No abstract

Frequent duplex surveillance after iliac arterial stenting is time-consuming and costly, so solid benefits of this approach must be available. Frequent duplex surveillance was performed at our center, this was reviewed retrospectively.A total of 117 stents were assessed. Duplex was done for 84 (71.8%) of 117 patients at 1 year and 25 (21.4%) of 117 at 5 years, mean follow-up 27.6 months. Totally, 456 scans were performed; 386 (84.6%) scans were normal, 43 (9.4%) showed an abnormality for which intervention was not necessary, 27 (5.9%) showed abnormalities which needed interventions. The maximum attendance of patients was 62%. In all, 18 patients had interventions unrelated to scheduled follow-up; 15 (83.3%) of 18 had no prior abnormalities on duplex, 3 (16.6%) of 18 had prior abnormalities which were not acted upon after clinical assessment. Our findings demonstrate a high nonattendance rate with frequent emergency presentations due to acute complications. We cannot, therefore, recommend frequent duplex surveillance program both in terms of results or resource allocation.

Iliopopliteal grafts are rarely undertaken severe disease requiring their use is infrequently encountered. High mortality and low primary patency mean its use can only be advocated in exceptional circumstances.

Low anterior resection is the most common operation in the USA for low rectal cancers. Seminal vesicle-rectal (SV-R) fistula is an extremely uncommon complication of this operation. The objective of the present literature review was to investigate risk factors that lead to the development of SV-R fistula, clinical presentation, investigation and management options. There were nine articles of relevance which reported a total of 12 cases of SV-R fistula. All other iatrogenic or cryptogenic fistula were excluded. Twelve cases were identified in the literature, and we describe one further case. Pneumaturia and fever were presenting symptoms in 10 of 13 cases; 69.2 per cent (n = 9) of cases presented within 2 weeks of the procedure. Computed tomography was the investigation of choice in nine of 13 cases. A variety of surgical and conservative management plans were utilized. Conservative management was successful in 46.1 per cent (n = 6) of cases. The present study provides the first concise review of SV-R fistula following low anterior resection and adds a further case. It is also the first article of its kind to recommend a treatment algorithm that consists of a trial of conservative management.