Studies reveal variations in the in the origin, number, and branching patterns of the lateral circumflex femoral artery (LCFA). The present study aimed to document such variations and their potential clinical applicability. Thirty-two femoral triangles of 16 embalmed adult human cadavers were dissected to investigate the variation in the origin, number, and branching patterns of LCFA. The main branches of the LCFA were tracked independently for numerical variations in branching pattern. The distance between the origin of LCFA and mid inguinal point (MIP) was also measured in each case. LCFA was most commonly arising from profunda femoris (PF), followed by femoral artery (FA) and common trunk of the femoral artery (CFA). Duplication LCFA was observed in 15 (46.87%) limbs, in 5 (31.25%) cases duplication was only on right side, in 4 (25%) cases duplication was only on left side and in 3 (18.75%), duplication was bilateral. Cases with duplication of LCFA, showed numerical variations with descending pattern being the most common. The average distance of LCFA1 and LCFA2 from mid-inguinal point was 5.77±1.35 cm and 6.14±2.05 cm respectively. Detailed information regarding the occurrence of duplication will be great importance for surgeons, interventional radiologists, and other medical professionals performing procedures in the femoral region. Knowledge of variation of branching pattern of LCFA is utmost important as surgeons use the descending branch of the LCFA in bypass grafting and vascular reconstruction surgeries.

BACKGROUND: Cognitive impairment affects nearly half of vascular surgery patients, but its association with postoperative outcomes remains poorly understood. This study explores the link between preoperative cognitive performance and postoperative complications, including postoperative delirium, in vascular surgery patients.
METHODS: A prospective cohort study was conducted on vascular surgery patients aged ≥65. Preoperative cognitive performance was assessed using the Montreal Cognitive Assessment, and postoperative complications were evaluated using the Comprehensive Complication Index. The association was analyzed through multivariable logistic regression.
RESULTS: Among 110 patients (18.2 ​% female, mean age 73.8 ​± ​5.7 years), cognitive impairment was evident in 48.2 ​%. Of the participants, 29 (26.3 ​%) experienced postoperative complications, among which 11 (10 ​%) experienced postoperative delirium. The adjusted odds ratio for the association between cognitive performance and postoperative complications was 1.19 (95 ​% CI 1.02-1.38; p ​= ​0.02).
CONCLUSIONS: Worse preoperative cognitive performance correlated with increased odds of postoperative complications and postoperative delirium in vascular surgery patients.

UNASSIGNED: Iatrogenic vascular injuries (IVIs) due to diagnostic and therapeutic interventions are known but rare or probably under-reported. We present our four-year findings on patients with IVIs after catheterization or surgery who underwent vascular surgical repairs in a resource-limited setting.
UNASSIGNED: A retrospective case series study between Jun 2018 and Sep 2022 of 35 patients diagnosed with IVIs and treated surgically at our hospital was included. The data on IVIs including patient characteristics, causes and type of injury, treatment, and outcomes were collected and analyzed.
UNASSIGNED: The mean age was 37.12± 17.0 years, and most patients (65.7%) were male. Of the 35 IVIs, 21 were caused by percutaneous procedures, while 14 occurred intraoperatively and affected various arteries and veins. The main injured vessels were the femoral artery (20%) and direct blood vessel puncture made by non-qualified specialists (42.9%) during dialysis cannulation was the main cause. The intraoperative IVI affected the inferior vena cava in three patients, the aorta in two patients, the external iliac artery in four, the tibial and popliteal arteries in four, and the internal carotid artery in one. The following types of repairs were recorded: direct suture of the vessel with or without endarterectomy (71.4%), synthetic patch placement (25.7%), ligation (8.6%), bypass or interposition graft (14.3%), and thromboembolectomy (5.7%). Vascular repair was successful in 32 (91.4%) patients while three patients (8.6%) were expired. Complications occurred in 7 (20%) patients, of which superficial wound infections were the common complication (11.6%) and were treated with proper antibiotic therapy.
UNASSIGNED: Prompt identification of IVIs, as well as proper triage for future treatment, can enhance patient outcomes. Our data showed that non-qualified specialists seem to be responsible for the majority of IVIs. For that, we emphasize the importance of performing vascular procedures by a qualified specialist with adequate training.

There is significant variability and equipoise in the management of critical limb ischemia (CLI). The Best Endovascular vs Best Surgical Therapy in Patients with Critical Limb Ischemia (BEST-CLI) trial, funded by the National Heart, Lung, and Blood Institute, is a prospective, open label, multicenter, multispecialty randomized controlled trial designed to compare treatment efficacy, functional outcomes, cost-effectiveness, and quality of life for 2100 patients suffering from CLI. BEST-CLI is enrolling those patients who are determined to be candidates for open surgical or endovascular revascularization and is designed to be comprehensive, pragmatic, and balanced. Enrollment is occurring at >130 sites across the world, and BEST-CLI is nearing the finish line. Although the trial has encountered a number of obstacles, they are being successfully navigated. This trial promises to establish an evidence-based standard of care in the management of this population of vulnerable patients.