No abstract

Thoracic aortic aneurysm (TAA) is generally a disease of the elderly which remains mostly asymptomatic. It is often detected incidentally with imaging studies of the chest done for other reasons. We present a 55year-old smoker, normotensive and non-diabetic male patient who was diagnosed as a case of TAA and treated by endovascular means with thoracic endovascular aortic repair (TEVAR) technique. Due to small caliber femoral artery, thoracic endograft was deployed through a Dacron graft conduit of 10 mm diameter which was anastomosed to the common iliac artery. It was a hybrid procedure done in cardiac catheterization laboratory under general anesthesia. Completion angiogram revealed good technical success with no endoleak or neurological deficit. Patient improved symptomatically after TEVAR. Bangladesh Heart Journal 2019; 34(2) : 146-150

Introduction:Varicose vein is one of the most common vascular conditions in the adult population. Symptoms ranged from dilated and tortuous veins with fatigue, heaviness, and itching to more serious conditions such as skin discolouration and leg ulceration. 1 Multiple techniques for treating saphenous reflux have been developed over the years, such as high ligation at saphenofemoral junction, stripping of great saphenous vein, ultrasonogram guided sclerotheraphy, as well as various combinations of these procedures. Recently, endovenous laser ablation identified as a viable treatment option for patients with saphenous reflux. 2 Surgical treatment includes high ligation of the saphenous vein or high ligation and stripping of GSV. High ligation alone demonstrated a 43%-71% failure rate at 5years and high ligation and stripping of GSV had a 25%-60% failure rate, ranging from 5-34 years in the available literature. [3][4][5][6] The failures associated with high ligation alone stemmed from neovascularization that occurred in the saphenofemoral surgical bed and was attributed to the process of skeletenization and ligation of all tributaries of the saphenoferal junction. In the recurrences that occurred after stripping, the etiology may be incomplete removal of the entire vein. 2 The most common complication of high ligation and GSV stripping is paresthesia with others like infection, haematoma, bruising. Because of high failure rates and recurrences of Foam Sclerotherapy and Laser Ablation of Varicose Veins: Newer Option in Bangladesh Perspective

Perianastomotic stenosis is a common scenario after creation of arteriovenous fistula for hemodialysis. Most of the interventionists prefer transvenous approach. But transradial approach can easily visualize radial artery and cephalic venous tree up to central vein. This retrospective study was performed from November 2012 to January 2017 in Ibn Sina Hospital, Dhanmondi, Dhaka. Total patients undergoing hemodialysis access were 148 (male 74, female 74, male-female ratio 1:1). Number of radiocephalic fistula was 95 (64%), brachiocephalic fistula 50 (34%) & others 3 (2%). Most of the punctures were done by palpation. Sometimes puncture was made by ultrasonogram guidance. Puncture needle size was 21 gauge, 2.5cm or 4cm long. Sheath size was 6 F x 4 cm or 7 F x 4cm. Majority of the cases (140) were successfully approached through retrograde transradial route. Few cases (8) were approached through retrograde venous route due to thrombosis of radial artery for previous intervention or creation of radiocephalic fistula in an end to end fashion. It was concluded that retrograde transradial approach to dilate perianastomotic stenosis as well as outflow vein is a good option. Bangladesh Heart Journal 2020; 35(1) : 54-60