Conclusions: This study demonstrates that CAS fractures are not associated with an increased risk of restenosis. The true incidence of stent fracture may be underestimated by x-ray analysis due to limited resolution and frequent artifacts. Additional methods to evaluate for subtle CAS frac- tures may assist in defining a more precise incidence and might lead to insight into the potential etiologies. Further evaluation with a larger study population and a longer follow-up both for stent integrity and its association with restenosis or adverse clinical outcomes is needed. Author Disclosures: M. Sarhan: None; S. L. Cavanagh: None; R. G. Molnar: None. Inferior Vena Cava Stenting: Technical Considerations, Early Outcomes, and Long-Term Durability Javairiah Fatima, MD, AbdulAziz AbdulAziz, Daniel G. Clair, MD. Cleveland Clinic, Cleveland, Ohio Objectives: Inferior vena cava (IVC) thrombosis is an uncommon condition but can cause devastating complications to those affected. Histor- ically, this has been treated with an open surgical approach, with high morbidity, and with angioplasty in more recent years. We describe technical aspects of IVC stenting in patients with recalcitrant chronic occlusive disease and evaluate its outcomes. Methods: We reviewed all of the patients treated in an endovascular fashion for venous pathology at our institution from 2005 to 2014 to iden- tify and include those with IVC stent placement. Clinical characteristics, treatment details, and outcomes data were collected using medical records. Primary end points were technical success, symptom resolution, freedom from reintervention, and patency rate at follow-up. Results: Twenty-eight patients (15 males), with mean age of 48 6 14 years, underwent IVC stent placement for 16 occlusions (four congenital) and 12 high-grade stenoses. Hypercoagulable state was noted in 14 pa- tients, seven of whom had malignancy. A previously placed IVC filter was present in 13 patients. Median time from onset of symptoms to presentation was 81 months (range, 3-480 months). Lytic therapy with alte- plase was performed in 12 patients for a mean of 2 6 1 days. Self-expanding stents (Wallstent) were used in the IVC in 22 patients, with adjunctive use of balloon-expandable (Palmaz) stents in seven patients. Technical success was 100%. At a median follow-up of 10 months (range, 0-56 months), thrombotic complications requiring reintervention occurred in four patients at 1, 4, 8, and 37 months. One patient died at 2 weeks secondary to under- lying malignancy. Freedom from reintervention, patency rate, and symp- tom-free survival rate at 2 years were 84%, 90%, and 80%. Conclusions: Endovascular stenting for chronic occlusive disease of the IVC is safe, effective, and durable, with minimal morbidity. The reinter- vention rate is low, with excellent outcomes. Author Disclosures: J. Fatima: None; A. AbdulAziz: None; D. G. Clair: None. Optimal Management of Renal Artery Aneurysms: Observation Versus Intervention Young Erben, Audra Duncan, MD, Adnan Rizvi, MD, Haraldur Bjarnason, MD, Manju Kalra, MD, Gustavo Oderich, MD, Mark Fleming, MD, Randall De Martino, MD, Thomas Bower, MD, Peter Gloviczki, MD. Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn Objectives: This study evaluated outcomes of treated renal artery an- eurysms (RAAs) and the natural history of observed RAAs. Methods: A total of 114 patients with RAA managed from 1994 to 2014 were retrospectively reviewed. Primary outcomes included morbidity and mortality of RAAs treated operatively (OP) with open and endovascular procedures and aneurysm growth rate and risk of rupture in patients managed nonoperatively (NOP). Secondary outcomes included renal artery patency and need for reintervention in the OP group and kidney function in the OP and NOP groups. Results: There were 49 OP patients (34 females) and 66 NOP (31 females). Three RAAs ruptured (sizes: 34, 36, and 41 mm). Mean aneurysm size was 26.8 6 8.9 mm (OP) and 13.6 6 5.2 mm (NOP; P < .001). A total of 57% of patients in OP were symptomatic, with flank pain (24%), he- maturia (18%), and severe hypertension (18%). Nine (19%) and 29 (60%) of OP patients had a RAA <20 and <30 mm, respectively. RAA location in the OP included the primary bifurcation in 28, main renal artery in 8, upper and lower segmental pole branches in 5 each, and middle segmental pole branch in 2. Operative management included RAA resection and saphenous vein graft (SVG) in 15, vein patch in 11, primary repair in 7, ex vivo reconstruc- tion in 7, Dacron graft in 2, internal iliac artery patch in 1, and endovascular coil embolization in 3. Mean renal ischemia time was 56 6 48 minutes (ex vivo: 151 6 27 minutes; not ex vivo: 40 6 27 minutes). The 30-day mor- tality was 0%. One patient had a nephrectomy at the time of repair due to venous injury, and a second one occurred at 3.7 months due to SVG occlu- sion. One patient underwent concomitant splenectomy. One patient’s oper- ation was aborted due inflammation from a previously ruptured and coiled RAA, who subsequently underwent definitive embolization. Complications included pancreatitis (n ¼ 1) and reexploration for small bowel obstruction (n ¼ 1) and bleeding (n ¼ 1). RAA reintervention was 0%. NOP RAAs were followed up for 76.8 6 54.4 months and had a growth rate of 0.3 6 0.9 mm/y. There were no ruptures and no conversions to OP. Kidney function in NOP remained stable (D glomerular filtration rate, 5.4 6 21.1 mL/min) but worsened in OP (D glomerular filtration rate, 5.9 6 23.5 mL/min; P ¼ .008). Conclusions: No RAA <34 mm ruptured. Because the rate of growth is slow and kidney function remains stable without repair, RAA <30 mm should be observed unless symptoms occur. Author Disclosures: Y. Erben: None; A. Duncan: None; A. Rizvi: None; H. Bjarnason: None; M. Kalra: None; G. Oderich: None; M. Fleming: None; R. De Martino: None; T. Bower: None; P. Gloviczki: None. A Comparison of Results With Eversion Versus Conventional Carotid Endarterectomy From the Vascular Quality Initiative Joseph R. Schneider, MD, 1 Andrew W. Hoel, MD, 2 Irene B. Helenowski, PhD, 3 Cheryl R. Jackson, RN, 4 Michael J. Verta, MD, 4 Sung Ham, MD, 5 Scott E. Musicant, MD, 6 Nilesh H. Patel, MD, 4 Stanley Kim, MD 4 . 1 Surgery, Vascular and Interventional Program of Cadence Health, Winfield, Ill; 2 Division of Vascular Surgery, Northwestern, Chicago, Ill; 3 Northwestern University School of Medicine, Chicago, Ill; 4 Vascular and Interventional Program of Cadence Health, Winfield, Ill; 5 University of Southern California, Los Angeles, Calif; 6 Vascular Associates of San Diego, San Diego, Calif Objectives: Carotid endarterectomy (CEA) is usually performed with eversion (ECEA) or conventional (CCEA) techniques. Previous studies report conflicting results with respect to outcomes for ECEA and CCEA. We compared patient characteristics and outcomes for ECEA and CCEA. Methods: Deidentified data for CEA patients were obtained from the Society for Vascular Surgery Vascular Quality Initiative database. Patients undergoing reoperative CEA or CEA concurrent with cardiac surgery were excluded, leaving 2828 ECEA and 20,831 CCEA for comparison. Univariate analysis compared patients, procedures, and outcomes. Survival analysis was also performed for primary outcomes of mortality, cerebral ischemic events, restenosis, and reintervention. Results: Groups were similar with respect to gender, comorbidities, and preoperative neurologic symptoms, except that ECEA patients tended to be older (71.3 vs 69.9 years; P < .0001). CCEA was more often per- formed with general anesthesia (92% vs 81%; P < .001) and with a shunt (59% vs 24%; P < .001). Perioperative ipsilateral neurologic events (ECEA, 1.3% vs CCEA, 1.2%; P ¼ .90) and any stroke (1.0% vs 0.8%; P ¼ .38) were uncommon in both groups. ECEA tended to take less time (100 vs 113 minutes; P < .001) but more often required a return to the operating room for bleeding (1.4% vs 0.8%; P ¼ .003). Kaplan-Meier 30 day freedom from stroke or death was similar (97.7% vs 97.6%; P ¼ .17). The 1-year freedom from recurrent stenosis >50% was lower for ECEA (88.9% vs 94.1%; P < .0001). However, ECEA and CCEA both had a very high rate of freedom from reoperation at 1 year (99.6% vs 99.5%; P ¼ .98). Conclusions: ECEA and CCEA appear to provide similar freedom from neurologic morbidity, death, and reintervention. ECEA was associated with significantly shorter procedure times. Furthermore, ECEA obviates the expenses of a patch, typically used in CCEA, and a shunt, more often used in CCEA in this database. However, these potential benefits may be reduced by a slightly greater requirement for early return to the operating room for bleeding. Author Disclosures: J. R. Schneider: None; A. W. Hoel: None; I. B. Helenowski: None; C. R. Jackson: None; M. J. Verta: None; S. Ham: None; S. E. Musicant: None; N. H. Patel: None; S. Kim: None. Cost Analysis of Trellis Device Versus Catheter-Directed Thrombolysis for Lower Extremity Deep Vein Thrombosis Jacob H. Rinker, MD, Douglas Massop, MD, Hayden L. Smith, PhD, Piper Wall, DVM. UnityPoint Health e Des Moines, Surgical Residency Program, Des Moines, Iowa Objectives: This study assessed total costs for lower extremity deep vein thrombosis (DVT) treatment using the Trellis device or JOURNAL OF VASCULAR SURGERY Volume 60, Number 4 Abstracts 1101