Vascular Surgery Workforce: Evaluation and Estimation of Future Demand in the United Kingdom.

Background: Vascular disease is a common cause of death and disability in our growing elderly population and the demand for vascular procedures is increasing worldwide. Workforce planning is essential to meet future demand and provide safe vascular services. Our aim was to evaluate the current workforce in the United Kingdom and estimate future demand for vascular surgeons.

Vascular Surgeon Burnout and Resilience in the United Kingdom: A Report from the Vascular Society Workforce Committee.

Background: Occupational burnout is a growing concern in frontline roles such as vascular surgery, and is associated with medical errors and shortened careers. Our aim is to measure burnout, resilience, and associated risk factors among vascular surgeons (VS) in the United Kingdom (UK).

Methods: We carried out an electronic survey of active VS in the UK using validated self-report questionnaires, including the following: Copenhagen Burnout Inventory (CBI), Brief Resilience Scale (BRS), and information on job characteristics, health, and well-being.

Making surgical wards safer for patients with diabetes: reducing hypoglycaemia and insulin errors.

High-quality perioperative diabetes care is essential to improve surgical outcomes for patients with diabetes. Inadequate perioperative diabetes care is associated with increased wound complications, higher mortality rates and increased length of hospital stay. Despite national guidelines, surgical wards remain a high-risk area for poor diabetes care.

End-stage vascular access: direct intra-atrial insertion of a dialysis catheter.

Central venous occlusions are a frequent problem in hemodialysis patients. We describe the case of a patient with end-stage vascular access in whom we successfully inserted a direct intra-atrial dialysis line during coronary artery bypass grafting. This technique could be a significant contribution to patients in whom alternative vascular access options are exhausted.

Justifying a third pancreas transplant: a case report.

Early pancreas graft failure after simultaneous pancreas-kidney transplant can occur in up to 20% of recipients. Results after pancreas retransplant continue to improve, with results comparable to primary pancreas transplants. We describe an unusual case of a third pancreas transplant in which a remnant of a previous arterial Y-graft was used for the arterial anastomosis, and we discuss the factors used to justify the decision to do a third pancreas transplant.

Arterio-ureteric fistula following iliac angioplasty.

Arterio-ureteric fistulae are rare but can be associated with significant morbidity and mortality. We describe a novel case in which an arterio-ureteric fistula occurred as a complication following external iliac artery angioplasty and stenting, in a patient who had undergone previous pelvic surgery, radiotherapy, ureteric stenting, and urinary diversion surgery. Prompt recognition enabled successful endovascular management using a covered stent.

The potassium channel opener levcromakalim causes expansive remodelling of experimental vein grafts.

Background: Maintenance of luminal area is essential for the optimal performance of venous bypass grafts. However, injury and response to the arterial circulation evoke vascular remodelling that favors intimal hyperplasia, with luminal encroachment and inward remodelling. Potassium channel-opening drugs reduce tissue workload and peripheral vascular resistance and through these mechanisms could favor outward or expansive remodelling of vein grafts.