European Journal of Vascular and Endovascular Surgery
To assess the effect of oral treatment with micronized purified flavonoid fraction (MPFF) on leg ulcer healing.Meta-analysis of randomised prospective studies using MPFF in addition to conventional treatment.Five prospective, randomised, controlled studies in which 723 patients with venous ulcers were treated between 1996 and 2001 were identified. Conventional treatment (compression and local care)...
We report a case of a chronic ruptured abdominal aortic aneurysm (AAA). The patient had back pain for 2 months. On examination, there was a pulsatile mass in his abdomen with no other abnormalities. Abdominal CT scan showed a retroperitoneal hematoma and vertebral body erosion. At operation, we found a retroperitoneal pseudoaneurysm due to a rupture in the posterior wall of an AAA. We repaired the...
Ehlers–Danlos syndrome (EDS) is a hereditary disorder of the connective tissue. Ten different types of EDS have been described, most of which are associated with skin hyperflexibility and joint hypermobility. The type most frequently encountered by surgeons is the arterial ecchymotic type, or type IV. The phenotypical variance that characterizes EDS can make recognition difficult. The diagnosis is...
The aim of this study was to analyse the results of brachiocephalic fistulas for haemodialysis and to determine possible predictors of failure.Between April 1999 and September 2004, a consecutive series of 100 autologous brachiocephalic fistulas were created in 96 patients. There were 57 men and 39 women with a mean (SD) age of 59.2 (15.6) years. Data were prospectively gathered.The mean (SD) follow-up...
The infection of an endoluminal stent graft (ESG) for AAA repair is unusual. We report the successful management of this serious complication with an open in situ graft replacement and omentopexy.
True aneurysms of the superficial temporal artery are rare in contrast to false aneurysms of the superficial temporal artery. We report a case of a true aneurysm that developed spontaneously in an HIV patient. The patient was treated with surgical excision of the aneurysm with an uneventful recovery. Histology revealed a true aneurysm. Clinical presentation and treatment as well as a review of the...
False aneurysms of the profunda femoris artery are usually associated with femoral fractures. We present a rare case of a patient who sustained blunt trauma to the thigh and developed a large haematoma with an underlying communication to the profunda femoris artery.
To compare the effect of unsupervised exercise, supervised exercise and intermittent pneumatic foot and calf compression (IPC) on the claudication distance, lower limb arterial haemodynamics and quality of life of patients with intermittent claudication.Thirty-four eligible patients with stable intermittent claudication were randomised to IPC (n=13, 3h/d for 6 months), supervised exercise (n=12, three...
We have previously shown that the operative competence of trainees can be reliably assessed using structured checklists and video recording. These assessments are useful for training (formative assessment). However, a standard setting exercise is required before they can be used for examinations (summative assessment).Blinded videos of a saphenofemoral disconnection by an experienced (competent) trainee...
We report 13 successful emergency embolisations for 12 pseudoaneurysms performed in 10 patients. For five pseudoaneurysms the embolisation technique was modified according to number of supplying vessels, flow rate of pseudoaneurysms, vascular anatomy and whether there was clinical evidence of re-bleeding or not. Apart from traditional embolisation technique, modified embolisation techniques are also...
Pseudoaneurysms of the inferior gluteal artery are rare. We describe a case of an inferior gluteal pseudoaneurysm that presented as a painful mass in the buttock. A percutaneous thrombin injection under ultrasound guidance failed to occlude the sac, probably due to the wide neck of the aneurysm. Subsequently, transluminal coil embolization by ultrasound-guided direct puncture of the inferior gluteal...
A 79-year old male patient was admitted with hemoptysis and anemia. Eight years previously he underwent wrapping of a thoracic aortic aneurysm. Magnetic resonance angiography (MRA) disclosed a thoracic aortic aneurysm, which was ruptured into the left bronchus. This was successfully treated with two endofit thoracic stent grafts.
To test whether the T variant of the C677T polymorphism in the gene for 5,10-methylenetetrahydrofolate reductase (MTHFR) would associate with three distinct forms of vascular disease, abdominal aortic aneurysm (AAA), coronary artery disease (CAD) and peripheral vascular disease (PVD).Increases in homocysteine induce elastolytic activity in the arterial wall, a condition which may favour vascular pathogenesis...
The isolated internal iliac artery aneurysm (IIIAA) is rare but rupture has a high mortality rate. This paper reviews the available literature regarding the epidemiology, aetiology, natural history, diagnosis and management with a focus on aneurysms of atherosclerotic origin.A literature search was performed using internet databases PubMed, Medline and Medscape followed by manual cross referencing...
We present two patients who presented with pain and swelling 3 weeks after a stab injury to the lower leg. Duplex scanning and arteriography revealed a pseudoaneurysm of a crural artery. Early diagnosis is important for a successful surgical reconstruction and delay in presentation may increase the risk of compartmental syndrome and subsequent soft tissue injury.
We present a case of a symptomatic obturator artery aneurysm. The patient was investigated for a possible rectal tumor. The final diagnosis was made during surgery, despite the presence of imaging studies. The operation consisted of simple ligation of inflow and outflow of the aneurysm. Satisfying early and long term result indicates that this is a sufficient operative procedure in such an aneurysm.
A retrospective review of the results of management of congenital vascular malformation (CVM) patients was made to assess the efficacy of newly introduced approaches.CVMs were categorised according to the Hamburg classification on the basis of minimally invasive tests. Invasive studies such as angiography are used to provide a road map for treatment. A new multidisciplinary approach was adopted, which...
Vascular injuries in a multi-trauma patient are associated with significant cardiovascular instability and organ injury. Injuries with active bleeding are best treated with a quick, safe and the least less invasive procedure available to the trauma surgeon. We report two cases of blunt trauma induced common and external iliac vessel injury, managed by endovascular treatment. In the second case, endovascular...