European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
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The unit cost for crossmatching blood is £137.22 (€158.94). A maximum surgical blood order schedule for elective EVAR does not exist. We studied the crossmatch to transfusion ratio in our series to establish this recommendation. ⋯ The maximum surgical blood order for elective EVAR should be a group and save (type and screen) sample because of the high crossmatch to transfusion ratio. Intraoperative transfusion is rarely required (<1%) but often necessitates large transfusion quantities. In this circumstance each hospital is required to have an emergency protocol to manage massive blood loss. Applying these principles across all surgical specialities may lead to significant financial savings, improve efficiency and reduce wastage.
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Eur J Vasc Endovasc Surg · Jan 2012
Multicenter StudyLaparoscopic surgery for coeliac artery compression syndrome: current management and technical aspects.
The study aims to assess the feasibility and midterm outcome of trans-peritoneal laparoscopy for coeliac artery compression syndrome (CACS). ⋯ Our study demonstrates that trans-peritoneal laparoscopy for treating median arcuate ligament syndrome is safe and feasible. Additional patients and a longer follow-up are needed for long-term assessment of this laparoscopic technique.
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Eur J Vasc Endovasc Surg · Jan 2012
Preoperative spirometry results as a determinant for long-term mortality after EVAR for AAA.
The aim of this study was to analyse lung function test determinants for long-term mortality after standard endovascular aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA). ⋯ Our findings strengthen the need for formal evaluation of lung function with spirometry prior to proceeding to AAA repair.
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Ulcerated diabetic foot is a complex problem. Ischaemia, neuropathy and infection are the three pathological components that lead to diabetic foot complications, and they frequently occur together as an aetiologic triad. Neuropathy and ischaemia are the initiating factors, most often together as neuroischaemia, whereas infection is mostly a consequence. ⋯ New strategies must be developed and implemented for diabetic foot patients with vascular impairment, to improve healing, to speed up healing rate and to avoid amputation, irrespective of the intervention technology chosen. Focused studies on the value of predictive tests, new treatment modalities as well as selective and targeted strategies are needed. As specific data on ulcerated neuroischaemic diabetic feet are scarce, recommendations are often of low grade.