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Purpose. To describe a case of abdominal aortic aneurysm (AAA) initially revealed by reversible segmental colonic ischemia and to put emphasis on the significance of inferior mesenteric artery (IMA) status before planning endovascular treatment for aneurysm exclusion. Case Description. A 79-year-old man presented with recent onset of acute abdominal syndrome with left lateralized pain, distension, and ileus. Computed tomography (CT) identified a 5.3 cm diameter infra-renal AAA with no sign of rupture. The IMA was apparently occluded, whereas the two other mesenteric arteries and hypogastric arteries were widely patent. Early lower colonic flexible endoscopy demonstrated a grade I segmental ischemic colitis. After a period of observation under medical treatment leading to clinical improvement, a bifurcated Talent™ aortic graft was implanted with successful total exclusion of the aneurysm. The patient was discharged one week later with satisfactory follow-up controls. Conclusion. Colonic

We present a case of Takayasu arteritis presenting with subclavian steal syndrome. A 50-year-old Korean female presented with chronic progressive right arm claudication associated with vertebrobasilar insufficiency. A high-grade focal ostial stenosis of the right subclavian artery was demonstrated via multiple imaging modalities. The stenosis was treated via percutaneous subclavian angioplasty and subsequently followed by stent delivery due to recoil. Our patient experienced complete resolution of her symptom complex without recurrence.

Wound healing is inextricably linked to adequate tissue perfusion. In fact, most wound care protocols include a non-invasive vascular test as part of the initial work-up for a patient with a non-healing wound. Depending on the composition and expertise of the wound center’s medical staff, many patients are referred to a vascular lab, vascular surgeon, or vascular interventionalist for this initial assessment. Classically trained vascular specialists focus on macro-vascular testing, such as Doppler based segmental pressures, waveforms, pulse volume recordings, duplex scanning, and ultimately, some form of angiography if the non-invasive testing is positive. Performing an ankle arm index is useful not only for wound healing prediction, but as an overall marker for cardiovascular health.1 The wound care clinician is interested in the tissue’s ability to ultimately heal and therefore, has to pay attention to both the macro-vascular and the micro-vascular status of the patient. At times, de

“More than half of all abdominal aortic aneurysm (AAA) repairs performed in the U.S. today are being done endovascularly. In other words, stent-graft intervention has already replaced the old open-surgery standard.”