Does the use of warfarin affect the outcome in radiofrequency ablation (RFA) of varicose veins?
Authors: M. Green, C. Marshall
Journal: International Journal of Surgery (2015)

s / International Journal of Surgery 23 (2015) S15eS134 S130 Aim: National guidelines recommend secondary prevention of cardiovascular disease in all patients with peripheral vascular disease. However, many patients undergoing vascular surgical procedures are not on optimal medical therapy. This study aims to assess the variation and impact of both antiplatelet and statin therapy on early morbidity andmortality in patients undergoing vascular surgery. Methods: A retrospective analysis of all elective vascular operations in the calendar year of 2014 identified 155 patients who had undergone aneurysm, carotid, suprainguinal, and/or infrainguinal surgery. Optimal medical therapy was defined as preoperative treatment with a statin and antiplatelet agent. 30-day mortality, postoperative complications, and duration of stay were primary outcome measures. Results: Overall, 77.4% of patients had optimal preoperative therapy. Those attending for carotid surgery had the highest rates of compliance (95.4%) with aneurysm patients having the lowest (60%). There were no 30-day postoperative deaths. There was no significant difference in duration of stay or complication rates between groups. Conclusion: Preoperative optimisation with medical therapy in vascular surgery remains variable. Although this study shows minimal effect on short-term patient outcomes the long-term benefits of secondary prevention are well understood. From a local perspective, ongoing audit and education will be essential in ensuring improving optimisation. 0394: TECHNIQUES IN BELOW KNEE AMPUTATION (BKA): A SKEWED VIEW? A. McKay, J. Kaczynski, R. Holdsworth. Forth Valley Royal Hospital, UK Aim: BKA is a common end point for both advanced critical limb ischaemia and aggressive diabetic foot sepsis and the results are highly influenced by surgical technique. Two major variations in technique are the type of skin incision and the use of a pneumatic tourniquet. We aimed to assess which techniques, if any, resulted in the best outcomes for patients undergoing BKA. Methods: A retrospective data analysis was performed on all patients who underwent BKA in a single Vascular Surgery Department between 2005 and 2014. Primary outcome measures were post-operative haemoglobin drop, revision rate and mortality. Results: 163 BK amputations were identified. 64.6% were male patients and the median age was 69 (IQR1⁄418). Skin incisions were as follows: Burgess 55.2%, Skew 38.1%, Other 6.7%. 53.4% were performed with a tourniquet. No particular incision or use of tourniquet was associated with a significant difference in any primary outcome measure. Conclusion: This small study highlights the variation in surgical practice that exists when performing BKA and its variable influence on surgical outcome. There was no single best-combined technique found and in practice, surgical preference and familiarity is often the determining factor in choice of technique. 0422: DOES THE USE OF WARFARIN AFFECT THE OUTCOME IN RADIOFREQUENCY ABLATION (RFA) OF VARICOSE VEINS? M. Green, C. Marshall. University Hospitals of Coventry and Warwickshire,