Significant chronic venous disease was observed in the patients who underwent combined resection of the femoral vein, the deep femoral vein, and the adductor muscles for a tumor.
Pseudoaneurysms of the inferior gluteal artery are rare. We describe a case of an inferior gluteal pseudoaneurysm that presented as a painful mass in the buttock. A percutaneous thrombin injection under ultrasound guidance failed to occlude the sac, probably due to the wide neck of the aneurysm. Subsequently, transluminal coil embolization by ultrasound-guided direct puncture of the inferior gluteal artery achieved complete thrombosis of the sac. Ultrasound-guided coil embolization is recommended in the treatment of peripheral aneurysms where catheter placement using conventional interventional procedures is difficult.
A 19-year-old female college student had numbness and the sensation of coldness of her left toes. She had a 3-year smoking history. Gangrene of the left foot developed rapidly. Angiography revealed peripheral arterial occlusion of both legs and arms. Detailed laboratory examination excluded collagen disease, a hypercoagulable state, and juvenile atherosclerosis. Below-knee amputation of the left leg was performed. Typical histologic findings of Buerger's disease were observed in the crural arteries and saphenous veins. The clinical course was uneventful after the patient stopped smoking. This is the second case report of Buerger's disease in a woman in the second decade of life. It is important that a correct diagnosis of Buerger's disease be established, because the disease process is benign, compared with collagen disease, if the patient stops smoking.
The case of a 71-year-old man with aneurysms of bilateral profunda femoris arteries associated with socalled ''arteriomegaly'' is presented. Both aneurysms were resected and only the left lateral femoral circumflex artery was reconstructed. Atherosclerotic aneurysms of the profunda femoris artery are rarely encountered, but once diagnosed, surgical repair is generally recommended to avoid complications. However, there are no cases presenting with complications of diameters less than 2 cm; therefore, we suggest that a profunda femoris aneurysm over 2 cm in diameter is an indication for surgical treatment. If the superficial femoral artery is patent, ligation without reconstruction of the profunda femoris artery does not cause severe leg ischemia; so that in such cases, reconstruction of the profunda femoris artery is not necessary.
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