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Previously excluded internal iliac artery (IIA) aneurysms can continue to expand and pose a risk of rupture. In this case series, we present three patients with previously excluded, expanding IIA aneurysms after endovascular stent coverage or open surgical ligation of the proximal IIA. We describe a hybrid approach to treat these patients safely and effectively.

Abstract Out‐of‐hospital cardiac arrest survival continues to be dismal with the only recent improvement being that of extracorporeal cardiopulmonary resuscitation (E‐CPR) or cardiopulmonary resuscitation (CPR), augmented by extracorporeal membrane oxygenation (ECMO). Minimizing time until initiation of E‐CPR is critical to improve neurologically intact survival. Bringing E‐CPR to the patient rather than requiring transport to the emergency department may increase the number of patients eligible for E‐CPR and the chances for a good outcome. We developed a out‐of‐hospital E‐CPR (P‐ECMO) program that includes the novel use of a hand‐crank and emergency medical services (EMS) providers as first assistants. Here, we report the first P‐ECMO procedure in North America for refractory ventricular fibrillation involving a 65‐year‐old male patient who was cannulated in the field within the recommended 60‐minute low‐flow window and transported to our institution where he underwent coronary stenting. Details of program design and the procedure used may allow other systems to consider implementation of a P‐ECMO program.

Inferior mesenteric artery (IMA) and inferior mesenteric vein (IMV) fistulas or malformations are extremely rare, with only 36 cases reported. Low incidence and nonspecific clinical signs and symptoms make mesenteric arteriovenous fistulas difficult to diagnose. We describe a case of a primary IMA-IMV fistula. Our patient presented with severe portal hypertension and cardiomyopathy along with robust arteriovenous connections between the IMA and IMV. Arterial embolization in this patient had to be followed by venous embolization for successful resolution of portal hypertension and cardiomyopathy. This case also highlights that close outpatient monitoring for treatment failure and recurrence is necessary for this disease process. Keywords: Inferior mesenteric artery, Inferior mesenteric vein, Arteriovenous fistula and malformation, Amplatzer, Embolization, Portal hypertension

Objective: Compare the effects of preoperative embolization for carotid body tumor resection on surgical outcomes to carotid body tumor resections without preoperative embolization. Methods: Single-center retrospective review of all consecutive patients who underwent carotid body tumor resection from 2001 to 2019. Surgical outcomes with emphasis on operative time (estimated blood loss and cranial nerve injury) of patients undergoing carotid body tumor resection following preoperative embolization were compared to those undergoing resection alone using unpaired Student’s t -test and Fisher’s exact test. Results: Forty-six patients (15% male, mean age 50 ± 15 years) underwent resection of 49 carotid body tumors. Patients undergoing preoperative embolization ( n = 20 (40%)) had larger mean tumor size (4.0 ± 0.7 vs 3.2 ± 1 cm, p = 0.006), increased Shamblin II/III tumor classification (18 (90%) vs 22 (76%), p