An Extension of the Bollinger Scoring System to Analyse the Distribution of Macrovascular Disease of the Lower Limb in Diabetes.

Objective: While it is generally considered that patients with diabetes mellitus (DM) have more distal peripheral arterial disease (PAD), there is little information on how individual vessels are affected. The aim of this study was to adapt Bollinger's scoring system for lower limb angiograms (DSAs) to include the distal and planter vessels. The reliability of this extension was tested and was used to compare the distribution of disease in two cohorts of patients with and without DM.

An unusual presentation of acute onset Charcot arthropathy.

Charcot arthropathy is a progressive condition primarily affecting the lower limbs in patients with diabetes mellitus. It is a rare complication of diabetic neuropathy and if left untreated can lead to severe limb destruction necessitating major amputation. Here, we report the case of a 41-year-old female who presented with rapidly progressive Charcot foot over a 10-day period, necessitating open reduction and internal fixation of Lisfranc-type fracture dislocations.

Impact of Frailty on Outcomes in Patients Undergoing Open Abdominal Aortic Aneurysm Repair.

Background: Frailty is a global state that does not relate directly to comorbidities and is prevalent among patients with vascular disease. The Clinical Frailty Scale (CFS) is a rapid assessment tool to identify vulnerable and frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to independently predict mortality and morbidity after elective open abdominal aortic aneurysm (AAA) repair.

Early and Late Outcomes of Surgery for Neurogenic Thoracic Outlet Syndrome in Adolescents.

Background: Neurogenic thoracic outlet syndrome is a condition that is both complex to diagnose and manage successfully. The aim of our study was to present our experience and outcomes of surgical management of thoracic outlet syndrome in adolescents.

Methods: We performed a retrospective analysis of a prospectively held database of consecutive adolescents (age 10-19 years) who underwent surgery for neurogenic thoracic outlet syndrome between 2005 and 2017 at our university hospital.

Artery Ligation for Infected Femoral Pseudoaneurysms Does Carry a High Risk of Major Amputation.

Background: Arterial ligation has been described in the literature as a safe and effective procedure with a relatively low number of patients requiring major amputations.

Methods: We performed a retrospective analysis of a prospectively held database of all patients who underwent arterial ligation for infected femoral pseudoaneurysms due to chronic intravenous drug abuse from January 2012 to March 2018. Information recorded for each patient included age, gender, blood investigations, microbiologic results, diagnostic modality, operative details, outcome of surgery, postoperative complications, and follow-up.

Early cannulation grafts for haemodialysis: An updated systematic review.

Purpose: Early cannulation grafts are specifically designed for dialysis, whereas standard expanded polytetrafluoroethylene grafts were not. There is developing collective experience and literature available to allow the assessment of outcomes of these early cannulation grafts. The aim of this review was to review the evidence for both short- and long-term outcomes of early cannulation grafts.

The role of compression after endovenous ablation of varicose veins.

Objective: The aim of this review was to identify the evidence regarding the optimal duration of compression therapy after endovenous ablation of varicose veins.

Methods: Electronic databases were searched for studies assessing the use of compression after endovenous ablation in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The primary outcomes for this study were pain score and complications.

Vascular access for home haemodialysis.

Introduction:: Home haemodialysis has been advocated due to improved quality of life. However, there are very little data on the optimum vascular access for it.

Method:: A retrospective cohort study was carried on all patients who initiated home haemodialysis between 2011 and 2016 at a large university hospital.

Effect of tumescent anesthesia and patient positioning on laser tip junctional distance during endovenous laser ablation.

Background: The correct positioning of the laser tip at the saphenofemoral or saphenopopliteal junction during endovenous laser therapy is paramount to ensure a safe and effective procedure. The aim of this study was to demonstrate how patient positioning and tumescence infiltration can affect this safe junctional distance.

Methods: A retrospective review of a prospectively maintained database was carried out for all patients who received endovenous laser treatment for symptomatic varicose veins between February 2008 and February 2014 in one surgeon's practice in a teaching hospital vascular unit.

Identification of occult active infection using PET-CT in a combined liver-kidney transplant candidate.

This case describes a patient being considered for combined liver-kidney transplantation for Caroli's disease with a failed renal transplant. A chronic septic focus could not be located with standard imaging techniques, such as ultrasonography and computed tomography. This case report highlights the observation that a retained non-functioning transplant can be the cause of fever of unknown origin and PET-CT can be useful in diagnosing these challenging cases.

Maintaining Patency of Vascular Access for Haemodialysis.

All types of vascular access, a necessity for haemodialysis, are prone to thrombosis and if untreated this results in failure. Thrombosis results from the combination of impaired blood flow, endothelial and vessel wall injury and a propensity towards pro-coagulative states, either intrinsic or aggravated by dialysis or dehydration. The treatment of access thrombosis relies on removal of the clot (thrombectomy) and treatment of the underlying problem.

Novel use of infrared thermal imaging to predict arteriovenous fistula patency and maturation.

Objective: The arteriovenous fistula (AVF) is the preferred method of long-term haemodialysis. However, it has been shown to have a substantial rate of maturation failure. The formation of an AVF creates haemodynamic changes to blood flow in the arm with diversion of blood away from the distal circulation into the low pressure venous system, in turn, leading to thermal changes distally.

Effect of cold ischaemia time on outcome after living donor renal transplantation.

Background: The aim of the present study was to determine the effects of cold ischaemia time (CIT) on living donor kidney transplant recipients in a large national data set.

Methods: Data from the National Health Service Blood and Transplant and UK Renal Registry databases for all patients receiving a living donor kidney transplant in the UK between January 2001 and December 2014 were analysed. Patients were divided into three groups depending on CIT (less than 2 h, 2-4 h, 4-8 h).

The novel use of infrared thermal imaging as an adjunct for the management of haemodialysis access induced distal ischaemia.

Introduction: Haemodialysis access-induced distal ischaemia (HAIDI) whilst unusual may be a difficult complication to diagnose and manage particularly in patients with small vessel disease.Infrared thermal imaging (IRTI) has been used for several decades to monitor cutaneous temperature distribution and has been used in medical applications. The use of IRTI in HAIDI is attractive as it can be used as a non-invasive measure of tissue perfusion.

Duplex ultrasound surveillance after carotid artery endarterectomy.

Objective: After carotid endarterectomy (CEA), patients have been regularly followed up by duplex ultrasound imaging. However, the evidence for long-term follow-up is not clear, especially if the results from an early duplex scan are normal. This study assessed and systematically reviewed the evidence base for long-term surveillance after CEA and a normal early scan.