The incidence of insufficiency is significant: approximately every third patient has short saphenous vein insufficiency, while three third of patients have perforating veins insufficiency. Color Duplex limb's veins ultrasonography is highly reliable method for the examination and study of superficial veins diseases, which is very important for preoperative decision-making and selection of surgical technique as well as for postoperative follow-up.

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Between 1991-2001 total number of 1058 patients was operated at the Institute of Cardiovascular Diseases of Serbian Clinical Centre due to abdominal aortic aneurysm. Of this number, 288 patients underwent urgent surgical treatment because of ruptured abdominal aortic aneurysm. The aim of this retrospective study was to show results of the early outcome of the surgical treatment of patients with ruptured abdominal aortic aneurysm, and to define relevant preoperative factors that influenced their survival. There were 83% male and 17% female patients in the study, mean aged 67 years. Intrahospital mortality that included intraoperative and postoperative deaths was 53.7%. Therefore, 46.3% patients survived surgical treatment and were released from hospital. Intraoperative mortality was 13.5%. Statistics showed that the gender and the age did not have any influence on mortality of our patients, as well as their co morbid conditions (p > 0.05). Clinical parameters at admission in hospital such as state of consciousness, systolic blood pressure, cardiac arrest and diuresis significantly influenced the outcome of treatment, as well as laboratory findings such as levels of hematocrit, hemoglobin, white blood cells, urea and creatinin (p < 0.05; p < 0.01). Ruptured abdominal aortic aneurysm still remains one of the most dramatic surgical states with very high mortality reported. We assume that important preoperative factors that influence the outcome of surgical treatment can be defined, but there is no single parameter which can certainly predict the lethal outcome after surgery. Also, the presence of co morbid conditions does not significantly influence the outcome of treatment in these patients. Therefore, urgent operation should not be withheld in most of the patients with ruptured abdominal aortic aneurysm.

Uvod: Pleurocenteza (torakocenteza) je dijagnostičko-terapijska metoda koja se koristi za dobijanje uzorka ili evakuaciju pleuralne tečnosti. Palijativna pleurocenteza se izvodi u cilju evakuacije malignog izliva koji je znak uznapredovalog stadijuma maligne bolesti. Cilj: Prikazati primenu metode palijativne pleurocenteze i odnos broja pacijenata sa malignim pleuralnim izlivom u zavisnosti od porekla primarnog tumora u jednogodišnjem periodu. Pacijenti i metode: U periodu od 01. 08. 2014. do 01. 08. 2015. godine na hirurškom odeljenju Opšte bolnice u Kikindi primenjena je palijativna pleurocenteza kod 23 pacijenta, prosečne starosti 68,6 godina. Dijagnoza je prethodno postavljena na osnovu kliničkog pregleda i rendgenskog snimka pluća. Za punkciju je korišćen set za jednokratnu upotrebu Pleurofix® Nr.1, kompanije B. Braun. Kod svih pacijenata pleurocenteza je izvedena u sedećem položaju, u lokalnoj anesteziji (2% lidokain), u VII ili VIII međurebarnom prostoru, u zadnjoj aksilarnoj liniji, tik uz gornju ivicu donjeg rebra. Za statističku analizu korišćen je χ 2-test. Rezultati: Palijativna pleurocenteza je primenjena kod 14 (60,87%) žena i 9 (39,13%) muškaraca (χ 2 =1,08; p>0,05). Ukupno je urađeno 38 pleurocenteza, prosečno po pacijentu 1,65. Jedna pleurocenteza je urađena kod 18 (78,25%) pacijenata, a dve ili više kod 5 (21,75%) pacijenata (χ 2 =30,21; p<0,01). Dve pleurocenteze su urađene kod 1 (4,35%), tri kod 2 (8,7%) i šest kod 2 (8,7%) pacijenta. Sa desne strane je urađena kod 14 (60,87%), a sa leve kod 6 (26,09%) pacijenata (χ 2 =8,43; p<0,05). Obostrano je urađena kod 3 (13,04%) pacijenta. Etiološki, karcinom pluća je bio uzrok kod 9 (39,13%), dojke kod 4 (17,39%), GIT-a kod 3 (13,04%), UGT-a kod 3 (13,04%), dok je kod 4 (17,39%) pacijenta ostalo nepoznato mesto primarnog tumora. Zaključak: Maligni pleuralni izliv se najčešće javlja kod pacijenata obolelih od karcinoma pluća i dojke. Češće je lokalizovan na desnoj strani. Kod značajnog broja pacijenata ostaje nepoznato mesto primarnog tumora. Palijativna pleurocenteza ima ulogu u trenutnom ublažavanju simptoma. U cilju adekvatnog tretmana potrebno je konsultovati grudnog hirurga. Ključne reči: Maligni pleuralni izliv; pleurocenteza; torakocenteza.

INTRODUCTION The true aneurysm formation of the autogenous saphenous vein graft (ASVG) is a very rare complication after bypass surgery [1 -5]. In 1969 Pillet [1] first described a true fusiform aneurysm formation of the ASVG which had been used as a replacement of the iwured superficial femoral artery in 26-year-old male patient. We present nine cases. CASE!. A 71-year-old man with previous history of arterial hypertension and higher serum lipid level, was admitted with an asymptomatic pulsating swelling of the medial portion on the thigh. Five years ago the bellow knee F-P bypass with ASVG due to occlusive disease has been performed. The transfemoral angiography (Figure 1) showed patent graft with fusiform true aneurysm formation at its mid portion. This aneurysm has been replaced with PTFE graft. The pathohistological examination showed an atherosclerotic origin of the aneurysm. This patient died four years after operation due to myocardial infarction with patent graft. CASE 2. A 57-year-old female with previous history of arterial hypertension and higher serum lipid level, had an elective resection and replacement of the superficial femoral artery aneurysm. For the reconstruction an ASVG was used. The saphenous vein showed postflebitic changes. Four years later she was admitted with asymptomatic pulsating mass of the mid portion of the thigh. The control transfemoral angiography showed patent graft with fusiform aneurysm formation of its mid portion. After aneurismal resection, an above knee F-P bypass with 8 mm PTFE graft was performed. A pathohistological examination showed a partially degenerated elastic membrane with fragmentation and disruption, without atherosclerosis (Figure 2). During the follow up period an elective resection of the subclavian artery aneurysm as well as abdominal aortic aneurysm, were performed. CASE3. A subclavian artery aneurysm caused by TOS has been repaired with sapehnous vein graft at 40-year-old female patient with regular arterial tension and normal serum lipid level. The pathohistologycal examination showed an intimai fibroelastosis associated with intimai and medial connective tissue proliferation of the aneurysm. The atherosclerotic changes were absent. Four years later this patient has been admitted urgently with ischemia of the left hand, absent distala arterial pulses and with asymptomatic pulsating mass over the supradavicular area. The Duplex ultrasonography and angiography, showed aneurysm of the ASVG, associated with occlusion (embolism) of the brachial artery (Figure 3). This aneurysm has been replaced with 6 mm PTFE graft Transbrachial thrombembolectomy has been performed too. The pathohistological examination showed a non atherosclerotic origin of the ASVG aneurysm (Figure 4). Three years after secondary operation the PTFE graft is patent. Echocardiography of the same patient showed mitral valve prolaps, probably caused by connective tissue disorder. CASE 4. A 56-year-old female patient was admitted urgently, due to hemorrhagic shock and giant pulsating swelling ...