Success and reliability of extrafemoral Exoseal vascular closure device: "Off-label" usage.

Aim: The aim of this study is to present the reliability and efficacy of Exoseal vascular closure device (EVCD) for closure of extrafemoral punctures. Materials and methods: All patients who were treated with EVCD following arterial endovascular treatment involving an extrafemoral puncture between April 2013 and January 2014 were examined retrospectively. This study included 11 patients (4 women and 7 men between the ages of 48 and 87 years; average age = 65 years). A total of 13 procedures were performed in 11 patients involving the following access routes: brachial artery (n = 5), popliteal artery (n = 4), and polytetrafluoroethylene graft (n = 4). Results: Twelve out of 13 EVCD procedures achieved technical success and procedural success. One minor and one major complications occurred. Both complications were revealed to be pseudoaneurysms, both in the brachial artery. Pseudoaneurysm of the minor complication was treated by Fibrin Sealant (Tisseel) injection guided by ultrasonography and the other pseudoaneurysm was treated by covered stent placement. Conclusions: The femoral artery is an essential access route of arterial endovascular procedures; however, in some cases, the extrafemoral arterial route is necessary. In this study, EVCD was found to be useful for closing extrafemoral arterial routes. This study had a limited number of cases and more large-scale studies are needed.

Can ultrasonography-guided aspiration and steroid injection treat reflux venous blood flow around symptomatic Baker's cysts? Our short-term experience.

OBJECTIVE: The aim of the current study was to investigate the efficacy of ultrasonography-guided aspiration treatment with concomitant steroid injection on relieving reflux blood flow in veins located next to symptomatic Baker's cyst. METHODS: All patients were examined by ultrasonography at administration and 1 month follow-up after intervention. Puncture and aspiration of the cyst, as well as injection of 1 ml dexamethasone were performed by the same radiologist. Compression on popliteal vein and vena saphena parva and the degrees of reflux before and after treatment were recorded. RESULTS: Twenty-six patients were included in the study. An overall reduction of the cyst's size was observed in all patients of the study group. Reduction of the cyst size is more evident during the 1st week, which was observed by a slight enlargement during the 1st and the 3rd months controls. CONCLUSION: Ultrasonography-guided puncture, aspiration and steroid injection seems to yield promising outcomes in terms of relieving venous reflux flow around simple Baker's cysts.

Autoimmune polyglandular syndrome-3C in a child.

Vitiligo is a chronic disorder that causes hypopigmentation in patches of skin. It occurs when the melanocytes, which are derived from neural crest, die or are unable to function. The precise pathogenesis is not yet fully understood but there is evidence suggesting it is caused by a combination of autoimmune, genetic, and neurohumoral factors. Autoimmune polyglandular syndrome (APS) is one of these diseases. APS has a rare incidence; its four subtypes are accompanied by multiple endocrine deficiencies. Autoimmune polyglandular syndrome-3C appears with autoimmune thyroid disease along with one of autoimmune pathologies of skin, neuromuscular system, and nervous system. We report a case of APS-3C in 12-year-old boy with generalized vitiligo, alopecia universalis, and Hashimoto thyroiditis that is the youngest of previous reported cases.