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: Horseshoe kidney is a well-known congenital anomaly and the most common anomaly of the upper urinary tract. This condition is rarely associated with anomalous inferior vena cava (IVC). Polycystic horseshoe kidney is a very rare occurrence and however IVC anomalies common with polycistic disease are an increasingly recognized risk factor for iliofemoral deep venous thrombosis. Method: We present a case of 75-year-old patient with recurrent deep vein thrombosis (DVT) of right leg as a result of compression of large horseshoe kidney cysts in double inferior vena cava. Results: Large renal cyst were successful treated percutaneously punctured for the relief of compression and received injection of acidic solutions of 95% ethanol under ultrasound guidance for prevention against re-accumulation of cyst fluid. Conclusion: Percutaneous aspiration with ultrasound guidance with injection of sclerosing solutions as a relatively simple procedure and can be the method of choice for treatment of renal cysts. Also, any recurrent deep vein thrombosis on lower extremity requires additional evaluation in the form of an ultrasound or multidetector computed tomography examination of the abdomen.

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.

Introduction: This study presented our experience in the surgical treatment of carotid body tumors (CBT). Material and Methods: We retrospectively analyzed patients who underwent carotid surgery between 2009 and 2021. CBT patients were identified, and a control group of patients without CBT was selected using systematic sampling. Demographic and clinical characteristics were compared. Statistical analysis included Student's t-test, Pearson's chi-squared test, and Fisher's exact test. Results: Among 6728 patients operated for carotid pathology, 16 (0.24%) had CBT. Four CBT patients presented with compressive symptoms, while 12 had medium-sized tumors classified as Shamblin I or II. Subadventitial excision was performed in 12 cases; in four, carotid artery resection and reconstruction were necessary. CBT patients were significantly younger than controls (55.8 ± 17.9 vs. 69.2 ± 7.5 years, p = 0.009). The CBT group included fewer males (25% vs. 68.2%, p = 0.001) and fewer smokers (18.7% vs. 50%, p = 0,014). ASA physical status scores were significantly lower in the CBT group (p = 0.001), and hypertension was less prevalent (75% vs. 92.9%, p = 0.03). Conclusion: Subadventitial resection of CBT with deliberate resection of the external carotid artery is a simple and efficient procedure. A resection of the internal carotid artery during CBT surgery requires immediate repair or replacement. Our findings indicate significant differences in demographic and clinical characteristics between patients with CBT and those undergoing carotid surgery for atherosclerotic disease, emphasizing the importance of careful assessment and individualized management of this specific patient group.

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.