There was a high failure rate of AVF with radial artery ID of <1.5mm. In the presence of small radial arteries primary access AVF in the upper arm should be considered.

Obstructive jaundice was the presenting feature in 12 patients with benign, non-traumatic strictures of the extrahepatic bile ducts. Ages at presentation ranged from 1.5 to 60 years and 11 were initially referred with diagnoses of malignant strictures. Histological examination, however, showed benign changes of chronic inflammation, with ulceration in seven, which were distinct from those of primary sclerosing cholangitis. All of the patients remain well from 3 to 14 years after surgery. The aetiology of the strictures is not known.

This report should stimulate consideration of a targeted AAA screening programme for women aged over 65 years.

Nerve tissue protein S‐100 and neurone‐specific enolase levels in serum were studied in 10 patients before, during and for 2 days after elective carotid endarterectomy performed under general anaesthesia and using a Javid Shunt. In six patients, simultaneous cerebrospinal fluid samples were also obtained. Serum nerve tissue protein S‐100 was normal throughout the operation, but in one patient with severe hypertension, levels increased to 1.38 µg.l−1 at 1 h postoperatively. Two patients showed an increase in cerebrospinal fluid nerve tissue protein S‐100 during clamping: these patients also had neurological deficits at 6 months. Serum neurone‐specific enolase increased from 5.8 to 9.3 µg.l−1 during shunting while cerebrospinal fluid neurone‐specific enolase did not change. Uncomplicated carotid endarterectomy does not produce cerebral damage as measured by serum nerve tissue protein S‐100; cerebrospinal fluid nerve tissue protein S‐100 may be more sensitive for minor cerebral damage. Neurone‐specific enolase appeared to be nonspecific. The lack of correlation between the neuroproteins may need to be explained before relying on these simple assays as diagnostic indicators of cerebral ischaemia.

We observed a significant level of error and variation in PSV measurements across four sites within our vascular network. Variation in instrumentation-related factors may be accountable for this. In light of the centralisation of vascular services, it is increasingly important to unify and implement scanning protocols in order to reduce error and inter-site variability.