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Isolated aneurysms of the common iliac artery are rare, affecting less than 0.01% of the general adult population. Most of these aneurysms are asymptomatic and are discovered as an incidental finding. We describe an elderly patient presented with a urinary retention, which the investigations had led to the diagnosis of a large left common iliac artery aneurysm.

Summary Background Behcet's disease (BD) is a multisystem chronic autoimmune inflammatory disorder that involves multiple organs. Arterial involvement in BD is rare. Aortic involvement is one of the most severe manifestations and is associated with a much higher mortality. In this article, we will present our experience in open surgical repair of abdominal aortic aneurysm combined with immunosuppressive therapy. Methods Between January 2010 and December 2017, 7 patients were treated for abdominal aortic aneurysms (5 infra-renal and 2 supra-renal, in 1 woman and 6 men). All patients were Moroccan, the age range being 25–59 years, mean age 43.2 years. Three Dacron tube grafts, two Dacron aortobiiliac grafts and two patch closures were used. All 7 patients received immunosuppresive therapy after surgery. Results All patients underwent successful open surgical repair without major complications during the 30 days immediately after the procedure. During a mean follow-up of 36 months, there was no recurrent aneurysmal localization, but one patient had lost their sight. Until now, we have been following 6 patients and they continue to receive immunosuppressive therapy. Conclusion Long-term immunosuppressive therapy after aneurysm repair is important to limit pseudoaneurysm recurrence. Through our serie, we describe the results of the combination of surgical treatment and adjunctive immunosuppressive therapy, with a literature review.

Carbon monoxide (CO) poisoning is a very common reason for emergency ward admission, with symptoms varying from a simple headache and dizziness to severe neurological and cardiac impairment. We report here a rare clinical presentation of CO intoxication manifested by a severe cardiac impairment with intracardiac thrombus formation, acute limb ischemia, renal infarction, and carotid artery thrombosis. There have been initial reports of thromboembolic events in acute CO poisoning with intracardiac thrombosis being sparsely reported. Contrary to venous thromboembolism, arterial thromboembolism in CO poisoning seems to be extremely rare. To the best of our knowledge, this is the first report in recent literature of a combined intracardiac thrombosis and multiple arterial thromboembolism induced by CO poisoning.

Popliteal injuries are well known to be serious with a high rate of mortality due to damage caused to popliteal vessels. Pseudoaneurysm formation and arteriovenous fistulas are well-known complications of arterial injury, but are rarely concomitant. Diagnosis is usually done by computed tomography (CT) angiography. Treatment strategies consist of surgery or endovascular management. We report the surgical treatment of two cases of popliteal arteriovenous fistula associated with pseudoaneurysm complicating stab wounds.

Axillary artery injury from humeral neck fracture is an uncommon event. Vascular damage due to these injuries may threaten limb loss. In some cases, the signs of ischemia may not be evident just after the injury and may only appear later on. Therefore, a high index of suspicion is essential. It is important to bear this association in mind, so as to make an early diagnosis and avoid serious complications. We are describing the case of a young patient involved in a motor vehicle crash with an axillary artery trauma due to the surgical neck of humerus fracture. The patient underwent a basilic vein grafting, the postoperative course was good.

True atherosclerotic aneurysms of superficial femoral artery (SFA) are rare and often associated with other peripheral or aortic aneurysms. We are reporting the case of a 78-year-old man who has been admitted with a ruptured superficial femoral artery aneurysm associated with bilateral popliteal artery aneurysm. The patient underwent successful aneurysm resection and bypass grafting.

Infectious aortitis is a rare clinical entity that most often manifests itself by an aortic aneurysm. The syphilitic or tubercular forms can be subacute. When it is caused by Salmonella sp., Staphylococcus sp. or Streptococcus pneumoniae, the aortitis is acute with alarming symptoms. Germs found in most cases are Salmonella and Staphylococcus aureus. S. pneumoniae rarely causes infectious aortitis. We report the case of a 75-year-old patient seen in an emergency setting for sudden-onset abdominal pain with fever. An abdominal angio-computed tomography (CT) scan showed a sacciform infrarenal abdominal aortic aneurysm, with an inflammatory aspect and periaortic hematoma. Surgical cure was undertaken because of the impending rupture. An interposition aortic replacement graft was implanted. Blood cultures and bacteriological study of the aortic wall isolated a S. pneumoniae. The anatomical pathology study reported fibrin clot leukocyte remodeling of the aortic wall. An intravenous antibiotic regimen was started. Several organisms, including Streptococcus, can cause infectious aortitis. We found 36 cases described in the literature in addition to our patient.

We report the case for a 44-year-old patient without medical history, admitted in our department for bilateral acute limb ischemia (H6). The patient was hemodynamically stable and the physical examination shows limb sever ischemia (no femoral arterial pulses, coldness, cyanosis and paralysis). Abdominal CT angiography showed a complete occlusion of the infra renal abdominal aorta compatible with embolus. An embolectomy with Fogarty catheters was performed. Echocardiography showed a mass in the left atrium. Pathological examination of the material embolic confirmed the diagnosis of the cardiac myxoma. The clinical course was marked by the development of a sever syndrome of revascularization, death occurred the third day of hospitalization. Cardiac myxomas are the most common primary cardiac tumor. The mobility of the tumor and its gelatinous and crumbly consistency generates peripheral emboli.

The other reports a case of fibrodysplasic aneurysm of the extracranial internal carotid artery that was successfully treated by resection and direct end-to-end anastomosis of the internal carotid artery. Keywords: Extracranial internal carotid artery aneurysm, fibromuscular dysplasia, surgical treatment

Knee arthroscopy is a common procedure to treat sports injuries. It is a safe procedure with less injury to soft tissues and very few complications. Pseudoaneurysm of the popliteal artery and/or arteriovenous fistulae is a rare complication of arthroscopic procedure of the knee. We report a case of popliteal artery pseudoaneurysm with arteriovenous fistulae after arthroscopic procedure of the knee in a younger sportsman.

Acute type B aortic dissection can lead to acute limb ischemia which is of poor prognosis. The emergency is the revascularization of the limb. Several revascularization therapies are proposed and are constantly changing. We report a case of an acute limb ischemia revealing an acute type B aortic dissection treated surgically. Key words: Aortic dissection, Limb ischemia, Surgery.

Highlights • Pseudoaneurysms of the deep femoral artery are uncommon and occur as a late complication of various traumas. • We report two cases of profunda femoris artery injury which presented as false aneurysm secondary to penetrating trauma. • As these cases illustrate, the diagnosis of pseudoaneurysm of deep femoral artery following trauma and orthopedic procedures requires awareness and a high index of suspicion., Pseudoaneurysms of the deep femoral artery are uncommon and occur as a late complication of various traumas. Usually associated with femoral fractures, We report two cases of profunda femoris artery injury which presented as false aneurysm secondary to penetrating trauma. Because of its insidious onset, awareness and careful follow-up are the key issues for the early diagnosis.

Vascular leiomyosarcomas are extremely rare, and involve veins 5 times more often than arteries. In the lower extremity, the great saphenous vein is the most frequent site of origin. We report the case of a healthy 45-year-old patient who presented with a painless mass located proximally in the right thigh in line with the great saphenous vein. At surgery, the treatment consisted of wide local excision. Histopathological studies confirmed mass as leiomyosarcoma. In light of this report, we draw attention to this rare disease, though with a poor prognosis.

Aneurysms of the profunda femoris artery (PFA) are exceptionally rare but dreadful because of their high rate of rupture. In this report, we describe the case of a 70-year-old man presented to the emergency department with a ruptured PFA aneurysm. The patient underwent successful aneurysmorrhaphy and distal reconstruction with a vein graft.

Resume Propos L'atteinte des troncs supra-aortiques dans la maladie de Takayasu realise souvent des lesions diffuses et complexes inaccessibles au traitement endovasculaire. La chirurgie occupe par consequent une place importante dans la prise en charge de l'ischemie cerebrale dans cette maladie. Le but de ce travail est de preciser les indications et les techniques chirurgicales en cas d'atteinte des arteres a destinee encephalique dans cette maladie et d'exposer nos resultats. Materiel et methodes Nous rapportons une serie de sept cas de maladie de Takayasu avec atteinte des arteres carotides extracrâniennes traites chirurgicalement dans le service de chirurgie vasculaire de l'hopital Ibn-Sina de Rabat sur une periode de 11 ans. Resultats Il s'agit de six femmes et un homme d'âge moyen au moment du diagnostic de 33,8 ans. Les signes revelateurs etaient essentiellement d'ordre neurologique et oculaire. Six de nos patients etaient en poussee inflammatoire au moment du diagnostic, et ont necessite un traitement medical premier a base de corticoides. Il a ete realise une revascularisation carotidienne bilaterale dans trois cas, unilaterale dans quatre cas. L'axe donneur etait l'aorte ascendante dans six cas et le tronc arteriel brachiocephalique dans un cas. Un deces en rapport avec une hemorragie cerebrale est survenu deux jours apres la revascularisation. Une nette amelioration des signes fonctionnels etait notee chez trois patients, alors que l'amelioration etait partielle chez deux autres. Une thrombose secondaire du pontage est survenue dans trois cas. Conclusion L'histoire naturelle de la maladie de Takayasu et son evolution sont mal connues. Les indications operatoires ne doivent pas reposer uniquement sur le seul bilan anatomique, mais basees sur un faisceau d'arguments dans lesquels, l'evaluation du debit sanguin cerebral serait utile. Le syndrome d'hyperperfusion cerebrale constitue un risque majeur qui peut etre reduit par des revascularisations par etapes.

L'ischémie aiguë non traumatique du membre inférieur du nourrisson est une affection rare mais aux conséquences graves. Les étiologies sont multiples, mais il existe des cas idiopathiques. Nous rapportons un cas d'ischémie aiguë idiopathique d'un nourrisson traité médicalement. Malgré le retard de consultation, l’évolution a été spectaculaire avec une régression complète des signes en trois jours.

Popliteal artery entrapment syndrome is a rare and underdiagnosed cause of claudication in young adult. The typical clinical feature is calf claudication; the following case reports describe 2 rare clinical aspects, acute limb ischemia and pulsatile mass revealing a bilateral anatomic entrapment. These cases suggest that an early diagnosis is mandatory to avoid a dramatic clinical outcome and to limit the surgical treatment to a myotomy.

Elbow dislocations are the most frequently encountered after shoulder dislocations. In their vast majority, these injuries carry a good prognosis. Although, concomitant arterial injury is rare and make them more serious. In this paper, we report a case of a 17 year old woman with opened elbow dislocation with arterial injury associated to an artery variation: "accessory brachial artery".

La fistule artério-veineuse native est l'accès vasculaire de choix pour l'hémodialyse chronique en raison de sa longévité, son taux faible de complication et de mortalité par rapport aux pontages artério-veineux et aux cathéters. Cependant, il arrive assez souvent que l'on assiste à des complications qui sont dominées par la sténose et la thrombose. C'est une étude rétrospective des complications ayants survenues pour 31 fistules artério-veineuses pour hémodialyse chronique des 200 fistules réalisées chez 200 patients au sein du service de chirurgie vasculaire du CHU Hassan II de Fès sur une période de trois ans, étendue de Janvier 2007 à Décembre 2009. Ces complications ont été présentés par les thrombosesdans 14 cas soit 45,15% de l'ensemble des complications, les sténoses dans 4 cas (12,90%,) les anévrismes dans 4 cas (12,90%), les complications ischémiques dans 3 cas (9,67%), l'infection dans 3 cas (9,67%), l'hémorragie dans 2 cas (6,45%) et l' hyperdébit dans un seul cas soit 3,22%. On a pu conserver 22 fistules soit 70,96% par traitement chirurgical ou endovasculaire, on a confectionné une nouvelle fistule dans 8cas soit 25,80%, et on a adressé une patiente (3,22%) pour pose d'un cathéter veineux tunnelisé permanent. Les complications des fistules artério-veineuses pour l'hémodialyse chronique sont la principale cause de morbidité chez les patients hémodialysés, il est donc important de s'impliquer lors de leur création, et de donner un maximum d'attention quand ils sont manipulés. Ceci suggère la mise en place d'un programme de surveillance de ces fistules en raison de l'impact des complications sur la morbi-mortalité du patient hémodialysé et sur le plan financier.

Le syndrome de Klippel-Trenaunay (SKT) est une malformation vasculaire combinee complexe congenitale. Le SKT peut associer plusieurs anomalies vasculaires a « flux lent » : malformations capillaires, veineuses et/ou lymphatiques [1].Nous rapportons le cas d’une fillette âgee de 10 ans, qui presente depuis sa naissance une macule erythemateuse s’etendant progressivement lors de la croissance avec apparition progressive de paquets variqueux sur la face externe de la cuisse droite [...]

stv.2013.0783 Auteur(s) : Hamid Jiber Hamid_jiber@yahoo.fr, Othman Zizi, Youssef Zrihni, Abdellatif Bouarhroum CHU Hassan II, service de chirurgie vasculaire, Fes, Maroc Tires a part : H. Jiber L’incidence de la maladie renale chronique de stade 5 exigeant un traitement par hemodialyse immediate continue a augmenter. Il existe egalement un nombre croissant de patients qui ont des difficultes d’acces arterio-veineux en raison du diabete et d’echecs de fistule [1]. La plupart des [...]

Brachial-axillary bridge graft is an alternative to native fistula in the absence of vein access or defect of maturation. Infection of the prosthetic graft is a serious complication. It is a relatively common complication and is the second leading cause of graft loss. It should be prevented by the adoption of extreme rigor concerning monitoring of access, their care and punctures. We report three cases with different aspect clinic and therapeutic of infected brachial-axillary prosthesis for hemodialysis.

Le recours aux cathéters veineux centraux (CVC) est incontournable en hémodialyse. Comparé aux autres abords vasculaires, il est pourtant associé à une morbidité et une mortalité plus élevées. Selon une étude menée par El Minshawy et coll, l'atteinte de l'artère fémorale représente 5% de ces complications. Nous en rapportons 4 cas ayant été pris en charge au sein du service de chirurgie vasculaire. L'objectif de ce travail est d'élucider les aspects cliniques, anatomopathologiques et les modalités thérapeutiques.

Marfan’s syndrome is an autosomal dominant disorder of connective tissue characterized by a large number of possible mutations and by heterogeneity of clinical presentation primarily in skeletal, ocular and cardiovascular organ systems. Cardiovascular complications of the disease are responsible for high mortality. The case of a 42-year-old patient with a progressive advanced abdominal aorta dilatation visualized on computed tomography images is presented. Pathogenesis, diagnosis and management of patients with Marfan’s syndrome are also discussed.

The usual location of intrathoracic neurogenic tumors is the posterior mediastinum. Those in a mediastinal anterior or middle location arise from the intrathoracic phrenic nerve, which is extremely rare and causes a problem for etiologic diagnosis. We report what is, to our knowledge, the second case of a mediastinal neurofibroma originating from the phrenic nerve of a 59-year-old woman without von Recklinghausen disease. Diagnosis was suggested by the radiologic features and confirmed by histologic aspects after excision. The prognosis after complete resection is excellent.

Gluteal artery aneurysms are rare and mostly secondary to blunt or penetrating trauma. As an absolute rarity, we report an exceptional presentation of bilateral mycotic aneurysm of the superior gluteal artery in a 16-year-old boy associated with bacterial endocarditis. The left pseudoaneurysm was ruptured and treated using open surgery; 1 week later, the right location was successfully treated by embolization.