ONLINE FIRST

An extraordinary conference session

I have attended innumerable sessions at countless conferences over my career but a late afternoon session on Wednesday 22 November 2023 at the Annual Scientific Meeting of the Vascular Society of Great Britain and Ireland at the Convention Centre in Dublin will live long in the memory. It ran from 17:00–18:30 hours in a packed…

Read More...

Surgical Site Infections in Major Lower Limb Amputation: An International Multicentre Audit (SIMBA): Study Protocol

Introduction Background and rationale Surgical site infection (SSI) is a significant potential complication of any surgical procedure, acknowledged by the National Institute of Health and Care Excellence (NICE) as a leading cause of in-hospital morbidity and mortality.1 In vascular surgery, patients undergoing major lower limb amputation (MLLA) may be at an increased risk of developing…

Read More...

A feasibility survey to inform trial design investigating surgical site infection prevention in vascular surgery

Introduction Surgical site infection (SSI) is common following vascular surgery, complicating up to 40% of groin incisions and major lower limb amputations (MLLA).1–3 SSI significantly impairs quality of life due to associated pain, reduced mobility, depression and anxiety.4 SSI results in a fourfold increase in the risk of readmission and substantially increases healthcare costs, estimated…

Read More...

Pseudoaneurysm of the anterior tibial artery following arthrodesis on a background of ankle joint tuberculosis

Abstract A 65-year-old man presented with a 6-week history of worsening right anterior ankle swelling following an ankle arthrodesis. Examination revealed a warm pulsatile 8 cm swelling on the dorsum of the foot. Ultrasound doppler and computed tomography angiography revealed an  8 cm pseudoaneurysm arising from the anterior tibial artery. Fluoroscopic-guided embolisation successfully treated the…

Read More...

The FraiLTI (Frailty in chronic Limb-Threatening Ischaemia) Protocol

Introduction Frailty, a concept gaining significant attention in recent years, is defined as a clinically recognisable state of increased vulnerability resulting from ageing-associated decline in reserve and function across multiple physiologic systems such that the ability to cope with everyday or acute stressors is compromised.1 Frailty leaves patients vulnerable to stressors such as illness, trauma…

Read More...

A deformed Lunderquist wire in a percutaneous endovascular aortic aneurysm repair procedure

Abstract Introduction: An endovascular aortic aneurysm repair (EVAR) is a minimally invasive procedure for repairing an abdominal aneurysm. The advantage of this procedure is that EVAR does not require a laparotomy, hence reducing the physical insult to the body with a quicker recovery time for the patient. Percutaneous EVAR (PEVAR) involves accessing the femoral arteries…

Read More...

Long-term outcomes of major and minor lower limb amputation: eight-year retrospective analysis from a single tertiary referral centre

Introduction Major amputation is a life-changing yet common endpoint in the management of diabetic foot disease (DFD) and chronic limb-threatening ischaemia (CLTI). Less commonly, amputation is performed for traumatic limb injury, deformity, chronic pain or loss of function.1–4 Major amputation is estimated to affect 3–4% of all patients with peripheral arterial disease (PAD)5 and 15–20%…

Read More...

Vascular Anastomosis Course for Core Surgical Trainees (VACT)

Background On completion of Core Surgical Training, Core Surgical Trainees (CSTs) are expected to have an understanding of emergency and elective vascular conditions – specifically acute limb ischaemia, embolic arterial disease and vascular injury.1 These are CST curriculum index conditions that CSTs are required to know how to manage.1 In addition to this, an understanding…

Read More...

Management of iatrogenic acute limb ischaemia in the paediatric intensive care unit population

In the Paediatric Intensive Care Unit (PICU) an arterial line is often inserted in critically unwell children to allow for reliable blood pressure monitoring and access to arterial blood for point-of-care blood gas analysis and laboratory testing. However, arterial catheterisation is a procedure that carries the risk of serious complications including impaired tissue perfusion, thrombotic…

Read More...

Traumatic thigh AV fistula leading to aneurysmal changes in aorta and iliac arteries

Abstract Penetrating traumatic arteriovenous fistulas (AVFs) have the tendency to be clinically silent for many years and could be misdiagnosed as deep venous thrombosis (DVT) on initial presentation. A 52-year-old male underwent a duplex scan to evaluate swelling of the limb, which detected an AVF in the thigh. He was stabbed in the lateral aspect…

Read More...