The 5-year results of the COBEST demonstrated that the CS has an enduring patency advantage over the BMS in both the short and long terms. Furthermore, the CS showed acceptable patency rates for the treatment of more severe TASC C and D lesions, and patients who received a CS required fewer revascularization procedures. However, the choice of stent did not affect the rate of major limb amputations.

Background: Historically finding of portal venous gas (PVG) has been considered as an ominous sign and an indication for emergency surgery and reportedly has a high mortality rate. However, with the recent increasing use of imaging studies, cases of PVG associated with benign and non-life-threatening causes are increasing. The purpose of our study was to investigate the different aetiologies associated with PVG and their respective outcomes. Methods: A consecutive series of patients with PVG was identified in our group of tertiary hospitals in Western Australia over a 10-year period. Collected data included patients' demographic data, comorbidities, blood tests results, underlying aetiology of the PVG, patients' management and their outcomes. Results: During the study period of 2008 to 2018, 164 patients met the inclusion criteria. Male : Female 90 versus 74. Average age was 65.6. A diverse range of underlying causes identified broadly divided into thromboembolic events (n = 70), mechanical bowel obstruction (n = 29), inflammatory conditions (n = 37) and a wide range of other pathologies (n = 28). The overall mortality was 47.5%, however, varied depending on the underlying aetiology (14.3-72.8%). Conclusion: Our study demonstrates that PVG is not always a fatal sign and that mortality varies significantly depending on the aetiology. Both the patient's presenting history and the clinical findings have to be considered to recognize benign aetiology of PVG on computed tomography imaging and the treatment should be directed to the underlying disease with consideration of the high mortality rate of PVG associated with ischaemic bowel.© 2020 Royal Australasian College of Surgeons ANZ J Surg 90 (2020) 767-771ANZJSurg.com

Purpose: The present study aimed to determine the safety and efficacy of a drug-coated balloon inflated within a thin-strut self-expanding bare-metal stent in patients with severe and complex femoropopliteal occlusive disease. Methods: This prospective study used the Pulsar-self-expanding stent and Passeo-18 Lux drug-coated balloon in patients with severe and complex femoropopliteal occlusive disease. The primary endpoint was the 12-month primary patency, and the secondary endpoints included 24-month primary patency, assisted primary patency, secondary patency, and clinically associated target lesion revascularisation. Results: The study included 44 patients (51 limbs). The mean age of the patients was 67.6 AE 10.2 years, with 73% men. Chronic limb severity was classified as Rutherford Category III in 41% of the patients, stage IV in 31%, and stage V in 27%. Lesions were predominantly Trans-Atlantic Inter-Society Consensus (TASC 2007) D (51%) and C (45%), with 32 (63%) chronic total occlusions. Procedural success was obtained in all cases. The mean lesion length was 200 AE 74.55 mm (95% CI ¼ 167.09-208.01) with a mean number of stents per limb used of 1.57 AE 0.70 (95% CI ¼ 1.37-1.76). Distal embolisation occurred in two patients. The primary patency rates at the 12-and 24-month follow-up were 94% (95% CI ¼ 82.9-98.1) and 88% (95% CI ¼ 75.7-94.5), respectively. The assisted primary was 94% (95% CI ¼ 82.9-98.1) and secondary patency was 96% (95% CI ¼ 85.2-99.0) at 24-month follow-up. The cumulative stent fracture rate at the 24-month follow-up was 10%. Freedom from clinically driven target lesion revascularisation was 94% (95% CI ¼ 83-98%) at 12-month follow-up and 88% (95% CI ¼ 76-94%) at 24-month follow-up, with two patients requiring a bypass graft. Conclusion: Our novel approach involving the combination of a thin-strut bare-metal stent and a drug-coated balloon may be safe and effective, with sustainable and promising clinical outcomes up to 24 months after treatment.

Background. Several studies have reported worse outcomes in women compared to men after endovascular aneurysm repair (EVAR). This study aimed to evaluate sex-specific short-term and 5-year outcomes after EVAR. Methods. A total of 409 consecutive patients underwent elective EVAR from 2004 to 2017 at two tertiary hospitals in Western Australia. Baseline, intraoperative, and postoperative variables were examined retrospectively according to sex. The primary outcome was 30-day mortality (death within 30 days after EVAR). Secondary outcomes were 30-day composite endpoint, length of stay after EVAR, 5-year survival, freedom from reintervention, residual aneurysm size after EVAR, and major adverse event rate at 5-year follow-up. Results. A cohort of 409 patients, comprising 57 women (14%) and 352 men (86%), was analysed. Female patients were older (median age, 76.8 versus 73.5 years, p=0.017). Male patients were more likely to be past smokers (40.9% versus 22.8%, p=0.005) and have a history of coronary artery bypass grafting (11.2% versus 3.5%, p=0.042) and malignancy (24.1% versus 10.5%, p=0.014). No difference in 30-day mortality or composite endpoints was demonstrated for female patients compared with male patients (3.5% versus 0.3%, p=0.052 and 31.6% versus 27.8%, p=0.562, respectively). The Kaplan–Meier curves demonstrated similar 5-year mortality outcomes amongst male and female patients (p=0.928). Long-term survival analysis adjusting for covariates demonstrated no significant difference in long-term mortality, composite endpoints, and reintervention rate between sexes. Conclusion. This study found no significant differences in 30-day and 5-year outcomes between female and male patients treated with EVAR, implying that EVAR remains a safe treatment choice for female patients.

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