Splenic artery aneurysms (SAA) account for 46–60% of all visceral artery aneurysms. Small SAAs are usually asymptomatic, but giant aneurysms are more likely to cause symptoms and can result in life-threatening complications. Treatment of a splenic artery aneurysms includes laparotomy, laparoscopy or endovascular techniques. Case presentation: In this article, seven interesting cases of splenic artery aneurysms in different size and parts of artery and various interventions (open, endovascular and hybrid surgery) are discussed. Six of the patients were male. Five of them had giant SAAs (≥5 cm). Two patients underwent hybrid surgery. Coil embolization was carried out for one patient. All seven patients discharged with no procedure-related complications. Endovascular procedures considered as a first choice of treatment for splenic artery aneurysm. Open surgery is reserved mostly for the treatment of complications or if the endovascular techniques fail, lack of availability of endovascular procedures or allergy to contrast medium.

To assess satisfaction and perspectives of adult hemodialysis (HD) patients on different vascular access (VA) types (AVF, AVG, CVC) by synthesizing quantitative studies using validated questionnaires, focusing on overall satisfaction, physical symptoms, social functioning, and complications. We systematically searched Medline, Web of Science, and Scopus for studies assessing adult HD patients' perspectives on VA using structured questionnaires. Risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analysis was performed using a random-effects model across three pairwise comparisons: AVF vs. CVC, AVF vs. AVG, and CVC vs. AVG. Of 1,253 records, 11 studies (n = 2910) met inclusion criteria. AVF patients had higher overall satisfaction compared to those with CVCs (MD: 7.06%, 95% CI: 2.98-11.14). Compared to AVG, AVF patients had higher overall satisfaction, though not statistically significant (MD: 5.12%, 95% CI: - 0.42 to 10.66; p = 0.069). Dissatisfaction with physical symptoms was significantly higher in AVF patients than in those with CVCs (MD: 8.76%, 95% CI: 4.19 to 13.34). Compared to CVC, AVF patients reported significantly lower dissatisfaction in both social functioning (MD: - 9.48%, 95% CI: - 15.98 to - 2.98) and dialysis-related complications (MD: - 10.08%, 95% CI: -12.66 to -7.50). AVFs are associated with higher overall patient satisfaction compared to other VA types. While AVF patients experience more physical discomfort, this is outweighed by significantly greater satisfaction in areas such as social functioning and dialysis-related complications. These findings emphasize the importance of considering patient-reported outcomes when evaluating VA options in HD care. Not applicable.

Management of abdominal aortic aneurysms (AAA) tends to be an issue in patients with a previous history of abdominal transplantation surgeries. Open surgery poses the risk of ischemia to the grafted tissue. Additionally, these patients have comorbidities that make them unable to endure such procedures. As a result, endovascular repair is becoming the accepted procedure in the transplanted population. Herein, we describe a patient with a previous history of simultaneous orthotopic liver-kidney transplantation who successfully underwent EVAR for AAA correction.

Endovascular treatment of vascular injuries has resulted in reduced operating time, blood loss, hospital mortality and sepsis. The purpose of this study was to evaluate the success and complication rate of the endovascular management of penetrating peripheral vascular injuries during 5 years. In this observational study, the clinical records and imaging features of 22 penetrating trauma injuries of 276 penetrating vascular trauma patients (8%), which were repaired using endovascular stent-grafts or coil embolization, between April 2013 and August 2018, included in the study. The median age of patients was 43 years (Range, 20–78 years). There were 17 stab wounds (77.3%), 2 shotgun war remnants (9.1%) and 2 iatrogenic post-surgical lesions. Eleven stent-grafts (50%) and nine coil embolizations (40.9%) were deployed. Endovascular interventions in the management of peripheral vascular injuries can be efficient in definitive repair, damage control and hemorrhage control in severely ill trauma patients.

Objectives: Abdominal aortic aneurysm (AAA) is one of the most important cardiovascular diseases, especially in the elderly. People with this disease are at risk of rupture of the abdominal aorta and death. The present study was conducted with the aim of analyzing the cost-effectiveness of endovascular repair compared to open surgery in AAA patients in Iran. Methods: A Markov chain model was developed based on the use of endovascular repair and open surgery. The base-case patient was defined as a 65-year-old man presenting with AAA diameter greater than 5 cm. The determination of costs was from the perspective of the public sector provider. QALY was used to calculate the effectiveness. Incremental cost-effectiveness ratio (ICER) and TreeAge software were used for cost-effectiveness analysis. The follow-up period was 10 years and the willingness to pay (WTP) was determined as three times the Gross domestic product (GDP) per capita. Result: At the end of year 10, the endovascular aneurysm repair (EVAR) strategy gained 1 318 313 559 Iranian Rial (IRR) (67 885.29$) in cost and 3.57 QALYs in effectiveness. In contrast, the use of the open surgery repair (OSR) strategy gained 1 186 761 858 IRR (61 111.16$) in cost and 3·32 QALYs in effectiveness. The incremental cost-effectiveness ratio, comparing EVAR versus OSR, was 53, 346, 3757 IRR (178.36$) per QALYs, which is lower than the proposed WTP, indicating that EVAR is more expensive and more effective. Based on the Monte Carlo simulation test, EVAR is the preferred strategy in 58.6% of the population. Conclusion: Endovascular repair has a relative superiority compared to open surgery, and the probability of the effectiveness of endovascular repair compared to open surgery does not change with increasing willingness to pay.

Arterial aneurysm is a serious condition caused by weakened arterial walls. Aorto-uni-iliac (AUI) and femorofemoral bypass are safe and effective options for managing abdominal aortic aneurysm (AAA). However, fem-fem bypass leads to longer surgical procedures and introduces additional risks such as graft infection, occlusion, wound complications, and peripheral vascular problems. This report highlights two successful cases of AAA management using the AUI approach without the need for fem-fem bypass. Two male patients, both aged about 70, presented at our medical facility complaining of abdominal pain. Investigations unveiled an approximately 10-cm AAA that was previously undetected. Subsequently, we performed an elective AUI procedure without fem-fem bypass, marking the first instance of this technique being employed in Iran successfully. The placement of an AUI stent graft is generally less technically demanding compared to that of a standard bifurcated graft, especially when anatomical constraints are severe, making the latter difficult or even impossible to deploy. Beside the longer duration of stent deployment, sometimes we encounter contralateral complications to cannulate the main body. The AUI is typically used in emergency situations or when the distal aorta's internal diameter is small. The femoral-femoral bypass is advised in nearly all circumstances. AUI stent grafts are still a viable option for treatments of AAA, especially in cases of severe aortoiliac occlusive disease or comorbidities. AUI without crossover bypass is a viable option in the patients who have stenosis of contralateral iliac artery.