Lesions of the popliteal artery are difficult to treat due to the limitations of the operative field owing to the knee joint. A posterior approach in the prone position is recommended for exposing the lesions. However, accessing the proximal or distal parts of the knee joints and harvesting the great saphenous vein remains challenging. The modified Sims’ position involved lying prone with the opposite knee slightly flexed and the upper body slightly elevated. This position allows for a wide lesion approach and graft harvesting without changing the position.

49-year-old man with a descending thoracic dilatation associated with pseudocoarctation of the aorta underwent thoracic endovascular aortic repair (TEVAR) . Computed tomography demonstrated kinking of the descending thoracic aorta. The aortic dilatation was located distal to a kinking and constricting aortic isthmus. TEVAR was performed because of the patient’s history of the cardiac surgery. Debranched TEVAR was successfully performed, occurring slight migration of the stent graft.

The rupture of aneurysm of the deep femoral artery is considered rare. The patient was an 81-year-old man. He was admitted to our hospital because of a swelling and pain in the right lower limb. A computed tomography showed a ruptured deep femoral artery aneurysm, measuring 20 mm. Because of the poor distal vascularity of the deep femoral artery, we performed a resection of the deep femoral artery aneurysm without revascularization of the deep femoral artery. The patient was discharged from the hospital on the 14th day after surgery without complications of lower limb ischemia.