How the First Year of the COVID-19 Pandemic Impacted Patients' Hospital Admission and Care in the Vascular Surgery Divisions of the Southern Regions of the Italian Peninsula.

Background: To investigate the effects of the COVID-19 lockdowns on the vasculopathic population. Methods: The Divisions of Vascular Surgery of the southern Italian peninsula joined this multicenter retrospective study. Each received a 13-point questionnaire investigating the hospitalization rate of vascular patients in the first 11 months of the COVID-19 pandemic and in the preceding 11 months. Results: 27 out of 29 Centers were enrolled. April-December 2020 (7092 patients) vs. 2019 (9161 patients): post-EVAR surveillance, hospitalization for Rutherford category 3 peripheral arterial disease, and asymptomatic carotid stenosis revascularization significantly decreased (1484 (16.2%) vs. 1014 (14.3%), p = 0.0009; 1401 (15.29%) vs. 959 (13.52%), p = 0.0006; and 1558 (17.01%) vs. 934 (13.17%), p < 0.0001, respectively), while admissions for revascularization or major amputations for chronic limb-threatening ischemia and urgent revascularization for symptomatic carotid stenosis significantly increased (1204 (16.98%) vs. 1245 (13.59%), p < 0.0001; 355 (5.01%) vs. 358 (3.91%), p = 0.0007; and 153 (2.16%) vs. 140 (1.53%), p = 0.0009, respectively). Conclusions: The suspension of elective procedures during the COVID-19 pandemic caused a significant reduction in post-EVAR surveillance, and in the hospitalization of asymptomatic carotid stenosis revascularization and Rutherford 3 peripheral arterial disease. Consequentially, we observed a significant increase in admissions for urgent revascularization for symptomatic carotid stenosis, as well as for revascularization or major amputations for chronic limb-threatening ischemia.

An update in varicose vein pathology after ten years of endovenous laser therapy (EVLT) with a 980 nm diode laser: clinical experience of a single center.

AIM: To show our experience in the surgical treatment of superficial vein insufficiency of the lower limbs. SUBJECTS AND METHODS: Since 2002 we have performed 659 procedures of endovascular laser therapy (EVLT) (group A) in the treatment of chronic venous insufficiency of the great saphenous vein using a 980 nm diode laser. A closely matched group of 100 patients (50 Group A, 50 Group B) with homogeneous clinical findings (CEAP classification) was controlled with a mean follow-up of 18 months in our more recent experience (3 years). Most patients operated on in this period were lost to follow-up. RESULTS: The Final results showed that EVLT can be used only in a specific selected group of cases based on anatomy and hemodynamics and while 980 nm EVLT could not be selected as the best treatment for this pathology, it could be placed side by side with conventional therapy. CONCLUSIONS: In our one year's more recent experience, we observed an increased number of patients treated with conventional therapy. The development of new laser tools (new wavelengths and continuous radial laser) and the improvement of clinical follow up may lead us to a more correct application of EVLT in the absence of randomized trials because of widespread clinical findings and poor pathological follow-up of this approach to superficial venous insufficiency.