An alternative to aorto-uni-iliac EVAR and femoro-femoral crossover in a patient having an aorto-iliac aneurysm with an occluded external iliac artery.

INTRODUCTION: An endovascular procedure for excluding an aorto-iliac aneurysm whilst simultaneously preserving one internal iliac artery is described in a patient with complex iliac pathology. REPORT: The procedure involved the use of Advanta V12 covered stents to bridge the gap between the contralateral limb of the main body of a custom-made Zenith stent graft and the internal iliac artery on the side of an external iliac artery occlusion. DISCUSSION: Minimal modifications to the standard design of modular stent grafts make it possible to treat high risk patient with complex pathology with minimal morbidity.     

Allergic fungal sinusitis— A clinico-pathological study

The co-existence of fungal elements in allergic nasal Polyposis, has given rise to a distinct clinical entity known as ‘Allergic fungal sinusitis ’ (AF’S). Many a time, these fungal elements may not be diagnosed pre-operatively by routine diagnostic nasal endoscopy or CT scan of paranasal sinuses, due to the florid presentation of nasal polyps, which usually obscure the underlying fungal pathology. The diagnosis is often made intra-operatively. The post-operative confirmation of AFS is by histopathology, fungal smear, fungal culture, allergic murin study and fungal specific IgE titres. We report a series often such cases done in our institution, which highlight that AFS should be considered as a differential diagnosis in Sinonasal Polyposis cases, for their effective management.