Author
Gareth Bate
Other affiliations: Heart of England NHS Foundation Trust
Bio: Gareth Bate is an academic researcher from University of Birmingham. The author has contributed to research in topics: Sclerotherapy & Varicose veins. The author has an hindex of 17, co-authored 34 publications receiving 852 citations. Previous affiliations of Gareth Bate include Heart of England NHS Foundation Trust.
Topics: Sclerotherapy, Varicose veins, Angioplasty, Bypass surgery, Amputation
Papers
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TL;DR: The BASIL-2 trial is designed to be pragmatic and represent current practice within the United Kingdom, and an economic evaluation will be conducted from the perspective of the National Health Service and comprise a ‘within-study’ analysis, based on prospectively collected trial data and a “model-based” analysis, which will extrapolate and compare costs and effects beyond the study follow-up period.
Abstract: Severe limb ischaemia is defined by ischaemic rest/night pain, tissue loss, or both, secondary to arterial insufficiency and is increasingly caused by infra-popliteal (below the knee) disease, mainly as a result of the increasing worldwide prevalence of diabetes. Currently, it is unknown whether vein bypass surgery or the best endovascular treatment (angioplasty or stenting) represents the optimal revascularisation strategy in terms of amputation-free survival, overall survival, relief of symptoms, quality of life and cost-effective use of health care resources. The Bypass vs. Angioplasty in Severe Ischaemia of the Leg - 2 Trial is a UK National Institute of Health Research, Health Technology Assessment funded, multi-centre randomised controlled trial that compares, at the point of clinical equipoise, the clinical and cost-effectiveness of a ‘vein bypass first’ and a ‘best endovascular treatment first’ revascularisation strategy for severe limb ischaemia due to infra-popliteal disease. The primary clinical outcome is amputation-free survival defined as the time to major (above the ankle) amputation of the trial limb or death from any cause. The primary outcome for the cost-effectiveness analysis is cost per quality-adjusted life year. Secondary outcomes include overall survival, quality of life, in-hospital mortality and morbidity, repeat and crossover interventions, healing of tissue loss and haemodynamic changes following revascularisation. Sample size is estimated at 600 patients. An economic evaluation will be conducted from the perspective of the National Health Service and comprise a ‘within-study’ analysis, based on prospectively collected trial data and a ‘model-based’ analysis, which will extrapolate and compare costs and effects beyond the study follow-up period. The BASIL-2 trial is designed to be pragmatic and represent current practice within the United Kingdom. Patients with severe limb ischaemia can only be randomised into the trial where clinical equipose exists. The advent of hybrid operating procedures should not be a barrier to randomisation, should a patient require inflow correction prior to tibial revascularisation. ISRCTN:27728689
Date of registration: 12 May 2014.
127 citations
TL;DR: UGFS for CEAP 2-6 SVR is associated with a low complication and retreatment rate, however, as patients are at risk of developing recurrent and new SVR they should be kept under review.
81 citations
TL;DR: Physical and mental HRQL is significantly worse in VV patients with lower limb symptoms irrespective of the clinical stage of disease, confirming that VV are not primarily a cosmetic problem and that NHS rationing of treatment to those with CEAP C4-6 disease excludes many patients who would benefit from intervention in terms of HRQL.
68 citations
TL;DR: Re-recurrence at 12 months is superior to that reported after redo GSV surgery, similar to that observed following other minimally-invasive techniques and, when it occurs, is effectively and simply treated by a single further session of UGFS.
67 citations
TL;DR: Healing rates following UGFS for CVU are comparable to those reported after surgery but recurrence may be lower and UG FS is a safe, clinically effective and, thus, highly attractive minimally invasive alternative to surgery in patients with C5 and C6 disease.
58 citations
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TL;DR: 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS) as mentioned in this paper, covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries
Abstract: 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS) : Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries
1,754 citations
TL;DR: Understanding the mechanisms of ECM remodeling and its regulation is essential for developing new therapeutic interventions for diseases and novel strategies for tissue engineering and regenerative medicine.
Abstract: The extracellular matrix (ECM) serves diverse functions and is a major component of the cellular microenvironment. The ECM is a highly dynamic structure, constantly undergoing a remodeling process where ECM components are deposited, degraded, or otherwise modified. ECM dynamics are indispensible during restructuring of tissue architecture. ECM remodeling is an important mechanism whereby cell differentiation can be regulated, including processes such as the establishment and maintenance of stem cell niches, branching morphogenesis, angiogenesis, bone remodeling, and wound repair. In contrast, abnormal ECM dynamics lead to deregulated cell proliferation and invasion, failure of cell death, and loss of cell differentiation, resulting in congenital defects and pathological processes including tissue fibrosis and cancer. Understanding the mechanisms of ECM remodeling and its regulation, therefore, is essential for developing new therapeutic interventions for diseases and novel strategies for tissue engineering and regenerative medicine.
1,686 citations
TL;DR: Jonathan L. Halperin, MD, FACC, FAHA, Chair Glenn N. Levine, MD; Sana M. Al-Khatib; and Lesley H. Curtis, PhD,FAHA are the current members of the FACC/FAHA Board of Directors.
1,487 citations
Abstract:
1,392 citations
TL;DR: The Society for Vascular Surgery and the American Venous Forum have developed clinical practice guidelines for the care of patients with varicose veins of the lower limbs and pelvis, including recommendations on the management of superficial and perforating vein incompetence in patients with associated, more advanced chronic venous diseases.
1,162 citations