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Background: The Nellix endovascular sealing system (EVAS) was a unique concept with regard to its sealing concept that failed, related to high migration rates. We investigated the changes in aortoiliac morphology during the cardiac cycle before and after EVAS using electrocardiography (ECG)-gated CT., Methods: Eight patients scheduled for EVAS were prospectively enrolled. ECG-gated CT scans were made pre- and postoperatively. Measurements were performed in the mid-systolic and mid-diastolic phases. Endpoints were changes in infrarenal aortoiliac morphology postoperatively compared to preoperatively and their changes in the cardiac cycle., Results: Both pre- and postoperatively, there were no changes during the cardiac cycle. EVAS caused an increase in neck diameter and surface in both phases ( p < 0.001). EVAS increased the luminal AAA volume ( p < 0.001), with a decrease in thrombus volume ( p < 0.001) in both phases and an increase in total volume ( p < 0.001) in the systolic phase. During follow-up, one patient presented with >5 mm migration. There were no differences in the movements of this patient compared to the remaining patients., Conclusion: The cardiac cycle had a very limited effect on the aortoiliac dynamics before and after EVAS and, therefore, there is probably not a role for ECG-gated CT in enhanced surveillance programs. EVAS itself has a significant impact on anatomy, particularly the neck diameter, length, and volumes of the AAA., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Leo H. Van Den Ham et al.)

Aim: To compare the results of semiclosed retrograde loop endarterectomy from the superficial femoral artery (SFA) and proximal femoropopliteal bypass grafting (FPBG) with a synthetic prosthesis., Material and Methods: From 2007 to 2011, at the Department of Vascular Surgery of Municipal Clinical Hospital No 15 named after O.M. Filatov we operated on a total of 97 patients with occlusive and stenotic lesions of the femoropopliteal segment, with 83 (86%) of them being men. The mean age of the patients was 62.7 ± 8.9 years. By the degree of chronic ischaemia the patients were subdivided according to the Fontain-Pokrovsky classification as follows: 52 (53.6%) patients had stage 2B ischaemia, 22 (22.7%) patients presented with stage 3, and 14 (14.4%) patients had stage 4. Nine (9.3%) patients were diagnosed with symptoms of acute ischaemia. Depending on the operative treatment performed, the patients were subdivided into two groups: Group I (n=56) comprising patients subjected to FPBG above the knee-joint fissure and Group II (n=41) consisting of those who underwent loop endarterectomy from the SFA., Results: Technical success was obtained in 97 (100%) patients. After the operation the average ankle-brachial index (ABI) amounted to 0.87 ± 0.22 in Group I and 0.83 ± 0.22 in Group II. One (1.8%) patient from Group I developed shunt thrombosis successfully treated by thrombectomy. In Group II after surgery we also observed 1 thrombosis (2.4%) of the desobliterated superficial femoral artery, treated by thrombectomy from the SFA. The remote results were followed up during 4-7 years. Primary patency in the group of patients undergoing FPBG amounted after 1 and 2 years to 73.1% and 63.2% (p<0.005), and after 3 and 4 years to 34.1% and 30.7% (p>0.05). In the group of patients after loop EAE from the SFA 1-, 2-, 3- and 4-year primary patency amounted to 92.1%, 74.6% (p<0.05) and 63.1%, 58.9% (p>0.05), respectively., Conclusion: Semiclosed retrograde loop endarterectomy (EAE) demonstrated better results both in the immediate and remote postoperative periods as compared with femoropopliteal proximal bypass grafting using a synthetic prosthesis.