Ischaemic monomelic neuropathy of the lower limb.

Ischaemic mononeuropathy (IMN) is a rarely reported type of peripheral neuropathy secondary to an ischaemic injury, due to a complication of haemodialysis access. Although underreported, this phenomenon typically occurs in diabetic patients and may reflect the predisposition to neuropathic injury on a background of chronic deleterious changes in the microvasculature in diabetes. It is characterised by mononeuropathic features such as paraesthesia, pain and motor weakness and usually is reported as a rare complication of brachiocephalic fistula.

Early Results Using N-Terminal pro-B-Type Natriuretic Peptide (pro-BNP) as a Biomarker for the Efficacy of Secondary Extension Technique (SET) in Improving Myocardial Function in Dialysis Patients With High Flow Fistulas.

Background: The association of dialysis fistulas and heart failure is believed to be due to high cardiac output. N-terminal pro-B-Type Natriuretic Peptide (pro-BNP) which is secreted by the cardiac ventricles in response to excessive stretching of the myocytes has been used as a marker of heart failure with 90% sensitivity. We report our early experience using pro-BNP levels to test the efficacy of the novel 'secondary extension technique' (SET) in improving myocardial function by reducing fistula flow.

Delayed Complication Secondary to Unsuccessful Deployment of the StarClose Device.

The introduction of vascular closure devices (VCD) such as the StarClose device, has been an innovative step in interventional procedures. Earlier post-procedure ambulation, reduced hematoma formation, the time to hemostasis and the need for blood transfusion have been achievable. Few case reports describe complications following deployment of the StarClose device, resulting in acute ischemia.

Simple Things Are Not Simple: Pulsatile Tinnitus due to Tortuous Occipital Artery.

Background: Pulsatile tinnitus is often a chronic and debilitating condition and normally has a vascular origin. We describe a case of pulsatile tinnitus due to an aberrant branch of the external carotid artery (ECA), which has not been reported previously.

Method: A 67-year-old female with chronic unilateral pulsatile tinnitus, which could be controlled completely with direct pressure on a small tortuous superficial branch behind her left ear.

Clinical Negligence Claims Against Vascular Surgery in the United Kingdom: An Observational Study.

Background: Claims for clinical negligence awarded to patients and their families are on the increase. The annual "cost of harm" is approximately £7-9 billion in the United Kingdom. In 2017, the National Health Service (NHS) resolution service reported that they mediated more claims than in their entire history.

A review into the management of May-Thurner syndrome in adolescents.

Objective: To investigate the presentation, etiology, management and outcomes of May-Thurner syndrome (MTS) in adolescents aged under 18.

Methods: We searched electronic bibliographic databases to identify published reports of MTS in patients under 18 years of age. We conducted our review according to the PRISMA statement standards.

The efficacy of the secondary Extension Technique in the management of arterio-venous fistula-associated steal syndrome.

Background: Dialysis-associated steal syndrome remains a difficult clinical scenario for vascular access surgeons. The ideal treatment would improve blood flow to the hand without compromising the fistula; however, most treatment options rarely allow for both. The study describes an innovative technique used in clinical practice over a 17-year period for the treatment of dialysis-associated steal syndrome.

Long-term outcomes of the 'primary extension technique' in the prevention of Steal syndrome.

Purpose: To report our 13 years of experience with the 'primary extension technique' for the prevention of dialysis-associated steal syndrome.

Methods: All diabetic patients undergoing upper arm autogenous elbow fistula formation using the primary extension technique between September 2001 and September 2014 at a single centre were included. At follow-up all patients were evaluated for patency, adequacy of needling and the presence or absence of steal symptoms.

Management of Endurance Athletes with Flow Limitation in the Iliac Arteries: A Case Series.

Introduction: Vascular surgeons increasingly encounter flow limitation of iliac arteries (FLIA) in endurance athletes. An experience of managing this condition is reported.

Report: This is a retrospective cohort analysis of prospectively collected data at a single vascular centre.

Uncommon presentation of a common disease - Bouveret's syndrome: A case report and systematic literature review.

Aim: To investigate and summarise the current evidence surrounding management of Bouveret's syndrome (BS).

Methods: A MEDLINE search was performed for the BS. The search was conducted independently by two clinicians (Yahya AL-Habbal and Matthew Ng) in April 2016.

The modified operative technique of partial eversion carotid endarterectomy.

We report a modified operative technique termed partial eversion carotid endarterectomy (PECE). During a 9-year period (2006-2015), 352 patients underwent PECE. Indications for surgery, intraoperative details, and outcomes were recorded.

Intravascular ultrasound-guided angioplasty of hemodialysis loop graft in a patient with contrast allergy.

Purpose: A surveillance duplex scan detected a stenosis within a left groin hemodialysis loop graft in a 57-year-old woman who was allergic to both iohexol and gadolinium contrast agents. This precluded the use of standard angioplasty treatment techniques. Intravascular ultrasound (IVUS) uses a catheter mounted with a miniaturized ultrasound probe to produce detailed cross-sectional vessel images.

Patterns and management of vascular injuries in intravenous drug users: a literature review.

Background: Intravenous drug use is becoming an increasing problem in today's society causing an enormous socio-economic burden. Any intravenous injection will carry a risk of vascular injury. However, this risk will be significantly increased with repeated injections.

Total knee arthroplasty in patients with peripheral vascular disease.

Unlabelled: Vascular complications following total knee arthroplasty (TKA) are rare in the general population; however, the consequence could be devastating and limb threatening. Many of the patients who develop these complications, if not all, have pre-existing peripheral vascular disease (PVD). Following guidelines in the pre-operative assessment, intra-operative procedure and post-operative management in this group of patients can help orthopaedic surgeons to assess candidates for TKA and trim down the arterial complications afterwards.

Evaluation of a telephone clinic for patients with intermittent claudication.

Although the majority of patients with intermittent claudication are stable, those who develop complications can quickly deteriorate and need a rapid response. Because the majority of issues dealt with at a routine follow-up visit are in the form of a discussion, rely on symptoms and do not require an examination, it was considered appropriate to assess if a telephone follow-up service could replace these face-to-face meetings at the authors hospital. This article discusses an evaluation, the objective of which was to pilot a nurse-led telephone follow-up system for claudicant patients in terms of feasibility, patient satisfaction and impact on out-patient vascular surgery practice.

Prevalence of significant asymptomatic carotid artery disease in patients with peripheral vascular disease: a meta-analysis.

Objectives: To determine the prevalence of asymptomatic carotid artery stenosis (ACAS) in patients with peripheral vascular disease (PVD).

Methods: Literature search was carried out through Pubmed, Medline and Cochrane library. Prospective studies published on prevalence of significant carotid stenosis in patients with PVD and used a duplex scan for screenings were included.

Deep venous thrombosis after arterial surgery: a literature review.

Objective: To quantify the risk of DVT in arterial surgery, and to assess the need for prophylaxis.

Methods: A search was carried out through Medline, Embase and Cochrane databases to identify published studies on DVT in arterial surgery. To quantify the risk of DVT both randomised and prospective non-randomised studies were included for analysis.

Litigation claims in vascular surgery in the United Kingdom's NHS.

Objectives: To establish the incidence, costs and causes of medical negligence claims in relation to vascular surgery in the UK's NHS.

Methods: All claims related to vascular surgery reported to the NHS Litigation Authority from April 1995 to April 2007 were included in the study. Data was subsequently reviewed, coded and analysed.

Interventions for preventing venous thromboembolism following abdominal aortic surgery.

Background: Deep vein thrombosis (DVT) is one of the most common, preventable complications of surgery. Although the relationship between surgery and DVT is well established in general surgical operations and most other subspecialties, the same cannot be said about arterial surgery. Deep vein thrombosis is believed to be less common in aortic surgery where its management is rather controversial with a reported incidence of DVT from 2% to 18%.

Comparison of carotid Doppler ultrasound and computerised tomographic angiography in the evaluation of carotid artery stenosis.

Purpose: To compare results of carotid Doppler ultrasound (CDUS) and spiral computerised tomographic angiography (CTA) in patients with suspected carotid artery stenosis and to evaluate their combined effect on decision making for carotid endarterectomy (CEA).

Methods: A total of 107 patients were studied. All of the patients had CDUS followed by CTA as a standard method of investigation.

C-reactive protein (CRP) as a marker in peripheral vascular disease.

Objective: To review the role of CRP as a marker for the prediction of development of Peripheral Vascular Disease (PVD) and as a prognostic indicator.

Methods: Search of the Cochrane Vascular Group Control Trials Register, Medline and Embase for all published studies on the role of CRP as a marker in peripheral vascular disease was undertaken.13 prospective studies were found.

Hypothenar Hammer Syndrome: rare or underdiagnosed?

Hypothenar hammer Syndrome (HHS) is a condition characterised by digital ischaemia as a result of repetitive trauma to the hypothenar eminence of the hand. It occurs in people who repeatedly use the palm of the hand as a hammer to push, grind or twist objects. It is a curable and a preventable cause of upper digital ischemia.

Venous thromboembolic complications following air travel: what's the quantitative risk? A literature review.

Objectives: To quantify the risk of venous thromboembolism (VTE) following air travel and assess methods of prevention.

Design: Review of literature.

Methods: We reviewed Pubmed, Medline, Embase and Cochrane Databases for studies that have assessed the risk of VTE associated with air travel.

The brachial artery-basilic vein arterio-venous fistula in vascular access for haemodialysis--a review paper.

Aims: To review the available literature regarding patency rates and complications of the brachial-basilic arterio-venous fistula (BBAVF) and to discuss this with relation to the current dialysis outcomes quality initiative guidelines.

Methods: An internet based literature search was performed using Pubmed, Medline and Medscape databases to identify all published reports of the BBAVF in the English language from which the full articles were retrieved and cross-referenced.

Results: Of 136 papers identified, 28 were directly relevant to this review including four prospective studies (one randomised trial, three non-randomised trials) and 24 retrospective studies.