Absence of right common iliac vein causing suprapubic and scrotal varices in a young athletic man.

We have described the case of a 26-year-old man who had presented to his primary care physician with persistent, painful varices across his lower abdomen and bilateral tender scrotal varicoceles, which intensified with exercise. Thorough investigations revealed a congenitally atretic right common iliac vein with right-to-left collateralization of the femoral and internal iliac veins. This shunting resulted in the development of suprapubic and pelvic and gonadal varicosities, which provided a critical venous outflow pathway for his right lower extremity.

Low-Intensity Exercise Training Increases Heart Rate Variability in Patients With Peripheral Artery Disease.

Patients with peripheral artery disease (PAD), consistent with others with atherosclerotic occlusive disorders, have autonomic dysfunction (as measured by low heart rate variability [HRV]) that predisposes them to sympathetically mediated cardiac arrhythmias and sudden death. Exercise therapy has been shown to increase HRV in patients with coronary artery disease by increasing parasympathetic modulation of heart rate. This study quantified the circulatory and autonomic effects of a progressive, 12-week home-based, low-intensity (pain-free walking) exercise program in PAD and intermittent claudication.

Management of Major Vascular Injuries: Neck, Extremities, and Other Things that Bleed.

Vascular injuries represent a significant burden of mortality and disability. Blunt injuries to the neck vessels can present with signs of stroke either immediately or in a delayed fashion. Most injuries are detected with computed tomography angiography and managed with either antiplatelet medications or anticoagulation.

Remote Ischemic Preconditioning in High-risk Cardiovascular Surgery Patients: A Randomized-controlled Trial.

Remote ischemic preconditioning (RIPC) may reduce biomarkers of ischemic injury after cardiovascular surgery. However, it is unclear whether RIPC has a positive impact on clinical outcomes. We performed a blinded, randomized controlled trial to determine if RIPC resulted in fewer adverse clinical outcomes after cardiac or vascular surgery.