This report describes an ischemic stroke after foam injection sclerotherapy of varicose veins in a patient with a patent foramen ovale. Foam injection sclerotherapy has created resurgence in the minimally invasive treatment of varicose veins. The United States Food and Drug Administration halted a clinical phase 2 trial of a commercial preparation of polidocanol microfoam in 2003 because of concerns relating to possible gas embolism. These trials were recommenced in July 2005. Neurologic complications such as transient visual disturbances and transient confusional states have previously been reported. This case, with its strong circumstantial evidence, illustrates the previously unconfirmed potential for embolic complications using this technique.

The results of this study on the intermediate-term outcome of angioplasty suggest that angioplasty, when used preferentially for critical ischemia, in anatomically suitable patients provides very acceptable limb salvage and survival despite a relatively high restenosis rate.

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Percutaneous EVAR is both a feasible and safe method of performing endovascular abdominal aortic aneurysm repair, which is associated with a reduction in wound complication rates.

This study investigated the performance of a new gelling fibre dressing containing silver (DURAFIBER™ Ag; Smith & Nephew, Hull, UK) in moderate to highly exuding venous leg ulcers with one or more clinical signs of infection. Fourteen patients with venous leg ulceration of median ulcer duration 12·5 weeks, recruited from three centres in South Africa, received treatment with the new dressing for a maximum of 8 weeks. Multilayer compression bandaging was used for all patients, at the majority of assessments. The objectives of this study were to assess the clinical acceptability of the dressing in terms of the following characteristics: antimicrobial properties, the progress of the wound towards healing, wear time, exudate management, conformability, patient comfort, pain on application, pain on removal and dressing integrity. The new dressing was rated as clinically acceptable for all characteristics, for all 14 patients (100%). It was easy to apply and remove; in 96·8% of removals, the dressing stayed intact on removal and could be removed in one piece. Fifty per cent of the wounds healed within the 8-week study duration; between baseline and final assessment, the median percentage reduction in wound area was 98·2% and the median percentage reduction in devitalised tissue was 78%. Exudate levels and wound pain were significantly improved at final assessment compared to baseline assessment, and an increase in the number of patients with healthy peri-wound skin between baseline and final assessment was observed. A reduction in bioburden and signs of clinical infection and an improvement in quality of life were observed over the 8-week period. The average wear time was 6·4 days. This study supports the use of new dressing in the management of moderately to highly exuding venous leg ulcers with clinical signs of infection.

Hybrid techniques allow for the treatment of pathology that would otherwise not be amenable to surgery.

Microfoam ultrasoundguided sclerotherapy treatment for varicose veins in a subgroup with diameters at the junction of 10 mm or greater compared with a subgroup of less than 10 mm.

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