Two-Vessel Branched Stent Graft for Severely Angulated Aortic Arch Aneurysm in a Jehovah's Witness.

Aneurysmal disease involving the origins of supra aortic vessels often requires complex open and/or endovascular repair that is not only associated with significant risk of mortality and morbidity but also often with perioperative blood loss requiring transfusion. We report a successful repair of a large thoracic aortic aneurysm (TAA) involving the aortic arch with a custom-made Bolton Relay 2-vessel branched thoracic aortic endograft in a 42-year-old Jehovah's Witness who would otherwise be very unlikely to survive an open repair. Branched thoracic aortic endografting offers a potentially safe, minimally invasive, and effective alternative for TAA disease involving the supra-aortic arteries, especially in patients who are at high risk of open surgery.

An audit of the efficacy of a structured handover tool in obstetric anaesthesia.

Introduction: The SAFE handover tool was developed to reduce critical omissions during handovers in obstetric anaesthesia. It comprises a simple proforma onto which the outgoing team documents patients who fall into one of four anaesthetically relevant categories: Sick patients; At-risk patients (of emergency caesarean section, major haemorrhage or anaesthetic problems); Follow-ups; and Epidurals. We hypothesised that its use would reduce the number of critical omissions at handover.

One vs two applications of chlorhexidine/ethanol for disinfecting the skin: implications for regional anaesthesia.

Chlorohexidine/ethanol is commonly used for skin disinfection before neuraxial procedures. Two applications of this solution have been advocated but no evidence exists to support this. Our aim was to ascertain whether two applications of chlorohexidine/ethanol solution are more effective than one for skin disinfection before neuraxial anaesthesia.

Natural history of the common iliac artery in the presence of an abdominal aortic aneurysm.

Objective: Patients with an abdominal aortic aneurysm (AAA) often develop common iliac artery (CIA) aneurysms. We wished to assess the natural history of the CIA in the presence of an AAA and develop a model to predict CIA growth.

Methods: Data were gathered at a single center from 1996 to 2006 in patients undergoing AAA surveillance.