Background and Objectives: Despite the relatively large number of publications concerning the validation of these models, there is currently no solid evidence that they can be used with absolute precision to predict survival. The goal of this study is to identify preoperative factors that influenced 30-day mortality and to create a predictive model after open ruptured abdominal aortic aneurysm (RAAA) repair. Materials and Methods: This was a retrospective single-center cohort study derived from a prospective collected database, between 1 January 2009 and 2016. Multivariate logistic regression analysis was used to identify all significant predictive factors. Variables that were identified in the multivariate analysis were dichotomized at standard levels, and logistic regression was used for the analysis. To ensure that dichotomized variables were not overly simplistic, the C statistic was evaluated for both dichotomized and continuous models. Results: There were 500 patients with complete medical data included in the analysis during the study period. Of them, 37.6% were older than 74 years, and 83.8% were males. Multivariable logistic regression showed five variables that were predictive of mortality: age > 74 years (OR = 4.01, 95%CI 2.43–6.26), loss of consciousness (OR = 2.21, 95%CI 1.11–4.40), previous myocardial infarction (OR = 2.35, 95%CI 1.19–4.63), development of ventricular arrhythmia (OR = 4.54, 95%CI 1.75–11.78), and DAP < 60 mmHg (OR = 2.32, 95%CI 1.17–4.62). Assigning 1 point for each variable, patients were stratified according to the preoperative RAAA mortality risk score (range 0–5). Patients with 1 point suffered 15.3% mortality and 3 points 68.2% mortality, while all patients with 5 points died. Conclusions: This preoperative RAAA score identified risk factors readily assessed at the bedside and provides an accurate prediction of 30-day mortality after open repair of RAAA.

Background/Objectives: Risk stratification in asymptomatic carotid stenosis has traditionally relied on the degree of luminal narrowing; however, plaque vulnerability may better predict cerebrovascular events. Ipsilateral silent brain lesions (SBLs) are considered surrogate markers of stroke risk. This study aimed to identify carotid plaque features on duplex ultrasound (DUS) and computed tomography angiography (CTA), as well as circulating biomarkers, associated with ipsilateral SBL in patients with clinically asymptomatic ≥70% internal carotid artery stenosis. Methods: This prospective observational study with cross-sectional imaging analysis included 316 clinically asymptomatic patients with ≥70% carotid stenosis treated between January 2022 and October 2024. All patients underwent cranial non-contrast CT for SBL detection, DUS plaque characterization (according to the Gray–Weale classification and plaque surface morphology), and CTA analysis, including plaque surface, composition, length, and attenuation values categorized according to Schroeder’s criteria (120 HU calcified). Demographic, clinical, and laboratory parameters, including inflammatory biomarkers, were recorded. Multivariate logistic regression was performed to identify independent predictors of SBL. Results: SBL were detected in 72 patients (22.8%). On DUS, SBL were significantly associated with Gray–Weale class II plaques, heterogeneous composition, and irregular or ulcerated surfaces (all p < 0.001). On CTA, lipid-rich plaques (<50 HU), ulcerated surfaces, heterogeneous morphology, and lower median plaque density were significantly more frequent in the SBL group (all p < 0.001). In multivariate analysis, independent predictors of SBL were male sex (OR 2.2; 95% CI 1.2–5.7; p = 0.029), Gray–Weale class II plaques (p = 0.002), lipid-rich plaque morphology (OR 21.39; 95% CI 6.86–66.76; p < 0.001), and ulcerated plaque surface on CTA (OR 20.62; 95% CI 7.37–57.68; p < 0.001). Conclusions: Specific ultrasound and CT plaque characteristics were associated with ipsilateral silent brain lesions in patients with asymptomatic ≥70% carotid stenosis. A multiparametric imaging approach may improve risk stratification beyond stenosis severity alone.

Background/Aim. Visceral artery aneurysms (VAAs) are rare but potentially life-threatening conditions. With the increasing availability of diagnostic and therapeutic options, there is a growing need to determine the optimal treatment approach–endovascular (EV) vs. open surgical (OS) reconstruction. The aim of this study was to analyze treatment outcomes in patients with VAA at a single center and compare the efficacy of EV and OS approaches. Methods. The study included 27 OS (the OS group) or EV (the EV group) interventions for VAA, performed at our institution from January 2010 to November 2023, on 27 patients, 13 males and 14 females, with a mean age of 57 ± 13 years. Treatment decisions were reached by a multidisciplinary team of a vascular surgeon, an anesthesiologist, and an interventional radiologist. Results. Out of the 27 patients, 9 were treated in the emergency setting, with 6 of them having ruptured aneurysms. The most common was a splenic artery aneurysm, 50.0% of all VAAs. Thirteen patients underwent EV reconstruction, one patient underwent a hybrid approach, and 13 patients had OS reconstruction. Technical success was 24/27 or 88.9%. Eleven patients were treated by coil embolization, while two were treated with the implantation of a covered stent. In the EV group, mortality was nil. In 14 patients, OS treatment was performed with 9 VAA resections and arterial reconstructions (7 with Dacron graft, 1 with polytetrafluoroethylene graft, and 1 with autovenous graft), with 2 splenectomies and 3 aneurysm exclusions. Two patients died intraoperatively due to severe bleeding, and one after the procedure because of intestinal ischemic complications. Mean duration of hospitalization after OS or EV procedure was 7.43 and 4.92 days, respectively. Conclusion. Treating patients using the EV approach is safe, with less invasiveness and shorter hospital stays, suitable for elective and emergency cases when technically feasible. OS remains a reliable option at high-volume centers, particularly for complex cases unsuitable for EV approaches or in low-risk patients. Treatment decision should be guided by VAA characteristics (size, symptoms, location, morphology), patient comorbidities, and specific clinical context, such as prior abdominal surgeries.

Background and Objectives: Carotid artery stenosis has traditionally guided therapeutic decision-making; however, plaque morphology and composition are increasingly recognized as more reliable indicators of cerebrovascular risk than luminal narrowing alone. As imaging strategies shift toward vulnerability-based assessment, reproducibility of plaque characterization becomes essential for consistent clinical decision-making. This study aimed to evaluate interobserver agreement in carotid plaque assessment using multidetector computed tomography angiography (MDCTA) and to assess intermodality agreement with duplex ultrasonography (DUS). Materials and Methods: In this single-center study (January–September 2022), 50 patients with ≥60% internal carotid artery stenosis diagnosed by DUS (NASCET criteria), the majority of whom were asymptomatic (90%), were included. MDCTA examinations were independently analyzed by two radiologists, while DUS examinations were evaluated by a third observer. Plaque composition (lipid, fibrous, calcified), surface characteristics (regular, irregular, ulcerated), degree of stenosis, and plaque length were assessed. CT plaque characterization was based on Hounsfield unit (HU) thresholds (120 HU calcified). Interobserver agreement and intermodality agreement were calculated using Cohen’s kappa coefficient. Results: Good interobserver agreement was observed between the two MDCTA readers (κ = 0.751). Intermodality agreement between MDCTA and DUS was moderate (κ = 0.624 and κ = 0.595). Although significant differences were identified in 3 of 16 HU measurement points, no significant differences were found in overall plaque composition classification between MDCTA observers. DUS yielded significantly higher stenosis values (p = 0.007 and p = 0.005) and greater plaque length measurements (p < 0.0005) compared with MDCTA. Significant differences were also observed in plaque surface assessment between modalities (p = 0.044 and p = 0.033). Conclusions: MDCTA demonstrates good interobserver reproducibility for carotid plaque characterization, while intermodality agreement between MDCTA and DUS is moderate. Minor attenuation measurement differences do not significantly affect plaque classification; however, systematic intermodality differences in stenosis grading, plaque surface evaluation, and plaque length measurement should be considered in clinical decision-making.

Iatrogenic femoral artery injury is a rare complication of hip fracture surgery but may cause serious morbidity if unrecognized. The profunda femoris artery is most commonly affected because of its close anatomical relationship to the proximal femur, and pseudoaneurysm formation is the typical delayed presentation. We report a 72-year-old woman with a progressively enlarging pulsatile mass in the right groin 6 months after fixation of an intertrochanteric fracture using a dynamic hip screw and plate. Imaging demonstrated a large profunda femoris artery pseudoaneurysm measuring 170 × 107 mm, likely caused by screw tips protruding beyond the medial femoral cortex. Open surgery was performed with thrombus evacuation, pseudoaneurysm sac resection, and oversewing of the injured profunda femoris artery. Recovery was uneventful. Although uncommon, profunda femoris artery injury should be suspected in patients with unexplained thigh swelling, pain, or anemia after hip fracture surgery. Early diagnosis and appropriate imaging are essential.