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Background: Penetrating vascular injuries (PVIs) of the lower limbs due to stab wounds are associated with high mortality and limb loss rates. We analyzed the outcomes of a series of patients who underwent surgical treatment of these lesions, assessing the presence of any factor associated with limb loss and mortality; (2) Methods: Data of patients admitted from 01/2008 to 12/2018 were retrospectively analyzed. Primary outcomes were the limb loss and the mortality rate at 30 days postoperatively. Univariate and multivariate analyses were performed as appropriate. p values < 0.05 were considered significant; (3) Results: Data of 67 male patients were analyzed. Two died (3%) and three (4.5%) had a lower limb amputation after failed revascularization. In the univariate analysis, the clinical presentation significantly affected the risk of postoperative mortality and limb loss. The location of the lesion at the superficial femoral artery (OR 4.32, p = 0.001) or at the popliteal artery (OR 4.89, p = 0.0015) also increased the risk. In the multivariate analysis, the need for a vein graft bypass was the only significant predictor of limb loss and mortality (OR 4.58, p < 0.0001); (4) Conclusions: PVIs of lower limbs due to stab wounds were lethal in 3% of cases and lead to a secondary major amputation in 4.5% more cases. The need for a vein bypass grafting was the strongest predictor of postoperative limb loss and mortality.

Aim: To evaluate the outcomes of endovascular therapy in patients with subclavian steno-occlusive disease over the short and long term in a Tunisian population., Materials and Methods: Patients who underwent endovascular treatment of subclavian artery (SCA) steno-occlusive disease between 2013 and 2019 in three Tunisian centers were evaluated retrospectively. After treatment, patients were follow-up was scheduled at 1, 3, 6, 12 months postoperatively and annually afterwards by Doppler ultrasound and clinical findings. Primary outcomes included technical, clinical procedural success rates and limb salvage rate. Secondary outcomes included the occurrence of periprocedural complications and primary patency rates., Results: 56 patients (33 males, 58.9%) were evaluated. Patients' mean age was 61.5 + years. Technical success rate was 94.6 %, being 100% in case of stenosis and 78.5% in case of occlusion. The technical success rate was 94.6%. The clinical success rate was 100% and the upper limb salvage rate was 100%. Minor amputations were performed on 5 patients. Perioperative mortality and morbidity rates were 0% and 8.9% respectively. Mean follow-up was 26.7±16.4 months (range 12-86 months). Two in-stent restenosis occurred (at 12 and 15 months) and one case of thrombosis at the 16th month. The primary patency rates were 88.7%+4.3% at the end of the first year and 78.7%+6.1% at 3 years., Conclusion: Endovascular treatment can be considered as a safe and effective treatment of SCA steno-occlusive disease, with low perioperative complication rates and a good patency rates over long term., Key Words: Subclavian artery stenosis, Subclavian artery occlusion, endovascular, subclavian revascularization.

Iliac artery stenosis is a rare complication after renal transplantation. This complication affects elderly patients and related to atheromatous disease. It mimics the same clinical presentation as a transplant renal artery stenosis or renal artery stenosis. This entity is can be responsible for serious complications such as renal dysfunction, malignant hypertension and acute pulmonary oedema. We present in this paper the case of a 51-year-old patient, who benefited 7 years early of renal transplantation, with a good initial result, and who was admitted actually for malignant hypertension and renal function impairment due to an iliac artery stenosis proximal to the renal transplant and who was treated with a stenting angioplasty of the external iliac artery with a mixed outcome. Our case highlights the importance of the early diagnosis and treatment of such complications to avoid definitive renal failure and permanent hypertension., Competing Interests: The authors declare no competing interests., (Copyright: Imtinen Ben Mrad et al.)

Rarely performed nowadays, the Björk procedure is an alternative to the Fontan palliation for biventricular repair in patients with tricuspid atresia. The right atrium to right ventricle conduit failure leads to serious long-term complications. The management of such patients at high surgical risk remains challenging. We report a successful reoperation in a young adult 25 years after the modified Björk intervention, who presented with severely narrowed and calcified valved conduit., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Annals of Pediatric Cardiology.)

Isolated iliac artery aneurysms are rare, and treatment by conventional surgery gives good results. Endovascular repair of such aneurysms has recently become the preferred form of treatment, provided the appropriate anatomy for endovascular repair exists. We report the case of a 60-year-old man admitted in our department for an aneurysm of the left primitive iliac artery revealed by intermittent claudication and treated by a covered stent after embolization of the hypogastric artery by an Amplatzer Vascular Plug with a good result. This case highlights the importance of preservation of the collaterals of the hypogastric artery when you treat such entity; in order to avoid transient gluteal claudication and sexual dysfunction., Competing Interests: The authors declare no competing interests., (Copyright: Imtinene Ben Mrad et al.)

Aneurysms and pseudoaneurysms of the gluteal artery are rare. They represent less than 1% of the described arterial aneurysms. Those that touch the inferior gluteal artery are even rarer. Only a few cases have been described worldwide. Such cases often present with a variable time course, mode of injury, and associated symptoms, leading to their misdiagnosis and improper treatment. We present the case of a 30-year-old male, who presented to our emergency room one week after a stab wound in the left gluteal region causing a pseudoaneurysm of the left inferior gluteal artery with a sciatic compartment syndrome treated by a hybrid approach., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 Ben Mrad et al.)

Extracranial carotid artery aneurysms in children are extremely rare, nevertheless associated with a great potential of thromboembolic episodes and rupture especially those with mycotic origin. The surgical treatment is very challenging, and there is still a controversy concerning revascularisation after the resection of the aneurysm. In this manuscript, we report the observation of an 8-year-old boy with the medical history of Leukemia who is admitted urgently for a mycotic right common carotid artery aneurysm, occurring after a chemoport infection who was operated on in our cardiovascular surgery department with surgical resection and ligation. It is the second report in the pediatric literature of a mycotic pseudoaneurysm situated in the common carotid artery, but the first documented by medical imagery. Through this case, we highlight that ligation of the infected carotid artery can be a safe and efficient alternative especially in Children., Competing Interests: No competing interests were disclosed., (Copyright: © 2021 Imtinene BM et al.)

Subclavian artery injuries after central venous catheter placement constitute a rare but potentially fatal complication. The surgical repair of a subclavian artery trauma is a real challenge, associated with a high rate of morbidity and mortality. The role of endovascular treatment for vascular trauma, including injury to the subclavian artery, continues to evolve. In this manuscript, we report the case of an urgent endovascular repair by a covered stent graft of a subclavian artery perforation following the placement of a central venous catheter for dialysis in a 52-year-old patient, having a chronic kidney failure stage 5, with multiple comorbidities. The present case suggests that attention needs to be paid to preventing iatrogenic arterial cannulation during central vein catheterization to avoid potentially devastating complications. Endovascular treatment using a covered stent should be attempted as a first-line therapeutic option., Competing Interests: The authors report no conflicts of interest in this work., (© 2021 Ben Mrad et al.)

Objective: To evaluate in-hospital mortality and limb salvage of a series of patients presenting with arterial injury of the lower limbs complicating an osteoarticular trauma, and to determine any preoperative predictive factors of limb salvage., Methods: Data of consecutive patients treated between 01/2007 and 12/2017 were retrospectively analyzed. Primary outcomes were in-hospital mortality and limb salvage. Multivariate analysis was performed to assess any variable that could affect limb salvage. P values <0.05 were considered statistically significant., Results: The postoperative course, death occurred in 2 patients Lower limb amputation was performed in 13 cases (15.6%). The main factors predicting limb amputation were the timing of staged surgery, in particular when bone stabilization was performed first (P<0.001), and a delay Data concerning 74 patients with 83 traumatized lower limbs were analyzed. Most vascular lesions were located at the popliteal artery (47, 63.5%). Surgical bone stabilization was performed as a first step in 45 patients (60.8% of cases), followed by a delayed arterial repair. The median time to revascularization was 14.3 hours (range from 2 hours to 6 days). In 29 patients (39.2%) vascular repair and bone stabilization were performed simultaneously. During to limb revascularization longer than 6 hours (P<0.001). The location of injury at the popliteal artery (P=0.005), the presence of infection (P<0.001), and the severe ischemic signs at presentation (P=0.001) also were factors associated with amputation., Conclusions: The timing of staged surgical repair and the revascularization delay were the main predictor factors of limb salvage., Key Words: Osteoarticular trauma, Vascular injury, Limb salvage, Orthopedic trauma.

Ischemic iatrogenic lesions can complicate surgical procedures on the mitral valve. One of the causative mechanisms is direct injury to or distortion of the circumflex coronary artery. The risk of damaging the circumflex coronary artery depends mainly upon the proximity of that vessel to the posterior segment of the mitral annulus, and this varies from patient to patient. Herein, we report a case of iatrogenic circumflex coronary artery lesion with left ventricular aneurysm after mitral annuloplasty, in order to highlight a possible relationship between iatrogenic circumflex lesions and coronary dominance in a 70-year-old man who had severe mitral regurgitation. < Learning objective: Although mitral annuloplasty is a simple and reproducible gesture, it requires great technical care to avoid one of the serious complications of occlusion of circumflex coronary artery when crossing stitches. Occlusion can be sudden or gradual (thrombosis after stenosis) as in our case.>.