Otto H. Trippel

Leiomyosarcoma of the inferior vena cava

Abstract Judging by the number of reported cases, leiomyosarcoma of the inferior vena cava is an exceedingly rare neoplasm. Tumors of smooth muscle origin are, however, the most common primary neoplasms of major veins, and the inferior vena cava is the most common site of origin. The clinical manifestations are governed by the location of the tumor and the presence or absence of obstruction of the vena cava and/or its tributaries. Chiaris syndrome is frequently produced. The eighteenth recorded instance of leiomyosarcoma of the inferior vena cava is presented. The patient, the fourth to undergo surgical removal of the tumor, is living and free of apparent disease one year later. All but two of the patients with previously recorded cases were dead at the time of this report, and in both of these patients there was recurrence after surgical removal.

Innovative applications of extra-anatomic reconstruction.

The axillofemoral bypass, the femorofemoral bypass, and their modifications are valuable in patients who are debilitated, who have intra-abdominal sepsis or scarring, or who for any reason have unapproachable aortoiliac vessels. The long-term patency rate of these procedures, especially the femorofemoral crossover bypass, is highly acceptable.

Femoral aneurysmectomy. Management of the profunda femoris artery.

From the Department of Surgery of the Northwestern University. Aided by the Northwestern University Vascular Research Fund. Aneurysm excision with graft replacement has reached a high degree of surgical precision. Indications for surgery are dominated by the fact that the presence of a sizable aneurysm in an otherwise well individual constitutes need for surgical excision. Aneurysms in general enlarge and rupture. Those which cross joint creases carry an additional threat of acute occlusion. In