The time is ripe for universal understanding and acceptance of outcome assessment in venous disease. Outcome studies promote understanding of the diseases we treat and the results of treatment. The choice of a valid and reliable assessment tool is crucial. Patient-generated quality-of-life tools include generic instruments and disease-specific instruments. Generic instruments evaluate overall well-being and provide subjective measurements of treatment outcomes in various disease states. The 36-Item Short Form Health Survey and the Nottingham Health Profile are widely used generic surveys. Disease-specific instruments relate to a particular disease state. They are popular in venous disease reporting and have high sensitivity. The Chronic Venous Insufficiency Questionnaire, the Venous Insufficiency Epidemiological and Economic Study, the Aberdeen Varicose Vein Questionnaire and the Charing Cross Venous Ulceration Questionnaire are such devices. Physician-generated measurement tools are used to evaluate and classify the consequences of venous disease. The clinical, aetiology, anatomy, pathophysiology classification (CEAP) is a popular descriptive platform for chronic venous disease. The Venous Severity Scoring (VSS) system was derived from the CEAP classification to provide evaluative capabilities. The three elements of the VSS are the venous disability score, the venous segmental disease score and the venous clinical severity score (VCSS). The VCSS facilitates the follow-up of features of venous disease that change with treatment. Each of these outcomes tools has been validated, and each has strengths and weaknesses. Maintaining the dynamic nature of assessment with periodic review and revision is the way forward to generating universal applicability. Although the choice of instrument is debatable, the most important factor in improving treatment outcomes is the decision to examine results and to share them in a meaningful way.

Neurofibromatosis is a rare cause of aneurysmal degeneration of blood vessels. Repair of a ruptured cervical internal carotid artery aneurysm, though feasible, is difficult with stent grafts; however, this is a better option than surgical intervention in inaccessible vessels.

Outcome assessment is an important criterion for the objective determination of the risks and benefits of a given procedure. The choice of an assessment instrument is critical in order to generate meaningful and relevant data. Assessment instruments are platforms for comparison and stratification of information that provide a common ground and unified language for discussions on disease processes and therapies. Like many complex conditions, venous disease has benefited from the institution of several assessment instruments designed to clarify elements of the disease process. Among these is the venous clinical severity score (VCSS), which has proved to be a valuable tool for evaluating changes in condition over time with or without intervention. The VCSS has recently undergone a revision to increase its sensitivity and value in interpreting the language of venous disease.

Despite immunosuppression, the incidence of surgical wound infection was minimal, comparing favorably to rates reported for renal transplantation with the use of systemic antibiotics. Possible explanations for the low incidence of surgical wound infections include local wound irrigation, meticulous hemostasis, improved organ procurement techniques, and continuity in perioperative care.

Vascular access expanded polytetrafluoroethylene (ePTFE) grafts with external support systems consisting of parallel rings or in a spiral configuration are designed to resist kinking and compression at the apex of loop grafts or when crossing a joint. However, during the implantation procedure, the rings or spiral must be removed from the portion of the graft that is cut to allow the graft to be divided at the desired angle and suture the anastomosis. A new ePTFE graft (Intering) with an intrawall radial support system and a smooth lumen permits easy division of the support segments at the chosen angle. Moreover, minimal resistance is encountered during suturing of the graft. The results of early experience with Intering grafts crossing the elbow joint, in short-segment revisions, and in primary forearm loop configurations are encouraging.