Heparin-Bonded Expanded Polytetrafluoroethylene Is a Solution for Infrapopliteal Revascularization in the Absence of an Adequate Autologous Vein Graft.

Background: To analyze the outcomes of heparin-bonded expanded polytetrafluoroethylene (HePTFE) graft as an alternative conduit in infrapopliteal revascularization of chronic limb-threatening ischemia (CLTI) in the absence of an autologous vein conduit.

Methods: A single-center retrospective analysis of patients with CLTI submitted to infrapopliteal bypasses with autologous vein graft (VEIN group) or HePTFE graft (HePTFE group) was implemented. Primary end points were freedom from CLTI at 12 months and recurrence of CLTI at 3 years.

An Epithelioid Hemangioma Camouflaged As Radial Aneurysm.

Epithelioid hemangioma (EH) is an uncommon benign vascular lesion usually present as subcutaneous nodules in the head and neck area. Sometimes, these lesions can occur in the peripheral arteries, and when they do, they can be mistaken for aneurysmal dilatations of that respective vessel. We report a case of a 43-year-old male who underwent surgical recession of a radial aneurysm, which after anatomopathological examination, revealed an EH.

Evaluation of global limb anatomic staging system for patients with chronic limb-threatening ischemia treated with autogenous bypass grafts.

Objective: We evaluated the relationship of the global limb anatomic staging system (GLASS) stage with the clinical outcomes for patients with chronic limb-threatening ischemia (CLTI) who had undergone distal bypass with vein grafting.

Methods: We performed a single-center, retrospective analysis of patients with CLTI who had undergone distal bypass with vein grafting from January 2012 to December 2019. The primary end point was freedom from CLTI, including amputation-free survival, complete wound healing, and no ischemic rest pain.

RECURRENT VARICOSE VEINS FOLLOWING SMALL SAPHENOUS VEIN SURGERY: A 5-YEAR FOLLOW-UP DUPLEX ULTRASOUND STUDY.

Introduction: Chronic venous disease (CVD) of the lower limbs is a very prevalent medical condition with important socioeconomic repercussions. Small saphenous vein (SSV) incompetence, although less frequent than great saphenous vein (GSV) incompetence, presents a more challenging treatment, with higher rates of complication and recurrence.

Objectives: To determine the incidence and associated risk factors of varicose veins recurrence in patients submitted, for the first time and exclusively, to SSV surgery with 5 years of follow-up.

Behçet Syndrome and Crohn's Disease: What Are the Differences?

Unlabelled: Behçet syndrome (BS) is a variable vessel vasculitis that has pleiotropic manifestations. A 43-year-old male with a previous diagnosis of Crohn's disease (CD) presented with deep venous thrombosis and bilateral superficial femoral artery aneurysms. A diagnosis of BS was made, and the patient was treated aggressively with immunosuppressive therapy and bilateral bypass surgery, attaining a favourable outcome.

[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.

[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.

[Post EVAR rupture of an iliac artery aneurysm complicated with an iliac arteriovenous fistula. Clinical report].

Since the original description by Parodi in 1991, the aim of endovascular treatment of aortic and iliac aneurysms has been the prevention of rupture, with fewer risks than the conventional management. Much has been discussed about its technical feasibility, durability, and follow-up, however little emphasis has been given to the treatment of its emergent complications, namely the aneurysm rupture after endovascular treatment. The authors report the clinical case of a patient that underwent endovascular treatment of a left common iliac artery aneurysm four years before, which presented in the emergency department with symptoms suggestive of aneurysm rupture, together with high output iliac arteriovenous fistula.

[Large and extensive thoracoabdominal aortic aneurysm in a seropositive young woman, treated with the "simplified technique"].

The clinical case of a 37 years old female with the previous diagnosis of human immunodeficiency virus infection (HIV), under medical control, is reported, in whom an extensive and large thoracoabdominal aortic aneurysm was diagnosed (type II of the Stanley Crawford's classification), completely asymptomatic. The patient underwent surgical management, consisting in the resection of the aneurysm and prosthetic replacement, utilizing the "simplified technique", that was once again extremely well succeeded in this most demanding situation. The clinical and pathological features of this infection and the potential involvement in the pathogenesis of this uncommon aneurysm are discussed, according to the data published in the literature.

[Prosthetic revascularization of the midpopliteal artery through a posterior approach: a clinical experience].

Bypass grafting to the proximal or distal popliteal artery through a lateral approach is the most commum surgical technique used to treat patients with femoro-popliteal obstructive disease. We report all the patients who underwent a bypass graft to the midpopliteal artery through a posterior approach, in whom an autologous vein was not avalaiable, thus avoiding the use of a prosthetic graft implantation in to the infragenicular popliteal artery. Ten bypass grafts to the midpopliteal artery through a posterior approach were performed, for the last 6 years, in patients with critical limb ischaemia.

[High output heart failure due to an iatrogenic arteriovenous fistula after cardiac catheterization].

The occurrence of an arteriovenous fistula is a potential complication of cardiac catheterization. Most of these fistulas cause no harm. We report the clinical case of a 70 years old woman with high-output heart failure caused by an arteriovenous fistula (FAV) in the groin.

[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.

[An exceptional case of renal angiomyolipoma extended to the inferior vena cava. Successfull surgical management].

The clinical case of a 39 years old female is reported, with the diagnosis of tumor of the right kidney extending into the infra-hepatic vena cava, assuming the shape of a floating thrombus. The patient underwent right radical nephrectomy, followed by resection of the intra caval tumor. Both the procedure and post operative course were uneventfull.

[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.

[Thrombotic occlusion of an abdominal aortic aneurysm].

The clinical condition of a 78 years old male is reported, with a thrombotic occlusion of an abdominal aortic aneurysm, expressed by the acute onset of intermittent claudication of both legs, two months previously to the observation. On physical examination a pulsatile mass was observed in the abdomen, with no expansion, with 7 cms of diameter; femoral pulses were absent. CT-scans confirmed the clinical diagnosis, revealing the presence of a recent thrombus occluding the aortic lumen.

[Preoperative evaluation of superficial veins to be used in peripheral arterial revascularization surgery].

In this paper, the authors report their experience in the preoperative evaluation of the superficial veins of the lower limbs, using the color-coded Eco-Doppler, aimed at the evaluation of morphofunctional aspects of the veins, allowing an objective and reliable selection of the vein grafts to be used in peripheral arterial revascularization surgery. The advantages and disadvantages of the methodology are analysed and discussed, and they concluded by stating that the method can replace favourably the tradicional surgical exploration, avoiding the frequent unnecessary , unusefull or inconvenient surgical exploration for the veins assessment.

[Traumatic vasculo-orthopedic combined lesions: 18-years retrospective evaluation of epidemiology and risks factors for amputation].

This study was undertaken to assess retrospectively the epidemiology and risk factors for amputation of combined vasculo-orthopaedic traumatic lesions, during a 18-year period, from March 1987 to May 2005, comprising the review of the clinical charts of 149 patients. The series includes a predominance of male patients (84%) with an average age of 34 years. Eighty-five per cent of the lesions resulted from traffic accidents (49% velocipedes, 39% automobiles, 12% trampling), 10% were consequence of falls and 5% resulted from agriculture activities.

[Revascularization surgery of an anuric solitary kidney using the left colic artery as a free graft].

The thrombotic occlusion of one renal artery may become completely asymptomatic, due to the functionality of the contralateral kidney. However, in rare circumstances, such is the case of individuals with a solitary kidney, a situation of anuria and acute renal failure may constitute the main presentation of the condition. The authors report the clinical case of a 43 year old male patient, with the previous diagnosis of an infrarenal aortic occlusion and a single left kidney, who developed a thrombotic occlusion of the renal artery, with anuria and acute renal failure.