Endovascular techniques have been proposed as an alternative to open repair for lesions of the femoral bifurcation and origin of the deep femoral artery (DFA). Debulking prior to drug-coated balloon angioplasty might improve the technical success and patency. We report the case of a 51-year-old woman with resting foot pain, bilateral femoropopliteal occlusion, and thrombosis of the right DFA, with severe, diffuse, and heavily calcified atherosclerosis. Under locoregional anesthesia, the DFA lesion was recanalized and a ByCross rotational atherectomy system (ByCross Atherectomy Catheter©, Plusmedica) was used in combination with a drug-eluting balloon (DEB) angioplasty (IN.PACT Admiral©, Medtronic). Successful re-establishment of DFA patency was achieved with no evidence of residual stenosis, recoil or flow-limiting dissections. No periprocedural issues or complications related to the use of the ByCross device were observed. The day after the procedure, the patient was discharged on dual oral antiplatelet therapy. After six months of follow-up the duplex ultrasound demonstrated patency without hemodynamic restenosis. The treatment of DFA atherosclerotic disease with ByCross rotational atherectomy has not been previously reported. ByCross rotational atherectomy followed by paclitaxel-coated balloon angioplasty of the DFA appears to be useful in patients at high risk for open repair with severely calcified arterial disease.

OBJECTIVE:This study aimed to evaluate the outcomes of branch stent grafts for aortic arch pathologies, with proximal landing in zone 0. METHODS:This was a multicentre, prospective, clinical follow up, non-sponsored, nationwide study. Consecutive patients with aortic arch pathologies treated with branched stent grafts (Nexus stent graft system, Relay Branch, or Zenith Arch Branch Graft) from January 2022 to November 2025 were identified from a prospective database. The primary endpoint was 30 day mortality. RESULTS:Fifty one cases were identified from 11 centres. Patient age (mean ± SD) was 74.3 ± 7.8 (59 - 86) years, and 77% were men. Twenty eight patients (55%) had aortic aneurysms, 18 (35%) had chronic aortic dissection, 3 (6%) had penetrating aortic ulcers, and two (4%) had intramural haematoma. Thirty four patients (67%) were managed using the Nexus endograft, 14 (28%) with Relay, and three (6%) with Zenith. A total of 77 branches were included in the study, and 45 patients (88%) underwent supra-aortic vessel revascularisation surgery. Two patients (4%) died intraprocedurally. Technical success was achieved in 96% of cases. Minor strokes were recorded in nine cases (18%); 67% of these occurred after Relay Branch stent graft implantation (p = .027). Full recovery was observed in all cases. The 30 day technical success was 82%, and the total 30 day mortality rate was 18%. After 1 year follow up, the cumulative mortality was 22% and the cumulative reoperation rate was 16%. Despite the limited sample size, no statistically significant differences in mortality were found between endograft types. CONCLUSION:Endovascular treatment of aortic arch pathologies with branched endografts offers a minimally invasive treatment option for patients with prohibitive risk for open surgical repair, but it is not exempt from the occurrence of life threatening complications and short term mortality. Nevertheless, the 1 year results remain encouraging.

Background: This study examines the use of the E-liac stent-graft system for the endovascular treatment of aortoiliac or isolated common iliac aneurysms. Methods: Consecutive patients between January 2014 and December 2024 were included. Data on patient characteristics, clinical presentation, lesion features, procedural aspects, and follow-up outcomes were collected and examined. Complications during the perioperative period and subsequent reinterventions were also documented. Results: A total of 81 patients met the inclusion criteria (65 men, 80.2%, median age 71.2 ± 11.43 (range 61–86 years). Technical success was achieved in all cases. A total of 97 internal iliac arteries were revascularized; in 54 cases (66.7%), the endovascular technique was EVAR + unilateral iliac branch device (IBD), in 16 cases (19.8%), it was EVAR + bilateral IBDs, and unilateral isolated IBD was conducted in 11 (13.6%) patients. The median patient follow-up time was 64.7 months (range 1–120). During follow-up, the mortality rate was 22.2%, with an iliac branch patency of 90.1%. Buttock claudication was observed in five (6.2%) patients and nerve ischemia in one (1.2%). One type I endoleak (1.2%) occurred following endovascular treatment of an isolated common iliac artery aneurysm, and three type II endoleaks (3.7%) were observed; none of them were associated with aneurysm sac enlargement. Three type III endoleaks (3.7%) occurred due to disconnection of the iliac branch from the extension of the concomitant EVAR. Conclusions: This long-term study, with 11 years of follow-up, reports outcomes with the E-liac stent-graft for the treatment of aorto-iliac or iliac aneurysms and demonstrates that it can be safely applied with low mortality and reintervention rates, and high patency rates.

Background: This study examines the impact of the use of the combination of BeGraft and Solaris stent grafts on the outcomes during the covered endovascular reconstruction of aortic bifurcation (BS-CERAB) technique and extension to the iliac arteries. Methods: Consecutive patients with aortoiliac occlusive disease who underwent endovascular treatment using BS-CERAB between January 2020 and December 2023 were included. Patient demographics, symptoms, lesion characteristics, and procedural and follow-up details were collected and analyzed. Perioperative complications and reinterventions were also identified. Results: A total of 42 patients met the inclusion criteria (32 men, 76.2%, median age 72 years, range 59–85). Indications for treatment were intermittent claudication (42.9%) and critical limb ischemia (57.1%). Procedure success was achieved in all cases. The median patient follow-up time was 14 months (1–36). One patient died at a 10-month follow-up due to lung cancer. The mean pre-operative ABI increased from 0.37 ± 0.19 before intervention to 0.71 ± 1.23 post-operatively at 12 months (p = 0.037). The estimated primary patency rates at 3, 6, and 12 months were 90.5%, 85.7%, and 81.0% and primary assisted patency rates were 90.5%, 90.5%, and 85.7%, respectively. Secondary patency was 95.2% at 3 and 6 months and 90.5% at a 12-month follow-up. Active cancer (p = 0.023, OR 2.12 95%CI 1.14–3.25) was a risk factor for restenosis. Conclusions: This mid-term experience shows that the CERAB technique using the combination of BeGraft and Solaris stents grafts, for the endovascular treatment of severe aortoiliac atherosclerotic disease, may allow an effective reconstruction of the aortic bifurcation and iliac arteries related to high-patency and lower-reintervention rates.

BACKGROUND:Aortic aneurysms represent a chronic degenerative disease with life-threatening implications. In order for patients to comprehend health related information, it must be written at a level that can be readily understood.STUDY DESIGN:In January 2023, we searched "aneurisma aorta" and "endoprótesis aorta" terms on Google, Yahoo and Microsoft/Bing. The 31th websites provided by each search engine were analyzed. Four readability measures were used to evaluate websites regarding aortic aneurysm and their endovascular treatment in Spanish language: Flesch Index, Flesch-Szigriszt Index, Fernández-Huerta Index and grading Inflesz scale. The quality on information was evaluated by the HONcode seal, the DISCERN instrument and the JAMA benchmark criteria.RESULTS:180 websites containing the terms "aneurisma aorta" and "endoprótesis aorta" were analyzed. Among the websites retrieved, the mean Flesh index score (53.12 ± 6.09 and 47.48 ± 7.12, respectively; P = .019), the Flesch-Szigriszt index (56.39 ± 5.72 and 48.10 ± 8.33; P = .000), and the Fernández Huerta index (61.30 ± 5.59 and 53.19 ± 8.21; P = .000), corresponding to a "somewhat difficult" readability level. In addition, the Inflesz scale (2.62 ± .59 and 2.07 ± .61; P = .000) reported a "somewhat difficult" readability, higher for the websites regarding aortic aneurysm. The HONcode seal was only presented in websites regarding aortic aneurysm (16.7%), whereas none of the websites relating to aortic endoprostheses presented it (0%) (P = .000). Websites that presented the HONcode seal obtained higher DISCERN score (P = .000, 95% CI = 6.42-16.84) and JAMA score (P = .000, 95% CI = 3.44-11.32).CONCLUSION:Internet information on aortic aneurysms and aortic endoprostheses is too difficult to read for the general Spanish-speaking population and is lacking in quality.

La Facultad de Medicina de Valladolid, seis veces centenaria ha contado siempre con unos prestigiosos estudios en anatomía desde su fundación. Sin embargo, en los inicios del siglo XX se produce en la Facultad de Medicina de Valladolid un desarrollo espectacular en estos estudios de la mano del catedrático de Anatomía don Salvino Sierra y Val que logra obtener los recursos para crear una de las instituciones más prestigiosas de la universidad vallisoletana proporcionando medios, dependencias y profesores, que elevaron a un rango de alto nivel científico y docente los estudios de Anatomía. Se analiza en el trabajo la creación del Instituto Anatómico que llevaría posteriormente el nombre de su fundador y la figura del Profesor Salvino Sierra.

Angiología es una revista científica bimensual editada desde 1949. Está dedicada al estudio de las enfermedades vasculares, incluyendo todos los aspectos de la medicina vascular, el diagnóstico no invasivo, el tratamiento quirúrgico tradicional arterial y venoso, así como el mínimamente invasivo y/o endovascular.

PURPOSE:This study examines the use and impact of directional atherectomy with antirestenotic therapy (DAART) versus angioplasty plus Supera stent implantation on the outcomes during endovascular treatment of popliteal lesions in clinical practice. METHODS:Overall 143 consecutive patients (mean age 75.0±12.2 years, 72% male), with isolated atherosclerotic disease of the popliteal artery who underwent endovascular treatment using DAART therapy or percutaneous transluminal angioplasty (PTA)/Supera stenting of the popliteal artery between January 2016 and December 2021 were identified from a retrospectively database. Patient and plaque characteristics were collected. A propensity-score matched, case-control analysis was conducted to balance covariates between the group of patients who underwent DAART and the one treated by PTA/Supera stenting. RESULTS:A total of 51 patients (35.7%) showed severe claudication and 92 (64.3%) critical limb ischemia. There was a trend toward longer treated lesions (90.4±81 vs 72.5±5.3 mm, p=0.089) and more chronic total occlusions (60.5% vs 46.8%, p=0.058) in the PTA/Supera stenting group, although not reaching statistically significance. Moderate-to-severe calcification was present in most lesions treated (75.8% of DAART group, 80.2% of PTA/Supera stenting group, and 78.3% of total cohort). Among the 53 case-matched pairs of patients treated with DAART or PTA/Supera stenting, there were no significant differences in short-term outcomes, including rate of technical success (96.2% vs 98.1%, p=0.232), procedural success (88.7% vs 90.1%, p=0.251), distal embolization (1.9% vs 1.9%, p=0.178), dissection (5.7% vs 1.9%, p=0.268), perforation (3.8% vs 5.6%, p=0.163), hospital discharge (1.2±0.1 vs 1.0±0.1, p=0.325), 30 day minor (28.3% vs 32.1%, p=0.264) or major amputation rates (7.5% vs 3.8%, p=0.107), and 30 day mortality (1.9% vs 1.9%, p=0.173). At 1 year, there was no difference in primary patency (73.6% vs 77.4%, p=0.233), primary assisted patency (81.3% vs 84.9%, p=0.167), secondary patency (86.8% vs 92.5%, p=0.094), ipsilateral minor (35.8% vs 39.6%, p=0.472) or major amputation (9.4% vs 7.5%, p=0.186), ankle brachial index improvement (0.32±0.12 vs 0.37±0.37, p=0.401), or mortality (5.7% vs 5.7%, p=0.121) rate between patients who underwent DAART or PTA/Supera stenting for popliteal lesions. CONCLUSION:Twelve-month results following DAART technique or PTA/Supera stenting of atherosclerotic lesions of the popliteal artery are not different, regardless of patient and plaque characteristics.Clinical ImpactThe DAART technique for the treatment of popliteal artery atherosclerotic disease is presented as a "leave nothing behind" strategy with on-year clinical outcomes similar to ATP/Supera stenting.

A lo largo de la historia, el tratamiento de los enfermos ha tenido muchos enfoques. Al principio el tratamiento se realizaba por médicos que practicaban la cirugía. Más adelante existió una especialización del profesional que realizaba procedimientos quirúrgicos. En la edad media, existió una figura que era el barbero cirujano que trataba los enfermos sin grandes conocimientos ni formación técnica. A lo largo de los siglos estos barberos que coexistieron con cirujanos más científicos desaparecieron, especialmente al implantarse un sistema de formación para el profesional de la cirugía, hasta llegar al momento actual que el cirujano tiene una clara diferenciación y gran especialización

BACKGROUND:In order for patients to comprehend health related information, it must be written at a level that can be readily understood by the intended population. During 2021 the European Society for Vascular Surgery (ESVS) published a sub-section about information for patients into its Guidelines on the Management of Venous Thrombosis.METHODS:Nine readability measures were used to evaluate the patient educational material regarding venous thrombosis published by seven medical societies: ESVS, Society for Vascular Medicine (SVM), Society for Vascular Surgery (SVS), Vascular Society for Great Britain and Ireland (VS), Australia and New Zealand Society for Vascular Surgery (ANZSVS), Canadian Society for Vascular Surgery (CSVS) and American Heart Association (AHA).RESULTS:The mean reading grade level (RGL) for all the 58 recommendations was 10.61 (range 6.4-14.5) and the mean Flesch Reading Ease (FRE) was 56.10 (51.3-62.9), corresponding to a "fairly difficult" reading level. The mean RGL of the ESVS recommendations (11.45, 95% CI, 9.90-13.00) was significantly higher than the others. Post-hoc analysis determined a significant difference between the ESVS and the SVS (10.86, 95% CI, 9.84-11.91) recommendations (P=0.005). All the patient's education information published by the medical societies presented a RGL higher than recommended. The fifteen sub-sections of the information for patients included into the ESVS clinical guidelines presented a mean RGL above 9.5 points, revealing that no one (0%) was written at or below the recommended GRL. The mean FRE was 47.63 (28.2-61.6), corresponding to a "difficult" reading level.CONCLUSIONS:Venous thrombosis patient educational materials produced by leading medical societies have readability scores that are above the recommended levels. The innovative patient's information included into the ESVS venous thrombosis guidelines represents an important advance in the amelioration of the medical information for patients, but their readability should be improved to adapt the understanding to the general population.

Sr. Editor: La cirugía de enfermedades del arco aórtico tales como aneurismas y disecciones requiere intervenciones invasivas que incluyen derivación cardiopulmonar, perfusión cerebral selectiva, clampaje aórtico y parada circulatoria con hipotermia1. Por desgracia, a muchos de estos pacientes se les considera no aptos para reparación quirúrgica abierta y solo reciben tratamiento médico. El sistema de stent recubierto NEXUS (Endospan Ltd., Israel) está indicado para el tratamiento de pacientes de alto riesgo quirúrgico con enfermedad de la aorta ascendente y del arco aórtico2. Este dispositivo, que obtuvo la marca CE en marzo de 2019 para la reparación endovascular de patologías del arco aórtico incluidos aneurismas y disecciones, precisa anclaje en zona 0. El sistema de stent recubierto NEXUS es un dispositivo de doble módulo que se introduce a través de un sistema de liberación de...

Objective: The aim of the present study was to analyze and report the clinical presentation and treatment at a single center of bull horn vascular injuries (BHVIs) that had occurred during popular celebrations in the past four decades. Thus, we investigated BHVIs in a high-volume academic center in Spain. Methods: All the patients with a BHVI admitted between January 1980 and January 2021 were retrospectively enrolled in the present study. Data collection included demographics, injury profile, and outcomes. The primary outcome was in-hospital mortality. The hospital and intensive care unit lengths of stay, rates of reintervention, postoperative complications, and mortality were also analyzed. Data were collected from the electronic and/or digitized medical history records. Results: A total of 296 patients were included in the present analysis. The mean patient age was 33.4 years (range, 1791 years), and 93.9% were men. Of the 296 patients, 126 (42.6%) had experienced a complication, and 57 (19.3%) had required reoperation. The overall in-hospital mortality was 5.1%. The risk factors for mortality were arterial injury (odds ratio [OR], 5.11; 95% confidence interval [CI], 1.45-23.3; P=.009), injury to the abdominal region (OR, 3.45; 95% CI, 1.11-14.54; P=.038), American Society of Anesthesiologists classification IV (OR, 3.27; 95% CI, 1.87-17.83; P=.004), and age >65 years (OR, 3.13; 95% CI, 1.38-10.04; P=.001). Statistically significant differences were found between bull horn arterial injuries and arterial plus concomitant venous injuries in the intensive care unit length of stay (4.9 +/- 13.3 days vs 3.1 +/- 12.6 days; P=.024), hospital length of stay (12.0 +/- 8.2 days vs 10.1 +/- 6.3 days; P=.007), postoperative complications (45.2% vs 30.6%; P=.002), and mortality (3.4% vs 1.9%; P=.001). Conclusions: The morbidity and mortality from BHVIs have remained high for the past 40 years. Popular celebrations with bulls constitute an etiology of vascular trauma that can have dire consequences.

Background: Contrast-induced nephropathy (CIN) is a major inconvenience in the use of iodinated contrast media (ICM) and it is associated with a significant increase in morbidity and mortality and cost of hospitalization. Remote ischemic preconditioning (RIPC) is a noninvasive and cost-effective tissue protection technique that has showed to be beneficial in decreasing renal insult in patients receiving intravascular contrast. Aim: The primary outcome of this study is to evaluate the impact of RIPC on the incidence of CIN in patients undergoing endovascular aneurysm repair. Methods: Patients suffering from aortic aneurysm were recruited prior to the administration of ICM. Randomization was used to assign patients into the control/RIPC groups. Biochemical parameters determined renal function before and after surgery in immediate (24-72 hr) and at 30 days of follow-up. Results: Of the 120 patients included in the study, 98,3% were male. Mean age was 73 years (range: 56-87 years). Diabetes and chronic renal failure (considering estimated glomerular filtration [eGFR] <60) was present prior to administration of ICM in 29.16% and 38.33%, respectively. RIPC was applied in 50% (n = 60) of the patients. A total of 24.17% developed CIN regardless of fluidotherapy, RIPC, and other protective strategies. RIPC did not influence outcomes in terms of incidence on CIN, serum creatinine, urea, eGFR, or microalbuminuria in immediate postoperative period. However, the group of RIPC patients showed a statistically significant benefit in renal function in terms of serum creatinine (1.46 +/- 0.3 vs. 1.03 +/- 0.5; P < 0.001), urea (61.06 +/- 27.5 mg/dL vs. 43.78 +/- 12.9 mg/dL; P = 0.003), and an increase in eGFR (56.37 +/- 23.4 mL/min/1.73 m(2) vs. 72.85 +/- 17.7 mL/min/1.73 m(2); P = 0.004) at 30 days of follow-up. Conclusions: RIPC seems to be a reasonable, effective, and low-cost technique to alleviate effects of ICM on the renal parenchyma in endovascular aneurysm repair procedures during short-term postoperative period.

Patients unfit for open repair after development a postdissection aortic arch and thoraco-abdominal aneurysm after open ascending aortic replacement for type A dissection would have no other treatment options. We report the case of a 75-year-old man with a type A aortic dissection treated by ascending aortic replacement. The patient presented an enlargement of the downstream aorta and thoraco-abdominal aneurysm 6-months after. This patient underwent a three-stage surgical sessions, open surgery for extraanatomical supra-aortic trunks reconstruction, endovascular branched treatment of ascending, arch and descending aorta and another one to perform an endovascular fenestrated reconstruction of thoraco-abdominal and infrarenal aorta.

Background: The aim of this study was to analyze duplex ultrasound (DUS) and intraoperative angiography concordance for diagnosis of lower limb peripheral artery disease and its value for surgical planning. Materials and Methods: This was a prospective, observational study, including patients who underwent revascularization of the lower limbs during 2018, diagnosed by DUS only or combined with preoperative computed tomography (CT) angiography. The concordance between preoperative DUS or CT angiography and the intraoperative angiography was studied using the Cohen kappa coefficient (k). The degree of agreement between the DUS-based surgical plan and the final surgical technique was also evaluated. Results: Fifty-one patients were included, with mean age of 71.8 +/- 11.96 years (46-94); 23 had chronic kidney disease (45%). In 17 patients (34%), preoperative CT angiography was also performed. DUS showed a sensitivity of 100% (95% confidence interval (CI) [83.3-100%]), 80% (95% CI [50.21-100%,]), and 100% (95% CI [96.43-100%]) at the iliac, femoral, and popliteal sector, respectively, and a specificity of 93.55% (95% CI [83.29-100%]), 95.45% (95% CI [84.48-100%]), and 90.48% (95% CI [75.54-100%]) at the iliac, femoral, and popliteal sector, respectively. The positive predictive value for DUS was 60% (95% CI [7.06-100%]), 88.9% (95% CI [62.8-100%]), and 87.5% (95% CI [68.17-100%]) for the iliac, femoral, and popliteal sectors, respectively, whereas the negative predictive value was 100% (95% CI [98.28e100%]), 91.3% (95% CI [77.61-100%]), and 100% (95% CI, [97.37-100%]). The concordance between DUS and intraoperative angiography showed a k index of 0.587 (P = 0.000) in the iliac sector, 0.799 in the femoral sector (P = 0.000), and 0.699 in the popliteal sector (P = 0.000). The concordance between CT angiography/intraoperative angiography had a k index of 0.71 in the iliac sector (P = 0.0093), 0.566 in the femoral sector (P = 0.006), and 0.5 in the popliteal sector (P = 0.028). DUS-based surgical plan was accurate in 86% of cases (n = 44). Conclusions: Our experience suggests that DUS arterial mapping of the femoral and popliteal areas is better than CT angiography and can be considered as a unique preoperative imaging test during the surgical planning in patients undergoing a lower limb revascularization procedure.

Vascular calcification represents a group of several pathological states of differing aetiologies. Mönckeberg medial sclerosis is considered to be more widespread in the lower abdominal region and lower limbs. We present a 59-years-old male patient presented right foot gangrene. At physical exploration, femoral and popliteal pulses were presented and the ankle-brachial pressure index was 0.45, and the toe-brachial index was 0.33. The patient underwent distal angioplasty of anterior and posterior tibial arteries and due to inaccurate evolution a transmetatarsal amputation was required. Mönckeberg’s medial sclerosis is diagnosed with an ABI>1.1, however, questions have been raised about the validity and the role of ABI in diagnosis of Mönckeberg’s medial sclerosis. Colour-doppler vascular ultrasound allow a non-invasive technique widely available to detect vascular calcification and to differentiation between Mönckeberg’s medial sclerosis and the atherosclerosis-related lesions.

BACKGROUND:A pro-inflammatory state and a poor nutritional status have been associated with severity and prognosis of patients with peripheral arterial disease (PAD). The clinical applicability of the different pre-operative nutritional and inflammatory biomarkers in patients with critical limb-threatening ischemia (CLTI) was analyzed.METHODS:A retrospective observational study was performed, that included all patients with CLTI revascularized from January 2016 to July 2019. The inflammatory state was calculated using neutrophil/lymphocyte (NLR), lymphocyte/monocyte (LMR) and platelet/lymphocyte ratios (PLR). For nutritional status, the Prognostic Nutritional Index (PNI) was calculated. Mortality and number of major amputations at 6 months and hospital length-of stay were studied.RESULTS:310 patients were included. Higher levels of NLR and lower levels of PNI were associated with mortality (6.61±5.6 vs. 3.98±3.27, P=0.034; 40.33±7.89 vs. 45.73±7.48, P=0.05, respectively). Lower levels of PNI and LMR (42.57±7.82 vs. 45.44±7.65, P=0.036; 2.77±1.61 vs. 3.22±1.75, P=0.013, respectively) and higher levels of NLR (6.91±7.85 vs. 3.94±2.57, P=0.023) were associated with major amputations. The mean hospital length-of-stay was higher in patients with lower levels of PNI and LMR (P=0.000 and P=0.003) and higher levels of NLR and PLR (P=0.001 and P=0.002). A PNI<42.87 predicted short-term mortality with a 66.7% of sensitivity and a 66.8% of specificity (P=0.000).CONCLUSIONS:Our experience suggests that these inflammatory and nutritional biomarkers are independent predictors of short-term mortality and major amputations. In addition, our results suggest that PNI could be used to predict the short-term mortality with high sensitivity and specificity.

OBJECTIVES:To analyze the outcome of vascular procedures performed in patients with COVID-19 infection during the 2020 pandemic. METHODS:This is a multicenter, prospective observational cohort study. We analyzed data from 75 patients with COVID-19 infection undergoing vascular surgery procedures in 17 hospitals across Spain and Andorra between March and May 2020. The primary end point was 30-day mortality. Clinical Trials registry number NCT04333693. RESULTS:The mean age was 70.9 (45-94) and 58 (77.0%) patients were male. Around 70.7% had postoperative complications, 36.0% of patients experienced respiratory failure, 22.7% acute renal failure, and 22.7% acute respiratory distress syndrome (ARDS). All-cause 30-days mortality rate was 37.3%. Multivariate analysis identified age >65 years (P = 0.009), American Society of Anesthesiologists (ASA) classification IV (P = 0.004), preoperative lymphocyte count <0.6 (×109/L) (P = 0.001) and lactate dehydrogenase (LDH) >500 (UI/L) (P = 0.004), need for invasive ventilation (P = 0.043), postoperative acute renal failure (P = 0.001), ARDS (P = 0.003) and major amputation (P = 0.009) as independent variables associated with mortality. Preoperative coma (P = 0.001), quick Sepsis Related Organ Failure Assessment (qSOFA) score ≥2 (P = 0.043), lymphocytes <0.6 (×109/L) (P = 0.019) leucocytes >11.5 (×109/L) (P = 0.007) and serum ferritin >1800 mg/dL (P = 0.004), bilateral lung infiltrates on thorax computed tomography (P = 0.025), and postoperative acute renal failure (P = 0.009) increased the risk of postoperative ARDS. qSOFA score ≥2 was the only risk factor associated with postoperative sepsis (P = 0.041). CONCLUSIONS:Patients with COVID-19 infection undergoing vascular surgery procedures showed poor 30-days survival. Age >65 years, preoperative lymphocytes <0.6 (x109/L) and LDH >500 (UI/L), and postoperative acute renal failure, ARDS and need for major amputation were identified as prognostic factors of 30-days mortality.