The off-the-shelf t-Branch device (Cook Medical, Bloomington, Ind) significantly advanced the endovascular treatment of ruptured thoracoabdominal aortic aneurysms. Improved techniques for expeditious implantation of the t-Branch may improve clinical outcomes for this emergent procedure. Currently, implantation is described using axillary and femoral access. We describe the repair of a ruptured thoracoabdominal aortic aneurysm exclusively through femoral access aided by a steerable sheath and newer generation, low-profile bridging stents.
Solitary fibrous tumour of the pleura (SFTP) is a rare primary tumour of the pleura associated with 4% of cases with a paraneoplastic hypoglycaemia, termed Doege-Potter syndrome (DPS). We report a case of DPS presenting with severe coma in a 90-year-old woman. The cause was a malignant SFTP treated with surgical resection, from which the patient made a full recovery with prevention of recurrent hypoglycaemia. Surgical resection of the SFTP presenting with symptomatic hypoglycaemia should be considered even in elderly patients.
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