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England and Wales. Conclusion: This audit demonstrated that IR at St. Mary's Hospital performed better than the rest of England and Wales in the management of blunt splenic trauma. A higher proportion of splenic injuries were managed by IR at St. Mary's Hospital compared with the rest of England and Wales. Mortality rates and length of stay for IR were lower at St. Mary's hospital compared to the rest of England and Wales.

Background: Single donor apheresis platelets are superior in quality, but their usage is limited in a developing country due to cost and time constraints. Hence the product obtained must exceed in terms of yield, donor safety and technical convenience. Previous literature available on cell separators is on older versions. Aims: Prospective comparison of 5 latest cell separators (AmiCORE, COM. TEC, Haemonetics MCS+, SpectraOptia and TrimaAccel) for product yield, performance variables and donor adverse effects. Material & Methods: From October 2019-March 2020, 1108 donors were randomly allotted to a cell separator. Post-donation sample was taken from the donor 15-20 minutes after procedure completion. The platelet yield from the product collected was measured twice (day 0 and day 1). Donor demography, pre-and post-procedural donor peripheral blood values, performance and product variables were statistically analyzed. Results: AmiCORE had an optimal collection efficacy (44.6%) and collection rate (0.037 x 1011/minute). Haemonetics MCS+ had a better collection efficacy (48.4%) and rate (0.038 x 1011/minute). Spectra Optia achieved least procedural time (59.5 minutes), donor adverse effects (6.3%); highest collection efficacy (52.8%) and rate (0.056 x 1011/minute). Trima Accel achieved highest collection rate (0.056 x 1011/minute) and the least product volume (228 ml). Conclusion: Highest collection efficacy was achieved by Trima Accel, highest collection rate by Trima Accel and Spectra Optia, lowest donor adverse effects by Spectra Optia and least number of procedural troubleshooting by COM. TEC. Apart from this, fiscal factors and service availability also need to be considered before choosing a cell separator.

Stage IVB thyroid cancer includes carotid encasement or infiltration of the prevertebral fascia and mediastinal vessels. Stage IVB disease is considered unresectable due to grave consequences of attempting resection. We report a rare case of carotid artery engulfment being resected uneventfully without carotid resection.Keywords Anaplastic thyroid cancer . Carotid artery encasement . Resection . Total thyroidectomy . Prevertebral fascia . Mediastinal vessels A 65-year-old lady presented with large nontoxic multinodular goitre (MNG) since 10 years and respiratory distress for 1 month. Computerised tomography showed a large heterogenous mass and lymphadenopathy encasing the left common carotid artery (CCA) and trachea with extension up to the arch of aorta (Fig. 1). Doppler ultrasound showed normal blood flow at the site of carotid encasement. Through neck approach and sternotomy, total thyroidectomy with left modified radical neck dissection and mediastinal dissection was done. The carotid artery could be freed completely from the tumour and left lymph nodal mass, though it breached the carotid sheath (Fig. 2). Surgery was uneventful and histopathology was papillary thyroid cancer with anaplastic dedifferentiation and 22/44 lymph nodes positive for metastasis. Final diagnosis was T4bN1bM0-stage IVB.Stage IVB includes a differentiated thyroid cancer (DTC) with either encasement of the carotid artery or infiltration of the prevertebral fascia and mediastinal vessels [1]. In our case, the tumour along with jugular lymph nodal mass had encased the common carotid artery on the left side, though usually structures like the carotid sheath and oesophagus are less vulnerable to invasion. In this case, a long-standing DTC upstaged to anaplastic cancer at the site of invasion might have led to carotid sheath invasion. Traditionally, IVB disease is considered unresectable, though few case reports of aggressive resection with or without neurological sequelae have been reported in past [2]. Though IVB disease is unresectable, careful and meticulous planning

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