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Objectives: To confirm whether a relationship exists between male sex and coronavirus disease 2019 (COVID-19) mortality and whether this relationship is age dependent. Patients and Methods: We queried the COVID-19 Research Network, a multinational database using the TriNetX network, to identify patients with confirmed COVID-19 infection. The main end point of the study was all-cause mortality. Results: A total of 14,712 patients were included, of whom 6387 (43%) were men. Men were older (mean age, 55.0AE17.7 years vs 51.1AE17.9 years; P<.001) and had a higher prevalence of hypertension, diabetes, coronary disease, obstructive pulmonary disease, nicotine dependence, and heart failure but a lower prevalence of obesity. Before propensity score matching (PSM), all-cause mortality rate was 8.8% in men and 4.3% in women (odds ratio, 2.15; 95% CI, 1.87 to 2.46; P<.001) at a median follow-up duration of 34 and 32 days, respectively. In the Kaplan-Meier survival analysis, the cumulative probability of survival was significantly lower in men than in women (73% vs 86%; log-rank, P<.001). After PSM, all-cause mortality remained significantly higher in men than in women (8.13% vs 4.60%; odds ratio, 1.81; 95% CI, 1.55 to 2.11; P<.001). In the Kaplan-Meier survival analysis, the cumulative probability of survival remained significantly lower in men than in women (74% vs 86%; log-rank, P<.001). The cumulative probability of survival remained significantly lower in propensity scoreematched men than in women after excluding patients younger than 50 years and those who were taking angiotensin-converting enzyme inhibitor or angiotensin receptor blocker medications on admission. Conclusion: Among patients with COVID-19 infection, men had a significantly higher mortality than did women, and this difference was not completely explained by the higher prevalence of comorbidities in men.

EVAR can be used for patients with a short aortic neck; however, it was associated with a significantly higher rate of early and late type I endoleaks, resulting in an increased use of proximal aortic cuffs for sealing the endoleaks.

Patients with HNA can be treated with EVAR, but with higher rates of early (intraoperative) type I endoleak and intervention. The midterm outcomes are similar to FNA.

Background: Open surgical closure and small-bore suture-based preclosure devices have limitations when used for transcatheter aortic valve replacement, percutaneous endovascular abdominal aortic aneurysm repair, or percutaneous thoracic endovascular aortic aneurysm repair. The MANTA vascular closure device is a novel collagen-based technology designed to close large bore arteriotomies created by devices with an outer diameter ranging from 12F to 25F. In this study, we determined the safety and effectiveness of the MANTA vascular closure device. Methods and Results: A prospective, single arm, multicenter investigation in patients undergoing transcatheter aortic valve replacement, percutaneous endovascular abdominal aortic aneurysm repair, or thoracic endovascular aortic aneurysm repair at 20 sites in North America. The primary outcome was time to hemostasis. The primary safety outcomes were accessed site-related vascular injury or bleeding complications. A total of 341 patients, 78 roll-in, and 263 in the primary analysis cohort, were entered in the study between November 2016 and September 2017. For the primary analysis cohort, transcatheter aortic valve replacement was performed in 210 (79.8%), and percutaneous endovascular abdominal aortic aneurysm repair or thoracic endovascular aortic aneurysm repair was performed in 53 (20.2%). The 14F MANTA was used in 42 cases (16%), and the 18F was used in 221 cases(84%). The mean effective sheath outer diameter was 22F (7.3 mm). The mean time to hemostasis was 65±157 seconds with a median time to hemostasis of 24 seconds. Technical success was achieved in 257 (97.7%) patients, and a single device was deployed in 262 (99.6%) of cases. Valve Academic Research Consortium-2 major vascular complications occurred in 11 (4.2%) cases: 4 received a covered stent (1.5%), 3 had access site bleeding (1.1%), 2 underwent surgical repair (0.8%), and 2 underwent balloon inflation (0.8%). Conclusions: In a selected population, this study demonstrated that the MANTA percutaneous vascular closure device can safely and effectively close large bore arteriotomies created by current generation transcatheter aortic valve replacement, percutaneous endovascular abdominal aortic aneurysm repair, and thoracic endovascular aortic aneurysm repair devices. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02908880.

Purpose: To report a prospective, multicenter, observational study (ClinicalTrials.gov identifier NCT01609621) of the safety and effectiveness of tibiopedal access and retrograde crossing in the treatment of infrainguinal chronic total occlusions (CTOs). Methods: Twelve sites around the world prospectively enrolled 197 patients (mean age 71±11 years, range 41-93; 129 men) from May 2012 to July 2013 who met the inclusion criterion of at least one CTO for which a retrograde crossing procedure was planned or became necessary. The population consisted of 64 (32.5%) claudicants (Rutherford categories 2/3) and 133 (67.5%) patients with critical limb ischemia (Rutherford category ≥4). A primary antegrade attempt to cross had been made prior to the tibiopedal attempt in 132 (67.0%) cases. Techniques used for access, retrograde lesion crossing, and treatment were at the operator’s discretion. Follow-up data were obtained 30 days after the procedure. Results: Technical tibiopedal access success was achieved in 184 (93.4%) of 197 patients and technical occlusion crossing success in 157 (85.3%) of the 184 successful tibial accesses. Failed access attempts were more common in women (9 of 13 failures). The rate of successful crossing was roughly equivalent between sexes [84.7% (50/59) women compared to 85.6% (107/125) men]. Technical success did not differ significantly based on a prior failed antegrade attempt: the access success rate was 92.4% (122/132) after a failed antegrade access vs 95.4% (62/65) in those with a primary tibiopedal attempt (p=0.55). Similarly, crossing success was achieved in 82.8% (101/122) after a failed antegrade access vs 90.3% (56/62) for patients with no prior antegrade attempt (p=0.19). Minor complications related to the access site occurred in 11 (5.6%) cases; no patient had access vessel thrombosis, compartment syndrome, or surgical revascularization. Conclusion: Tibiopedal access appears to be safe and can be used effectively for the crossing of infrainguinal lesions in patients with severe lower limb ischemia.

and symptomatic venous hypertension in the remaining 8 (40%). Technical success and resolution of the symptoms was achieved in all cases. Locations CS placements are summarized in the Table. The mean follow-up was 8.4 months, 3 cases (15%) of thrombosis occurred within the first 3 months of stent placement requiring percutaneous thrombectomy and percutaneous transluminal angioplasty (PTA). Three patients required PTA for restenosis. The overall primary patency, assisted primary patency, and secondary patency were 66%, 94%, and 100% at 12 months, respectively.Conclusion: Endovascular therapy with CS for CVOD is safe and effective in hemodialysis patients. In the present series, we demonstrated promising results with higher primary and secondary patency than angioplasty and bare-metal stents. CS placement should be considered in recalcitrant lesions; however, further prospective and randomized studies are necessary to determine whether CSs provide superior long-term results to those achieved with PTA and bare-metal stents.Objective: This study compared the late outcomes in patients who survived 30 days after endovascular aneurysm repair (EVAR) and open repair (OR) for ruptured abdominal aortic aneurysms (RAAA).Methods: Retrospective analysis was done of prospective data from all RAAA presented to our service from 1998 to 2009. Of 252 RAAA, 13 patients (5%) were treated nonoperatively (logistic issue, 2; poor prognosis, 10; death during CT scan, 1). Two patients had a nonrelated diagnosis (gastrointestinal bleeding and type A dissection). A total of 122 patients (49%) were treated by EVAR, and 115 (46%) with OR. The 30-day survival for EVAR and OR was 85% (103 of 122) and 67% (78 of 115), respectively. Mean follow-up was 43 Ϯ 34.3 months (range, 1-132 months). Loss to follow-up for EVAR was Ͻ1%; for OR, 12%.Results: The actual overall survival rate of all early EVAR and OR survivors was 62% (64 of 103) and 45% (43 of 78), respectively. Cumulative survival rates at 1, 3, and 5 years were 90%, 79%, and 69% for EVAR and 87%, 78% and 60% for OR, respectively.Conclusions: This first series of long-term results after EVAR vs OR for RAAA shows an at least equivalent cumulative survival rate of 69% vs 60% at 5 years. Taking into account the short-term mortality reduction of EVAR vs OR (14% vs 33%, relative risk reduction of 62%), EVAR for RAAA is superior to open repair from the perspective of long-term as well as shortterm outcomes. EVAR should become the standard of care for all RAAA in patients with suitable anatomy for EVAR.

The results support the use of PMT as a first-line treatment for ALI, providing a rapid reperfusion to the extremity, reduced procedure time, and an acceptable risk profile without compromising limb salvage.