Sandip Nandhra, Emma Wilton, Steve Black

DOI: 10.58974/bjss/azbc040 Download PDF Unprovoked acute deep vein thrombosis (DVT) is a common problem, affecting around 50 to 100 per 10000 people.1,2 A significant number of these (20%) will involve the iliac veins or inferior vena cava. The symptoms of acute DVT are well described and include, sudden onset of swelling, pain, redness and difficultly mobilising. On occasion the extent of venous congestion can be so severe it threatens the limb, a phenomenon termed phlegmasia.

Fabio Stocco, Jing Yi Kwan, Marc A. Bailey, Patrick A. Coughlin

The incidence of peripheral arterial disease (PAD) has risen dramatically, and it is estimated to affect around 200 million people worldwide. This rise can be explained by an ageing population, persisting high rates of tobacco smoking and the increasing incidence of diabetes mellitus (DM).1,2 Chronic limb-threatening ischaemia (CLTI) is the most severe manifestation of PAD and is characterized by rest pain and/or tissue loss (e.g. ulceration or gangrene).1 It is estimated that CLTI affects about 10% of all patients with PAD.3 Figure 1. Typical critical ischaemia of the left foot. Patients with CLTI are at high risk of major limb amputation (MLA) and major adverse cardiovascular events (MACE – myocardial infarction and stroke)1 with a significant reduction in life expectancy. Overall mortality rates are similar to that of advanced cancers.3 They also commonly experience poor quality of life.

Matti Tolonen, MD, PhD, presents his BJS Lecture “Emergency general surgery model and acute mesenteric ischaemia – pathway” from the 2024 Association of Surgeons of Great Britain and Ireland (ASGBI) International Surgical Congress.