Daiki Uchida

A Case of Ruptured Aneurysm of the Persistent Sciatic Artery Presenting Acute Lower Limb Ischemia

Only 5 cases of ruptured aneurysm of the persistent sciatic artery have been previously reported to date. We experienced a case of ruptured aneurysm of the persistent sciatic artery presenting acute lower limb ischemia. Physical examination showed a pulsatile mass with a subcutaneous hemorrhage in the left buttock, drop foot and paresthesia of the foot due to limb ischemia. An enhanced computed tomography scan showed a ruptured aneurysm of the left persistent sciatic artery at the level of the greater trochanter. An exclusion of the aneurysm and creation of common iliac to popliteal artery bypass was performed as an emergency operation.

IF10. The Influence of Postoperative Ambulatory Status on Graft Flow After Infrainguinal Bypass Surgery With Vein Grafts

had widely patent SMAs at last follow-up. Mean total seal zone length was 41.4 mm. There was a single secondary intervention for asymptomatic SMA stenosis requiring stent placement 1 year after F-EVAR. There were no Type IA endoleaks and no endoleaks related to SMA fenestrations. Five patients of the entire cohort (4.7%) required SMA stenting at the index procedure. Three of these patients had prior EVAR (n 1⁄42) or open repair (n 1⁄4 1), One patient had a pre-existing critical SMA stenosis and underwent planned SMA stenting, and in one patient, the graft was deployed imprecisely and low, and the SMA was successfully stented from a brachial approach. Conclusions: The unstented SMA in association with F-EVAR remains widely patent in the presence of fenestrations or struts and is not associated with endoleaks. The need for adjunctive SMA stenting may be related to prior aortic intervention and case complexity. Follow-up DUS and CTA surveillance confirms that SMA patency remains in the normal or <70% stenosis range after F-EVAR regardless of whether it is encompassed by a large fenestration or crossing struts.

PC140. Clinical Outcomes of Surgical Revascularization for Patients With Threatened Limb Attributed to Pure Isolated Infrapopliteal Lesions

CI, Confidence interval; OR, odds ratio.Note: Area under the Receiver Operating Characteristic curve 1⁄4 0.83; model adjusted for self-reported symptom severity Component of the Barratt’s Impulsivity Questionnaire used to measure behavioral economics factors; time orientation suggests that individuals oriented to the future enact behaviors that have delayed effects. Journal of Vascular Surgery Abstracts e211 Volume 67, Number 6

Fatal Vasospasm of the Coronary Arteries in a Patient Undergoing Distal Bypass Surgery and Endovascular Therapy for Threatened Lower Limbs Due to Acute Exacerbation of Peripheral Arterial Disease

A 79-year-old man with a heavy smoking history presented with threatened lower limbs due to acute exacerbation of peripheral artery disease (PAD). He underwent emergent distal bypass surgery for the right leg and external iliac stenting for the left leg. Fatal coronary artery spasm (CAS) with ST segment changes on electrocardiography was observed 28 h after the procedures, resulting in cardiac arrest. Coronary angiography showed widespread CAS with improvement after intra-arterial nitroglycerin infusion. We should keep in mind that CAS may occur more frequently than expected in PAD patients, especially those who have not stopped smoking prior to revascularization.