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Background Chronic limb-threatening ischemia (CLTI) is the most severe manifestation of peripheral arterial disease. Various revascularization techniques are employed to treat peripheral arterial disease. Intravascular shockwave lithotripsy (IVL) is a relatively new procedure for the treatment of calcific lower limb peripheral arterial diseases (PAD). Objectives To assess the effectiveness and safety of shockwave lithotripsy in patients with severe PAD through an evaluation of limb salvage rate and patient survival. Methods A retrospective study of all patients treated with shockwave lithotripsy between November 2019 and June 2024 was performed. The primary outcome was amputation-free survival and secondary outcomes were potential complications of IVL (thrombo-embolization, perforation, and restenosis). Patients were followed up in the clinic and assessed both clinically and with a duplex scan at three months. Results A total of 38 patients were included in the study. The median age was 71 years; 28 were males. Among the patients, 28 (73.68%) were diabetic, 4 patients (10.53%) were current smokers, 10 patients (26.32%) were ex-smokers, and 24 patients (63.16%) were non-smokers. According to the Rutherford classification of PAD, 33 of the 38 patients were in stages 4-6. Only five patients were stage 3. Total number of treated arteries was 47. Treated lesions were 49% in the superficial femoral artery (SFA), 36% in the popliteal artery, 8% in the common femoral artery (CFA), 4% received treatment of the iliac arteries, and 2% of the posterior tibial artery. All treated arteries showed improved angiographic results. Four patients (10.53%) developed distal embolization. No perforation was recorded, and no significant flow-limiting dissection was recorded to require treatment. At the three-month follow-up, imaging revealed improvement in 58% of patients while 5% showed no improvement. Notably, follow-up imaging was not conducted in 37% of patients due to evident clinical improvement such as ulcer healing, palpable pulses, and the presence of Doppler signals. Seven patients required reintervention within three months after the initial IVL operation and 4 patients got revascularized after this period resulting in 11 patients requiring revascularisation after the initial operation. Amputation-free survival was 79% (30 patients). Conclusion Shockwave lithotripsy is associated with a high limb salvage rate and low complication rate. Further research is needed into long-term effectiveness and the role of shockwave treatment as an adjuvant to traditional revascularization techniques of patients with CLTI and short-distance claudicants., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2025, Salihi et al.)

Background: Carotid body tumours (CBTs) are neoplasms originating from the paraganglionic cells of the carotid body. Excision is the main route of treatment. This study sought to assess the surgical outcomes of post-carotid body tumour resection without preoperative embolization and discern any underlying relationships between modified Shamblin classes (MSC) and related complications., Methods: A retrospective medical record review of prospectively collected data is performed at Sulaymaniyah Teaching Hospital between 2008 and 2019, for 54 patients. Presurgical and postsurgical variables such as comorbidities and complications were noted, respectively., Results: Patient ages ranged between 26 and 60 years (x̄=40.06) with a minimal female predominance (57.4%). Complications included one minor stroke. MSC and postoperative complications were significantly related ( P ≤0.001). Our analyses also suggested a significant relationship between intraoperative blood loss and the incidence of postoperative complications ( P =0.001, χ²=25). The MSC III subtype was significantly associated with intraoperative blood loss ( P =0.000), length of stay ( P =0.000), and operating time ( P =0.001)., Conclusions: Our study purports a strong relationship between greater MSC and complications of all types. As such, surgeons may benefit from preoperative strategies to minimize complications., Competing Interests: Not applicable.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

The incidence of unusual coronary patterns including single coronary artery is high in Taussig-Bing anomaly (TBA). The relocation of a single coronary artery from a nonfacing sinus can be technically challenging with implications on early and late outcomes. Many innovative techniques for coronary transfer have been described and no coronary pattern precludes arterial switch operation in the current era. We describe a technique of coronary transfer using autologous pericardial tube extension with good early outcome., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Annals of Pediatric Cardiology.)

Introduction . Pediatric thoracic empyema is a special entity with increasing frequency. Consensus regarding the best management strategy is still evolving. We describe our single-center 10-year experience adopting intrapleural thrombolytics using tissue plasminogen activator as first-line treatment following failure of simple thoracostomy drainage techniques. Methods . Observational prospective study included all children from 1 day to 18 years admitted for parapneumonic effusion and treated with intrapleural thrombolytics. Results . From January 2008 to December 2018, 95 patients were treated by intrapleural thrombolytics for different stages of empyema thoracis. Number of thrombolytic doses required is 2.1 (range = 1-3), and mean amount of drainage is 1050 mL (range = 400-2500 mL). Mean total days of hospitalization is 7.3 days. Complete re-expansion was the primary outcome in 94 patients (98.9%). Conclusion . Intrapleural thrombolytics in complicated pediatric thoracic empyema results in excellent outcome and should be encouraged particularly in limited resource countries., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)