Materials: A retrospective review of all patients who underwent below the knee arterial revascularization interventions between January 2012 and September 2018 was performed. Demographics such as age, sex, race and ethnicity were assessed with comorbidities including hypertension, diabetes, dyslipidemia and smoking status. Population was grouped in race and ethnicity (White, African American (AA) and Hispanic) according to patient selfidentification and limb salvage rates for each group was evaluated. All below the knee interventions were reviewed for technical success rates defined as successful creation of inline flow to the wound. Follow up duration and limb salvage rates were determined for all cases. Comparison of each race and ethnicity group in terms of technical success and clinical outcome was made using Chi Square test with SPSS software. Results: We identified 393 patients who underwent percutaneous arterial revascularization, 201 males and 192 females with mean age of 69.08 years (range 34-98). Mean follow up duration was 2.3 years (1 month to 5.8 years) Out of the total population, 365 patients (92.9%) had hypertension, 262 (66.7%) were diabetic, 246 (62.6%) had dyslipidemia and 271 (68.9%) had a less than 5-year without smoking history. Technical success rates in each group was also not statistically significant with 88.8 in AAs, 78.9% in Hispanics, and 89.7% in Whites) Limb salvage rates showed no significant difference (p-value 0.256) among the groups, AA (70.7%), Hispanic (84.2%) and White population (74.1%). Conclusions: In our study limb salvage rates in patients with critical limb ischemia undergoing below the knee interventions is not impacted by race or ethnicity in contrast to what was published in the literature. We believe existing publications claiming poorer outcomes in African American and Hispanic populations may have institutional and/or geographical biases and larger studies need to be conducted for more definitive conclusions.

Subclavian Artery Aneurysms (SCA) are extremely rare, affecting less than 1% of the population [1]. Studies show that 30-60% of these are co-existent with aorto-iliac or other peripheral aneurysms [2]. Abnormal dilation of the subclavian artery vessel can be caused most commonly (60%) by atherosclerosis, post thoracic outlet obstruction or congenital causes such as Marfan's, Turner's syndrome in addition to infective causes like tuberculosis and syphilis [1,3].

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pre-syncope and unsteadiness [1]. The posterior circulation is defined primarily by the vertebro-basilar arterial system, which arises from the subclavian arteries. Infarcts affecting the superior or Posterior Inferior Cerebellar Arteries (PICA) can cause symptoms of vertigo.Many patients with unexplained dizziness ultimately undergo an MRI scan to rule out a posterior circulation ischaemic stroke. Prior research showed that only 3.2% of patients presenting with dizziness, vertigo or imbalance were diagnosed with a stroke or Transient Ischaemic Attack (TIA) [2]. Vestibular symptoms such as vertigo can be attributed to both peripheral causes such as vestibular neuritis or central causes like brainstem/cerebellar stroke. In a study of 240 patients who presented with vertigo lasting more than a day and no other focal neurological deficits, 10% were diagnosed with cerebellar strokes but ischaemia associated with vertigo is often accompanied by other brainstem signs [3]. However, only 17% of patients with confirmed PICA strokes had symptoms of vestibular neuritis [3]. Manoeuvres such as Dix-Hallpike can help distinguish between peripheral or central aetiology since none of the patients who had symptoms of vestibular neuritis due to ischaemic stroke had a positive head thrust [4]. Nevertheless, it has been argued that MRI plays an important role in differentiating between peripheral and central aetiology when clinical diagnosis fails [5].CT scan has been proven to have poor sensitivity in diagnosing posterior Fossa strokes in patients with dizziness and vertigo as it provides suboptimal visualisation of structures secondary to artefact produced by bony structures of the cranial base and therefore early ischaemic events are missed [5,6]. Accordingly, diffusion weighted MRI scans is more commonly used, but even this modality misses up to 20% posterior Fossa infarcts in the first 24-48 hours of presentation [1]. The yield of MRI for stroke in this cohort of patients was only 21%, with a diagnostic impact on management for 22% of these patients [5]. This unreliability of MRI scan is reinforced by a study which showed that diffusion weighted imaging was falsely negative in 12 of patients with acute vestibular symptoms and posterior Fossa strokes [7]. MethodA total of 603 MRI scans were performed for patients presenting with vertigo and dizziness with suspicion of cerebellar or brainstem infarcts during the one year period analysed at Royal Derby Hospital. Prior research showed that there is a low yield of posterior circulation infarcts diagnosed on MRI in this cohort of patients with dizziness [1,5].Data was accumulated for those 603 patients with MRI scans through screening of patients who underwent MRI scan in the last year and key words on the request or report cards included 'cerebellar infarct' , 'cerebellar stroke' , 'brainstem stroke' , 'vertigo' , 'dizziness' , 'ataxia' or 'unsteadiness' . Methods: 588 patients under went MRI within a one-year period. Data was ascertained through requests and results on ICM compute...

Materials: A retrospective review of all patients who underwent below the knee arterial revascularization interventions between January 2012 and September 2018 was performed. Demographics such as age, sex, race and ethnicity were assessed with comorbidities including hypertension, diabetes, dyslipidemia and smoking status. Population was grouped in race and ethnicity (White, African American (AA) and Hispanic) according to patient selfidentification and limb salvage rates for each group was evaluated. All below the knee interventions were reviewed for technical success rates defined as successful creation of inline flow to the wound. Follow up duration and limb salvage rates were determined for all cases. Comparison of each race and ethnicity group in terms of technical success and clinical outcome was made using Chi Square test with SPSS software. Results: We identified 393 patients who underwent percutaneous arterial revascularization, 201 males and 192 females with mean age of 69.08 years (range 34-98). Mean follow up duration was 2.3 years (1 month to 5.8 years) Out of the total population, 365 patients (92.9%) had hypertension, 262 (66.7%) were diabetic, 246 (62.6%) had dyslipidemia and 271 (68.9%) had a less than 5-year without smoking history. Technical success rates in each group was also not statistically significant with 88.8 in AAs, 78.9% in Hispanics, and 89.7% in Whites) Limb salvage rates showed no significant difference (p-value 0.256) among the groups, AA (70.7%), Hispanic (84.2%) and White population (74.1%). Conclusions: In our study limb salvage rates in patients with critical limb ischemia undergoing below the knee interventions is not impacted by race or ethnicity in contrast to what was published in the literature. We believe existing publications claiming poorer outcomes in African American and Hispanic populations may have institutional and/or geographical biases and larger studies need to be conducted for more definitive conclusions.