Remote endarterectomy: an alternative to surgical bypass.

We present our preliminary results of remote endarterectomy performed during June 2003 to June 2010. 8 cases of unilateral ileofemoral disease, 3 cases of bilateral ileofemoral disease and 4 cases of femoro-popliteal disease constituting 18 limbs were successfully operated. All patients had comorbid conditions like Diabetes mellitus, hypertension, cardiac disease and smoking. Patency at 3 months with loss of one patient for follow up was 100 %. At one year follow up, the overall success rate was 90.90 %. One patient with Iliofemoral Endarterectomy had progression of the disease and hence had to undergo Aorto-Femoral bypass. All patients who had tissue loss, showed complete recovery by 3 months and one patient was lost to follow up. A 5 year follow up had a patency rate of 74 %. Remote endarterectomy is a viable and durable alternative to standard bypass procedures. Remote endarterectomy combines the advantages of minimally invasive surgery with endovascular techniques.

An unusual presentation of cutaneous tuberculosis for surgeons-review of literature.

Tuberculosis is one of the oldest diseases on earth. With rising trends of immunosuppressive states, the extrapulmonary manifestations of tuberculosis have emerged and are flourishing. Most often it is the systemic dissemination of the bacilli from the primary infective foci during the periods of low immunity. Cutaneous manifestation of tuberculosis in the form of injection abscess or traumatic inoculation is well known; however, sporadic occurrence of it in the form of abscess with no underlying lesions is quite rare. This would caution the treating units in the endemic areas about the possibility of tuberculosis as the disease in any inflammatory disorder of skin with acute presentations with no systemic symptoms. Only a high index of suspicion would render an early detection and recovery. Our case is one such incident.