[Management of carotid-jugular fistula: Case report and review of the literature]. / Prise en charge des fistules carotido-jugulaires : cas clinique et revue de la littérature.

We report here the management of an acquired left carotid-jugular fistula in a 29-year-old man. This patient was referred to us for a ballistic wound of the left cheek evolving since one month with the diagnosis of a carotid pseudo-aneurysm discovered on Doppler ultrasound. The clinical presentation was marked by cervical thrill in favor of an arteriovenous fistula confirmed by computed tomography angiography. The surgical exploration by cervicotomy revealed a communication between common carotid artery and internal jugular vein that were repaired using a saphenous vein patch and a lateral suture respectively without complication. The control at five months found an asymptomatic patient with good patency of the repaired vessels.

[Surgical treatment of a ruptured aneurysm of the left common iliac artery in a patient with miliary tuberculosis]. / Traitement chirurgical d'un anévrisme rompu de l'artère iliaque commune gauche chez un patient présentant une tuberculose miliaire.

Tuberculous aneurysms of the common iliac artery are rare. Only a few cases have been reported in the literature. We report a new case in a 47-year-old man admitted for abdominal pain and persistent fever. The aneurysm was evoked in the duplex ultrasound scan and confirmed by computed tomographic angiography. The patient underwent an extra-anatomic femorofemoral bypass with a dacron prosthesis and ligation of the aneurysmal artery. The postoperative course was marked by febrile dyspnea related to the tuberculous miliary found on the chest x-ray. Histological analysis of the operative specimens confirmed the tuberculous origin of the aneurysm. The patient was put on antituberculous drugs and the follow-up was uneventful. With a follow-up of four months, the patient was asymptomatic and the bypass was well patent.

[Dramatic evolution of a bilateral femoral artery aneurysm in a 16-year-old girl]. / Évolution dramatique d'un anévrisme bilatéral de l'artère fémorale chez une fille de 16 ans.

Femoral artery aneurysm is a rare entity among the vascular complications of Takayasu's disease. It is sometimes characterized by the risk of serious local complications with hemorrhagic or ischemic event, as well as by a big therapeutic handling difficulty. We report a case of bilateral femoral artery aneurysm in a 16-year-old girl having a dramatic evolution turn after surgical treatment and irreversible limb ischemia.

[Management of traumatic and iatrogenic arterial pseudoaneurysms in a tropical environment]. / Prise en charge des faux anévrysmes artériels traumatiques et iatrogènes en milieu tropical.

A false aneurysm or pseudoaneurysm (PA) is the formation of a pulsatile and encapsulated hematoma in communication with the lumen of a perforated artery. Its origin is different but most cases are associated with a traumatic event. Currently, the referenced treatment is endovascular surgery but it is not feasible for the majority of vascular surgeons working in a tropical environment. The aim of this study was to describe the diagnostic and therapeutic aspects of arterial PA (APA) encountered in our institution and to evaluate the place of open surgical technique in their management. This was a 30-month retrospective and descriptive study carried out in our institution (CHU-JRA, Antananarivo, Madagascar). Between 2012 and 2014, ten cases of APA were operated. There were 8 men with an average age of 30 years. The etiologies were accidental trauma (n=6) or iatrogenic vascular injury (n=4). Most patients had a painful and pulsatile swelling (n=8). The presence of a wound scar located on the swelling was observed in 5 patients. The false aneurysms were localized in the radial (n=3), femoral (n=2), brachial (n=2), carotid (n=2) and ulnar (n=1) arteries. The diagnosis was confirmed by ultrasound Doppler in all patients. The treatment was an open surgical procedure and consisted of lateral suture (n=4), resection with direct end-to-end anastomosis (n=1) or using autologous saphenous vein graft (n=2) or ligation (n=3). Postoperative courses and outcomes at last follow-up were uneventful with optimal patency rate.