We did a retrospective review of 83 femoropopliteal bypasses with grafting of saphenous vein performed for two groups of limbs: those with arteriosclerosis obliterans (n=71) and thromboangiitis obliterans (n=12) over the past 15 years. The purpose of the study is to assess factors that influence long-term graft patency. We also examined methods used for reoperation. After a mean follow-up of 35 months (ranges, 1-164), the cumulative patency rate was 79% at 5 years and again 79% at 8 years, which was better than the patency of PTFE grafts or other prosthetics reported by other authors. The two groups were compared for the severity of ischemia, condition of the outflow tract, and whether anastomosis was above or below the knee. These factors were different between the two groups, but the difference in patency was statistically not significant. Two reoperations for claudication were needed. One was carried out with use of the bilateral saphenous veins from below the portions used earlier. The other was done for obstruction of a PTFE graft; anastomosis was done at the mid portion with the use of Vitagraft.

Angiosarcoma is an uncommon malignancy, which spread out from the endothelial cells of vessels. Scalp angiosarcoma with cervical lymph node metastasis is particularly rare. This article describes a rare case of angiosarcoma of the scalp, presenting as neck inflammation. Imaging procedures such as computed tomography (CT), magnetic resonance image (MRI) and ultrasonography (US) were not sufficient to diagnose this case. A needle biopsy provided an effective and accurate diagnosis of cervical lymph node metastasis. Additional observation and physical examination was required to diagnose the origin of the primary cancerous lesion. Once the angiosarcoma diagnosis was confirmed histologically, sequential weekly and monthly docetaxel (DTX) treatment was effective in preventing reoccurrence. Nonetheless, the optimization of angiosarcoma treatment remains a future goal. Although patients generally describe pain and swelling at the primary lesion site, this patient complained only of painful neck inflammation, without any indication of pain or swelling of the scalp. A revised diagnostic protocol should note that cervical lymph node metastasis of unknown primary origin may result from angiosarcoma of the scalp.
Aged ; Antineoplastic Agents ; therapeutic use ; Cranial Irradiation ; Head and Neck Neoplasms ; diagnostic imaging ; pathology ; therapy ; Hemangiosarcoma ; diagnostic imaging ; pathology ; therapy ; Humans ; Lymphatic Metastasis ; Male ; Neck ; pathology ; Positron-Emission Tomography ; Radiography ; Scalp ; pathology ; Skin Neoplasms ; diagnostic imaging ; pathology ; therapy ; Taxoids ; therapeutic use ; Ultrasonography