[Conventional open surgery of a splenic artery aneurysm following failure of endovascular management].

The clinical case of a 73 years old man is reported, complaining for a long time of a persistent abdominal pain in the left upper quadrants, without irradiation and no identified causative factor. These symptoms affected notoriously his quality of life, becoming disabling for his social and professional activities. The investigation by means of CT-scans disclosed a spheric mass, partially calcified, having 44x41mms of maximum size, located between the pancreatic tail and the splenic hilum.

[Abdominal angina due to fibromuscular dysplasia of the celiac axis. Surgical management].

The clinical case of a 27-year old man with the diagnosis of chronic mesenteric ischemia ("abdominal angina") is reported, whose chief complaints were severe postprandial pain and remarkable weight loss, for the last 4 months. Following na inconclusive observation in gastroenterology, he underwent an angiographic-CT examination, that disclosed a critical stenosis at the origin of the celiac axis. The remaining digestive vessels, superior and inferior mesenteric arteries, were found free of lesions.

[Chronic mesenteric ischemia revisited].

The authors report two clinical cases of rare and complex situations - an aortic dissection and an aortitis -, which had as a common denominator a chronic mesenteric ischemia. They discuss the indications and surgical strategies adopted.

[Surgical management of a spontaneous dissection of the celiac axis caused by fibromuscular dysplasia. First clinical report].

The clinical case of a 46 years old male is reported, who complained of a sudden and sharp epigastric pain, with no other accompanying symptoms or signs. The patient was evaluated in the emergency department of a local hospital and the clinical and laboratory analysis excluded the occurrence of a common acute abdominal pathology. A CT and an angio CT study disclosed a spontaneous dissection and aneurismal dilatation of the celiac axis, along its extension.

["Ex-vivo" surgical repair of renal artery branches aneurysms].

The authors report the clinical case of complex aneurysms of intra-hilar branches of the renal artery, managed recently through a renal auto-transplantation procedures with "ex-vivo" repair, discussing the technique, the principles and the indications for this kind of procedure.

[Secondary aortoenteric fistula, multidisciplinary surgical management].

The authors report the clinical case of a 77-year old man, who underwent the surgical treatment of an abdominal aortic aneurism 11 years before, admitted in the hospital emergency department complaining of abdominal pain and melena. Clinical and laboratorial findings, together with CT-scan and endoscopy data, lead to the diagnosis of secondary aortoenteric fistula. This is a rare clinical entity, coursing with high morbimortality levels of and is still one of the most controversial issues in vascular surgery.

[Synchronous revascularization surgery of supraaortic trunks and abdominal visceral arteries. Case report].

The clinical case of a 50 years old female is reported, who was admitted at our hospital in very poor general condition, in a physical and psychologic state of exhaustion, due to a mesenteric vascular insufficiency syndrome (abdominal angina), for the last three years. She underwent a conventional angiographic evaluation, disclosing an occlusion of both the celiac axis and superior mesenteric artery and at the level of the aortic arch, an occlusion of the innominate artery associated to an ostial stenosis of the left common carotid artery was also found. The coronary circulation was normal.

[Large post traumatic internal carotid artery aneurysm simulating a neurogenic tumor. Surgical management].

The clinical case of a 60 year old female is reported who, incidentally, had the diagnosis of a retropharyngeal tumor, causing the anterior dislocation of the right tonsil. Imagiological studies (CT and NMR scans) were compatible with the diagnosis of "neurogenic tumor" or "vagal paraganglioma" and an attempt to a biopsy was failed, having collected only blood. An angio-RM allowed the definitive diagnosis of a large sacular aneurysm of the internal carotid artery, of unknown etiology.

[Reconstructive surgery of deep veins of the lower extremities: the Palma operation revisited].

It has been grossly estimated that one fifth of the patients with post thrombotic chronic venous diseases suffer from obstructive or hypertensive symptoms, due to a failure of the physiologic repermeabilization mechanisms. In clinical practice, only a small group of these patients, with disabling symptoms, fill the essential requirements for a deep vein reconstructive surgery. The authors report the clinical case of a 27 years old male, with a chronic segmentar thrombotic occlusion of the right external iliac and common femoral veins, causing disabling symptoms to his normal professional activity.

[Non-atherosclerotic lower limbs ischemia in young athletes].

Although rare, the iliac endofibrosis and the popliteal artery entrapment syndrome are undoubtfully recognised as causes of intermittent claudication in young patients, particularly in athletes. The authors report the clinical case of a young female athlete, with disabling claudication of the right lower limb due to a stenosis of the external iliac artery and a case of an acute ischemia in a male cyclist owing to an extrinsic compression of the popliteal artery by anomalous muscular bundles. Both cases underwent successful surgical management.

A new approach for the surgical management of unilateral iliac artery occlusive disease: the iliofemoral crossover transposition.

Aortobifemoral bypass remains the standard therapy for aortoiliac occlusive disease. Extraanatomic revascularization has been considered as an acceptable alternative and provides reasonable long-term results. Because some of the causes for its failure are related to the prosthetic material used, a technique that uses autologous material and is applicable in patients with unilateral common iliac lesions was developed.