344 results found
Abdallah N, Mouchati C, Crowley C, et al., 2022, Trends in mortality from aortic dissection analyzed from the World Health Organization Mortality Database from 2000 to 2017, International Journal of Cardiology, ISSN: 0167-5273
Abdallah N, Mouchati C, Crowley C, et al., 2022, Trends in mortality from aortic dissection analyzed from the World Health Organization Mortality Database from 2000 to 2017, International Journal of Cardiology, ISSN: 0167-5273
Shalhoub J, 2022, The contracting role of graduated compression stockings in prevention of peri-operative venous thromboembolism, British Journal of Surgery, ISSN: 0007-1323
Lawton R, Shalhoub J, Davies A, 2022, Implementation of the graduated compression as an adjunct to pharmaco-thromboprophylaxis in surgery (GAPS) trial results across the UK, Phlebology, ISSN: 0268-3555
ObjectivesTo examine uptake and dissemination of a National Institute for Health Research (NIHR) Health Technology Assessment (HTA) funded trial- Graduated compression as an Adjunct to Pharmaco-thromboprophylaxis in Surgery (GAPS) (project number: 14/140/61) amongst health professionals in the UK. To evaluate the impact of the trial on venous thromboembolism (VTE) prevention policies 7 months after publication.MethodA 12-question online survey emailed to 2750 individuals via several vascular societies, 34 VTE Exemplar Centre leads and 1 charity over a 3-month period.ResultsIn total, 250 responses were received; a 9.1% response rate. Over half of all respondents (52.4%) had read the GAPS trial results prior to completing the survey. Precisely, 77.1% said their hospital had not yet made changes or did not intend to make changes to local hospital VTE policy based on the GAPS trial.ConclusionsFindings must be interpreted in the context of the low response rate. Further in-depth interviews would aid understanding of barriers to implementing change.
Salciccioli J, Marshall D, Goodall R, et al., 2022, Interstitial lung disease incidence and mortality in the United Kingdom and the European Union: an observational study, 2001-2017, ERJ Open Research, ISSN: 2312-0541
Taha M, Busuttil A, Bootun R, et al., 2022, Clinical outcomes and overview of dedicated venous stents for management of chronic iliocaval and femoral deep venous disease, Vascular, Vol: 30, Pages: 320-330, ISSN: 0967-2109
ObjectivesVenous stenting of the lower extremities has grown in popularity and is now considered a key component of the primary treatment strategy for the management of pathologically obstructive or stenotic lesions of the deep venous system. This review aims to provide an overview of the role of venous stenting in the management of chronic conditions affecting the deep venous system of the lower limbs.MethodsAn overview of venous stents design and current role of stenting procedure in individuals presenting with Chronic Venous Insufficiency (CVI) and presenting the current trials of dedicated venous stenting in management of chronic deep venous lesions. This review provides a focused insight on venous stent design, physical properties and the available dedicated venous stents selected studies with their related patency outcome based on selective literature search of the PubMed database and Cochrane library.ConclusionsDedicated venous stent technology is advancing at a rapid pace alongside the increased undertaking of endovascular deep venous stent reconstruction in the management of iliocaval vein pathologies. The ideal design(s) for venous stents remain unknown, although it is hoped that the presence of new dedicated venous stents in clinical practice will allow the generation of experience and data to advance our understanding in this area.
Essa M, Ghajar A, Delago A, et al., 2022, Demographic and state-level trends in mortality due to ischemic heart disease in the United States frmo 1999-2019, American Journal of Cardiology, ISSN: 0002-9149
Although there have been advances in ischemic heart disease (IHD) care, variation in IHD-related mortality trends across the United States has not been well described. We used the CDC-WONDER database to evaluate variation in IHD-related mortality for demographic groups in the U.S. between 1999 and 2019. Age-adjusted mortality rates (AAMR) were stratified by sex, race, Hispanic ethnicity, and U.S. state. Crude mortality rates were evaluated using 10-year age groups. IHD-related AAMR decreased from 195 to 88 per 100,000 nationally, with slower decline from 2010-2019 (average annual percent change [AAPC] -2.6% [95% CI -2.9% to -2.2%) compared to 2002-2010 (AAPC -5.3% [95% CI -5.6% to -4.9%]). All groups had decreases in AAMR, though black populations persistently had the highest AAMR, and women had greater relative decreases than men. AAPC was -3.7% for white men; -4.7% for white women; -3.9% for black men; -4.9% for black women; -4.1% for Hispanic men, and -5.1% for Hispanic women. Populations ≥65 years old had greater relative mortality declines compared to populations <65 years. The median AAMR (2019) and AAPC (1999-2019) across states was 86.3 (range 58 – 134) and -3.8% (range -1.7% to -4.8%), respectively. In conclusion, mortality declines due to IHD have slowed in the U.S., with significant geographic variation. Black populations persistently had the highest AAMR, and declines were relatively greater for women and populations ≥65 years. The impact of demographics and geography on IHD should be further explored and addressed as part of public health measures.
Eves J, Sudarsanam A, Shalhoub J, et al., 2022, 320Augmented Reality in Vascular and Endovascular Surgery: A Scoping Review, ASiT Surgical Innovation Summit - Future Surgery Show, Publisher: OXFORD UNIV PRESS, ISSN: 0007-1323
Gebran A, Gaitanidis A, Argandykov D, et al., 2022, Mortality & pulmonary complications in emergency general surgery patients with mortality COVID-19, Journal of Trauma and Acute Care Surgery, ISSN: 2163-0755
Objectives The outcomes of emergency general surgery (EGS) patients with concomitant COVID-19 infection remain unknown. With a multicenter study in 361 hospitals from 52 countries, we sought to study the mortality and pulmonary complications of COVID-19 patients undergoing EGS.Methods All patients aged ≥17 years and diagnosed preoperatively with COVID-19 between February and July 2020 were included. EGS was defined as the urgent/emergent performance of appendectomy, cholecystectomy, or laparotomy. The main outcomes were 30-day mortality and 30-day pulmonary complications (a composite of acute respiratory distress syndrome, unexpected mechanical ventilation, pneumonia). Planned subgroup analyses were performed based on presence of preoperative COVID-related respiratory findings (e.g. cough, dyspnea, need for oxygen therapy, chest radiology abnormality).Results A total of 1,045 patients were included, of which 40.1% were female and 50.0% were older than 50 years; 461 (44.1%), 145 (13.9%), and 439 (42.0%) underwent appendectomy, cholecystectomy, and laparotomy, respectively. The overall mortality rate was 15.1% (158/1,045) and the overall pulmonary complication rate was 32.9% (344/1,045); in the subgroup of laparotomy patients, the rates were 30.6% (134/438) and 59.2% (260/439), respectively. Subgroup analyses found mortality and pulmonary complication risk to be especially increased in patients with preoperative respiratory findings.Conclusion COVID-19 patients undergoing EGS have significantly high rates of mortality and pulmonary complications, but the risk is most pronounced in those with preoperative respiratory findings.Level of Evidence Level III
Jani C, Mouchati C, Abdallah N, et al., 2022, Trends in prostate cancer mortality in the United States of America, by state and race, from 1999 to 2019: Estimates from the Centers for Disease Control WONDER database., Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0732-183X
Mouchati C, Abdallah N, Jani C, et al., 2022, Trends in disease burden from prostate cancer amongst different regions of the world and extensively the European Union 15+countries, from 1990 to 2019: Estimates from the Global Burden of Disease study., Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0732-183X
Abdallah N, Jani C, Mouchati C, et al., 2022, Trends of kidney cancer burden from 1990 to 2019 in European Union 15+countries., Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0732-183X
Machin M, Younan H-C, Guéroult A, et al., 2022, Systematic review of inframalleolar endovascular interventions and rates of limb salvage, wound healing, restenosis, rest pain, reintervention and complications, Vascular, Vol: 30, Pages: 105-114, ISSN: 0967-2109
ObjectivesPeripheral artery disease is estimated to affect 237 million individuals worldwide. Critical limb ischaemia, also known as chronic limb threatening ischaemia is a consequence of the progression of peripheral artery disease which occurs in ∼21% of patients over a five-year period. The aim of this systematic review is to assess the use of additional below-the-ankle angioplasty in comparison to the use of above-the-ankle angioplasty alone, and the subsequent rates of amputation, wound healing, restenosis, rest pain, reintervention and complications.MethodsThis systematic review was undertaken in accordance with PRISMA guidelines following a registered protocol (CRD42019154893). Online databases were searched using a search strategy of 20 keywords. Included articles reported the outcome for inframalleolar (pedal artery, pedal arch, plantar arteries) angioplasty with additional proximal angioplasty in comparison to proximal angioplasty alone. GRADE assessment was applied to assess the quality of the evidence.ResultsAfter screening 1089 articles, 10 articles met the inclusion criteria. Comparative performance assessment of below-the-ankle with above-the-ankle versus above-the-ankle angioplasty alone was undertaken in 3 articles, with the remaining 7 articles reporting outcomes of below-the-ankle with above-the-ankle angioplasty with no distinct comparator group. Significant decrease in major lower limb amputation at the last follow-up in the below-the-ankle group when compared with the above-the-ankle angioplasty alone group was observed in a single study (3.45% vs. 14.9%, p < 0.05). Improved wound healing rate at follow-up in the below-the-ankle group versus above-the-ankle angioplasty alone group was also reported in a single study (59.3% vs. 38.1%, p < 0.05). Subsequent rate of amputation after below-the-ankle angioplasty has been estimated as 23.5%.ConclusionTo date, there is a lack of studies assessing inframalleolar in
Hartley A, Pradeep M, Van den Berg V, et al., 2022, Depletion of homeostatic antibodies against malondialdehyde-modified low-density lipoprotein correlates with adverse events in major vascular surgery, Antioxidants, Vol: 11, ISSN: 2076-3921
We aimed to investigate if major vascular surgery induces LDL oxidation, and whether circulating antibodies against malondialdehyde-modified LDL (MDA-LDL) alter dynamically in this setting. We also questioned relationships between these biomarkers and post-operative cardiovascular events. Major surgery can induce an oxidative stress response. However, the role of the humoral immune system in clearance of oxidized LDL following such an insult is unknown. Plasma samples were obtained from a prospective cohort of 131 patients undergoing major non-cardiac vascular surgery, with samples obtained preoperatively and at 24- and 72 h postoperatively. Enzyme-linked immunoassays were developed to assess MDA-LDL-related antibodies and complexes. Adverse events were myocardial infarction (primary outcome), and a composite of unstable angina, stroke and all-cause mortality (secondary outcome). MDA-LDL significantly increased at 24 h post-operatively (p < 0.0001). Conversely, levels of IgG and IgM anti-MDA-LDL, as well as IgG/IgM-MDA-LDL complexes and total IgG/IgM, were significantly lower at 24 h (each p < 0.0001). A smaller decrease in IgG anti-MDA-LDL related to combined clinical adverse events in a post hoc analysis, withstanding adjustment for age, sex, and total IgG (OR 0.13, 95% CI [0.03–0.5], p < 0.001; p value for trend <0.001). Major vascular surgery resulted in an increase in plasma MDA-LDL, in parallel with a decrease in antibody/complex levels, likely due to antibody binding and subsequent removal from the circulation. Our study provides novel insight into the role of the immune system during the oxidative stress of major surgery, and suggests a homeostatic clearance role for IgG antibodies, with greater reduction relating to downstream adverse events.
Gradinariu G, Lyons O, Musajee M, et al., 2022, Predictors of percutaneous access-related complications in aortic endovascular procedures – 'real-world' insights and a comparison to open access. International Angiology 2022, International Angiology: a journal on angiology, ISSN: 0392-9590
Gimzewska M, Berthelot M, Sarai P, et al., 2022, Evaluation of a novel wireless near-infrared spectroscopy (NIRS) device in the detection of tourniquet induced ischaemia, BMJ Innovations, ISSN: 2055-8074
Schuster-Bruce J, Jani C, Goodall R, et al., 2022, A comparison of the burden of thyroid cancer between the European Union 15 countries, 1990-2019: estimates from the Global Burden of Disease Study, JAMA Otolaryngology-Head and Neck Surgery, ISSN: 2168-6181
Importance:The global incidence of thyroid cancer has been increasing rapidly and this has an attendant burden on health-systems. It is unclear how the burden of this disease differs between nations.Objective:To observe the trends in mortality, incidence and disability-adjusted life years (DALYs) from thyroid cancer between 1990-2019 in European Union (EU) 15+ nations.Design, Setting, Participants:Observational analysis using data obtained from the Global Burden of Disease (GBD) Study database. Countries of the EU15+ were included.Exposure:Thyroid cancer.Main Outcomes and Measures:Age-standarised incidence rates (ASIR), age-standardised mortality rates (ASMR) and disability-adjusted life years (DALYs) were extracted for individual EU15+ countries per sex for each of the years 1990-2019, and mortality-to-incidence indices (MII) were computed. Joinpoint regression analysis was used to describe the trends.Results:Thirteen of 19 countries showed an average annual percentage change (AAPC) increase in ASIR across the study period. Joinpoint regression analysis reveals largely plateauing ASIR trends in recent years across the majority of EU15+ nations since 1990. Australia, Belgium and the US are the only countries with increasing ASMR trends with positive AAPCs, whilst the remaining 16 countries show negative trends. DALYs decreased in all EU15+ countries except Australia, Denmark and the US. Conclusions and Relevance:Overall, the burden of thyroid cancer across EU15+ countries appears to be reducing, evidenced by plateauing incidence rates and reductions in mortality and DALYs over the 30-year study period. However, the US and Australia demonstrate unfavorable, increasing ASMR and DALY trends. Ongoing observation is required to monitor how changes in international clinical practice guidelines impact upon thyroid cancer DALYs and mortality.
Otunla A, Shanmugarajah K, Madariaga M, et al., 2022, Chronic rejection and atherosclerosis in post-transplant cardiovascular mortality: two sides of the same coin, Heart Lung and Circulation, Vol: 31, Pages: 162-166, ISSN: 1443-9506
Post-transplant cardiovascular disease (CVD) is the single most common cause of death in solid organ transplant recipients. The prevailing school of thought is that post-transplant CVD is driven by the same underlying atherosclerotic processes as the CVD of aging seen in the general population. This is reflected in current management strategies, which focus on the minimisation of traditional cardiovascular risk factors. In this article, we argue that atherosclerosis is not the sole aetiology of post-transplant CVD. Instead, chronic rejection drives post-transplant CVD through an antibody-mediated systemic vasculopathy termed systemic accelerated arteriosclerosis (SAA). SAA is fundamentally distinct from atherosclerosis, associated with unique histology, pathophysiology and risk factors. In order to effectively manage post-transplant CVD, SAA needs to be addressed in current management strategies through revised risk factor minimisation and use of immunomodulatory pharmaceuticals.
Tabiri S, Kamarajah SK, Nepogodiev D, et al., 2022, Impact of Bacillus Calmette-Guerin (BCG) vaccination on postoperative mortality in patients with perioperative SARS-CoV-2 infection, BJS Open, Vol: 5, ISSN: 2474-9842
Otunla AA, Shanmugarajah K, Davies AH, et al., 2022, The biological parallels between atherosclerosis and cardiac allograft vasculopathy, Cardiology in Review, Vol: Publish Ahead of Print, ISSN: 1061-5377
Houdmont J, Daliya P, Theophilidou E, et al., 2022, Burnout among surgeons in the United Kingdom during the COVID-19 pandemic: a cohort study, World Journal of Surgery, Vol: 46, Pages: 1-9, ISSN: 0364-2313
Background:Surgeon burnout has implications for patient safety and workforce sustainability. The aim of this study was to establish the prevalence of burnout among surgeons in the UK during the COVID-19 pandemic.MethodsThis cross-sectional online survey was set in the UK National Health Service and involved 601 surgeons across the UK of all specialities and grades. Participants completed the Maslach Burnout Inventory and a bespoke questionnaire. Outcome measures included emotional exhaustion, depersonalisation and low personal accomplishment, as measured by the Maslach Burnout Inventory-Human Services Survey (MBI-HSS).Results:A total of 142 surgeons reported having contracted COVID-19. Burnout prevalence was particularly high in the emotional exhaustion (57%) and depersonalisation (50%) domains, while lower on the low personal accomplishment domain (15%). Burnout prevalence was unrelated to COVID-19 status; however, the greater the perceived impact of COVID-19 on work, the higher the prevalence of emotional exhaustion and depersonalisation. Degree of worry about contracting COVID-19 oneself and degree of worry about family and friends contacting COVID-19 was positively associated with prevalence on all three burnout domains. Across all three domains, burnout prevalence was exceptionally high in the Core Trainee 1–2 and Specialty Trainee 1–2 grades.Conclusions:These findings highlight potential undesirable implications for patient safety arising from surgeon burnout. Moreover, there is a need for ongoing monitoring in addition to an enhanced focus on mental health self-care in surgeon training and the provision of accessible and confidential support for practising surgeons.
Taha M, Busuttil A, Bootun R, et al., 2022, A clinical guide to deep venous stenting for chronic iliofemoral venous obstruction, Journal of vascular surgery. Venous and lymphatic disorders, Vol: 10, Pages: 258-266.e1, ISSN: 2213-3348
BackgroundAn increase in endovenous interventions for deep venous pathologies has been observed. This article aims to provide an overview of the role of venous stenting in the management of chronic conditions affecting the deep venous system of the lower limbs, with a focus on intervention relating to the vena cava and iliofemoral venous segments.MethodsAn overview of the literature on the minimally invasive venous stenting procedures that are being increasingly used in the management of chronic conditions affecting the deep venous system of the lower limbs.ResultsWe discuss key areas of interest to a venous specialist practicing in this area, including diagnostic imaging in chronic deep venous disease, with a focus on the use of intravascular ultrasound examination in this context; the treatment of chronic venous outflow obstruction, including the rationale and structural indications for stenting, current guidance regarding stent placement, and fundamental points to consider during decision-making (endophlebectomy and stenting, stenting across the inguinal ligament, optimal sizing of venous stents, extension of venous stenting to beyond the common femoral vein confluence, the role of thrombolysis useful in chronic venous disease, and arteriovenous fistulae); outcomes and initial reports of stenting; and the future of venous stents.ConclusionsDeep venous stenting has become a key treatment option for chronic (thrombotic or nonthrombotic) obstructive venous disease. Dedicated venous stents and intravascular ultrasound examination represent important technological advances in the minimally invasive treatment of symptomatic chronic deep venous obstruction, which previously required open surgical reconstruction.
Normahani P, Shalhoub J, 2022, Diabetic foot disease, Surgery (Oxford), Vol: 40, Pages: 53-61, ISSN: 0263-9319
Diabetic foot disease, or ulceration, is prevalent and is associated with high rates of lower limb amputation and mortality. Its underlying aetiology is complex and multifactorial. However, neuropathy and peripheral arterial disease represent two important precipitating risk factors. Regular, comprehensive foot examinations are important in the prevention of ulceration and cardiovascular complications as they provide an opportunity to assess risk, modify risk factors and deliver patient education. Charcot neuropathic osteoarthropathy is commonly misdiagnosed and should always be suspected in an individual with diabetes presenting with a hot and swollen foot. Diabetic foot ulcers are challenging to manage. The key to optimizing outcomes includes early diagnosis with referral for coordinated multidisciplinary care where prompt treatment of infection and peripheral arterial disease, as well as appropriate wound care and offloading can be initiated and monitored.
COVIDSurg Collaborative, GlobalSurg Collaborative, 2022, SARS‐CoV‐2 infection and venous thromboembolism after surgery: an international prospective cohort study, Anaesthesia, Vol: 77, Pages: 28-39, ISSN: 0003-2409
SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1–2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2–3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9–3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3–6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no his
Jani C, Al Omari O, Singh H, et al., 2021, Trends of HIV-related cancer mortality between 2001 and 2018: an observational analysis, Tropical Medicine and Infectious Disease, Vol: 6, ISSN: 2414-6366
The burden of AIDS-defining cancers has remained relatively steady for the past two decades, whilst the burden of non-AIDS-defining cancer has increased. Here, we conduct a study to describe mortality trends attributed to HIV-associated cancers in 31 countries. We extracted HIV-related cancer mortality data from 2001 to 2018 from the World Health Organization Mortality Database. We computed age-standardized death rates (ASDRs) per 100,000 population using the World Standard Population. Data were visualized using Locally Weighted Scatterplot Smoothing (LOWESS). Data for females were available for 25 countries. Overall, there has been a decrease in mortality attributed to HIV-associated cancers among most of the countries. In total, 18 out of 31 countries (58.0%) and 14 out of 25 countries (56.0%) showed decreases in male and female mortality, respectively. An increasing mortality trend was observed in many developing countries, such as Malaysia and Thailand, and some developed countries, such as the United Kingdom. Malaysia had the greatest increase in male mortality (+495.0%), and Canada had the greatest decrease (-88.5%). Thailand had the greatest increase in female mortality (+540.0%), and Germany had the greatest decrease (-86.0%). At the endpoint year, South Africa had the highest ASDRs for both males (16.8/100,000) and females (19.2/100,000). The lowest was in Japan for males (0.07/100,000) and Egypt for females (0.028/100,000).
Jani C, Salcicciol I, Rupal A, et al., 2021, Trends in breast cancer mortality between 2001 and 2017: an observational study in the European Union and the United Kingdom., Jco Global Oncology, Vol: 7, Pages: 1682-1693, ISSN: 2687-8941
PURPOSE: Breast cancer is the most common cancer in women worldwide, representing 25.4% of the newly diagnosed cases in 2018. The past two decades have seen advancements in screening technologies, guidelines, and newer modalities of treatment. Our study reports and compares trends in breast cancer mortality in the European Union and the United Kingdom. MATERIALS AND METHODS: We used the WHO Mortality Database. We extracted breast cancer mortality data from 2001 to 2017 on the basis of the International Classification of Diseases, 10th revision system. Crude mortality rates were dichotomized by sex and reported by year. We computed age-standardized death rates (ASDRs) per 100,000 population using the world standard population. Breast cancer mortality trends were compared using joinpoint regression analysis. RESULTS: We analyzed data from 24 EU countries, including the United Kingdom. For women, breast cancer mortality was observed to be downtrending in all countries except Croatia, France, and Poland. For the most recent female data, the highest ASDR for breast cancer was identified in Croatia (19.29 per 100,000), and the lowest ASDR was noted in Spain (12.8 per 100,000). Denmark had the highest change in ASDR and the highest estimated annual percentage change of -3.2%. For men, breast cancer mortality decreased in 18 countries, with the largest relative reduction observed in Denmark with an estimated annual percentage change of -27.5%. For the most recent male data, the highest ASDR for breast cancer was identified in Latvia (0.54 per 100,000). CONCLUSION: Breast cancer mortality rates have down trended in most EU countries between 2001 and 2017 for both men and women. Given the observational nature of this study, causality to the observed trends cannot be reliably ascribed. However, possible contributing factors should be considered and subject to further study.
Gottardi R, Wyss TR, van den Berg JC, et al., 2021, Current trends in reduction or elimination of the aortic impulse during stent-graft deployment and balloon moulding during thoracic endovascular aortic repair, European Journal of Cardio-Thoracic Surgery, Vol: 60, Pages: 1466-1474, ISSN: 1010-7940
<jats:title>Abstract</jats:title> <jats:sec> <jats:title> </jats:title> </jats:sec> <jats:sec> <jats:title>OBJECTIVES</jats:title> <jats:p>A survey was performed to evaluate the methods used for reduction or elimination of the aortic impulse (REAI) to facilitate precise stent graft placement and balloon moulding during thoracic endovascular aortic repair (TEVAR).</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>A total of 127 physicians (1 per hospital) were contacted and asked to fill out a short, comprehensive questionnaire on an internet-based platform.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Fifty physicians (39.4%) responded and completed the survey. Routine use of REAI for stent graft deployment is most frequently used in the ascending aorta and less frequently in the aortic arch and the descending aorta (86.4% vs 69.4% vs 56%). Some physicians based the decision of whether to use REAI on the type of stent graft in the respective location (13.6% vs 24.5% vs 24.0%). Stent-graft deployment without REAI, irrespective of the type of stent graft used, was never done in the ascending aorta (0.0%), in 3 centres in the aortic arch (6.1%) and in 10 centres in the descending aorta (20%). The REAI method most frequently used was dependent on the aortic segment (ascending aorta vs aortic arch vs descending aorta) rapid right ventricular pacing (90.9% vs 59.2% vs 28.0%), followed by pharmacological blood pressure reduction (13.6% vs 53.1% vs 64.0%) and venous inflow occlusion (13.6% vs 14.3% vs 4.0%), respectively. Tip capture and non-occlusive deployment systems were f
Hitchman L, Nandhra S, Gooday C, et al., 2021, Tenotomy for diabetic foot ulcers: a scoping survey of current practice, Journal of Vascular Societies Great Britain and Ireland, Vol: 1, ISSN: 2754-0022
<jats:p>Background: Diabetes mellitus is one of the fastest growing health crises of our time. One of the major complications is diabetic foot ulcers, many of which fail to heal. Tenotomy – transection of tendon fibres – may help to redistribute pressure in the foot and therefore help ulcer healing and prevent recurrence. The aim of this survey was to explore the availability of pressure relieving adjuncts, including tenotomy, in diabetic foot services and interest in collaborating in further research studies. Methods: An online survey was performed of healthcare professionals involved in the management of diabetic foot ulcers to explore the multidisciplinary composition of diabetic foot services, offloading therapies available and interest in collaborating in further research. Results: The survey gained 168 responses from 10 countries. Most responders were orthopaedic surgeons (61.3%, 103/168). Of those who responded, 70.8% (119/168) had a dedicated diabetic foot clinic and 99 (58.9%) reported having an active tenotomy service. 73.8% (124/168) of responders wished to further collaborate and 82.1% (138/168) were willing to help involve their patients in a future trial. Conclusions: The results of this survey showed the variation in tenotomy practice and an appetite for collaborative research in this area. The Vascular Society of Great Britain and Ireland Diabetic Foot Specialist Interest Group will address these uncertainties through targeted collaborative research to investigate tenotomy as a potential clinical and cost-effective treatment in diabetic foot care.</jats:p>
Khatri A, Davies A, Shalhoub J, 2021, Mechanical prophylaxis for venous thromboembolism prevention in obese individuals, Phlebology, Vol: 36, Pages: 768-770, ISSN: 0268-3555
Panhelleux B, Shalhoub J, Silverman A, et al., 2021, A review of through-knee amputation, Vascular, ISSN: 0967-2109
Objectives: Through knee amputation (TKA) is an umbrella term for several different surgical techniques, which may affect clinical and functional outcomes. This makes it hard to evaluate the benefits and need for a TKA approach. This paper seeks to: (1) Determine the number of TKAs performed compared with other major lower limb amputations (MLLA) in England over the past decade; (2) identify the theoretical concepts behind TKA surgical approaches and their potential effect on functional and clinical outcomes; and (3) provide a platform for discussion and research on TKA and surgical outcomes.Methods: National Health Service Hospital Episodes Statistics were used to obtain recent numbers of MLLAs in England. EMBASE and MEDLINE were searched using a systematic approach with predefined criteria for relevant literature on TKA surgery.Results: In the past decade, 4.6% of MLLA in England were TKAs. Twenty-six articles presenting TKA surgical techniques met our criteria. These articles detailed three TKA surgical techniques; the classical approach, which keeps the femur intact and retains the patella; the Mazet technique, which shaves the femoral condyles into a box shape; and the Gritti-Stokes technique, which divides the femur proximal to the level of the condyles and attaches the patella at the distal cut femur.Conclusions: TKA has persisted as a surgical approach over the past decade, with three core approaches identified. Studies reporting clinical, functional, and biomechanical outcomes of TKA frequently fail to distinguish between the 3 distinct and differing approaches, making direct comparisons difficult. Future studies that compare TKA approaches to one another and to other amputation levels are needed.
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