Osteochondromas occasionally cause arterial complications, mainly concerning the distal superficial femoral and popliteal arteries. The authors present 11 patients (12 cases) with arterial disorders caused by exostoses who were hospitalized in their Vascular Clinic. All but 1 had signs or symptoms of peripheral arterial disease such as intermittent claudication or diminished peripheral pulses, and 1 also presented serious neurologic sequelae. All were examined by radiography, ankle-brachial index (ABI), computed tomography scan, color duplex scan, arteriography, and scintigraphy. The popliteal artery was the most commonly affected vessel in 7 cases. In addition to the removal of the offending osteochondroma, 7 patients underwent excision of the diseased arterial segment and replacement by a saphenous vein interposition graft. The remaining 5 cases received a vein graft patch. The authors achieved good results with no serious complications detected in the immediate postoperative period and subsequent follow up. Surgical treatment of the vascular complications caused by exostoses is mandatory. Even in the absence of vascular symptoms, such bony lesions in close proximity to a vessel should be on a close follow-up in order to prevent permanent arterial damage.

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The purpose of this retrospective study was to evaluate the early and long-term results of vascular reconstruction for popliteal artery entrapment syndrome (PAES). Fourteen patients (18 legs) who underwent surgical treatment for PAES over a 10-year period were included. Seven patients underwent simple myotomy and remained symptom-free for a 5- to 96-month follow-up period. Seven patients underwent myotomy and vein graft: the graft remained patent in four cases, in one case the graft thrombosed and was successfully reoperated on, and two patients remain asymptomatic without palpable pulses. Of the three patients with a polytetrafluoroethylene (PTFE) graft, one is symptom-free with a patent graft, one continues to present with intermittent claudication (IC), whereas the third subsequently underwent above-knee amputation. PAES, a congenital abnormality, requires surgical treatment and any conservative management may be deleterious. Early diagnosis is of utmost importance because in the early stage, simple surgical procedure offers a permanent therapeutic result. Thus, every young sportsperson, with even minor lower extremity problems, should be examined by a vascular surgeon.

The purpose is to evaluate the role of endovascular management for primary aortoduodenal fistula in poor surgical risk patients. A 70-year-old-man was admitted at the emergency room of our hospital with recurrent upper-gastrointestinal bleeding. A diagnostic workup was suggestive of a primary aortoduodenal fistula caused by erosion of an infrarenal abdominal aortic aneurysm. Intractable cardiac arrhythmia, recurrent hemorrhage, and poor patient condition were compatible with an exceedingly high surgical risk. The fistula was successfully treated, and gastrointestinal bleeding was eliminated with placement of a Lifepath endoluminal aortoiliac stent graft. At the 21-month follow-up, the patient was not presenting with symptoms and signs of graft infection, and radiologic studies confirmed decreasing aneurysm size without associated signs of local sepsis. Endovascular stent grafts can efficiently arrest massive exsanguination in critically ill patients with primary aortoenteric fistula. The risk of graft infection remains the most serious problem associated with this approach.