Objectives/Background : With decreased patient downtime and reduction in health expenditures, endovascular treatments have become popular for the treatment of venous insufficiency. In this study, we assessed the outcomes of using radiofrequency ablation (RFA) and sclerotherapy for refluxing veins and incompetent perforators in a developing country. Materials and Methods : Subjects were selected from an ongoing registry from October 15, 2015 to April 5, 2018. Patients were followed up until 6 months. Pre- and post-procedural Clinical, Etiologic, Anatomic, and Pathophysiologic (CEAP) scores were compared, and complications were documented and treated accordingly. Results: In total, 102 limbs (n=97) with 76 great saphenous veins (GSVs) and 26 small saphenous veins (SSVs) underwent RFA, with 79% undergoing concomitant sclerotherapy. Mean follow-up time was 188 days (±33.16). Moreover, 59% were males and 41% females. At the end of follow-up, 99% of the legs had complete occlusion. Pre- and post-procedural CEAP scores were 4.21±1.5 and 3.36±1.7, respectively (p-value <0.001). Endovenous heat-induced thrombosis (EHIT) types 1, 2, 3, and 4 were found in 8.8%, 3.9%, 1.9%, and 0% of the legs, respectively. Most common complications were pain and tenderness (51%), bruising (18%), and paresthesia (7%). Conclusion : RFA and sclerotherapy have proved to be safe and efficacious. Computed tomography (CT) venous mapping aids in delineating complex venous anatomy and in ruling out deep vein thrombosis (DVT) in cases with discrepancy on Doppler ultrasound. Strict compliance of procedural and post-procedural protocol can assure promising results and futuristic value.

Spontaneous aneurysms are rare in the pediatric age group. Aneurysms of peripheral arteries are even rarer. The diagnosis should not be missed to prevent distal limb ischemia and life-threatening complications. Hence, timely surgery to save the affected limb is advised. There is an increasing number of reported cases of such aneurysms in the English scientific literature. We present a rare case of pediatric idiopathic popliteal artery aneurysm (PAA), with no known risk factors. This scientific writing is unique in its way of reporting an idiopathic aneurysm with spontaneous onset. However, we have successfully investigated and managed the patient considering the established guidelines on aneurysmal surgery.

Purpose: The aim of our study was to determine the incidence and extent of deep venous thrombosis in hospitalized patient of tertiary care hospital.Methodology: This was observational cross sectional study. The data of patients had been collected from Jinnah hospital Lahore, Pakistan. After taking informed consent, data was collected through the Doppler ultrasound which was performed for lower limb in symptomatic patients. Equipment used was TOSHIBA Xario (200) with linear probe frequency ranging from 7-10 MHz. The data analysis was performed with the help of SPSS version 24.Findings: Total 124 patients were included in this study in which the mean age of the patient was 45.38 ± 16.846 with a range of 14-90 years. The Mean weight of patients was = 70.31±9.285 with the range 48­-90kg. The females were 56 and males were 68 in number included in this study. Out of 124 patients, right leg DVT present in 44(35.5%), and left leg DVT present in 74(59.7%), and bilateral DVT present in 6(4.8%) of patients. Unique contribution to theory, practice and policy: It was concluded that age plays a significant role in the development of DVT. Patients with acute DVT have hypoechoic thrombus while the chronic DVT have hyperechoic echogenicity. DVT was most commonly seen in the left leg in comparison with right leg. Ultrasound is the best modality in the detection of DVT.

Aim: To assess the outcomes of ligation and excision of brachial artery pseudoaneurysm without revascularization in IV drugs users. Place & duration of study: From Jan 2021 to Jan 2022 at the department of Surgery of Doctors Hospital & Medical Centre Lahore. Methodology: A retrospective observational study was conducted at the surgery department of Doctors Hospital & Medical Centre Lahore for 1 year. Intravenous drug abusers, aged between 18-65 years diagnosed with brachial artery pseudoaneurysm were included in the study whereas pseudoaneurysm was caused due to arteriovenous fistula, hemodialysis, and trauma or in patients who had undergone revascularization were excluded from the study. The data were processed using SPSS 20.0. Results: A total of 15 intravenous drug users were enrolled in the study. The mean age of the participants was 33.4±5.4 years, and the mean period of addiction was 1.9±2.5 years. Majority of patients (65%) presented with an affected right arm. The most common presentations were: bleeding pseudoaneurysm (73.3%), oozing pulsatile mass (20%), and infected pulsatile mass (6.6%). Following the intervention, limb salvage was achieved in all patients. Ischemia was reported in none of the patients. Conclusion: The excision and ligation of the pseudoaneurysm can be an effective treatment option for the pseudoaneurysm of a brachial artery caused due to drug addiction. Keywords: The brachial artery, pseudoaneurysm, intravenous drug users, drug addiction