Surgeons have learnt the value of intraluminal shunting

Perhaps the quarter century of futile terrorism and internecine strife in Northern Ireland is coming to an end, leaving in its wake over 3100people dead and 36500 injured. The civil population and those defending it have endured physical suffering and grief with dignity and spirit, while the fabric of their lives has been blighted by the systematic destruction of their homes and places of work and leisure. The cease fire has generated a mixture of relief, scepticism and hope.

Belfast's largest teaching hospital, the Royal Victoria, took on the main responsibilities of a front line evacuation centre. Staff treated casualties, often from major disasters, while ensuring that specialist practice, undergraduate teaching, postgraduate training, and research continued undeterred. Despite witnessing horrific injuries and having little access to counselling they have remained uninured to pain and distress.

Over the past 25 years vascular surgeons in this province have dealt with an estimated 1500 injured major blood vessels.1 2 3 Progress in managing vascular trauma has usually been made in wartime,4 5 and this conflict offered unique opportunities.6 7 8 9 10 …