Welcome to the June 2026 edition of the Vascular Trials UK journal club. Each month we select three to four recently published papers that every vascular trainee and researcher should be aware of, and provide a structured critical appraisal.
Paper 1: Long-term outcomes of carotid artery stenting versus endarterectomy in octogenarians — a propensity-matched analysis from the UK National Vascular Registry.
This registry study addressed the important question of whether stenting offers advantages over surgery in older patients. Using propensity matching to account for selection bias, the authors compared 30-day and 5-year outcomes. The key finding was that in patients over 80, stenting was associated with a higher 30-day stroke rate but similar 5-year survival. The study is limited by its observational design, but the sample size (over 3,000 patients) gives it considerable statistical power.
Paper 2: Artificial intelligence for automated AAA measurement on CT — validation against expert radiologists.
This multicentre validation study tested a deep-learning algorithm for measuring AAA diameter on CT scans. The AI showed excellent agreement with expert measurements (within 2mm in 94% of cases) and was significantly more consistent than junior radiologists. The implications for screening programmes and surveillance are significant, though implementation questions around governance and liability remain unanswered.
Paper 3: Patient-reported outcomes after major lower limb amputation — the PROFILE cohort study at 12 months.
This prospective cohort study systematically assessed quality of life, mobility, pain, and psychological wellbeing in 480 patients following major lower limb amputation across 22 UK centres. The results highlight the substantial burden of phantom limb pain (affecting 72% at 12 months), the low rate of prosthetic limb use in above-knee amputees (38%), and the association between pre-operative depression and poor functional outcomes. This paper should change how we counsel patients before amputation.
Each paper is available through your NHS OpenAthens account. We encourage trainees to use these summaries as a starting point and read the full papers critically.