Objective: The objective of this study is to compare the long-term outcomes of femorofemoral crossover bypass (FCOB) and endovascular treatment (ET) in managing iliac artery occlusions. Methods: The data of 200 patients with iliac artery lesions who were treated at a single center within 7 years were evaluated retrospectively. Of these, 82 (41%) underwent FCOB, and 118 (59%) received ET. Primary outcomes included patency, limb salvage, and survival rates, while secondary outcomes assessed complications, including wound infections and restenosis. Follow-up was conducted over a median of 4.98 years. Results: Primary patency (PP) rates after 3 years were 80% for FCOB and 88% for ET. Primary assisted patency (PAP) was 95% for FCOB and 93% for ET. Secondary patency (SP) was 97% for FCOB and 98% for ET. Both FCOB and ET achieved comparable long-term outcomes in limb salvage, 94% in both groups at 8 years. ET demonstrated advantages in shorter hospital stays (1.49 ± 2.51 vs. 8.21 ± 9.82 days, p < 0.0001) and lower perioperative complications, including transfusion rates (3.4% vs. 13.4%, p = 0.01226). However, FCOB exhibited lower restenosis rates (6.1% vs. 20.39%, p = 0.00441), despite a higher rate of reocclusion (19.5% vs. 6.8%, p = 0.00800). Survival rates at 8 years were 54% for FCOB and 67% for ET. Conclusions: ET is the preferred first-line approach due to its minimally invasive technique, shorter recovery time, and fewer complications. FCOB remains essential for patients with complex lesions or when ET is not feasible, offering durable long-term outcomes. Appropriate treatment selection should consider both the patient’s condition and clinical and anatomical factors to optimize the best possible patient outcomes.

Introduction: Sternoclavicular joint infections (SCJIs) are extremely rare, making up less than 1% of all septic arthritis cases. This retrospective study aims to evaluate the management and outcomes of SCJIs, including both surgical and non-surgical approaches. Methods: This retrospective study included 55 patients treated between January 2005 and December 2023 at the Division of Thoracic and Hyperbaric Surgery in Graz, Austria. Data on patient characteristics, treatment approach, and outcome were analyzed. Results: Out of the 55 patients, 50 (90.91%) underwent surgery. Among them, 21 (38.18%) had pleural involvement and 9 (16.36%) developed sepsis. Primary debridement and sternoclavicular joint resection with muscle flap closure were performed in 5 patients (9.3%), whilst debridement and negative pressure wound therapy (NPWT) followed by joint resection were applied in 32 patients (59.3%). In total, 15 (27.2%) of these cases required a secondary muscle flap. Positive cultures were found in 35 patients (63.64%), with Staphylococcus aureus being the most common pathogen. Multivariate analysis identified elevated CRP and leukocyte levels as significant predictors of sepsis. Defects requiring myoplastic procedures were associated with a higher risk of complications, sepsis, and prolonged hospital stays. Postoperative complications occurred in 20 patients (36.36%), but there was no 30-day mortality. Conclusions: SCJI is a rare but serious condition that requires prompt surgical intervention. Our findings suggest that combining surgical resection with NPWT and/or myocutaneous flap techniques is effective. Close monitoring of inflammatory markers is crucial for identifying sepsis risk and improving patient outcomes.

Background: This study addresses a longstanding discrepancy between the observed course of the superior epigastric artery in anatomical specimens and its depiction in many German-language anatomy textbooks. While the artery typically runs ventral to the diaphragm, textbooks inaccurately describe it as passing through the sternocostal triangle (Larrey's fissure). Methods: Anatomical dissections were performed on 40 formalin-fixed cadavers at the Medical University of Vienna. The thoracic and abdominal walls were dissected, and the course of the superior epigastric artery was documented. Literature from the time of Dominique Larrey to present was reviewed to trace the origin of the incorrect anatomical description.Discussion: Findings confirm that the superior epigastric artery does not traverse Larrey's space but remains ventral to the pleural and peritoneal cavities. The erroneous description appears to have originated from a 19th-century misinterpretation by Joseph Hyrtl and was perpetuated in German-language textbooks.Conclusion: The study refutes the long-standing but incorrect description of the superior epigastric artery's course in German-language anatomy textbooks. The findings highlight the importance of revising anatomical literature to correct historical inaccuracies.