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Abstract

CFD technique was used to determine the effect of a stent-graft spatial configuration and hematocrit value on blood flow hemodynamic and the risk of a stent-graft occlusion. Spatial configurations of an endovascular prosthesis placed in Abdominal Aortic Aneurysm (AAA) for numerical simulations were developed on the basis of AngioCT data for 10 patients. The results of calculations showed that narrows or angular bends in the prosthesis as well as increased hematocrit affects blood flow reducing velocity and WSS which might result in thrombus development.

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Authors and Affiliations

Andrzej Polańczyk
Marek Podyma
Ludomir Stefańczyk
Ireneusz Zbiciński
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Abstract

Anatomical variations of the inferior vena cava, including the double inferior vena cava or isolated left inferior vena cava, are uncommon and of great clinical importance. Inferior vena cava variations signify predisposition to deep vein thrombosis and may complicate retroperitoneal surgeries including abdominal aortic surgery. Failure to recognize such variations may predispose a patient to life- threatening complications. This prospective anatomical study assessed 129 cadavers for variations of the inferior vena cava. One of the 129 cadavers (0.78%) possessed a double inferior vena cava and none (0%) possessed an isolated left inferior vena cava. The left-sided inferior vena cava was of a larger diameter than that of the right-sided inferior vena cava — opposite of what would be seen in a Type III duplication. Therefore, this observation expands the three-type classification system to include a Type IV duplication.

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Authors and Affiliations

Penprapa S. Klinkhachorn
Brianna K. Ritz
Samuel I. Umstot
Janusz Skrzat
Matthew J. Zdilla
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Abstract

An 11-year old boy presented with a blunt trauma in the right inguinal area after a bicycle accident. Initial clinical picture was indicative of decreased arterial blood supply to the right lower extremity and the diagnostic confirmation was made with a colour flow Doppler ultrasonography. During operative investigation, a thrombosis of the common femoral artery, 3.5 cm in length, was found. The thrombotic part of the femoral artery was removed and replaced with a venous graft taken from the major saphenous vein, before the saphenofemoral junction. Postoperative course was uneventful. Traumatic thrombosis of the common femoral artery as a result of a blunt trauma is very rare, as only 4 relevant cases have been described previously.
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Bibliography

1. Corneille M.G., Gallup T.M., Villa C., et al.: Pediatric vascular injuries: acute management and early outcomes. J Trauma. 2011; 70: 823–828.
2. Allison N.D., Anderson C.M., Shah S.K., et al.: Outcomes of truncal vascular injuries in children. J Pediatr Surg. 2009; 44: 1958–1964.
3. Mommsen P., Zeckey C., Hildebrand F., et al.: Traumatic extremity arterial injury in children: epidemiology, diagnostics, treatment and prognostic value of Mangled Extremity Severity Score. J Orthop Surg Res. 2010; 5: 25.
4. Sarfati M.R., Galt S.W., Treiman G.S., Kraiss L.W.: Common femoral artery injury secondary to bicycle handlebar trauma. J Vasc Surg. 2002; 35: 589–591.
5. Conrad M.F., Patton J.H. Jr., Parikshak M., Kralovich K.A.: Evaluation of vascular injury in penetrating extremity trauma: angiographers stay home. Am Surg. 2002; 68: 269–274.
6. Harris L.M., Hordines J.: Major vascular injuries in the pediatric population. Ann Vasc Surg. 2003; 17: 266–269.
7. Hossny A.: Blunt popliteal artery injury with complete lower limb ischemia: is routine use of temporary intraluminal arterial shunt justified? J Vasc Surg. 2004; 40: 61–66.
8. Milas Z.L., Dodson T.F., Ricketts R.R.: Pediatric blunt trauma resulting in major arterial injuries. Am Surg. 2004; 70: 443–447.
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Authors and Affiliations

Ioannis Patoulias
1
Ioannis Panopoulos
2
Georgios Pitoulias
3
Thomas Feidantsis
1
Dimitrios Patoulias
4

  1. First Department of Pediatric Surgery, Aristotle University of Thessaloniki Greece, General Hospital “G. Gennimatas”, Greece
  2. Department of Pediatrics, General Hospital “G. Gennimatas”, Thessaloniki, Greece
  3. Department of Vascular Surgery, Aristotle University of Thessaloniki Greece, General Hospital “G. Gennimatas”, Greece
  4. Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, General Hospital “Hippokration”, Greece

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