Articles

How do you solve the problem of aortic dissection?

July 20, 2022

“The tragedies of life are largely arterial” – Sir William Osler1 Every vascular surgeon can remember stories of patients with aortic dissection having thrombolysis for a presumed myocardial infarction, or a V/Q scan and full anticoagulation for a likely pulmonary embolus. My most memorable story is of an international sports coach who developed tearing intrascapular…

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Research priorities in diabetic foot disease

July 4, 2022

Introduction Diabetic foot disease is among a number of serious complications of diabetes mellitus.1 In the UK there are over 7,000 diabetes-related lower limb amputations each year.2 Diabetic foot ulceration (DFU) precedes diabetes-related lower limb amputations in 80% of cases, with studies reporting a prevalence of DFUs as between 1%3 and 2%4 in people living…

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A survey of surgical site infection prevention practice in UK vascular surgery

June 29, 2022

Introduction Surgical site infections (SSI) are a common complication following vascular surgery, with significant detrimental effects for patients and healthcare providers.1 Reported SSI rates vary, but may be as high as 40%.2 This high rate is due to vascular surgical patients often being elderly, smokers and diabetics, frequently having multiple long-term conditions. Undesirable physical sequelae…

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The future of exercise therapy for people with intermittent claudication?

June 29, 2022

National Institute for Health and Care Excellence (NICE) guideline 147 recommends supervised exercise therapy (SET) for all patients with intermittent claudication, consisting of 2 hours of SET per week for a 3-month period.1 This is supported by good evidence from Cochrane reviews2,3 that SET shows improvement in mean walking performance compared with home-based exercise and…

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Ilio-mesenteric bypass for chronic mesenteric ischaemia where prior endovascular treatment has failed: a case series

June 28, 2022

Abstract Background: Symptomatic chronic mesenteric ischaemia is a rare but debilitating disease, and its diagnosis is often delayed by the time taken to rule out underlying malignancy or other abdominal pathology. Once diagnosed, definitive revascularisation should not be delayed to avoid future bowel infarction. There is no consensus on the best treatment option, but most…

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