Pseudoaneurysms: Different ultrasound patterns, aetiologies and locations.

Pseudoaneurysms are frequent vascular anomalies. This review article aims to describe the unique specific aspect of pseudoaneurysm (PSA) that allows to make the diagnosis using different modalities: colour Doppler ultrasound, computed tomographic angiography, magnetic resonance angiography and conventional angiography. It is essential to know the various aetiologies of PSA: iatrogenic, traumatic, dissecting and anastomotic; different locations and the possible complications, information to help clinicians choose the best treatment. Our review is supported by illustrated series of cases.

Cryoablation and Immunotherapy: An Enthralling Synergy for Cancer Treatment.

As less invasive options for surgical tumor removal, minimally invasive ablative techniques have gained popularity. Several solid tumors are being treated with cryoablation, a non-heat-based ablation technique. Cryoablation data in comparison over time demonstrates better tumor response and faster recovery. Combining cryosurgery with other cancer therapies has been explored to improve the cancer-killing process. Cryoablation with the combination of immunotherapy, results in a robust and efficient attack on the cancer cells. This article focuses on investigating the ability of cryosurgery to create a strong antitumor response when combined with immunologic agents resulting in a synergetic effect. To achieve this objective, we combined cryosurgery with immunotherapy using Nivolumab and lpilimumab. Five clinical cases of lymph node, lung cancer, bone, and lung metastasis were followed and analyzed. In this series of patients, percutaneous cryoablation and addressing immunity agents were technically feasible. In the follow-ups, there appeared to be no radiological evidence of new tumor development.

When There Is a Will, There Is Always a Way: Superior Vena Cava Recanalization Using a Hepatic Vein Access.

Superior vena cava (SVC) obstruction is a major complication of different benign, malignant, or iatrogenic etiologies. Angioplasty is the standard of care when conservative treatment fails. We hereby report a hepatic vein percutaneous access when conventional venous access fails or is not available to perform vascular recanalization in a young patient with SVC obstruction.

Radiation-induced rupture of the superficial femoral artery: a case report.

BACKGROUND: Radiation-induced necrosis and arteriopathy are well-known iatrogenic pathologic entities. However, radiation-induced rupture of the superficial femoral artery is an exceptional life-threatening event. REPORT: We hereby report a case of radiation-induced rupture of the superficial femoral artery that was successfully treated by fascial stitching then by an endovascular approach by stenting. RESULTS: Infection, skin stiffness, and major tissue loss in a previously irradiated field are important limiting factors to an open surgical approach. CONCLUSION: It is important to consider using a combined approach for selected patients.

Anterior spinal artery syndrome after percutaneous vertebroplasty.

BACKGROUND CONTEXT: Vertebroplasty is commonly performed for the management of pain associated with benign compression fractures, multiple myelomas, lymphomas, vertebral metastatic lesions, and hemangiomas. We describe a severe complication associated with this procedure; only one previous case has been reported in the literature. OBJECTIVE: To report a case of anterior spinal cord syndrome caused by a direct cement leakage in the arterial vessels after vertebroplasty. METHODS: A 20-year-old man who has been diagnosed with multifocal Ewing sarcoma for 5 months suffered from severe and chronic inflammatory polyarthralgia in the left knee, pelvis, and the low back. The imaging studies, X-ray and computed tomography scan, showed the presence of pathologic fractures of T8 and L1 vertebrae. There was no retropulsion of bony fragment in the vertebral canal. A percutaneous vertebroplasty of T8 and L1 level was performed. RESULTS: Immediately after the procedure, the patient experienced a total paralysis and loss of sensitivity to pain and temperature in both lower limbs; however, deep pressure sensation and two-point discrimination below the umbilicus were preserved. Computed tomography scans showed no leakage of polymethylmethacrylate of T8 and L1 vertebral bodies, with opacification of the right intercostal artery at the L1 level and a segment of the anterior spinal artery at the T10-L1 level. CONCLUSIONS: Although percutaneous vertebroplasty has many benefits, including its simplicity and relative safety, it could lead to serious complications. The current case demonstrates the direct leakage of cement within the anterior spinal artery leading to an irreversible paralysis. The clinicians should be aware of such complications to happen and explain it to their patients.

[Surgical treatment of mesenteric venous thrombosis]. / Traitement chirurgical d'une thrombose de la veine mésentérique.

INTRODUCTION: Mesenteric venous thrombosis is a rare form of mesenteric ischemia that can be lethal when appropriate treatment is delayed. CASE: A 61-year-old woman consulted with nonirradiating epigastric and left upper abdominal pain, nausea and vomiting, all of which had been increasing for 4 days. Two years earlier, she had had phlebitis and a pulmonary embolism. Her white blood cell count was 15,300/mm3. Abdominal computed tomography (CT) showed thrombosis of the superior mesenteric vein with no evidence of intestinal parietal ischemia. The patient received a full dose of heparin promptly and underwent selective intra-arterial thrombolysis. As her clinical condition deteriorated, an emergency laparotomy was performed to resect 1.5 meters of gangrenous jejunum. Full anticoagulation with heparin was resumed postoperatively, and she was discharged 15 days after surgery. She continued taking oral anticoagulants. All results of a thorough laboratory work-up were negative. DISCUSSION: The clinic presentation of acute mesenteric venous thrombosis is generally insidious. CT scanning is a reliable diagnostic method. The goal of initial treatment is to define the underlying cause of the patient's hypercoagulable state and to treat it appropriately. After achieving appropriate anticoagulation, patients should start long-term warfarin. Indications for surgery include signs of peritonitis, possible bowel infarction, and hemodynamic instability. Once treated, patients with this condition have a fairly good prognosis.