Transposition veins, in some cases when there is no adequate superficial veins, preferred is model of the vascular access. This approach may be acceptable version vascular access where is not possible to create other shapes. But basilic vein transposition is time consuming and technically challenging procedure with significant perioperative morbidity. Complication rate for basilic vein transposition remains high at 47-71%. We report a patient who underwent transposition basilic vein, and its anastomosis with radial artery, in which developed the digital hypoperfusion ischemic syndrome.

Pulmonary embolism (PE) and venous thromboembolism are two clinical manifestations of a single entity - venous thromboembolism. PE usually occurs through due thrombi from the lower veins, and in 10-15% of cases are due thrombus from upper veins or right heart failure. Significance is mainly determined by the frequency (1/1000 per year in the adult population; less in younger but significant increase with increasing age), the risk of mortality is important in acute and chronic diseases that are associated with this clinical manifestation. Acute pulmonary embolism is often fatal, with a mean annual mortality of about 30% in untreated. Many deaths occur because of recurrent PE within the first few hours after the initial event. In the nineteenth century, Virchow the mechanism of thromboembolism categorized into three groups: changes in the blood vessel wall, a reduction of blood flow (path) and changes in the composition of the blood (hypercoagulable, prothrombotic). Modern interpretation of the pathogenesis of thromboembolism, which is processed corresponds Virhovljevom concept. In general thromboembolic events can be a result of complications of individual risk factors as increased thrombotic potential.

Autors reports 20 ten old boy received penetrating vulns thorasic with naif at midle linea.subksifoid area. Patient with angina pectoris, hypovolemic shock end cardiac arrest received at department intensive care Clinic hospital centre Prishtine in Gracanica. In cardiogenic arrest under reanimation is introduction in general endotracheal anestesy and intervention surgery. Maden midle sternotomy and verification laesio pericardii under right cordis longth of 20 mm,hematopericard and vulnus at parietis diaphragmalis right ventricular in area septoapicalis.Past evacuation sangui from pericard heart mobilisation and made compresion phingin.Placement closure laesion with cardiorraphia prolen 0000 sec.Cooley.Lesion right pleurae mediastinalis and placement drain in right torasic cavum and drain mediastine in restrosternal area i aspiration undervother sec. Bilay. Fixation sternum with fillum metalicum sec. Kurschner. Reanimation intensive care all time and past realisation complete haemostasis along linae sutturae heart folow up substitution adecquat failure volumen total sangui plasm and cristolid. Realisation total stability hemodinamic and patient move at department intensive care. Control EKG, echocardiography and cardiac ensims 5 and 10 dely psotoperative show fingins corectly. Not signs ischemic laesaoin and disfunction conducti and arrhythmi. Haert pariets is all corectly viability and cinesy.