title: Vascular surgeries in West Africa: challenges and prospects.
abstract: BACKGROUND
  The field of vascular surgery is evolving in sub-Saharan Africa but the practice is bedeviled by lack of expertise and infrastructure challenges. The consequences are a low volume of operations and a dearth of data. Available data are not representative of the wider picture, therefore, this study was undertaken to evaluate the practice of vascular surgery in a tertiary institution, in the light of the prevailing challenges.
  
  
  METHODS
  Data from all patients with vascular-related pathologies managed in our surgical outpatient clinic and accident and emergency wards were obtained from the clinic and in-patient records from January 2008 to December 2012. Age, sex, diagnosis, treatment, and complications were noted. There were 73 patients comprising 45 (61.6%) males and 28 (38.4%) females. The age range was 1-90 years (mean 43.5 years).
  
  
  RESULTS
  The pathologies managed included end-stage renal disease (n = 36, 49.3%), nontraumatic and posttraumatic aneurysms (n = 13, 17.8%), vascular trauma (n = 12, 16.4%), peripheral vascular disease (n = 5, 6.9%), congenital vascular malformations (n = 4, 5.5%), and thrombotic diseases (n = 3, 4.1%). Fifty-four (74.0%) surgeries were performed, with a complication rate of 5.5% and 2.7% mortality.
  
  
  CONCLUSIONS
  The practice of vascular surgery in Zaria, Nigeria, is fraught with challenges. The gap created by the dearth of skilled vascular surgeons is filled by competent cardiothoracic surgeons. Infrastructure decay and lack of prostheses limit the number and variety of operable cases. These challenges result in preventable morbidity and mortality.
authors.affiliation: Division of Cardiothoracic Surgery, Ahmadu Bello University, Zaria, Nigeria edais23@yahoo.com.
authors.forename: Sunday A
authors.initials: SA
authors.lastname: Edaigbini
authors.affiliation: Division of Cardiothoracic Surgery, Ahmadu Bello University, Zaria, Nigeria.
authors.forename: Ibrahim Z
authors.initials: IZ
authors.lastname: Delia
authors.affiliation: Division of Cardiothoracic Surgery, Ahmadu Bello University, Zaria, Nigeria.
authors.forename: Muhammad B
authors.initials: MB
authors.lastname: Aminu
authors.affiliation: Division of Nephrology, Department of Medicine, Ahmadu Bello University, Zaria, Nigeria.
authors.forename: Istifanus B
authors.initials: IB
authors.lastname: Bosan
authors.affiliation: Division of Plastic and Reconstructive Surgery, Ahmadu Bello University, Zaria, Nigeria.
authors.forename: Abdulrasheed
authors.initials: A
authors.lastname: Ibrahim
authors.affiliation: Division of Cardiothoracic Surgery, Ahmadu Bello University, Zaria, Nigeria.
authors.forename: Ndubuisi
authors.initials: N
authors.lastname: Anumenechi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D066231:Surgeons; D015996:Survival Rate; D014652:Vascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D055815:Young Adult
keywords: Developing countries; nigeria; peripheral vascular diseases; vascular fistula; vascular surgical procedures; wounds and injuries