87 year old male with a 1 month history of an enlarging pulsatile right groin mass. 15 years prior the patient had an aorto bifemoral bypass graft placed for iliac artery occlusive disease and claudication. The patient did not want the open surgical repair that was offered. I performed an endovascular repair in 45 minutes. The advantages of an endovascular approach versus an open surgical procedure are clear - safer, faster recovery, no general anesthesia, almost no risk of infection and no large groin incision.
Recurrent lower extermity DVT should prompt an investigation for venous outflow obstruction. Too often these patients are under treated.
The tip of a hydrophilic wire was fractured and subsequently retrieved during the crossing of a distal anterior tibial artery near occlusion
59 year old male, smoker, sudden onset of pain and discoloration of the right 3rd toe.