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1. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

Ruffino, M. A., Chan, S., Coughlin, P., Awopetu, A., Stather, P., Lane, T., Theodosiou, D., Ahmed, M. A., Vasudevan, T., Ibrahim, M., Al Maadany, F., Eljareh, M., Alkhafeefi, F. S., Coscas, R., Unal, E. U., Pulli, R., Zaca, S., Angiletta, D., Kotsis, T., Moawad, M., Tozzi, M., Patelis, N., Lazaris, A. M., Chuen, J., Croo, A., Tsolaki, E., Zenunaj, G., Kamal, D., Tolba, M. M., Maresch, M., Khetarpaul, V., Mills, J., Gangwani, G., Elahwal, M., Khalil, R., Azab, M. A., Mahomed, A., Whiston, R., Contractor, U., Esposito, D., Pratesi, C., Giacomelli, E., Troncoso, M. V., Elkouri, S., Johansson, F. G., Dodos, I., Benezit, M., Vidoedo, J., Rocha-Neves, J., Pereira-Neves, A. H., Dias-Neto, M. F., Campos Jacome, A. F., Loureiro, L., Silva, I., Garza-Herrera, R., Canata, V., Bezard, C., Bowser, K., Tobar, J. F., Vera, C. G., Parra, C. S., Lopez, E., Serra, Y. G., Varela, J., Rubio, V., Victoria, G., Johnson, A., O'Banion, L. A., Makar, R., Tantawy, T. G., Storck, M., Jongkind, V., Falah, O., Mcbride, O., Isik, A., Papaioannou, A., Ocke Reis, P. E., Bracale, U. M., Atkins, E., Tinelli, Giovanni, Scott, E., Wales, L., Sivaharan, A., Priona, G., Nesbitt, C., Grainger, T., Shelmerdine, L., Chong, P., Bajwa, A., Arwynck, L., Hadjievangelou, N., Elbasty, A., Rubio, O., Ricardo, M., Ulloa, J. H., Tarazona, M., Pabon, M., Pitoulias, G., Corless, K., Ioannidis, O., Friedrich, O., Van Herzeele, I., Vijaynagar, B., Cohnert, T., Bell, R., Moore, H., Saha, P., Gifford, E., Laine, M., Barkat, A., Karkos, C., Binti Safri, L. S., Buitron, G., Del Castillo, J., Carrera, P., Salinas, N., Biagioni, R. B., Benites, S., Mafla, C. A., Pian, P. M., Albino, P., Serrano, E., Marin, A., Gonzalez, M., Foreroga, M., Russo, A., Reyes, A., Guglielmone, D., Grillo, L., Flumignan, R., Palones, F. G., Silveira, P. G., Ramely, R. B., Edeiken, S., Chetter, I., Green, L., Sudarsanam, A., Lyons, O., Lemmon, G., Neville, R., Castelli, M., Hinojosa, C. A., Carvajal, R. R., Rivera, A., Wong, P., Drudi, L., Perkins, J., Sieunarine, K., Attia, D., Atef, M., Eftychios, L., Weaver, F., Ren, L. C., Alomari, M., Jamjoom, R., Aljarrah, Q., Abbas, A., Alomran, F., Kumar, A., Altoijri, A., Elsanhoury, K. T., Alhumaid, A., Fekry, T., Sekhar, R., Theodoridis, P., Panagiotis, T., Roditis, K., Tsiantoula, P., Antoniou, A., Soler, R., Hasemaki, N., Baili, E., Mpaili, E., Huasen, B., Wallace, T., Duncan, A., Metcalfe, M., Mannoia, K., Bechara, C. F., Tsilimparis, N., Aranson, N., Riding, D., Palena, M., Mcdonnell, C., Mouawad, N. J., Banegas, S., Rossi, P., Oshodi, T., Diaz, R., Afifi, R., Dindyal, S., Thapar, A., Kordzadeh, A., Pullas, G., Lin, S., Davies, C., Darvall, K., Kodama, A., Gooneratne, T., Gunawansa, N., Munoz, A., Jie, N. J., Bradley, N., Al-Jundi, W., Meyer, F., Lee, C., Malina, M., Renton, S., Lui, D., Batchelder, A., Oszkinis, G., Freyrie, A., Giordano, J., Saratzis, N., Tigkiropoulos, K., Kyriakos, S., Popov, G., Cheema, M. U., Lapolla, P., Ling Patricia, Y. C., Ennab, R., Ullery, B. W., Pasenidou, K., Tam, J., Sidel, G., Jayaprakash, V. V., Bennett, L., Hardy, S., Davies, E., Baker, S., Wijesinghe, L., Tam, A., Mccune, K., Chana, M., Lowe, C., Goh, A., Powezka, K., Kyrou, I., Altaf, N., Harkin, D., Travers, H., Cragg, J., Sharif, A., Akhtar, T., Chavez, J. A., Ordonez, C., Mazzurco, M., Choke, E., Asghar, I., Summerour, V., Dunlop, P., Morley, R., Hardy, T., Bevis, P., Cuff, R., Stavroulakis, K., Beropoulis, E., Argyriou, A., Loftus, I., Azhar, B., Sheth, S., Usai, M. V., Choudhry, A., Nicole, K., Boyle, E., Joyce, D., Abdelaty Hassan, M. H., Saltiel, A., Frahm-Jensen, G., Antoniou, G., Elhadi, M., Kimyaghalam, A., Malgor, R., Telve, D., Isaak, A., Schmidli, J., Mckevitt, K., Siddiqui, T., Asciutto, G., Floros, N., Papadopoulos, G., Kafetzakis, A., Koutsias, S. G., Nana, P., Giannoukas, A., Kakkos, S., Moulakakis, K. G., Shafique, N., Jawien, A., Popplewell, M., Imray, C., Abayasekara, K., Rowlands, T., Kuhan, G., Rajagopalan, S., Jaipersad, A., Sadia, U., Kobe, I., Mittapalli, D., Enemosah, I., Behrendt, C. -A., Beck, A., Almudhafer, M., Ancetti, S., Jacobs, D., Jayakumar, P., Malekpour, F., Shalhub, S., Keldiyorov, B., Simon, M., Khashram, M., Rich, N., Shepherd, A., Meecham, L., Doherty, D., Benson, R. A., Tinelli G. (ORCID:0000-0002-2212-3226), Ruffino, M. A., Chan, S., Coughlin, P., Awopetu, A., Stather, P., Lane, T., Theodosiou, D., Ahmed, M. A., Vasudevan, T., Ibrahim, M., Al Maadany, F., Eljareh, M., Alkhafeefi, F. S., Coscas, R., Unal, E. U., Pulli, R., Zaca, S., Angiletta, D., Kotsis, T., Moawad, M., Tozzi, M., Patelis, N., Lazaris, A. M., Chuen, J., Croo, A., Tsolaki, E., Zenunaj, G., Kamal, D., Tolba, M. M., Maresch, M., Khetarpaul, V., Mills, J., Gangwani, G., Elahwal, M., Khalil, R., Azab, M. A., Mahomed, A., Whiston, R., Contractor, U., Esposito, D., Pratesi, C., Giacomelli, E., Troncoso, M. V., Elkouri, S., Johansson, F. G., Dodos, I., Benezit, M., Vidoedo, J., Rocha-Neves, J., Pereira-Neves, A. H., Dias-Neto, M. F., Campos Jacome, A. F., Loureiro, L., Silva, I., Garza-Herrera, R., Canata, V., Bezard, C., Bowser, K., Tobar, J. F., Vera, C. G., Parra, C. S., Lopez, E., Serra, Y. G., Varela, J., Rubio, V., Victoria, G., Johnson, A., O'Banion, L. A., Makar, R., Tantawy, T. G., Storck, M., Jongkind, V., Falah, O., Mcbride, O., Isik, A., Papaioannou, A., Ocke Reis, P. E., Bracale, U. M., Atkins, E., Tinelli, Giovanni, Scott, E., Wales, L., Sivaharan, A., Priona, G., Nesbitt, C., Grainger, T., Shelmerdine, L., Chong, P., Bajwa, A., Arwynck, L., Hadjievangelou, N., Elbasty, A., Rubio, O., Ricardo, M., Ulloa, J. H., Tarazona, M., Pabon, M., Pitoulias, G., Corless, K., Ioannidis, O., Friedrich, O., Van Herzeele, I., Vijaynagar, B., Cohnert, T., Bell, R., Moore, H., Saha, P., Gifford, E., Laine, M., Barkat, A., Karkos, C., Binti Safri, L. S., Buitron, G., Del Castillo, J., Carrera, P., Salinas, N., Biagioni, R. B., Benites, S., Mafla, C. A., Pian, P. M., Albino, P., Serrano, E., Marin, A., Gonzalez, M., Foreroga, M., Russo, A., Reyes, A., Guglielmone, D., Grillo, L., Flumignan, R., Palones, F. G., Silveira, P. G., Ramely, R. B., Edeiken, S., Chetter, I., Green, L., Sudarsanam, A., Lyons, O., Lemmon, G., Neville, R., Castelli, M., Hinojosa, C. A., Carvajal, R. R., Rivera, A., Wong, P., Drudi, L., Perkins, J., Sieunarine, K., Attia, D., Atef, M., Eftychios, L., Weaver, F., Ren, L. C., Alomari, M., Jamjoom, R., Aljarrah, Q., Abbas, A., Alomran, F., Kumar, A., Altoijri, A., Elsanhoury, K. T., Alhumaid, A., Fekry, T., Sekhar, R., Theodoridis, P., Panagiotis, T., Roditis, K., Tsiantoula, P., Antoniou, A., Soler, R., Hasemaki, N., Baili, E., Mpaili, E., Huasen, B., Wallace, T., Duncan, A., Metcalfe, M., Mannoia, K., Bechara, C. F., Tsilimparis, N., Aranson, N., Riding, D., Palena, M., Mcdonnell, C., Mouawad, N. J., Banegas, S., Rossi, P., Oshodi, T., Diaz, R., Afifi, R., Dindyal, S., Thapar, A., Kordzadeh, A., Pullas, G., Lin, S., Davies, C., Darvall, K., Kodama, A., Gooneratne, T., Gunawansa, N., Munoz, A., Jie, N. J., Bradley, N., Al-Jundi, W., Meyer, F., Lee, C., Malina, M., Renton, S., Lui, D., Batchelder, A., Oszkinis, G., Freyrie, A., Giordano, J., Saratzis, N., Tigkiropoulos, K., Kyriakos, S., Popov, G., Cheema, M. U., Lapolla, P., Ling Patricia, Y. C., Ennab, R., Ullery, B. W., Pasenidou, K., Tam, J., Sidel, G., Jayaprakash, V. V., Bennett, L., Hardy, S., Davies, E., Baker, S., Wijesinghe, L., Tam, A., Mccune, K., Chana, M., Lowe, C., Goh, A., Powezka, K., Kyrou, I., Altaf, N., Harkin, D., Travers, H., Cragg, J., Sharif, A., Akhtar, T., Chavez, J. A., Ordonez, C., Mazzurco, M., Choke, E., Asghar, I., Summerour, V., Dunlop, P., Morley, R., Hardy, T., Bevis, P., Cuff, R., Stavroulakis, K., Beropoulis, E., Argyriou, A., Loftus, I., Azhar, B., Sheth, S., Usai, M. V., Choudhry, A., Nicole, K., Boyle, E., Joyce, D., Abdelaty Hassan, M. H., Saltiel, A., Frahm-Jensen, G., Antoniou, G., Elhadi, M., Kimyaghalam, A., Malgor, R., Telve, D., Isaak, A., Schmidli, J., Mckevitt, K., Siddiqui, T., Asciutto, G., Floros, N., Papadopoulos, G., Kafetzakis, A., Koutsias, S. G., Nana, P., Giannoukas, A., Kakkos, S., Moulakakis, K. G., Shafique, N., Jawien, A., Popplewell, M., Imray, C., Abayasekara, K., Rowlands, T., Kuhan, G., Rajagopalan, S., Jaipersad, A., Sadia, U., Kobe, I., Mittapalli, D., Enemosah, I., Behrendt, C. -A., Beck, A., Almudhafer, M., Ancetti, S., Jacobs, D., Jayakumar, P., Malekpour, F., Shalhub, S., Keldiyorov, B., Simon, M., Khashram, M., Rich, N., Shepherd, A., Meecham, L., Doherty, D., Benson, R. A., and Tinelli G. (ORCID:0000-0002-2212-3226)

Abstract

Objective: To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods: An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March – May 2020, “period 1”), and then again between May and June (“period 2”) and June and July 2020 (“period 3”). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. Results: The impact of the pandemic continued to be felt well after countries’ first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. Conclusion: Centres reported a broad return of services approaching pre-pandemic “normal” by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries.

Published
2022

3. Documenting the Recovery of Vascular Services in European Centres Following the Initial COVID-19 Pandemic Peak: Results from a Multicentre Collaborative Study

Author

Ruth A. Benson, Maria Antonella Ruffino, Sharon Chan, Patrick Coughlin, Ayoola Awopetu, Philip Stather, Tristan Lane, Dimitrios Theodosiou, Mohamed Abozeid Ahmed, Thodur Vasudevan, Mohammed Ibrahim, Faraj Al Maadany, Mohamed Eljareh, Fatimah Saad Alkhafeefi, Raphael Coscas, Ertekin Utku Ünal, Raffaele Pulli, Sergio Zacà, Domenico Angiletta, Thomas Kotsis, Magdy Moawad, Matteo Tozzi, Nikolaos Patelis, Andreas M. Lazaris, Jason Chuen, Alexander Croo, Elpiniki Tsolaki, Gladiol Zenunaj, Dhafer Kamal, Mahmoud MH. Tolba, Martin Maresch, Vipul Khetarpaul, Joseph Mills, Gaurav Gangwani, Mohamed Elahwal, Rana Khalil, Mohammed A. Azab, Anver Mahomed, Richard Whiston, Ummul Contractor, Davide Esposito, Carlo Pratesi, Elena Giacomelli, Martín Veras Troncoso, Stephane Elkouri, Flavia Gentile Johansson, Ilias Dodos, Marie Benezit, José Vidoedo, João Rocha-Neves, António Henrique Pereira-Neves, Marina Felicidade Dias-Neto, Ana Filipa Campos Jácome, Luis Loureiro, Ivone Silva, Rodrigo Garza-Herrera, Victor Canata, Charlotte Bezard, Kathryn Bowser, Jorge Felipe Tobar, Carlos Gomez Vera, Carolina Salinas Parra, Eugenia Lopez, Yvis Gadelha Serra, Juan Varela, Vanessa Rubio, Gerardo Victoria, Adam Johnson, Leigh Ann O’Banion, Ragai Makar, Tamer Ghatwary Tantawy, Martin Storck, Vincent Jongkind, Orwa falah, Olivia McBride, Arda Isik, Athanasios Papaioannou, Paulo Eduardo Ocke Reis, Umberto Marcello Bracale, Ellie Atkins, Giovanni Tinelli, Emma Scott, Lucy Wales, Ashwin Sivaharan, Georgia Priona, Craig Nesbitt, Tabitha Grainger, Lauren Shelmerdine, Patrick Chong, Adnan Bajwa, Luke Arwynck, Nancy Hadjievangelou, Ahmed Elbasty, Oscar Rubio, Michael Ricardo, Jorge H. Ulloa, Marcos Tarazona, Manuel Pabon, Georgios Pitoulias, Kevin Corless, Orestis Ioannidis, Oliver Friedrich, Isabelle Van Herzeele, Badri Vijaynagar, Tina Cohnert, Rachel Bell, Hayley Moore, Prakash Saha, Edward Gifford, Matti Laine, Adel Barkat, Christos Karkos, Lenny Suryani Binti Safri, Gabriel Buitron, Javier Del Castillo, Paul Carrera, Nilson Salinas, Rodrigo Bruno Biagioni, Sergio Benites, César Andrés Mafla, Putera Mas Pian, Pereira Albino, Ernesto Serrano, Andres Marin, Marco González, Marsha Foreroga, Alejandro Russo, Andrés Reyes, Daniel Guglielmone, Lorena Grillo, Ronald Flumignan, Francisco Gomez Palones, Pierre Galvagni Silveira, Rosnelifaizur Bin Ramely, Sara Edeiken, Ian Chetter, Lucy Green, Abhilash Sudarsanam, Oliver Lyons, Gary Lemmon, Richard Neville, Mariano Castelli, Carlos A. Hinojosa, Rubén Rodríguez Carvajal, Aksim Rivera, Peng Wong, Laura Drudi, Jeremy Perkins, Kishore Sieunarine, Doaa Attia, Mahmoud Atef, Lostoridis Eftychios, Fred Weaver, Leong Chuo Ren, Mohannad Alomari, Reda Jamjoom, Qusai Aljarrah, Ayman Abbas, Faris Alomran, Ambrish Kumar, Abdulmajeed Altoijri, Kareem T. ElSanhoury, Ahmed Alhumaid, Tamer Fekry, Raghuram Sekhar, Panagiotis Theodoridis, Theodoridis Panagiotis, Konstantinos Roditis, Paraskevi Tsiantoula, Afroditi Antoniou, Raphael Soler, Natasha Hasemaki, Efstratia Baili, Eustratia Mpaili, Bella Huasen, Tom Wallace, Andrew Duncan, Matthew Metcalfe, Kristyn Mannoia, Carlos F. Bechara, Nikolaos Tsilimparis, Nathan Aranson, David Riding, Mariano Palena, Ciarán McDonnell, Nicolas J. Mouawad, Shonda Banegas, Peter Rossi, Taohid Oshodi, Rodney Diaz, Rana Afifi, Shiva Dindyal, Ankur Thapar, Ali Kordzadeh, Gonzalo Pullas, Stephanie Lin, Chris Davies, Katy Darvall, Akio Kodama, Thushan Gooneratne, Nalaka Gunawansa, Alberto Munoz, Ng Jun Jie, Nicholas Bradley, Wissam Al-Jundi, Felicity Meyer, Cheong Lee, Martin Malina, Sophie Renton, Dennis Lui, Andrew Batchelder, Grzegorz Oszkinis, Antonio Freyrie, Jacopo Giordano, Nikolaos Saratzis, Konstantinos Tigkiropoulos, Stavridis Kyriakos, Guriy Popov, Muhammad Usman Cheema, Pierfrancesco Lapolla, Yih Chun Ling Patricia, Raed Ennab, Brant W. Ullery, Ketino Pasenidou, Jacky Tam, Gabriel Sidel, Vivek Vardhan Jayaprakash, Lisa Bennett, Simon Hardy, Emma Davies, Sara Baker, Lasantha Wijesinghe, Adam Tam, Ken McCune, Manik Chana, Chris Lowe, Aaron Goh, Katarzyna Powezka, Ioanna Kyrou, Nishath Altaf, Denis Harkin, Hannah Travers, James Cragg, Atif sharif, Tasleem Akhtar, José Antonio Chávez, Claudia Ordonez, Martin Mazzurco, Edward Choke, Imran Asghar, Virginia Summerour, Paul Dunlop, Rachel Morley, Thomas Hardy, Paul Bevis, Robert Cuff, Konstantinos Stavroulakis, Efthymios Beropoulis, Angeliki Argyriou, Ian Loftus, Bilal Azhar, Sharvil Sheth, Marco Virgilio Usai, Asad Choudhry, Kira Nicole, Emily Boyle, Doireann Joyce, Mohammed Hassan Abdelaty Hassan, Alberto Saltiel, Gert Frahm-Jensen, George Antoniou, Muhammed Elhadi, Ali Kimyaghalam, Rafael Malgor, Leigh Ann O'Banion, Diego Telve, Andrej Isaak, Jürg Schmidli, Kevin McKevitt, Tam Siddiqui, Giuseppe Asciutto, Nikolaos Floros, George Papadopoulos, Alexandros Kafetzakis, Stylianos G. Koutsias, Petroula Nana, Athanasios Giannoukas, Stavros Kakkos, Konstantinos G. Moulakakis, Natasha Shafique, Arkadiusz Jawien, Matthew Popplewell, Chris Imray, Kumar Abayasekara, Timothy Rowlands, Ganesh Kuhan, Sriram Rajagopalan, Anthony Jaipersad, Uzma Sadia, Isaac Kobe, Devender Mittapalli, Ibrahim Enemosah, Christian-Alexander Behrendt, Adam Beck, Muayyad Almudhafer, Stefano Ancetti, Donald Jacobs, Priya Jayakumar, Fatemeh Malekpour, Sherene Shalhub, Boboyor Keldiyorov, Meryl Simon, Manar Khashram, Nicole Rich, Amanda Shepherd, Lewis Meecham, Daniel Doherty, Surgery, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, Benson, Ruth A, Bracale, Umberto Marcello, Ruffino M.A., Chan S., Coughlin P., Awopetu A., Stather P., Lane T., Theodosiou D., Ahmed M.A., Vasudevan T., Ibrahim M., Al Maadany F., Eljareh M., Alkhafeefi F.S., Coscas R., Unal E.U., Pulli R., Zaca S., Angiletta D., Kotsis T., Moawad M., Tozzi M., Patelis N., Lazaris A.M., Chuen J., Croo A., Tsolaki E., Zenunaj G., Kamal D., Tolba M.M., Maresch M., Khetarpaul V., Mills J., Gangwani G., Elahwal M., Khalil R., Azab M.A., Mahomed A., Whiston R., Contractor U., Esposito D., Pratesi C., Giacomelli E., Troncoso M.V., Elkouri S., Johansson F.G., Dodos I., Benezit M., Vidoedo J., Rocha-Neves J., Pereira-Neves A.H., Dias-Neto M.F., Campos Jacome A.F., Loureiro L., Silva I., Garza-Herrera R., Canata V., Bezard C., Bowser K., Tobar J.F., Vera C.G., Parra C.S., Lopez E., Serra Y.G., Varela J., Rubio V., Victoria G., Johnson A., O'Banion L.A., Makar R., Tantawy T.G., Storck M., Jongkind V., falah O., McBride O., Isik A., Papaioannou A., Ocke Reis P.E., Bracale U.M., Atkins E., Tinelli G., Scott E., Wales L., Sivaharan A., Priona G., Nesbitt C., Grainger T., Shelmerdine L., Chong P., Bajwa A., Arwynck L., Hadjievangelou N., Elbasty A., Rubio O., Ricardo M., Ulloa J.H., Tarazona M., Pabon M., Pitoulias G., Corless K., Ioannidis O., Friedrich O., Van Herzeele I., Vijaynagar B., Cohnert T., Bell R., Moore H., Saha P., Gifford E., Laine M., Barkat A., Karkos C., Binti Safri L.S., Buitron G., Del Castillo J., Carrera P., Salinas N., Biagioni R.B., Benites S., Mafla C.A., Pian P.M., Albino P., Serrano E., Marin A., Gonzalez M., Foreroga M., Russo A., Reyes A., Guglielmone D., Grillo L., Flumignan R., Palones F.G., Silveira P.G., Ramely R.B., Edeiken S., Chetter I., Green L., Sudarsanam A., Lyons O., Lemmon G., Neville R., Castelli M., Hinojosa C.A., Carvajal R.R., Rivera A., Wong P., Drudi L., Perkins J., Sieunarine K., Attia D., Atef M., Eftychios L., Weaver F., Ren L.C., Alomari M., Jamjoom R., Aljarrah Q., Abbas A., Alomran F., Kumar A., Altoijri A., ElSanhoury K.T., Alhumaid A., Fekry T., Sekhar R., Theodoridis P., Panagiotis T., Roditis K., Tsiantoula P., Antoniou A., Soler R., Hasemaki N., Baili E., Mpaili E., Huasen B., Wallace T., Duncan A., Metcalfe M., Mannoia K., Bechara C.F., Tsilimparis N., Aranson N., Riding D., Palena M., McDonnell C., Mouawad N.J., Banegas S., Rossi P., Oshodi T., Diaz R., Afifi R., Dindyal S., Thapar A., Kordzadeh A., Pullas G., Lin S., Davies C., Darvall K., Kodama A., Gooneratne T., Gunawansa N., Munoz A., Jie N.J., Bradley N., Al-Jundi W., Meyer F., Lee C., Malina M., Renton S., Lui D., Batchelder A., Oszkinis G., Freyrie A., Giordano J., Saratzis N., Tigkiropoulos K., Kyriakos S., Popov G., Cheema M.U., Lapolla P., Ling Patricia Y.C., Ennab R., Ullery B.W., Pasenidou K., Tam J., Sidel G., Jayaprakash V.V., Bennett L., Hardy S., Davies E., Baker S., Wijesinghe L., Tam A., McCune K., Chana M., Lowe C., Goh A., Powezka K., Kyrou I., Altaf N., Harkin D., Travers H., Cragg J., sharif A., Akhtar T., Chavez J.A., Ordonez C., Mazzurco M., Choke E., Asghar I., Summerour V., Dunlop P., Morley R., Hardy T., Bevis P., Cuff R., Stavroulakis K., Beropoulis E., Argyriou A., Loftus I., Azhar B., Sheth S., Usai M.V., Choudhry A., Nicole K., Boyle E., Joyce D., Abdelaty Hassan M.H., Saltiel A., Frahm-Jensen G., Antoniou G., Elhadi M., Kimyaghalam A., Malgor R., Telve D., Isaak A., Schmidli J., McKevitt K., Siddiqui T., Asciutto G., Floros N., Papadopoulos G., Kafetzakis A., Koutsias S.G., Nana P., Giannoukas A., Kakkos S., Moulakakis K.G., Shafique N., Jawien A., Popplewell M., Imray C., Abayasekara K., Rowlands T., Kuhan G., Rajagopalan S., Jaipersad A., Sadia U., Kobe I., Mittapalli D., Enemosah I., Behrendt C.-A., Beck A., Almudhafer M., Ancetti S., Jacobs D., Jayakumar P., Malekpour F., Shalhub S., Keldiyorov B., Simon M., Khashram M., Rich N., Shepherd A., Meecham L., Doherty D., and Benson R.A.

Subjects
Vascular surgery, Peripheral artery disease, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Abdominal aortic aneurysm, COVID-19, 610 Medicine & health, Surgery, AAA, Cardiology and Cardiovascular Medicine, Survey, Settore MED/22 - CHIRURGIA VASCOLARE, PAD
Abstract

OBJECTIVE To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. METHODS An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March - May 2020, "period 1"), and then again between May and June ("period 2") and June and July 2020 ("period 3"). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. RESULTS The impact of the pandemic continued to be felt well after countries' first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. CONCLUSION Centres reported a broad return of services approaching pre-pandemic "normal" by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries.

Published
2022
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4. Selective internal radiation therapy (SIRT) for hepatocellular carcinoma (HCC): informing clinical practice for multidisciplinary teams in England.

Author

Reeves HL, Reicher J, Priona G, Manas DM, and Littler P

Abstract

Objective: Hepatocellular carcinoma (HCC) deaths are rising alarmingly. Many patients are unsuitable for available therapies. Poor response rates further hamper outcomes for those that are. Selective internal radiation therapy (SIRT) offers hope, although which patients benefit over standard approaches remains unclear., Design/method: As a quality/service improvement, we audited consecutive patients treated with SIRT (2015-2020) by the Newcastle upon Tyne Hospitals National Health Service Foundation Trust HCC multidisciplinary team. Indications, Barcelona clinic liver cancer (BCLC) stage, treatment response, subsequent therapies and survival at 30 September 2021 were assessed., Results: Fifty-one patients received SIRT. Thirty-day mortality was zero. Three months partial response, stable disease and progressive disease on imaging were 50%, 22% and 28%, respectively. Overall median survival was 21 months. There were four subgroups: (1) BCLC-B: HCC>7 cm too large for transarterial chemoembolisation (TACE) alone (n=21); (2) BCLC-B: HCC progressed post TACE (n=7); (3) BCLC-C: HCC with any combination of large tumour burden, branch portal vein thrombosis, non-hepatitis C virus aetiology (n=16); (4) BCLC-C: sorafenib inappropriate (n=7). In group 1, 5/21 (23.8%) of patients were downstaged to resection, 33% received subsequent medical therapies and median survival was >40 months. In BCLC-B patients treated second line (group 2), median survival was 14.2 months. In BCLC-C, median survival was 20.2 months for group 3 and 4.2 months for group 4., Conclusion: SIRT outcomes for advanced HCC, often bridging patients with adverse predictive factors to subsequent surgery or medical therapies, were encouraging. A role after TACE or for BCLC-C patients requires further assessment., Competing Interests: Competing interests: HLR is a member of the European Association for Study of Liver Disease (EASL) education committee, the HCC-UK Committee, the NCRI hepatobiliary subgroup and the Patient Advocacy group for the International Association for Liver cancer (ILCA). She is an expert advisor to the LiverNorth patient Charity and the British Liver Trust and has acted as an expert advisor to NICE Committee Multiple Technology Appraisal (MTA) assessing selective internal radiation therapies (SIRT) for treating hepatocellular carcinoma (ID1276). On behalf of Newcastle University, she has acted as an advisor to Boston Scientific UK and SIRTEX. JR is a member of the British Society of Interventional Radiology Education Committee. GP is a member of the British Society of Interventional Radiology Scientific Program Committee. DMM is the medical director for NHS British Transplant, council member for British Transplant Society, secretary for Cholangiocarcinoma-UK, member of the Transplant Oncology Group and trustee for British Association for Cancer Surgery (BASO). He has been on advisory boards for Boston Scientific UK and SIRTEX. PL is the secretary for Interventional Oncology UK (IOUK) and the Chair for the British Society of Interventional Radiology Scientific Programme Committee. He has received honoraria for lectures from Boston Scientific UK, Sirtex and Johnson and Johnson. He has participated in advisory boards for Boston Scientific UK, Guerbet and Johnson and Johnson., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)

Published
2022
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5. Early Experience of Trans-arterial Chemo-Embolisation for Hepatocellular Carcinoma with a Novel Radiopaque Bead.

Author

Reicher J, Mafeld S, Priona G, Reeves HL, Manas DM, Jackson R, and Littler P

Subjects
Adult, Aged, Aged, 80 and over, Carcinoma, Hepatocellular diagnostic imaging, Female, Humans, Liver diagnostic imaging, Liver Neoplasms diagnostic imaging, Magnetic Resonance Imaging methods, Male, Middle Aged, Retrospective Studies, Tomography, X-Ray Computed methods, Carcinoma, Hepatocellular therapy, Chemoembolization, Therapeutic methods, Drug Delivery Systems methods, Liver Neoplasms therapy
Abstract

Aims: To evaluate early outcomes of patients with hepatocellular carcinoma (HCC) treated with a novel radiopaque bead, the 75-150 μm DC Bead LUMI™ (Biocompatibles UK Ltd)., Materials and Methods: This was a retrospective review of the first 40 consecutive patients at a UK tertiary hepato-biliary centre, treated for HCC with TACE using radiopaque beads, between May 2017 and March 2019. Information regarding complications, mortality, lesion response and subsequent ablation procedures was collected from electronic records and case notes. Intra- and post-operative imaging was reviewed for visibility of the embolised territory., Results: Fifty-five TACE procedures were performed in 40 patients, with a median age of 70 years (range 28-88) and median lesion size of 3.8 cm (range 1.5-7.8). The median follow-up period was 30 weeks (range 6-101). Mean post-procedure hospital stay was 1.2 days. Complications of CIRSE Grade II or above occurred after 4/55 procedures (7.3%). Mortality at 30 days was zero. Objective response rates (mRECIST) at 1, 3 and 6 months were 32/35 (91.4%), 21/24 (87.5%) and 12/15 (80%), respectively. Complete response rates at 1, 3 and 6 months were 16/35 (45.7%), 12/24 (50%) and 9/15 (60%). The embolised territory was visible on intra-operative and follow-up CT imaging in all patients. The radiopaque beads were used as a fiducial marker to guide ablation in 5/40 patients (12.5%)., Conclusion: TACE with radiopaque beads shows promising tolerability and efficacy. The radiopaque beads ensure visualisation of the embolised lesion on intra- and post-operative imaging and, in selected cases, can act as a marker for CT-guided ablation.

Published
2019
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6. Polypoid pseudomyxoma of ascending aorta after replacement with a Dacron graft.

Author

Attaran S, Field M, Desmond M, Priona G, Helliwell TR, Collis SA, Kuduvalli M, and Oo A

Subjects
Aorta pathology, Aorta surgery, Aortic Aneurysm, Thoracic diagnostic imaging, Blood Vessel Prosthesis Implantation methods, Diagnosis, Differential, Follow-Up Studies, Granuloma, Foreign-Body diagnostic imaging, Granuloma, Foreign-Body surgery, Humans, Immunohistochemistry, Male, Middle Aged, Myxoma diagnosis, Myxoma etiology, Reoperation methods, Tomography, X-Ray Computed methods, Treatment Outcome, Vascular Neoplasms diagnosis, Vascular Neoplasms etiology, Vascular Surgical Procedures methods, Aortic Aneurysm, Thoracic surgery, Blood Vessel Prosthesis Implantation adverse effects, Granuloma, Foreign-Body etiology, Granuloma, Foreign-Body pathology, Polyethylene Terephthalates adverse effects
Abstract

We report a 58-year-old man who had a multi-lobulated pseudomyxomatous lesion in his ascending aorta 6 months after his root and ascending aorta was replaced by a Dacron graft., (Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Published
2011
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