UNLABELLED Article presents a rare case of posttraumatic pseudoaneurysm and A-V fistula between deep femoral artery and vein in 16 year old patient with stab wound in middle third of the lateral side of left femoral region. There were no signs of arterial injury on initial angiogram. During the observation we noticed subcutaneous bruise on the posterior side of the femoral region, and strong systolic murmur by ordinary auscultation over the involved region as a significant sign of the A-V fistula. At day 3, CT angiogram and Doppler analysis showed 4 cm sized false aneurysm combined with A-V fistula between distal portion of the deep femoral artery and vein. We made ipsilateral transfemoral catheterization and coiling of the feeding arterial branch with good immediate result, but at next Doppler checking, appearance of the same picture was disappointing. After we recognized retrograde filling through distal collateral artery, technically unsuitable for endovascular procedure, conventional surgery with posterolateral approach was indicated. An excision of the pseudoaneurysm, and ligation of the A-V fistula was done with good postoperative result. CONCLUSION Obliterative endovascular procedure is a method of choice, but sometimes can not guarantee satisfactory result. In those cases conventional surgery is recommended.

Last data from 2005 shows that Bosnia and Herzegovina has 37.6 % current smokers between 18-65 years. 29.7% of them are female and 49.2 % male. In the region of Sarajevo 13.8% pupils are active smokers (16.8% boys, and 10% girls). We have evaluated smoking impact on patients in Clinical Center Sarajevo treated for occlusive arterial disease who had finished their treatment with amputation after exhausting efforts of vascular surgery and angiological therapy measures. Evaluation covers period of ten years (from 1998 to 2007) and patients treated in Vascular Surgery Department and Orthopaedic and Traumatology Department. Average age of patients was 56 year. The youngest patient was 22 and the oldest was 88 year. 70.3% of total number (990 patients) were smokers. From total number of 387 above knee amputations, 159 was done in diabetic patients - smokers which means 41.08%, or 16.06% of total number of amputations. 699 (70.6%) smoking patients underwent major amputation operations (above and below knee amputations). Only 63 patients (6.36%) without major risk factors (smoking and diabetes) had amputation as a final result of treatment. In 52 (5.25%) patients with major or other amputations we have found obliterative thromboangiitis (Buerger’s disease). In 23 patients (2.32%) with amputation we have found other inflammatory thrombotic diseases. In some cases amputation was done as urgent measure in which surgeons had no time for details in diagnostic evaluation. Smoking rates among the general population in Bosnia and Herzegovina are extremely high, and national campaigns to lower smoking rates have not yet begun.

Case of post reconstructive aneurism of right a. femoralis has been solved with excision, resection of part of grapht and bifurcation of a. femoralis comunis, and then we made revascularization with interposes of tubular grapht with reinsertion of a. profunda femoris. Post operative complication is dehiscence of wound and exposition of front wall of interpenetrated grapht. Complication is solved by covering defect with rotate muscle-skin part. Final result of surgical treatment is completely successful.

One of the 15 most common cause of death in USA is rupture of the aneurism of the abdominal aorta. In 8-10% cases patients have no previous symptoms of aneurysm of the abdominal aorta, and they are coming to thr hospital with clinical picture of rupture This paperwork presents one such case. After assuming the data of basic lab. findings, clinical finding, and diagnostic procedures, an urgent operation was indicated. A resection of aneurismaticly changed infrarenal portion of abdominal aorta and its reconstruction with synthetic graft was done. In postoperative course we noticed cardiac decompensation followed by acute ischaemic attac of the left lower limb. It was solved by urgent disobliterative procedure--embolectomy in local anestesion. Patient was discharged after 21 day in good general condition.