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The authors report a case of an aneurysm of the common iliac artery of atherosclerotic etiology, treated by percutaneous endoluminal stent-graft placement. They describe the technique and review the medical literature.

With the objective of studying the spectrum of clinical manifestations of Chronic Venous Insufficiency (CVI), we conducted an epidemiological survey in 17 of the 20 districts in Portugal. This study involved 436 general practitioners and 8243 consecutive attendants of the national health service aged 15 and over, who were inquired for symptoms and signs of CVI. The diagnosis of CVI was established on clinical grounds by the physicians, who recorded data on demography, associated diseases, past history, symptoms, physical signs, and characteristics and location of varicose veins. These data were combined with the estimates of prevalence of CVI obtained in a previous study on 45,000 individuals and with the results of the population census of 1991 to obtain age and sex adjusted population prevalences of the disease manifestations. The results show that the prevalence of CVI, radicular and troncular varices, and troncular varices is 20, 12 and 6% in males and 40, 22 and 10% in females. The prevalence of grade 0, 1, 2 and 3 CVI is 2, 10, 6 and 3% in males and 4, 22, 12 and 4% in females. The prevalence of a history of phlebitis and venous thrombosis is 4.5 and 1.3% in males and 8.9 and 1.5% in females. The prevalence of chronic venous ulcer, either active and inactive, is 3.2% in males and 3.9% in females. These data indicate that the situation of CVI in Portugal is similar to that reported in other European countries.

The prevalence of chronic venous insufficiency (CVI) was investigated in 44,777 unselected primary care outpatient clinics in 17 of the 20 districts in Portugal, during 1993. The diagnosis of CVI was established clinically by 427 participating general practitioners. CVI was more prevalent in females, with a female to male ratio of 2.1:1. The disease affects all age groups, but in females its prevalence increases sharply between 15 and 20 years, while in males it begins to become important about 10 years later. The maximum age-specific prevalence is reached between 55 and 64 years in both sexes, when CVI is present in 58% of females and in 35% of males. Overall prevalence of CVI was calculated using the data from the population census of 1991, by the direct standardization method. The estimated prevalence of CVI in males is 17.8% and in females is 34.1%, corresponding to 812 thousand and 1,741 thousand cases in Portugal, respectively. In the population over 15 years old, the prevalence is 20.7% in males and 40.8% in females. These estimates have an error of +/- 2.5% with 95% confidence. The geographical distribution of the disease showed different patterns in males and in females. Prevalence decreases from coast to inland in males, and from south to north in females.

Chronic Venous Insufficiency (CVI) affects a large proportion of individuals and, with the ageing of the population of Western Europe, its prevalence is expected to increase. Epidemiological data, particularly regarding risk factors, is scarce and controversial. The purpose of this study was to identify clinical factors that are associated with an increase in severity of CVI. Eighteen physicians observed 474 unselected patients with symptoms suggesting CVI. A multivariate model is forwarded in which age is a major risk factor. Other factors that are independently correlated with the severity of CVI are body weight, environmental heat, sedentariness, double heredity, high-dose oestrogen formulations, osteo-articular disease of the lower limbs, presence of troncular varices, involvement of the internal saphena, lymphedema or history of thrombophlebitis. Since most studies do not adjust for age when testing for risk factors, this may be an important reason for the multiplicity of reported factors and the lack of consistency of their results.