J.H.N. Wolfe

Prevention of Paraplegia during Thoracoabdominal Aortic Aneurysm Repair

Paraplegia affects up to 22% of patients undergoing thoarcoabdominal aneurysm surgery, producing long-term morbidity and a significant burden to healthcare. This article discusses the mechanisms that may lead to paraplegia during open and endovascular repair from an anatomical and physiological perspective. There are many adjuncts that must be considered to reduce the risk of spinal cord injury, such as revascularisation of intercostal arteries, maintenance of high mean blood pressure, spinal cord drainage and cooling. These adjuncts are discussed, highlighting the evidence available for each method and the practical ways in which they may be used.

Renal dysfunction and prolonged visceral ischaemia increase mortality rate after suprarenal aneurysm repair

Elective juxtarenal abdominal aneurysm repair has a significantly lower mortality rate than suprarenal repair. Identification of factors affecting outcome may lead to a reduction in mortality rate for suprarenal repair.

The examination assessment of technical competence in vascular surgery

The European Board of Surgery Qualification in Vascular Surgery is a pan‐European examination for vascular surgeons who have attained a national certificate of completion of specialist training. A 2‐year study was conducted before the introduction of a technical skills assessment in the examination.