European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
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Eur J Vasc Endovasc Surg · Jul 2007
Randomized Controlled TrialHigh-risk and low-risk screening for abdominal aortic aneurysm both reduce aneurysm-related mortality. A stratified analysis from a single-centre randomised screening trial.
Cardiovascular diseases and chronic obstructive pulmonary disease (COPD) are both associated with abdominal aortic aneurysms (AAA). The aim of this study was therefore to analyse whether screening for AAA could be restricted to men with such diseases (high risk group). ⋯ High-risk population screening would prevent less than half of AAA-related deaths. Therefore, restricting screening to such high-risk groups does not seem justified, but cost effectiveness analyses are needed to reach a firm conclusion.
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Eur J Vasc Endovasc Surg · Jun 2007
Multicenter Study Clinical TrialPreoperative nutritional status predicts the severity of the systemic inflammatory response syndrome (SIRS) following major vascular surgery.
This study examined the relationship between pre-operative nutritional status and systemic inflammatory response syndrome (SIRS) or sepsis following major vascular surgery. ⋯ Lower pre-operative nutritional indices, indicating protein energy malnutrition, were associated with more severe systemic inflammatory responses following major vascular surgery.
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Eur J Vasc Endovasc Surg · Jun 2007
Clinical TrialLate outcome of spinal cord stimulation for unreconstructable and limb-threatening lower limb ischemia.
To determine whether the initial benefits of spinal cord stimulation (SCS) treatment for critical limb ischemia (CLI) persist over years. ⋯ In CLI patients the beneficial effects of SCS persist far beyond the first year of treatment and major amputation becomes infrequent after the second year.
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A 35 year old male presented 9 months after sustaining a penetrating injury to the neck with a false aneurysm of the common carotid artery (CCA). At exploration, a 5mm piece of granite was embedded in the posterior wall of the CCA with overlying endothelialisation. He was treated with segmental resection and an interposition vein graft. Apart from the risk of foreign body embolisation at the time of the original presentation, it seems remarkable that the patient did not suffer a stroke due to embolism of thrombus that one would normally have expected to form on the highly thrombogenic stone surface.
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Eur J Vasc Endovasc Surg · May 2007
Randomized Controlled TrialIdentification of skills common to renal and iliac endovascular procedures performed on a virtual reality simulator.
There is a learning curve in the acquisition of endovascular skills for the treatment of vascular disease. Integration of Virtual reality (VR) simulator based training into the educational training curriculum offers a potential solution to overcome this learning curve. However evidence-based training curricula that define which tasks, how often and in which order they should be performed have yet to be developed. The aim of this study was to determine the nature of skills acquisition on the renal and iliac modules of a commercially-available VR simulator. ⋯ Novice endovascular surgeons can significantly improve their performance of simulated procedures through repeated practice on VR simulators. Skills transfer between tasks was demonstrated but complex task training, such as selective arterial cannulation in simulators and possibly in the real world appears to involve a separate skill. It is thus suggested that a stepwise and hierarchical training curriculum is developed for acquisition of endovascular skill using VR simulation to supplement training on patients.