European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
-
Eur J Vasc Endovasc Surg · Dec 2008
Randomized Controlled Trial Multicenter Study Comparative StudyThe adjuvant benefit of angioplasty in patients with mild to moderate intermittent claudication (MIMIC) managed by supervised exercise, smoking cessation advice and best medical therapy: results from two randomised trials for stenotic femoropopliteal and aortoiliac arterial disease.
Uncertainty exists on whether there is adjuvant benefit of percutaneous transluminal angioplasty (PTA) over supervised exercise and best medical therapy in the treatment of intermittent claudication. ⋯ PTA confers adjuvant benefit over supervised exercise and best medical therapy in terms of walking distances and ABPI 24 months after PTA in patients with stable mild to moderate intermittent claudication.
-
Eur J Vasc Endovasc Surg · Dec 2008
ReviewThe pink pulseless hand: a review of the literature regarding management of vascular complications of supracondylar humeral fractures in children.
Supracondylar fractures of the humerus are the commonest upper limb fractures in children, accounting for up to 70% of all paediatric elbow fractures [Wilson MJ, Hunter JB. Supracondylar fractures of the humerus in children--wire removal in the outpatient setting. Injury Extra 2006 Aug;37(8):313-315] and are often complicated by neurovascular injury. ⋯ The literature contains a number of case series with variable follow-up. Both angiography and colour duplex ultrasound provide little benefit in the management of these patients. A child with a pink pulseless hand post-fracture reduction can be managed expectantly unless additional signs of vascular compromise develop, in which case exploration should be undertaken.
-
Eur J Vasc Endovasc Surg · Dec 2008
Effect of varicose vein surgery on venous reflux scoring and plethysmographic assessment of venous function.
Colour duplex ultrasonography (CDU) is widely recommended before varicose vein surgery, combined with quantification of venous reflux by plethysmography where required. This study assessed venous haemodynamics before and after varicose vein surgery by venous outflow plethysmography (VOP), venous reflux plethysmography (VRP) and by adoption of a modified segmental venous reflux score (VRS). The effect of wearing one or two class I medical compression stockings was also assessed. The aim of the study was to identify parameters which reflect the outcome of treatment using medical compression stockings or surgical intervention. ⋯ Venous reflux assessed by plethysmography was moderated by the use of compression stockings pre-operatively but did not reflect the outcome of surgical treatment of superficial venous reflux. Increased venous volume and venous outflow were restored to the levels of normal contralateral limbs by surgery. The VRS decreased considerably following surgery, reflecting the effect of surgical treatment on the number of incompetent venous segments. Changes in this parameter did not correlate with any of the plethysmographic measurements.