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Carotid and vertebral artery injury is uncommon but may lead to stroke and death. We reported our experience over the last five years in our center. There were 14 cases: 11 cases with trauma and 3 cases with iatrogenic injury. Three cases had stroke and two cases died. The most common traumatic cases were penetrating injuries. Stab wound injuries had better prognosis than firearm injuries. Blunt trauma had the worst outcome due to severe organ injury. All iatrogenic cases were due to central line cannulation and all recovered uneventfully. Early recognition and proper treatment were crucial in these patients. [ABSTRACT FROM AUTHOR]

Posterior-type nutcracker syndrome (NCS) is a rare disease characterized by the compression of the left renal vein between the aorta and the vertebral body. The optimal management strategy for NCS remains a subject of debate, with surgical intervention being considered for selected patients. Here we report the case of a 68-year-old male who presented with a one-month history of abdominal and flank pain as well as hematuria. Abdominal computed tomography angiography revealed the compression of left renal vein between an abdominal aortic aneurysm (AAA) and the vertebral body. The patient was suspected to have a posterior-type NCS, which significantly improved following open surgical repair of the AAA. In cases of posterior-type NCS, surgical intervention should be performed selectively in symptomatic patients, and open surgery is the preferred treatment modality for this condition. For posterior-type NCS associated with AAA, open surgical repair may represent the optimal choice for decompression of the NCS.

Objective: Phlegmasia cerulea dolens (PCD) and venous gangrene are limb and life-threatening conditions of iliofemoral acute deep vein thrombosis (DVT)., Material and Method: The authors retrospectively evaluated surgical management of 15 patients from 125 patients with acute iliofemoral DVT (6 PCD and 9 venous gangrene) between January 1991 and August 2002 with long-term follow-up., Results: All of our 15 patients underwent surgery within 10 days of the onset of symptoms. Six patient with impending gangrene and failure for initial management with bed rest, extremity elevation, fluid resuscitation, and systemic anticoagulation for six to 12 hours underwent iliofemoral venous thrombectomy and distal arteriovenous fistula (AVF) can preserve limbs. In nine patients with venous gangrene that underwent iliofemoral thrombectomy below knee had transmetatarsal amputation done after decreasing leg edema. All patients underwent caval filter insertion before venous thrombectomy. There was no pulmonary embolism (PE) or immediate mortality. Anticoagulation treatment was given for at least six months. The distal arteriovenous fistula was closed as a secondary operation six weeks after initial operation. On the follow-up, 10-year period, seven patients died from the advanced carcinomas 7, 9, 9, 12, 14, 18, and 20 months after an operation. The remaining eight patients have regularly followed-up over 120 months. Three patients (37.5%) had recurrence of DVT; the rate of recanalization in common iliac veins on duplex scan was 100%. Three patients (37.5%) developed reflux in at least one deep venous segment without signs and symptoms of postphlebitic syndrome., Conclusion: Surgical venous thrombectomy with distal AVF are safe method and should be reserved to treat PCD and venous gangrene patients with contraindications to thrombolysis or in condition that thrombolytic therapy is not available. There is no postphlebitic syndrome on the long-term follow-up (> 120 months) of all surviving patients.