315 results on '"Hinchliffe RJ"'
Search Results
2. Research priorities for lower limb amputation in patients with vascular disease
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Bosanquet, D, primary, Nandhra, S, additional, Wong, KHF, additional, Long, J, additional, Chetter, I, additional, and Hinchliffe, RJ, additional
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- 2021
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3. Research priorities for lower limb amputation in patients with vascular disease
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Bosanquet, DC, primary, Nandhra, S, additional, Wong, KHF, additional, Long, J, additional, Chetter, I, additional, and Hinchliffe, RJ, additional
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- 2021
- Full Text
- View/download PDF
4. P6: ANTIPLATELET AND ANTICOAGULANT USE IN RANDOMISED TRIALS OF PATIENTS UNDERGOING ENDOVASCULAR INTERVENTION FOR PERIPHERAL ARTERIAL DISEASE: SYSTEMATIC REVIEW
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Qureshi, MI, primary, Li, HL, additional, Ambler, GK, additional, Wong, KHF, additional, Dawson, S, additional, Chaplin, K, additional, Cheng, V, additional, Hinchliffe, RJ, additional, and Twine, CP, additional
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- 2021
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5. The CLEAR (Considering Leading Experts' Antithrombotic Regimes around peripheral angioplasty) survey: an international perspective on antiplatelet and anticoagulant practice for peripheral arterial endovascular intervention (vol 2, 37, 2019)
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Wong, KHF, Bosanquet, DC, Ambler, GK, Qureshi, MI, Hinchliffe, RJ, Twine, CP, Wong, KHF, Bosanquet, DC, Ambler, GK, Qureshi, MI, Hinchliffe, RJ, and Twine, CP
- Abstract
An amendment to this paper has been published and can be accessed via the original article.
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- 2020
6. The CLEAR (Considering Leading Experts' Antithrombotic Regimes around peripheral angioplasty) survey: an international perspective on antiplatelet and anticoagulant practice for peripheral arterial endovascular intervention
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Wong, Khf, Bosanquet, Dc, Ambler, Gk, Qureshi, Mi, Hinchliffe, Rj, Twine, Cp, Aldo, Betanco, Andrea, Mingoli, Andrej, Isaak, Andrew, Holden, Andrew, Tambyraja, Angeliki, Argyriou, Anthony Dean Godfrey, Ashraf, Hassouna, Athanasios, Diamantopoulos, Athanasios, Saratzis, Atif, Sharif, Ayoola, Awopetu, Brennig, Gwilym, Calvin, Eng, Carlo, Maturi, Charutha, Senaratne, Christopher, Graham, Colin, Oliver, Coscas, Raphael, Cristina, L Espada, Eamon, Kavanagh, Eckhard, Klenk, Efthymios, Beropoulis, Esau, Martinez, Eustratia, Mpaili, Fabio, Verzini, Fernando, Gallardo, Piffaretti, Gabriele, Gianni, Celoria, Gladiol, Gonzalo, P Tapia, Greta, Saggu, Hannah, Travers, James, Gordon-Smith, James, Kirk, James, Olivier, Jason, Chuen, Jennifer, Buxton, Jiber, Hamid, John, Quarmby, Jonathan, Nicholls, Konstantinos, Stavroulakis, Laura, Drudi, Marco, V Usai, Mariano, Rotger, Michael, Gawenda, Mihai, Ionac, Muayyad, Almuhdhafer, Ng Jun Jie, Nicola, Troisi, Nikesh, Dattani, Nikolaos, Patelis, Paolo, Sapienza, Pasqualino, Sirignano, Pierfrancesco, Lapolla, Raveen, Nijjer, Rengarajan, Rajagopal, Roberto, Farraresi, Rodrigo, Biagioni, Rohan, Pancharatnam, Sandeep, Bahia, Simona, Sica, Staros, Spiliopoulos, Stefano, Fazzini, Tanya, Moledina, Tasleem, Akhtar, Thomas, Aherne, Thomas, Broszey, and Tony, Moloney
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medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.drug_class ,Short Communication ,medicine.medical_treatment ,endovascular procedures ,MEDLINE ,Peripheral Arterial Disease ,peripheral arterial disease ,Angioplasty ,Intervention (counseling) ,Internal medicine ,Surveys and Questionnaires ,Antithrombotic ,medicine ,media_common.cataloged_instance ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,European union ,platelet aggregation inhibitors ,media_common ,medicine.diagnostic_test ,business.industry ,Anticoagulant ,Endovascular Procedures ,Correction ,Interventional radiology ,Platelet Aggregation Inhibitors ,lcsh:RC666-701 ,surveys and questionnaires ,Platelet aggregation inhibitor ,Cardiology and Cardiovascular Medicine ,business - Abstract
BackgroundAntiplatelet and anticoagulant therapy are commonly used before, during and after peripheral arterial endovascular intervention. This survey aimed to establish antiplatelet and anticoagulant choice for peripheral arterial endovascular intervention in contemporary clinical practice.MethodsPilot-tested questionnaire distributed via collaborative research networks.ResultsOne hundred and sixty-two complete responses were collected from responders in 22 countries, predominantly the UK (48%) and the rest of the European Union (44%). Antiplatelet monotherapy was the most common choice pre-procedurally (62%). In the UK, there was no difference between dual and single antiplatelet therapy use post procedure (50% vs. 37%p = 0.107). However, a significant majority of EU respondents used dual therapy (68% vs. 20%p ConclusionsThere is widespread variation in the use of antiplatelet therapy, especially post peripheral arterial endovascular intervention. Clinicians would support the development of a randomised trial comparing dual antiplatelet therapy with monotherapy.
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- 2019
7. The immediate management of the patient with rupture: open versus endovascular repair (IMPROVE) randomised controlled trial for abdominal aortic aneurysm: clinical and health economic evaluation
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Sweeting, MJ, Ulug, P, Hinchliffe, RJ, Gomes, M, Thompson, MM, Thompson, SG, Grieve, RJ, Ashleigh, R, Greenlaugh, RM, Powell, JT, Sweeting, Michael [0000-0003-0980-8965], and Apollo - University of Cambridge Repository
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cardiovascular system ,cardiovascular diseases - Abstract
Background: Ruptured abdominal aortic aneurysm is a common vascular emergency. The mortality from emergency endovascular repair may be much lower than the 40-50% reported for open surgery. Objectives: To assess whether a strategy of endovascular repair versus open repair reduces 30-day and mid-term mortality (costs and cost-effectiveness) for patients with suspected ruptured abdominal aortic aneurysm. Design: Randomised controlled trial, with computer-generated telephone randomisation of patients in a 1:1 ratio, using variable block size, stratified by centre, without blinding
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- 2019
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8. Diabetes, established renal failure and the risk to the lower limb
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Hinchliffe, RJ, Jeffcoate, WJ, and Game, FL
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- 2006
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9. Value of risk scores in the decision to palliate patients with ruptured abdominal aortic aneurysm
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Sweeting, MJ, Ulug, P, Roy, J, Hultgren, R, Indrakusuma, R, Balm, R, Thompson, MM, Hinchliffe, RJ, Thompson, SG, Powell, JT, Ruptured Aneurysm Collaborators: AJAX Trial investigators, ECAR Trial investigators, IMPROVE Trial investigators: management committee, STAR Cohort investigators, Sweeting, MJ [0000-0003-0980-8965], Indrakusuma, R [0000-0002-0938-0500], and Apollo - University of Cambridge Repository
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Male ,Time Factors ,Aortic Rupture ,Endovascular Procedures ,Palliative Care ,Risk Assessment ,United Kingdom ,Decision Support Techniques ,Survival Rate ,Treatment Outcome ,ROC Curve ,Risk Factors ,Humans ,Female ,Hospital Mortality ,Aged ,Aortic Aneurysm, Abdominal ,Follow-Up Studies ,Retrospective Studies - Abstract
BACKGROUND: The aim of this study was to develop a 48-h mortality risk score, which included morphology data, for patients with ruptured abdominal aortic aneurysm presenting to an emergency department, and to assess its predictive accuracy and clinical effectiveness in triaging patients to immediate aneurysm repair, transfer or palliative care. METHODS: Data from patients in the IMPROVE (Immediate Management of the Patient With Ruptured Aneurysm: Open Versus Endovascular Repair) randomized trial were used to develop the risk score. Variables considered included age, sex, haemodynamic markers and aortic morphology. Backwards selection was used to identify relevant predictors. Predictive performance was assessed using calibration plots and the C-statistic. Validation of the newly developed and other previously published scores was conducted in four external populations. The net benefit of treating patients based on a risk threshold compared with treating none was quantified. RESULTS: Data from 536 patients in the IMPROVE trial were included. The final variables retained were age, sex, haemoglobin level, serum creatinine level, systolic BP, aortic neck length and angle, and acute myocardial ischaemia. The discrimination of the score for 48-h mortality in the IMPROVE data was reasonable (C-statistic 0·710, 95 per cent c.i. 0·659 to 0·760), but varied in external populations (from 0·652 to 0·761). The new score outperformed other published risk scores in some, but not all, populations. An 8 (95 per cent c.i. 5 to 11) per cent improvement in the C-statistic was estimated compared with using age alone. CONCLUSION: The assessed risk scores did not have sufficient accuracy to enable potentially life-saving decisions to be made regarding intervention. Focus should therefore shift to offering repair to more patients and reducing non-intervention rates, while respecting the wishes of the patient and family.
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- 2018
10. Re-interventions after repair of ruptured abdominal aortic aneurysm: a report from the IMPROVE randomised trial
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Powell, JT, Sweeting, MJ, Ulug, P, Thompson, MM, Hinchliffe, RJ, and IMPROVE Trial Investigators
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Morphology ,Rupture ,Cardiovascular System & Hematology ,Re-intervention ,IMPROVE Trial Investigators ,Abdominal aortic aneurysm ,1103 Clinical Sciences ,1102 Cardiovascular Medicine And Haematology - Abstract
OBJECTIVE/BACKGROUND: The aim was to describe the re-interventions after endovascular and open repair of rupture, and investigate whether these were associated with aortic morphology. METHODS: In total, 502 patients from the IMPROVE randomised trial (ISRCTN48334791) with repair of rupture were followed-up for re-interventions for at least 3 years. Pre-operative aortic morphology was assessed in a core laboratory. Re-interventions were described by time (0-90 days, 3 months-3 years) as arterial or laparotomy related, respectively, and ranked for severity by surgeons and patients separately. Rare re-interventions to 1 year, were summarised across three ruptured abdominal aortic aneurysm trials (IMPROVE, AJAX, and ECAR) and odds ratios (OR) describing differences were pooled via meta-analysis. RESULTS: Re-interventions were most common in the first 90 days. Overall rates were 186 and 226 per 100 person years for the endovascular strategy and open repair groups, respectively (p = .20) but between 3 months and 3 years (mid-term) the rates had slowed to 9.5 and 6.0 re-interventions per 100 person years, respectively (p = .090) and about one third of these were for a life threatening condition. In this latter, mid-term period, 42 of 313 remaining patients (13%) required at least one re-intervention, most commonly for endoleak or other endograft complication after treatment by endovascular aneurysm repair (EVAR) (21 of 38 re-interventions), whereas distal aneurysms were the commonest reason (four of 23) for re-interventions after treatment by open repair. Arterial re-interventions within 3 years were associated with increasing common iliac artery diameter (OR 1.48, 95% confidence interval [CI] 0.13-0.93; p = .004). Amputation, rare but ranked as the worst re-intervention by patients, was less common in the first year after treatment with EVAR (OR 0.2, 95% CI 0.05-0.88) from meta-analysis of three trials. CONCLUSION: The rate of mid-term re-interventions after rupture is high, more than double that after elective EVAR and open repair, suggesting the need for bespoke surveillance protocols. Amputations are much less common in patients treated by EVAR than in those treated by open repair.
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- 2018
11. Comparative clinical effectiveness and cost effectiveness of endovascular strategy vs open repair for ruptured abdominal aortic aneurysm: three year results of the IMPROVE randomised trial
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Sweeting, MJ, Ulug, P, Gomes, M, Hinchliffe, RJ, Thompson, MM, Thompson, SG, Grieve, R, Greenhalgh, RM, Sweeting, Michael [0000-0003-0980-8965], Thompson, Simon [0000-0002-5274-7814], and Apollo - University of Cambridge Repository
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Male ,Canada ,Cost-Benefit Analysis ,Endovascular Procedures ,Health Care Costs ,Kaplan-Meier Estimate ,Aneurysm, Ruptured ,Middle Aged ,Risk Assessment ,Survival Analysis ,United Kingdom ,Logistic Models ,Postoperative Complications ,Cause of Death ,Outcome Assessment, Health Care ,Humans ,Female ,Quality-Adjusted Life Years ,Vascular Surgical Procedures ,Aged ,Aortic Aneurysm, Abdominal ,Proportional Hazards Models - Abstract
Objective To assess the three year clinical outcomes and cost effectiveness of a strategy of endovascular repair (if aortic morphology is suitable, open repair if not) versus open repair for patients with suspected ruptured abdominal aortic aneurysm. Design Randomised controlled trial. Participants 613 eligible patients (480 men) with a clinical diagnosis of ruptured aneurysm, of whom 502 underwent emergency repair for rupture. Interventions 316 patients were randomised to an endovascular strategy (275 with confirmed rupture) and 297 to open repair (261 with confirmed rupture). Main outcome measures Mortality, with reinterventions after aneurysm repair, quality of life, and hospital costs to three years as secondary measures. Results The maximum follow-up for mortality was 7.1 years, with two patients in each group lost to follow-up by three years. After similar mortality by 90 days, in the mid-term (three months to three years) there were fewer deaths in the endovascular than the open repair group (hazard ratio 0.57, 95% confidence interval 0.36 to 0.90), but by seven years mortality was about 60% in each group (hazard ratio 0.92, 0.75 to 1.13). Results for the 502 patients with repaired ruptures were more pronounced: three year mortality was lower in the endovascular strategy group (42% v 54%; odds ratio 0.62, 0.43 to 0.88), but after seven years there was no clear difference between the groups (hazard ratio 0.86, 0.68 to 1.08). Reintervention rates up to three years were not significantly different between the randomised groups (hazard ratio 1.02, 0.79 to 1.32); the initial rapid rate of reinterventions was followed by a much slower mid-term reintervention rate in both groups. The early higher average quality of life in the endovascular strategy versus open repair group, coupled with the lower mortality at three years, led to a gain in average quality adjusted life years (QALYs) at three years of 0.17 (95% confidence interval 0.00 to 0.33). The endovascular strategy group spent fewer days in hospital and had lower average costs of −£2605 (€2813; $3439) (95% confidence interval −£5966 to £702). The probability that the endovascular strategy is cost effective was >90% at all levels of willingness to pay for a QALY gain. Conclusions At three years, compared with open repair, an endovascular strategy for suspected ruptured abdominal aortic aneurysm was associated with a survival advantage, a gain in QALYs, similar levels of reintervention, and reduced costs, and this strategy was cost effective. These findings support the increasing use of an endovascular strategy, with wider availability of emergency endovascular repair. Trial registration Current Controlled Trials ISRCTN48334791; ClinicalTrials NCT00746122
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- 2017
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12. Editor’s Choice e Management of Descending Thoracic Aorta Diseases Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS)
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Riambau, V, Böckler, D, Brunkwall, J, Cao, P, Chiesa, R, Coppi, G, Czerny, M, Fraedrich, G, Haulon, S, Jacobs, Mj, Lachat, Ml, Moll, Fl, Setacci, C, Taylor, Pr, Thompson, M, Trimarchi, S, Verhagen, Hj, Verhoeven, El, Kolh, P, de Borst Gj, Chakfé, N, Debus, Es, Hinchliffe, Rj, Kakkos, S, Koncar, I, Lindholt, Js, Vega de Ceniga, M, Vermassen, F, Verzini, F, Black III Jh, Busund, R, Björck, M, Dake, M, Dick, F, Eggebrecht, H, Evangelista, A, Grabenwöger, M, Milner, R, Naylor, Ar, Ricco, Jb, Rousseau, H, and Stimuli, J
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Descending thoracic aorta ,Descending thoracic aortic management ,Clinical practice ,Guideline ,Recommendations ,Thoracic aorta abnormalities ,Thoracic aorta diseases ,Thoracic aorta disorders ,Thoraco-abdominal aorta - Published
- 2017
13. Surgery for popliteal artery entrapment syndrome: use of an intraoperative tibial nerve stimulator and duplex ultrasound
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Dovell, G, primary and Hinchliffe, RJ, additional
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- 2018
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14. Transfer of patients with ruptured abdominal aortic aneurysm from general hospitals to specialist vascular centres: results of a Delphi consensus study
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Hinchliffe, RJ, Ribbons, T, Ulug, P, and Powell, JT
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Male ,Patient Transfer ,Delphi Technique ,Aortic Rupture ,Hospitals, General ,clinical ,Blood Vessel Prosthesis Implantation ,rupture diagnosis ,Risk Factors ,Humans ,Emergency Treatment ,Aged ,Aged, 80 and over ,research ,Age Factors ,Middle Aged ,thrombo-embolic disease ,Women's Health Services ,Treatment Outcome ,inter-hospital transfer ,Abdominal aortic aneurysm ,Original Article ,Female ,Triage ,Vascular Surgical Procedures ,abdomen ,Aortic Aneurysm, Abdominal - Abstract
Aim To explore areas of consensus and disagreement concerning the interhospital transfer of patients with a clinical diagnosis of ruptured abdominal aortic aneurysm. Methods A three-round Delphi questionnaire approach was used among vascular and endovascular surgery and emergency medicine specialists to explore patient characteristics and clinical management issues for emergency interhospital transfer. Analysis is based on 38 responses to rounds 2 and 3 (19 vascular surgeons, 6 interventional radiologists, 13 emergency care specialists) with agreement reported when 70% of respondents were in agreement. Results Initially there was agreement that transfer patients should be
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- 2012
15. A standardized aortic aneurysm model for the assessment of endovascular stent-graft technology
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Hinchliffe Rj, Albertini Jn, and Macierewicz Ja
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medicine.medical_specialty ,medicine.medical_treatment ,Autopsy ,Blood Vessel Prosthesis Implantation ,Aortic aneurysm ,Aneurysm ,medicine.artery ,Animals ,Medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Ultrasonography, Doppler, Duplex ,Aorta ,Sheep ,medicine.diagnostic_test ,business.industry ,Endovascular Procedures ,Ultrasound ,Stent ,General Medicine ,medicine.disease ,Abdominal aortic aneurysm ,Aortic Aneurysm ,Surgery ,Disease Models, Animal ,surgical procedures, operative ,Angiography ,cardiovascular system ,Female ,Stents ,Cardiology and Cardiovascular Medicine ,business - Abstract
Reliable models of aortic aneurysms are required to test endovascular stent-graft technology prior to human use. We describe the creation of a standardized prosthetic aneurysm in an ovine model to assess endovascular technology. In an adult ovine model under general anesthesia, a polyester sphere measuring 6 cm across was sutured onto the infrarenal aorta following aortotomy. Two weeks later an endovascular stent-graft was deployed in the aorta. Exclusion was confirmed on monthly ultrasound duplex and during angiography at three months and under terminal anesthesia at six months. Autopsy along with histology of the specimen were then performed. A total of 10 sheep underwent aneurysm implantation. Nine received a straight tube endovascular stent-graft (Lombard Medical, Abingdon, Oxon, UK) and seven completed the study. Five prosthetic aneurysms shrank during serial imaging with duplex ultrasound and angiography. However, two remained the same size. One of these had a type I endoleak whereas the other had endotension (type I endoleak confirmed at autopsy). This animal model provides a reliable and reproducible method of creating prosthetic aneurysms for assessing endovascular stent-grafts. It was possible to assess aneurysm exclusion non-invasively using duplex ultrasound. Aneurysms effectively excluded from the circulation shrank whereas those with an endoleak did not.
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- 2011
16. The effect of aortic morphology on peri-operative mortality of ruptured abdominal aortic aneurysm
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Powell, JT, Sweeting, MJ, Thompson, MM, Hinchliffe, RJ, Ashleigh, R, Bell, R, Greenhalgh, RM, Thompson, SG, Ulug, P, and Investigators, IMPROVET
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Aims \ud \ud To investigate whether aneurysm shape and extent, which indicate whether a patient with ruptured abdominal aortic aneurysm (rAAA) is eligible for endovascular repair (EVAR), influence the outcome of both EVAR and open surgical repair.\ud \ud Methods and results \ud \ud The influence of six morphological parameters (maximum aortic diameter, aneurysm neck diameter, length and conicality, proximal neck angle, and maximum common iliac diameter) on mortality and reinterventions within 30 days was investigated in rAAA patients randomized before morphological assessment in the Immediate Management of the Patient with Rupture: Open Versus Endovascular strategies (IMPROVE) trial. Patients with a proven diagnosis of rAAA, who underwent repair and had their admission computerized tomography scan submitted to the core laboratory, were included. Among 458 patients (364 men, mean age 76 years), who had either EVAR (n = 177) or open repair (n = 281) started, there were 155 deaths and 88 re-interventions within 30 days of randomization analysed according to a pre-specified plan. The mean maximum aortic diameter was 8.6 cm. There were no substantial correlations between the six morphological variables. Aneurysm neck length was shorter in those undergoing open repair (vs. EVAR). Aneurysm neck length (mean 23.3, SD 16.1 mm) was inversely associated with mortality for open repair and overall: adjusted OR 0.72 (95% CI 0.57, 0.92) for each 16 mm (SD) increase in length. There were no convincing associations of morphological parameters with reinterventions.\ud \ud Conclusion \ud \ud Short aneurysm necks adversely influence mortality after open repair of rAAA and preclude conventional EVAR. This may help explain why observational studies, but not randomized trials, have shown an early survival benefit for EVAR.\ud \ud Clinical trial registration: ISRCTN 48334791.
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- 2015
17. Design Of Three New Condition-Specific Questionnaires To Assess Quality Of Life, Symptoms And Treatment Satisfaction Of Patients With Abdominal Aortic Aneurysm: The Aneurysm-Dqol, Aneurysm-Srq And Aneurysm-Tsq
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Peach, G, primary, Wilson, A, additional, Plowright, R, additional, Romaine, J, additional, Thompson, M, additional, Hinchliffe, RJ, additional, and Bradley, C, additional
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- 2015
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18. Effect of Endovascular Aneurysm Repair on the Volume-Outcome Relationship in Aneurysm Repair
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Holt, PJ, Poloniecki, JD, Khalid, U, Hinchliffe, RJ, Loftus, IM, and Thompson, MM
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Background— We aim to quantify the relationship between the annual caseload (volume) and outcome from elective endovascular (EVR) or open repair of abdominal aortic aneurysms (AAAs) in England between 2005 and 2007.\ud \ud Methods and Results— Individual patient data were obtained from the Hospital Episode Statistics. Statistical methods included multiple logistic regression models, mortality control charts, and safety plots to determine the nature of any relationship between volume and outcome. The case-mix between hospitals of different sizes was examined using observed and expected values for in-hospital mortality. Outcome measures included in-hospital mortality and hospital length of stay. Between 2005 and 2007, a total of 57 587 patients were admitted to hospitals in England with a diagnosis of AAA, and 11 574 underwent AAA repair. There were 7313 elective AAA repairs, of which 5668 (78%) were open and 1645 (22%) were EVR. In-hospital mortality rates were 5.63% for all elective AAA repairs with rates of 6.18% for open repair and 3.77% for EVR (odds ratio, 0.676; 95% CI, 0.501 to 0.913; P=0.011). High-volume aneurysm services were associated with significantly lower mortality rates overall (0.991; 0.988 to 0.994; P
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- 2009
19. Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms
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Veith, F. J, Lachat, M, Mayer, D, Malina, M, Holst, J, Mehta, M, Verhoeven, E. L. G, Larzon, T, Gennai, S, Coppi, G, Lipsitz, E. C, Gargiulo, N. J, van der Vliet, J. A, Blankensteijn, J, Buth, J, Lee, W. A, Deleo, G, Kasirajan, K, Moore, R, Soong, C. V, Cayne, NS, Farber, MA, Raithel, D, Greenberg, RK, van Sambeek, MRHM, Brunkwall, JS, Rockman, CB, Hinchliffe, RJ, RAAA Investigators: Adiseshiah, M, Alimi, Y, Bekkema, F, Bell, P, Becquemin, JP, Benatti, C, Braithwaite, B, Camesasca, W, Cao, P, Casali, R, Castellani, L, Chester, J, Criado, F, Cuypers, P, Dake, M, Darling, RC, Eliasson, K, Fillinger, M, Gloviczki, P, Goode, S, Gruber, G, Hopkinson, B, Hodgson, K, Ivancev, K, Kapma, M, Koskas, F, Liapis, C, Long, J, Loan, W, MacSweeney, S, Makaroun, M, Matsumura, J, Matyas, L, May, J, Moore, W, Pamler, R, Parodi, J, Paty, P, Sunder Plassmann, L, Pfammatter, T, Peppelenbosch, N, Piglionica, M, Ross, J, Resch, T, Roddy, S, Rubin, B, Saitta, G, Sales, C, Sanchez, L, Silingardi, R, Sonesson, B, Taggert, J, Sternbach, Y, Toivola, A, van den Berg, J, van Dijk, L, Vermassen, F, Villa, V, White, R, Zipfel, B., BIASI, GIORGIO MARIA, FROIO, ALBERTO, University of Zurich, Faculteit Medische Wetenschappen/UMCG, Veith, F, Lachat, M, Mayer, D, Malina, M, Holst, J, Mehta, M, Verhoeven, E, Larzon, T, Gennai, S, Coppi, G, Lipsitz, E, Gargiulo, N, van der Vliet, J, Blankensteijn, J, Buth, J, Lee, W, Biasi, G, Deleo, G, Kasirajan, K, Moore, R, Soong, C, Cayne, N, Farber, M, Raithel, D, Greenberg, R, van Sambeek, M, Brunkwall, J, Rockman, C, Hinchliffe, R, RAAA Investigators: Adiseshiah, M, Alimi, Y, Bekkema, F, Bell, P, Becquemin, J, Benatti, C, Braithwaite, B, Camesasca, W, Cao, P, Casali, R, Castellani, L, Chester, J, Criado, F, Cuypers, P, Dake, M, Darling, R, Eliasson, K, Fillinger, M, Froio, A, Gloviczki, P, Goode, S, Gruber, G, Hopkinson, B, Hodgson, K, Ivancev, K, Kapma, M, Koskas, F, Liapis, C, Long, J, Loan, W, Macsweeney, S, Makaroun, M, Matsumura, J, Matyas, L, May, J, Moore, W, Pamler, R, Parodi, J, Paty, P, Sunder Plassmann, L, Pfammatter, T, Peppelenbosch, N, Piglionica, M, Ross, J, Resch, T, Roddy, S, Rubin, B, Saitta, G, Sales, C, Sanchez, L, Silingardi, R, Sonesson, B, Taggert, J, Sternbach, Y, Toivola, A, van den Berg, J, van Dijk, L, Vermassen, F, Villa, V, White, R, and Zipfel, B
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medicine.medical_specialty ,collected international experience ,Abdominal compartment syndrome ,Decompression ,medicine.medical_treatment ,Aortic Rupture ,610 Medicine & health ,Balloon ,Single Center ,Endovascular aneurysm repair ,Aortic aneurysm ,Blood Vessel Prosthesis Implantation ,abdominal aortic aneurysm rupture ,medicine.artery ,Surveys and Questionnaires ,medicine ,MED/22 - CHIRURGIA VASCOLARE ,Humans ,Endovascular treatment ,endovascualr treatment ,Cardiovascular diseases [NCEBP 14] ,business.industry ,10042 Clinic for Diagnostic and Interventional Radiology ,Data Collection ,Abdominal aorta ,medicine.disease ,Surgery ,10020 Clinic for Cardiac Surgery ,2746 Surgery ,Aneurysm, endovascular repair, rupture, open repair, endograft ,Radiology ,business ,Aortic Aneurysm, Abdominal - Abstract
Contains fulltext : 81133.pdf (Publisher’s version ) (Closed access) BACKGROUND: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE: To clarify these we examined a collected experience with use of EVAR for RAAA treatment from 49 centers. METHODS: Data were obtained by questionnaires from these centers, updated from 13 centers committed to EVAR treatment whenever possible and included treatment details from a single center and information on 1037 patients treated by EVAR and 763 patients treated by open repair (OR). RESULTS: Overall 30-day mortality after EVAR in 1037 patients was 21.2%. Centers performing EVAR for RAAAs whenever possible did so in 28% to 79% (mean 49.1%) of their patients, had a 30-day mortality of 19.7% (range: 0%-32%) for 680 EVAR patients and 36.3% (range: 8%-53%) for 763 OR patients (P < 0.0001). Supraceliac aortic balloon control was obtained in 19.1% +/- 12.0% (+/-SD) of 680 EVAR patients. Abdominal compartment syndrome was treated by some form of decompression in 12.2% +/- 8.3% (+/-SD) of these EVAR patients. CONCLUSION: These results indicate that EVAR has a lower procedural mortality at 30 days than OR in at least some patients and that EVAR is better than OR for treating RAAA patients provided they have favorable anatomy; adequate skills, facilities, and protocols are available; and optimal strategies, techniques, and adjuncts are employed.
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- 2009
20. Radial artery grafts for lower limb revascularisation
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Griffin, M, primary, Karthikesalingam, A, additional, Brownrigg, J, additional, and Hinchliffe, RJ, additional
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- 2014
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21. Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms
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Veith, F, Lachat, M, Mayer, D, Malina, M, Holst, J, Mehta, M, Verhoeven, E, Larzon, T, Gennai, S, Coppi, G, Lipsitz, E, Gargiulo, N, van der Vliet, J, Blankensteijn, J, Buth, J, Lee, W, Biasi, G, Deleo, G, Kasirajan, K, Moore, R, Soong, C, Cayne, N, Farber, M, Raithel, D, Greenberg, R, van Sambeek, M, Brunkwall, J, Rockman, C, Hinchliffe, R, RAAA Investigators: Adiseshiah, M, Alimi, Y, Bekkema, F, Bell, P, Becquemin, J, Benatti, C, Braithwaite, B, Camesasca, W, Cao, P, Casali, R, Castellani, L, Chester, J, Criado, F, Cuypers, P, Dake, M, Darling, R, Eliasson, K, Fillinger, M, Froio, A, Gloviczki, P, Goode, S, Gruber, G, Hopkinson, B, Hodgson, K, Ivancev, K, Kapma, M, Koskas, F, Liapis, C, Long, J, Loan, W, Macsweeney, S, Makaroun, M, Matsumura, J, Matyas, L, May, J, Moore, W, Pamler, R, Parodi, J, Paty, P, Sunder Plassmann, L, Pfammatter, T, Peppelenbosch, N, Piglionica, M, Ross, J, Resch, T, Roddy, S, Rubin, B, Saitta, G, Sales, C, Sanchez, L, Silingardi, R, Sonesson, B, Taggert, J, Sternbach, Y, Toivola, A, van den Berg, J, van Dijk, L, Vermassen, F, Villa, V, White, R, Zipfel, B, Veith, F. J, Verhoeven, E. L. G, Lipsitz, E. C, Gargiulo, N. J, van der Vliet, J. A, Lee, W. A, Soong, C. V, Cayne, NS, Farber, MA, Greenberg, RK, van Sambeek, MRHM, Brunkwall, JS, Rockman, CB, Hinchliffe, RJ, Becquemin, JP, Darling, RC, MacSweeney, S, Zipfel, B., BIASI, GIORGIO MARIA, FROIO, ALBERTO, Veith, F, Lachat, M, Mayer, D, Malina, M, Holst, J, Mehta, M, Verhoeven, E, Larzon, T, Gennai, S, Coppi, G, Lipsitz, E, Gargiulo, N, van der Vliet, J, Blankensteijn, J, Buth, J, Lee, W, Biasi, G, Deleo, G, Kasirajan, K, Moore, R, Soong, C, Cayne, N, Farber, M, Raithel, D, Greenberg, R, van Sambeek, M, Brunkwall, J, Rockman, C, Hinchliffe, R, RAAA Investigators: Adiseshiah, M, Alimi, Y, Bekkema, F, Bell, P, Becquemin, J, Benatti, C, Braithwaite, B, Camesasca, W, Cao, P, Casali, R, Castellani, L, Chester, J, Criado, F, Cuypers, P, Dake, M, Darling, R, Eliasson, K, Fillinger, M, Froio, A, Gloviczki, P, Goode, S, Gruber, G, Hopkinson, B, Hodgson, K, Ivancev, K, Kapma, M, Koskas, F, Liapis, C, Long, J, Loan, W, Macsweeney, S, Makaroun, M, Matsumura, J, Matyas, L, May, J, Moore, W, Pamler, R, Parodi, J, Paty, P, Sunder Plassmann, L, Pfammatter, T, Peppelenbosch, N, Piglionica, M, Ross, J, Resch, T, Roddy, S, Rubin, B, Saitta, G, Sales, C, Sanchez, L, Silingardi, R, Sonesson, B, Taggert, J, Sternbach, Y, Toivola, A, van den Berg, J, van Dijk, L, Vermassen, F, Villa, V, White, R, Zipfel, B, Veith, F. J, Verhoeven, E. L. G, Lipsitz, E. C, Gargiulo, N. J, van der Vliet, J. A, Lee, W. A, Soong, C. V, Cayne, NS, Farber, MA, Greenberg, RK, van Sambeek, MRHM, Brunkwall, JS, Rockman, CB, Hinchliffe, RJ, Becquemin, JP, Darling, RC, MacSweeney, S, Zipfel, B., BIASI, GIORGIO MARIA, and FROIO, ALBERTO
- Abstract
BACKGROUND: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE: To clarify these we examined a collected experience with use of EVAR for RAAA treatment from 49 centers. METHODS: Data were obtained by questionnaires from these centers, updated from 13 centers committed to EVAR treatment whenever possible and included treatment details from a single center and information on 1037 patients treated by EVAR and 763 patients treated by open repair (OR). RESULTS: Overall 30-day mortality after EVAR in 1037 patients was 21.2%. Centers performing EVAR for RAAAs whenever possible did so in 28% to 79% (mean 49.1%) of their patients, had a 30-day mortality of 19.7% (range: 0%-32%) for 680 EVAR patients and 36.3% (range: 8%-53%) for 763 OR patients (P < 0.0001). Supraceliac aortic balloon control was obtained in 19.1% +/- 12.0% (+/-SD) of 680 EVAR patients. Abdominal compartment syndrome was treated by some form of decompression in 12.2% +/- 8.3% (+/-SD) of these EVAR patients. CONCLUSION: These results indicate that EVAR has a lower procedural mortality at 30 days than OR in at least some patients and that EVAR is better than OR for treating RAAA patients provided they have favorable anatomy; adequate skills, facilities, and protocols are available; and optimal strategies, techniques, and adjuncts are employed.
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- 2009
22. Posterolateral fibula preserving approach to the peroneal artery
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Kamel, F, primary, Nordon, IM, additional, and Hinchliffe, RJ, additional
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- 2013
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23. Improving the outcomes from ruptured abdominal aortic aneurysm: interdisciplinary best practice guidelines
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Hinchliffe, RJ, primary and Powell, JT, additional
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- 2013
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24. A systematic review of protocols for the three-dimensional morphologic assessment of abdominal aortic aneurysms using computed tomographic angiography.
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Ghatwary TM, Patterson BO, Karthikesalingam A, Hinchliffe RJ, Loftus IM, Morgan R, Thompson MM, Holt PJ, Ghatwary, Tamer M H, Patterson, Benjamin O, Karthikesalingam, Alan, Hinchliffe, Robert J, Loftus, Ian M, Morgan, Robert, Thompson, Matt M, and Holt, Peter J E
- Abstract
The morphology of infrarenal abdominal aortic aneurysms (AAAs) directly influences the perioperative outcome and long-term durability of endovascular aneurysm repair. A variety of methods have been proposed for the characterization of AAA morphology using reconstructed three-dimensional (3D) computed tomography (CT) images. At present, there is lack of consensus as to which of these methods is most applicable to clinical practice or research. The purpose of this review was to evaluate existing protocols that used 3D CT images in the assessment of various aspects of AAA morphology. An electronic search was performed, from January 1996 to the end of October 2010, using the Embase and Medline databases. The literature review conformed to PRISMA statement standards. The literature search identified 604 articles, of which 31 studies met inclusion criteria. Only 15 of 31 studies objectively assessed reproducibility. Existing published protocols were insufficient to define a single evidence-based methodology for preoperative assessment of AAA morphology. Further development and expert consensus are required to establish a standardized and validated protocol to determine precisely how morphology relates to outcomes after endovascular aneurysm repair. [ABSTRACT FROM AUTHOR]
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- 2013
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25. Management of acute aortic syndrome and chronic aortic dissection.
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Nordon IM, Hinchliffe RJ, Loftus IM, Morgan RA, and Thompson MM
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- 2011
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26. A standardized aortic aneurysm model for the assessment of endovascular stent-graft technology.
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Macierewicz, JA, Albertini, J-N, and Hinchliffe, RJ
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- 2011
27. Centralization harnessing volume -- outcome relationships in vascular surgery and aortic aneurysm care should not focus solely on threshold operative caseload.
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Karthikesalingam A, Hinchliffe RJ, Poloniecki JD, Phil D, Loftus IM, Thompson MM, and Holt PJE
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- 2010
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28. Toward an 'off-the-shelf' fenestrated endograft for management of short-necked abdominal aortic aneurysms: an analysis of current graft morphological diversity.
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Nordon IM, Hinchliffe RJ, Manning B, Ivancev K, Holt PJ, Loftus IM, and Thompson MM
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Purpose: To examine the feasibility of an 'off-the-shelf' fenestrated endograft repository to broaden the applicability of fenestrated endovascular aneurysm repair (f-EVAR) to a greater number of emergent cases. Methods: Graft dimensions of 438 consecutive customized fenestrated endografts for juxtarenal aneurysms were obtained from the commercial manufacturer, classified into tolerance ranges, and encoded in a database for statistical analysis. Limits of variability for tolerance ranges were set to maintain target vessel patency within acceptable surgical limits at deployment. Key independent structural variables were identified and analyzed for trends. Detailed analysis was performed of 282 (64%) 3-fenestration endografts, representing 232 structurally unique grafts. Results: Seven key individual structural variables were identified, constituting 21,952 possible combinations. Only 8/232 (3.5%) graft configurations were compatible with greater than or equal to 3 patients. Nearly a third of the patients (86/282, 30.5%) were treated by a range of 36 customized endografts. Graft dimensions were not uniformly distributed; there were modal sizes that were likely to recur at a median 39 cases (95% CI 17-121). Deploying endografts incorporating double diameter-reducing tie technology increased the tolerance such that 28 grafts would treat 81% of this population. Conclusion: The current design of fenestrated stent-grafts means that an 'off-the-shelf' option is not practicable. However, there is evidence of recurrent patterns of morphology. Statistical modeling is capable of predicting demand for graft configurations. Innovations in f-EVAR endograft technology may decrease the required variability in graft morphology, paving the way for ready-to-deploy fenestrated stent-grafts. [ABSTRACT FROM AUTHOR]
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- 2010
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29. PCV138 - Design Of Three New Condition-Specific Questionnaires To Assess Quality Of Life, Symptoms And Treatment Satisfaction Of Patients With Abdominal Aortic Aneurysm: The Aneurysm-Dqol, Aneurysm-Srq And Aneurysm-Tsq
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Peach, G, Wilson, A, Plowright, R, Romaine, J, Thompson, M, Hinchliffe, RJ, and Bradley, C
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- 2015
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30. Cardiac rehabilitation versus standard care after aortic aneurysm repair (Aneurysm CaRe): study protocol for a randomised controlled trial
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Bahia, SS, Holt, PJ, Ray, KK, Ussher, M, Poloniecki, JD, Sharma, R, Bown, MJ, Hinchliffe, RJ, Thompson, MM, and Karthikesalingam, A
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General & Internal Medicine ,Medicine (miscellaneous) ,1103 Clinical Sciences ,Pharmacology (medical) ,1102 Cardiovascular Medicine And Haematology - Abstract
BACKGROUND: Abdominal and thoracic aortic aneurysms (A/TAA) are an important cause of mortality amongst the older population. Although A/TAA repair can be performed with low peri-operative risk, overall life expectancy remains poor in the years that follow surgery. The majority of deaths are caused by heart attack or stroke, which can both be prevented by cardiac rehabilitation (CR) in patients with clinically-manifest coronary artery disease. A Cochrane review has urged researchers to widen the use of CR to other populations with severe cardiovascular risk, and patients surviving A/TAA repair appear ideal candidates. However, it is unknown whether CR is feasible or acceptable to A/TAA patients, who are a decade older than those currently enrolling in CR. Aneurysm-CaRe is a feasibility randomised controlled trial (RCT) that will address these issues. METHODS AND DESIGN: Aneurysm-CaRe is a pilot RCT of CR versus standard care after A/TAA repair, with the primary objectives of estimating enrolment to a trial of CR after A/TAA repair and estimating compliance with CR amongst patients with A/TAA. Aneurysm-CaRe will randomise 84 patients at two sites. Patients discharged from hospital after elective A/TAA repair will be randomised to standard care or enrolment in their local CR programme with a protocolised approach to medical cardiovascular risk reduction. The primary outcome measures are enrolment in the RCT and compliance with CR. Secondary outcomes will include phenotypic markers of cardiovascular risk and smoking cessation, alongside disease-specific and generic quality-of-life measures. TRIAL REGISTRATION: ISRCTN 65746249 5 June 2014.
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31. Value of risk scores in the decision to palliate patients with ruptured abdominal aortic aneurysm
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Sweeting, MJ, Ulug, P, Roy, J, Hultgren, R, Indrakusuma, R, Balm, R, Thompson, MM, Hinchliffe, RJ, Thompson, SG, Powell, JT, Ruptured Aneurysm Collaborators: AJAX Trial Investigators, ECAR Trial Investigators, IMPROVE Trial Investigators: Management Committee, and STAR Cohort Investigators
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Male ,Time Factors ,Aortic Rupture ,Endovascular Procedures ,Palliative Care ,Risk Assessment ,United Kingdom ,3. Good health ,Decision Support Techniques ,Survival Rate ,Treatment Outcome ,ROC Curve ,Risk Factors ,Humans ,Female ,Hospital Mortality ,Aged ,Aortic Aneurysm, Abdominal ,Follow-Up Studies ,Retrospective Studies - Abstract
BACKGROUND: The aim of this study was to develop a 48-h mortality risk score, which included morphology data, for patients with ruptured abdominal aortic aneurysm presenting to an emergency department, and to assess its predictive accuracy and clinical effectiveness in triaging patients to immediate aneurysm repair, transfer or palliative care. METHODS: Data from patients in the IMPROVE (Immediate Management of the Patient With Ruptured Aneurysm: Open Versus Endovascular Repair) randomized trial were used to develop the risk score. Variables considered included age, sex, haemodynamic markers and aortic morphology. Backwards selection was used to identify relevant predictors. Predictive performance was assessed using calibration plots and the C-statistic. Validation of the newly developed and other previously published scores was conducted in four external populations. The net benefit of treating patients based on a risk threshold compared with treating none was quantified. RESULTS: Data from 536 patients in the IMPROVE trial were included. The final variables retained were age, sex, haemoglobin level, serum creatinine level, systolic BP, aortic neck length and angle, and acute myocardial ischaemia. The discrimination of the score for 48-h mortality in the IMPROVE data was reasonable (C-statistic 0·710, 95 per cent c.i. 0·659 to 0·760), but varied in external populations (from 0·652 to 0·761). The new score outperformed other published risk scores in some, but not all, populations. An 8 (95 per cent c.i. 5 to 11) per cent improvement in the C-statistic was estimated compared with using age alone. CONCLUSION: The assessed risk scores did not have sufficient accuracy to enable potentially life-saving decisions to be made regarding intervention. Focus should therefore shift to offering repair to more patients and reducing non-intervention rates, while respecting the wishes of the patient and family.
32. Open Survey on Barriers for International Research in Vascular Surgery and Potential Role of the European Society for Vascular Surgery.
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Lareyre F, Trenner M, Raffort J, Hinchliffe RJ, and Saratzis A
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- 2024
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33. The European Venous Registry.
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Hinchliffe RJ
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- 2024
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34. Systematic Review of Outcome Reporting for Interventions to Treat Patients with Acute Lower Limb Ischaemia.
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Doelare SAN, Oukrich S, Yeung KK, Hinchliffe RJ, and Jongkind V
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Objective: Inconsistencies in outcome data of therapeutic strategies for acute lower limb ischaemia (ALI) have hindered the synthesis of findings. A core outcome set (COS) may offer a solution to this problem by defining a minimum set of outcomes that are considered essential to all stakeholders involved. The first step in developing a COS is to review the previously reported outcomes on various treatment strategies for ALI., Data Sources: PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases were searched from inception to August 2023., Review Methods: This systematic review was conducted in accordance with the Core Outcome Measures in Effectiveness Trials (COMET) initiative framework, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and was pre-registered with PROSPERO (CRD42022320073). Abstracts were independently screened by two authors for full text review. All outcomes and their definitions were extracted from selected papers. Outcomes with different terminologies were then categorised into an agreed outcome term. The list of agreed outcomes was given a standardised outcome domain and core area using a 38 item standardised taxonomy., Results: Of 6 184 articles identified, 176 relevant studies were included, yielding 1 325 verbatim outcomes. After deduplication, 72 unique verbatim outcomes were categorised into five broad outcome domains. Outcomes considered key to the evaluation of treatment of ALI were further categorised as delivery of care (19.4%), vascular outcomes (13.8%), and adverse events (12.5%). The three most frequently reported agreed outcomes were amputation (14.1%), death (12.3%), and general bleeding (11.6%)., Conclusion: This systematic review provides an overview of currently reported outcomes in the literature of interventions for ALI. After categorisation into agreed outcome terms, 72 outcomes were identified that can be used in the development of a COS., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2024
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35. Editor's Choice - Prevalence of Smoking and Impact on Peri-Operative Outcomes After Elective Abdominal Aortic Aneurysm Repair.
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Wong KHF, Mouton R, and Hinchliffe RJ
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- Humans, Male, Female, Aged, Prevalence, United Kingdom epidemiology, Risk Factors, Length of Stay statistics & numerical data, Treatment Outcome, Middle Aged, Endovascular Procedures adverse effects, Endovascular Procedures mortality, Aged, 80 and over, Registries, Smokers statistics & numerical data, Aortic Aneurysm, Abdominal surgery, Aortic Aneurysm, Abdominal mortality, Aortic Aneurysm, Abdominal epidemiology, Elective Surgical Procedures adverse effects, Smoking adverse effects, Smoking epidemiology, Postoperative Complications epidemiology, Postoperative Complications etiology, Postoperative Complications mortality, Hospital Mortality
- Abstract
Objective: The contemporary burden of smoking in patients undergoing elective abdominal aortic aneurysm (AAA) repair in the UK is unknown. This study aimed to quantify the prevalence of smoking in patients undergoing AAA repair in the UK and determine the association between smoking and peri-operative outcomes., Methods: This was an observational cohort study. The National Vascular Registry was interrogated for adults undergoing elective infrarenal AAA repair from 2014 to 2021 for prevalence of current smokers, former smokers, and non-smokers over time. The primary outcomes were post-operative complications by smoking status. Secondary outcomes were variation in smoking rates over time and by hospital, in hospital mortality, and length of stay by smoking status. All analyses were adjusted using the validated British Aneurysm Repair score., Results: Overall, 26 916 patients undergoing elective AAA repair were included (21.9% smokers, 62.2% former smokers, 15.9% non-smokers). The prevalence of smoking did not change over time, with a 2.4 fold variation between UK hospitals (range 13.0 - 31.8% excluding outliers). In hospital mortality was not significantly different between smokers, former smokers, and non-smokers (p > .050 for all comparisons). Compared with non-smokers, smoking was associated with increased overall (odds ratio [OR] 1.40, 95% confidence interval [CI] 1.24 - 1.57) and respiratory complications (OR 1.98, 95% CI 1.63 - 2.39), limb ischaemia (OR 1.63, 95% CI 1.19 - 2.23), bowel ischaemia (OR 1.64, 95% CI 1.06 - 2.54), return to theatre (OR 1.38, 95% CI 1.11 - 1.71), and intensive care admission (OR 1.43, 95% CI 1.31 - 1.56). Compared with former smokers, smoking was associated with increased overall (OR 1.24, 95% CI 1.14 - 1.36), respiratory (OR 1.44, 95% CI 1.27 - 1.63) and limb ischaemia complications (OR 1.48, 95% CI 1.19 - 1.84), and intensive care admission (OR 1.37, 95% CI 1.28 - 1.46). On analysis of the endovascular aneurysm repair subgroup, active smoking was associated with significantly higher rates of limb ischaemia compared with former and non-smokers (OR 2.12, 95% CI 1.49 - 3.01 and OR 1.94, 95% CI 1.19 - 3.16 respectively)., Conclusion: The prevalence of smoking remains high in patients undergoing elective AAA repair with no evidence of a decline in active smokers from 2014 to 2021 compared with the general UK population. Smoking is associated with increased peri-operative complication rates., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
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- 2024
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36. Epidemiology of tobacco smoking in patients undergoing elective vascular surgery in the UK.
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Wong KHF, Mouton R, and Hinchliffe RJ
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- Humans, United Kingdom epidemiology, Female, Male, Aged, Middle Aged, Elective Surgical Procedures statistics & numerical data, Vascular Surgical Procedures, Tobacco Smoking epidemiology
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- 2024
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37. Definitions and criteria for diabetes-related foot disease (IWGDF 2023 update).
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van Netten JJ, Bus SA, Apelqvist J, Chen P, Chuter V, Fitridge R, Game F, Hinchliffe RJ, Lazzarini PA, Mills J, Monteiro-Soares M, Peters EJG, Raspovic KM, Senneville E, Wukich DK, and Schaper NC
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- Humans, Diabetic Foot diagnosis, Diabetic Foot etiology, Foot Diseases, Diabetes Mellitus
- Abstract
Multiple disciplines are involved in the management of diabetes-related foot disease and a common vocabulary is essential for clear communication. Based on the systematic reviews of the literature that form the basis of the International Working Group on the Diabetic Foot (IWGDF) Guidelines, the IWGDF has developed a set of definitions and criteria for diabetes-related foot disease. This document describes the 2023 update of these definitions and criteria. We suggest these definitions be used consistently in both clinical practice and research, to facilitate clear communication with people with diabetes-related foot disease and between professionals around the world., (© 2023 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons Ltd.)
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- 2024
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38. European Research Hub: European Society for Vascular Surgery Research Initiative Has Materialised.
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Kakkos SK, Antoniou GA, and Hinchliffe RJ
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- Humans, Vascular Surgical Procedures, Europe, Stroke, Specialties, Surgical
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- 2024
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39. The Key Role of the European Society for Vascular Surgery in Improving the Surveillance of High Risk Medical Devices.
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Behrendt CA, Kolh P, Loftus I, and Hinchliffe RJ
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- Humans, Vascular Surgical Procedures, Societies, Medical, Specialties, Surgical
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- 2024
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40. BEST-CLI International Collaborative: planning a better future for patients with chronic limb-threatening ischaemia globally.
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Farber A, Menard MT, Bonaca MP, Bradbury A, Conte MS, Debus ES, Eldrup N, Goodney P, Gupta PC, Hinchliffe RJ, Houlind KC, Kolh P, Kum SWC, Nordanstig J, Parikh SA, Patel MR, Patrone L, Sillesen H, Strong MB, Varcoe RL, Vega de Ceniga M, Venermo MA, and Rosenfield K
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- Humans, Ischemia surgery, Treatment Outcome, Risk Factors, Chronic Limb-Threatening Ischemia, Peripheral Arterial Disease
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- 2024
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41. PACE: randomized, controlled, multicentre, multinational, phase III study of PLX-PAD for critical limb ischaemia in patients unsuitable for revascularization: randomized clinical trial.
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Norgren L, Weiss N, Nikol S, Lantis JC, Patel MR, Hinchliffe RJ, Reinecke H, Volk HD, Reinke P, Fadini GP, Ofir R, Rothenstein D, Halevy N, Karagjozov M, and Rundback JH
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- Humans, Male, Female, Pregnancy, Ischemia, Placenta metabolism, Vascular Surgical Procedures, Treatment Outcome, Chronic Limb-Threatening Ischemia, Peripheral Arterial Disease therapy
- Abstract
Background: Revascularization is the primary treatment modality for chronic limb-threatening ischaemia (CLTI), but is not feasible in all patients. PLX-PAD is an off-the-shelf, placental-derived, mesenchymal stromal cell-like cell therapy. This study aimed to evaluate whether PLX-PAD would increase amputation-free survival in people with CLTI who were not candidates for revascularization., Methods: People with CLTI and minor tissue loss (Rutherford 5) who were unsuitable for revascularization were entered into a randomized, parallel-group, placebo-controlled, multinational, blinded, trial, in which PLX-PAD was compared with placebo (2 : 1 randomization), with 30 intramuscular injections (0.5 ml each) into the index leg on days 0 and 60. Planned follow-up was 12-36 months, and included vital status, amputations, lesion size, pain and quality-of-life assessments, haemodynamic parameters, and adverse events., Results: Of 213 patients enrolled, 143 were randomized to PLX-PAD and 70 to placebo. Demographics and baseline characteristics were balanced. Most patients were Caucasian (96.2%), male (76.1%), and ambulatory (85.9%). Most patients (76.6%) reported at least one adverse event, which were mostly expected events in CLTI, such as skin ulcer or gangrene. The probability of major amputation or death was similar for placebo and PLX-PAD (33 and 28.6% respectively; HR 0.93, 95% c.i. 0.53 to 1.63; P = 0.788). Revascularization and complete wound healing rates were similar in the two groups. A post hoc analysis of a subpopulation of 121 patients with a baseline haemoglobin A1c level below 6.5% showed improved 12-month amputation-free survival (HR 0.46, 0.21 to 0.99; P = 0.048)., Conclusion: Although there was no evidence that PLX-PAD reduced amputation-free survival in the entire study population, benefit was observed in patients without diabetes mellitus or whose diabetes was well controlled; this requires confirmation in further studies. Trial registration: NCT03006770 (http://www.clinicaltrials.gov); 2015-005532-18 (EudraCT Clinical Trials register - Search for 2015-005532-18)., (© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.)
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- 2024
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42. Exploring the Reporting Standards of Randomised Controlled Trials Involving Endovascular Interventions for Peripheral Arterial Disease: A Systematic Review.
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Zywicka EM, McNally E, Elliott L, Twine CP, Mouton R, and Hinchliffe RJ
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- Humans, Reference Standards, Checklist, Randomized Controlled Trials as Topic, Peripheral Arterial Disease therapy
- Abstract
Objective: Endovascular technology innovation requires rigorous evaluation in high quality randomised controlled trials (RCTs). However, due to numerous methodological challenges, RCTs evaluating endovascular interventions are complex and potentially difficult to design, conduct, and report. This systematic review aimed to assess the quality of reporting of RCTs for endovascular interventions for lower limb peripheral arterial disease (PAD)., Data Sources and Review Methods: A systematic review of Medline, Embase, and the Cochrane Library databases from inception to December 2021 was performed to identify RCTs including participants with PAD undergoing any infrainguinal lower limb endovascular intervention. Study data were extracted and assessed against the Consolidating Standards of Reporting Trials extension for Non-Pharmacological Treatments (CONSORT-NPT) and the Template for Intervention Description and Replication (TIDieR) checklists. Descriptive statistics were used to summarise general study details and reporting standards of the trials., Results: After screening 6 567 abstracts and 526 full text articles, 112 eligible studies were identified, reporting on 228 different endovascular devices and techniques. Details judged sufficient to replicate the investigated intervention were provided for 47 (21%) interventions. It was unclear whether the description was reported with sufficient details in a further 56 (24%), and the description was judged inadequate in 125 (55%). Any intervention descriptions were provided for 184 (81%), with variable levels of detail (some in 134 [59%] and precise in 50 [22%]). Standardisation of intervention or some aspect of this was reported in 25 (22%) trials, but only one specified that adherence to the study protocol would be monitored., Conclusion: The quality of the reporting standards of RCTs investigating lower limb endovascular treatments is severely limited because the interventions are poorly described, standardised, and reported. PROSPERO registration number: CRD42022288214., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
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- 2024
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43. Through Knee Amputation: A Neglected Technique that Offers Opportunities for Future Research.
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Guo S and Hinchliffe RJ
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- Humans, Amputation, Surgical, Knee
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- 2023
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44. Editor's Choice - Quality Assessment of European Society for Vascular Surgery Clinical Practice Guidelines.
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Vinojan S, Gooneratne TD, Twine CP, and Hinchliffe RJ
- Abstract
Objective: An increasing number of clinical practice guidelines (CPGs) have emerged over recent years. To have clinical utility, they need to be rigorously developed and scientifically robust. Instruments have been developed to assess the quality of clinical guideline development and reporting. The aim of this study was to evaluate CPGs from the European Society for Vascular Surgery (ESVS) using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument., Methods: CPGs published by the ESVS during the period January 2011 to January 2023 were included. Two independent reviewers assessed the guidelines after receiving training in the use and application of the AGREE II instrument. Inter-reviewer reliability was assessed with the intraclass correlation coefficient. Maximum scaled scores were 100. Statistical analysis was performed using SPSS Statistics v.26., Results: Sixteen guidelines were included in the study. Good inter-reviewer score reliability was found on statistical analysis (> 0.9). The mean ± standard deviation domain scores were 68.1 ± 20.3% for scope and purpose, 57.1 ± 21.1% for stakeholder involvement, 67.8 ± 19.5% for rigour of development, 78.1 ± 20.6% for clarity of presentation, 50.3 ± 15.4% for applicability, 77.6 ± 17.6% for editorial independence, and 69.8 ± 20.1% for overall quality. Stakeholder involvement and applicability have improved in quality over time but are still the lowest scoring domains., Conclusion: Most ESVS clinical guidelines are of high quality and reporting. There is scope for improvement, specifically by addressing the domains of stakeholder involvement and clinical applicability., (Crown Copyright © 2023. Published by Elsevier B.V. All rights reserved.)
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- 2023
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45. Editor's Choice - Antithrombotics in Atherosclerotic Renal and Mesenteric Arterial Disease: A Systematic Review.
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Ahmed H, Mercer RT, Wong KHF, Hinchliffe RJ, and Twine CP
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- 2023
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46. Peripheral arterial disease (PAD) - A challenging manifestation of atherosclerosis.
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Nordanstig J, Behrendt CA, Bradbury AW, de Borst GJ, Fowkes F, Golledge J, Gottsater A, Hinchliffe RJ, Nikol S, and Norgren L
- Subjects
- Humans, Risk Factors, Peripheral Arterial Disease diagnosis, Atherosclerosis diagnosis
- Abstract
The diagnosis of peripheral arterial disease (PAD) is not always evident as symptoms and signs may show great variation. As all grades of PAD are linked to both an increased risk for cardiovascular complications and adverse limb events, awareness of the condition and knowledge about diagnostic measures, prevention and treatment is crucial. This article presents in a condensed form information on PAD and its management., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved.)
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- 2023
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47. Editor's Choice - European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on Antithrombotic Therapy for Vascular Diseases.
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Twine CP, Kakkos SK, Aboyans V, Baumgartner I, Behrendt CA, Bellmunt-Montoya S, Jilma B, Nordanstig J, Saratzis A, Reekers JA, Zlatanovic P, Antoniou GA, de Borst GJ, Bastos Gonçalves F, Chakfé N, Coscas R, Dias NV, Hinchliffe RJ, Kolh P, Lindholt JS, Mees BME, Resch TA, Trimarchi S, Tulamo R, Vermassen FEG, Wanhainen A, Koncar I, Fitridge R, Matsagkas M, and Valgimigli M
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- 2023
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48. A systematic review of reported outcomes in people with lower limb chronic venous insufficiency of the deep veins.
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McNally EH, Rudd S, Mezes P, Black SA, Hinchliffe RJ, and Ozdemir BA
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- Humans, Outcome Assessment, Health Care, Lower Extremity, Patient Reported Outcome Measures, Venous Insufficiency diagnostic imaging, Venous Insufficiency epidemiology
- Abstract
Objective: The prevalence of lower limb chronic venous insufficiency (CVI) of the deep veins is increasing and presents a significant burden to patients and health care services. To improve the evaluation of interventions it is necessary to standardise their reporting. The aim of this study was to perform a systematic review of the outcomes of interventions delivered to people with CVI of the deep veins as part of the development of a novel core outcome set (COS)., Methods: Following the Core Outcome Measures in Effectiveness Trials (COMET) framework for COS development, a systematic review was conducted to PRISMA guidance. The protocol was preregistered on PROSPERO (CRD42021236795). MEDLINE, Embase, Emcare, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews and Clinicaltrials.gov were searched from January 2018 to January 2021. Clinical trials and observational studies involving more than 20 participants, reporting outcomes for patients with CVI of the deep veins were eligible. Outcomes were extracted verbatim, condensed into agreed outcome terms and coded into domains using standard COMET taxonomy. Outcome reporting consistency, where outcomes were fully reported throughout the methods and results of their respective articles was also assessed., Results: Some 103 studies were eligible. There were 1183 verbatim outcomes extracted, spanning 22 domains. No outcome was reported unanimously, with the most widely reported outcome of primary patency featuring in 51 articles (<50%). There was a predominant focus on reporting clinical outcomes (n = 963 [81%]), with treatment durability (n = 278 [23%]) and clinical severity (n = 108 [9%]) reported frequently. Life impact outcomes were relatively under-reported (n = 60 [5%]). Outcome reporting consistency was poor, with just 50% of outcomes reported fully., Conclusions: Outcome reporting in studies of people with CVI of the deep veins is currently heterogeneous. Life impact outcomes, which likely reflect patients' priorities are under-reported. This study provides the first step in the development of a COS for people with lower limb CVI of the deep veins., (Copyright © 2022 Society for Vascular Surgery. All rights reserved.)
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- 2023
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49. Protocol for a systematic review of reporting standards of lower limb endovascular interventions in peripheral arterial disease.
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Zywicka EM, Elliott L, Twine CP, Mouton R, and Hinchliffe RJ
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- Humans, Lower Extremity, Checklist, Systematic Reviews as Topic, Peripheral Arterial Disease surgery
- Abstract
Introduction: Techniques and devices for the endovascular treatment of peripheral arterial disease (PAD) are continuously evolving. High-quality clinical trials limit the variation in how endovascular interventions are described, performed and reported. The aim of this systematic review is to assess the quality of reporting standards in randomised controlled trials (RCTs) of endovascular lower limb interventions against the Consolidated Standards of Reporting Trials for Non-Pharmacologic Treatments (CONSORT-NPT) and template for intervention description and replication (TIDieR) framework., Methods: Randomised trials including participants with peripheral arterial disease undergoing any infra-inguinal lower limb endovascular arterial intervention, searched from Medline, Embase and Cochrane Library databases from inception to December 2021, will be included. All study data, including details of the procedure investigated, will be extracted in keeping with the CONSORT-NPT and TIDieR checklist. Descriptive statistics will be used to summarise general study details and reporting standards of the trials., Discussion: The results will be used to inform the design of future RCTs in this area by optimising the way the interventions are described, standardised, and monitored. The systematic review will be disseminated via peer-reviewed manuscripts and presentations at relevant conferences., Systematic Review Registration: PROSPERO CRD42022288214., (© 2023. The Author(s).)
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- 2023
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50. Editor's Choice - European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on Radiation Safety.
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Modarai B, Haulon S, Ainsbury E, Böckler D, Vano-Carruana E, Dawson J, Farber M, Van Herzeele I, Hertault A, van Herwaarden J, Patel A, Wanhainen A, Weiss S, Esvs Guidelines Committee, Bastos Gonçalves F, Björck M, Chakfé N, de Borst GJ, Coscas R, Dias NV, Dick F, Hinchliffe RJ, Kakkos SK, Koncar IB, Kolh P, Lindholt JS, Trimarchi S, Tulamo R, Twine CP, Vermassen F, Document Reviewers, Bacher K, Brountzos E, Fanelli F, Fidalgo Domingos LA, Gargiulo M, Mani K, Mastracci TM, Maurel B, Morgan RA, and Schneider P
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- 2023
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