Lower-extremity vascular access has acceptable results in terms of patency, with femoral vein transposition having better patency rates than femoral grafts. Autologous access is associated with less infective complications, however, at the expense of increased ischaemic complications rates. Further research with randomised trials is required to assess the outcomes of lower-extremity vascular access.

Early (12 months) results suggest similar clinical performance of the Endurant stent graft system in endovascular treatment of AAAs with friendly and hostile anatomies, however, demonstrating more intra- and perioperative adversities for the last group. Larger prospective studies or even randomized trials comparing different new generation graft models are required to evaluate the comparable long-term results and possible expansion of EVAR indications for this specific endograft in adverse anatomies.

Buerger's disease is an inflammatory occlusive disorder affecting the small and medium-size arteries and veins of young, predominantly male, smokers. The disorder has been identified as an autoimmune response triggered when nicotine is present. Tobacco abuse is the major contributing risk factor; however, smoking seems to be a synergistic factor rather than the cause of the disease. The traditional diagnosis of Buerger's disease is based on 5 criteria (smoking history, onset before the age of 50 years, infrapopliteal arterial occlusive disease, either upper limb involvement or phlebitis migrans, and absence of atherosclerotic risk factors other than smoking). As there is no specific diagnostic test and an absence of positive serologic markers, confident clinical diagnosis should be made only when all these 5 criteria have been fulfilled although not universally accepted. The angiographic findings in Buerger's disease ("corkscrew," "spider legs," or "tree roots") are helpful but not pathognomonic. A wide spectrum of medical or surgical therapeutic options have been proposed; however, total abstinence from tobacco use remains the only means of stopping the disease progression. The initial management of patients with Buerger's disease should be conservative. Because several arteries may be unaffected, claudicants should be encouraged to walk, whereas patients with "critical" ischemia should be admitted for bed rest in the hospital. Bypass grafting is seldom an option, as the location of the lesions distally leaves little to bypass because of lack of target vessels. A literature review revealed only a few series reporting vascular reconstruction (mainly femorodistal bypasses) in Buerger's disease. Bypass patency rates were suboptimal; however, the corresponding limb salvage rates were satisfactory. A possible explanation is that patent grafts, even over a short period of time, are sufficient to allow healing of ulcers in patients with Buerger's disease.

Urgent and elective endovascular repair of aPAUs can be achieved with high technical success. The significant co-morbid status of the treated patients is illustrated in the considerable in-hospital mortality and underlines the advantage of such treatment over open surgical repair.

No abstract

Upper limb vein aneurysms complicate all types of autogenous arteriovenous fistulae (AVF) and comprise false aneurysms secondary to venipuncture trauma as well as true aneurysms, characterized by dilatation of native veins. The dilatation of a normal vein and the development of a true aneurysm are strongly influenced by local hemodynamic factors affecting the flow in the drainage venous system and are also the target of operative interventions. This review article focuses on the description of these hemodynamic aspects which all physicians involved in the management of dialysis patients should be aware of. Furthermore, it delineates their complicated interactions and also highlights their utility in clinical decision-making and therapeutic management.

No difference was found between the crossed-limb technique and the conventional endograft position as regards short- or midterm clinical outcomes.

Thromboprophylaxis practices following varicose veins procedures vary among vascular surgeons in Greece. This reflects the uncertainty regarding the exact incidence of thromboembolic events in the existing literature as well as the absence of specific guidelines.