Introduction Female gender is considered a risk factor for worse perioperative outcomes following Fenestrated Endovascular Aneurysm repair (FEVAR). We hypothesized that women would have more unfavorable anatomy, increasing case complexity and leading to higher radiation doses. Our aim was to evaluate the effect of gender on radiation dose during FEVARs. Methods This single-center retrospective study was performed from 1/2015-2/2018. For patient data, linear model and stepwise variable selection algorithm were used. All dose measurements were log-transformed before analysis. Significance level for parameter estimates and corresponding 95% confidence intervals were all transformed back using an exponential function. P-value of less then 0.05 was considered statistically significant. All analyses were done in SAS 9.4 (SAS Institute Inc., Cary, NC). Results 169 FEVARs (45 women) were performed on a Philips Allura Xper FD 20 fluoroscopy system equipped with clarity technology. There was no difference in BMI or operative time between genders, p=0.9. The median RAK for women was significantly lower compared to men (1672 mGy vs. 2496 mGy), p less then 0.001. Women had on average a 28% total dose reduction after controlling for BMI, number of vessels fenestrated, operative time and type of device, p less then 0.001. The median fluorography and fluoroscopy doses for women were significantly lower compared to men (973 mGy vs. Meclofenamate Sodium price 1401 mGy and 659 mGy vs. 1008 mGy), resulting in a 24% fluorography dose reduction and a 38% fluoroscopy dose reduction for females, p less then 0.001. Conclusion FEVARs can be performed successfully in women with comparatively lower radiation doses.Purpose To assess the endograft displacement forces (DF), which quantify the forces exerted by the pulsatile blood flow on the vessel wall and transmitted on the terminal fixation site of the endograft after its deployment, in proximal landing zones (PLZs) of the bovine aortic arch variant. Methods Thirty healthy aortic CT angiographies of subjects with bovine arch configuration (10 per Type of arch, I to III) were selected for the purpose of the study. A 3D model of the aortic arch lumen was reconstructed. Computational fluid dynamics modelling was then employed to compute DF magnitude and orientation (i.e. x,y,z axes) in PLZs of each case. DF values were normalised to the corresponding aortic wall area to estimate equivalent surface traction (EST). Results DF were highest in Zone 0, consistently with the greater surface area. DF in Zone 3 were much greater than in Zone 2 due to a three-fold greater upward component (z-axis) (P less then .001), being therefore mainly oriented orthogonally to the aortic blood flow and to the vessel longitudinal axis in that zone. EST progressively increased from Zone 0 towards more distal PLZs, with EST in Zone 3 being much greater than that in Zone 2 (P less then .001). The same pattern was observed after stratification by Type of Arch. Conclusions The bovine arch is associated with a consistent fluid dynamic pattern, which identifies in Zone 3 an unfavorable biomechanical environment for endograft deployment.Objective Carotid revascularization, both endarterectomy (CEA) and transfemoral carotid artery stenting (TFCAS), are associated with an increased risk of adverse outcomes in patients >80 years of age. Transcarotid artery revascularization (TCAR) is a technique that combines surgical principles of neuroprotection with less invasive endovascular techniques to treat severe carotid stenosis. Data from a recent registry study comparing TCAR to that of CEA and TFCAS demonstrated no significant difference in outcomes between TCAR and CEA in patients >80 years old, and a significant reduction in stroke and composite outcomes between TCAR and TFCAS in patients >80 years of age. To add to these studies, a more in-depth analysis of demographic, procedural, and outcome factors is warranted for elderly patients >80 years undergoing TCAR. At our center, with a large volume of elderly patients based on local demographics, we expect there will be no significant effect of age on outcome measures between patients less then 80atients ≥80 years of age, the mean procedure time was 47 ± 12 minutes, clamp/flow reversal time was 4.7 ± 1.1 minutes, fluoroscopy time was 4.1 ± 1.6 minutes, and median LOS was 2.0 ± 1.0 days. Procedure time, clamp/flow reversal time, and fluoroscopy time were not significantly different between the age groups. However, there was a significant difference in the LOS, with patients less then 80 years of age demonstrating a median LOS of 1.0 ± 0.0 days (P = less then .001). Conclusion Our experience with TCAR confirms that it can be performed successfully in both symptomatic and asymptomatic high-risk elderly patients, with our series finding no incidence of perioperative cerebral ischemic event, MI, or death.Objectives In the current diabetes era, severe calcified femoral bifurcation lesions extending to the external elastic lamina are sometimes experienced and are technically challenging during conventional endarterectomy. We previously reported an alternative method, a decalcification technique with a Cavitron Ultrasonic Surgical Aspirator (CUSA), for calcified lesions. This study aimed to clarify the efficacy of CUSA decalcification technique. Methods Twenty-six limbs treated with CUSA decalcification from 2014 to 2017 were enrolled and evaluated hemodynamically with ankle brachial index (ABI) and morphologically with computed tomography angiography (CTA). ABI was measured every 6 months, and CTA was performed early after surgery and then annually thereafter. Curved planar reformation images and cross-sectional multiplanar reconstruction images obtained by CTA were employed to measure cross-sectional area of common femoral artery (CFA). Then, the time courses of ABI and CFA areas were analyzed. Results The operative indication was claudication in 80.8%, rest pain in 7.7%, and tissue loss in 11.5% of the cases. A concomitant profundaplasty was performed in 34.6% of the cases. One case of an intraoperative arterial wall perforation was experienced as a procedure-related complication. Hemodynamic success rate was 96.2% (preoperative ABI 0.37 ± 0.28, postoperative ABI 0.75 ± 0.15, p50% decrease in cross-sectional area. Conclusions CUSA decalcification is a safe and effective alternative method to treat heavily calcified femoral lesions with a good patency rate and a low restenosis rate.