Comparative Performance of Clinician and Computational Approaches in Forecasting Adverse Outcomes in Intermittent Claudication.

Background: Recent evidence has shown that machine learning (ML) techniques can accurately forecast adverse cardiovascular and limb events in patients with intermittent claudication. This is the first study to compare the predictive performance of ML versus traditional logistic regression (LR) and clinicians.

Methods: An anonymized dataset of 99 patients with 27 baseline characteristics, compliance with best medical therapy/smoking cessation was used for comparison.

Approaches to improve 12-month circuit primary patency and target lesion primary patency in arteriovenous fistulae: An umbrella review of systematic reviews and meta-analyses.

Background: Clinical practice guidelines endorse arteriovenous fistulae (AVF) as the preferred form of vascular access. Despite recent advancements, concerns persist regarding variable AVF patency rates. This umbrella review aimed to evaluate and synthesize evidence on interventions and strategies associated with improved 12-month patency rates in AVF.

Endovascular rectal artery embolisation (RAE) for symptomatic haemorrhoids.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the safety and clinical effectiveness of endovascular rectal artery embolisation (RAE) for symptomatic haemorrhoids.

Exploring UK clinician perceptions of through-knee amputation compared to above-knee amputation: a mixed methods study.

Background: Through-knee amputation (TKA) has potential advantages over above-knee amputation (AKA) but is rarely performed in the United Kingdom (UK). This mixed methods study aimed to explore clinicians' perceptions of TKA compared to AKA.

Method: An online survey of vascular surgeons, prosthetists, and physiotherapists between May 2019 and April 2020.

The Association Between Completion of Supervised Exercise Therapy and Long-Term Outcomes in Patients with Intermittent Claudication, Concomitant Sarcopenia, and Cardiometabolic Multimorbidity.

Introduction: The combination of intermittent claudication (IC), cardiometabolic multimorbidity (CMM), and sarcopenia is associated with worse outcomes than IC alone. This study aimed to identify whether the completion of supervised exercise therapy (SET) attenuates these adverse outcomes in patients with combined IC, sarcopenia, and CMM.

Methods: This registry review included consecutive IC patients with concomitant CMM and sarcopenia, who were referred for SET from 2014 to 2017.

Barriers and facilitators to vascular access point-of-care ultrasound in haemodialysis: An international survey of haemodialysis clinicians.

Background: Utilising point-of-care ultrasound for assessment and cannulation of vascular access in people receiving haemodialysis has shown positive clinical results. Nonetheless, there is variation in how renal health care professionals worldwide embrace this method, and there's a lack of research on the factors that promote or hinder its adoption.

Objectives: To explore regional differences, and barriers and facilitators, to the use of point-of-care ultrasound for assessment and cannulation of vascular access in haemodialysis.

Doppler ultrasound surveillance of recently formed haemodialysis arteriovenous fistula: the SONAR observational cohort study.

Background: Arteriovenous fistulas are considered the best option for haemodialysis provision, but as many as 30% fail to mature or suffer early failure.

Objective: To assess the feasibility of performing a randomised controlled trial that examines whether, by informing early and effective salvage intervention of fistulas that would otherwise fail, Doppler ultrasound surveillance of developing arteriovenous fistulas improves longer-term arteriovenous fistula patency.

Design: A prospective multicentre observational cohort study (the 'SONAR' study).

Tailored risk assessment and forecasting in intermittent claudication.

Background: Guidelines recommend cardiovascular risk reduction and supervised exercise therapy as the first line of treatment in intermittent claudication, but implementation challenges and poor patient compliance lead to significant variation in management and therefore outcomes. The development of a precise risk stratification tool is proposed through a machine-learning algorithm that aims to provide personalized outcome predictions for different management strategies.

Methods: Feature selection was performed using the least absolute shrinkage and selection operator method.

Supervised Exercise Therapy for Intermittent Claudication: A Propensity Score Matched Analysis of Retrospective Data on Long Term Cardiovascular Outcomes.

Objective: This study aimed to explore the long term outcomes of patients with intermittent claudication (IC) who completed supervised exercise therapy (SET) vs. those who declined or prematurely discontinued SET, focusing on the incidence of chronic limb threatening ischaemia (CLTI), revascularisation, major adverse limb events (MALE), and major adverse cardiovascular events (MACE).

Methods: A retrospective registry analysis of consecutive patients with IC who were referred for SET between March 2015 and August 2016 and followed up for a minimum of five years.

A preoperative supervised exercise program potentially improves long-term survival after elective abdominal aortic aneurysm repair.

Objective: A preoperative supervised exercise program (SEP) improves cardiorespiratory fitness and perioperative outcomes for patients undergoing elective abdominal aortic aneurysm (AAA) repair. The aim of this study was to assess the effect of a preoperative SEP on long-term survival of these patients. A secondary aim was to consider long-term changes in cardiorespiratory fitness and quality of life.

Endovenous ablation for venous leg ulcers.

Background: Venous leg ulcers (VLUs) are a serious manifestation of chronic venous disease affecting up to 3% of the adult population. This typically recalcitrant and recurring condition significantly impairs quality of life, and its treatment places a heavy financial burden upon healthcare systems. The longstanding mainstay treatment for VLUs is compression therapy.

Extracorporeal shockwave therapy for diabetic foot ulcers: a feasibility study.

Objective: The purpose of this study was to assess the feasibility of delivering extracorporeal shockwave therapy (ESWT) to patients with diabetic foot ulcers (DFUs). It also aimed to explore any potential clinical effect of ESWT on wound healing and investigate whether ESWT offers any patient-reported benefits.

Method: In this single-centre, mixed methods feasibility study, patients with a DFU who met the eligibility criteria underwent ESWT three times over a seven-day period.

Long term outcomes of 'Christmas Tree' banding for haemodialysis access induced distal ischemia: A 13-year experience.

Background: The reduction in distal arterial flow following arteriovenous fistula (AVF) creation can cause a perfusion deficit known as haemodialysis access induced distal ischemia (HAIDI). Various techniques have been advocated to treat this difficult problem with varying success. We present the long-term outcomes following a novel banding technique.

Extracorporeal shockwave therapy compared with standard care for diabetic foot ulcer healing: An updated systematic review.

Emerging evidence suggests that extracorporeal shockwave therapy (ESWT) may improve time to DFU healing. The aim of this review was to appraise the evidence on role of ESWT in DFU healing and impact of different ESWT doses. Databases were searched for trials comparing ESWT plus standard care to standard care alone in participants with DFUs.

Provision of NICE-recommended varicose vein treatment in the NHS.

Background: Standardization of access to treatment and compliance with clinical guidelines are important to ensure the delivery of high-quality care to people with varicose veins. In the National Health Service (NHS) in England, commissioning of care for people with varicose veins is performed by Clinical Commissioning Groups (CCGs) and clinical guidelines have been developed by the National Institute for Health and Care Excellence (NICE CG168). The Evidence-Based Intervention (EBI) programme was introduced in the NHS with the aim of improving care quality and supporting implementation of NICE CG168.

The local physiological effects of a single-use topical negative pressure device in healthy volunteers: the PICO-1 study.

Objective: This study aimed to investigate the effects of a single-use negative pressure wound therapy (sNPWT) device on tissue perfusion, oxygenation and pressure in the intact skin of healthy volunteers.

Method: Healthy volunteers wore a PICO sNPWT device (Smith+Nephew, UK) on their right medial calf for one week. Perfusion, tissue oxygenation and tissue pressure were recorded in superficial and deep tissues over a period of seven days.

Wound complications following surgery to the lymph nodes: A protocol for a systematic review and meta-analysis.

Background: Malignancies that spread to the lymph nodes may be identified through surgical biopsy, and treatment of metastatic disease may be through lymph node dissection. These surgeries, however, may be associated with significant adverse outcomes, particularly wound complications, the true incidence of which remains unknown. Multiple studies have reported their individual rates of complications in isolation.

The Edinburgh Claudication Questionnaire has poor diagnostic accuracy in people with intermittent claudication.

Background: The screening and diagnosis of intermittent claudication is a challenging process and often relies on the expertise of specialist vascular clinicians. We sought to investigate the diagnostic performance of the Edinburgh Claudication Questionnaire (ECQ) as a screening tool for referrals of suspected intermittent claudication from primary to secondary care.

Method: Prospectively, 100 referrals from primary care with a stated diagnosis or query regarding intermittent claudication were recruited.

Through-knee versus above-knee amputation for vascular and non-vascular major lower limb amputations.

Background: Diabetes and vascular disease are the leading causes of lower limb amputation. Currently, 463 million adults are living with diabetes, and 202 million with peripheral vascular disease, worldwide. When a lower limb amputation is considered, preservation of the knee in a below-knee amputation allows for superior functional recovery when compared with amputation at a higher level.

The impact of surgical site infection on hospitalisation, treatment costs, and health-related quality of life after vascular surgery.

Surgical site infections (SSI) substantially increase costs for healthcare providers because of additional treatments and extended patient recovery. The objective of this study was to assess the cost and health-related quality of life impact of SSI, from the perspective of a large teaching hospital in England. Data were available for 144 participants undergoing clean or clean-contaminated vascular surgery.

Considering the Feasibility, Tolerability, and Safety of High-Intensity Interval Training as a Novel Treatment for Patients With Intermittent Claudication.

Purpose: This study assessed the feasibility, tolerability, safety, and potential efficacy of a novel, 6-wk, high-intensity interval training (HIIT) program for patients with intermittent claudication (IC).

Methods: Patients referred to a usual-care supervised exercise program were invited to undertake a HIIT program. All recruited patients performed a baseline cardiopulmonary exercise test (CPX) to inform their exercise prescription.

Presurgery exercise-based conditioning interventions (prehabilitation) in adults undergoing lower limb surgery for peripheral arterial disease.

Background: Lower limb peripheral arterial disease (PAD) is a type of cardiovascular disease where the blood vessels that carry the blood to the legs are hardened and narrowed. The most severe manifestation of PAD is critical limb ischaemia (CLI). This condition results in symptoms of intractable rest pain, non-healing wounds and ulceration, gangrene or both.

A systematic review of high-intensity interval training as an exercise intervention for intermittent claudication.

Background: Intermittent claudication (IC) is the most common symptom of peripheral arterial disease, which significantly affects walking ability, functional capacity and quality of life. Supervised exercise programs (SEP) are recommended as first-line treatment, but recruitment and adherence rates are poor. The time required to complete a SEP is the most common barrier to participation cited by patients who decline.

A pilot feasibility randomised clinical trial comparing dialkylcarbamoylchloride-coated dressings versus standard care for the primary prevention of surgical site infection.

A surgical site infection (SSI) may occur in up to 30% of procedures and results in significant morbidity and mortality. We aimed to assess the feasibility of conducting a randomised controlled trial (RCT) examining the use of dialkylcarbamoylchloride (DACC)-impregnated dressings, which bind bacteria at the wound bed, in the prevention of SSI in primarily closed incisional wounds. This pilot RCT recruited patients undergoing clean or clean-contaminated vascular surgery.