Birmingham Masterclass


At the Birmingham Vascular and Endovascular Masterclass 2003 held in January, nearly 300 people attended the meeting over its two days.

The meeting’s first day focused on the medical management of peripheral vascular disease. Three sessions, chaired respectively by Cliff Shearman, Kevin Burnand and Gordon Lowe, tackled this issue.

These presentations concluded with care providers perspectives: the primary care perspective (Richard Hobbs), a vascular nurse specialist perspective (Shelagh Murray), an interventionalist’s perspective (Tony Nicholson), a vascular physician’s perspective (Dimitri Mikhalidis), and a vascular surgeons perspective (Cliff Shearman).

Attention then switched to venous disease, with Kevin Burnand providing an update on economy class syndrome and Philip Coleridge Smith reviewing possible alternatives to surgery for trunk varicose veins, which included radiofrequency obliteration, endovenous laser treatment and ultrasound guided foam sclerotherapy.In the evening there was a dinner laid on over which the day’s presentations were discussed and then live music was provided by a band, giving everyone the chance to let their hair down.

Refreshed, the second day started off with presentations on severe limb ischaemia, chaired by Peter Harris. Rajiv Vohra. Ray Ashleigh and Malcolm Simms discussed how best to manage thrombus in the calf and foot.

Vohra looked at the issue of adjunctive thrombolysis. He said that thrombolyis is an important modality available to the vascular surgeon when treating patients with severe lower limb ischeamia. Ashleigh tackled the subject of percutaneous thrombectomy. He reviewed the two techniques available aspiration and mechanical thrombectomy. “At present there are no randomised trials comparing thrombectomy with thrombolysis or acute reconstructive surgery,”said Ashleigh. However, a multicentre trial of mechanical thrombectomy versus thrombolysis has Multi-centre Research Ethics Committee approval and is due to start recruiting in Spring 2003. In conclusion, Ashleigh said that aspiration and mechanical thrombectomy can be used to treat acute infra-inguinal occlusions but their exact role in the management of the ischaemic leg has yet to be determined. At present, the choice of technique for dealing with the acutely threatened limb depends on local preference and expertise. Simms closed this session with a review of microtibal embolectomy.

The next session focused on carotid artery disease and Ross Naylor called for better quality data regarding the natural history of stroke (death + ipsilateral stroke and death + any stroke) in patients undergoing isolated CABG in the presence of severe carotid disease, especially those with >80% stenoses. This was followed a session on aortic disease.

A session on training, governance and provision of services closed the meeting with Jo Gibson giving a fine talk on the need for more vascular nurse consultants, who are seen as a valuable resource in bridging the gap between clinical nursing, research and development, education and strategic leadership.

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