Panagiotis Dimakakos

External Iliac Venous Aneurysm Treated With Tangential Aneurysmatectomy and Lateral Venorrhaphy: A Case Report and Review of the Literature

Venous aneurysms of the femoro-iliac axis are uncommon abnormalities of the vascular system with a potentially life-threatening course; they can be associated with the disastrous events of thromboembolism or rupture. Therefore, a focused imaging evaluation and prophylactic treatment is essential. The appropriate surgical approach is, however, dictated by the morphological parameters and the extent of the aneurysm. We present an external iliac venous aneurysm in a 31-year-old woman that was revealed incidentally and treated successfully by tangential aneurysmectomy and lateral venorrhaphy. The choice of surgical technique is discussed along with a review of the literature on venous aneurysms.

Screening for abdominal aortic aneurysms during routine lumbar CT scan Modification of the standard technique

INTRODUCTION Abdominal aortic aneurysms (AAAs) are often incidental findings in patients undergoing US, CT or MRI studies. The recommended field of view (FOV) for standard CT examinations of the spine is 14 cm. This FOV does not allow full visualization of the abdominal aorta. PURPOSE To justify a larger FOV for male smokers older than 55 years and women older than 65 years, with a higher incidence of AAA. MATERIALS AND METHODS The lumbar CT examinations of 100 consecutive patients (age: mean 68 years, range 55-85 years) presented with low-back pain were retrospectively reviewed. Measurements of the abdominal aorta and lumbar abnormalities were analysed. A control study in 850 patients who underwent abdominal CT scans for other causes was available for comparison. RESULTS There were three men with AAAs measuring 4.5, 5.5 and 5.6 cm (mean 5.2 cm). Findings related to the clinical problem were disk prolapse or herniation, spondylosis, spinal stenosis and grade I spondylolesthesis. In the control group, 17 patients were found with AAAs with diameter greater than 4 cm (2%). CONCLUSIONS Patients with low-back pain, older than 55 years of age, examined with lumbar spine CT, should also be screened for aortic disease, since the prevalence of AAA is similar with that of an age-matched control group. Appropriate modification in the applied FOV is recommended.

Abdominal Aortic Aneurysm With Ectopic Renal Artery Origins: A Case Report

The coexistense of an abdominal aortic aneurysm with ectopic main renal vasculature complicates aortic surgery and mandates a focused imaging evaluation and a carefully planned operation to minimize renal ischemia. We present the case of a 75-year-old man with an abdominal aortic aneurysm and a right kidney with two ectopic main renal arteries, one originating from the aneurysmal distal aorta and the other from the right common iliac artery; the patient underwent a surgical repair and followed an uneventful course with no deterioration of renal function. The preoperative and intraoperative details are reported, along with a review of the literature.