Posterior circumflex humeral artery (PCHA) aneurysm is a rare condition. It mostly affects young professional sports player and might be career threatening. This is the report of the case of a 28 year old volleyball player presenting with symptoms of right digital ischaemia caused by a PCHA aneurysm. Surgical treatment by resection of the aneurysm without revascularisation was performed. The post-operative course was uneventful and the patient returned to professional competition one month after surgery. A literature review is also presented in an attempt to provide recommendations for PCHA aneurysm diagnosis and management.
The aim of this study was to analyze complications and outcomes of cryopreserved arterial allografts used as vascular substitute in the setting of vascular prosthetic infection, aorto-enteric fistula, or lower limb revascularization without venous material available. Methods: A retrospective analysis of prospectively collected data concerning all consecutive interventions performed with cryopreserved arterial allografts between January 2005 and December 2014 was conducted. 5year outcomes included survival, primary patency and allograft-related reintervention for allograft disruption, aneurysmal degeneration or anastomotic aneurysm. Multivariate analysis was performed in order to identify risk factors for death, thrombosis or reintervention. Results: During this time, 79 cryopreserved allografts were used: 42 for vascular prosthetic infection (Group 1), 11 for aorto-enteric fistula (Group 2) and 26 for femoro-tibial bypasses in the absence of venous material (Group 3). Mean follow-up was 54 months. 5-year survival was 61% in Group 1, 34% in Group 2 and 41% in Group 3 respectively. 5-year primary patency was 65%, 89% and 25% in Group 1, 2 and 3 respectively. 5-year allograft-related reintervention was 61%, 34% and 23% in Group 1, 2 and 3 respectively. Absence of antifungal therapy appeared as risk factor for death (HR ¼ 2.30; 95% CI ¼ 1.50e3.61, p < 0.05) and reintervention (HR ¼ 2.46; 95% CI ¼ 1.57e3.32, p < 0.01) and denutrition appeared as risk factor for thrombosis (HR ¼ 3.52; 95% CI ¼ 1.54e3.94, p < 0.01). Conclusion: Cryopreserved arterial allografts outcomes are tempered by suboptimal 5-year outcome with high reintervention rates. Multidisciplinary care is mandatory in order to improve long-term outcome.
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