Background: Several case studies have described the use of the superficial inferior epigastric artery (SIEA) flap as a pedicled flap for reconstruction of upper and lower ex tremities, or a free fasciocutaneous flap when a large amount of skin coverage is required for hemifacial atrophy, breast or head and neck reconstruction. Apparently, the anatomical findings of previous studies are relatively discrepant. This study was designed to describe the anatomical variations of SIEA and superficial inferior epigastric vein (SIEV).Methods: A series of 40 dissections were performed on 20 preserved or fresh male cadavers. The site of origin and drainage of vessels, caliber, length, and correlation between diameter and length of pedicle were identified.Results: The SIEA and SIEV were identified at the inguinal ligament level in 38 (95%) and 40 (100%) dissections, respectively. The SIEA originated directly from the common femoral artery in 22 (57.9%) or as a common trunk with other arteries. The SIEA was found within 1 cm of the midpoint of the inguinal ligament in 33 of 38 cases. The mean±SD length of SIEA was 3.04±1.73 (0.5- 7) cm. The mean±SD caliber of SIEA was 1.45±0.35 (0.7- 2.1) mm. The length of SIEV ranged from 2.2 to 12 cm with a mean±SD of 5.45±2.08 cm. The caliber of SIEV ranged from 1.6 to 4 mm with a mean±SD of 2.14±.45 mm. The length of SIEA correlated with caliber of the arterial pedicle (p<0.001 and correlation coefficient = 0.517).Conclusion: This study suggests that the SIEA flap can be applied for microsurgical flap transfer, potentially in breast reconstruction, hemifacial atrophy, phalloplasty, or when extremely large amounts of skin coverage are required.

Inferior epigastric artery (IEA) pseudoaneurysms are well-known postoperative abdominal complications, which often require proper treatment. Treatment options include surgical ligation, transcatheter embolization, and thrombin injection. Here, we report a rare case of an IEA pseudoaneurysm, accompanied by a postsurgical enterocutaneous fistula. The pseudoaneurysm relapsed after transcatheter coil embolization and percutaneous thrombin injection; it was completely occluded by transcatheter arterial embolization using n-butyl-2-cyanoacrylate. The present case shows that a coexisting enterocutaneous fistula can affect the unresponsiveness of patients with IEA pseudoaneurysm to widely accepted treatments, such as coil embolization and thrombin injection, by creating an inflammatory environment. In such cases, repeated therapeutic trials may be required. Transcatheter arterial embolization using n-butyl-2-cyanoacrylate can be a feasible therapeutic option for patients with refractory IEA pseudoaneurysm, accompanied by an enterocutaneous fistula.

Introduction: The brachial artery runs at lower border of the teres major muscle as a continuation of the third part of the axillary artery. It divided into radial and ulnar arteries at the neck of the radius. For surgeons performing operations on the upper extremity, clinical knowledge of the morphology of brachial arteries in the upper limb is important. This study aims to study the course, branching pattern, and termination of the brachial artery in human cadavers. Methods: In this study, 30 upper limb specimens were collected from adult human embalmed cadavers used for undergraduate dissection at the Institute of Anatomy, Madras Medical College in Chennai, India. Results: Of 30 dissected specimens, 29(96. 7%) had normal brachial artery course and one had superficial brachial artery (3. 3%). The brachial artery division was seen in 28 specimens (93. 3%) below the intercondylar line (at the neck of the radius). In 2 cases (6. 7%), the brachial artery division into radial and ulnar arteries occurred above the intercondylar line. Conclusion: The variations in origin, course, branching pattern, and termination of the upper limb’s brachial artery are important both structurally and therapeutically. Surgeons, physicians, radiologists, and cardiologists should pay attention to these variations. Due to the use of modern surgical techniques in vascular surgery, plastic and reconstructive surgeries, diagnostic & therapeutic tests, these variances have attracted the attention of surgeons, physicians, radiologists, and interventionists.

Introduction: A pseudoaneurysm is a pulsetile hematoma secondary to bleeding into soft tissue, which involves peripheral vessels in the most cases. A femoral artery pseudoaneurysm that is a rare complication, mainly occurs following prior arterial catheterization but it may also be formed with trauma. In this article a superficial femoral artery is reported.Case: The patient is a 24 years old woman who was admitted with a wound in the posteroinferior region of right tight 10 days before her recent referral. The skin of the wound had been repaired. After 1 week; pain, progressing swelling in inferior region of tight and knee, fever, shivering and limping were presented. In physical examination, 90 degree flexion of knee, edema, warmth and tenderness in inferior region of tight were observed. Any pulse of dorsalis-pedis and posterior-tibialis was not touched. In the next step; blood laboratory test, simple X-ray, Doppler sonography and magnetic resonance imaging (MRI) of right lower limb were accomplished. Finally, with the diagnosis of femoral artery pseudoaneurysm, excision of the pseudoaneurysm with reverse saphenous vein grafting was performed.Conclusion: Pseudoaneurysm should be noticed in patients with history of penetrating trauma and symptoms due to infection. In these cases sonography is necessary to get the exact diagnosis. The size of aneurysm and patient’s symptoms, determine the method of treatment.

Single superficial femoral artery (SFA) aneurysm is rare and occurs in approximately 5 per 100, 000 patients. Rupture is a rare complication in this aneurysm. In this case report, we present the diagnostic and therapeutic work up of a ruptured SFA aneurysm of the right lower limb in a 75-year-old diabetic man with ischemic heart disease. Pre-surgical diagnosis was through physical examination findings and color Doppler flow imaging. The defective part of the artery was resected and then reconstructed through autologous saphenous vein grafting harvested from the opposite limb. No early post-surgical complication was observed. If a pulsatile mass is found in the thigh, the SFA aneurysm should be considered as a differential diagnosis to prevent premature death and lower limb amputation by timely surgery.

Inferior gluteal artery is the greatest branch of interior trunk of internal iliac artery that supplies the gluteal region and posterior of thigh. This artery emerges from inferior border of piriformis and descends toward the thigh deep to the gluteus maximus muscle. Several variations have been reported about inferior gluteal artery. In this case, the artery has emerged from superior border of pirifomis muscle and entered the gluteal region.

Background & Aim: The management of vertebral artery-posterior inferior cerebellar artery (VA-PICA) saccular aneurysms is challenging because of anatomy and function of posterior circulation. The aim of our study was to evaluate the outcome of patients with VA-PICA saccular aneurysms after treatment.Methods & Materials/Patients: This was a retrospective series of 4 patients with a VA-PICA saccular aneurysm operated at our institution.Results: Among 4 patients, 2 patients presented with subarachnoid hemorrhage, and 2 patients had non-specific presentation for aneurysms. In one case, we sacrificed nondominant vertebral artey and in 1 patient, aneurysm was ruptured during surgery and clipped but the patient died because of locked- in syndrome and pulmonary thromboembolism 3 weeks after surgery, and 3 cases were discharged without new neurological deficit.Conclusion: VA-PICA aneurysms are rare and require multidisciplinary management. Microsurgical treatment should be discussed when the PICA originates from the aneurysmal neck and when aneurysm is located at domianant vertebral artery.