ABSTRACT
Iliac vein aneurysm is a rare vascular abnormality. It has been reported as a primary aneurysm of unknown cause, or, when a cause could be identified, as a secondary iliac vein aneurysm. Occasionally, iliac vein aneurysm develops in association with distal arteriovenous fistula. Although venous aneurysms occur most commonly in the neck and central thoracic veins, they also have been reported in the visceral veins and the extremities.Herein, we present the case of a 34-year-old man in whom a giant external-iliac-vein aneurysm was incidentally found during the investigation of a post-traumatic femoral arteriovenous fistula. The aneurysm was surgically resected, the iliac vein was reconstructed by means of lateral venorrhaphy, and the patient had an uneventful, complete recovery. We discuss the origin of the aneurysm and our choice of surgical techniques.
Subject(s)
Aneurysm/surgery , Arteriovenous Fistula/surgery , Femoral Artery/surgery , Femoral Vein/surgery , Iliac Vein/surgery , Vascular Surgical Procedures , Vascular System Injuries/surgery , Wounds, Gunshot/surgery , Adult , Aneurysm/diagnosis , Aneurysm/etiology , Anticoagulants/administration & dosage , Arteriovenous Fistula/diagnosis , Arteriovenous Fistula/etiology , Femoral Artery/diagnostic imaging , Femoral Artery/injuries , Femoral Vein/diagnostic imaging , Femoral Vein/injuries , Humans , Iliac Vein/diagnostic imaging , Incidental Findings , Male , Stockings, Compression , Tomography, X-Ray Computed , Treatment Outcome , Ultrasonography, Doppler , Vascular System Injuries/diagnosis , Vascular System Injuries/etiology , Warfarin/administration & dosage , Wounds, Gunshot/complications , Wounds, Gunshot/diagnosisABSTRACT
According to the literature data, the prevalence of restenosis after carotid endarterectomy ranges between 6 and 36%. The etiological factor is intimal hyperplasia for early period, whereas it is atherosclerosis for late period. A 67-year-old male patient admitted to our clinic with a history of headache and minor stroke. His medical history was significant for right carotid endarterectomy 8 years ago. Recent Doppler ultrasound and digital substraction angiography revealed 75% stenosis and kinking corresponding to the segment distal to the endarterectomy region. Surgical endarterectomy is the treatment of choice in critical carotid stenosis. Endovascular therapy is primarily considered for patients if there is restenosis after carotid endarterectomy. However, the treatment modality is controversial in cases with concomitant carotid stenosis and kinking of internal carotid artery. We present our surgical approach to a case with significant stenosis and kinking of internal carotid artery. We performed a 6-mm-PTFE graft interposition between common and internal carotid artery and resection of the kinking segment.
