EJVES Short Reports

Introduction: The development of metastatic renal cell carcinoma (RCC) many years after a nephrectomy is not common but has been reported. A metastasis appearing as a hypervascular tumour, mimicking an arteriovenous malformation (AVM), is a highly unusual phenomenon, with a biopsy required for diagnostic confirmation. Surgery is an option for a solitary metastatic lesion amenable to complete excision, with proven survival benefits. However, widespread metastatic disease carries a very poor prognosis, and is best treated with systemic agents such as anti-angiogenic drugs or tyrosine kinase inhibitors...

Complete disruption of an expanded polytetrafluoroethylene (ePTFE) vascular graft is rare. This is a report of a case of a 70 year old man presenting with left shoulder dislocation, which was reduced immediately. Two weeks later, the patient presented with Rutherford 2b bilateral lower limb ischaemia related to the thrombosis of an ePTFE axillobifemoral bypass. The graft was implanted five years earlier for treatment of an aorto-enteric fistula secondary to an infected aortobifemoral bypass. A non-anastomotic pseudoaneurysm associated with complete disruption of the ePTFE graft was found...

INTRODUCTION: Approximately 40 cases of spontaneous rupture of the aorta have been described in the literature. Diagnosis can be challenging, and a high index of clinical suspicion enabling prompt treatment can be lifesaving. REPORT: This report presents the case of a 73 year old man who had three multilevel ruptures of the aorta at different times, all treated endovascularly. The patient had a good post-operative course, with no complaints during regular follow up...

No abstract text is available yet for this article.

INTRODUCTION: The parallel grafting technique (PGT) is a valuable alternative to prefabricated branched or fenestrated endovascular aortic repair. An often overlooked advantage of PGT is its unique adaptability to different anatomical challenges that might appear intra-operatively. REPORT: A 72 year old male patient presented with a 60 mm thoracic aneurysm, 59 mm juxtarenal abdominal aortic aneurysm, and 32 mm common iliac aneurysm (CIAA). Thoracic endovascular aortic repair plus endovascular aortic repair with bilateral renal artery chimneys and CIAA exclusion applying the sandwich technique was proposed...

Hybrid treatment is a well reported technique for tandem carotid artery disease. Herein, we present a previously undescribed technique to facilitate safe passage of a guidewire via the inflow limb of the Pruitt-Inahara shunt in the proximal common carotid artery. This technique helps to obviate the risk of causing dissection or intimal damage during retrograde access and carotid stenting in hybrid carotid procedures.

No abstract text is available yet for this article.

Introduction: Isolated dissection of the superior mesenteric artery (SMA) is rare and remains the most common reason for aneurysmal degeneration of the vessel. The treatment is challenging and not standardised. The purpose of this report is to demonstrate that coiling of the false lumen is a good alternative for dissecting SMA aneurysms. Report: A 50 year old male presented with a 3.3 cm dissecting aneurysm of the SMA and epigastric pain of moderate severity. More than 50% of the ileal arteries arose from the collapsed true lumen...

OBJECTIVES: Varicose vein operations are traditionally performed during the winter season because of supposed advantages during post-operative care. This prospective study aimed to investigate how, and on what grounds, patients and physicians time varicose vein surgery. METHODS: Unselected patients attending a consultation for varicose vein surgery at a Regional Hospital in Thun, Switzerland were asked to fill out an anonymous and standardised questionnaire to register the C of CEAP, age, and gender and to understand the drivers behind the timing of the actual intervention...

Introduction: The posterior approach to the lumbar spine is most commonly used to treat lumbar spine pathology. Vascular complications, although rare, have a high mortality rate. This is the report of an arterial lesion complicating a L5 hemilaminectomy and its surgical resolution. The need to remain vigilant for this condition, which requires prompt diagnosis and treatment, is emphasised. Report: A 31 year old woman was admitted to the neurosurgery department with L5 right-sided sciatica and an associated radiculopathy, and paraesthesia of the first toe of the right foot...

Introduction: Testicular ischaemia is a potential complication after endovascular aneurysm repair (EVAR), which has only rarely been reported in the literature. This is the report of a patient who presented with acute testicular ischaemia in the immediate post-EVAR period. Report: A 65 year old patient underwent EVAR for an aortic and bilateral iliac aneurysms. During the procedure, the right internal iliac artery was intentionally occluded to facilitate treatment of the common iliac aneurysm; however, the left internal iliac artery was preserved...

INTRODUCTION: Injury to the popliteal vessels during total knee replacement is rare but can lead to catastrophic outcomes. REPORT: An 81 year old female presented with Rutherford IIb acute left limb ischaemia (ALI) 13 years after total knee replacement. The polyethylene insert in the knee implant had dislocated from the other components and had moved into the popliteal fossa, leading to popliteal artery compression. She underwent emergency multidisciplinary surgery including removal of the polyethylene component, thrombectomy, and popliteal artery stenting, but major amputation was required...

Introduction: In patients with popliteal artery aneurysm lacking a suitable vein for bypass, prosthetic graft, or endovascular stent graft are alternative treatment options. However, durability is limited. Construction of an autologous spiral vein graft has previously been used to replace infected aortic grafts and arteriovenous fistulas. Technical summary: Five patients underwent surgery for popliteal arterial aneurysm with the spiral vein graft technique. Technical success was 100%...

Introduction: Secondary aorto-enteric fistula (AEF) after endovascular abdominal aortic aneurysm repair (EVAR) is a rare but potentially fatal disease. The aetiology and mechanisms are unclear. This study presents a patient who developed secondary AEF and type II endoleak five years after EVAR. Case: A 73 year old man underwent successful EVAR with a bifurcated aortic stent graft for a 5.5 cm infrarenal abdominal aortic aneurysm. The aneurysm sac showed no change in size for three years, then shrank 20 mm to 3...

Introduction: The vascular pathology of patients with type 1 neurofibromatosis (NF-1) is known. Aneurysms of the brachial artery in NF-1 patients are rare and surgical treatment remains a challenge. Report: A patient known to have NF-1 presented with swelling of the left arm. Computed tomography angiography showed a ruptured aneurysm of the brachial artery. Operative reconstruction was performed using reversed saphenous vein. Discussion: Up to now four cases had been published describing brachial aneurysms in NF-1 patients...

Introduction: Pseudoaneurysms of the renal artery are fairly uncommon and mostly asymptomatic. They develop mostly in the right renal artery and in female patients. Report: In this report, a female patient with an intraparenchymal renal artery pseudoaneurysm with one year follow up is described. She presented with non-specific abdominal pain. A computed tomography scan revealed hydronephrosis of the right kidney and a giant, intracapsular, contained rupture of a pseudoaneurysm of the right renal artery...

Objective: This study reports the case of a 72 year old male who presented with rhabdomyolysis and a symptomatic juxtarenal inflammatory abdominal aortic aneurysm (IAAA). He underwent open repair of his IAAA with a polytetrafluoroethylene graft using the transperitoneal approach. Results: The patient's aneurysm had significant inflammation with a thick rind of friable tissue overlying the native aorta. He had no history of autoimmune disease to serve as a potential trigger of his symptomatic IAAA...

No abstract text is available yet for this article.

Introduction: The aim was to describe possible management of a persistent gutter related type Ia endoleak after treatment of a symptomatic pararenal aortic aneurysm with the chimney endovascular technique. Report: A 77 year old man with a symptomatic 6 cm pararenal aortic aneurysm was referred. Computed tomography angiography (CTA) showed a pararenal aortic aneurysm with involvement of both renal arteries and extension up to the superior mesenteric artery. The patient underwent treatment by placement of triple chimney grafts and an abdominal stent graft...

No abstract text is available yet for this article.