The purpose of this study was to review the effectiveness and feasibility of endovascular intervention for chronic mesenteric ischemia and its effect on morbidity and mortality.Patients and methods: Between march 2014, and October 2016, 7 patients diagnosed with chronic mesenteric ischemia had endovascular treatment. Demographic, clinical, diagnostic and procedure-related data were recorded, and strict follow up was done for 24 month postoperative.Results: Data was obtained for 7 patients who underwent endovascular procedures during the study period. Superior mesenteric artery (SMA) was affected in all patients, inferior mesenteric in 3 patients (42.9%) and celiac artery was affected in 2 patients (28.6%)Technical success was achieved in 6 patients. SMA was the main target for revascularization. Technical success was achieved in 6 patients (85.7%). 24 month Primary assisted patency was 71.4%. There were no major complications, minor complications occurred in 2 patients (28.6%). Conclusion:Endovascular management of chronic mesenteric ischemia has comparable outcome to surgical solutions but with less morbidity and mortality. However strict follow up and timely secondary intervention is mandatory.

Background: Classification systems are powerful tools for health care providers to use when managing patients with threatened limbs. The ability to define and delineate a heterogeneous group into fine-grained cohorts not only aids communication between providers, but also allows for a more accurate analysis of outcomes across treatment strategies. Thus, classification systems are essential for clinical decision making as well as setting meaningful goals and expectations with patients and their families. Aim of the work:To evaluate the predicative ability of this classification in a real world selection at Ain Shams University at period of 1 year depending on the Society for Vascular Surgery, Classification depending on: Wound, Ischemia and Foot Infection (WIFI).Patients and methods: This study included 60 patients with non-healing wound ulcer at Ain Shams University hospitals during year 2017 and 2018.Results: As our study showed WIfI classification was predictive of 1 year limb amputation and wound non healing and correlated significantly with outcomes predicted by the SVS consensus panel. The study showed 1 year amputation rates were 0% for stage 1, 7.7% for stage 2, 18.75% for stage 3 And 64.7% for stage 4. It also showed among the 60 patients studied 15 patients had done amputations where 6.7% were stage 2, 20% were stage 3 and 73.7% were stage 4. Conclusion:WIFI classification can be very useful in predicting the possibility of amputation during 1 year; also the study showed the benefit of using WIFI to plan management of patients presented with foot ulcer.

Background: Acute deep vein thrombosis (DVT) of the lower limbs occurs in about 1.0 person per 1000 population per year and is associated with substantial morbidity. Although anticoagulation effectively prevents thrombus extension, pulmonary embolism, death, and recurrence may occur. Moreover, many patients develop venous dysfunction resulting in post-thrombotic syndrome (PTS). PTS is associated with reduced individual health-related quality of life and a substantially increased economic burden. Hence, additional and more aggressive treatment, including systemic thrombolysis, thrombectomy, and catheter-directed thrombolysis (CDT), has been introduced to accelerate thrombus removal. Numerous studies suggest that additional CDT may provide highly effective clot lysis. There is little doubt that the overall benefit of thrombolysis depends on multiple factors, including predisposing risks, symptom duration, thrombus extension, and technical approaches and interventional success. Aim of the Work: This study aimed to define predictors of immediate and mid-long-term anatomic and clinical failures to guide patient selection and to set a standard for patient and physician expectations. Patients and Methods: This is a prospective observational cohort study that enrolled 20 patients (22 limbs) who presented to the Ain Shams University hospitals in the period from 7/2015 to 7/2017 with acute iliofemoral deep venous thrombosis (IFDVT) and fulfilled the inclusion criteria (mentioned below). Intrathrombus catheter directed thrombolysis (CDT) was done. Assessments of predictors of immediate periprocedural success was based on degree of clot lysis and resolution of symptoms and signs. Incidence of postthrombotic syndrome (PTS) was calculated at 6 months postoperative using Villalta score (≥5 vs <5). Results: During the study duration, 20 patients (22 limbs) were recruited. The mean age was 40.95 ± 12.35 years old, 11 patients (12 limbs) were women. The indication for CDT was severe progressive pain/swelling (18 limbs), and phlegmasia cerulea dolens (4 limbs). 5 patients (7 limbs) had IVC thrombosis at the initial venography. 5 limbs had balloon dilatation only while iliac stenting was done in 12 limbs. 15 patients received CDT for 48 hours while 5 patients (7 limbs) received CDT for 24 hours (mean duration of CDT was 1.68 days). As regards bleeding, only 2 cases of those who had CDT for 24 hours had bleeding, while bleeding occurred in 12 cases of those who had CDT for 48 hours. There were no recurrent DVT, intra or postoperative pulmonary embolism nor death within the study population till the end of the follow up period (6months). 6 months post intervention, 7 limbs were free of PTS (Villalta score < 5), 15 limbs had mild to moderate PTS, and no patients had severe PTS. The mean Villalta score was 5.14 ± 1.859. Conclusion: In our study, determinants of outcome following CDT for acute IFDVT were: 1) access site, 2) dose of thrombolytic agent used, 3) duration of thrombolysis, and 4) thrombus score at the end of the procedure. Mo...

Background: Varicose veins are a very common problem all over the world. Surgery has been the gold standard treatment for many years, however now other less invasive options are available and sometimes more efficient. Aim of the Work:To evaluate the RFA technique in treatment of GSV varicosities and to compare the results, clinical outcome, complications and recurrence rate after RFA and CS of GSV.Patients and methods: This observational retrospective study included 41 patients with varicose veins recruited from general surgery department and vascular surgery unit at Ain Shams Hospitals and in Nasser Institute for Research and Treatment.Results: Operative time was significantly less in CS compared to RFA. One , six and twelve months post intervention follow up using clinical examination and duplex imaging were used to asses outcome and detect complications and recurrence rate. No major complications were detected after both techniques; however minor post operative complications like paresthesia and ecchymosis were significantly less after RFA. Post operative pain, duration of analgesia use and time needed to return to normal activity were also significantly less in RFA group than CS group. Recanalization of GSV was not detected after radiofrequency maneuver nor CS. This study proved that radiofrequency ablation technique is safe and efficient in treating varicose veins however long-term results and cost effectiveness need further evaluation. Conclusion:Conventional surgery has been used for a long time for treatment of varicose veins with variable degrees of minor to major complications. Duplex guided radiofrequency ablation is an efficient and a safe modality in the treatment of great saphenous vein varicosities. Of most importance is an adequate Duplex scan to identify accessory channels and double superficial systems.

Background Classification systems are powerful tools for health care providers to use when managing patients with threatened limbs. The ability to define and delineate a heterogeneous group into fine-grained cohorts not only aids communication between providers, it allows for a more accurate analysis of outcomes across treatment strategies. Thus, classification systems are essential for clinical decision making as well as setting meaningful goals and expectations with patients and their families. Aim of the Work to evaluate the predicative ability of this classification in a real world selection at Ain Shams University at period of 1 year depending on the Society for Vascular Surgery Wound, Ischemia and Foot Infection (WIFI) classification system. Patients and Methods This study included 60 patients with non-healing wound ulcer at Ain Shams University hospitals during year 2017 and 2018. Results As our study showed WIfI classification was predictive of 1 year limb amputation and wound non healing and correlated significantly with outcomes predicted by the SVS consensus panel. The study showed 1 year amputation rates were 0% for stage 1, 7.7% for stage 2, 18.75% for stage 3 And 64.7% for stage 4. It also showed among the 60 patients studied 15 patients had done amputations where 6.7% were stage 2, 20% were stage 3 and 73.7% were stage 4. Conclusion WIFI classification can be very useful in predicting the possibility of amputation during 1 year; also the study showed the benefit of using WIFI to plan management of patients presented with foot ulcer.