Showing papers by "Donald J. Adam published in 2009"
TL;DR: Patients with VV, and particularly CVU, have significantly higher prevalences of single and multiple thrombophilias than age- and sex-matched controls without clinical or duplex evidence of lower limb venous disease, and this data support the hypothesis that thROMbophilia predisposes to the development of superficial and deep lower limb Venous reflux.
58 citations
TL;DR: Increased stiffness observed in subjects with peripheral vascular disease is a result of change in both quantity and quality of the arterial wall, suggesting that indices of arterial stiffness are a sensitive early marker of atherosclerosis.
57 citations
TL;DR: Surgical mesenteric reconstruction is associated with significantly longer hospital stay, but superior long-term outcome compared to endovascular reconstruction, and at 2 years, SR demonstrated superior secondary patency and clinical patency.
Abstract: Objective: To assess the outcome of surgical (SR) and endovascular (ER) reconstruction for chronic mesenteric ischemia (CMI). Methods: Retrospective review of consecutive patients who underwent SR or ER for CMI in 3 UK vascular surgery units between 1996 and 2006. Early ( 30 days) outcomes (symptom recurrence, vessel/graft patency, reintervention, mortality) were assessed. Results: A total of 27 patients underwent 32 reconstructions (SR = 17, ER = 15). A total of 44 of 56 (79%) diseased arteries underwent SR (n = 26; bypass = 24, reimplantation = 2; occlusion = 16, stenosis = 10) or ER (n = 18; stenosis = 16, occlusion = 2). Perioperative mortality for SR and ER was 6% and 0%, respectively (P ≥ .99). Hospital stay was shorter following ER (mean, 4.3 vs. 14.2 days, P = .0003). Mean (range) follow-up for SR and ER was 34 (1-94) and 34 (0-135) months, respectively. At 2 years, SR demonstrated superior secondary patency (100...
45 citations
TL;DR: Following UGFS as an adjunct to compression, 96% of CVU healed within 3 months and only 2 healed ulcers had recurred at 12 months, which appears to be an attractive minimally-invasive alternative to surgery to treat SVR in patients with CVU, especially the elderly and frail.
39 citations
TL;DR: The aim was to review the medium‐term outcomes of ultrasound‐guided foam sclerotherapy for SSV and the role of minimally invasive alternatives remains incompletely defined.
Abstract: Background: The results of surgery for small saphenous varicose vein (SSV) varicosities may be suboptimal in terms of recurrence and complications. The role of minimally invasive alternatives remains incompletely defined. The aim was to review the medium-term outcomes of ultrasound-guided foam sclerotherapy (UGFS) for SSV. Methods: Eighty-six patients (92 legs) undergoing UGFS for SSV were assessed before, and 1, 6 and 12 months after treatment. Outcome measures were occlusion of, and abolition of reflux in, the SSV (technical success), absence of visible varicose veins (clinical success) and improvement in disease-specific health-related quality of life (HRQL) following treatment (Aberdeen Varicose Vein Symptom Severity Score (AVSS)). Results: The technical and clinical success rates at 12 months were 91 and 93 per cent respectively; only three patients required a second treatment. After treatment of isolated SSV varicosities there was a significant improvement in AVSS, from a median of 19·0 (interquartile range 13·4‐26·8) before treatment to 10· 2( 4·0‐18·3) and 9· 7( 3·5‐19·1) at 6 and 12 months respectively. The only complication was a popliteal vein thrombosis that required anticoagulation. Conclusion: UGFS was an effective treatment for SSV, with abolition of reflux and visible varicose veins, and improvement in HRQL for at least 12 months.
36 citations
TL;DR: The aim was to compare morbidity, analgesia use, and time to return to driving and work following UGFS with those reported after conventional surgery for varicose veins.
Abstract: Background:
The advantages of minimally invasive alternatives such as ultrasound-guided foam sclerotherapy (UGFS) over conventional surgery for the treatment of varicose veins include lower morbidity and faster recovery times. The aim was to compare morbidity, analgesia use, and time to return to driving and work following UGFS with those reported after conventional surgery for varicose veins.
Methods:
Patients who had UGFS or surgery for varicose veins were sent a questionnaire 4 weeks after treatment.
Results:
A total of 332 (84·9 per cent) of 391 patients who had UGFS and 53 (56 per cent) of 94 who had surgery returned a questionnaire. The groups were similar in terms of age, sex, and the proportion who had treatment of bilateral or recurrent veins. Patients who had surgery were more likely to have significant bruising (44 versus 7·2 per cent; P < 0·001) and pain (17 versus 5·5 per cent; P = 0·001). After UGFS, 43·2 per cent of patients returned to work within 24 h compared with none who had surgery (P < 0·001). Patients who had UGFS were more likely to return to driving within 4 days (P = 0·014).
Conclusion:
UGFS was associated with less pain and analgesia requirement, time off work and quicker return to driving. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
36 citations
TL;DR: Examination of patients' expectations before and satisfaction after UGFS for VV in terms of relief of lower limb symptoms, improvement in appearance, and beneficial effect on life-style indicates that UG FS is usually able to meet, and often exceeds, these physical and psychosocial needs and expectations.
20 citations
TL;DR: This work describes a successful hybrid open endovascular repair of a large tender para-anastomotic common iliac artery aneurysm arising after previous open abdominal aortic aneurYSm repair in a high-risk patient with bilateral chronic total external iliAC artery occlusions.
6 citations
TL;DR: Nous decrivons le traitement hybride chirurgical et endovasculaire d'un gros anevrysme iliaque commun peri-anastomotique dans les suites d'une cure chir surgicale conventionnelle precedente d' un anevryme de l'aorte abdominale chez un patient.
Abstract: Nous decrivons le traitement hybride chirurgical et endovasculaire d'un gros anevrysme iliaque commun peri-anastomotique dans les suites d'une cure chirurgicale conventionnelle precedente d'un anevrysme de l'aorte abdominale chez un patient a haut risque presentant des occlusions des arteres iliaques externes chroniques bilaterales.