Effect of anticoagulant therapy for 6 weeks vs 3 months on recurrence and bleeding events in patients younger than 21 years of age with provoked venous thromboembolism. The Kids-DOTT randomized clinical trial.

Terlouw LG, van Dijk LJD, van Noord D, Bakker OJ, Bijdevaate DC, Erler NS et al, on behalf of the Dutch Mesenteric Ischemia Study Group.

Lancet Gastrohepatol 2024; 9: 299-309.

Ninety-four patients with chronic mesenteric ischaemia were included. Only one patient died. After 24 months, the patency of covered stents was better than bare metal stents: 81 versus 49 per cent, P<0.0001. Access site adverse events were more common in covered stent procedures.

Comment: This study does not address whether symptoms were improved alongside patency.

Mohamed AH, Howitt A, Rae S, Cai PL, Hitchman L, Wallace T et al.

Br J Surg 2024; 111: znae195.

Some 206 of the original 280 patients were available for analysis. Both procedures resulted in durable improvements in disease-specific quality of life (P<0.001). Clinical recurrence was lower after endothermal ablation: 37 versus 59 per cent, P=0.005.

Comment: Endothermal ablation has real long term advantages.

Souroullas P, Barnes R, Carradice D, Smith G, Huang C, Chetter I.

Br J Surg 2022; 109: 426-432.

In this study that included 152 procedures, the five day course reduced the rate of surgical site infection (11.8 versus 39.5 per cent, P<0.001) and revisional surgery (6.6 versus 21 per cent, P=0.01).

Comment: Is this now the standard of care?