INTRODUCTION In the context of chronic limb threatening ischemia (CLTI), the prognostic impact of angiosome-targeted revascularization and of the status of the pedal arch are debated. MATERIALS AND METHOD This series includes 580 patients who underwent endovascular (n=407) and surgical revascularization (n=173) of the infrapopliteal arteries for CLTI associated with foot ulcer or gangrene. The risk of major amputation after infrapopliteal revascularization was assessed by a competing risk approach. A subanalysis was made separately for patients who underwent endovascular or open surgical revascualrization. RESULTS At 2 years, survival was 65.1% and leg salvage was 76.1%. Multivariable competing risk analysis showed that C-reactive protein≥ 10 mg/dL, diabetes, rheumatoid arthritis, increased number of affected angiosomes and the incomplete or total absence of pedal arch compared to complete pedal arch were independent predictors of major amputation after infrapopliteal revascularization. Multivariable analysis showed increasing risk estimates of major amputation in patients with incomplete (SHR 2.131, 95%CI 1.282-3.543) and no visualized pedal arch (SHR 3.022, 95%CI 1.553-5.883) compared to complete pedal arch. Pedal arch was important even if angiosome-targeted revascularization was achieved Angiosome-directed revascularization in presence of complete pedal arch had a lower risk of major amputation (adjusted SHR 0.463, 95%CI 0.240-0.894) compared to angiosome-directed revascularization without complete pedal arch. In the subanalysis, among patients who underwent endovascular revascularization, complete pedal arch (SHR 0.509, 95%CI 0.286-0.905) and angiosome-targeted revascularization (SHR 0.613, 95%CI 0.394-0.956) were associated with a lower risk of major amputation. CONCLUSIONS Competing risk analysis showed that a patent pedal arch had significant impact on leg salvage and that the subset of patients undergoing endovascular procedure may most benefit of an angiosome-targeted revascularization. We report an innovative technique in a 82 year-old patient with a patent but infected right axillo-bifemoral (AxBF) bypass performed 7 years ago due to critical limb ischemia who underwent a semi-elective de novo left-sided composite AxBF bypass consisting of a central prosthetic PTFE segment and distal autologous limbs to the femoral regions (femoral crossover bypass vein to the right limb using femoral vein and jump-graft to the left femoral limb using great saphenous vein). Although AxBF bypass is not considered the „gold-standard” surgical composite revascularization procedure in the suprainguinal region, it can constitute an acceptable intervention in selected cases. BACKGROUND Peripheral atherectomy is utilised in the treatment of heavily calcified plaques from peripheral arterial lesions. Commonly reported complications include access site injury, perforations, dissections, embolism and retroperitoneal haemorrhage. PURPOSE We report the case of a 74-year-old Caucasian male who developed a 50x43x40mm saccular pseudoaneurysm in the native mid superficial femoral artery after TurboHawk atherectomy. METHOD We describe the diagnostic steps in identifying this complication secondary to directional atherectomy and the successful treatment of this pseudoaneurysm using a Viabahn stent graft. CONCLUSION Pseudoaneurysm is a rare complication associated with the procedure which must be followed up with repeat imaging. Symptoms such as limb pain or swelling, or increase in size of pseudoaneurysm should prompt timely assessment of atherectomy site. Stenting with a Viabahn stent has proven to be a viable and successful treatment option. OBJECTIVES The impact of presence of an IVC filter in patients undergoing stenting for symptomatic femoroiliocaval obstruction has not been explored in detail. This study attempts to fill this gap by evaluating clinical and stent related outcomes in such patients. The incidence of deep venous thrombosis (DVT) in this setting is also analyzed. METHODS A retrospective review of contemporaneously entered EMR data on initial ilio-caval stents placed in patients with an indwelling IVC filter (or placed post stenting) over a 15-year period from 2000 to 2015 was performed. A separate matched cohort that underwent initial stenting during the time frame, but which did not have an IVC filter was utilized as the control group. Clinical outcomes were evaluated through use of the venous clinical severity score (VCSS) and VAS pain scores. Incidence of deep venous thrombosis post stenting was also reviewed in both groups. Kaplan Meier analysis was used to assess stent patency post intervention while T-tests were used to exap (p=0.006). CONCLUSIONS Patients with an IVC filter in the setting of a femoroiliocaval stent tend to have an increased rate of deep venous thrombosis on the stented side. Additionally, an increased rate of reintervention secondary to instent restenosis was also noted. In light of this every attempt should be made to remove the IVC filter as soon as the need for the filter no longer exists. OBJECTIVE Hemodynamics has been known to play a major role in the development of intimal hyperplasia leading to arteriovenous fistula failure. The goal of our study is to investigate the influence of different angles of side-to-end radiocephalic anastomosis upon the hemodynamic parameters that promote intimal dysfunction and therefore intimal hyperplasia. METHODS Realistic 3D meshes were reconstructed using ultrasound measurements from distal side-to-end radiocephalic fistulas. The velocity at the proximal and distal radial inflows and at specific locations along the anastomosis and cephalic vein was measured through single examiner duplex ultrasound. A computational parametric study, virtually changing the inner angle of anastomosis, was performed. For this purpose, we used advanced computational models that include suitable tools to capture the pulsatile and turbulent nature of the blood flow found in arteriovenous fistulas. The results were analyzed in terms of velocity fields, wall shear stress distribution and oscillatory shear index. RESULTS Results show that the regions with high oscillatory shear index, that are more prone to the development of hyperplasia, are greater and progressively shift toward the anastomosis area and the proximal vein segment with the decrease of the inner angle of anastomosis. These results are specific to distal radiocephalic fistulas since they are subject to proximal and distal radial inflow. CONCLUSIONS The results of this study show that inner anastomosis angles approaching 60°-70° seem to yield the best hemodynamic conditions for maturation and long-term patency of distal radiocephalic fistulas. Inner angles greater than 90°, representing the smooth loop technique, did not show a clear hemodynamic advantage. Pulmonary artery dissection (PAD) is a rare and extremely dangerous disease with high mortality rates. It is one of the most serious complications of chronic pulmonary hypertension. It may be related to chronic pulmonary hypertension and pulmonary artery dilatation. Early diagnosis of pulmonary dissection is particularly important because of its high mortality. Once the symptoms worsen or severe deterioration of the disease occurs, imaging examination should be performed promptly for early diagnosis and timely treatment. BACKGROUND Although supervised exercise therapy (SET) is effective in improving walking distance among adults with symptomatic peripheral artery disease (PAD), some research suggests that individuals with comorbid PAD and type 2 diabetes mellitus (T2DM) may experience a blunted response to SET. It is unknown whether free-living sedentary time changes during SET, and if increases in sedentary time could, in part, explain poor response to SET. OBJECTIVES The purposes of this pilot study were to 1) determine if older adults with PAD (with and without T2DM) engaging in SET change their sedentary behavior; and 2) examine the relationship between changes in sedentary behavior and SET outcomes. We hypothesized that decreased sedentary time during SET would be associated with greater improvements in six-minute walk test (6MWT) total distance and other key SET outcomes. METHODS Participants (n = 44) initiating a 12-week SET program completed the six-minute walk test (6MWT), Short Physical Performance Battery, Walking Impairment Questionnaire, and accelerometer-assessed sedentary behavior at SET initiation, 6 weeks, and 12 weeks. RESULTS Participants’ mean age was 72.3 (7.1) years, mean ankle-brachial index was 0.71 (0.25), and 47.7% were female. On average, sedentary time did not change following SET, although there was substantial variability (-40% to +38% change in minutes of sedentary time/day). Participants with T2DM experienced greater improvements in claudication onset distance when compared to participants without T2DM (mean 35 m, p = .044, 95% CI 1.6 to 115.4 meters). Neither changes in sedentary time from baseline to 6 weeks (p = .419) nor T2DM (p = .154) predicted changes in 6MWT total distance from baseline to 12 weeks. CONCLUSIONS As SET availability increases, further examination of factors that may influence SET outcomes will help maximize benefits of this proven therapy. INTRODUCTION The Altura (Alt) endograft is a new design lacking the classic mainbody with the flow divider. Instead, 2 proximal D-shaped endografts form a round circumference in the aortic neck for secure sealing and land in the iliac arteries in across-limb fashion. The aim of this computational study was to compare hemodynamically this model to the classic-bifurcated (Bif) and cross-limb (Cx) endograft designs of equal total length. MATERIALS AND METHODS All 3D endograft models were created using the finite volume analysis application ANSYS CFX (Ansys Inc., Canonsburg, PA, USA). The Alt inlet was constructed as two opposing D-shaped sections. Flow was quantified by time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT) and helicity. The displacement forces were also compared for all models with computational fluid dynamics analysis. RESULTS The Alt design was associated with lower forces (range 4.0-5.9Ν) compared to Bif (4.17-6.15N) and Cx (4.43-6.53N). The 2-piece inlet site of the separated limbs of Alt has higher TAWSS that the uniform inlet segment of the Cx and the Bif model. Most importantly, the mid-and distal segment of the limbs in the Altura design present higher TAWSS in a greater area than the other two models. The inlet of the Alt design showed higher OSI than the other accommodations and similar or comparable OSI values along their mid- and distal limb segments. The range, location and values or RRT were comparable between the three models. Helicity in the iliac limbs is more prominent in the crossed accommodations (Alt, Cx). CONCLUSION Only small differences in the hemodynamic indices and displacement forces were detected between the Alt and classic accommodations. From this point of view, the Alt design could be theoretically considered not inferior to other widely used endograft configurations. BACKGROUND A rapidly expanding pandemic of the new coronavirus has become the focus of global scientific attention. Data are lacking on the impact of the pandemic caused by the severe acute respiratory syndrome coronavirus 2 on health-related quality of life among patients affected by primary antibody deficiencies (PADs). OBJECTIVE To identify factors impacting the health-related-quality of life (HRQOL) among Italian patients affected by PADs switched to remote assistance at the time of the coronavirus disease 2019 pandemic. METHODS The quality of life was surveyed in 158 patients with PADs by the Common Variable Immune Deficiency Quality of Life questionnaire, a disease-specific tool, and by the 12-item General Health Questionnaire, a generic tool to assess the risk of anxiety/depression. Since the beginning of the coronavirus disease 2019 epidemic, we shifted all patients with PADs to home therapy, and activated remote visits. Questionnaires were sent by email 4 weeks later. Common Variable Immune Deficiency Quality of Life questionnaire and 12-item General Health Questionnaire data scores were compared with the same set of data from a survey done in 2017.