This study was conducted to assess surgical outcomes of abdominal aortic aneurysm (AAA) in patients aged 80 years and older. We analyzed 24 aged patients who underwent surgical repair of AAA between January 2011 and March 2013 retrospectively. Mean age was 84.8±4.5 years, eight cases of AAA rupture were present. There were two hospital deaths (8.3%), which were preoperative ruptured cases. Postoperative morbidity occurred in eight. In 16 non-ruptured cases, we did not experience any in hospital deaths (p=0.6560). Of the 22 survivors, 13 (59%) were discharged on foot. In non-ruptured cases, 12 (75%) out of 16 were discharged on foot. Surgical outcomes of AAA, in aged patients at our hospital, were satisfactory in elective surgeries.
Iliac compression syndrome may cause venous congestion, resulting in deep vein thrombosis (DVT). We experienced a case in which DVT occurred after varicose vein surgery. To assess the risk of DVT before varicose vein surgery, we introduced the preoperative percutaneous vascular ultrasonography. Forty-four consecutive patients were enrolled in this retrospective study. Minimum diameter (Dmin) of the left common iliac vein (CIV), the ratio of minimum and distal maximal diameters (m/d) of the left CIV and maximal flow-velocity (Vmax) at the minimum diameter site were measured and distal flow-velocity (Vd) was calculated from these three values as an index of iliac venous congestion. The averages of Dmin, m/d, Vmax and Vd was 4.7 ± 1.8 mm, 0.66 ± 0.20, 31.7 ± 12.4 cm/s and 14.7 ± 10.4 cm/s, respectively. Dmin (R2=0.37, P<0.01) and m/d (R2=0.57, P<0.01) strongly correlated with Vd. In the receiver operating characteristic curve analysis, m/d was able to predict low Vd under 10.0cm/s accurately (sensitivity: 67%, specificity: 92%, area under the curve: 0.83). Thus, m/d may become an anatomical index for predicting the risk of DVT after varicose vein surgery.
Three cases of ascending thrombophlebitis in the great or small saphenous vein were treated with high saphenous ligation. They were a 65-year-old man, 67-year-old woman and 74-year-old man. Superficial venous thrombophlebitis is relatively common disorder, and it is generally viewed as a benign and self-limiting disorder. But ascending thrombophlebitis will often develop into deep venous thrombosis and pulmonary embolism. Therefore ascending thrombophlebitis in the saphenous vein should be treated carefully with an emergency operation or anticoagulation.
We report a case of spontaneous nonaneurysmal rupture of posterior tibial artery in a patient with bacteremia. The patient was an 82-year-old male. He felt slight pain with his left calf after admission for enterocolitis and Escherichia coli bacteremia. Ultrasonography showed suspected deep vein thrombosis without aneurysms, and heparinization was started. Eighteen days after admission, his painful left calf was swollen with a sudden pulsation. Computed tomography and ultrasonography showed suspected pseudoaneurysm of his left posterior tibial artery. However, there was no aneurysmal vascular tissue and the artery was completely ruptured. The arterial stumps were ligated without revascularization.