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Introduction: Critical limb ischemia (CLI) represents the most severe form of Peripheral artery disease (PAD). Its prevalence is estimated to be between 0.5% and 2.3% of the population over 40 years old. Despite its importance, epidemiological studies on CLI remain patchy. In Morocco, few studies have been carried out on this subject, and we have no epidemiological data on the morbimortality of chronic critical ischemia of the lower limbs on a national scale. Objective: The objective of our study was to evaluate the results of surgical treatment of critical limb ischemia and to identify the factors associated with the medium-term evolution. Methods: We conducted a retrospective cohort study of all patients admitted to the vascular surgery department of the Hassan II University Hospital for the management of critical ischemia of the lower limbs, who underwent revascularization surgery between 01/01/2013 and 31/12/2019. Patients who underwent a major amputation of the affected limb and those for whom the revascularization procedure was a revision were subsequently excluded. The follow-up period was 2 years and the events of major interest were the occurrence of a major limb amputation and 30-day mortality. Results: The cohort included 232 patients with critical ischemia. The mean age was 62 years with a clear male predominance of 84.5%. The most common comorbidities were diabetes (65.8%), active smoking (42.5%), and hypertension (31.2%). The majority of patients (62%) benefited from endovascular procedures. The primary technical success was 94.1%, the major amputation rate was 19.7%, and the 30-day mortality was 4.3%. In multivariate analysis, factors independently associated with a high postoperative complication rate were preoperative hyperglycemia, concomitant ischemic heart disease, female sex, young age, and intensive care unit stay. Conclusion: Our study highlights several risk factors for the occurrence of postoperative complications of CLI. These results .....

Pseudoaneurysms are post-traumatic anomalies affecting the vascular layers occuring usually after a trauma. Their treatment, consensual in the adults, lacks guidelines in the pediatric population due to rare cases in children. We report three cases of pediatric pseudoaneurysms treated surgically in our hospital.

Cannabis is one of the most present and easily accessible narcotics in the world. The responsibility of cannabis in these consumers in the occurrence of psychiatric and neuropsychiatric effects has been demonstrated by researchers for a long time, but in recent decades it has been indexed in the occurrence of somatic events, notably cardiovascular. We will report the case of a young patient aged 29, with no pathological history; hospitalized in the vascular surgery department of the CHU Hassan II for ischemic stroke and acute ischemia of the right upper limb after the consumption of cannabis. The etiological research of these clinical events orients us to direct the responsibility of cannabis whose consumption emerged during the anamnesis in our patient, after the elimination of all possible etiologies that may be responsible for the clinical events. This case highlights the possible involvement of cannabis in the occurrence of stroke and acute ischemia of the limb in a young subject without any cardiovascular risk factors. Note that the responsibility of cannabis in the occurrence of ischemic stroke is well known but its responsibility in the occurrence of acute limb ischemia has not been reported in any literature.

The placement of a central venous catheter is a life-saving gesture with multiple indications but it can be the cause of several complications including the migration of the metallic guide, in which we present a case that occurred in a 30-year-old patient; admitted to the emergency department for polytrauma following a road traffic accident. She benefited from the placement of a left femoral venous catheter for emergency intensive care; there was the migration of the guide wire during the insertion of the catheter. A control X-ray shows the presence of the guide wire from the inferior vena cava to the right internal jugular vein. Surgery was indicated employing a mini approach to the internal jugular vein to extract the guide.

Congenital arteriovenous fistula (AVF) is a rare vascular disease, which may occur anywhere in the body. The forearm is a very rare location. Clinical manifestations are not very specific and can vary from an asymptomatic fistula to a life-threatening congestive heart failure. Although embolization can be an alternative treatment for AVF of the forearm, surgery is still considered as the standard treatment. Herein, we report the case of a 7-year-old boy with a congenital AVF between the radial artery and the superficial cephalic vein in the forearm without any dysmorphic features treated surgically.

Venous aneurysm of external jugular vein is very rare clinical entity. Often asymptomatic, the diagnosis may be suggested by clinical features and is usually confirmed by imaging. Surgical excision is indicated in symptomatic aneurysms and for esthetic reasons, other treatments such as endovascular treatment are being evaluated. We report a case of a 27-year-old woman with a saccular aneurysm of the right external jugular vein diagnosed by computerized tomogram angiography. The patient received successful surgical treatment.

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.