The use of minimally invasive endovascular procedures has increased, and as such, the frequency of associated vascular complications has also increased. Regardless of the access site location, rarely, arterial perforation can occur, which can be fatal if not properly managed. Interventionalists should be aware of the risk factors for perforation, commonly perforated vessels, and how different sites of perforation are diagnosed and managed. Rapid recognition and endovascular management reduce the need for open surgical repair, and thus reduce the morbidity and mortality of these complications. This review outlines the presentation, diagnosis, and management of iatrogenic perforations of the subclavian artery, thyrocervical trunk (TT), common carotid artery, superficial femoral artery (SFA), and external iliac artery.

Topical hemostatic agents are commonly used in a wide variety of surgical procedures to assist in hemostasis. However, the use of these agents is not without risk as many contain biologically active agents derived from human and animal products that have the potential to cause adverse reactions. This case report covers a 44-year-old man with a history of alpha-gal syndrome who was scheduled for an open reduction and internal fixation of a left distal radius fracture. Alphagal syndrome is characterized by an IgE-mediated type 1 hypersensitivity reaction to a mammalian oligosaccharide epitope. Patients with this condition have a history of a past tick bite and subsequent development of an allergic reaction to mammalian protein products, most notably red meat. The patient had concerns about products used during surgery and potential reactions based on his allergy. The intent of this case report is to promote physician awareness of the widespread use of mammalian products in surgical hemostatic agents and potential immunogenic reactions. By increasing awareness of the alpha-gal syndrome, the goal is that medical device companies will actively disclose product components that could potentiate these adverse reactions and continue to develop alternative agents.

BACKGROUND: To be acquainted with gastrointestinal vasculature variations is of utmost importance for establishing proper surgical management, improving safety, and decreasing the frequency of iatrogenic errors or complications arising in operational and post-operational settings. CASE REPORT: The subject of the present publication involves a unique case of an 80-year-old Caucasian male who presented with various vascular variations during routine cadaveric dissection. Key variations presented in this report include unique findings such as an abnormal trifurcation of the celiac trunk, a bifurcation of the superior mesenteric artery, and its associated branches; an unusual portocaval system communication; and various renal variations. These variations are examined in an anatomical and clinical context. We further discuss the possible embryologic and genetic mechanisms which may lead to such vascular abnormalities. CONCLUSION: Furthermore, with this report, we aim to demonstrate the strong need for adequate knowledge of vascular variations as well as the important role of pre-operative imaging in the identification of vascular variations and the elimination of iatrogenic errors during surgical procedures.