https://www.um.edu.mt/library/oar/handle/123456789/8447 Thu, 04 Jun 2026 08:17:37 GMT 2026-06-04T08:17:37Z https://www.um.edu.mt/library/oar/handle/123456789/8810 Title: Screening for non-significant stenosis in native arteriovenous fistula within the Maltese population Abstract: Purpose: To assess the feasibility of introducing a screening programme for patients with end stage renal disease undergoing haemodialysis through an autogenous arteriovenous fistula for the detection of asymptomatic stenosis of the feeding artery and/or fistula Objectives: To scan using duplex ultrasound the autogenous arteriovenous fistulae of the patients with end stage renal disease and identify any asymptomatic clinical stenosis; identify any co-morbid disease that can increase the risk of a stenosis. Create and test a suitable data collection tool. Methodology: Ninety nine patients that fulfilled the inclusion criteria were recruited for the study. Ten of these patients were enrolled for the pilot study and were not included in the main study. Eighty nine patients were asked a series of demographic questions and also underwent a duplex ultrasound examination where both the lumen diameter measurements and blood flow velocities were measured from the arterial and fistula segments. The results were then statistically analysed. Results: The introduction of a screening programme is recommended as the results show that 36% of the patients had undetected, asymptomatic stenoses within their fistula. Fifteen percent from these undetected stenoses were significant. The remaining were non-significant in nature. No stenosis was detected in the arterial segment. All the stenoses were within the anastamotic area or in the fistula itself. The results also showed that 25% of the scanned population had already suffered from either a stenotic or thrombotic event. The mean flow velocity was slightly higher than what is published in the literature. Diseases such as diabetes and hypertension accounted to 71% of the scanned population but these diseases did not show an increased risk for the patients to develop a stenosis. A costing exercise is recommended in order to assess that screening and treatment costs as well as the additional burden of hospital resources are justifiable. Conclusions: Thirty six percent of the patients currently undergoing haemodialysis with an autogenous arteriovenous fistula have an undetected stenoses. A screening programme would be beneficial for the patients undergoing haemodialysis using an autogenous arteriovenous fistula. Description: M.SC.RADIOGRAPHY Thu, 01 Jan 2015 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/8810 2015-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/8650 Title: The prevalence of carotid artery stenosis in Maltese patients with peripheral vascular disease Abstract: Purpose: Peripheral vascular disease is a manifestation of systemic atherosclerosis leading to significant narrowing of arteries distal to the arch of the aorta. Building of atherosclerotic plaque into the internal carotid artery may lead to serious complications such as cerebro - vascular accident. In Malta the prevalence of internal carotid stenosis in patients suffering from peripheral vascular disease is not yet known. The purpose of the study is to determine the prevalence of internal carotid artery stenosis in Maltese patients with peripheral vascular disease. Aim and Objectives: Identification of Maltese patients with PVD, selection of a sample and ultrasound scanning of the carotid arteries of the selected sample, determination of the prevalence of carotid artery stenosis from the scanned sample and determination of the degree of carotid artery stenosis categorising the severity of the disease from the ultrasound examinations; Methodology: The research design used in this study is mainly quantitative in nature. It included 50 Maltese patients suffering from PVD presently admitted to a local state hospital. These selected patients were screened for internal carotid stenosis by means of ultrasound. Results: The prevalence of >70% internal carotid artery stenosis in Maltese patients with PVD was 22%. Smoking was found to be the only significant predictor of internal carotid stenosis (p = 0.003) in this cohort of patients from among a number of risk factors such as family history of PVD, CHD, hypercholesterolemia, dibates mellitus, obesity, age, hypertension and gender. Conclusion: The results obtained in this study were based on such a small sample that they may only be interpreted as providing a small picture of prevalence of carotid stenosis in Maltese patients with PVD. However this can act as a pilot study for a larger project, which could provide more definite statements on the local situation in relation to the prevalence of internal carotid stenosis in Maltese patients with PVD. Description: M.SC.RADIOGRAPHY Thu, 01 Jan 2015 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/8650 2015-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/8633 Title: Recurrent varicose veins following surgical treatment in the Maltese population Abstract: Purpose: Various causes for recurrent varicose veins have been discussed and identified in several peer-reviewed studies. However there has been no consensus on the dominant type that leads to symptomatic recurrence and thus to the need for a second intervention. Locally there are no scientific studies that address the issue of recurrence and thus this study aimed to identify the different types of recurrence of varicose veins in the Maltese population. Method: During June 2014 and October 2014, patients with a history of previous varicose veins surgery and recurrent varicose veins were prospectively assessed at the Vascular unit of a general acute public hospital, in Malta. Data regarding the patients’ past medical history, clinical severity of venous disease, and source and route of incompetency was collected through clinical and ultrasonographic diagnosis. Data collected was recorded in a validated structured data record sheet. Quantitative analysis of the data was performed while recurrent varicose veins were anatomically classified according to the Edinburgh classification. Results: Fifty-three (53) limbs from 46 patients with symptomatic recurrent varicose veins were included. Half of these limbs (52.3%) had skin changes (C4) to the lower limb. The mean time since the initial surgery was 19 years while in 92.3% of patients previous surgery was performed to the groin. The saphenofemoral junction was the most common source of incompetency (69.8%), while the great saphenous vein was the most common route of incompetency (60.4%). A completely intact great saphenous vein (type 1A) was present in 30.2% of limbs while a residual great saphenous vein stump (type1B) was present in 32.1% of limbs. Neovascularisation (type 1C) was identified in 24.5% of limbs. Non-saphenous incompetence (type 2) was identified in 26.4% of limbs mostly due to pelvic incompetence (type 2A). Conclusion: All patients were symptomatic with different severity of venous disease. It was established that in the Maltese sample, technical errors (type 1A and type 1B) were the dominant cause for symptomatic recurrent varicose veins. The high proportion of these types of recurrences emphasizes the importance of meticulous preoperative assessment using duplex ultrasound, and the need of a standardised protocol for the initial treatment of varicose veins. This will eventually reduce the need for re treatment in a substantial amount of patients and thus reduce the high levels of morbidity associated with chronic venous disease. Description: M.SC.RADIOGRAPHY Thu, 01 Jan 2015 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/8633 2015-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/8621 Title: Use of anatomical side markers (ASMs) during planar x-ray imaging Abstract: Purpose: The purpose of the study was to evaluate the perception and use of ASMs by radiographers working in a local radiology department in a general hospital in Malta and develop an information leaflet based on the outcomes of the study to promote awareness amongst radiographers highlighting areas of improvement of ASM use. Methodology: The study was divided into two phases. Phase 1 involving a retrospective observation of radiographs over 5 years, using a self-designed data record sheet and phase 2 the distribution of a self-designed questionnaire to radiographers evaluating their perception of the use of ASMs. Data obtained was analysed using both descriptive and inferential statistics. Results: In phase 1, 430 radiographs (86%) had evidence of ASM, of which 110 (25.6%) had a pre-exposure ASM and 320 (74.4%) had a post-processing ASM. The remaining 14% of radiographs had no evidence of either a pre-exposure or post-processing ASM. Two hundred and eighty two (282) (56.4%) of the radiographs having either pre-exposure or post-processing ASMs were placed according to stipulated guidelines. In phase 2, 15.4% of respondents stated that they prefer using pre-exposure ASM during practice while 84.6% of the respondents stated that they prefer using post-processing ASMs. Seventy seven percent (76.6%) of radiographers find it often or occasionally time consuming when applying pre-exposure ASMs. The average percentage score of correct answers to find out the radiographers’ knowledge about the guidelines was estimated to be 60.5%. Conclusion: The study showed non-use and misuse of ASMs by radiographers indicating improvement in some areas. Preference in using post-processing ASMs was shown over the use of pre-exposure ASMs. Both phase 1 and 2 of the study were generally in agreement showing the need of more awareness on the use of pre-exposure ASMs hence the reason why an information leaflet was distributed in the radiology department where the study took place. Description: B.SC.(HONS)RADIOGRAPHY Thu, 01 Jan 2015 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/8621 2015-01-01T00:00:00Z