A Newcastle Hospitals’ vascular surgeon is leading a first-of-its-kind clinical study to compare two surgical options for acute limb ischaemia (ALI).
ALI is a common emergency condition that happens when the arteries supplying blood to the legs suddenly become blocked due to a blood clot.
Without blood getting to the legs, the nerves, muscles, and skin die within hours, leading to amputation and, in some cases, death.
Treatment for ALI involves an emergency procedure to unblock the artery, which can be done through open or keyhole surgery.
In open surgery, a skin incision (cut) is needed to open the affected artery and remove the clot or to bypass it.
Keyhole surgery (endovascular) can be done with local anaesthetic and requires only small needle punctures.
Mr Sandip Nandhra, consultant vascular surgeon at the Freeman Hospital and senior clinical fellow at Newcastle University, is leading the study nationally. He said:
“ALI is one of the most common causes of amputation in the NHS. Sadly, one in ten people treated for ALI die in hospital within a few days, with four in ten dying within a year.
“We currently don’t know which surgical technique is better for patients in terms of recovery, length of stay in hospital, and risk of infection.
“The study aims to provide comprehensive evidence to help surgeons decide on the best surgical option for patients and inform which is the most cost-effective for the NHS.”
The study is taking place in 30 NHS hospitals in the UK and aims to recruit 470 patients with ALI. The study is randomised so patients have an equal chance of having open or keyhole surgery.
The number of amputations, deaths, and returns to hospital in each group (open vs. keyhole surgery) will be collected. People’s quality of life, complications, and costs to the NHS will also be analysed.
The study is being run from The Centre for Healthcare Randomised Trials (CHaRT) based at the University of Aberdeen. Newcastle Hospitals is also collaborating with Professor Athanasios Saratzis, professor of vascular surgery at the University of Leicester, and other UK vascular experts.
Mr Nandhra added:
“This is the first-of-its-kind study worldwide and we hope that the results inform clinical guidelines and reduce the number of deaths we see in ALI cases.”
