hospital mortality and long-term morbidity. Here we report 1-year outcomes of total endovascular repair of BTAI with the GORE® TAG® Thoracic Branch Endoprosthesis for LSA preservation. METHODS Across 34 investigative sites, 9 patients with BTAI requiring left subclavian artery coverage were enrolled in a nonrandomized, prospective study of a single branched aortic endograft. The thoracic branch endoprosthesis device allows for graft placement proximal to the LSA and incorporates a single side branch for LSA perfusion. RESULTS This initial cohort included 8 male and 1 female patient with a median age of 43 (22, 76) and 12 months of follow-up. Five total years of follow-up is planned. All participants had grade 3 BTAI. All procedures took place between 2018-2019. The median injury severity score was 2 (0, 66). The median procedure time was 109 minutes (78, 162). All aortic injuries were repaired under general anesthesia and with heparinization. A spinal drain was used in one patient. Post-deployment balloon angioplasty was conducted in one case at the distal landing zone. There was one asymptomatic LSA branch occlusion 6 months after repair. It was attributed to purposeful proximal deployment of the branch stent to accommodate an early vertebral takeoff. The occlusion did not require revascularization. There were no strokes, mortalities, or aortic adverse events (migration, endoleak, native aortic expansion, dissection or thrombosis) through 12 months of follow-up. CONCLUSIONS Initial cohort outcomes suggest that endovascular repair of zone 2 BTAI is feasible and has favorable outcomes using the thoracic branch device with LSA preservation. Additional cases and longer-term follow-up are required for definitive assessment of the device safety and durability in traumatic aortic injuries.
Collapse
Affiliation(s)
- Elizabeth L Chou
- Division of Vascular Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.
| | - Eileen Lu
- Division of Vascular Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Michael D Dake
- Department of Medical Imaging, University of Arizona Health System, Tucson, AZ
| | - Michael P Fischbein
- Department of Cardiothoracic Surgery, Stanford University Hospitals, Palo Alto, CA
| | - Joseph E Bavaria
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PE
| | | | - Michel S Makaroun
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PE
| | - Kristofer M Charlton-Ouw
- Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, TX
| | - Thomas Naslund
- Department of Vascular Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Bjoern D Suckow
- Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Jon S Matsumura
- Department of Surgery, University of Colorado School of Medicine, Department of Surgery, Division of Vascular Surgery, Aurora, CO
| | - Himanshu J Patel
- Department of Cardiac Surgery, University of Michigan Frankel Cardiovascular Center, Ann Arbor, MI
| | - Ali Azizzadeh
- Division of Vascular Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| |
Collapse
|
3
|
Lafleur BJ, White L, Dake MD, Nikolich JZ, Sprissler R, Bhattacharya D. No Evidence That Analgesic Use after COVID-19 Vaccination Negatively Impacts Antibody Responses. Immunohorizons 2023; 7:834-841. [PMID: 38085168 PMCID: PMC10759157 DOI: 10.4049/immunohorizons.2300090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
Uptake of mRNA vaccines, especially booster immunizations, against COVID-19 has been lower than hoped, perhaps in part due to their reactogenicity. Analgesics might alleviate symptoms associated with vaccination, but they might also impact immune responses. We semiquantitatively measured Ab responses following COVID-19 vaccination in 2354 human participants surveyed about analgesic use after vaccination. Participants who used nonsteroidal anti-inflammatory drugs or acetaminophen after vaccination showed elevated Ab levels against the receptor-binding domain of Spike protein relative to those who did not use analgesics. This pattern was observed for both mRNA-1273 and BNT162b2 and across age groups. Participants who used analgesics more frequently reported fatigue, muscle aches, and headaches than did those who did not use painkillers. Among participants who reported these symptoms, we observed no statistically significant differences in Ab levels irrespective of analgesic use. These data suggest that elevated Ab levels are associated with symptoms and inflammatory processes rather than painkiller use per se. Taken together, we find no evidence that analgesic use reduces Ab responses after COVID-19 vaccination. Recommendation of their use to alleviate symptoms might improve uptake of booster immunizations.
Collapse
Affiliation(s)
- Bonnie J. Lafleur
- BIO5 Institute, University of Arizona, Tucson, AZ
- Department of Pharmacy Practice and Science, R. Ken Coit College of Pharmacy, University of Arizona, Tucson, AZ
| | - Lisa White
- BIO5 Institute, University of Arizona, Tucson, AZ
| | - Michael D. Dake
- Office of the Senior Vice-President for Health Sciences, University of Arizona, Tucson, AZ
| | - Janko Z. Nikolich
- BIO5 Institute, University of Arizona, Tucson, AZ
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, AZ
- University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, AZ
| | - Ryan Sprissler
- BIO5 Institute, University of Arizona, Tucson, AZ
- University of Arizona Genomics Core and the Arizona Research Labs, University of Arizona Genetics Core, University of Arizona, Tucson, AZ
| | - Deepta Bhattacharya
- BIO5 Institute, University of Arizona, Tucson, AZ
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, AZ
- Department of Surgery, University of Arizona College of Medicine, Tucson, AZ
| |
Collapse
|
4
|
Matsumoto AH, Dake MD. Implications of IR Being a Primary Specialty on the Professional Organizational Relationship between Interventional and Diagnostic Radiology. J Vasc Interv Radiol 2023; 34:2080-2084. [PMID: 38008543 DOI: 10.1016/j.jvir.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/12/2023] [Indexed: 11/28/2023] Open
Abstract
The recent awarding of primary specialty status to interventional radiology (IR) invites a re-examination of the long-standing relationship between IR and diagnostic radiology (DR). In this new era, it is important to evaluate how the organizations that represent these 2 specialties can best contribute to strengthening a growth in collaborations and partnerships that will benefit their members and patients. Areas of organizational focus with the potential to enhance the future for both groups include combining efforts directed toward advocacy and government relations, developing practice models to create successful IR and DR working relationships, and providing more data to demonstrate the value of IR above and beyond the work relative value units and professional revenues that IR generates.
Collapse
Affiliation(s)
- Alan H Matsumoto
- Department of Radiology and Medical Imaging, University of Virginia Health, Charlottesville, Virginia.
| | - Michael D Dake
- Department of Medical Imaging, Surgery and Medicine, University of Arizona Health Sciences, Tucson Campus, Health Sciences Innovation Building, Tucson, Arizona
| |
Collapse
|
5
|
Bondesson J, Suh GY, Dake MD, Lee JT, Cheng CP. Cardiac Pulsatile Helical Deformation of the Thoracic Aorta Before and After Thoracic Endovascular Aortic Repair of Type B Dissections. J Endovasc Ther 2023:15266028231179592. [PMID: 37300396 DOI: 10.1177/15266028231179592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE Type B aortic dissections propagate with either achiral (nonspiraling) or right-handed chiral (spiraling) morphology, have mobile dissection flaps, and are often treated with thoracic endovascular aortic repair (TEVAR). We aim to quantify cardiac-induced helical deformation of the true lumen of type B aortic dissections before and after TEVAR. MATERIAL AND METHODS Retrospective cardiac-gated computed tomography (CT) images before and after TEVAR of type B aortic dissections were used to construct systolic and diastolic 3-dimensional (3D) surface models, including true lumen, whole lumen (true+false lumens), and branch vessels. This was followed by extraction of true lumen helicity (helical angle, twist, and radius) and cross-sectional (area, circumference, and minor/major diameter ratio) metrics. Deformations between systole and diastole were quantified, and deformations between pre- and post-TEVAR were compared. RESULTS Eleven TEVAR patients (59.9±4.6 years) were included in this study. Pre-TEVAR, there were no significant cardiac-induced deformations of helical metrics; however, post-TEVAR, significant deformation was observed for the true lumen proximal angular position. Pre-TEVAR, cardiac-induced deformations of all cross-sectional metrics were significant; however, only area and circumference deformations remained significant post-TEVAR. There were no significant differences of pulsatile deformation from pre- to post-TEVAR. Variance of proximal angular position and cross-sectional circumference deformation decreased after TEVAR. CONCLUSION Pre-TEVAR, type B aortic dissections did not exhibit significant helical cardiac-induced deformation, indicating that the true and false lumens move in unison (do not move with respect to each other). Post-TEVAR, true lumens exhibited significant cardiac-induced deformation of proximal angular position, suggesting that exclusion of the false lumen leads to greater rotational deformations of the true lumen and lack of true lumen major/minor deformation post-TEVAR means that the endograft promotes static circularity. Population variance of deformations is muted after TEVAR, and dissection acuity influences pulsatile deformation while pre-TEVAR chirality does not. CLINICAL IMPACT Description of thoracic aortic dissection helical morphology and dynamics, and understanding the impact of thoracic endovascular aortic repair (TEVAR) on dissection helicity, are important for improving endovascular treatment. These findings provide nuance to the complex shape and motion of the true and false lumens, enabling clinicians to better stratify dissection disease. The impact of TEVAR on dissection helicity provides a description of how treatment alters morphology and motion, and may provide clues for treatment durability. Finally, the helical component to endograft deformation is important to form comprehensive boundary conditions for testing and developing new endovascular devices.
Collapse
Affiliation(s)
- Johan Bondesson
- Division of Vascular Surgery, Stanford University, Stanford, CA, USA
- Division of Dynamics, Chalmers University of Technology, Gothenburg, Sweden
| | - Ga-Young Suh
- Division of Vascular Surgery, Stanford University, Stanford, CA, USA
- Department of Biomedical Engineering, California State University, Long Beach, CA, USA
| | - Michael D Dake
- Department of Surgery, The University of Arizona, Tucson, AZ, USA
| | - Jason T Lee
- Division of Vascular Surgery, Stanford University, Stanford, CA, USA
| | | |
Collapse
|
6
|
Bondesson J, Raja S, Suh GY, Dake MD, Lee JT, Cheng CP. Longitudinal Mapping of True Lumen Morphology for Accurate Endograft Oversizing in Patients with Type B Aortic Dissections. J Vasc Surg 2023. [DOI: 10.1016/j.jvs.2023.01.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
|
7
|
Iwakoshi S, Ogawa Y, Dake MD, Ono Y, Higashihara H, Ikoma A, Nakai M, Taniguchi T, Ogi T, Kawada H, Tamura A, Ieko Y, Tanaka R, Sohgawa E, Nagatomi S, Woodhams R, Ikeda O, Mori K, Nishimaki H, Koizumi J, Senokuchi T, Hagihara M, Shimohira M, Takasugi S, Imaizumi A, Higashiura W, Sakaguchi S, Ichihashi S, Inoue T, Inoue T, Kichikawa K. Outcomes of embolization procedures for type II endoleaks following endovascular abdominal aortic repair. J Vasc Surg 2023; 77:114-121.e2. [PMID: 35985566 DOI: 10.1016/j.jvs.2022.07.168] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 07/16/2022] [Accepted: 07/25/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of this study was to investigate the mid-term outcomes of embolization procedures for type II endoleak after endovascular abdominal aortic repair, and clarify the risk factors for aneurysm enlargement after embolization procedures. METHODS This was a retrospective multicenter registry study enrolling patients who underwent embolization procedures for type II endoleaks after EVAR from January 2012 to December 2018 at 19 Japanese centers. The primary end point was the rate of freedom from aneurysm enlargement, more than 5 mm in the aortic maximum diameter, after an embolization procedure. Demographic, procedural, follow-up, and laboratory data were collected. Continuous variables were summarized descriptively, and Kaplan-Meier analyses and a Cox regression model were used for statistical analyses. RESULTS A total of 315 patients (248 men and 67 women) were enrolled. The average duration from the initial embolization procedure to the last follow-up was 31.6 ± 24.6 months. The rates of freedom from aneurysm enlargement at 3 and 5 years were 55.4 ± 3.8% and 37.0 ± 5.2%, respectively. A multivariate analysis revealed that a larger aortic diameter at the initial embolization procedure and the presence of a Moyamoya endoleak, defined as heterogeneous contrast opacity with an indistinct faint border, were associated with aneurysm enlargement after embolization management. CONCLUSIONS The embolization procedures were generally ineffective in preventing further expansion of abdominal aortic aneurysms in patients with type II endoleaks after EVAR, especially in patients with a large abdominal aortic aneurysm and/or a presence of a Moyamoya endoleak.
Collapse
Affiliation(s)
| | - Yukihisa Ogawa
- Department of Radiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Michael D Dake
- Department of Medical Imaging, University of Arizona College of Medicine, Tucson, AZ
| | - Yusuke Ono
- Department of Radiology, Osaka University, Suita, Japan
| | | | - Akira Ikoma
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | - Motoki Nakai
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | | | - Takahiro Ogi
- Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Hiroshi Kawada
- Department of Radiology, Gifu University Hospital, Gifu, Japan
| | - Akio Tamura
- Department of Radiology, Iwate Medical University, Morioka, Japan
| | - Yoshirou Ieko
- Department of Radiology, Iwate Medical University, Morioka, Japan
| | - Ryoichi Tanaka
- Department of Radiology, Iwate Medical University, Morioka, Japan
| | - Etsuji Sohgawa
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Satoru Nagatomi
- Department of Radiology, Nara Medical University, Kashihara, Japan
| | - Reiko Woodhams
- Department of Radiology, Kitazato University, Tokyo, Japan
| | - Osamu Ikeda
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Kensaku Mori
- Department of Radiology, Tsukuba University, Tsukuba, Japan
| | - Hiroshi Nishimaki
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Jun Koizumi
- Department of Radiology, Tokai University, Tokai, Japan
| | - Terutoshi Senokuchi
- Department of Radiology, Kagoshima University Graduate School of Medical and Dental Science, Kagoshima, Japan
| | - Makiyo Hagihara
- Department of Radiology, Aichi Medical University, Nagakute, Japan
| | - Masashi Shimohira
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shohei Takasugi
- Department of Radiology, Tottori University Hospital, Tottori, Japan
| | - Akira Imaizumi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Wataru Higashiura
- Department of Radiology, Okinawa Prefectural Chubu Hospital, Uruma, Japan
| | - Shoji Sakaguchi
- Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan
| | - Shigeo Ichihashi
- Department of Radiology, Nara Medical University, Kashihara, Japan
| | - Takeshi Inoue
- Department of Central Radiology, Nara Medical University, Kashihara, Japan
| | - Takashi Inoue
- Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan
| | | |
Collapse
|
8
|
Iwakoshi S, Ogawa Y, Dake MD, Ono Y, Higashihara H, Ikoma A, Nakai M, Taniguchi T, Ogi T, Kawada H, Tamura A, Ieko Y, Tanaka R, Sohgawa E, Nagatomi S, Woodhams R, Ikeda O, Mori K, Nishimaki H, Koizumi J, Senokuchi T, Hagihara M, Shimohira M, Takasugi S, Imaizumi A, Higashiura W, Sakaguchi S, Ichihashi S, Inoue T, Inoue T, Kichikawa K. Outcomes of embolization procedures for type II endoleaks following endovascular abdominal aortic repair. Eur J Vasc Endovasc Surg 2023. [DOI: 10.1016/j.ejvs.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
9
|
Watkins AC, Dossabhoy S, Dalal AR, Yasin A, Leipzig M, Colvard B, Lee JT, Dake MD. Controlled Balloon False Lumen Obliteration for the Endovascular Management of Chronic Dissection in the Descending Thoracic Aorta. JTCVS Tech 2023. [DOI: 10.1016/j.xjtc.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
|
10
|
Farber A, Menard MT, Conte MS, Kaufman JA, Powell RJ, Choudhry NK, Hamza TH, Assmann SF, Creager MA, Cziraky MJ, Dake MD, Jaff MR, Reid D, Siami FS, Sopko G, White CJ, van Over M, Strong MB, Villarreal MF, McKean M, Azene E, Azarbal A, Barleben A, Chew DK, Clavijo LC, Douville Y, Findeiss L, Garg N, Gasper W, Giles KA, Goodney PP, Hawkins BM, Herman CR, Kalish JA, Koopmann MC, Laskowski IA, Mena-Hurtado C, Motaganahalli R, Rowe VL, Schanzer A, Schneider PA, Siracuse JJ, Venermo M, Rosenfield K. Surgery or Endovascular Therapy for Chronic Limb-Threatening Ischemia. N Engl J Med 2022; 387:2305-2316. [PMID: 36342173 DOI: 10.1056/nejmoa2207899] [Citation(s) in RCA: 213] [Impact Index Per Article: 106.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Patients with chronic limb-threatening ischemia (CLTI) require revascularization to improve limb perfusion and thereby limit the risk of amputation. It is uncertain whether an initial strategy of endovascular therapy or surgical revascularization for CLTI is superior for improving limb outcomes. METHODS In this international, randomized trial, we enrolled 1830 patients with CLTI and infrainguinal peripheral artery disease in two parallel-cohort trials. Patients who had a single segment of great saphenous vein that could be used for surgery were assigned to cohort 1. Patients who needed an alternative bypass conduit were assigned to cohort 2. The primary outcome was a composite of a major adverse limb event - which was defined as amputation above the ankle or a major limb reintervention (a new bypass graft or graft revision, thrombectomy, or thrombolysis) - or death from any cause. RESULTS In cohort 1, after a median follow-up of 2.7 years, a primary-outcome event occurred in 302 of 709 patients (42.6%) in the surgical group and in 408 of 711 patients (57.4%) in the endovascular group (hazard ratio, 0.68; 95% confidence interval [CI], 0.59 to 0.79; P<0.001). In cohort 2, a primary-outcome event occurred in 83 of 194 patients (42.8%) in the surgical group and in 95 of 199 patients (47.7%) in the endovascular group (hazard ratio, 0.79; 95% CI, 0.58 to 1.06; P = 0.12) after a median follow-up of 1.6 years. The incidence of adverse events was similar in the two groups in the two cohorts. CONCLUSIONS Among patients with CLTI who had an adequate great saphenous vein for surgical revascularization (cohort 1), the incidence of a major adverse limb event or death was significantly lower in the surgical group than in the endovascular group. Among the patients who lacked an adequate saphenous vein conduit (cohort 2), the outcomes in the two groups were similar. (Funded by the National Heart, Lung, and Blood Institute; BEST-CLI ClinicalTrials.gov number, NCT02060630.).
Collapse
Affiliation(s)
- Alik Farber
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Matthew T Menard
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Michael S Conte
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - John A Kaufman
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Richard J Powell
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Niteesh K Choudhry
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Taye H Hamza
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Susan F Assmann
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Mark A Creager
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Mark J Cziraky
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Michael D Dake
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Michael R Jaff
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Diane Reid
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Flora S Siami
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - George Sopko
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Christopher J White
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Max van Over
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Michael B Strong
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Maria F Villarreal
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Michelle McKean
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Ezana Azene
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Amir Azarbal
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Andrew Barleben
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - David K Chew
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Leonardo C Clavijo
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Yvan Douville
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Laura Findeiss
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Nitin Garg
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Warren Gasper
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Kristina A Giles
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Philip P Goodney
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Beau M Hawkins
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Christine R Herman
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Jeffrey A Kalish
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Matthew C Koopmann
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Igor A Laskowski
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Carlos Mena-Hurtado
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Raghu Motaganahalli
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Vincent L Rowe
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Andres Schanzer
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Peter A Schneider
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Jeffrey J Siracuse
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Maarit Venermo
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| | - Kenneth Rosenfield
- From the Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine (A.F., M.F.V., J.A. Kalish, J.J.S.), the Division of Vascular and Endovascular Surgery (M.T.M., M.B.S.) and the Department of Medicine (N.K.C.), Brigham and Women's Hospital, Harvard Medical School (M.R.J.), and the Section of Vascular Medicine and Intervention, Massachusetts General Hospital (K.R.), Boston, HealthCore, Watertown (T.H.H., S.F.A., M.J.C., M.O., M.M.), and the Division of Vascular Surgery, UMass Memorial Health, Worcester (A.S.) - all in Massachusetts; the Division of Vascular and Endovascular Surgery, University of California, San Francisco, San Francisco (M.S.C., W.G., P.A.S.), the Division of Vascular Surgery, UC San Diego Health, La Jolla (A.B.), Coastal Cardiology, French Hospital Medical Center, San Luis Obispo (L.C.C.), and the Division of Vascular Surgery and Endovascular Therapy, University of Southern California, Los Angeles (V.L.R.) - all in California; the Department of Interventional Radiology (J.A. Kaufman) and the Division of Vascular Surgery, School of Medicine (A.A.), Oregon Health and Science University, and the Operative Care Division, Portland VA Medical Center (M.C.K.) - all in Portland; the Heart and Vascular Center, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH (R.J.P., M.A.C., P.P.G.); the Department of Medical Imaging, University of Arizona Health Sciences, Tucson (M.D.D.), and the Division of Vascular Surgery, Peak Heart and Vascular, Glendale (N.G.) - both in Arizona; the National Heart, Lung, and Blood Institute, Bethesda, MD (D.R., G.S.); the Medical Device Innovation Consortium, National Evaluation System for Health Technology Coordinating Center, Arlington, VA (F.S.S.); the Department of Cardiovascular Diseases, Ochsner Clinical School, University of Queensland, Brisbane, Australia (C.J.W.); the Department of Interventional Radiology, Gundersen Health System, La Crosse, WI (E.A.); the Iowa Heart Center, Des Moines (D.K.C.); the Division of Vascular Surgery, Centre Hospitalier Universitaire de Quebec-Université Laval, Quebec City (Y.D.), and Dalhousie University, Division of Cardiac and Vascular Surgery, Department of Surgery, Nova Scotia Health Association, Halifax (C.R.H.) - both in Canada; the Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta (L.F.); the Division of Vascular and Endovascular Surgery, Maine Medical Center, Portland (K.A.G.); the Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (B.M.H.); Westchester Medical Center and the Department of Surgery, Section of Vascular Surgery, New York Medical College - both in Valhalla, NY (I.A.L.); the Vascular Medicine Outcomes Program, Yale University, New Haven, CT (C.M.-H.); the Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis (R.M.); and the Department of Vascular Surgery, University of Helsinki, and Helsinki University Hospital - both in Helsinki (M.V.)
| |
Collapse
|
11
|
Liang NL, Dake MD, Fischbein MP, Bavaria JE, Desai ND, Oderich GS, Singh MJ, Fillinger M, Suckow BD, Matsumura JS, Patel HJ, Makaroun MS. Midterm Outcomes of Endovascular Repair of Aortic Arch Aneurysms with the Gore Thoracic Branch Endoprosthesis. Eur J Vasc Endovasc Surg 2022; 64:639-645. [PMID: 35970335 DOI: 10.1016/j.ejvs.2022.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 07/17/2022] [Accepted: 08/05/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Aortic aneurysms involving aortic arch vessels are anatomically unsuitable for standard thoracic endovascular repair (TEVAR) without cervical debranching of the arch vessels. Three year outcomes of a single branched thoracic endograft following previous publication of peri-operative and one year outcomes are reported. METHODS This was a multicentre feasibility trial of the GORE TAG Thoracic Branch Endoprosthesis (TBE), a thoracic endovascular graft incorporating a single retrograde branch for aortic arch vessel perfusion. The first study arm enrolled patients with an intact descending thoracic aortic aneurysm extending to the distal arch with left subclavian artery (LSA) incorporation (zone 2). The second arm enrolled patients with arch aneurysms requiring incorporation of the left carotid or innominate artery (zone 0/1) and extra-anatomic surgical revascularisation of the remaining aortic arch vessels. Outcomes at three years are reported. RESULTS The cohort comprised 40 patients (31 zone 2, nine zone 0/1). The majority were male (52%). Mean follow up was 1 408 ± 552 days in the zone 2 and 1 187 ± 766 days in the zone 0/1 cohort. During three year follow up there was no device migration, fracture, or aortic rupture in either arm. In the zone 2 arm, freedom from re-intervention was 97% at one and three years but there were two side branch occlusions. Two patients had aneurysm enlargement > 5 mm without documented endoleak or re-intervention. Freedom from death at one and three years was 90% and 84%. In the zone 0/1 arm there were no re-interventions, loss of branch patency, or aneurysm enlargement at three years. Cerebrovascular events occurred in three patients during follow up: two unrelated to the device or procedure, and one of unknown relationship. Two patients in this arm died during the follow up period, both unrelated to the procedure or the aneurysm. CONCLUSION Initial three year results of the TBE device for endovascular repair of arch aneurysms show favourable patency and durability with low rates of graft related complications.
Collapse
Affiliation(s)
- Nathan L Liang
- Division of Vascular Surgery, University of Pittsburgh Medical Centre, Pittsburgh, PA, USA.
| | - Michael D Dake
- Department of Medical Imaging, University of Arizona Health System, Tucson, AZ, USA
| | - Michael P Fischbein
- Department of Cardiothoracic Surgery, Stanford University Hospitals, Palo Alto, CA, USA
| | - Joseph E Bavaria
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Nimesh D Desai
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Gustavo S Oderich
- Department of Cardiothoracic and Vascular Surgery, The University of Texas Health Science Centre at Houston, McGovern Medical School, Houston, TX, USA
| | - Michael J Singh
- Division of Vascular Surgery, University of Pittsburgh Medical Centre, Pittsburgh, PA, USA
| | - Mark Fillinger
- Section of Vascular of Surgery, Dartmouth-Hitchcock Medical Centre, Lebanon, NH, USA
| | - Bjoern D Suckow
- Section of Vascular of Surgery, Dartmouth-Hitchcock Medical Centre, Lebanon, NH, USA
| | - Jon S Matsumura
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison WI, USA
| | - Himanshu J Patel
- Department of Cardiac Surgery, University of Michigan Frankel Cardiovascular Centre, Ann Arbor, MI, USA
| | - Michel S Makaroun
- Division of Vascular Surgery, University of Pittsburgh Medical Centre, Pittsburgh, PA, USA
| |
Collapse
|
12
|
Lombardi JV, Gleason TG, Panneton JM, Starnes BW, Dake MD, Haulon S, Mossop PJ, Segbefia E, Bharadwaj P. Five-year results of the STABLE II study for the endovascular treatment of complicated, acute type B aortic dissection with a composite device design. Eur J Vasc Endovasc Surg 2022. [DOI: 10.1016/j.ejvs.2022.10.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
13
|
Ye W, Böhme T, Fu W, Liu C, Zhang X, Liu P, Zhang J, Zou Y, Lu X, Lottes AE, O'Leary EE, Zeller T, Dake MD. First peripheral drug-eluting stent clinical results from China: 1-year outcomes of the Zilver PTX China study. Front Cardiovasc Med 2022; 9:877578. [PMID: 36237908 PMCID: PMC9551216 DOI: 10.3389/fcvm.2022.877578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose The benefit of using the Zilver PTX drug-eluting stent (DES) in superficial femoral artery (SFA) lesions has been demonstrated in multiple clinical studies. This prospective, multicenter study evaluated the 1-year safety and effectiveness of the DES for the treatment of femoropopliteal lesions in a Chinese patient population. Methods Patients with a single de novo or restenotic SFA lesion ≤140 mm and a Rutherford classification of 2 to 4 were treated with the DES. The primary endpoint was primary patency assessed by duplex ultrasound at 1-year. Secondary endpoints included adverse events, event-free survival (EFS), and freedom from target lesion revascularization (TLR). Clinical outcomes included Rutherford classification, ankle-brachial index (ABI), and the walking impairment questionnaire (WIQ). Results In this study, 178 patients with symptomatic peripheral artery disease were enrolled at nine institutions in China. The average lesion length was 79.0 ± 48.6 mm (range 14.8–245.4 mm) and 50.0% of lesions were total occlusions. The 1-year primary patency rate was 81.9%. Covariate analysis revealed that lesion length (p < 0.01) was the only significant factor for patency. No paclitaxel-related adverse events or amputations were reported. The 1-year rate for EFS was 94.9% and freedom from TLR was 95.5%. Through 1-year, treatment with the DES resulted in statistically significant improvement in ABI and WIQ scores compared with pre-procedure (p < 0.001). Clinical improvement of at least 1 Rutherford class was achieved in 142 of 174 patients (81.6%). Conclusion This study showed promising short-term results for the treatment of SFA lesions with Zilver PTX DES in Chinese patients. Unique identifier ClinicalTrials.gov, identifier: NCT02171962.
Collapse
Affiliation(s)
- Wei Ye
- Vascular Surgical Department, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
- *Correspondence: Wei Ye
| | - Tanja Böhme
- Department of Angiology, Universitaets-Herz-Zentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | - Weiguo Fu
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Changwei Liu
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xiaoming Zhang
- Department of Vascular Surgery, Peking University People's Hospital, Beijing, China
| | - Peng Liu
- Department of Vascular Surgery, China-Japan Friendship Hospital, Beijing, China
| | - Jiwei Zhang
- Department of Vascular Surgery, Renji Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yinghua Zou
- Department of IR and Vascular Surgery, Peking University, Beijing, China
| | - Xinwu Lu
- Department of Vascular Surgery, Shanghai 9th People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Aaron E. Lottes
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - Erin E. O'Leary
- Cook Research Incorporated, West Lafayette, IN, United States
| | - Thomas Zeller
- Department of Angiology, Universitaets-Herz-Zentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | - Michael D. Dake
- Department of Medical Imaging, The University of Arizona, Tucson, AZ, United States
- Department of Surgery, The University of Arizona, Tucson, AZ, United States
- Department of Medicine, The University of Arizona, Tucson, AZ, United States
| |
Collapse
|
14
|
Lombardi JV, Gleason TG, Panneton JM, Starnes BW, Dake MD, Haulon S, Mossop PJ, Segbefia E, Bharadwaj P. Five-year results of the STABLE II study for the endovascular treatment of complicated, acute type B aortic dissection with a composite device design. J Vasc Surg 2022; 76:1189-1197.e3. [PMID: 35809819 DOI: 10.1016/j.jvs.2022.06.092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/20/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To provide the five-year outcomes of the use of a composite device (proximal covered stent-graft + distal bare stent) for endovascular repair of patients with acute, type B aortic dissection complicated by aortic rupture and/or malperfusion. METHODS STABLE II was a prospective, multicenter study of the Zenith Dissection Endovascular System (William Cook Europe, Denmark). Patients were enrolled between August 2012 and January 2015 at sites in the United States and Japan. Five-year follow-up was completed by January 2020. RESULTS In total, 73 patients (mean age 60.7±10.9 years; 65.8% male) with acute type B dissection complicated by malperfusion (72.6%), rupture (21.9%), or both (5.5%) were enrolled. Patients were treated with either a composite device (79.5%) or the proximal stent-graft alone (no distal bare stent, 20.5%). Dissections were more extensive in patients who received the composite device (408.9±121.3 mm) than in patients who did not receive a bare stent (315.9±100.1 mm). Mean follow-up was 1209.4±754.6 days. Freedom from all-cause mortality was 80.3%±4.7% at one year and 68.9%± 7.3% at five years. Freedom from dissection-related mortality remained at 97.1%±2.1% from one-year through five-year follow-up. Within the stent-graft region, the rate of either complete thrombosis or elimination of the false lumen increased over time (82.1% of all patients at five years vs. 55.7% at first post-procedure CT), with a higher rate at five years in patients who received the composite device (90.5%) compared with patients without the bare stent (57.1%). Throughout follow-up, overall true lumen diameter increased within the stent-graft region, and overall false lumen diameter decreased. At five years, 20.7% of patients experienced a decrease in maximum transaortic diameter within the stent-graft region, 17.2% experienced an increase, and 62.1% experienced no change. Distal to the treated segment (but within the dissected aorta), 23.1% of patients experience no change in transaortic diameter at five years; a bare stent was deployed in all these patients at the procedure. Five-year freedom from all secondary intervention was 70.7%±7.2%. CONCLUSIONS These five-year outcomes indicate a low rate of dissection-related mortality for the Zenith Dissection Endovascular System in the treatment of patients with acute, complicated type B aortic dissection. Further, these data suggest a positive influence of composite device use on false lumen thrombosis. Continuous monitoring for distal aortic growth is necessary in all patients.
Collapse
Affiliation(s)
- Joseph V Lombardi
- Division of Vascular Surgery, Cooper University Hospital, Camden, NJ.
| | - Thomas G Gleason
- Division of Cardiothoracic Surgery, University of Maryland Medical Center, Baltimore, MD
| | - Jean M Panneton
- Division of Vascular Surgery, Eastern Virginia Medical School, Norfolk, VA
| | - Benjamin W Starnes
- Division of Vascular Surgery, Harborview Medical Center, University of Washington, Seattle, WA
| | | | - Stephan Haulon
- Division of Vascular Surgery, Aortic Centre, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, Université Paris-Saclay, Paris, France
| | - Peter J Mossop
- Division of Interventional Radiology, St. Vincent's Hospital, Melbourne, Australia
| | - Edem Segbefia
- Research Division, Cook Research Incorporated, West Lafayette, IN
| | - Priya Bharadwaj
- Research Division, Cook Research Incorporated, West Lafayette, IN
| |
Collapse
|
15
|
Dake MD, Brinkman WT, Han SM, Matsumura JS, Sweet MP, Patel HJ, Taylor BS, Oderich GS. Outcomes of Endovascular Repair of Aortic Aneurysms with the GORE® Thoracic Branch Endoprosthesis for Left Subclavian Artery Preservation. J Vasc Surg 2022; 76:1141-1149.e3. [PMID: 35709864 DOI: 10.1016/j.jvs.2022.05.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/10/2022] [Accepted: 05/23/2022] [Indexed: 01/16/2023]
Abstract
OBJECTIVE OR BACKGROUND Thoracic endovascular aortic repair has emerged as the dominant paradigm for treatment of patients with descending thoracic aortic aneurysms. For aneurysms involving the aortic arch in the region of the left subclavian artery (LSA), branch vessel preservation to maintain blood flow to the LSA is recommended. Branched aortic endografts are an alternative to surgical revascularization of the LSA. METHODS Across 34 investigative sites, 84 patients with Zone 2 aneurysm were enrolled in a nonrandomized, prospective study of a single branched aortic endograft. The thoracic branch endoprosthesis device allows for graft placement proximal to the LSA and incorporates a single side branch for left subclavian perfusion. RESULTS Over half of the patients were male (63%). Their average age was 70 (±11) years. The aneurysm morphology was fusiform in 43 and saccular in 41 patients. The mean aneurysm diameter at screening was 56.2 mm. The mean follow up was 30 months (range 2.6 to 50.7 months). Reported here are the patient outcomes at 1 and 12 months. Pre-defined technical success with implantation of the device in landing Zone 2 was achieved in 92% (n=77) of patients. There were no cases of aortic rupture, lesion-related mortality, or new onset renal failure. There was no peri-operative (30-day) mortality. A single case each of permanent paraplegia and paraparesis occurred. Three patients experienced a procedure-related stroke. Through 12 months, four patients died; none of the deaths were adjudicated as related to the device or procedure. One aortic reintervention was required. A single case of aortic enlargement (core laboratory) was reported at 6 months. Type 1 (n=3) and III (n=5) endoleaks occurred in 9.8% of patients of which one (Type III) required reintervention. CONCLUSIONS Results from this device study in patients with Zone 2 aneurysm demonstrate that early safety and efficacy outcomes are maintained up to 12 months after the endovascular procedure with low mortality and reintervention rates and an acceptable frequency of procedural complications, including neurologic complications.
Collapse
Affiliation(s)
- Michael D Dake
- Department of Medical Imaging, University of Arizona Health System, Tucson, AZ.
| | | | - Sukgu M Han
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jon S Matsumura
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Matthew P Sweet
- Department of Surgery, University of Washington, Seattle, WA
| | - Himanshu J Patel
- Joe D. Morris Collegiate Professor in Cardiac Surgery, University of Michigan, Ann Arbor, MI
| | - Bradley S Taylor
- Department of Surgery, University of Maryland Medical Center, Baltimore, MD
| | - Gustavo S Oderich
- Cardiothoracic & Vascular Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX
| |
Collapse
|
16
|
Dake MD, O'Sullivan G, Shammas NW, Lichtenberg M, Mwipatayi BP, Settlage RA. Correction to: Three-Year Results from the Venovo Venous Stent Study for the Treatment of Iliac and Femoral Vein Obstruction. Cardiovasc Intervent Radiol 2021; 44:2027. [PMID: 34668057 DOI: 10.1007/s00270-021-02982-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Michael D Dake
- University of Arizona Health Sciences, Health Sciences Innovation Building, 9Th Floor SVP Suite,1670 E. Drachman Street, P.O. Box 210216, Tucson, AZ, 85721-0216, USA.
| | | | | | | | | | | | | |
Collapse
|
17
|
Dake MD, O'Sullivan G, Shammas NW, Lichtenberg M, Mwipatayi BP, Settlage RA. Three-Year Results from the Venovo Venous Stent Study for the Treatment of Iliac and Femoral Vein Obstruction. Cardiovasc Intervent Radiol 2021; 44:1918-1929. [PMID: 34545448 PMCID: PMC8451739 DOI: 10.1007/s00270-021-02975-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/11/2021] [Indexed: 11/24/2022]
Abstract
Purpose To assess safety and patency of the Venovo venous stent for the treatment of iliofemoral vein obstruction. Materials and Methods Twenty-two international centers enrolled 170 patients in the VERNACULAR study (93 post-thrombotic syndrome; 77 non-thrombotic iliac vein lesions). Primary outcome measures were major adverse events at 30 days and 12-month primary patency (freedom from target vessel revascularization, thrombotic occlusion, or stenosis > 50%). Secondary outcomes included the Venous Clinical Severity Score Pain Assessment and Chronic Venous Quality-of-Life Questionnaire assessments (hypothesis tested). Secondary observations included primary patency, target vessel and lesion revascularization (TVR/TLR), and assessment of stent integrity through 36 months. Results Freedom from major adverse events through 30 days was 93.5%, statistically higher than a pre-specified performance goal of 89% (p = 0.032) while primary patency at 12 months was 88.6%, also statistically higher than a performance goal of 74% (p < 0.0001). Mean quality-of-life measures were statistically improved compared to baseline values at 12 months (p < 0.0001). Primary patency at 36 months was 84% (Kaplan–Meier analysis) while freedom from TVR/TLR was 88.1%. There was no stent embolization/migration, and no core laboratory assessed stent fractures reported through 36 months. Six deaths were reported; none adjudicated as device or procedure related. Conclusion The Venovo venous stent was successfully deployed in obstructive iliofemoral vein lesions and met the pre-specified primary outcome measures through 12 months. At 3 years, primary patency was 84%, reintervention rates were low, standardized quality-of-life and pain measures improved from baseline, and there was no stent migration or fractures. Level of Evidence Level 2—prospective, multicenter, controlled clinical study without a concurrent control or randomization. Pre-specified endpoints were hypothesis-tested to performance goals derived from peer-reviewed clinical literature. Registration clinicaltrials.gov Unique Identifier NCT02655887.
Collapse
Affiliation(s)
- Michael D Dake
- University of Arizona Health Sciences, Health Sciences Innovation Building, 9Th Floor SVP Suite,1670 E. Drachman Street, P.O. Box 210216, Tucson, AZ, 85721-0216, USA.
| | | | | | | | | | | | | |
Collapse
|
18
|
Lombardi JV, Gleason T, Panneton JM, Starnes B, Dake MD, Haulon S, Mossop PJ, Segbefia E. Five-Year Results of STABLE II Study for Endovascular Treatment of Complicated, Acute Type B Aortic Dissection With a Composite Device Design. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.06.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Harris DT, Badowski M, Jernigan B, Sprissler R, Edwards T, Cohen R, Paul S, Merchant N, Weinkauf CC, Bime C, Erickson HE, Bixby B, Parthasarathy S, Chaudhary S, Natt B, Cristan E, El Aini T, Rischard F, Campion J, Chopra M, Insel M, Sam A, Knepler JL, Knox K, Mosier J, Spier C, Dake MD. SARS-CoV-2 Rapid Antigen Testing of Symptomatic and Asymptomatic Individuals on the University of Arizona Campus. Biomedicines 2021; 9:539. [PMID: 34066047 PMCID: PMC8150898 DOI: 10.3390/biomedicines9050539] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 01/29/2023] Open
Abstract
SARS-CoV-2, the cause of COVID19, has caused a pandemic that has infected more than 80 M and killed more than 1.6 M persons worldwide. In the US as of December 2020, it has infected more than 32 M people while causing more than 570,000 deaths. As the pandemic persists, there has been a public demand to reopen schools and university campuses. To consider these demands, it is necessary to rapidly identify those individuals infected with the virus and isolate them so that disease transmission can be stopped. In the present study, we examined the sensitivity of the Quidel Rapid Antigen test for use in screening both symptomatic and asymptomatic individuals at the University of Arizona from June to August 2020. A total of 885 symptomatic and 1551 asymptomatic subjects were assessed by antigen testing and real-time PCR testing. The sensitivity of the test for both symptomatic and asymptomatic persons was between 82 and 90%, with some caveats.
Collapse
Affiliation(s)
- David T. Harris
- Biorepository, College of Medicine-Tucson, University of Arizona Health Sciences, University of Arizona, Tucson, AZ 85724, USA; (M.B.); (B.J.)
- Department of Immunobiology & Medicine, College of Medicine-Tucson, University of Arizona Health Sciences, University of Arizona, Tucson, AZ 85724, USA
| | - Michael Badowski
- Biorepository, College of Medicine-Tucson, University of Arizona Health Sciences, University of Arizona, Tucson, AZ 85724, USA; (M.B.); (B.J.)
| | - Brandon Jernigan
- Biorepository, College of Medicine-Tucson, University of Arizona Health Sciences, University of Arizona, Tucson, AZ 85724, USA; (M.B.); (B.J.)
| | - Ryan Sprissler
- College of Medicine-Tucson, University of Arizona Genetics Core, University of Arizona, Tucson, AZ 85724, USA; (R.S.); (T.E.)
| | - Taylor Edwards
- College of Medicine-Tucson, University of Arizona Genetics Core, University of Arizona, Tucson, AZ 85724, USA; (R.S.); (T.E.)
| | - Randall Cohen
- Department of Athletic, University of Arizona, Tucson, AZ 85724, USA; (R.C.); (S.P.)
| | - Stephen Paul
- Department of Athletic, University of Arizona, Tucson, AZ 85724, USA; (R.C.); (S.P.)
| | - Nirav Merchant
- Data Science Institute, University of Arizona, Tucson, AZ 85724, USA;
| | - Craig C. Weinkauf
- Department of Surgery, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA;
| | - Christian Bime
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Heidi E. Erickson
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Billie Bixby
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Sachin Chaudhary
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Bhupinder Natt
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Elaine Cristan
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Tammer El Aini
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Franz Rischard
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Janet Campion
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Madhav Chopra
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Michael Insel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Afshin Sam
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - James L. Knepler
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA; (C.B.); (H.E.E.); (B.B.); (S.P.); (S.C.); (B.N.); (E.C.); (T.E.A.); (F.R.); (J.C.); (M.C.); (M.I.); (A.S.); (J.L.K.)
| | - Kenneth Knox
- Department of Medicine, University of Arizona-Phoenix, Phoenix, AZ 85724, USA;
| | - Jarrod Mosier
- Department of Emergency Medicine, College of Medicine-Tucson, Tucson, AZ 85724, USA;
| | - Catherine Spier
- Department of Pathology, University of Arizona College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA;
| | - Michael D. Dake
- Office of the Senior Vice-President for Health Sciences, University of Arizona, Tucson, AZ 85724, USA;
| |
Collapse
|
20
|
Bondesson J, Suh GY, Marks N, Dake MD, Lee JT, Cheng CP. Influence of thoracic endovascular aortic repair on true lumen helical morphology for Stanford type B dissections. J Vasc Surg 2021; 74:1499-1507.e1. [PMID: 33940073 DOI: 10.1016/j.jvs.2021.04.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Thoracic endovascular aortic repair (TEVAR) can change the morphology of the flow lumen in aortic dissections, which may affect aortic hemodynamics and function. This study characterizes how the helical morphology of the true lumen in type B aortic dissections is altered by TEVAR. METHODS Patients with type B aortic dissection who underwent computed tomography angiography before and after TEVAR were retrospectively reviewed. Images were used to construct three-dimensional stereolithographic surface models of the true lumen and whole aorta using custom software. Stereolithographic models were segmented and co-registered to determine helical morphology of the true lumen with respect to the whole aorta. The true lumen region covered by the endograft was defined based on fiducial markers before and after TEVAR. The helical angle, average helical twist, peak helical twist, and cross-sectional eccentricity, area, and circumference were quantified in this region for pre- and post-TEVAR geometries. RESULTS Sixteen patients (61.3 ± 8.0 years; 12.5% female) were treated successfully for type B dissection (5 acute and 11 chronic) with TEVAR and scans before and after TEVAR were retrospectively obtained (follow-up interval 52 ± 91 days). From before to after TEVAR, the true lumen helical angle (-70.0 ± 71.1 to -64.9 ± 75.4°; P = .782), average helical twist (-4.1 ± 4.0 to -3.7 ± 3.8°/cm; P = .674), and peak helical twist (-13.2 ± 15.2 to -15.4 ± 14.2°/cm; P = .629) did not change. However, the true lumen helical radius (1.4 ± 0.5 to 1.0 ± 0.6 cm; P < .05) and eccentricity (0.9 ± 0.1 to 0.7 ± 0.1; P < .05) decreased, and the cross-sectional area (3.0 ± 1.1 to 5.0 ± 2.0 cm2; P < .05) and circumference (7.1 ± 1.0 to 8.0 ± 1.4 cm; P < .05) increased significantly from before to after TEVAR. The distinct bimodal distribution of chiral and achiral native dissections disappeared after TEVAR, and subgroup analyses showed that the true lumen circumference of acute dissections increased with TEVAR, although it did not for chronic dissections. CONCLUSIONS The unchanged helical angle and average and peak helical twists as a result of TEVAR suggest that the angular positions of the true lumen are constrained and that the endografts were helically conformable in the angular direction. The decrease of helical radius indicated a straightening of the corkscrew shape of the true lumen, and in combination with more circular and expanded lumen cross-sections, TEVAR produced luminal morphology that theoretically allows for lower flow resistance through the endografted portion. The impact of TEVAR on dissection flow lumen morphology and the interaction between endografts and aortic tissue can provide insight for improving device design, implantation technique, and long-term clinical outcomes.
Collapse
Affiliation(s)
- Johan Bondesson
- Division of Dynamics, Chalmers University of Technology, Gothenburg, Sweden.
| | - Ga-Young Suh
- Department of Biomedical Engineering, California State University, Long Beach, Calif; Division of Vascular Surgery, Stanford University, Stanford, Calif
| | - Neil Marks
- Division of Vascular Surgery, Stanford University, Stanford, Calif
| | - Michael D Dake
- Department of Surgery, University of Arizona, Tucson, Ariz
| | - Jason T Lee
- Division of Vascular Surgery, Stanford University, Stanford, Calif
| | | |
Collapse
|
21
|
Dake MD, Fischbein MP, Bavaria JE, Desai ND, Oderich G, Singh MJ, Fillinger M, Suckow BD, Matsumura JS, Patel HJ. Evaluation of the Gore TAG thoracic branch endoprosthesis in the treatment of proximal descending thoracic aortic aneurysms. J Vasc Surg 2021; 74:1483-1490.e2. [PMID: 33940079 DOI: 10.1016/j.jvs.2021.04.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/19/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Thoracic endovascular aortic repair has radically transformed the treatment of descending thoracic aortic aneurysms. However, when aneurysms involve the aortic arch in the region of the left subclavian artery, branch vessel preservation must be considered. Branched aortic endografts have provided a new option to maintain branch patency. METHODS Six investigative sites enrolled 31 patients in a nonrandomized, prospective investigational device exemption feasibility trial of a single branched aortic endograft for the management of aneurysms that include the distal aortic arch. The Gore TAG thoracic branch endoprosthesis (W. L. Gore & Associates, Inc, Flagstaff, Ariz), an investigational device, allows for graft placement proximal to the left subclavian artery and incorporates a single side branch for left subclavian perfusion. RESULTS All 31 patients (100%) had undergone successful implantation of the investigational device in landing zone 2. Men slightly outnumbered women (51.6%). Their average age was 74.1 ± 10.4 years. The aneurysm morphology was fusiform in 12 and saccular in 19 patients, with a mean maximum aortic diameter of 54.8 ± 10.9 mm. The mean follow-up period for the cohort was 25.2 ± 11.1 months. We have reported the patient outcomes at 1 month and 1 year. At 1 month, the side branch patency was 100% and the freedom from core laboratory-reported device-related endoleak (types I and III) was 96.7%, without 30-day death or permanent paraplegia. One patient experienced a procedure-related stroke. Through 1 year, five patients had died; none of the deaths were related to the device or procedure (clinical endpoint committee adjudicated). One thoracic reintervention was required. No conversions were required, and no aneurysm growth (core laboratory) was reported. One case of the loss of side branch patency was diagnosed in the left subclavian artery in an asymptomatic individual from computed tomography at 6 months, with no reported subsequent adverse events due to loss of patency. Endoleaks were reported by the core laboratory in five patients at 12 months (two, type II; and three, indeterminate). CONCLUSIONS The present investigational device exemption feasibility study has reported the preliminary results of the use of a single side branch endograft to treat patients with proximal descending thoracic aortic aneurysms.
Collapse
Affiliation(s)
- Michael D Dake
- Department of Medical Imaging, University of Arizona Health System, Tuscon, Ariz.
| | - Michael P Fischbein
- Department of Cardiothoracic Surgery, Stanford University Hospitals, Palo Alto, Calif
| | - Joseph E Bavaria
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
| | - Nimesh D Desai
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
| | | | - Michael J Singh
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Mark Fillinger
- Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Bjoern D Suckow
- Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Jon S Matsumura
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Himanshu J Patel
- Department of Cardiac Surgery, University of Michigan Frankel Cardiovascular Center, Ann Arbor, Mich
| |
Collapse
|
22
|
Suh GY, Bondesson J, Zhu YD, Lee JT, Dake MD, Cheng CP. Multiaxial pulsatile dynamics of the thoracic aorta and impact of thoracic endovascular repair. Eur J Radiol Open 2021; 8:100333. [PMID: 33748348 PMCID: PMC7957153 DOI: 10.1016/j.ejro.2021.100333] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 11/17/2022] Open
Abstract
Altered motion of the thoracic aorta after thoracic endovascular aortic repair. Geometric analysis with cardiac-gated computed tomography and computer modeling. Decreased motion of the stented aorta and increased motion above the stented aorta. Longitudinal curvature and diametric deformation affected by presence of endograft.
Purpose The thoracic aorta is a highly mobile organ whose dynamics are altered by thoracic endovascular aorta repair (TEVAR). The aim of this study was to quantify cardiac pulsatility-induced multi-axial deformation of the thoracic aorta before and after descending aortic TEVAR. Methods Eleven TEVAR patients (8 males and 3 females, age 57–89) underwent retrospective cardiac-gated CT angiography before and after TEVAR. 3D geometric models of the thoracic aorta were constructed, and lumen centerlines, inner and outer surface curves, and cross-sections were extracted to measure aortic arclength, centerline, inner surface, and outer surface longitudinal curvatures, as well as cross-sectional effective diameter and eccentricity for the ascending and stented aortic portions. Results From pre- to post-TEVAR, arclength deformation was increased at the ascending aorta from 5.9 ± 3.1 % to 8.8 ± 4.4 % (P < 0.05), and decreased at the stented aorta from 7.5 ± 5.1 % to 2.7 ± 2.5 % (P < 0.05). Longitudinal curvature and diametric deformations were reduced at the stented aorta. Centerline curvature, inner surface curvature, and cross-sectional eccentricity deformations were increased at the distal ascending aorta. Conclusions Deformations were reduced in the stented thoracic aorta after TEVAR, but increased in the ascending aorta near the aortic arch, possibly as a compensatory mechanism to maintain overall thoracic compliance in the presence of reduced deformation in the stiffened stented aorta.
Collapse
Affiliation(s)
- Ga-Young Suh
- Department of Biomedical Engineering, California State University, Long Beach: 1250 Bellflower Blvd, Long Beach, CA, 90840, USA.,Department of Vascular Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - Johan Bondesson
- Division of Dynamics, Chalmers University of Technology, SE-412 96, Gothenburg, Sweden
| | - Yufei D Zhu
- Department of Vascular Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - Jason T Lee
- Department of Vascular Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - Michael D Dake
- Department of Cardiothoracic Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - Christopher P Cheng
- Department of Vascular Surgery, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305, USA
| |
Collapse
|
23
|
Dake MD, Bavaria JE, Singh MJ, Oderich G, Filinger M, Fischbein MP, Matsumura JS, Patel HJ. Management of arch aneurysms with a single-branch thoracic endograft in zone 0. JTCVS Tech 2021; 7:1-6. [PMID: 34318189 PMCID: PMC8311452 DOI: 10.1016/j.xjtc.2021.01.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background We present preliminary data from a patient cohort undergoing thoracic endovascular aortic repair for Ishimaru zone 0 and 1 using a novel branched arch endograft. Methods This US multicenter early feasibility investigational device exemption clinical trial treated 9 patients with a mean age 72.8 ± 8.0 years (77.8% male). The endograft was designed with a single side branch designed to facilitate aortic coverage proximal to the innominate or left carotid artery while maintaining branch vessel patency. Pathology treated included fusiform (n = 2) or saccular (n = 7) aneurysm, with a maximum aortic diameter of 6.3 ± 0.7 cm. Treatment was into zone 0 in 8 patients, and zone 1 in 1 patient. Results All patients underwent initial successful first-stage supra-aortic trunk revascularization using a variety of techniques, without the occurrence of stroke. For the second thoracic endovascular aortic repair stage, median total treatment length was 20 cm. The primary end point of device delivery and branch vessel patency was achieved in 100% of patients, without 30-day mortality or spinal cord ischemia. Cerebrovascular events were observed in 2 patients through 30 days. No type I or III endoleaks were reported and all side branches were patent at 12-month imaging follow-up. Conclusions Endovascular repair of Ishimaru zone 0 or 1 arch aortic aneurysms can be achieved with a novel branched arch endograft. Future studies will evaluate the mid-term outcomes with this device in other pathologies and further define the occurrence of postoperative neurologic events.
Collapse
Affiliation(s)
- Michael D Dake
- Department of Medical Imaging, University of Arizona Health System, Tucson, Ariz
| | - Joseph E Bavaria
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
| | - Michael J Singh
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | | | - Mark Filinger
- Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH
| | - Michael P Fischbein
- Department of Cardiothoracic Surgery, Stanford University Hospitals, Palo Alto, Calif
| | - Jon S Matsumura
- University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Himanshu J Patel
- Department of Cardiac Surgery, University of Michigan Frankel Cardiovascular Center, Ann Arbor, Mich
| |
Collapse
|
24
|
Bondesson J, Suh GY, Lundh T, Dake MD, Lee JT, Cheng CP. Quantification of true lumen helical morphology and chirality in type B aortic dissections. Am J Physiol Heart Circ Physiol 2020; 320:H901-H911. [PMID: 33382638 DOI: 10.1152/ajpheart.00778.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Chirality is a fundamental property in many biological systems. Motivated by previous observations of helical aortic blood flow, aortic tissue fibers, and propagation of aortic dissections, we introduce methods to characterize helical morphology of aortic dissections. After validation on computer-generated phantoms, the methods were applied to patients with type B dissection. For this cohort, there was a distinct bimodal distribution of helical propagation of the dissection with either achiral or exclusively right-handed chirality, with no intermediate cases or left-handed cases. This clear grouping indicates that dissection propagation favors these two modes, which is potentially due to the right-handedness of helical aortic blood flow and cell orientation. The characterization of dissection chirality and quantification of helical morphology advances our understanding of dissection pathology and lays a foundation for applications in clinical research and treatment practice. For example, the chirality and magnitude of helical metrics of dissections may indicate risk of dissection progression, help define treatment and surveillance strategies, and enable development of novel devices that account for various helical morphologies.NEW & NOTEWORTHY A novel definition of helical propagation of type B aortic dissections reveals a distinct bimodality, with the true lumen being either achiral (nonhelical) or exclusively right-handed. This right-handed chirality is consistent with anatomic and physiological phenomena such as right-handed twist during left ventricle contraction, helical blood flow, and tissue fiber direction. The helical character of aortic dissections may be useful for pathology research, diagnostics, treatment selection, therapeutic durability prediction, and aortic device design.
Collapse
Affiliation(s)
- Johan Bondesson
- Division of Dynamics, Chalmers University of Technology, Gothenburg, Sweden
| | - Ga-Young Suh
- Department of Biomedical Engineering, California State University, Long Beach, California.,Division of Vascular Surgery, Stanford University, Stanford, California
| | - Torbjörn Lundh
- Mathematical Sciences, Chalmers University of Technology and University of Gothenburg, Gothenburg, Sweden
| | - Michael D Dake
- Department of Surgery, University of Arizona, Tucson, Arizona
| | - Jason T Lee
- Division of Vascular Surgery, Stanford University, Stanford, California
| | | |
Collapse
|
25
|
Ripperger TJ, Uhrlaub JL, Watanabe M, Wong R, Castaneda Y, Pizzato HA, Thompson MR, Bradshaw C, Weinkauf CC, Bime C, Erickson HL, Knox K, Bixby B, Parthasarathy S, Chaudhary S, Natt B, Cristan E, El Aini T, Rischard F, Campion J, Chopra M, Insel M, Sam A, Knepler JL, Capaldi AP, Spier CM, Dake MD, Edwards T, Kaplan ME, Scott SJ, Hypes C, Mosier J, Harris DT, LaFleur BJ, Sprissler R, Nikolich-Žugich J, Bhattacharya D. Orthogonal SARS-CoV-2 Serological Assays Enable Surveillance of Low-Prevalence Communities and Reveal Durable Humoral Immunity. Immunity 2020; 53:925-933.e4. [PMID: 33129373 PMCID: PMC7554472 DOI: 10.1016/j.immuni.2020.10.004] [Citation(s) in RCA: 239] [Impact Index Per Article: 59.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/01/2020] [Accepted: 10/05/2020] [Indexed: 12/21/2022]
Abstract
We conducted a serological study to define correlates of immunity against SARS-CoV-2. Compared to those with mild coronavirus disease 2019 (COVID-19) cases, individuals with severe disease exhibited elevated virus-neutralizing titers and antibodies against the nucleocapsid (N) and the receptor binding domain (RBD) of the spike protein. Age and sex played lesser roles. All cases, including asymptomatic individuals, seroconverted by 2 weeks after PCR confirmation. Spike RBD and S2 and neutralizing antibodies remained detectable through 5-7 months after onset, whereas α-N titers diminished. Testing 5,882 members of the local community revealed only 1 sample with seroreactivity to both RBD and S2 that lacked neutralizing antibodies. This fidelity could not be achieved with either RBD or S2 alone. Thus, inclusion of multiple independent assays improved the accuracy of antibody tests in low-seroprevalence communities and revealed differences in antibody kinetics depending on the antigen. We conclude that neutralizing antibodies are stably produced for at least 5-7 months after SARS-CoV-2 infection.
Collapse
MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Neutralizing/blood
- Antibodies, Viral/blood
- Arizona/epidemiology
- Betacoronavirus/immunology
- Betacoronavirus/isolation & purification
- COVID-19
- COVID-19 Testing
- Clinical Laboratory Techniques/methods
- Coronavirus Infections/blood
- Coronavirus Infections/diagnosis
- Coronavirus Infections/epidemiology
- Coronavirus Infections/immunology
- Coronavirus Nucleocapsid Proteins
- Female
- Humans
- Immunity, Humoral
- Male
- Middle Aged
- Nucleocapsid Proteins/immunology
- Pandemics
- Phosphoproteins
- Pneumonia, Viral/blood
- Pneumonia, Viral/diagnosis
- Pneumonia, Viral/epidemiology
- Pneumonia, Viral/immunology
- Prevalence
- Protein Interaction Domains and Motifs
- SARS-CoV-2
- Seroepidemiologic Studies
- Spike Glycoprotein, Coronavirus/chemistry
- Spike Glycoprotein, Coronavirus/immunology
- Young Adult
Collapse
Affiliation(s)
- Tyler J Ripperger
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Jennifer L Uhrlaub
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Makiko Watanabe
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Rachel Wong
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Division of Biological and Biomedical Sciences, Washington University, St. Louis, MO, USA
| | - Yvonne Castaneda
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Hannah A Pizzato
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Division of Biological and Biomedical Sciences, Washington University, St. Louis, MO, USA
| | - Mallory R Thompson
- Department of Surgery, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Department of Cellular and Molecular Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Christine Bradshaw
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Craig C Weinkauf
- Department of Surgery, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Christian Bime
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Heidi L Erickson
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Kenneth Knox
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Department of Medicine, University of Arizona, Phoenix, Phoenix, AZ, USA
| | - Billie Bixby
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Sachin Chaudhary
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Bhupinder Natt
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Elaine Cristan
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Tammer El Aini
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Franz Rischard
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Janet Campion
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Madhav Chopra
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Michael Insel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Afshin Sam
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - James L Knepler
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Andrew P Capaldi
- Department of Molecular and Cellular Biology, University of Arizona, Tucson, Tucson, AZ, USA; Functional Genomics Core, University of Arizona, Tucson, AZ, USA
| | - Catherine M Spier
- Department of Pathology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Michael D Dake
- Office of the Senior Vice-President for Health Sciences, University of Arizona, Tucson, AZ, USA
| | - Taylor Edwards
- University of Arizona Genomics Core and the Arizona Research Labs, University of Arizona Genetics Core, University of Arizona, Tucson, AZ, USA
| | - Matthew E Kaplan
- Functional Genomics Core, University of Arizona, Tucson, AZ, USA
| | - Serena Jain Scott
- Division of Geriatrics, General Medicine and Palliative Care, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Cameron Hypes
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - Jarrod Mosier
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; Department of Emergency Medicine, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA
| | - David T Harris
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Health Sciences Biobank, University of Arizona, Tucson, AZ, USA
| | | | - Ryan Sprissler
- University of Arizona Genomics Core and the Arizona Research Labs, University of Arizona Genetics Core, University of Arizona, Tucson, AZ, USA; BIO5 Institute, University of Arizona, Tucson, AZ, USA
| | - Janko Nikolich-Žugich
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; University of Arizona Center on Aging, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; BIO5 Institute, University of Arizona, Tucson, AZ, USA.
| | - Deepta Bhattacharya
- Department of Immunobiology, University of Arizona College of Medicine, Tucson, Tucson, AZ, USA; BIO5 Institute, University of Arizona, Tucson, AZ, USA.
| |
Collapse
|
26
|
Sugimoto M, Komori K, Yokoi H, Ohki T, Kichikawa K, Nakamura M, Nanto S, O'Leary EE, Lottes AE, Saunders AT, Dake MD. Long-Term Effectiveness of a Drug-Eluting Stent for Femoropopliteal In-Stent Restenosis: Subanalysis of the Zilver PTX Japan Post-Market Surveillance Study. J Endovasc Ther 2020; 28:229-235. [PMID: 33084502 DOI: 10.1177/1526602820966708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To present a subgroup analysis of patients from a large real-world study evaluating the safety and effectiveness of the Zilver PTX drug-eluting stent (DES) for treating femoropopliteal in-stent restenosis (ISR). MATERIALS AND METHODS This study examined patients enrolled in the Zilver PTX Japan Post-Market Surveillance Study (ClinicalTrials.gov identifier NCT02254837), a prospective, multicenter registry of 904 symptomatic patients with 1082 femoropopliteal lesions treated with the DES at 95 institutions in Japan. Five-year outcomes, including mortality, stent radiography, freedom from target lesion revascularization (TLR), and clinical benefit, were evaluated for 177 patients (mean age 74.2±8.3 years; 118 men) with 204 ISR lesions treated with the Zilver DES. Over half of the patients (108, 61.0%) were diabetic. Mean lesion length was 17.8±10.4 cm, and a third (72, 35.3%) were total occlusions. Outcome measures were all-cause mortality, thrombosis, freedom from TLR, and clinical benefit, defined as freedom from persistent or deteriorating ischemic symptoms. RESULTS No device-related or procedure-related deaths or paclitaxel-related adverse events were reported. All-cause mortality was 25.1% at 5 years. Stent fracture was observed in 5 stents through 5 years. The 5-year rate of freedom from clinically-driven TLR was 73.4%, and the rate of clinical benefit was 63.6%. Improvement in Rutherford category and ankle-brachial index was sustained through 5 years. CONCLUSION The safety and effectiveness of the Zilver PTX stent for the treatment of femoropopliteal ISR lesions demonstrated that this device provides a favorable treatment option in this difficult-to-treat subgroup.
Collapse
Affiliation(s)
- Masayuki Sugimoto
- Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kimihiro Komori
- Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroyoshi Yokoi
- Department of Cardiovascular Medicine, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Takao Ohki
- Department of Surgery, Jikei University Hospital, Tokyo, Japan
| | - Kimihiko Kichikawa
- Department of Radiology, Nara Medical University, Kashihara, Nara, Japan
| | - Masato Nakamura
- Division of Cardiovascular Medicine, Toho University, Ohashi Medical Center, Tokyo, Japan
| | - Shinsuke Nanto
- Department of Cardiology, Nishinomiya Municipal Central Hospital, Nishinomiya, Japan
| | | | | | | | - Michael D Dake
- The University of Arizona Health Sciences, Tucson, AZ, USA
| |
Collapse
|
27
|
Dake MD, Fanelli F, Lottes AE, O'Leary EE, Reichert H, Jiang X, Fu W, Iida O, Zen K, Schermerhorn M, Zeller T, Ansel GM. Prediction Model for Freedom from TLR from a Multi-study Analysis of Long-Term Results with the Zilver PTX Drug-Eluting Peripheral Stent. Cardiovasc Intervent Radiol 2020; 44:196-206. [PMID: 33025243 PMCID: PMC7806559 DOI: 10.1007/s00270-020-02648-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/08/2020] [Indexed: 01/20/2023]
Abstract
Purpose Develop a prediction model to determine the impact of patient and lesion factors on freedom from target lesion revascularization (ffTLR) for patients who are candidates for Zilver PTX drug-eluting stent (DES) treatment for femoropopliteal lesions. Methods Patient factors, lesion characteristics, and TLR results from five global studies were utilized for model development. Factors potentially associated with TLR (sex, age, diabetes, hypertension, hypercholesterolemia, renal disease, smoking status, Rutherford classification, lesion length, reference vessel diameter (RVD), popliteal involvement, total occlusion, calcification severity, prior interventions, and number of runoff vessels) were analyzed in a Cox proportional hazards model. Probability of ffTLR was generated for three example patient profiles via combinations of patient and lesion factors. TLR was defined as reintervention performed for ≥ 50% diameter stenosis after recurrent clinical symptoms. Results The model used records from 2227 patients. The median follow-up time was 23.9 months (range: 0.03–60.8). The Kaplan–Meier estimates for ffTLR were 90.5% through 1 year and 75.2% through 5 years. In a multivariate analysis, sex, age, Rutherford classification, lesion length, RVD, total occlusion, and prior interventions were significant factors. The example patient profiles have predicted 1-year ffTLRs of 97.4, 92.3, and 86.0% and 5-year predicted ffTLRs of 92.8, 79.5, and 64.8%. The prediction model is available as an interactive web-based tool (https://cooksfa.z13.web.core.windows.net). Conclusions This is the first prediction model that uses an extensive dataset to determine the impact of patient and lesion factors on ffTLR through 5 years and provides an interactive web-based tool for expected patient outcomes with the Zilver PTX DES. Clinical Trial Registrations Zilver PTX RCT unique identifier: NCT00120406; Zilver PTX single-arm study unique identifier: NCT01094678; Zilver PTX China study unique identifier: NCT02171962; Zilver PTX US post-approval study unique identifier: NCT01901289; Zilver PTX Japan post-market surveillance study unique identifier: NCT02254837. Levels of Evidence Zilver PTX RCT: Level 2, randomized controlled trial; Single-arm study: Level 4, large case series; China study: Level 4, case series; US post-approval study: Level 4, case series Japan PMS study: Level 4, large case series. Electronic supplementary material The online version of this article (10.1007/s00270-020-02648-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Michael D Dake
- The University of Arizona, Health Sciences Innovation Building, 1670 East Drachman Street, 9th Floor SVP Suite, P.O. Box 210216, Tucson, AZ, 85721-0216, USA.
| | - Fabrizio Fanelli
- Department of Vascular and Interventional Radiology, "Careggi" University Hospital, Florence, Italy
| | | | | | | | | | - Weiguo Fu
- Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Osamu Iida
- Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan
| | - Kan Zen
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Marc Schermerhorn
- Division of Vascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Thomas Zeller
- Universitaets-Herz-Zentrum Freiburg - Bad Krozingen, Bad Krozingen, Germany
| | - Gary M Ansel
- Department of Medicine, Ohio Health/Riverside Methodist Hospital, Columbus, OH, USA
| |
Collapse
|
28
|
Frohlich MM, Suh GY, Bondesson J, Leineweber M, Lee JT, Dake MD, Cheng CP. Thoracic aortic geometry correlates with endograft bird-beaking severity. J Vasc Surg 2020; 72:1196-1205. [DOI: 10.1016/j.jvs.2019.11.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 11/22/2019] [Indexed: 10/25/2022]
|
29
|
Bondesson J, Suh GY, Dake MD, Lee JT, Cheng CP. Influence of Thoracic Endovascular Aortic Repair on True Lumen Helical Morphology for Stanford Type B Dissections. J Vasc Surg 2020. [DOI: 10.1016/j.jvs.2020.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
30
|
Ripperger TJ, Uhrlaub JL, Watanabe M, Wong R, Castaneda Y, Pizzato HA, Thompson MR, Bradshaw C, Weinkauf CC, Bime C, Erickson HL, Knox K, Bixby B, Parthasarathy S, Chaudhary S, Natt B, Cristan E, Aini TE, Rischard F, Campion J, Chopra M, Insel M, Sam A, Knepler JL, Capaldi AP, Spier CM, Dake MD, Edwards T, Kaplan ME, Scott SJ, Hypes C, Mosier J, Harris DT, LaFleur BJ, Sprissler R, Nikolich-Žugich J, Bhattacharya D. Detection, prevalence, and duration of humoral responses to SARS-CoV-2 under conditions of limited population exposure. medRxiv 2020:2020.08.14.20174490. [PMID: 32817969 PMCID: PMC7430613 DOI: 10.1101/2020.08.14.20174490] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We conducted an extensive serological study to quantify population-level exposure and define correlates of immunity against SARS-CoV-2. We found that relative to mild COVID-19 cases, individuals with severe disease exhibited elevated authentic virus-neutralizing titers and antibody levels against nucleocapsid (N) and the receptor binding domain (RBD) and the S2 region of spike protein. Unlike disease severity, age and sex played lesser roles in serological responses. All cases, including asymptomatic individuals, seroconverted by 2 weeks post-PCR confirmation. RBD- and S2-specific and neutralizing antibody titers remained elevated and stable for at least 2-3 months post-onset, whereas those against N were more variable with rapid declines in many samples. Testing of 5882 self-recruited members of the local community demonstrated that 1.24% of individuals showed antibody reactivity to RBD. However, 18% (13/73) of these putative seropositive samples failed to neutralize authentic SARS-CoV-2 virus. Each of the neutralizing, but only 1 of the non-neutralizing samples, also displayed potent reactivity to S2. Thus, inclusion of multiple independent assays markedly improved the accuracy of antibody tests in low seroprevalence communities and revealed differences in antibody kinetics depending on the viral antigen. In contrast to other reports, we conclude that immunity is durable for at least several months after SARS-CoV-2 infection.
Collapse
Affiliation(s)
- Tyler J. Ripperger
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Jennifer L. Uhrlaub
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Makiko Watanabe
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Rachel Wong
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Division of Biological and Biomedical Sciences, Washington University, St. Louis, MO, USA
| | - Yvonne Castaneda
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Hannah A. Pizzato
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Division of Biological and Biomedical Sciences, Washington University, St. Louis, MO, USA
| | - Mallory R. Thompson
- Department of Surgery, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Department of Cellular and Molecular Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Christine Bradshaw
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Craig C. Weinkauf
- Department of Surgery, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Christian Bime
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Heidi L. Erickson
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Kenneth Knox
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Department of Medicine, University of Arizona-Phoenix, Phoenix, AZ
| | - Billie Bixby
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Sachin Chaudhary
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Bhupinder Natt
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Elaine Cristan
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Tammer El Aini
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Franz Rischard
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Janet Campion
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Madhav Chopra
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Michael Insel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Afshin Sam
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - James L. Knepler
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Andrew P. Capaldi
- Department of Molecular and Cellular Biology, University of Arizona – Tucson, Tucson, AZ, USA
- Functional Genomics Core, University of Arizona, Tucson, AZ
| | - Catherine M. Spier
- Department of Pathology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
| | - Michael D. Dake
- Office of the Senior Vice-President for Health Sciences, University of Arizona, Tucson, USA
| | - Taylor Edwards
- University of Arizona Genomics Core, University of Arizona, Tucson, AZ and the Arizona Research Labs, University of Arizona Genetics Core, University of Arizona, Tucson, AZ, USA
| | | | - Serena Jain Scott
- Division of Geriatrics, General Medicine and Palliative Care, Department of Medicine, University of Arizona College of Medicine-Tucson, Tucson, USA
| | - Cameron Hypes
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Department of Emergency Medicine, University of Arizona College of Medicine-Tucson, Tucson, USA
| | - Jarrod Mosier
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- Department of Emergency Medicine, University of Arizona College of Medicine-Tucson, Tucson, USA
| | - David T. Harris
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Health Sciences Biobank, University of Arizona, Tucson, USA
| | | | - Ryan Sprissler
- University of Arizona Genomics Core, University of Arizona, Tucson, AZ and the Arizona Research Labs, University of Arizona Genetics Core, University of Arizona, Tucson, AZ, USA
- BIO5 Institute, University of Arizona, Tucson, USA
| | - Janko Nikolich-Žugich
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- University of Arizona Center on Aging, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- BIO5 Institute, University of Arizona, Tucson, USA
| | - Deepta Bhattacharya
- Department of Immunobiology, University of Arizona College of Medicine – Tucson, Tucson, AZ, USA
- BIO5 Institute, University of Arizona, Tucson, USA
| |
Collapse
|
31
|
Magee GA, Plotkin A, Dake MD, Starnes BW, Han SM, Ding L, Weaver FA. Branch Vessel Patency after Thoracic Endovascular Aortic Repair for Type B Aortic Dissection. Ann Vasc Surg 2020; 70:152-161. [PMID: 32634562 DOI: 10.1016/j.avsg.2020.06.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Thoracic endovascular aortic repair (TEVAR) for type B aortic dissections is used to promote false lumen (FL) thrombosis and favorable aortic remodeling, but its impact on occlusion of FL origin branch vessels has not been widely described. We compare FL versus true lumen (TL) branch vessel patency after TEVAR. METHODS Patients treated by TEVAR for type B aortic dissection in zones 2-5 in the Vascular Quality Initiative from 2009 to 2018 were evaluated. The primary outcome was postoperative branch patency. Secondary outcomes were need for branch vessel intervention, preoperative origin, and postoperative patency of individual branch vessels (celiac, superior mesenteric artery, renal arteries, and iliac arteries). A subset analysis was performed comparing acute and chronic dissections. RESULTS Of 11,774 patients, 1,484 met criteria for analysis. The left renal was the most common to have FL origin (21.6%), whereas right and left common iliac arteries were the most likely to originate off both lumens (BLs; 22% and 24%). Branch vessels that originated from the TL, FL, BLs, or were obstructed had postoperative patency rates of 99%, 99%, 99%, and 87% (P < 0.0001). Branch vessel treatment was performed in 5% of patients. The right (2.5%) and left (2.8%) renal arteries were the most frequently obstructed branches postoperatively. On multivariate analysis, preoperatively obstructed branches (odds ratio 0.03, P < 0.0001) were negatively associated with postoperative branch patency and branch vessel treatment (odds ratio 3.8, P = 0.004) was positively associated with postoperative patency. FL or BL origin, number of zones covered by TEVAR, urgency, dissection chronicity (acute versus chronic), and demographics were not independently associated with patency. These findings remained unchanged in the subset analysis of only acute dissections. CONCLUSIONS Branch vessel patency rates after TEVAR for a type B aortic dissection are high and are not significantly different for FL or BL origin vessels compared with TL vessels. Branches that are patent before TEVAR almost always remain patent after TEVAR, but branch vessel stenting may be required in less than 5%.
Collapse
Affiliation(s)
- Gregory A Magee
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA.
| | - Anastasia Plotkin
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA
| | - Michael D Dake
- Department of Surgery, University of Arizona Health Sciences, Tucson, AZ; Department of Medical Imaging, University of Arizona Health Sciences, Tucson, AZ; Department of Medicine, University of Arizona Health Sciences, Tucson, AZ
| | - Benjamin W Starnes
- Division of Vascular Surgery, Department of Surgery, University of Washington, Seattle, WA
| | - Sukgu M Han
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA
| | - Li Ding
- Division of Biostatistics, Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA
| | - Fred A Weaver
- Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA
| |
Collapse
|
32
|
Watkins AC, Dalal A, Lee JT, Dake MD. Current Status of Endoluminal Treatment of Descending Thoracic Aortic Aneurysms. Cardiovasc Intervent Radiol 2020; 43:1770-1778. [PMID: 32449019 DOI: 10.1007/s00270-020-02526-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 05/09/2020] [Indexed: 11/27/2022]
Abstract
Thoracic endovascular aortic repair (TEVAR) was proved to be effective in thoracic descending aortic aneurysm (TDAA) repair in 1994 and approved by the FDA in 2005. Since then, TEVAR has become the first-line, recommended treatment for intact or ruptured DTAA or as a bridge to definitive open surgical repair in connective tissue disease. TEVAR has decreased perioperative morbidity and mortality compared to open surgery due to the lack of thoracotomy, aortic cross-clamping and left heart bypass. Improvement in materials, manufacturing and device delivery systems have allowed for the expansion of indications. Thoughtful and accurate pre-procedure planning is the hallmark of successful TEVAR. Familiarization and adherence to the instructions for use for an aortic device will give the best possible chance of success.
Collapse
Affiliation(s)
- A Claire Watkins
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA
| | - Alex Dalal
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA
| | - Jason T Lee
- Division of Vascular Surgery, Stanford University, Stanford, CA, USA
| | - Michael D Dake
- University for Health Sciences, University of Arizona, Health Sciences Innovation Building, 9th Floor SVP Suite, 1670 E. Drachman Street, PO Box 210216, Tucson, AZ, 85721-0216, USA.
| |
Collapse
|
33
|
Iwakoshi S, Dake MD, Irie Y, Katada Y, Sakaguchi S, Hongo N, Oji K, Fukuda T, Matsuda H, Kawasaki R, Taniguchi T, Motoki M, Hagihara M, Kurimoto Y, Morikage N, Nishimaki H, Sueyoshi E, Inoue K, Shimizu H, Ideta I, Higashigawa T, Ikeda O, Miyamoto N, Nakai M, Nakai T, Ichihashi S, Inoue T, Inoue T, Yamaguchi M, Tanaka R, Kichikawa K. Management of Renal Arteries in Conjunction with Thoracic Endovascular Aortic Repair for Complicated Stanford Type B Aortic Dissection: The Japanese Multicenter Study (J-Predictive Study). Radiology 2020; 295:E5. [PMID: 32310734 DOI: 10.1148/radiol.2020204008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
34
|
Magee GA, Plotkin A, Dake MD, Starnes BW, Han SM, Ding L, Weaver FA. Branch Vessel Patency After TEVAR for Type B Aortic Dissection. Ann Vasc Surg 2020. [DOI: 10.1016/j.avsg.2020.01.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
35
|
Iwakoshi S, Watkins CA, Ogawa Y, Fischbein M, Lee A, Lee JT, Hiesinger W, Dake MD. “Cheese Wire” Fenestration of Dissection Intimal Flap to Facilitate Thoracic Endovascular Aortic Repair in Chronic Dissection. J Vasc Interv Radiol 2020; 31:150-154.e2. [DOI: 10.1016/j.jvir.2019.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/07/2019] [Accepted: 06/08/2019] [Indexed: 10/26/2022] Open
|
36
|
Ho VT, George EL, Dua A, Lavingia KS, Sgroi MD, Dake MD, Lee JT. Early Real-World Experience with EndoAnchors by Indication. Ann Vasc Surg 2020; 62:30-34. [DOI: 10.1016/j.avsg.2019.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/16/2019] [Accepted: 05/25/2019] [Indexed: 11/28/2022]
|
37
|
Affiliation(s)
- Sanjay Misra
- Mayo Clinic Rochester, Department of Radiology, MN (S.M.)
| | - Michael D Dake
- Health Sciences, The University of Arizona, Tucson (M.D.D.)
| |
Collapse
|
38
|
Bondesson J, Suh GY, Lundh T, Lee JT, Dake MD, Cheng CP. Automated Quantification of Diseased Thoracic Aortic Longitudinal Centerline and Surface Curvatures. J Biomech Eng 2019; 142:1065879. [DOI: 10.1115/1.4045271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Indexed: 11/08/2022]
Abstract
Abstract
Precise description of vascular morphometry is crucial to support medical device manufacturers and clinicians for improving device development and interventional outcomes. A compact and intuitive method is presented to automatically characterize the surface geometry of tubular anatomic structures and quantify surface curvatures starting from generic stereolithographic (STL) surfaces. The method was validated with software phantoms and used to quantify the longitudinal surface curvatures of 37 human thoracic aortas with aneurysm or dissection. The quantification of surface curvatures showed good agreement with analytic solutions from the software phantoms, and demonstrated better agreement as compared to estimation methods using only centerline geometry and cross-sectional radii. For the human thoracic aortas, longitudinal inner surface curvature was significantly higher than centerline curvature (0.33 ± 0.06 versus 0.16 ± 0.02 cm−1 for mean; 1.38 ± 0.48 versus 0.45 ± 0.11 cm−1 for peak; both p < 0.001). These findings show the importance of quantifying surface curvatures in order to better describe the geometry and biomechanical behavior of the thoracic aorta, which can assist in treatment planning and supplying device manufactures with more precise boundary conditions for mechanical evaluation.
Collapse
Affiliation(s)
- Johan Bondesson
- Division of Dynamics,Chalmers University of Technology, Hörsalsvägen 7A,Gothenburg 412 96, Sweden
| | - Ga-Young Suh
- Division of Vascular Surgery,Stanford University, 300 Pasteur Dr.,Always Building M121,Stanford, CA 94305
| | - Torbjörn Lundh
- Mathematical Sciences,Chalmers University of Technology and University of Gothenburg, Chalmers tvärgata 3,Gothenburg 412 58, Sweden
| | - Jason T. Lee
- Division of Vascular Surgery,Stanford University, 300 Pasteur Dr.,Always Building M121,Stanford, CA 94305
| | - Michael D. Dake
- Department of Cardiothoracic Surgery,Stanford University, Falk Building, 870 Quarry Road,Palo Alto, CA 94304
| | - Christopher P. Cheng
- Division of Vascular Surgery,Stanford University, 300 Pasteur Dr.,Always Building M121,Stanford, CA 94305
| |
Collapse
|
39
|
Iwakoshi S, Dake MD, Irie Y, Katada Y, Sakaguchi S, Hongo N, Oji K, Fukuda T, Matsuda H, Kawasaki R, Taniguchi T, Motoki M, Hagihara M, Kurimoto Y, Morikage N, Nishimaki H, Sueyoshi E, Inoue K, Shimizu H, Ideta I, Higashigawa T, Ikeda O, Miyamoto N, Nakai M, Nakai T, Ichihashi S, Inoue T, Inoue T, Yamaguchi M, Tanaka R, Kichikawa K. Management of Renal Arteries in Conjunction with Thoracic Endovascular Aortic Repair for Complicated Stanford Type B Aortic Dissection: The Japanese Multicenter Study (J-Predictive Study). Radiology 2019; 294:455-463. [PMID: 31821120 DOI: 10.1148/radiol.2019190598] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background Management of abdominal branches associated with Stanford type B aortic dissection is controversial without definite criteria for therapy after thoracic endovascular aortic repair (TEVAR). This is in part due to lack of data on natural history related to branch vessels and their relationship with the dissection flap, true lumen, and false lumen. Purpose To investigate the natural history of abdominal branches after TEVAR for type B aortic dissection and the relationship between renal artery anatomy and renal volume as a surrogate measure of perfusion. Materials and Methods This study included patients who underwent TEVAR for complicated type B dissection from January 2012 to March 2017 at 20 centers. Abdominal aortic branches were classified with following features: patency, branch vessel origin, and presence of extension of the aortic dissection into a branch (pattern 1, supplied by the true lumen without branch dissection; pattern 2, supplied by the true lumen with branch dissection, etc). The branch artery patterns before TEVAR were compared with those of the last follow-up CT (mean interval, 19.7 months) for spontaneous healing. Patients with one kidney supplied by pattern 1 and the other kidney by a different pattern were identified, and kidney volumes over the course were compared by using a simple linear regression model. Results Two hundred nine patients (mean age ± standard deviation, 66 years ± 13; 165 men and 44 women; median follow-up, 18 months) were included. Four hundred fifty-nine abdominal branches at the last follow-up were evaluable. Spontaneous healing of the dissected branch occurred in 63% (64 of 102) of pattern 2 branches. Regarding the other patterns, 6.5% (six of 93) of branches achieved spontaneous healing. In 79 patients, renal volumes decreased in kidneys with pattern 2 branches with more than 50% stenosis and branches supplied by the aortic false lumen (patterns 3 and 4) compared with contralateral kidneys supplied by pattern 1 (pattern 2 vs pattern 1: -16% ± 16 vs 0.10% ± 11, P = .002; patterns 3 and 4 vs pattern 1: -13% ± 14 vs 8.5% ± 14, P = .004). Conclusion Spontaneous healing occurs more frequently in dissected branches arising from the true lumen than in other branch patterns. Renal artery branches supplied by the aortic false lumen or a persistently dissected artery with greater than 50% stenosis are associated with significantly greater kidney volume loss. © RSNA, 2019 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Shinichi Iwakoshi
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Michael D Dake
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Yoshihito Irie
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Yoshiaki Katada
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Shoji Sakaguchi
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Norio Hongo
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Katsuki Oji
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Tetsuya Fukuda
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Hitoshi Matsuda
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Ryota Kawasaki
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Takanori Taniguchi
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Manabu Motoki
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Makiyo Hagihara
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Yoshihiko Kurimoto
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Noriyasu Morikage
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Hiroshi Nishimaki
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Eijun Sueyoshi
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Kyozo Inoue
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Hideyuki Shimizu
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Ichiro Ideta
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Takatoshi Higashigawa
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Osamu Ikeda
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Naokazu Miyamoto
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Motoki Nakai
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Takahiro Nakai
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Shigeo Ichihashi
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Takeshi Inoue
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Takashi Inoue
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Masato Yamaguchi
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Ryoichi Tanaka
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| | - Kimihiko Kichikawa
- From the Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan (S. Iwakoshi, T.N., S. Ichihashi, K.K.); University of Arizona Health Sciences, Tucson, Ariz (M.D.D.); Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan (Y.I., Y. Katada); Department of Radiology, Matsubara Tokusyukai Hospital, Matsubara, Japan (S.S.); Department of Radiology, Oita University Faculty of Medicine, Yufu, Japan (N.H., K.O.); Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Japan (T.F.); Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan (H.M.); Department of Radiology, Hyogo Brain and Heart Center, Himeji, Japan (R.K.); Department of Radiology, Tenri Hospital, Tenri, Japan (T.T.); Department of Cardiovascular Surgery, Morinomiya Hospital, Osaka, Japan (M.M.); Department of Radiology, Aichi Medical University, Nagakute, Japan (M.H.); Department of Cardiovascular Surgery, Teine Keijinkai Hospital, Sapporo, Japan (Y. Kurimoto); Division of Vascular Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan (N. Morikage); Department of Cardiovascular Surgery, Cardiovascular Surgery, St. Marianna University School of Medicine, Kawasaki, Japan (H.N.); Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan (E.S.); Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan (K.I.); Department of Cardiovascular Surgery, Keio University, Tokyo, Japan (H.S.); Department of Cardiovascular Medicine & Surgery, Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan (I.I.); Department of Radiology, Mie University Hospital, Tsu, Japan (T.H.); Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (O.I.); Department of Radiology, Kita-Harima Medical Center, Ono, Japan (N. Miyamoto); Department of Radiology, Wakayama Medical University, Wakayama, Japan (M.N.); Department of Central Radiology, Nara Medical University, Kashihara, Japan (Takeshi Inoue); Institute for Clinical and Translational Science, Nara Medical University, Kashihara, Japan (Takashi Inoue); Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan (M.Y.); and Department of Radiology, Iwate Medical University, Morioka, Japan (K.K.)
| |
Collapse
|
40
|
Ogawa Y, Watkins AC, Lingala B, Nathan I, Chiu P, Iwakoshi S, He H, Lee JT, Fischbein M, Woo YJ, Dake MD. Improved midterm outcomes after endovascular repair of nontraumatic descending thoracic aortic rupture compared with open surgery. J Thorac Cardiovasc Surg 2019; 161:2004-2012. [PMID: 31926735 DOI: 10.1016/j.jtcvs.2019.10.156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 10/23/2019] [Accepted: 10/24/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Thoracic endovascular aortic repair (TEVAR) has become first-line treatment for descending thoracic aortic rupture (DTAR), but its midterm and long-term outcomes remain undescribed. This study evaluated whether TEVAR would improve midterm outcomes of nontraumatic DTAR relative to open surgical repair (OSR). METHODS Between December 1999 and October 2018, 118 patients with DTAR were treated with either OSR (n = 39) or TEVAR (n = 79) at a single center. Primary end points were 30-day and long-term all-cause mortalities. Secondary end points included stroke, permanent spinal cord ischemia (SCI), prolonged ventilation support or tracheostomy, permanent hemodialysis, and aortic reintervention. RESULTS Thirty-day mortality was significantly lower with TEVAR (OSR, 38.5%; TEVAR, 16.5%; P = .01). Stroke (15.6% vs 3.8%; P = .03), permanent SCI (15.6% vs 2.5%; P = .02), prolonged ventilation (30.8% vs 8.9%; P = .002), and tracheostomy (12.8% vs 2.5%; P = .04) were significantly lower after TEVAR than OSR. Need for hemodialysis trended higher after OSR (12.8% vs 5.1%; P = .2). Mean follow ups were 1048 ± 1591 days for OSR group and 828 ± 1258 days for TEVAR. All-cause mortality at last follow-up was significantly lower after TEVAR than OSR (35.4% vs 66.7%; P = .001). Aortic reintervention was required more frequently within 30 days after TEVAR (15.2% vs 2.6%; P = .06). By multivariate analysis, TAAA was an independent predictor for mortality. CONCLUSIONS TEVAR improves both early and midterm outcomes of DTAR relative to OSR. TAAA was a predictor of mortality. Endovascular approach to DTAR may provide the greatest chance at survival.
Collapse
Affiliation(s)
- Yukihisa Ogawa
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif
| | - A Claire Watkins
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Bharathi Lingala
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Itoga Nathan
- Division of Vascular Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Peter Chiu
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Shinichi Iwakoshi
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Hao He
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Jason T Lee
- Division of Vascular Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Michael Fischbein
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Y Joseph Woo
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Michael D Dake
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif; University of Arizona Heath Sciences, Tucson, Ariz.
| |
Collapse
|
41
|
Dua A, Lavingia KS, Deslarzes-Dubuis C, Dake MD, Lee JT. Early Experience with the Octopus Endovascular Strategy in the Management of Thoracoabdominal Aneurysms. Ann Vasc Surg 2019; 61:350-355. [DOI: 10.1016/j.avsg.2019.05.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/18/2019] [Accepted: 05/24/2019] [Indexed: 12/20/2022]
|
42
|
Dake MD, Ansel GM, Bosiers M, Holden A, Iida O, Jaff MR, Lottes AE, O'Leary EE, Saunders AT, Schermerhorn M, Yokoi H, Zeller T. Paclitaxel-Coated Zilver PTX Drug-Eluting Stent Treatment Does Not Result in Increased Long-Term All-Cause Mortality Compared to Uncoated Devices. Cardiovasc Intervent Radiol 2019; 43:8-19. [PMID: 31502026 PMCID: PMC6940321 DOI: 10.1007/s00270-019-02324-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 08/21/2019] [Indexed: 12/24/2022]
Abstract
Purpose Patient-level data from two large studies of the Zilver PTX drug-eluting stent (DES) with long-term follow-up and concurrent non-drug comparator groups were analyzed to determine whether there was an increased mortality risk due to paclitaxel. Methods Data from the Zilver PTX randomized controlled trial (RCT) and Zilver PTX and bare metal stent (BMS) Japan post-market surveillance studies were analyzed. Five-year follow-up is complete in both DES studies; follow-up for the BMS study was limited to 3 years and is complete. Kaplan–Meier analyses assessed mortality. A Cox proportional hazards model identified significant factors related to mortality. Results In the RCT, there were 336 patients treated with the DES and 143 patients treated with percutaneous transluminal angioplasty (PTA) or BMS. In Japan, there were 904 DES patients and 190 BMS patients. There was no difference in all-cause mortality for the DES compared to PTA/BMS in the RCT (19.1% DES versus 17.1% PTA/BMS through 5 years, p = 0.60) or Japan (15.8% DES versus 15.3% BMS through 3 years, p = 0.89). Cox proportional hazard models revealed that age, tissue loss, and congestive heart failure were significantly associated with mortality in the RCT, and critical limb ischemia, age, renal failure, and gender were significantly associated with mortality in Japan (all p < 0.05). Neither treatment with Zilver PTX (p = 0.46 RCT, p = 0.49 Japan) nor paclitaxel dose (p = 0.86 RCT, p = 0.07 Japan) was associated with mortality. Conclusion Analyses of the Zilver PTX patient-level data demonstrated no increase in long-term all-cause mortality. Level of Evidence Zilver PTX RCT: Level 1, randomized controlled trial; Japan PMS studies: Level 3, post-market surveillance study. Electronic supplementary material The online version of this article (10.1007/s00270-019-02324-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Michael D Dake
- The University of Arizona, Roy P. Drachman Hall Building, B207, 1295 North Martin Avenue, P.O. Box 210202, Tucson, AZ, 85721-0202, USA.
| | - Gary M Ansel
- Department of Medicine, Ohio Health/Riverside Methodist Hospital, Columbus, OH, USA
| | - Marc Bosiers
- Foundation of Cardiovascular Research and Education, Münster, Germany
| | - Andrew Holden
- Department of Interventional Radiology, Auckland City Hospital, Auckland, New Zealand
| | - Osamu Iida
- Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan
| | | | | | | | | | - Marc Schermerhorn
- Division of Vascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Hiroyoshi Yokoi
- Department of Cardiovascular Medicine, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Thomas Zeller
- Universitaets-Herz-Zentrum Freiburg - Bad Krozingen, Bad Krozingen, Germany
| |
Collapse
|
43
|
Watkins AC, de Biasi AR, Iwakoshi S, Ogawa Y, Dake MD. Thoracic endovascular aortic repair for type B intramural hematoma. Ann Cardiothorac Surg 2019; 8:509-511. [PMID: 31463217 DOI: 10.21037/acs.2019.06.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- A Claire Watkins
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Andreas R de Biasi
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Shinichi Iwakoshi
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Yukihisa Ogawa
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | | |
Collapse
|
44
|
Dake MD, Ansel GM, Lottes AE. Zilver PTX RCT mortality analysis: no difference in long-term mortality rate for Zilver PTX drug-eluting stent compared to PTA/BMS. CVIR Endovasc 2019; 2:25. [PMID: 32027000 PMCID: PMC6966343 DOI: 10.1186/s42155-019-0069-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/17/2019] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Gary M Ansel
- Department of Medicine, Ohio Health / Riverside Methodist Hospital, Columbus, OH, USA
| | | |
Collapse
|
45
|
Chiu P, Goldstone AB, Schaffer JM, Lingala B, Miller DC, Mitchell RS, Woo YJ, Fischbein MP, Dake MD. Endovascular Versus Open Repair of Intact Descending Thoracic Aortic Aneurysms. J Am Coll Cardiol 2019; 73:643-651. [PMID: 30765029 PMCID: PMC6675458 DOI: 10.1016/j.jacc.2018.10.086] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 10/22/2018] [Accepted: 10/30/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND For the management of descending thoracic aortic aneurysms, recent evidence has suggested that outcomes of open surgical repair may surpass thoracic endovascular aortic repair (TEVAR) in as early as 2 years. OBJECTIVES The purpose of this study was to evaluate the comparative effectiveness of TEVAR and open surgical repair in the treatment of intact descending thoracic aortic aneurysms. METHODS Using the Medicare database, a retrospective study using regression discontinuity design and propensity score matching was performed on patients with intact descending thoracic aortic aneurysms who underwent TEVAR or open surgical repair between 1999 and 2010 with follow-up through 2014. Survival was assessed with restricted mean survival time. Perioperative mortality was assessed with logistic regression. Reintervention was evaluated as a secondary outcome. RESULTS Matching created comparable groups with 1,235 open surgical repair patients matched to 2,470 TEVAR patients. The odds of perioperative mortality were greater for open surgical repair: high-volume center, odds ratio (OR): 1.97 (95% confidence interval [CI]: 1.53 to 2.61); low-volume center, OR: 3.62 (95% CI: 2.88 to 4.51). The restricted mean survival time difference favored TEVAR at 9 years, -209.2 days (95% CI: -298.7 to -119.7 days; p < 0.001) for open surgical repair. Risk of reintervention was lower for open surgical repair, hazard ratio: 0.40 (95% CI: 0.34 to 0.60; p < 0.001). CONCLUSIONS Open surgical repair was associated with increased odds of early postoperative mortality but reduced late hazard of death. Despite the late advantage of open repair, mean survival was superior for TEVAR. TEVAR should be considered the first line for repair of intact descending thoracic aortic aneurysms in Medicare beneficiaries.
Collapse
Affiliation(s)
- Peter Chiu
- Department of Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford, California; Department of Health and Research Policy, Stanford University, School of Medicine, Stanford, California
| | - Andrew B Goldstone
- Department of Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford, California; Department of Health and Research Policy, Stanford University, School of Medicine, Stanford, California
| | | | - Bharathi Lingala
- Department of Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford, California
| | - D Craig Miller
- Department of Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford, California
| | - R Scott Mitchell
- Department of Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford, California
| | - Y Joseph Woo
- Department of Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford, California
| | - Michael P Fischbein
- Department of Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford, California
| | - Michael D Dake
- Department of Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford, California.
| |
Collapse
|
46
|
Dake MD. Reply to: "Further Evidence on the Lack of Utility of IVC Filters". J Vasc Interv Radiol 2019; 30:266-267. [PMID: 30717963 DOI: 10.1016/j.jvir.2018.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 11/08/2018] [Indexed: 10/27/2022] Open
Affiliation(s)
- Michael D Dake
- Medical Imaging, Surgery, and Medicine, University of Arizona, Roy P. Drachman Hall, Room B207, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85719
| | -
- Medical Imaging, Surgery, and Medicine, University of Arizona, Roy P. Drachman Hall, Room B207, 1295 N. Martin Ave., PO Box 210202, Tucson, AZ 85719
| |
Collapse
|
47
|
|
48
|
Suh GY, Ullery BW, Lee JT, Dake MD, Fleischmann D, Cheng C. Cardiopulmonary-induced deformations of the thoracic aorta following thoracic endovascular aortic repair. Vascular 2018; 27:181-189. [DOI: 10.1177/1708538118811204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Thoracic endovascular aortic repair has become a preferred treatment strategy for thoracic aortic aneurysms and dissections. Yet, it is not well understood if the performance of endografts is affected by physiologic strain due to cyclic aortic motion during cardiac pulsation and respiration. We aim to quantify cardiac- and respiratory-induced changes of the postthoracic endovascular aortic repair thoracic aorta and endograft geometries. Methods Fifteen thoracic endovascular aortic repair patients (66 ± 10 years) underwent cardiac-resolved computed tomography angiographies during inspiratory/expiratory breath holds. The computed tomography angiography images were utilized to build models of the aorta, and lumen centerlines and cross-sections were extracted. Arclength and curvature were computed from the lumen centerline. Effective diameter was computed from cross-sections of the thoracic aorta. Deformation was computed from the mid-diastole to end-systole (cardiac deformation) and expiration to inspiration (respiratory deformation). Results Cardiac pulsation induced significant changes in arclength, mean curvature, maximum curvature change, and effective diameter of the ascending aorta, as well as effective diameter of the stented aortic segment. Respiration, however, induced significant change in mean curvature and effective diameter of the ascending aorta only. Cardiac-induced arclength change of the ascending aorta was significantly greater than respiratory-induced arclength change. Conclusions Deformations are present across the thoracic aorta due to cardiopulmonary influences after thoracic endovascular aortic repair. The geometric deformations are greatest in the ascending aorta and decline at the stented thoracic aorta. Additional investigation is warranted to correlate aortic deformation to endograft performance.
Collapse
Affiliation(s)
- Ga-Young Suh
- Stanford University School of Medicine, Vascular Surgery, Stanford, USA
| | | | - Jason T. Lee
- Stanford University School of Medicine, Vascular Surgery, Stanford, USA
| | - Michael D. Dake
- Stanford University School of Medicine, Cardiothoracic Surgery, Stanford, USA
| | - Dominik Fleischmann
- Stanford University School of Medicine, Radiology, Stanford, USAGS and BWU contributed equally to this work
| | - Christopher Cheng
- Stanford University School of Medicine, Vascular Surgery, Stanford, USA
| |
Collapse
|
49
|
Kichikawa K, Ichihashi S, Yokoi H, Ohki T, Nakamura M, Komori K, Nanto S, O'Leary EE, Lottes AE, Snyder SA, Dake MD. Zilver PTX Post-market Surveillance Study of Paclitaxel-Eluting Stents for Treating Femoropopliteal Artery Disease in Japan: 2-Year Results. Cardiovasc Intervent Radiol 2018; 42:358-364. [PMID: 30411151 PMCID: PMC6373439 DOI: 10.1007/s00270-018-2110-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 10/30/2018] [Indexed: 11/30/2022]
Abstract
Purpose A prospective, multicenter post-market surveillance study in Japan evaluated the 2-year safety and effectiveness of the DES in real-world patients with complex femoropopliteal artery lesions. Methods There were no exclusion criteria, and consecutive symptomatic patients with femoropopliteal lesions treated with the DES were enrolled in the study. Clinically driven target lesion revascularization (TLR) was defined as reintervention performed for > 50% diameter stenosis after recurrent clinical symptoms of peripheral arterial disease. Clinical benefit was defined as freedom from persistent or deteriorating ischemic symptoms. Patency was evaluated by duplex ultrasound where physicians considered this standard of care. Results In this study, 905 patients were enrolled at 95 institutions in Japan. There were numerous comorbidities including a high incidence of diabetes (58.8%) and chronic kidney disease (43.6%). Additionally, 21.4% of patients were classified with critical limb ischemia. Lesions were complex, with an average length of 14.6 ± 9.6 cm (range 0.5–40 cm), 41.5% total occlusions, and 18.7% in-stent restenosis. In total, 1861 DES were placed in 1080 lesions. Two-year follow-up was obtained for > 90% of eligible patients. Freedom from TLR was 83.7%, and clinical benefit was 80.0% through 2 years. The 2-year primary patency rate was 70.3%. Rutherford classification significantly improved (p < 0.01), with approximately 80% of patients classified as Rutherford class 0 or 1 at 2 years. Conclusion Despite more challenging lesion characteristics, 2-year results from the current study are similar to outcomes from the previous Zilver PTX studies, confirming the efficacy of the Zilver PTX DES in a complicated femoropopliteal lesion (Zilver PTX Post-Market Study in Japan; NCT02254837). Level of Evidence Post-market surveillance study, Level III.
Collapse
Affiliation(s)
| | - Shigeo Ichihashi
- Department of Radiology, Nara Medical University, Kashihara, Japan.
| | - Hiroyoshi Yokoi
- Department of Cardiovascular Medicine, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Takao Ohki
- Department of Surgery, Jikei University Hospital, Tokyo, Japan
| | - Masato Nakamura
- Division of Cardiovascular Medicine, Ohashi Medical Center, Toho University, Tokyo, Japan
| | - Kimihiro Komori
- Division of Vascular Surgery, Division of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinsuke Nanto
- Nishinomiya Hospital Affairs, Nishinomiya Municipal Central Hospital, Nishinomiya, Japan
| | | | | | | | - Michael D Dake
- Department of Cardiothoracic Surgery, Stanford University Medical Center, Stanford, CA, USA
| |
Collapse
|
50
|
Dake MD, Murphy TP, Krämer AH, Darcy MD, Sewall LE, Curi MA, Johnson MS, Arena F, Swischuk JL, Ansel GM, Silver MJ, Saddekni S, Brower JS, Mendes R, Dake MD, Feezor R, Kalva S, Kies D, Bosiers M, Ziegler W, Farber M, Paolini D, Spillane R, Jones S, Peeters P. One-Year Analysis of the Prospective Multicenter SENTRY Clinical Trial: Safety and Effectiveness of the Novate Sentry Bioconvertible Inferior Vena Cava Filter. J Vasc Interv Radiol 2018; 29:1350-1361.e4. [DOI: 10.1016/j.jvir.2018.05.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/16/2018] [Accepted: 05/17/2018] [Indexed: 11/25/2022] Open
|