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Mycotic aneurysms resulting from intravesical bacillus Calmette-Guérin (BCG) treatment are exceptionally rare. We report on the case of a 73-year-old man who underwent intravesical therapy of BCG for bladder carcinoma and developed a right neck mass. A carotid pseudoaneurysm within a fibrotic mass was noted on surgical exploration. Radical resection was performed followed by a polytetrafluoroethylene interposition graft. Final pathology revealed necrotizing granulomas and multinucleated giant cells concerning for tuberculoma. Intravesicular BCG immunotherapy is an accepted treatment for patients with urothelial carcinoma. Carotid aneurysms are exceptionally rare in this setting and should prompt evaluation for systemic tuberculoid dissemination.

We used the National Trauma Data Bank (NTDB) to examine the incidence of blunt thoracic and carotid trauma nationally and survival outcomes based on treatment approach.All vascular traumas were identified from the 2008 NTDB. International Classification of Diseases, 9th Revision (ICD-9) diagnosis coding was used to identify 178 blunt thoracic aortic injuries and 313 traumatic blunt carotid injuries.In all, 2089 vascular traumas were identified. Patients with blunt thoracic trauma within the highest injury severity score (ISS) range (61-75) had a significant survival advantage when observation was compared with endovascular management (P.05). In the carotid trauma cohort, those with the highest ISS range (61-75) had a significant survival advantage with open surgery compared with observation (P.01).Patients with traumatic blunt thoracic injury and an ISS61 appeared to benefit from endovascular approaches compared with open management. Patients with blunt carotid trauma and an ISS61 appeared to benefit from open surgical management.

Introduction This study aimed to compare management patterns of patients with superficial venous thrombophlebitis (SVT) among phlebologists and vascular surgeons. Methods A survey was provided to practitioners who attended the American Venous Forum meeting in 2011. Statistical analysis included descriptive statistics, unpaired t tests, and Friedman's test for correlation. Results There were 354 US or Canadian health care providers of whom 169 were phlebologists and 185 were vascular surgeons. There was a significant different in anticoagulation administration and duration (P = .034, P = .032, respectively). Friedman's test for correlation between multiple surgical treatments showed no correlation between surgical treatments tested with all treatments having an equal distribution in our data. Follow-up differed between groups with vascular surgeons following up with imaging more than phlebologists (P = .03). Conclusion Our data indicate that there is no consensus between or among phlebologists or vascular surgeons as to the surgical management of superficial venous thrombophlebitis, duration of follow-up, and anticoagulation parameters.

Introduction. This study identified characteristics of patients with moderate internal carotid artery stenosis that are at increased risk for disease progression. Methods. Patients with asymptomatic moderate internal carotid disease correlating to 50% to 75% diameter reduction were followed for 3 years. Progression to greater than 75% diameter reduction or presentation with focal neurological symptoms was documented. Descriptive statistics and χ2 testing provided statistical analysis. Results. During follow-up, 26 (9%) developed symptoms or had an asymptomatic increase in diameter reduction to >75%. The rate of disease progression and/or development of symptoms was 5.5% at 12 months and increased to 7.2% by 24 months. Comorbidities with the highest associated event incidences were coronary artery disease (8.1%), hyperlipidemia (7.3%), and hypertension (6.7%). Conclusion. Male patients with coronary artery disease, hyperlipidemia, and hypertension are at increased risk and are candidates for frequent scree...

A 75-year-old man with invasive thymoma encasing the aortic arch and pulmonary arteries was referred to our institution with a 1-year history of dyspnea and worsening right heart failure. Pulmonary angiogram demonstrated greater than 90% stenosis of the right pulmonary artery. Balloon angioplasty and stent placement were performed with immediate improvement in his shortness of breath and peripheral edema. Improved lung opacification was noted on completion arteriography, and the stents remained patent until the patient expired from complications related to his cancer 2 years later. Pulmonary artery stenting in noncongenital causes of stenosis is a safe and effective therapy.

Ileocolic pseudoaneurysmal disease is a rare splanchnic aneurysm that affects 3 out of 100 000 patients, and only 7 cases have been described in the past 40 years in patients without preexisting connective tissue disorders. Abdominal pain is the most common presenting symptom and nearly 30% of patients present with hemorrhage. Ileocolic pseudoaneurysms are diagnosed by contrasted computed tomography scans and verified by arteriography. We present a case report and review of the literature in which a patient was initially managed by coil embolization, followed by laparotomy and suture ligation due to pseudoaneurysm rupture.