James H Black, MD 𝑨𝒕𝒊𝒆𝒉 𝑨𝒎𝒎𝒂𝒓 frank arko Dr Himanshu Verma Matthew Smeds Necio Lizola MD Chris Paprzycki MD, FACS Xavier Berard Prof Ramesh K Tripathi I agree, once aorta and external are clamped the iliac aneurysm sac gets decompressed, grab it with a Kocher, lift up and dissect the internal iliac which works well or just control from the inside with a Fogarty as shown

Tandem carotid lesions : CCA ulcer with ICA ruptured plaque!! Double whammy!@FutureVascSurgn and students.

Ricardo Bernardo da Silva Sergi Bellmunt Xavier Berard Sree Kanna, MD, FRCSC frank arko 𝑨𝒕𝒊𝒆𝒉 𝑨𝒎𝒎𝒂𝒓 Dr Himanshu Verma Matthew Smeds Necio Lizola MD Chris Paprzycki MD, FACS Prof Ramesh K Tripathi It works very well and avoids evisceration. We usually place a large one to separate the skin and aponeurosis and then a small one to separate the intestine. We place the latter Alexis when the dissection of the retroperitoneum has finished. Sergi Bellmunt Ricardo Bernardo da Silva

@AaronGoodman33 That is a beautiful case. That high of occlusion best managed with open surgery if candidate. Extends up to renals. Similar case reconstruction. Clamp above renals to remove clot extending into renals and graft beveled onto renals. Graft extended to femorals.

𝑨𝒕𝒊𝒆𝒉 𝑨𝒎𝒎𝒂𝒓 Yep, I do put two on though

#anatomy Renal veins Right renal artery

4 y o with previous hospitalization Presented with edema of the right upper limb and engorgement of thoracic and arm veins ,diagnosed as Iatrogenic AVF(IV line), underwent surgical repair frank arko Fórum Vascular Dr Himanshu Verma

#AortaEd distal aortic perfusion with cold renal perfusion and visceral perfusion. Left renal bypass/Right bypass with reimplantation of visceral branches

No conduit was utilized with this carotid endarterectomy

Nice case below, I incorporate the bovine about a venous stent to minimize any compression in the future and to keep anastomoses widely patent. Have 4 with good results at 6 months.

The body will often surprise you: based on the X-ray you might predict a very hard/calcified AT artery, when in fact, what you find is a beautiful, soft, patent artery 🤩 #CLTIFighters Leigh Ann O'Banion Joseph L. Mills MD ᗰIGᑌEᒪ ᗰOᑎTEᖇO-ᗷᗩKEᖇ 👊🏾👍🏾BT Fisher Sr., MD frank arko Lorenzo Patrone

This is how to do a CEA. No stent, no ridiculous conduit, no lithotripsy, no flow reversal. Safe and probably home the next day. Not sure why we are making this disease process so difficult

Joedd Biggs Westley Ohman Yep. I deploy the stent. Put in warm water to fully expand it. Secure the stent with a few sutures. Than do anastomosis with 4-0 on a BB needle

Raimundo C. Santos, MD. frank arko Adam W. Beck Prof Ramesh K Tripathi Xavier Berard You have options, open and endo. One trick I’ve used few times in large iliac aneurysms, if you decide open, to allow clamping external and internal easily. Once you clamp the aorta, grab the iliac aneurysm with ALLIS clamp pull it up and you’ll be looking at the bifurcation

𝑨𝒕𝒊𝒆𝒉 𝑨𝒎𝒎𝒂𝒓 Ringed (except if hemodyalisis access)

Iliac occlusion crossed - felt to be acute on chronic. Angiojet pulse spray 10mg in 100ml Angiojet thrombectomy 100s Iliac thrombus cleared and underlying stenosis identified. 10mm X 8cm bare metal stent deployed. TPA infusion left for SFA and pop thrombus

AVM of lower limb Erosion of the fibula bone with adjacent calcification within the AVM is noticed.

PSA to all PAD interventionalists. Please, please, PLEASE send for a surgical evaluation ANY patient with a long segment SFA-Pop occlusion and a proximal tibial that is open. A full metal jacket from the CFA INTO the last tibial either leads to amp or a high risk bypass.

SupraRenal RetroHepatic IVC cross clamping before en bloc resection of IVC sarcoma and R Kidney. Spiegel veins divided, blue loop around LRV and distal & proximal IVC. Subcostal chevron incision, right visceral rotation. #oncovascular