Background Cancer patients with acute venous thromboembolism (VTE) receiving anticoagulant treatment have an increased bleeding risk. Objectives We performed a prespecified secondary analysis of the randomized, open-label, Phase III CATCH trial (NCT01130025) to assess the rate and sites of and the risk factors for clinically relevant bleeding (CRB). Patients/Methods Patients with active cancer and acute, symptomatic VTE received either tinzaparin 175 IU kg once daily or warfarin (target International Normalized Ratio [INR] of 2.0-3.0) for 6 months. Fisher's exact test was used to screen prespecified clinical risk factors; those identified as being significantly associated with an increased risk of CRB then underwent competing risk regression analysis of time to first CRB. Results Among 900 randomized patients, 138 (15.3%) had 180 CRB events. CRB occurred in 60 patients (81 events) in the tinzaparin group and in 78 patients (99 events) in the warfarin group (hazard ratio [HR] 0.64; 95% confidence interval [CI] 0.45-0.89). Common bleeding sites were gastrointestinal (36.7%; n = 66), genitourinary (22.8%; n = 41), and nasal (10.0%; n = 18). In multivariate analysis, the risk of CRB increased with age > 75 years (HR 1.83, 95% CI 1.14-2.94) and intracranial malignancy (HR 1.97, 95% CI 1.07-3.62). In the warfarin group, 40.4% of CRB events occurred in patients with with an INR of < 3.0. A lower time in therapeutic range was associated with a higher risk of CRB. Conclusions CRB is a frequent complication in cancer patients with VTE during anticoagulant treatment, and is associated with age > 75 years and intracranial malignancy.

The article describes two clinical cases of vascular complications related to hereditary exostose chondrodysplasia of the lower limbs in children. Despite early diagnostics the newgrowth was not timely removed. The anatomical localization of the exostoses in the vicinity of the main arterial trunks resulted in formation of pseudo-aneurysms due to a prolonged exposure of the vascular wall to the actively growing bone formations. After diagnostic imaging (ultrasonography and Doppler sonography, CT angiography, MR angiography of the vessels in the lower extremities) the authors performed a simultaneous resection of the femoral artery aneurysm with autovenous grafting and total resection of exostoses in both cases. Late follow up of both patients demonstrated vascular permeability at the graft site and no symptoms of stenosis were observed.

We examined 53 patients suffering from obliterating atherosclerosis with localization only in the aortoiliac segment, who were treated in the clinic from 1982 to 1984. The patients were aged from 42 to 61 years. According to the WHO classification, 16 (24.5%) were young (under 45 years) and 37 (75.5%) were middle-aged (46-60 years).