Teflon guide-wire-assisted semi-closed Vollmar endarterectomy of the superficial femoral artery. A review of 25 cases and the state of the art from a literature review.

In this retrospective study, we analysed 25 guide-wire-assisted Vollmar endarterectomies of an occluded superficial femoral artery. In 96% of the cases, the patient suffered from a Fontaine stage III or IV. After a mean follow-up of 24.7 months, limb salvage is 96%. The patency rate is 84% which is comparable with a femoropopliteal bypass with a reversed greater saphenous vein graft. We advocate the Vollmar endarterectomy as a valuable alternative surgical treatment for occlusive superficial femoral artery in the absence of a greater saphenous vein or in young smoking patients (< 65 years).

[Three-dimensional imaging of acetabular fractures using spiral CT]. / Driedimensionele beeldvorming van acetabulumfrakturen met spiraal CT.

Seven adult patients with acetabular fractures were investigated with conventional X-rays, axial spiral computed tomographic (CT) images and three-dimensional (3D) surface rendered reconstructions. Spiral CT has the advantage that it acquires the data much faster than incremental CT, resulting in less motion artefacts. A semi-automatic three-dimensional environment for segmentation has been developed in our institution. It created significant reduction of user interaction and improved visualization of acetabular and femoral joint surfaces. The main advantages of three-dimensional visualization of acetabular fractures included: creation of unlimited and unique views by which fracture location, fracture extension, fragment shape and fragment position became more clear, better visualization of acetabular dome and quadrilateral plate and more simple and easier interpretation of these complex fracture patterns. On the other hand, 3D surface reconstructions do not accurately demonstrate undisplaced fractures, intra-articular fragments may be obscured, congruence assessment is uneasy, and soft tissue injuries are not shown. Therefore, we consider 3D images of acetabular fractures as being complementary to and not a substitute to plain radiographs and axial CT scans.