A5078240857- Diagnosis and Treatment of Venous Diseases
- Venous Thromboembolism Diagnosis and Management
- Aortic aneurysm repair treatments
- Peripheral Artery Disease Management
- Cardiac, Anesthesia and Surgical Outcomes
- Wound Healing and Treatments
- Pressure Ulcer Prevention and Management
- Diabetic Foot Ulcer Assessment and Management
- Aortic Disease and Treatment Approaches
- Central Venous Catheters and Hemodialysis
- Global Health Care Issues
- Cerebrovascular and Carotid Artery Diseases
- Antiplatelet Therapy and Cardiovascular Diseases
- Renal and Vascular Pathologies
- Abdominal Surgery and Complications
- Cardiac and Coronary Surgery Techniques
- Pulmonary Hypertension Research and Treatments
- Atrial Fibrillation Management and Outcomes
- Gallbladder and Bile Duct Disorders
- Dermatologic Treatments and Research
- Vascular anomalies and interventions
- Hernia repair and management
- Thermoregulation and physiological responses
- Cardiovascular Health and Disease Prevention
- Vascular Procedures and Complications
Cheltenham General Hospital
2008-2021
Gloucestershire Hospitals NHS Foundation Trust
2018-2021
National Health Service
2020
Cheltenham Festivals
2000-2019
Addenbrooke's Hospital
2010
Gloucestershire Royal Hospital
2000-2009
Southmead Hospital
2009
Northern General Hospital
2003
University Hospitals Coventry and Warwickshire NHS Trust
2003
Hull Royal Infirmary
2003
The aim of this study was to evaluate the anatomical and haemodynamic effects superficial venous surgery compression on legs with chronic ulceration.Legs open or recently healed ulceration saphenous reflux were treated multilayer bandaging plus as part a clinical trial. Venous duplex imaging performed before treatment at 1 year. Legs stratified having no deep reflux, segmental total reflux. refill times (VRTs) calculated year using photoplethysmography, without narrow below-knee cuff...
<b>Objective</b> To determine whether recurrence of leg ulcers may be prevented by surgical correction superficial venous reflux in addition to compression. <b>Design</b> Randomised controlled trial. <b>Setting</b> Specialist nurse led ulcer clinics three UK vascular centres. <b>Participants</b> 500 patients (500 legs) with open or recently healed and reflux. <b>Interventions</b> Compression alone compression plus saphenous surgery. <b>Main outcome measures</b> Primary outcomes were healing...
Venous disease is the most common cause of leg ulceration. Although compression therapy improves venous ulcer healing, it does not treat underlying causes hypertension. Treatment superficial reflux has been shown to reduce rate recurrence, but effect early endovenous ablation on healing remains unclear.
Incisional herniation is a common complication of abdominal aortic aneurysm (AAA) repair. This study investigated whether prophylactic mesh placement could reduce the rate postoperative incisional hernia after open repair AAA.This randomized clinical trial was undertaken in three hospitals. Patients undergoing elective AAA were to routine mass closure or polypropylene preperitoneal plane.Eighty-five patients with mean age 73 (range 59-89) years recruited, 77 (91 per cent) whom men. There...
The aim was to assess healing in patients with mixed arterial and venous leg ulcers after protocol-driven treatment a specialist ulcer clinic.The study included consecutive referred ulceration reflux over 6 years. Legs without disease (ankle : brachial pressure index (ABPI) above 0.85) were treated multilayer compression bandaging severe (ABPI 0.5 or less) considered for immediate revascularization. Those moderate compromise up initially managed supervised modified revascularization if their...
Introduction The ESCHAR trial showed that superficial venous surgery and compression in chronic ulceration achieved a 24-week healing rate of 65% 12-month recurrence 12%. Foam sclerotherapy treatment is an alternative to surgery. aim this study assess the effect foam on ulcer leg ulcers. Methods Chronic ulcers (CEAP [clinical, aetiological, anatomical pathological elements] 5 CEAP 6) with reflux were treated between March 2006 June 2011 ultrasound-guided compression. Venous duplex was...
One-year outcomes from the Early Venous Reflux Ablation (EVRA) randomized trial showed accelerated venous leg ulcer healing and greater ulcer-free time for participants who are treated with early endovenous ablation of lower extremity superficial reflux.To evaluate clinical cost-effectiveness reflux in patients ulceration.Between October 24, 2013, September 27, 2016, EVRA enrolled 450 (450 legs) ulceration less than 6 months' duration reflux. Initially, 6555 were assessed eligibility, 6105...
Abstract Background Rupture of an unsuspected abdominal aortic aneurysm is a major cause death in men over the age 65 years. A significant reduction deaths likely to result only from higher rates detection and increased numbers elective repairs. Screening reaching years has been taking place county Gloucestershire, UK since 1990 aim this study was investigate any change mortality rate screened portion population. Methods Total number all aneurysm-related causes county's population calculated...
Screening for abdominal aortic aneurysm (AAA) has been carried out in Gloucestershire since 1990. All men the county are offered ultrasonography their 65th year. Men with an diameter of less than 26 mm considered 'normal' and no follow-up is arranged. The aim this study was to ascertain if diameters at age 65 years ever develop a clinically significant aneurysm.A cohort performed on 223 65-year-old who had aorta 1988. These repeat 1993 2000. causes death died during interval were...
The aim was to determine the optimum rescreening interval for small abdominal aortic aneurysms (AAAs).Data from 12 years of population screening 65-year-old men were analysed and 1121 AAAs (less than 4.0 cm in initial diameter) divided into groups: group 1 (2.6-2.9 cm; n = 625), 2 (3.0-3.4 330) 3 (3.5-3.9 166). Expansion rate cumulative proportions expand over 5.5 cm, or require surgery, rupture calculated.Expansion related diameter: 0.09 per year 1, 0.16 0.32 (P < 0.001). Aneurysms 2.4 cent...
Chronic venous ulcers are common, and even with effective compression or elevation large may take months to heal. Pinch skin grafting allow healing from epithelial islands throughout the surface area of ulcer, a prospective randomised trial was therefore conducted comparing this treatment porcine dermis dressings. Most patients were treated as outpatients, 25 being pinch grafts 28 dermis. Though groups well matched, mean rate in first week 15 cm2 for compared 3.5 (p less than 0.02). By life...
Colour duplex ultrasonographic imaging has largely replaced venography in the assessment of lower-limb venous disorders. This is a study use management patients with chronic ulceration community ulcer clinics. Patients leg and an ankle: brachial pressure index 0.85 or greater were studied. Assessment competence both deep superficial systems affected unaffected legs was performed using colour imaging. Reflux defined as reverse flow for than 1 s after manual calf compression. One hundred...
The organization of leg ulcer care is poorly defined in the community. This study assessed overall influence a specialized community service on management and outcome chronic ulcers, irrespective aetiology.Assessment ulcers were compared patient samples (n = 200) from East West Gloucestershire, before after introduction clinics into Gloucestershire. In clinics, vascular disease was routinely by duplex scanning determination ankle : brachial pressure index.There no coordinated structure for...
Gloucestershire's screening project shows the potential benefits of a national programme and how it could be run Every year about 6000 men die from ruptured abdominal aortic aneurysm in England Wales. 1 Although this represents only 2% all deaths men, condition is largely preventable.It also disease that seems to increasingly prevalent, at least Scotland, despite fact other atherosclerotic conditions are reducing. 2This article explores requirements for programme, using as model...
To assess the outcome after transthoracic endoscopic sympathectomy (TES) for upper limb hyperhidrosis.Prospective cohort study.District general hospital.Consecutive patients undergoing TES hyperhidrosis over a fifteen month period.One-stage bilateral TES.Change in quality of life as shown by Short Form-36 health assessment questionnaire.Sixteen (11 women and 5 men, median age 26 years) underwent operation without complications. At follow-up 6.2 months, symptomatic improvement was found 32...
Background Venous ulceration is a common and costly health-care issue worldwide, with poor healing rates greatly affecting patient quality of life. Compression bandaging has been shown to improve reduce recurrence, but does not address the underlying cause, which often superficial venous reflux. Surgical correction reflux reduces ulcer recurrence; however, effect early endovenous ablation on unclear. Objectives To determine clinical effectiveness cost-effectiveness compression therapy...