Lower extremity revascularization via the lateral plantar artery.

Lower extremity bypass grafts to the tibial and crural arteries are commonly employed to treat patients with atherosclerotic limb-threatening ischemia. Although occasional series have mentioned bypasses to a plantar artery, few of these specifically examine the results of arterial reconstructions using these vessels. Six patients underwent femoral to lateral plantar artery (LPA) bypass within a 19-month period for gangrene of the forefoot.

Traumatic juxtarenal aortocaval fistula and pseudoaneurysm.

We discuss the treatment of a fistula located between the aorta and inferior vena cava which was caused by trauma. Fewer than 30 such cases have been reported in the English literature. A juxtarenal pseudoaneurysm and aortocaval fistula resulting from a gunshot wound, unrecognized upon the initial presentation of the patient, is reported herein.

Primary venous aneurysms.

Venous aneurysms are rare lesions. They may, however, be the source of pulmonary emboli and can result in death. We have recently treated several patients who had venous aneurysms of the upper extremity and jugular system.

A technique for reducing the size discrepancy between large reversed veins and small arteries.

Autogenous vein remains the conduit of choice for lower extremity revascularization. When a large or dilated vein is used in a reversed manner, there may occasionally be a large size discrepancy between it and a small tibial artery. A technique is presented that reduces this mismatch and facilitates anastomoses between large veins and small arteries.

Abdominal aortic aneurysmectomy without preoperative angiography. A prospective study.

In an attempt to analyze whether routine angiography is necessary prior to elective abdominal aortic aneurysmectomy (AAA), a prospective study was designed in which this examination was obtained only for specific indications. These included significant hypertension, renal dysfunction, symptoms of visceral ischemia, suprarenal extension of the aneurysm or a coexisting thoracic aneurysm, and diminished or absent femoral pulses. A consecutive series of 124 abdominal aortic aneurysms is reported, in which 110 procedures were performed electively.