Diabetic ulcers always require vascular evaluation, and when ischaemia is suspected the diagnostics should be organised rapidly to ensure revascularisation without delay, according to this study within 2 weeks from the first evaluation.

Objective: To evaluate treatment outcomes of in situ abdominal aortic reconstruction with cryopreserved arterial allograft (CAA) for patients with abdominal aortic infection.Materials and methods: A retrospective review of prospectively collected data was conducted of patients who underwent in situ aortic reconstruction using CAA for primary, secondary, or prosthetic infection of the abdominal aorta between May 2006 and July 2015, at a single institution. Clinical presentation, indications for treatment, procedural details, early post-operative mortality and morbidity, late death, and graft related complications during the follow up period were investigated. Patient survival and event free survival (any death or re-operation) were calculated using the Kaplan-Meier method.Results: Twenty-five patients (male, n = 20, 80%; mean age, 70.2 6 8.7 years) underwent in situ abdominal aortic reconstruction (48% aortic, 52% aorto-bi-iliac) with vessel size and ABO matched CAA for treatment of abdominal aortic infection caused by infected abdominal aortic aneurysm (n = 15), aortic prosthesis infection (n = 7), aortic reconstruction with concomitant colon resection (n = 2), and primary suppurative aortitis (n = 1). The median follow up was 19.1 months (range 1-73 months). There were seven post-operative deaths including two (8%) early (<30 days) and five (20%) late deaths There were three (12%) graft related complications including thrombotic occlusion of the CAA, aneurysmal dilatation, and aorto-enteric fistula. Three years after CAA implantation, patient survival was 74% and the event free survival was 58%.Conclusions: It is believed that in situ abdominal aortic reconstruction with CAA is a useful option for treating primary, secondary, or prosthetic infection of the abdominal aorta.

This study demonstrates how it is possible to shorten the delay to carotid endarterectomy among patients with symptomatic carotid stenosis with quite simple changes made in the surgical and the neurological unit. However, affecting only the in-hospital delay, optimal results are still not achieved, as our study corroborates. At the same time, our study points out the areas where we could and should still focus more carefully in order to minimise the delay and maximise the expected benefit in stroke prevention.

The occlusion rate for MOCA at three years after GSV ablation is lower (82%) than for EVLA or RFA (both 100%). Veins with diameters of over 7 mm recanalized more often than those with smaller diameter.Take home Message: Though MOCA has some advantages over thermal ablation, the occlusion rate remains inferior at mid-term follow-up.

Background: A variety of minimally invasive techniques are available for the treatment of varicose great saphenous vein (GSVs). Non-tumescent, non-thermal ablation methods have been developed. This study compared mechanochemical ablation (MOCA), a non-tumescent, non-thermal ablation technique, with two endovenous thermal ablation methods requiring tumescence in an RCT.Methods: Patients with GSV reflux were randomized to undergo MOCA, or thermal ablation with endovenous laser (EVLA) or radiofrequency (RFA). The primary outcome measure was the occlusion rate of the GSV at 1 year. Results: The study finally included 125 patients, of whom 117 (93⋅6 per cent) attended 1-year follow-up. At 1 year, the treated part of the GSV was fully occluded in all patients in the EVLA and RFA groups, and in 45 of 55 in the MOCA group (occlusion rates 100, 100 and 82 per cent respectively; P = 0⋅002). The preoperative GSV diameter was associated with the recanalization rate of the proximal GSV in the MOCA group. At 1 year after treatment, disease-specific life quality was similar in the three groups. Conclusion: The GSV occlusion rate 1 year after treatment was significantly higher after EVLA and RFA than after MOCA. Quality of life was similar between interventions. Registration number: NCT03722134 (http://www.clinicaltrials.gov). Assessed for eligibility n = 4027 Randomized n = 132 Excluded n = 3895 Did not meet inclusion criteria n = 3850 Declined to participate n = 45 Allocated to RFA n = 33 Received allocated intervention n = 32 Did not receive allocated intervention n = 1 Declined to participate n = 1 Allocated to MOCA n = 65 Received allocated intervention n = 58 Did not receive allocated intervention n = 7 Received EVLA n = 1* Declined to participate n = 3 Exclusion criteria identified n = 3 Allocated to EVLA n = 34 Received allocated intervention n = 34 Lost to follow-up n = 1 Analysed n = 33 Analysed n = 29 Analysed n = 55 Lost to follow-up n = 3 Lost to follow-up n = 4 Enrolment Allocation Follow-up Analysis *Patient crossed over to endovenous laser ablation (EVLA) but analysed in mechanochemical ablation (MOCA) group. RFA, radiofrequency ablation.