Introduction. Promising results of endovascular abdominal aortic aneurysm treatment prompts one to consider applying the method in order to manage complications following the previous open procedures in the aorto-iliac segment. The study aimed at assessing the technical feasibility of applying endovascular methods to manage complications in this group. Material and methods. From December 2009 to August 2018, 26 patients (24 males, 2 females) with a mean age of 72 years, underwent endovascular procedures as reinterventions to manage paraanastomotic aneurysms and new true aneurysms in aorto-iliac segment. Twenty one bifurcated, two branched devices and five tube stent-grafts have been implanted. Results. One immediate open conversion was performed. Eventually, in all of the analysed cases, perianastomotic pseudoaneurysms and true aneurysms were successfully managed. Two cases of type I endoleaks were noticed and managed intraoperatively. No deaths occurred in the perioperative period. In six patients, there were early local complications and early general complications were reported in eight patients. The average length of hospital stay was seven days. Patients have been followed up for 6 to 90 months. No endoleaks nor stent-graft migrations have been reported. Five deaths have been noted not connected with the secondary intervention. Sixteen patients remain in follow-up. Conclusions. Endovascular perianastomotic aneurysm treatment is technically feasible and associated with a low risk of perioperative complications, and a high surgical efficacy. When planning the reintervention, one should take into account the altered anatomy of the aorto-iliac segment. Familiarity with the equipment and experience in the endovascular techniques is of crucial significance.

Alpha-1-antitrypsin is a potent antiprotease playing an important role in maintaining protease-antiprotease balance. It protects the structures of extracellular matrix against destruction by proteolytic enzymes. Loss of elasticity occurs when increased protease activity is accompanied by qualitative impairment or reduced concentrations of antiproteases. Alpha-1-antitrypsin deficiency is a risk factor for obstructive lung disease, including emphysema, liver and kidney disorders and, less often, follicular panniculitis, granulomatosis with polyangiitis (previously Wegener's granulomatosis). Literature also emphasises the role of AAT in the development of aortic aneurysms, and results of biochemical studies support this theory. Aortic aneurysm is an important clinical problem, unceasingly associated with high mortality. For this reason, it is exceptionally important to identify its risk factors. Studies on the relationship between AAT and development of AAA (abdominal aortic aneurysm) have been conducted since the 1990s. Due to the development in molecular diagnostic techniques, new reports on the topic appeared over the last decade.

Isolated abdominal aortic dissection constitutes a relatively small percentage of all aortic dissections. In this paper we present a case of a 59-year-old man who reported to the hospital because of the sudden appearance of intermittent claudication of his left lower limb. After establishing the diagnosis the patient was qualified for endovascular treatment due to dissection involving the final 1 cm of his abdominal aorta and extending to his left common iliac artery with significant true lumen compression. Stent was implanted into the left common iliac artery with almost complete occlusion of the false lumen and expansion of the true lumen of his iliac artery. During the 70-month follow-up we achieved a good result with evidence of stent patency and no signs of expansion of the false lumen. The paper discusses the epidemiology, aetiology, diagnosis and treatment of isolated abdominal dissections.

Deep veins thrombosis is commonly encountered in clinical practice. The reasons and risk factors are well known. Unusual conditions leading to complete obstruction of larger veins are rarely anticipated. A 34-years-old woman was treated in our hospital because of segmental thrombosis of her right common femoral vein. Color duplex Doppler revealed a solitary thrombus 5 centimeters in lengths narrowing it by 80–90%. During emergency operation a small tumour in the orifice of greater saphenous vein was found with adhering thrombus. Segmental thrombosis of large vein can be connected with an occult underlying pathology. Color duplex Doppler alone does not allow complete evaluation of such problems.

Introduction. Even though EVLA is increasingly popular and together with other minimally-invasive techniques is rapidly replacing surgical stripping, surgical treatment is still widely used. Our study aimed to compare the clinical outcomes and the quality of life following either endovenous laser ablation (EVLA) or conventional surgery for varicose veins of the lower limbs. Material and methods. This prospective non-randomised study included 299 patients, who were treated for symptomatic varicose veins of the lower limbs in two centres. In one, 159 patients underwent open surgery (the surgery group), while in the other, 140 patients received the EVLA (the EVLA group). The patients were invited to follow-up evaluations at six weeks, one year, and two years after the surgery. Results. Disease-specific quality of life at six weeks was significantly better in the EVLA group (median AVVQ scores — 3.2 (2.1–8) vs. 9.2 (7.1–13.8), p < 0.001). Similarly, VCSS scores at six weeks were also better in the EVLA group (median VCSS scores — 1 (0–2) vs. 4 (3–6), p < 0.001). Patients in the EVLA group experienced less postoperative pain (p < 0.001), and therefore needed fewer supplementary analgesic drugs (p = 0.007). In addition, patients in the EVLA group managed to return to work and normal activities sooner than those in the surgery group (p < 0.001). No statistically significant differences were found between groups for clinical recurrence, overall satisfaction, rate of complications and secondary procedures. Conclusions. Both treatment techniques yielded similar results in terms of efficacy, clinical recurrence rates and overall patient satisfaction. However, early postoperative results in the EVLA group were superior to those of patients in the surgery group.

Published data concerning increased incidence of venous thromboembolic disease (VTE) in different seasons of the year are divergent. In the 12-month period lasting from 1st December 2007 to 30th November 2008, 48 cases of deep vein thrombosis (DVT) of the lower limbs were diagnosed in the population of Bemowo, a district of Warsaw. The analysis of the incidence of DVT of the lower limbs occurrence at particular times of the year was performed. During the winter time, 11 episodes of DVT were diagnosed and, respectively, 16 episodes during the spring, 11 during the summer and 10 episodes of DVT during autumn. Using the Chi-square test, the authors revealed no statistically significant differences in the incidence of DVT of the lower extremities in different seasons.