The LS produces supraphysiologic seals with significantly higher bursting pressures than the PK in vessels ranging from 4 to 7 mm. The PK seals become progressively weaker while the LS seals increase in strength as the vessel size increases. Although thermal spread increases with vessel size, the degree of lateral thermal injury is no different between the two instruments.

No abstract

Follow-up surveillance after EVAR is less intense in practice environments outside of clinical trials. Patients with incomplete follow-up have higher fatal complication rates than patients with frequent follow-up. These data expose a potential under-appreciated limitation of EVAR, questioning whether the findings in clinical trials defining the efficacy of EVAR can be routinely extrapolated to ordinary practice.

Early failure after isolated endovascular intervention of the superficial femoral artery is infrequent and alters the distal target in 30% of early-failure patients if open bypass is planned. Salvage with repeat angioplasty, if necessary, can be accomplished in most patients, and the need for limb amputation is exceedingly rare. The early failure results in this study support a more liberal application of endovascular intervention to the superficial femoral artery in patients with lower extremity ischemia, especially claudication. The repercussions of late endovascular failure as well as the effects of disease progression need further study.