Editorials
Frailty in peripheral arterial disease
Introduction It has been consistently demonstrated that frail vascular patients have poorer outcomes compared with their robust counterparts.1 Consideration of frailty is particularly important, not only as our population continues to age but as advances in anaesthetic, surgical and endovascular techniques are enabling a broader range of interventional options for those people who may have…
The CRG for Vascular Services
The last decade has witnessed a number of changes in the delivery of vascular services nationwide. Vascular surgery attained speciality status in 2012, and is well recognised as an urgent and emergent speciality delivering time-dependent care for patients with aortic aneurysms, carotid surgery for stroke prevention and lower limb revascularisation for critical limb-threatening ischaemia. The…
Abdominal Aortic Aneurysm (AAA) UK
Background Abdominal Aortic Aneurysm (AAA) UK is a newly formed patient representative group giving national representation to AAA patients and their loved ones, providing a platform for national discussion on the impact of – and potential policy changes relating to – the condition. For too long the patient voice has not been a focal point…
Bullying and harassment: a disease for eradication
Some diseases are endemic and persistent. In this edition of the journal, the paper by vascular trainees Madurska et al points to bullying and harassment being such a disorder which is stubbornly resistant to intervention.1 Previous surveys have highlighted this problem and, although reported here in vascular surgery, it pervades much of surgery. Why is…
How do you solve the problem of aortic dissection?
“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…
The future of exercise therapy for people with intermittent claudication?
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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