In individuals considered fit for conventional surgery, EVAR was associated with lower short-term mortality than OSR. However, this benefit from EVAR did not persist at the intermediate- and long-term follow ups. Individuals undergoing EVAR had a higher reintervention rate than those undergoing OSR. Most of the reinterventions undertaken following EVAR, however, were catheter-based interventions associated with low mortality. Operative complications, health-related quality of life and sexual dysfunction were generally comparable between EVAR and OSR. However, there was a slightly higher incidence of pulmonary complications in the OSR group than in the EVAR group.In individuals considered unfit for open surgery, the results of a single trial found no overall short- or long-term benefits of EVAR over no intervention with regard to all-cause mortality, but individuals may differ and individual preferences should always be taken into account.

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BackgroundHeadache is an extremely common presentation to primary care, with some patients requiring referral to general neurology or specialist headache services.AimsHere we describe the cohort of patients who are referred to secondary care for management of headaches.MethodsNeurology outpatient clinics at Brighton and Sussex University Hospitals NHS during June 2019 were retrospectively analysed using electronic records.ResultsOf the 538 patients seen, 123 (23.4%) presented with headache. 48 patients were new referrals and 75 were follow up. 38% of new patients required a follow up appointment.26 patients (21%) had 2 simultaneous headache disorders. 77 patients (63%) presented with migraine while cervicogenic (n=9), cluster (n=8) and idiopathic intracranial hypertension (n=6) were the next most prevalent.22 patients with migraine were initiated on a preventative medication while 7 had a dose adjustment. 11 were prescribed an abortive treatment. 1 patient was prescribed simple analgesia. 10 patients received greater occipital nerve block while 6 received Erenumab. For 9 patients, their headache had resolved by the time they attended clinic.ConclusionAs new treatments such as monoclonal antibodies become available for migraine, ongoing discussion will be vital to ensure headache services can adapt and deliver these therapies effectively.j.scott3@uni.bsms.ac.uk|ABN Bursary

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