Subclavian-Brachial Bypass for Chronic Limb Threatening Ischemia Associated with an Old Motorcycle Accident

Chronic limb-threatening ischemia is rarely associated with previous traumatic injury. We present a case of a 28-year-old male with progressive digit ulcers, a weak pulse, cyanosis, and a cold limb. Eight months prior, he had a motorcycle accident resulting in a right clavicle fracture and brachial plexus injury. Computed tomography angiography revealed occlusion of the right subclavian artery near a surgically implanted reduction plate. The patient underwent an open subclavianbrachial bypass with a reversed saphenous vein graft. His postoperative recovery was uneventful. After 3 months, he had a euthermic right hand with a palpable pulse and his ulcers had completely healed. This case reinforces the need for patients with a neurological deficit in the upper extremity caused by blunt trauma to undergo thorough vascular examination to identify potential arterial injury and compromised perfusion.

Surgical Management of a Type II Extracranial Internal Carotid Aneurysm near to the Skull Base

True aneurysmal disease in the carotid arteries is very uncommon, but individuals with this pathology face the grave risk of thromboembolism, which may consequently lead to cerebrovascular accidents. Clinical knowledge remains relatively limited owing to its rarity. We present the case of a 41-year-old obese female with a type II right extracranial internal carotid artery aneurysm incidentally found during imaging work-up. She underwent open surgical reconstruction with an autologous interposition graft from the common carotid artery to the internal carotid artery at the base level of the skull. Her postoperative period was uneventful, and the patient was discharged on postoperative day five with aspirin. At 12 months of follow-up, the patient remained symptom-free without complications.

Surgical Management of a Type II Extracranial Internal Carotid Aneurysm near to the Skull Base

True aneurysmal disease in the carotid arteries is very uncommon, but individuals with this pathology face the grave risk of thromboembolism, which may consequently lead to cerebrovascular accidents. Clinical knowledge remains relatively limited owing to its rarity. We present the case of a 41-year-old obese female with a type II right extracranial internal carotid artery aneurysm incidentally found during imaging work-up. She underwent open surgical reconstruction with an autologous interposition graft from the common carotid artery to the internal carotid artery at the base level of the skull. Her postoperative period was uneventful, and the patient was discharged on postoperative day five with aspirin. At 12 months of follow-up, the patient remained symptom-free without complications.