The quality of reporting randomized controlled trials in cardiothoracic surgery is suboptimal. Endorsement of the Consolidated Standards for Reporting of Trials statement by the cardiothoracic journals may improve the quality of reporting.

Multiple associations between short telomere length and vascular disease characterised by atherosclerosis suggest a possible link between telomere attrition and disease mechanisms. Further studies are warranted to validate and define the role of telomeres in vascular disease pathogenesis.

Our data show that patients with AAA have shorter leukocyte telomere length compared to controls. This suggests that vascular biological aging may have a role in the pathogenesis of AAA.

All four patients who had arterial ligation performed proximal to the inguinal ligament were critically ischemic after ligation while when the level of ligation was below the inguinal ligament 14 out of 16 patients were compensated (significant).Pedal doppler flow signal was detected in ten patients only intraoperatively. However, four more patients regained Doppler signal in the ward few hours after the operation. All 14 patients with Doppler signal were compensated and required no further revascularization for limb salvage till discharge from hospital.In compensated patients the mean pre-operative ABI was 0.88 and the mean post-operative ABI was 0.49 with an average ABI drop of 0.39. However, in patients who required revascularization or amputation, the mean preoperative ABI was 0.83 and the mean post-operative ABI was 0.00 with an average ABI drop of 0.83 Conclusion -In drug addicts with infected femoral pseudoaneurysms, arterial ligation with local debridement without revascularization salvaged 70% of limbs in our study. The detection of pedal Doppler flow after ligation can stratify patients in whom revascularization might not be required for limb salvage. Additionally all efforts should be made to ligate the femoral artery below the inguinal ligament to preserve important juxta-inguinal collateral branches that can have great impact on limb outcome after ligation.

Peripheral arterial disease (PAD) is a progressive disease with significant morbidity and mortality. Risk factor control, using diet and lifestyle modification, exercise, and pharmacological methods, improves symptoms and reduces associated cardiovascular events in these patients. Antiplatelet agents and anticoagulants may be used to reduce the incidence of acute events related to thrombosis. The armamentarium available for symptom relief and disease modification is discussed. Novel treatments such as therapeutic angiogenesis are in their evolutionary phase with promising preclinical data.

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