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Direct oral anticoagulants (DOACs) are the drug of choice for the treatment of atrial fibrillation-associated systemic embolism and reducing the risk of strokes in chronic kidney disease (CKD) patients. DOACs have fewer drug-to-drug interactions as well as fewer side effects, compared to warfarin. This article compiled up-to-date research on the use of DOACs in CKD patients, taking the AHA 2019 guidelines into consideration. The aim of this article was to compare the efficacy and safety of DOACs with warfarin and to assess whether DOACs are a better alternative to warfarin. Among DOACs, apixaban has been shown to have the best outcome compared to other DOACs. As a result, the AHA 2019 updated guidelines have recommended warfarin and apixaban to be the first line agents for CKD patients. This review concluded that DOACs are better option in patients with mild to moderate CKD and excluding apixaban other DOACs are not indicated in patients with CrCl < 25 ml/min.

Introduction: With the steady rise in interest in e-learning and the sudden boost provoked by the COVID-19 pandemic, it becomes necessary to explore the e-learning experience within the medical community in the MENA region. Methods: An online survey was conducted during the early phase of the COVID-19 pandemic (June 15 – October 15, 2020). Results: Seventy-eight vascular surgeons and trainees from 16 countries participated. 88% of the participants were male. 55% attended more than 4 activities. More than half of the activities did not lead to any official certification. Topic was the primary determinant for attending an activity. National societies and social media played a major role in disseminating activity-related information. Lack of time, increased workload, differences in time zone, and technical issues were the main obstacles cited. 84.7% of the participants had a positive impression. Conclusion: As the COVID-19 pandemic boosted e-learning activities in vascular surgery, a shift was observed in the learning mode and new leadership skills were called upon. Novel ways of quality control are required.

This dataset supports the findings of the vascular e-Learning during the COVID-19 pandemic survey (the EL-COVID survey). The General Data Protection Regulation (GDPR) of the European Union was taken into consideration in all steps of data handling. The survey was approved by the institutional ethics committee of the Primary Investigator and an online English survey consisting of 18 questions was developed ad-hoc. A bilingual English-Mandarin version of the questionnaire was developed according to the instructions of the Chinese Medical Association in order to be used in mainland People's Republic of China. Differences between the two questionnaires were minor and did affect the process of data collection. Both questionnaires were hosted online.The EL-COVID survey was advertised through major social media. All national and regional contributors contacted their respective colleagues through direct messaging on social media or by email. Eight national societies or groups supported the dissemination of the EL-COVID survey.The data provided demographics information of the EL-COVID participants and an insight on the level of difficulty in accessing or citing previously attended online activities and whether participants were keen on citing these activities in their Curricula Vitae. A categorization of additional comments made by the participants are also based on the data.The survey responses were filtered, anonymized and submitted to descriptive analysis of percentage.

Nutcracker syndrome (NCS) seems to be an under-diagnosed condition defined as external compression of the left renal vein and consequent blood outflow impairment. The majority of cases involve the left renal vein entrapment between abdominal aorta and the superior mesenteric artery. The exact epidemiology is unknown due to lack of consensus on diagnostic criteria and often asymptomatic courses. NCS may occur at any age with peak presentation in the second and third decade of life. There is a slight prevalence in females. The most frequent presentations include micro and macroscopic hematuria, orthostatic proteinuria, orthostatic hypotension, flank pain. Patients may develop pelvic congestion syndrome comprising dyspareunia, dysmenorrhea, abdominal pain, pelvic, gluteal, vulvar varicose veins and varicocele in men. Clinical suspicion of NCS based on signs and symptoms, requires imaging confirmation utilising modalities such as doppler ultrasonography, computed tomography and magnetic resonance angiography, intravascular ultrasound and phlebography. Treatment options of NCS range from conservative surveillance to nephrectomy, thus appropriate approach should be based on clinical manifestation and severity of symptoms. Patients presenting with mild to moderate haematuria, and acceptable symptoms should be treated conservatively. In cases of severe symptoms or when conservative management fails, invasive treatment should be considered. Recommended open surgical procedures include left renal vein distal transposition and renal autotransplantation. Endovascular stenting approach seems to be an encouraging solution. Further long term follow-up is required to create objective treatment guidelines.

Traditional surgical repair and endovascular repair (EVAR) are the treatment options for abdominal aortic aneurysm repair. EVAR as less invasive becomes a significant and widely accepted way of treatment aortic aneurysms with expanding number of procedures. This technique has a lover short-term mortality and a shorter hospital stay but is not free from complications. The most common complication after EVAR are endoleaks. For the first time summarised and assessed in 1997. Although it is often asymptomatic but may cause aneurysm expanding and rupture. Endoleak is defined as persistent blood flow into the aneurysm sac. It can be revealed intra-operatively or during the follow up – CT; arteriography, angio-MRI enables endoleak diagnosis. Usage of duplex sonography is questionable. In this mini-review we summarise endolek diagnostic, classification and treatment options.