The difficulties and solutions in operationalising a hybrid operating room.

As the population ages and grows, health services must evolve in ways to offer versatile patient care, whilst improving patient outcomes and maintaining long-term economic viability. A facility assisting in the provision of such healthcare is the hybrid operating room (HOR): a specialised suite allowing simultaneous radiological and surgical diagnostics and therapeutics in a single episode of care. Versatile and customizable, the HOR is utilised by a broad range of subspecialties in elective and emergency settings, including (but not limited to) vascular surgery, trauma surgery and interventional radiology.

Prognostic value of left ventricular systolic function before vascular surgery: a systematic review.

Background: Vascular surgery carries a high risk of post-operative cardiac complications. Recent studies have shown an association between asymptomatic left ventricular systolic dysfunction and increased risk of major adverse cardiovascular events (MACE). This systematic review aims to evaluate the prognostic value of left ventricular function as determined by left ventricular ejection fraction (LVEF) measured by resting echocardiography before vascular surgery.

Aberrant anatomy angel - a near-miss penetrating neck trauma and a life-saving retropharyngeal right subclavian artery.

Penetrating neck injuries constitute a relatively rare subset of trauma, which unfortunately carries with it significant morbidity and mortality. In the Emergency Department (ED), rapid clinical decompensation related to haemorrhagic, obstructive or mixed damage to major vessels and airways is typically the primary culprit, which is compounded even further by any intrathoracic involvement. Even rarer, however, is to sustain such an injury with no haemodynamic compromise and follow through with an uneventful clinical course.

A systematic review on nutcracker syndrome and proposed diagnostic algorithm.

Objective: Nutcracker syndrome (NCS) is an increasingly recognized venous compressive disease. Although people with NCS can experience debilitating symptoms, making an accurate diagnosis can often be challenging owing to the broad spectrum of clinical presentations and radiologic findings. In the present systematic review, we assessed the most frequent clinical and radiologic criteria used in establishing a diagnosis of NCS and have proposed a comprehensive framework for clinical decision-making.

Imaging modalities for endoleak surveillance.

As the global population ages, the issue of abdominal aortic aneurysm continues to grow. With the evolution of new devices and refined operative technique, aneurysm treatment via endovascular aortic repair is becoming increasingly favourable. This, however, is not without drawbacks, where regular surveillance is paramount to long-term success and detection of post-procedure complications.

A rare case of post-traumatic high-flow priapism requiring endovascular salvage with bilateral superselective microcoil embolization.

Post-traumatic high-flow priapism is a rare occurrence, with potentially debilitating long-term erectile dysfunction if left unaddressed. Even rarer, however, is for the priapism symptoms to be caused by a single cavernosal arterial pseudoaneurysm, with feeding vessels from the distal branched vessels of 'both' the left and right internal pudendal arteries. To the best of our knowledge, we present the first documented case of endovascular salvage utilizing superselective microcoil embolization in the treatment of high-flow priapism caused by a singular pseudoaneurysm with bilateral inflow.

Delayed presentation of a rare and complex multi-vessel pulmonary arteriovenous fistula following penetrating chest-wall trauma.

The formation of a pulmonary arteriovenous malformation (PAVM) following penetrating chest trauma is a rare occurrence, often rapidly fatal or requiring emergency surgery. Even rarer still, is for the malformation to formed by an entangled and grossly tortuous network of multiple arteries and veins, with symptoms and eventual presentation to a medical facility taking place years after the initial injury. Without substantial literature available, and nil regarding instances of more than one involved artery and vein, we present the case of a complex left-sided PAVM, becoming symptomatic 15 years after a chest-wall stabbing.

Bilateral Popliteal Artery Entrapment Syndrome: An Approach to Diagnosis and Salvage.

Popliteal artery entrapment syndrome (PAES) is a rare cause of limb-threatening vascular disease. Usually, it arises from aberrant embryological development or acquired dysfunctionality of the popliteal artery and its surrounding musculotendinous structures in the popliteal fossa. Here, we present a case report of a young woman with relatively sudden-onset short-distance claudication and paraesthesia affecting her right leg primarily.