PhD Defence Henry Davies

Keywords: End-of-life care, Palliative care, Vascular surgery, Chronic limb-threatening ischemia, Aortic aneurysm 
 

"End of Life and Palliative Care for Vascular Patients"

This thesis shows that patients with vascular disease, including chronic limb-threatening ischemia and inoperable aneurysms, are not receiving 

palliative and end of life care appropriate for the mortality and morbidity associated with these conditions and are therefore experiencing quality of life lower than we are capable of offering. Despite advancements in surgical techniques, many patients experience poor quality of life due to pain, non-healing wounds, and limited mobility. 

The thesis shows there is a possible association between palliative and end of life care and quality of life, but currently these services are offered too late to realise their full potential. The research highlights how incorporating palliative care principles—such as better pain management, patient-centered decision-making, and holistic support—could improve patient quality of life markers.  

By analysing clinical data, reviewing published evidence, guidelines and training curricula, this study provides evidence-based recommendations for improving care pathways and also recommendations for how to deliver more focused patient orientated care which increases the chance management plans align with the care objectives of the patient. Ultimately, the findings advocate for a shift in vascular surgery practices, ensuring that treatment plans align with patient needs and preferences, particularly for those who may not benefit from aggressive surgical interventions. 

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