OBJECTIVES Endovascular stent and prosthetic graft placement are commonplace techniques for correction of subclavian artery (SCA) lesions. However, when initial surgical repair of the SCA becomes complicated by subsequent infection or thrombosis of the repair site, stents and prosthetic grafts are no longer suitable for secondary repair due to the risk of recurrent failure and limited longevity. Autogenous tissue is more resistant to infection and has improved long-term patency, and thus may be a better option for secondary reconstruction in these complex clinical scenarios. The most commonly used autogenous conduit for SCA reconstruction is the great saphenous vein; however, the significant size mismatch makes this unsuitable in many circumstances. The autogenous femoral vein is a promising alternative conduit for SCA repair. Here we present three successful cases of its use as a salvage technique following iatrogenic complications of prior surgical repair. METHODS From 2015 to 2019, three patients underwenttion of the repair site. CONCLUSIONS The success of these cases demonstrates that the autogenous femoral vein is an effective and safe option for SCA reconstruction. It is particularly useful for secondary salvage when prior surgical repair via standard techniques is complicated by infection or thrombosis, and when target vessel size precludes the use of the great saphenous vein. This is an excellent choice of conduit that vascular surgeons should consider for use in complex SCA repairs. OBJECTIVES Type Ia endoleaks are common following thoracic endovascular aortic repair(TEVAR). However, the repair of type Ia endoleaks involving the distal arch is challenging because of the presence of the interventional endografts, potential damage to the aortic arch vessels, and the location and size of the aneurysmal body. We retrospectively reviewed our experience of the surgical treatment of type Ia endoleaks with distal arch involvement using left subclavian artery(LSCA)-left common carotid artery(LCCA) transposition with a stented elephant trunk. METHODS Sixteen patients (male=16; mean age, 47±9 years, range 31-63 years) with type Ia endoleaks involving the distal arch underwent LSCA-LCCA transposition with a stented elephant trunk from July 2010 to July 2018. TEVAR failure occurred in 12 patients, re-TEVAR was performed in two patients, hybrid aortic arch repair in one patient, and the chimney technique in one patient. RESULTS There were no in-hospital deaths. Fourteen patients required mechanical ventilation for less then 24h and one for less then 48h. One patient required re-intubation after mechanical ventilation for 19h and continuous renal replacement therapy because of renal failure. One patient received pericardial drainage, and recurrent laryngeal nerve injury occurred in one patient. Three patients died during follow-up. CONCLUSIONS LSCA-LCCA transposition with a stented elephant trunk can produce satisfactory results in patients with a type Ia endoleak involving the distal arch. Using this technique, it is possible to exclude the aneurysm sac distal to the LCCA origin and seclude the failed interventional endograft. These encouraging outcomes suggested that this technique could be a suitable surgical treatment for this type of lesion. BACKGROUND Carotid blowout syndrome is a severe complication of head and neck cancer, associated with high mortality and morbidity. METHODS We present a case of acute hemorrhage from the carotid artery of a 59-year-old man with a history of chemo-radiotherapy for lingual base and oropharyngeal squamous cells carcinoma. The case was managed by a staged multidisciplinary approach of open arterial reconstruction, after initial endovascular hemorrhage control using stent-graft. RESULTS The patient was discharged to home with patent carotid artery, no sign of infection or bleeding and autonomous ambulation. A CT/PET scan performed 6 months later confirmed healing and absence of tumor recurrence. selleck CONCLUSIONS A multi-disciplinary approach involving vascular surgeons, ENT surgeons, plastic and maxillofacial surgeons is particularly appropriate in the management of carotid blowout syndrome in order to warrant a durable and effective repair of all the anatomical structures involved. AIMS A distal approach in endovascular procedures for revascularization of lowers limbs can be considered in case of no re-entry in subintimal recanalization. The aim of this study is to evaluate the feasibility of a medial approach to the infrageniculate popliteal artery (IPA) using existing CT scan simulation and punctures performed on cadavers. METHODS AND RESULTS CT angiographies of lower extremities were used to simulate IPA puncture and puncture trajectory. Tissues damaged during the trajectory between the puncture site and the access related injuries were analyzed. Anatomical punctures on cadaverous model were also performed. Corpses were placed in supine position, the hip in slight flexion (40°) and abduction (external rotation of 60°). A 16G needle was used for the IPA puncture. Twelve CT angiography simulations were made. Out of these 12 simulations, 9 revealed an isolated lesion of the popliteal vein, 2 isolated lesions of the tibial nerve. A lesion of the tibial nerve and the popliteal vein on the same simulation was once observed. Damage to the medial gastrocnemius muscle could not be avoided in each case. Ten punctures were performed on cadavers with technical success. There were 6 popliteal vein lesions, 3 tibial nerve lesions and 1 case without lesion. In all cases, damage to the medial gastrocnemius muscle was seen. CONCLUSION This medial approach was feasible and is accompanied by trauma of elements of the popliteal pedicle. Preoperative CT angiography could anticipate best site of puncture and potential access related injury. OBJECTIVES Popliteal artery aneurysms (PAA) are the most common peripheral aneurysms. Although rare and often asymptomatic there is a significant risk of thrombosis, embolism and limb loss. The aim of this study was to evaluate the eligibility for endovascular repair of patients treated for symptomatic and asymptomatic PAA according to the instructions for use (IFU). MATERIAL AND METHODS All patients treated for PAA with open surgical repair between the years 2010 - 2017 were analysed if suitable for endovascular treatment. Preoperative imaging was reviewed for applicability with an interventional radiologist and two vascular surgeons. Evaluation was performed according to the following criteria adapted from the IFU of Gore ® Viabahn stent graft at least a single vessel tibial run-off, proximal and distal landing zone more than 2 cm, no large difference in vessel diameter proximal and distal to the aneurysm, no overstenting of significant collaterals necessary and no inadequate kinking of the artery. The patients were classified in three categories the patient was eligible, endovascular treatment was feasible and endovascular treatment was not appropriate.