Randomized clinical trial of intradermal suture and metallic stapling for incisional groin closure after vascular surgery (VASC-INF 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.

Goldenberg NA, Kittelson JM, Abshire TC, Bonaca M, Casella JF, Dale RA et al, for the Kids-DOTT Trial investigators and the ATLAS Group.
JAMA 2022; 327: 129-137.

Some 417 patients under 21 years of age were included. Rates of recurrent venous thromboembolism were similarly low after both treatments: 0.66 per cent after six weeks of versus 0.7 per cent after three months of anticoagulation.

Comment: Very low recurrence rates, but six weeks of anticoagulation seems reasonable.