Successful treatment of a large profunda femoris artery aneurysm and associated pseudoaneurysm using endovascular stenting.

Profunda femoris artery aneurysms are a rare form of peripheral arterial aneurysm. In this report, we present the case of an 83-year-old lady who was found to have a 65 mm aneurysm arising from the proximal left profunda femoris artery and associated pseudoaneurysm. Successful treatment was achieved using an endovascular approach in which two stents were deployed.

Systematic review of groin wound surgical site infection incidence after arterial intervention.

The objectives were to determine the surgical site infection incidence (including superficial/deep) fter arterial intervention through non-infected groin incisions and identify variables associated with incidence. MEDLINE, EMBASE and CENTRAL databases were searched for randomised controlled trials and observational studies of adults undergoing arterial intervention through a groin incision and reported surgical site infection. Infection incidence was examined in subgroups, variables were subjected to meta-regression. One hundred seventeen studies reporting 65 138 groin incisions in 42 347 patients were included. Overall surgical site infection incidence per incision was 8.1% (1730/21 431): 6.3% (804/12 786) were superficial and 1.9% (241/12 863) were deep. Superficial infection incidence was higher in randomised controlled trials (15.8% [278/1762]) compared with observational studies (4.8% [526/11 024]); deep infection incidence was similar (1.7% (30/1762) and 1.9% (211/11 101) respectively). Aneurysmal pathology (ß = -10.229, P < .001) and retrospective observational design (ß = -1.118, P = .002) were associated with lower infection incidence. Surgical site infection being a primary outcome was associated with a higher incidence of surgical site infections (ß = 3.429, P = .017). The three-fold higher incidence of superficial surgical site infection reported in randomised controlled trials may be because of a more robust clinical review of patients. These results should be considered when benchmarking practice and could inform future trial design.

Brachial plexus lipomata presenting with neurogenic and venous thoracic outlet syndrome: case reports and review of the literature.

BACKGROUND: Compression of the brachial plexus causing neurogenic symptoms is involved in most cases referred to vascular surgeons for consideration of treatment of thoracic outlet syndrome (TOS). The causative factor of the compression can be difficult to diagnose with multiple pathologies implicated. METHODS: We present 2 rare cases of supraclavicular lipomata causing compression of the neurovascular structures in the thoracic outlet. The only 6 other cases of brachial plexus lipomata were described to our knowledge in the literature worldwide. RESULTS: We highlight that there are a small number of neurogenic TOS cases where the causative pathology can be successfully managed by surgery with expectation of a good recovery. CONCLUSIONS: Surgeons operating on these lesions can expect good symptom resolution for their patients.