European Society for Vascular Surgery

Rosalinda D’Amico interviews Prof. Kevin Mani on one of the key controversies in EVAR follow-up: is aneurysm sac shrinkage truly a marker of success, or can it sometimes provide false reassurance? They discuss the current definition of sac regression, the importance of timing and sac stability and whether sac shrinkage should influence surveillance strategies. The episode also explores the role of CTA versus duplex ultrasound and the future potential of volumetric and AI-based assessment in EVAR surveillance
References:
Tinelli G, D'Oria M, Sica S, Mani K, Rancic Z, Resch TA, Beccia F, Azizzadeh A, Da Volta Ferreira MM, Gargiulo M, Lepidi S, Tshomba Y, Oderich GS, Haulon S; SLIM F-U EVAR, Collaborative Study Group. The sac evolution imaging follow-up after endovascular aortic repair: An international expert opinion-based Delphi consensus study. J Vasc Surg. 2024 Sep;80(3):937-945. doi: 10.1016/j.jvs.2024.03.007. Epub 2024 Mar 8. PMID: 38462062.

In this episode of the ESVS Podcast, we explore air pollution as an often-overlooked risk factor for peripheral arterial disease (PAD).
We are joined by Professor Alberto Maria Settembrini. Professor Settembrini is a vascular surgeon in Milan in MultiMedica and Professor of vascular surgery at Unicamillus University in Rome. He is a co-author of a large Rome-based longitudinal study involving over 1.7 million individuals. The study shows that long-term exposure to PM2.5, NO₂, and black carbon is associated with increased PAD incidence, with stronger effects in males and people aged 55–69.
Professor Settembrini discusses the links between different pollutants and PAD, how pollution interacts with traditional risk factors (obesity, diabetes, smoking, hypertension), the underlying mechanisms, and practical advice for vascular specialists in daily practice.
During the episode, we also hear from Porto’s City Councillor for the Mobility and Transportation, Engineer Hugo Beirão, who shares the city’s efforts to improve urban health.
References:
1- Ravalli S, Musumeci G, et al. Chelation therapy in patients with cardiovascular disease: a systematic review. Journal of Clinical Medicine. 2022;11(4):1033. doi:10.3390/jcm11041033
2- Serra R, Abramo A, Ielapi N, Procopio S, Marino P. Environmental pollution and peripheral artery disease. Risk Manag Healthc Policy. 2021;14:2181–2190.
3- Liao SH, Chiu CS, Jang LH, Hu SY, How CK, Hsieh VCR, et al. Long-term exposures to air pollutants and risk of peripheral arterial occlusive disease: a nationwide cohort study in Taiwan. Front Cardiovasc Med. 2022;9:796423.
4- Gwon JG, Park JH, Kim JS, Seo HM. Exposure to long-term air pollution and incidence of peripheral arterial disease in the general population: a national population-based retrospective cohort study. [Preprint]. 2021.
5- Deng Z, Duan L, Wang K. Revisiting the association between air pollution and peripheral artery disease: evidence from Mendelian randomization analysis. Eur J Intern Med. 2025;132:164–166.
6- Di Blasi C, Nobile F, Settembrini AM, Stafoggia M, Davoli M, Michelozzi P, et al. Association between long-term exposure to air pollution and incidence of peripheral artery disease: evidence from a longitudinal study. Eur J Intern Med. 2025;132:113–117.

In this episode, we’ll focus on the final sections of the guideline, which deal with rupture, trauma, and post-operative complications. These are scenarios where decisions are often made under time pressure, evidence is limited, and outcomes can be profoundly affected by organisation of care, experience, and judgement.
Guests:
Prof. Anders Wanhainen
Dr. Carlota Fernández-Prendes
Prof. Athanasios Katsargyris

Welcome back to the ESVS Podcasts. This is Suzanne Stokmans, and you are listening to part 2 of the Q&A series on the ESVS 2026 Clinical Practice Guidelines on the Management of Descending Thoracic and Thoraco-Abdominal Aortic Diseases.
In this episode, we move from the general principles discussed in part 1 to disease-specific management. We’ll focus on acute thoracic aortic syndromes, chronic type B aortic dissection, and degenerative descending thoracic and thoraco-abdominal aortic aneurysms, conditions that make up a large part of daily aortic practice, where decision-making is often nuanced and time-critical.

Full names of guests:
Prof. Anders Wanhainen
Dr. Carlota Fernández Prendes
Prof. Athanasios Katsargyris.

In today’s episode, the first of this three-part series, we will discuss the opening section of the guideline: service standards and general considerations. Before moving to specific disease entities or operative strategies, the guideline deliberately starts with the fundamentals — how care should be organised, how patients should be assessed, and which general principles should guide our decision making.
Full names of guests:
Prof. Anders Wanhainen
Dr. Carlota Fernández Prendes
Prof. Athanasios Katsargyris.