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Introduction: Central venous occlusion (CVO), which is caused by central venous catheters in haemodialysis patients , remains a challenge in vascular surgery., Case Presentation: The authors report data evaluating bypass graft patency and complications of two patients with CVO who have benefited from a subclavian artery to right atrium bypass using polytetrafuloroetylene. The first patient , underwent three times an angioplasty of the atrio prothetic anastomosis , finally the graft failed at 12 month. The second one, presented a steal syndrome with ischaemia of the right upper limb immediately postoperatively. Three months after the procedure , she underwent an angiographic control that showed a stenosis of the protheto atrial junction., Clinical Discussion: Central venous occlusion in patients with end-stage kidney disease is most often due to central venous catheters. Although the endovascular therapy is the first-line approach to the treatment of CVO, the surgical bypass to the right atrium is often the last resort to preserve adequate vascular access in haemodialysis patients, with CVO. The autologous vein and bovine arterial bypass remains better than polytetrafuloroetylene grafts in terms of long-term patency. Only few cases have been reported un the literature , besides no long-term outcome data has been previously reported., Conclusion: Long-term secondary patency of bypass to the right atrium can be achieved, but requires strict follow-up, and multiple endovascular procedures to maintain the bypass access., Competing Interests: The authors declare that they have no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Coronavirus disease 2019 (COVID-19) is a worldwide pandemic systemic infection that is responsible for serious coagulopathies similar to disseminated intravascular coagulation., Case Presentation: The authors report the case of a COVID-19 patient who presented with phlegmasia cerulea dolens (PCD) of the left lower limb, so he benefited from aponeurotomies of the internal and anterolateral muscular compartments., Clinical Discussion: The severe acute respiratory syndrome coronavirus 2 involves an inflammatory process in thrombotic events in COVID-19 patients, including a cytokine storm. PCD evolves in three semiological phases: venous stasis, weakening of the pulses, and the constitution of major ischemia. In the literature, the authors find many reports that have been published regarding increased thrombus formation in COVID-19 patients; these include DVT formation, pulmonary embolism, and stroke. Nevertheless, publications concerning PCD in COVID-19 patients remain rare., Conclusion: Although the severe acute respiratory syndrome coronavirus 2 remains a thrombogenic pathology, systematic anticoagulation is the subject of hypothesis. Hence the importance of regular monitoring of markers of vascular thrombosis., Competing Interests: There is no conflicts of interest between the authors.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Diclofenac sodium is a nonsteroidal anti-inflammatory, the injection of which by the intra-arterial route can lead to serious vascular complications, including limb ischemia., Case Presentation: We report the case of accidental intra-arterial injection of diclofenac sodium in the brachial artery leading to acute limb ischemia., Clinical Discussion: Iatrogenic intra-arterial injection is rarely reported in the literature; however, it is toxic and can lead to limb amputation. Only two cases of intra-arterial injection of diclofenac have been reported in the literature. The proposed pathophysiological mechanism is vasospasm, intravascular thrombosis, and chemical endoarteritis. The most common anatomical location in accidental intra-arterial injection is the antecubital fossa, where branches of the ulnar and brachial arteries are more superficial., Conclusion: The injection of medication must be as careful as possible, since the intra-arterial injection can affect the functional prognosis of the organ., Competing Interests: There are no conflicts of interest between the authors.Sponsorships or competing interests that may be relevant to the content are disclosed at the end of this article., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Infective endocarditis remains a dreaded and severe disease because of its course, its complications, its need for good antibiotic management, as well as its morbidity. Peripheral mycotic aneurysm is a rare complication of infective endocarditis. We report the case of a 62-year-old female patient who presented with Streptococcus SPP infective endocarditis treated by antibiotics. Two months later, she presented with a mycotic aneurysm of the right brachial artery with the same germ, we have performed a brachial artery ligation, then a complete revascularization by graft of the saphenous vein. Through this case, we should not forget that the lesional assessment is always necessary to avoid missing serious complications that could threaten the functional prognosis, even vital., Competing Interests: The authors declare no competing interest., (Copyright: Hammam Rasras et al.)

Endovascular treatment of abdominal aortic aneurysm concerns the introduction of aortic endoprosthesis which aims to isolate aneurysm from the circulation. The leading complication of this technique is the endoleak which is defined by the persistence of blood flow within the aneurysm sac. The main risk is the rupture of the aorta which can jeopardize the vital prognosis of patient. White classification defines five types of endoleaks. Type III is secondary either to a disconnection between the components of the endoprosthesis (type IIIA) or to material damage (type IIIB). This type presents a particularly high risk of aortic rupture. Endovascular approach is the treatment of choice for this type of endoleaks through stent-grafts implantation. Type III endoleak may appear at any time after endovascular aortic aneurysm repair (EVAR). Although the frequency of endoleak after EVAR has been reduced after improvement and development of stent-graft systems, there are still many improvements and additions expected to improve the prognoses for patients after EVAR. Our case is an 80-year-old patient, who received an EVAR in 2012 for his abdominal aortic aneurysm, admitted to our vascular surgery department for a type III endoleak, for which he benefited from an endovascular treatment by placement of stent-grafts., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Suliemeh et al.)

Introduction: Cannabis is commonly misused psychoactive drug which is known to be associated with a number of psychotic and somatic side-effects. Cannabis arteritis is a rare vascular disorder, since only about fifty cases have been reported in the literature., Case Presentation: We report a case of a 40-year-old chronic cannabis user male, who was admitted for painful necrosis of the fifth toe of the right foot. The etiological investigation ruled out the main causes of juvenile arterial disease. Therefore cannabis was the only causative factor found in this patient. An amputation of the fifth toe was performed 20 days later of administrating Prostacyclin (Iloprost) , with a good postoperative improvement., Discussion: The main causes of juvenile arterial disease are: atheromatous arterial disease, thromboangiitis obliterans (Buerger's disease) , systemic or autoimmune diseases. The diagnosis of cannabis arteritis remains a diagnosis of exclusion. it remains a rare phenomenon which is responsible for various symptoms, which can go as far as the amputation of the limb. Several authors have classified cannabis arteritis as a clinical form of Buerger's disease, due to similar clinical semiology and similar appearance at arteriography. Nowadays, we don't know exactly the histopathologic patterns of this pathology., Conclusion: Although several therapeutic options exist, Cannabis weaning still the main part of cannabis arteritis treatment., Competing Interests: All authors are consent for the final version. There is no conflicts of interest between the authors., (© 2022 The Authors.)

Introduction: Central venous Occlusion (CVO) is a serious complication that occurs mainly in patients with long term central venous catheters for dialysis. It remains a challenge in vascular surgery., Case Presentation: We report a case of a patient with end-stage kidney disease (ESKD), who was admitted for chronic occlusion of the superior and inferior vena cava and underwent a right subclavian artery to right atrium (RA) bypass using polytetrafuloroetylene (PTFE) graft., Clinical Discussion: Central venous catheters remains the main cause of CVO in ESKD. Although the endovascular therapy is the main approach in the treatment of CVO, the surgical bypass to the RA is often the last resort to preserve vascular access in hemodialysis patients. The autologous vein and bovine arterial bypass remains better than PTFE grafts in terms of long term patency., Conclusion: fistulas as a first approach for dialysis access must be privileged at the expense of central catheters. However bypass to RA by mini thoracotomy incision remains as an excellent option for dialysis access in ESKD with CVO., Competing Interests: There is no conflicts of interest between the authors., (© 2022 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.)

Post-traumatic vascular lesions of the lower extremity in children are uncommon and present some particularities in their management in comparison to those that occur in adults. Here, we report the case of an 11-year-old boy who presented with a diaphyseal fracture of the right femur associated with an injury of the homolateral superficial femoral artery after blunt trauma of the lower limb. The bone and the arterial injuries were surgically and successfully treated by an elastic stable centromedullary nailing and a venous bypass, respectively, with a good clinical and radiological evolution. The management of vascular injuries in childhood can be challenging and requires some special measures to avoid undesirable complications. Functional prognosis is generally described to be good if a rapid and adequate treatment is performed., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Benradi et al.)

Introduction: Coronavirus disease-2019 is a worldwilde pandemic not limited to pulmonary dysfunction. it is a systemic infection responsible for serious coagulopathies., Case Presentation: We report the case of a patient who presented an acute ischemia of the left lower limb, after day 5 of (Covid-19) infection, with a second thrombotic localization in the left upper limb at the twentieth day of post covid while he was on anticoagulation., Clinical Discussion: Several studies have shown the involvement of the inflammatory process in the thrombotic state in patients with (Covid-19) infection. The inflammatory process leads to the activation of the thrombotic cascade. Various elevated markers have been identified frequently and described to determine the progression of sepsis-induced prothrombotic disease secondary to Covid-19. Our case remains unique in its kind, since the patient presented twice the acute ischemia of the limbs, the first at the left lower limb, while he was on preventive low molecular weight heparin (LMWH), the second time at the left upper limb, while he was on anticoagulation (RIVAROXABAN 20 mg/jr). Although the efficiency of preventive anticoagulation in Covid-19 patients has not been established, it remains systematic as a prescription in the hospital environment., Conclusion: All in all, The regular monitoring of vascular markers thrombosis, and preventive anticoagulation remains the only weapon available to any clinician to fight against vascular thrombotic complications in Covid-19 patients, though its realiability has not been proven., Competing Interests: There is no conflicts of interest between the authors., (© 2021 The Authors.)

Introduction: Paradoxical embolism is a rare medical phenomenon. Depending on the site of embolisation, it can cause different symptoms. Although rare, mesenteric ischemia can reveal paradoxical embolism, and the embolisation of two different sites is rarely described in the literature., Case Presentation: We report the observation of a patient with a table associating an acute mesenteric ischemia and an acute ischemia of the upper limb; whose the etiological assessment revealed a deep venous thrombosis of the lower limbs complicated by pulmonary embolism., Clinical Discussion: These paradoxical embolisms occurred through a patent foramen ovale. The diagnosis of the patent foramen ovale in this patient was revealed by transthoracic echocardiography, with bubble test. The patient benefited from an embolectomy of the superior mesenteric artery and an embolectomy using fogarty catheter by approching humeral artery at the elbow crease with good postoperative evolution. The patient was put on long-term anticoagulation with Acenocoumarol (because of low socio-economic level of our patient). We didn't recommended the closure of the PFO because of the small size of the shunt and especially because the patient refuses that procedure., Conclusion: Paradoxical embolism remains a pathology rarely mentioned by clinicians, although it can engage the functional and vital prognosis of the patient, hence the interest of a good cardiac evaluation in any patient with embolic ischemia., Competing Interests: Non-conflicts., (© 2021 The Authors.)

Background: Abdominal Compartment Syndrome (ACS) is a pathological condition that results from an increase in pressure within the abdomen associated with organ failure. It can be acute or chronic, primary or secondary. ACS poses a serious diagnostic challenge for physicians as the clinical presentation is varied and can mimic other medical pathologies. To prevent a multi-organ failure and ultimately death due to this disease, the World Society of Abdominal Compartment Syndrome (WSACS) suggested clinical criteria and biology tests to facilitate an early diagnosis of acute ACS., Case Presentation: We report a case of 61 year-old man diagnosed with chronic mesenteric ischemia that has been successfully treated by prosthetic bypass. The postoperative period was eventual, the patient presented complications corresponding essentially to a manifest acute ACS. The treatment consisted on abdominal decompression and resuscitation measures., Conclusions: An early diagnosis of ACS disease for an appropriate therapeutic initiation is mandatory to prevent its complications and save the patient's life prognosis., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)