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Lower extremity deep venous thrombosis (DVT) is uncommon in the pediatric population, but it can be associated with severe symptoms and potential long-term morbidity secondary to post-thrombotic syndrome. Inferior vena cava (IVC) atresia can predispose a patient to the development of extremity DVT. There is no clear consensus on optimal management of extensive extremity DVT in pediatric patients, especially in patients with IVC anomalies. We report a case of iliofemoral DVT in a 9-year-old boy with IVC atresia and presumed protein S deficiency that was treated successfully using pharmacomechanical thrombectomy and catheter-directed thrombolysis. He was maintained on long-term anticoagulation and remained symptom free at 6 months' follow-up., (© The Author(s) 2014.)

Objectives: Extracranial carotid artery true aneurysm is extremely uncommon, and definite treatment has traditionally involved open surgical repair. Although successful management of the internal carotid artery aneurysms using endovascular stenting and embolization has recently been reported, only a limited number of cases have been reported., Methods: We present a case of symptomatic carotid true aneurysm repaired with covered stent and coil embolization of the external carotid artery. We also review the English literature and discuss the epidemiology, causes, diagnosis, and management options of internal carotid artery aneurysms., Results: The patient did not have any complications, and was discharged home on the postoperative day 1 in stable condition., Conclusion: Our report suggests that endovascular procedure is feasible in the treatment of extracranial carotid artery aneurysms.

Central venous obstruction associated with a distal arteriovenous fistula can result in massive swelling of the affected extremity and venous hypertension. We present the surgical rescue of an axillary-axillary arteriovenous access ((necklace graft) between the left axillary artery to the contralateral axillary vein), compromised by central venous stenosis, by conversion into an arteriovenous axillary loop graft (AVALG) as an additional 'exotic' grafting procedure in the anterior chest. This procedure resulted in the salvage of the patient's access and rapid resolution of the associated upper extremity swelling.