BRAVISSIMO: 12-month results from a large scale prospective trial.

The BRAVISSIMO study is a prospective, non-randomized, multi-center, multi-national, monitored trial, conducted at 12 hospitals in Belgium and 11 hospitals in Italy. This manuscript reports the findings up to the 12-month follow-up time point for both the TASC A&B cohort and the TASC C&D cohort. The primary endpoint of the study is primary patency at 12 months, defined as a target lesion without a hemodynamically significant stenosis on Duplex ultrasound (>50%, systolic velocity ratio no greater than 2.0) and without target lesion revascularization (TLR) within 12 months. Between July 2009 and September 2010, 190 patients with TASC A or TASC B aortoiliac lesions and 135 patients with TASC C or TASC D aortoiliac lesions were included. The demographic data were comparable for the TASC A/B cohort and the TASC C/D cohort. The number of claudicants was significantly higher in the TASC A/B cohort, The TASC C/D cohort contains more CLI patients. The primary patency rate for the total patient population was 93.1%. The primary patency rates at 12 months for the TASC A, B, C and D lesions were 94.0%, 96.5%, 91.3% and 90.2% respectively. No statistical significant difference was shown when comparing these groups. Our findings confirm that endovascular therapy, and more specifically primary stenting, is the preferred treatment for patients with TASC A, B, C and D aortoiliac lesions. We notice similar endovascular results compared to surgery, however without the invasive character of surgery.

Pseudoaneurysm of the anterior tibial artery: a complication of ankle arthroscopy.

The authors describe a case of pseudoaneurysm of the anterior tibial artery after ankle arthroscopy that was undiagnosed for more then 10 weeks. The pseudoaneurysm was resected and postoperative recovery was uneventful. Anterior tibial artery pseudoaneurysm is a rare complication of ankle arthroscopy and should be considered when a patient presents with a local swelling of the anterolateral ankle joint.

Chronic contained rupture of an abdominal aortic aneurysm presenting as a Grynfeltt lumbar hernia. A case report.

We report a unique case of chronic contained thoraco-abdominal aneurysm rupture presenting as a Grynfeltt lumbar hernia. A 79-year-old man presented with backpain and a bluish swelling in the left lumbar region in the presence of a non tender aortic aneurysm. CT scan confirmed contained rupture of a type IV thoraco-abdominal aortic aneurysm. The peri-aortic haematoma protruded through the lumbar wall causing a Grynfeltt lumbar hernia. The aneurysm was replaced through a thoraco-phreno-lumbotomy. The patient survived and is doing well six months postoperatively.

Ruptured femoral pseudo-aneurysm through the skin: a rare vexing complication following aortobifemoral reconstruction.

A man, aged 73, presented with a pulsatile mass in his left groin area after an aortobifemoral reconstruction 24 years ago. This case showed a femoral pseudo-aneurysm that evolved very quickly to rupture through the skin requiring emergency operative repair.

Endovascular stent graft treatment for iatrogenic arteriovenous fistulas after femoral catheterisation.

This article presents a case report of a 79-year-old patient who was suffering from a large femoral arteriovenous fistula and a stenosis of the external iliac artery and who was treated successfully with stent grafts. The fistula, which consisted of three parts, was caused by a percutaneous transluminal coronary angioplasty. Two Jo-stents and one Medtronic AVE stent were used to cover the fistula and to dilate the stenosis. This article also describes the possible causes of iatrogenic arteriovenous fistulas such as the technique of arterial puncture and its localisation. The treatment of iatrogenic arteriovenous fistulas with stent grafts is a safe alternative for surgery in patients who often suffer from multiple cardiovascular problems. It could become the treatment of choice in the future.

Streptococcus pneumoniae-infected aneurysm extending from a persistent lobar pneumonia: case report and review of the literature.

Presented here is the case of a 63-year-old patient with a Streptococcus pneumoniae-infected aneurysm extending from a persistent lobar pneumonia of the left lung into the thoracic aorta. The patient was successfully treated with surgery and high-dose penicillin, and he remained well at 6-month follow-up. A review of the English-language literature over the past 25 years revealed 22 cases of mycotic or infected aortic aneurysms due to Streptococcus pneumoniae; however, none of these cases resulted in a positive outcome for the patient. The characteristics of these cases are discussed.

Combined revascularization of coronary and femoral arteries, using the ascending aorta as inflow source.

A patient with severe coronary artery disease and leg ischaemia was successfully treated with a combined revascularization procedure. The coronary arteries were bypassed with three vein grafts, and the bilateral femoral arteries were bypassed with a Dacron graft using the ascending aorta as the source of inflow. The patient recovered well and experienced no angina or claudication two years later.

Aortic coarctation associated with an aberrant right subclavian artery.

We report a case of aortic coarctation associated with an aberrant right subclavian artery in a young male who was investigated for hypertension. Angiography, CT examination with multiplanar reconstruction and MRI were useful in delineating the extension of the coarctation and the exact anatomy of the aberrant right subclavian artery.

Small omphalocele with ileal prolapse through a patent omphalomesenteric duct. A case report and review of literature.

A patent omphalomesenteric duct is an uncommon condition. These lesions are prone to give a small bowel prolapse, which complicates the situation. We report 1 such patient. Early surgical management is necessary to prevent complications.