Background: Popliteal venous aneurysms (PVA) are an uncommon but potentially severe condition due to their association with increased risk of recurrent pulmonary embolisms. Because of their rarity, their aetiology, natural history, and optimal treatment strategies have been poorly defined. The aim of this paper is to report a comprehensive systematic review on the treatment strategies and outcomes in PVA, summarizing current evidence. Methods: A systematic literature search was conducted in PubMed, Scopus, and Web of Science, covering studies published from database inception through February 2025 (protocol registered on PROSPERO CRD420251008927). The primary endpoint was the analysis of outcomes and complications associated with surgical and conservative management. Results: Nine studies, including 173 adult patients with popliteal venous aneurysms, were included. The mean age was 56 years (range 18–86 years, mean aneurysm diameter 25.4 mm). Most of the patients were female (73, 42.2%). Overall, 85 (49.1%) aneurysms were saccular and 74 (42.8%) fusiform, although morphology was not consistently reported across all studies. Intraluminal thrombus was reported in 26 cases (15.0%), and pulmonary embolism upon presentation in 21 (12.1%). Surgical treatment was performed in 119 patients (68.8%), while 54 (31.2%) were managed conservatively. Fifteen patients (13.0%) experienced postoperative complications, including wound infections (4, 3.5%), hematomas (7, 6.0%), and nerve injury (4, 3.5%), but no cases of postoperative pulmonary embolisms were observed. Following surgery, anticoagulation was indicated in most cases for 3–6 months or a long life. During follow-up (mean 35 months, range 1–262), thrombosis of the surgical reconstruction was observed in 1 patient (0.8%). Death occurred in 3 cases (5.5%), all in the non-surgical group: 2 (3.7%) due to malignancy and 1 (1.9%) from myocardial infarction. Conclusions: PVA is a rarely described condition potentially associated with the risk of PE. In their management, surgical strategies in association with oral anticoagulation represent the most commonly described approach, allowing for satisfactory results and a low rate of complications.

Background: The treatment of thoraco-abdominal aortic aneurysms (TAAAs) and chronic type B aortic dissections (TAAD), is technically challenging. Traditional open surgery repair carries high morbidity and mortality rates, while endovascular repair is limited by anatomical constraints. This study investigates the safety and effectiveness of a hybrid approach in high-risk patients with TAA disease and complex renal and hypogastric anatomy. Methods: This was a retrospective single-center study, including all consecutive patients with TAAA and TAAD with complex renal and/or hypogastric artery anatomy treated with a hybrid approach between 2020 and 2024 in a high-volume aortic center. Primary endpoint was technical success. Secondary endpoints were early complications, overall and aortic-related mortality, aortic-related reintervention, the incidence of endoleaks, and the target vessel (TV) patency and TV instability at 30-day and during follow-up. Results: During the study period, a total of 92 patients with TAAA or TAAD were treated at our institution. Five high-risk patients (5.4%) with complex renal/hypogastric artery anatomy underwent open renal debranching and hypogastric revascularization followed by staged endovascular repair with custom-made double fenestrated/branched device. Technical success was achieved in all cases with no intra-operative mortality. No spinal cord ischemia or 30-day mortality occurred. Target vessel patency at 30 days was 90%. At a median follow-up of 38 months (IQR 26–49 months), there were no cases of aortic-related death. Conclusions: Hybrid repair is a feasible and effective option for managing complex TAAA and TAAD in high-risk patients. Larger studies with longer follow-up are needed to better define the clinical role of this approach.

Introduction: Revascularization interventions are the gold-standard treatment to obtain limb salvage in chronic limb-threatening ischemia (CLTI). Unfortunately, almost 15% of patients are not eligible. Recent studies stressed the possible role of peripheral-blood mononuclear cells (PB-MNCs) promoting postnatal vasculogenesis in no-option CLTI patients through monocytes, reducing mortality and limb loss. In this case series, we present our first results with this clinical approach. Presentation of cases: We treated 18 no-option CLTI patients (with diabetes or vasculitis) with autologous cellular therapy using PB-MNCs in the last 6 years in our center. Eighty-nine percent of patients presented with foot lesions. The mean age of our patients was 72 years (43–90 years). Mean follow-up was 21.8 (2–48) months, and the median follow-up was 15 months. During the follow-up, we registered one major amputation at 1 month and another major amputation at 25 months. Two patients died, respectively, at 2nd and 3rd month follow-up (12th month death rate of 11%), and a third one died at 13 months follow-up (long-term death rate of 6%). All deaths were for causes not related to sepsis. Discussion: Our results are promising: at 12-month follow-up, only one patient had a major amputation intervention (5.6%), and two patients died (11%). These results are better than recent evidence in literature, even though the 2019 European Society for Vascular Surgery guidelines consider this therapy investigational. Conclusion: In our experience, use of PB-MNCs in no-option CLTI patients appears safe and effective. Larger, controlled studies are needed, in particular with non-diabetic CLTI patients, to confirm these results.