Harmonic Focus Versus Conventional Electrocautery for Femoral Artery Exposure: a "Direct" Comparison on the Same Patients.

Surgical access complications during endovascular aneurysm repair (EVAR) are reported relatively frequent. HARMONIC FOCUS® (HF; Ethicon Endo-Surgery Inc., Cincinnati, Ohio, USA) is a device developed to improve bleeding control and reduce heat-related damage stemming from surgical preparation. The aim of this study was to evaluate outcomes and safety of HF versus conventional haemostasis with electrocautery, both techniques used in the same patient. Five patients developed bilateral wound's thickening (13.9%) demonstrated at the CT scan, two of whom had no clinical manifestation while in three cases the thickening was associated with lymphocele (4.54%), 2 of which were in the side where the EC was used (5.5%), and 1 case (2.7%), in the HF applied side. One isolated lymphocele occurred at the left groin (2.7%) (tables n.2-3). A Fisher's exact test was conducted between EC and HF on the occurrence of wound healing complications (3/36 for EC and 1/36 for HF) that resulted statistically significant at p<0.05. Focus Harmonic Scalpel has certain advantages than conventional haemostasis in avoiding surgical access complications.

Double-Microcatheter Technique through Tortuous Anatomy for Coil Embolization of a Saccular $plenic Aneurysm: a Technical Report.

We report on a case of an asymptomatic splenic artery aneurysm (SAA) with a large neck in a 53-year-old female with an extreme vessel tortuosity which was treated with a Double Microcatheter Technique. This endovascular procedure consists of embolization of the aneurysm using detachable coils with no application of any glue, stent or balloon. At the end of procedure, no complications occurred. At the three-month follow-up an MRI showed the aneurysm's complete exclusion and patency of the splenic artery.