Hyperhomocysteinemia and arterial aneurysm

Brachial artery aneurysm accompanying a homozygous methylenetetrahydrofolate reductase mutation

Elevated plasma homocysteine (Hcy) is one of the suggested risk factors for endothelial dysfunction. There is evidence of association between raised plasma Hcy and an increased risk of developing peripheral arterial disease. A causal relationship, however, has not been established. In this report, a 37-year old male patient with the complaints of intermittent hand pain is presented. Brachial artery aneurysm accompanying a homozygous methylenetetrahydrofolate reductase mutation was detected.

Use of ultrasonic scalpel in subfascial endoscopic perforator vein surgery: a novel approach

BACKGROUND

The aim of this study was to determine the feasibility of using the ultrasonic scalpel in subfascial endoscopic perforator vein surgery (SEPS) and study the results of ulcer healing and reversal of skin changes.

MATERIALS AND METHODS

From January 2003 to November 2005, we performed 47 SEPS in 42 patients under spinal anesthesia, using the two-port technique. All patients had chronic venous insufficiency ranging from class IV to VI.

RESULTS

Duration of surgery for SEPS averaged 30 minutes, with no postoperative mortality. One patient developed a wound infection at the port site, which was managed conservatively. None of the procedures required a conversion to open surgery. We have had no recurrence of venous ulcer, so far. Barring 1 patient, all patients returned to normal routine within 5 days of surgery. In more then 90% of patients, ulcer healing was achieved within 8 weeks of surgery.

CONCLUSION

Our study clearly shows that the ultrasonic scalpel is a very safe, reliable tool in SEPS, as there was very low morbidity regarding wound complications and other per- or postoperative complications, which can be there when one uses the metallic clips or electrocautery for SEPS.