This comprehensive vascular and endovascular surgery training manual serves as an essential educational resource for medical professionals specializing in vascular interventions. The document provides systematic instruction on surgical techniques, procedural protocols, and clinical best practices pertinent to vascular and endovascular procedures. Designed for surgical trainees and practitioners, this manual consolidates theoretical knowledge with practical guidance, covering fundamental principles through advanced interventional techniques. The structured content facilitates professional development within the vascular surgery discipline, supporting evidence-based clinical decision-making and skill acquisition. This training resource represents a valuable reference tool for maintaining surgical competency standards and advancing professional expertise in vascular and endovascular medicine.

This study presents five-year clinical outcomes for the GORE VIABAHN endoprosthesis, a significant advancement in vascular intervention technology. The research evaluates the long-term efficacy and safety profile of this device in treating vascular conditions over an extended follow-up period. The findings provide valuable data on patency rates, clinical success, and complication profiles, contributing to the evidence base for informed clinical decision-making. These results are essential for healthcare professionals assessing treatment options and understanding the durability of endovascular interventions in patient populations requiring vascular repair or reconstruction therapies.

Below-the-knee (BTK) arterial disease is associated with a high risk of limb loss, yet evidence supporting the use of paclitaxel-coated balloons (PCB) in routine clinical practice remains limited. This study aimed to evaluate the safety and clinical performance of Peripherics™ PCB catheter (Sahajanand Medical Technologies Limited, Surat, India) in the treatment of BTK arteries during routine clinical practice.

Recent registry data demonstrates that combined atherectomy and intravascular lithotripsy (IVL) approaches yield superior outcomes in managing severe coronary calcification. The dual-preparation strategy effectively addresses the clinical challenge of heavily calcified lesions that traditionally resist conventional interventional techniques. By leveraging both mechanical debulking and energy-based calcium fracturing, this integrated methodology significantly improves vessel preparation and stent delivery success rates. These findings suggest that multimodal lesion preparation should be considered standard practice for complex calcified coronary disease, potentially reducing procedural complications and enhancing long-term patient outcomes in this high-risk population.

Luca Saba, Dean of the University of Cagliari's School of Medicine, presents a groundbreaking perspective on atherosclerosis heterogeneity published in Nature Cardiovascular Research. Building upon established concepts of vulnerable plaques and vulnerable patients, Saba and colleague Jagat Narula introduce the novel concept of "vulnerable territory." They argue that the arterial system comprises biologically distinct vascular territories with unique embryologic origins, hemodynamic environments, and structural characteristics. These territorial differences fundamentally influence how systemic risk factors manifest and progress, meaning identical calcification patterns in different arteries carry distinct biological and clinical significance. This framework resolves why atherosclerosis operates systemically yet remains nonuniform, offering profound implications for cardiovascular research and clinical practice.

The cross-talking between inflammatory molecular pathways, the coagulation system, and the artery wall represents an important substrate for the development and thrombogenic progression of atherosclerotic lesions in PAD. Coagulation acts on several levels, intersecting and acting in synergy with the inflammatory pathways. Nevertheless, the apport of the coagulation profile needs to be deeply investigated to elucidate the phenomenon of atherothrombotic occlusion associated with a non-significant intimal inflammatory pathology in PAD. The activation of the coagulation and inflammatory pathways appears to differ according to the location of the plaques (coronary or peripheral) and the characteristics of the plaque itself. It is likely that the specific interactions between the arterial wall, inflammatory molecules, and coagulation in each type of plaque can be an important determinant in the histopathological composition of atherosclerosis and in its future stability. New studies to assess the influence of coagulation and the immune system on the atherogenesis of peripheral plaques will probably allow for the identification of more plaque subtypes with different characteristics that are responsible for different clinical scenarios. Understanding the role of coagulation and the immune system in atherosclerosis genesis and progression could help in choosing the right patients for future possible anti-inflammatory and dual pathway inhibition strategies.

The Medical University of Graz has enrolled the first patient in the DEEPER CHALLENGE clinical trial, a grant-supported study investigating early vessel recoil in below-the-knee treatments using Reflow Medical's Spur Peripheral Retrievable Scaffold System combined with drug-coated balloons. The prospective trial will enroll up to 40 patients with chronic limb-threatening ischemia, including those with diabetes and end-stage renal disease, with mandatory female representation of at least 50 percent per cohort. The study assesses mechanical vessel response through angiography within 15 minutes post-treatment, with secondary endpoints tracking major adverse limb events, mortality, and reintervention outcomes over twelve months, addressing restenosis challenges in complex lesion populations.

Drug-eluting resorbable scaffold was associated with high patency and low reintervention rates in this systematic review of predominantly observational studies. Nevertheless, additional large-scale randomized controlled trials are warranted for direct comparison between DRS and PTA and further investigation to establish long-term durability.

Stenting addresses the two principal limitations of balloon angioplasty alone: elastic recoil and flow-limiting dissection. By providing a scaffold, it maintains luminal diameter. The choice between primary stenting (planned) and provisional stenting (bailout for suboptimal PTA) depends on the vascular bed and lesion characteristics.

Drug-coated balloons (DCBs) are devices used for the treatment of both coronary artery disease (CAD) and peripheral artery disease (PAD). One of the hypothesized advantages of DCB angioplasty over stent implantation is that DCB angioplasty does not result in the presence of a permanent metallic scaffold in the vessel wall. However, DCB angioplasty also has some important limitations, such as a potentially lower efficacy compared with other modalities; therefore, the role of DCBs in the treatment of CAD and PAD is not fully defined. Over the past 20 years, many clinical trials have been performed to investigate the use of these devices for a variety of indications. In this Review, we describe the device design and mechanism of action of DCBs and discuss important procedural considerations for successful DCB use. We summarize the scientific and clinical evidence for DCB angioplasty in CAD and PAD. In addition, we highlight the recommendations for DCB use in clinical practice guidelines and provide perspectives on the potential future role that DCB angioplasty might have in the treatment of CAD and PAD.

Reflow Medical announced the enrollment of the first patient in the DEEPER CHALLENGE clinical trial at the Medical University of Graz. This investigator-initiated study evaluates early vessel recoil following below-the-knee treatment using the Spur peripheral retrievable scaffold system combined with a drug-coated balloon in patients with chronic limb-threatening ischemia. The trial will enroll up to 40 patients across two cohorts: those with diabetes and those with end-stage renal disease receiving hemodialysis, with balanced gender representation. The study addresses a critical gap by focusing on underrepresented patient populations experiencing complex lesion morphology and higher restenosis rates. Primary endpoints measure early vessel recoil via angiography within 15 minutes post-treatment, while secondary endpoints track major adverse limb events, mortality, and reintervention rates through 12 months, providing valuable insights for treating complex peripheral artery disease.

Sitting down in the CX Studio after presenting the results for the first time in Europe at CX 2026, Barco explains the thought process behind the “unique” SirPAD trial design, how the primary outcome of major adverse limb events (MALE) occurred in 8.8% of patients enrolled in the sirolimus-coated balloon group compared to 15% in the uncoated balloon group at one year, and how there was a statistically significant reduction in the composite key secondary endpoint of any unplanned target limb amputation or target limb revascularisation.

The Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC) guidelines were last updated in 2007 (TASC II) and represented the collaboration of international vascular specialties involved in the management of patients with peripheral arterial disease (PAD). Since the publication of TASC II, there have been innovations in endovascular revascularization strategies for patients with PAD. The intent of this publication is to provide a complete anatomic lower limb TASC lesion classification, including the infrapopliteal segment, and an updated literature review of new endovascular techniques and practice patterns employed by vascular specialists today.

Debulking with DCB reduces amputation risk and 12-month TLR in patients with FP-ISR, particularly those with long lesions (>20 cm) or occlusive lesions (Tosaka type III), in whom it may improve 12-month primary patency. However, the advantages require further confirmation because of the limited number of studies.

by S Zaghloul · 2026 — DCBs are angioplasty balloons coated with an antiproliferative drug—most commonly paclitaxel or sirolimus—that is released to the vessel wall during a brief ...

Orbital atherectomy is a minimally invasive interventional cardiology procedure designed to treat severely calcified coronary arteries that resist conventional treatments. The technique employs a specialized catheter with a rotating, diamond-coated crown that mechanically removes calcium buildup into microscopic particles, enabling successful stent deployment and restoring normal blood flow. When standard balloon angioplasty proves ineffective against dense calcium deposits, orbital atherectomy offers a precise mechanical solution for managing advanced coronary artery disease. This comprehensive guide examines how the procedure works, why calcified arteries require specialized intervention, the step-by-step procedural approach, and comparative analysis with alternative technologies such as rotational atherectomy and shockwave therapy, providing patients with essential information for informed decision-making regarding long-term cardiovascular health management.

Learn how Spur Peripheral Retrievable Stent System is designed to treat BTK lesions after predilatation, with clinical data on patency, limb salvage, and wound healing.

Even under extreme mechanical stress known to delay endothelial recovery, the CD31-coated stent preserved lumen geometry and flow comparable to a DES while achieving complete endothelial coverage without drug release. Higher minimum stent and mean lumen areas suggest maintained expansion and limited neointimal growth despite the absence of antiproliferative drug. These findings indicate that the CD31 coating preserves mechanical integrity and vascular compatibility even in a stringent injury model, warranting further evaluation under standard implantation (BAR ≈ 1.05) and high-bleeding-risk conditions. By promoting rapid vascular healing without an antiproliferative agent, this biomimetic approach may represent a path toward safer DAPT de-escalation in interventional cardiology.

Quantifying rat venous stent patency and endothelialization via histology and microscopy revealed complete patency with anticoagulation and pathological occlusions (RT, ISR) when withholding anticoagulation. This rodent model will facilitate the preclinical testing of future venous stents.

Murine models are widely used valuable tools to study deep vein thrombosis. Leading experts in venous thrombosis research came together through the American Venous Forum to develop a consensus on maximizing the utility and application of available mouse models of venous thrombosis. In this work, we provide an algorithm for model selection, with discussion of the advantages, disadvantages, and applications of the main mouse models of venous thrombosis. Additionally, we provide a detailed surgical description of the models with guidelines to validate surgical technique.