I read the article by Ishikawa et al  with interest. Whilst they emphasise the many methods for assessing cerebral blood flow during carotid endarterectomy (CEA) in order to guide the need for shunt usage, there are some issues that stand out. All the procedures undertaken in the series presented were undertaken under general (GA-CEA) rather than local anaesthesia (LA-CEA), and it is precisely this approach that has driven the need for cerebral monitoring, all of which have varying levels of sensitivity and specificity.
: Failure of maturation of arteriovenous fistulae (AVF) remains an ongoing concern for dialysis access. One etiology is the presence of side branches which divert flow from the main AVF channel. This study aims to evaluate the outcomes of endovascular and open surgical interventions for AVF side branches in the setting of maturation failure.
: This systematic review investigated the incidence of stent migration in patients with acute and chronic deep venous iliofemoral disease who were treated with dedicated venous stents. Procedural approaches, clinical and stent patency outcomes, and other complications are described.
Peripheral artery disease (PAD) is present in approximately 20.0% of the population over 80 years of age and is a marker of cardiovascular disease.1,2 The most severe state of PAD is chronic limb threatening ischemia (CTLI), often associated with an ABI below 0.50 and manifests as rest pain and tissue loss. Wounds associated with CLTI frequently present with gangrene. Dry gangrene is characterized by aseptic dehydrated tissue necrosis. Bacteria typically fail to survive in the mummified tissue. If left untreated, dry gangrene can autoamputate (i.e.
The clavicle is a long bone that forms the anterior border of the thoracic inlet. Anatomic abnormalities of the clavicle can lead to compression of the innominate artery and trachea due to mass effect. These anatomic abnormalities can be amenable to surgical resection, which can provide complete resolution of symptoms.
There is currently no consensus or standardized method to measure abdominal aortic aneurysm (AAA) diameters based on computed tomography angiography (CTA) (1). An accurate assessment of AAA maximal diameter (Dmax) is crucial in clinical practice as it used to evaluate the size of the aneurysm, its growth over time, and determine the indication for surgical repair (1). Several methods have been described and their reproducibility is debated due to intra and inter-operator variability (2). Perry et al.
Congenital abnormalities of the first rib (ABNFR) are a rare cause of thoracic outlet syndrome (TOS). The range of abnormalities have not been clearly documented in the literature. Surgical decompression in these patients presents with increased complexity secondary to anomalous anatomy. Our goal is to review an institutional experience of first rib resection (FRR) performed for ABNFRs, to present a novel classification system, and to analyze outcomes according to clinical presentation.
The interesting paper by Pini et al. about platelets depletion after thoraco-abdominal aortic aneurysm endovascular repair merits to be deepened in its pathophysiological features, being a challenging and dangerous surgical complication. It has an 'early' expression, when arising within the first 5 postoperative days, or a ‘later’ one in the following postoperative period.1 The first form can be primarily referred to platelets consumption, typically due to a post-hemorrhagic disseminated intravascular coagulation, which explains its greater incidence in case of aneurysm rupture.
Several RCTs have been conducted to assess the efficacy and safety of angiotensin receptor blocker (ARB) and beta-blocker (BB) therapy for Marfan syndrome (MFS), but the existing evidence is limited and conflicting. This study aimed to compare the efficacy and safety of different therapies.