Publications
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Tiwari A, Chong TT, Walsh SR, et al., 2019, Reporting outcomes of new and old endovenous technologies using a standardized dataset - Now is the time for change., Phlebology, Pages: 268355518764988-268355518764988
Goodall R, Langridge B, Onida S, et al., 2019, Current status of non-invasive perfusion assessment in individuals with diabetic foot ulceration, Journal of Vascular Surgery, Vol: 69, Pages: 315-317, ISSN: 0741-5214
Lurie F, Lal BK, Antignani PL, et al., 2019, Compression therapy after invasive treatment of superficial veins of the lower extremities: Clinical practice guidelines of the American Venous Forum, Society for Vascular Surgery, American College of Phlebology, Society for Vascular Medicine, and International Union of Phlebology., J Vasc Surg Venous Lymphat Disord, Vol: 7, Pages: 17-28
Guideline 1.1: Compression after thermal ablation or stripping of the saphenous veins. When possible, we suggest compression (elastic stockings or wraps) should be used after surgical or thermal procedures to eliminate varicose veins. [GRADE - 2; LEVEL OF EVIDENCE - C] Guideline 1.2: Dose of compression after thermal ablation or stripping of the varicose veins. If compression dressings are to be used postprocedurally in patients undergoing ablation or surgical procedures on the saphenous veins, those providing pressures >20 mm Hg together with eccentric pads placed directly over the vein ablated or operated on provide the greatest reduction in postoperative pain.[GRADE - 2; LEVEL OF EVIDENCE - B] Guideline 2.1: Duration of compression therapy after thermal ablation or stripping of the saphenous veins. In the absence of convincing evidence, we recommend best clinical judgment to determine the duration of compression therapy after treatment. [BEST PRACTICE] Guideline 3.1: Compression therapy after sclerotherapy. We suggest compression therapy immediately after treatment of superficial veins with sclerotherapy to improve outcomes of sclerotherapy. [GRADE - 2; LEVEL OF EVIDENCE - C] Guideline 3.2: Duration of compression therapy after sclerotherapy. In the absence of convincing evidence, we recommend best clinical judgment to determine the duration of compression therapy after sclerotherapy. [BEST PRACTICE] Guideline 4.1: Compression after superficial vein treatment in patients with a venous leg ulcer. In a patient with a venous leg ulcer, we recommend compression therapy over no compression therapy to increase venous leg ulcer healing rate and to decrease the risk of ulcer recurrence. [GRADE - 1; LEVEL OF EVIDENCE - B] Guideline 4.2: Compression after superficial vein treatment in patients with a mixed arterial and venous leg ulcer. In a patient with a venous leg ulcer and underlying arterial disease, we suggest limiting the use of compression to patients with
Tan MKH, Luo R, Onida S, et al., 2019, Venous Leg Ulcer Clinical Practice Guidelines: What is AGREEd?, EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, Vol: 57, Pages: 121-129, ISSN: 1078-5884
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- Citations: 24
Tan MKH, Onida S, Laffan M, et al., 2018, Thrombophilia in non-thrombotic chronic venous disease of the lower limb - a systematic review, British Journal of Haematology, Vol: 183, Pages: 703-716, ISSN: 1365-2141
Chronic venous disease (CVD) represents a significant healthcare burden. Thrombophilia is proposed as a risk factor, particularly for post‐thrombotic CVD. A systematic review was performed to determine the relationship between thrombophilia and non‐thrombotic CVD. MEDLINE® and Embase® databases were searched from 1946 up to March 2018. Case‐control studies, cohort studies or randomised clinical trials reporting on thrombophilias in non‐thrombotic lower limb CVD in adult patients were included. Non‐English and post‐thrombotic syndrome studies were excluded. Study selection and data extraction were performed by two reviewers. Fifteen studies were included, reporting on 916 cases and 1261 controls. Studies largely focused on venous ulceration and investigated multiple haemostatic factors. An association between thrombophilia and non‐thrombotic CVD was identified, with greater prevalence and factor concentration alteration reported in patients compared to controls. Concomitant thrombophilia presence was associated with earlier CVD onset. Relationship strength varied, with commoner aetiologies showing clearer correlation than rarer ones. Thrombophilia is associated with non‐thrombotic CVD but the mechanism is unclear and causation cannot be determined. Future research should focus on prospective studies with larger populations and identify adjunct therapies targeting thrombophilia.
Grover G, Perera AH, Hamady M, et al., 2018, Cerebral embolic protection in thoracic endovascular aortic repair, JOURNAL OF VASCULAR SURGERY, Vol: 68, Pages: 1656-1666, ISSN: 0741-5214
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- Citations: 28
Bootun R, Lane TRA, Davies AH, 2018, One-stop vein clinic: The ideal option, Venous Disorders: Current Concepts, Pages: 225-233, ISBN: 9789811311079
Milinis K, Shalhoub J, Coupland A, et al., 2018, The effectiveness of graduated compression stockings for prevention of venous thromboembolism in orthopedic and abdominal surgery patients requiring extended pharmacological thromboprophylaxis, Journal of vascular surgery. Venous and lymphatic disorders, Vol: 6, Pages: 766-777.e2, ISSN: 2213-3348
Objectives: There is an increasing evidence base to support the use of extended pharmacological thromboprophylaxis in selected surgical patients to prevent venous thromboembolism (VTE). The benefit of graduated compression stockings (GCS) in addition to extended pharmacological thromboprophylaxis is unclear. The aim of this study was to systematically review the evidence relating to the effectiveness of using GCS in conjunction with extended pharmacological thromboprophylaxis to prevent VTE in surgical patients.Methods: A literature search of MEDLINE, Embase, Cochrane Library and clinicaltrials.gov databases was performed in accordance with PRISMA guidelines in April 2017. The review protocol was published on PROSPERO (CRD42017062655). Randomized controlled trials (RCTs) were eligible if one of the study arms included patients receiving extended pharmacological thromboprophylaxis alone (> 21 days) or in conjunction with GCS. Data on deep vein thrombosis (DVT), pulmonary embolism (PE), and VTE-related death were compiled. Pooled proportions of the VTE rates were determined using random-effects meta-analysis.Results: The systematic search identified 1291 studies, of which 19 studies were eligible for inclusion. No RCT directly compared extended pharmacological thromboprophylaxis alone with GCS plus extended pharmacological thromboprophylaxis. A total of 9824 patients from 16 RCTs were treated with extended pharmacological thromboprophylaxis, of whom 0.81% (95% CI 0.5-1.20) were diagnosed with symptomatic DVT and 0.2% (95% 0.12-0.36%) with PE. Three trials included 337 patients who received extended pharmacological thromboprophylaxis in conjunction with GCS. In this group, 1.61% (95% CI 0.03-5.43) had symptomatic DVT with no reported PEs. Similar VTE rates were observed when studies in orthopedic and abdominal surgery were analyzed separately.Conclusions: There is insufficient evidence to recommend GCS in conjunction with extended pharmacological prophylaxis to prev
Pitt J, Milanovic K, Coupland A, et al., 2018, A collective adaptive socio-technical system for remote- and self-supervised exercise in the treatment of intermittent claudication, International Symposium on Leveraging Applications of Formal Methods, Verification and Validation, Publisher: Springer Verlag, Pages: 63-78, ISSN: 0302-9743
Vascular surgeons have recognised that the condition of many patients presenting with intermittent claudication and peripheral arterial disease is better treated by physical exercise rather than endovascular or surgical intervention. Such exercise causes pain, though, before and until the health improvements are realised. Therefore, patients experiencing pain tend to stop doing that which causes it, unless they are supervised performing the necessary exercise programmes. However, supervised exercise is an extremely costly and time-consuming use of medical resources.To overcome this series of problems, we propose to develop and deploy a healthcare application which provides patient exercise programmes that are both centrally organised and remotely supervised by a health practitioner, and self-organized and self-supervised by the patients themselves. This demands that two dimensions of adaptation should be addressed: adaptation prompted by the health practitioner as the patient group improves and meets programme targets; and adaptation prompted from within the patient group enabling them to manage their own community effectively and sustainably.This position paper explores this application from the perspective of engineering a collective adaptive system for a mobile healthcare application, providing both remote- and self-supervised exercise. This requires, on the one hand, converging recent technological advances in sensors and mobile devices, audio and video connectivity, and social computing; with, on the other hand, innovative value-sensitive and user-centric design methodologies, together with formal methods for interaction and interface design and specification. The ultimate ambition is to create a ‘win-win-win’ situation in which the benefits of exercise as a treatment, the reduced costs of supervision, and the pro-social incentives to perform the exercise are all derived from computer-supported self-organised collective action.
Gohel MS, Heatley F, Davies AH, 2018, Endovenous Ablation in Venous Ulceration REPLY, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 379, Pages: 1483-1483, ISSN: 0028-4793
Aherne TM, Walsh SR, O'Sullivan GJ, et al., 2018, The ATTRACT trial may seem more attractive than it first looks for the management of acute deep vein thrombosis!, Phlebology, Pages: 268355518797567-268355518797567
Belramman A, Bootun R, Tang TY, et al., 2018, Mechanochemical ablation versus cyanoacrylate adhesive for the treatment of varicose veins: study protocol for a randomised controlled trial, Trials, Vol: 19, ISSN: 1745-6215
Background:Thermal ablation techniques have become the first-line treatment of truncal veins in the management of chronic venous disease (CVD). Despite excellent outcomes, these methods are often associated with pain; generally due to their use of heat and the necessity of fluid infiltration around the vein. More recently, novel non-thermal techniques, such as mechanochemical ablation (MOCA) and cyanoacrylate adhesive (CAE) have been developed to overcome these unwelcome effects. So far, the novel techniques have been found to have similar efficacy to thermal methods, yet no direct comparisons between the non-thermal treatment techniques have been conducted to date, giving rise to this study.Methods/design:This is a prospective, multicentre, randomised clinical trial, recruiting patients with truncal saphenous incompetence. Patients will be randomised to undergo either MOCA or CAE truncal ablation, followed by treatment of any varicosities. All patients will be required to wear compression stockings for 4 days post intervention. The primary outcome measure is the pain score immediately following completion of truncal ablation, measured by a 100-mm Visual Analogue Scale (VAS). The secondary outcomes are entire treatment pain scores, clinical scores, quality of life scores, occlusion rates, time to return to usual activities/work at 2 weeks, 3, 6 and 12 months. Re-intervention rate will be considered from the third month. Cost-effectiveness will be assessed for each intervention at 12 months. The study is powered to detect a mean 10-mm difference in maximum pain score. Allowing for loss to follow-up, the total target recruitment is 180 patients.Discussion:The study will be the first study to compare MOCA against CAE and is designed to determine which method causes less pain. Completion of this study is expected to be the end of 2019.Trial registration:ClinicalTrials.gov, ID: NCT03392753. Registered on 17 November 2017.
Hameed M, Coupland A, Davies AH, 2018, Popliteal artery entrapment syndrome: an approach to diagnosis and management, British Journal of Sports Medicine, Vol: 52, Pages: 1073-1074, ISSN: 1473-0480
Epstein D, Gohel MS, Heatley FM, et al., 2018, Cost-effectiveness of treatments for superficial venous refluxin patients with chronic venous ulceration., BJS Open, Vol: 2, Pages: 203-212, ISSN: 2474-9842
BackgroundVenous leg ulcers impair quality of life significantly, with substantial costs to health services. The aim of this study was to estimate the cost‐effectiveness of interventional procedures alongside compression therapy versus compression therapy alone for the treatment of chronic venous leg ulceration.MethodsA Markov decision analytical model was developed. The main outcome measures were quality‐adjusted life‐years (QALYs) and lifetime costs per patient, from the perspective of the UK National Health Service at 2015 prices. Resource use included the initial procedures, compression therapy, primary care and outpatient consultations. The interventional procedures included superficial venous surgery, endothermal ablation and ultrasound‐guided foam sclerotherapy (UGFS). The study population was patients with a chronic venous ulcer who were eligible for either compression therapy or an interventional procedure. Data were obtained from systematic review and meta‐analysis of RCTs.ResultsSurgery gained 0·112 (95 per cent c.i. −0·011 to 0·213) QALYs compared with compression therapy alone, with a difference in lifetime costs of €−1330 (−3570 to 1262). Given the expected savings in community care, the procedure would pay for itself within 4 years. There was insufficient evidence regarding endothermal ablation and UGFS to draw conclusions.DiscussionThis modelling study found surgery to be more effective and less costly than compression therapy alone. Further RCT evidence is required for both endothermal ablation and UGFS.
Ravikumar R, Williams KJ, Babber A, et al., 2018, Neuromuscular electrical stimulation (NMES) for the prevention of venous thromboembolism (VTE), Phlebology, Vol: 33, Pages: 367-378, ISSN: 0268-3555
ObjectiveVenous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a significant cause of morbidity and mortality, affecting 1 in 1000 adults per year. Neuromuscular electrical stimulation (NMES) is the transcutaneous application of electrical impulses to elicit muscle contraction, preventing venous stasis. This review aims to investigate the evidence underlying the use of NMES in thromboprophylaxis.MethodsThe Medline and Embase databases were systematically searched, adhering to PRISMA guidelines, for articles relating to electrical stimulation and thromboprophylaxis. Articles were screened according to a priori inclusion and exclusion criteria.ResultsThe search strategy identified 10 randomised controlled trials, which were used in three separate meta-analyses; 5 trials compared NMES to control, favouring NMES (odds ratio (OR) of DVT 0.29, 95%CI 0.13-0.65; P=.003); 3 trials compared NMES to heparin, favouring heparin (OR of DVT 2.00, 95%CI 1.13-3.52; P=.02); 3 trials compared NMES as an adjunct to heparin versus heparin only, demonstrating no significant difference (OR of DVT 0.33, 95%CI 0.10-1.14; P=.08).ConclusionNMES significantly reduces the risk of deep vein thrombosis compared to no prophylaxis. It is inferior to heparin in preventing DVT and there is no evidence for its use as an adjunct to heparin.
Machin M, Coupland A, Thapar A, et al., 2018, An inferior vena cava aneurysm in a patient with Klippel-Trenaunay Syndrome, Annals of Vascular Surgery, Vol: 50, Pages: 300.e1-300.e3, ISSN: 0890-5096
Aneurysms of the inferior vena cava are rare, with 54 cases reported in the literature. They carry a significant morbidity and mortality risk. A case of an inferior vena cava aneurysm in a patient with Klippel-Trenaunay Syndrome is reported. Open aneurysmorrhaphy of the Type III aneurysm was successfully performed. The patient's leg swelling, back pain and exercise tolerance improved. Inferior vena cava aneurysms are not known to be associated with Klippel-Trenaunay Syndrome. However, clinicians should have a high index of suspicion for great vessel aneurysms in these patients as they are associated with greater thromboembolic risk.
Belramman A, Bootun R, Lane TRA, et al., 2018, Endovenous management of varicose veins, Angiology, Vol: 70, Pages: 388-396, ISSN: 1940-1574
Varicose veins are a very common condition and have been the subject of a recent proliferation of treatment modalities. The advent of the endovenous treatment era has led to a confusing array of different techniques that can be daunting when making the transition from traditional surgery. All modalities offer excellent results in the right situation, and each has its own treatment profile. Thermal ablation techniques have matured and have a reassuring and reliable outcome, but the arrival of nonthermal techniques has delivered further options for both patient and surgeon. This article provides an overview of the different treatment devices and modalities available to the modern superficial vein surgeon and details the currently available evidence and summation analysis to help surgeons to make an appropriate treatment choice for their patients.
Clark SL, Onida S, Davies A, 2018, Long-haul travel and venous thrombosis: what is the evidence?, Phlebology, Vol: 33, Pages: 295-297, ISSN: 0268-3555
Staniszewska A, Onida S, Davies AH, 2018, Compression therapy for uncomplicated varicose veins - Too little for too much?, Phlebology, Pages: 268355518781432-268355518781432
Gohel MS, Heatley F, Liu X, et al., 2018, A randomized trial of early endovenous ablation in venous ulceration, New England Journal of Medicine, Vol: 378, Pages: 2105-2114, ISSN: 0028-4793
Background: Venous disease is the most common cause of leg ulceration. Although compression therapy improves venous ulcer healing, it does not treat the underlying causes of venous hypertension. Treatment of superficial venous reflux has been shown to reduce the rate of ulcer recurrence, but the effect of early endovenous ablation of superficial venous reflux on ulcer healing remains unclear.Methods:In a trial conducted at 20 centers in the United Kingdom, we randomly assigned 450 patients with venous leg ulcers to receive compression therapy and undergo early endovenous ablation of superficial venous reflux within 2 weeks after randomization (early-intervention group) or to receive compression therapy alone, with consideration of endovenous ablation deferred until after the ulcer was healed or until 6 months after randomization if the ulcer was unhealed (deferred-intervention group). The primary outcome was the time to ulcer healing. Secondary outcomes were the rate of ulcer healing at 24 weeks, the rate of ulcer recurrence, the length of time free from ulcers (ulcer-free time) during the first year after randomization, and patient-reported health-related quality of life.Results:Patient and clinical characteristics at baseline were similar in the two treatment groups. The time to ulcer healing was shorter in the early-intervention group than in the deferred-intervention group; more patients had healed ulcers with early intervention (hazard ratio for ulcer healing, 1.38; 95% confidence interval [CI], 1.13 to 1.68; P=0.001). The median time to ulcer healing was 56 days (95% CI, 49 to 66) in the early-intervention group and 82 days (95% CI, 69 to 92) in the deferred-intervention group. The rate of ulcer healing at 24 weeks was 85.6% in the early-intervention group and 76.3% in the deferred-intervention group. The median ulcer-free time during the first year after trial enrollment was 306 days (interquartile range, 240 to 328) in the early-intervention group and 278 da
Sung Y, Spagou K, Kafeza M, et al., 2018, Deep vein thrombosis exhibits characteristic serum and vein wall metabolic phenotypes in the inferior vena cava ligation mouse model, European Journal of Vascular and Endovascular Surgery, Vol: 55, Pages: 703-713, ISSN: 1078-5884
Deep vein thrombosis (DVT) is a major health problem, responsible for significant morbidity and mortality, and imposes a heavy economic burden to healthcare systems (1). Although most events resolve without complication through spontaneous lysis and recanalization, DVT can be complicated with life-threatening pulmonary embolism (2), while approximately one third of DVT patients develop post-thrombotic syndrome with swelling, pain, skin changes and/or venous ulceration (3).Treatment with anticoagulation prevents further thrombus extension, protects from pulmonary embolism and reduces the risk of chronic lower limb complications. Importantly, unnecessary treatment can result in bleeding. Therefore, accurate and reliable DVT diagnosis is essential. Currently, diagnosis relies on subjective clinical examination and ultrasound imaging (4). A number of biological markers have been investigated with variable results. D-dimer, the most widely used biomarker, is sensitive but lacks specificity (5, 6). Ongoing research efforts target the utility of alternative blood diagnostic biomarkers able to accurately diagnose DVT, guide length and type of treatment, and potentially identify patients who may benefit from more aggressive therapies than standard anticoagulation. New molecular technologies and methods have entered the scientific arena, offering the opportunity to revisit this important clinical need. Metabolic profiling has emerged as a new approach to investigate complex metabolic disease and enable precision medicine. Metabolomics is the comprehensive and systematic identification of the small molecules present in differential abundance in biofluids and are affected by various factors such as diet, lifestyle, genetics, disease, environmental factors and medications. Metabolic profiling approaches to characterizing the metabolome can be either targeted or untargeted. In targeted approaches specific metabolites, representative of suspected biological pathways, are analysed
Harput S, Christensen-Jeffries K, Brown J, et al., 2018, Two-stage motion correction for super-resolution ultrasound imaging in human lower limb, IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control, Vol: 65, Pages: 803-814, ISSN: 0885-3010
The structure of microvasculature cannot be resolved using conventional ultrasound imaging due to the fundamental diffraction limit at clinical ultrasound frequencies. It is possible to overcome this resolution limitation by localizing individual microbubbles through multiple frames and forming a super-resolved image, which usually requires seconds to minutes of acquisition. Over this time interval, motion is inevitable and tissue movement is typically a combination of large and small scale tissue translation and deformation. Therefore, super-resolution imaging is prone to motion artefacts as other imaging modalities based on multiple acquisitions are. This study investigates the feasibility of a two-stage motion estimation method, which is a combination of affine and non-rigid estimation, for super-resolution ultrasound imaging. Firstly, the motion correction accuracy of the proposed method is evaluated using simulations with increasing complexity of motion. A mean absolute error of 12.2 μm was achieved in simulations for the worst case scenario. The motion correction algorithm was then applied to a clinical dataset to demonstrate its potential to enable in vivo super-resolution ultrasound imaging in the presence of patient motion. The size of the identified microvessels from the clinical super-resolution images were measured to assess the feasibility of the two-stage motion correction method, which reduced the width of the motion blurred microvessels approximately 1.5-fold.
Milinis K, Thapar A, Shalhoub J, et al., 2018, Antithrombotic Therapy Following Venous Stenting: International Delphi Consensus, Journal of Vascular Surgery, Vol: 67, Pages: 1633-1633, ISSN: 0741-5214
Milinis K, Thapar A, Shalhoub J, et al., 2018, Antithrombotic therapy following venous stenting: international Delphi consensus, European Journal of Vascular and Endovascular Surgery, Vol: 55, Pages: 537-544, ISSN: 1078-5884
Objective/backgroundDeep venous stenting is increasingly used in the treatment of deep venous obstruction; however, there is currently no consensus regarding post-procedural antithrombotic therapy. The aim of the present study was to determine the most commonly used antithrombotic regimens and facilitate global consensus.MethodsAn electronic survey containing three clinical scenarios on venous stenting for non-thrombotic iliac vein lesions, acute deep vein thrombosis (DVT), and post-thrombotic syndrome was distributed to five societies whose members included vascular surgeons, interventional radiologists, and haematologists. The results of the initial survey (phase 1) were used to produce seven consensus statements, which were distributed to the respondents for evaluation in the second round (phase 2), along with the results of phase 1. Consensus was defined a priori as endorsement or rejection of a statement by ≥ 67% of respondents.ResultsPhase 1 was completed by 106 experts, who practiced in 78 venous stenting centres in 28 countries. Sixty-one respondents (58% response rate) completed phase 2. Five of seven statements met the consensus criteria. Anticoagulation was the preferred treatment during the first 6–12 months following venous stenting for a compressive iliac vein lesion. Low molecular weight heparin was the antithrombotic agent of choice during the first 2–6 weeks. Lifelong anticoagulation was recommended after multiple DVTs. Discontinuation of anticoagulation after 6–12 months was advised following venous stenting for a single acute DVT. No agreement was reached regarding the role of long-term antiplatelet therapy.ConclusionsConsensus existed amongst respondents regarding anticoagulant therapy following venous stenting. At present, there is no consensus regarding the role of antiplatelet agents in this context.
Epstein D, Onida S, Bootun R, et al., 2018, Cost-Effectiveness of Current and Emerging Treatments of Varicose Veins, Value in Health, ISSN: 1098-3015
© 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Objectives: To analyze the cost-effectiveness of current technologies (conservative care [CONS], high-ligation surgery [HL/S], ultrasound-guided foam sclerotherapy [UGFS], endovenous laser ablation [EVLA], and radiofrequency ablation [RFA]) and emerging technologies (mechanochemical ablation [MOCA] and cyanoacrylate glue occlusion [CAE]) for treatment of varicose veins over 5 years. Methods: A Markov decision model was constructed. Effectiveness was measured by re-intervention on the truncal vein, re-treatment of residual varicosities, and quality-adjusted life-years (QALYs) over 5 years. Model inputs were estimated from systematic review, the UK National Health Service unit costs, and manufacturers’ list prices. Univariate and probabilistic sensitivity analyses were undertaken. Results: CONS has the lowest overall cost and quality of life per person over 5 years; HL/S, EVLA, RFA, and MOCA have on average similar costs and effectiveness; and CAE has the highest overall cost but is no more effective than other therapies. The incremental cost per QALY of RFA versus CONS was £5,148/QALY. Time to return to work or normal activities was significantly longer after HL/S than after other procedures. Conclusions: At a threshold of £20,000/QALY, RFA was the treatment with highest median rank for net benefit, with MOCA second, EVLA third, HL/S fourth, CAE fifth, and CONS and UGFS sixth. Further evidence on effectiveness and health-related quality of life for MOCA and CAE is needed. At current prices, CAE is not a cost-effective option because it is costlier but has not been shown to be more effective than other options.
Kankam HKN, Lim CS, Fiorentino F, et al., 2018, A Summation Analysis of Compliance and Complications of Compression Hosiery for Patients with Chronic Venous Disease or Post-thrombotic Syndrome, EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, Vol: 55, Pages: 406-416, ISSN: 1078-5884
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Manley LR, Onida S, Davies AH, 2018, A SYSTEMATIC REVIEW OF PERIPHERAL BLOOD BIOMARKERS IN PRIMARY CHRONIC VENOUS DISEASE, Annual Meeting of the Society-of-Academic-and-Research-Surgery (SARS), Publisher: WILEY, Pages: 11-11, ISSN: 0007-1323
Qureshi MI, Davies AH, 2018, Endovascular aneurysm repair in the elderly: First do no harm, VASCULAR, Vol: 26, Pages: 113-114, ISSN: 1708-5381
Bath MF, Sidloff D, Saratzis A, et al., 2018, Impact of abdominal aortic aneurysm screening on quality of life., Br J Surg, Vol: 105, Pages: 203-208
BACKGROUND: Screening for abdominal aortic aneurysm (AAA) is known to reduce AAA-related mortality; however, the psychological impact of population AAA screening is unclear. The aim was to assess the impact of AAA diagnosis on quality of life (QoL) using data from an established AAA screening programme. METHODS: Mental and physical QoL scores for men diagnosed with AAA through participation in the English and Welsh AAA screening programmes were compared with no-AAA controls. Participants were identified through the United Kingdom Aneurysm Growth Study (UKAGS), a nationwide prospective cohort study of men with an AAA of less than 55 mm diagnosed through voluntary participation in screening. The UKAGS participants completed QoL questionnaires at the time of screening and annually thereafter. RESULTS: A transient reduction in mental QoL scores was observed following the diagnosis of AAA, returning to baseline levels after 12 months. Physical QoL remained consistently lower in the AAA cohort. Participants thought about their AAA and the AAA growth progressively less 12 months after the initial screening diagnosis. AAA growth rate had no influence over QoL parameters. DISCUSSION: This study suggests that screening for AAA does reduce mental QoL; however, this effect is transient (less than 12 months). Men diagnosed with AAA have a consistently worse physical QoL compared with controls.
Grant Y, Onida S, Dharmarajah B, et al., 2018, Exercise-induced median arcuate ligament syndrome in athletes, JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS, Vol: 58, Pages: 193-195, ISSN: 0022-4707
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