Sheffield, United Kingdom
Sheffield, United Kingdom

Time filter

Source Type

Doig D.,University College London | Turner E.L.,Duke University | Dobson J.,London School of Hygiene and Tropical Medicine | Featherstone R.L.,University College London | And 7 more authors.
European Journal of Vascular and Endovascular Surgery | Year: 2016

Objectives Stroke, myocardial infarction (MI), and death are complications of carotid artery stenting (CAS). The effect of baseline patient demographic factors, processes of care, and technical factors during CAS on the risk of stroke, MI, or death within 30 days of CAS in the International Carotid Stenting Study (ICSS) were investigated. Methods In ICSS, suitable patients with recently symptomatic carotid stenosis > 50% were randomly allocated to CAS or endarterectomy. Factors influencing the risk of stroke, MI, or death within 30 days of CAS were examined in a regression model for the 828 patients randomized to CAS in whom the procedure was initiated. Results Of the patients, 7.4% suffered stroke, MI, or death within 30 days of CAS. Independent predictors of risk were age (risk ratio [RR] 1.17 per 5 years of age, 95% CI 1.01-1.37), a right-sided procedure (RR 0.54, 95% CI 0.32-0.91), aspirin and clopidogrel in combination prior to CAS (compared with any other antiplatelet regimen, RR 0.59, 95% CI 0.36-0.98), smoking status, and the severity of index event. In patients in whom a stent was deployed, use of an open-cell stent conferred higher risk than use of a closed-cell stent (RR 1.92, 95% CI 1.11-3.33). Cerebral protection device (CPD) use did not modify the risk. Conclusions Selection of patients for CAS should take into account symptoms, age, and side of the procedure. The results favour the use of closed-cell stents. CPDs in ICSS did not protect against stroke. © 2015 The Authors.


Chellamuthu S.,Sheffield Teaching Hospitals NHS Trust | Bottomley J.R.,Sheffield Vascular Institute
Respiratory Medicine Case Reports | Year: 2012

Pulmonary artery pseudoaneurysms (PAP) may result in life threatening haemoptysis but are fortunately uncommon. Most are caused by trauma, iatrogenic injury or infection. We describe a case of large PAP secondary to fungal infection in an immunocompromised patient, which was successfully treated percutaneously using Amplatzer embolisation plugs. The technical considerations and advantages of these new devices are explained. © 2011 Elsevier Ltd.


PubMed | University Utrecht, Sheffield Vascular Institute, University of Basel, Duke University and 4 more.
Type: Journal Article | Journal: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery | Year: 2016

Stroke, myocardial infarction (MI), and death are complications of carotid artery stenting (CAS). The effect of baseline patient demographic factors, processes of care, and technical factors during CAS on the risk of stroke, MI, or death within 30 days of CAS in the International Carotid Stenting Study (ICSS) were investigated.In ICSS, suitable patients with recently symptomatic carotid stenosis > 50% were randomly allocated to CAS or endarterectomy. Factors influencing the risk of stroke, MI, or death within 30 days of CAS were examined in a regression model for the 828 patients randomized to CAS in whom the procedure was initiated.Of the patients, 7.4% suffered stroke, MI, or death within 30 days of CAS. Independent predictors of risk were age (risk ratio [RR] 1.17 per 5 years of age, 95% CI 1.01-1.37), a right-sided procedure (RR 0.54, 95% CI 0.32-0.91), aspirin and clopidogrel in combination prior to CAS (compared with any other antiplatelet regimen, RR 0.59, 95% CI 0.36-0.98), smoking status, and the severity of index event. In patients in whom a stent was deployed, use of an open-cell stent conferred higher risk than use of a closed-cell stent (RR 1.92, 95% CI 1.11-3.33). Cerebral protection device (CPD) use did not modify the risk.Selection of patients for CAS should take into account symptoms, age, and side of the procedure. The results favour the use of closed-cell stents. CPDs in ICSS did not protect against stroke.


Berczi V.,Sheffield Vascular Institute | Berczi V.,Semmelweis University | Bottomley J.R.,Sheffield Vascular Institute | Gopalan D.,Sheffield Vascular Institute | And 3 more authors.
Journal of Vascular Surgery | Year: 2014

Absent common carotid artery with independent origin of internal and external carotid arteries from the subclavian artery is a rare but recognized phenomenon. We describe one such case with an associated symptomatic proximal high-grade stenosis of the right internal carotid artery. The abnormal carotid anatomy was not initially well appreciated, resulting in a failed surgical exploration and subsequent successful endovascular carotid stenting. To our knowledge, this is the first reported case of carotid stent in a right internal carotid artery originating from the subclavian artery. Copyright © 2014 by the Society for Vascular Surgery.


Palfreyman S.,Sheffield Vascular Institute
Nursing older people | Year: 2011

Patient-reported outcome measures (PROMs) are increasingly being used in the NHS to inform clinical treatments and even the funding of individual healthcare providers. This article examines the background to their increasing use. It aims to provide nurses with information and advice about resources to increase their knowledge of PROMs. It outlines the importance of patient-centred outcomes, describes the different types of PROMs and their use in clinical practice.


Haldipur N.,Sheffield Vascular Institute | Devaraj S.,Sheffield Vascular Institute | Shehata A.,Sheffield Vascular Institute | Lewis A.K.,Sheffield Vascular Institute | And 4 more authors.
Annals of the Royal College of Surgeons of England | Year: 2011

Introduction: In the North Trent Cancer Network (NTCN) patients requiring retroperitoneal lymphadenectomy for metastatic testicular cancer have been treated by vascular service since 1990. This paper reviews our experience and considers the case for involvement of vascular surgeons in the management of these tumours. Patients and Methods: Patients referred by the NTCN to the vascular service for retroperitoneal lymphadenectomy between 1990 and 2009 were identified through a germ cell database. Data were supplemented by a review of case notes to record histology, intraoperative and postoperative details. Results: A total of 64 patients were referred to the vascular service for retroperitoneal lymph node dissection, with a median age of 29 years (16-63 years) and a median follow-up of 4.9 years. Ten patients died: eight from tumour recurrence, one from septicaemia during chemotherapy and one by suicide. Of the 54 who survived, 7 were alive with residual masses and 47 patients were disease-free at the last follow-up. Sixteen patients required vascular procedures: four had aortic repair (fascia), three had aortic replacement (spiral graft), four had inferior vena cava resection, two had iliac artery replacement and two had iliac vein resection. Conclusions: Retroperitoneal lymph node dissection often involves mobilisation and/or the resection/replacement of major vessels. We recommend that a vascular surgeon should be a part of testicular germ cell multidisciplinary team.


PubMed | Sheffield Vascular Institute
Type: Journal Article | Journal: Annals of the Royal College of Surgeons of England | Year: 2011

In the North Trent Cancer network (NTCN) patients requiring retroperitoneal lymphadenectomy for metastatic testicular cancer have been treated by vascular service since 1990. This paper reviews our experience and considers the case for involvement of vascular surgeons in the management of these tumours.Patients referred by the NTCN to the vascular service for retroperitoneal lymphadenectomy between 1990 and 2009 were identified through a germ cell database. Data were supplemented by a review of case notes to record histology, intraoperative and postoperative details.A total of 64 patients were referred to the vascular service for retroperitoneal lymph node dissection, with a median age of 29 years (16-63 years) and a median follow-up of 4.9 years. Ten patients died: eight from tumour recurrence, one from septicaemia during chemotherapy and one by suicide. Of the 54 who survived, 7 were alive with residual masses and 47 patients were disease-free at the last follow-up. Sixteen patients required vascular procedures: four had aortic repair (fascia), three had aortic replacement (spiral graft), four had inferior vena cava resection, two had iliac artery replacement and two had iliac vein resection.Retroperitoneal lymph node dissection often involves mobilisation and/or the resection/replacement of major vessels. We recommend that a vascular surgeon should be a part of testicular germ cell multidisciplinary team.


PubMed | Sheffield Vascular Institute
Type: Journal Article | Journal: Nursing older people | Year: 2011

Patient-reported outcome measures (PROMs) are increasingly being used in the NHS to inform clinical treatments and even the funding of individual healthcare providers. This article examines the background to their increasing use. It aims to provide nurses with information and advice about resources to increase their knowledge of PROMs. It outlines the importance of patient-centred outcomes, describes the different types of PROMs and their use in clinical practice.


PubMed | University of Sheffield, Sheffield Vascular Institute and Semmelweis University
Type: Case Reports | Journal: Journal of vascular surgery | Year: 2014

Absent common carotid artery with independent origin of internal and external carotid arteries from the subclavian artery is a rare but recognized phenomenon. We describe one such case with an associated symptomatic proximal high-grade stenosis of the right internal carotid artery. The abnormal carotid anatomy was not initially well appreciated, resulting in a failed surgical exploration and subsequent successful endovascular carotid stenting. To our knowledge, this is the first reported case of carotid stent in a right internal carotid artery originating from the subclavian artery.

Loading Sheffield Vascular Institute collaborators
Loading Sheffield Vascular Institute collaborators