Mr Christopher Twine

FRCS, MD, MB BCh (dist), BSc

  • BS8 2PS

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Personal profile

Research interests

My main research interests are improving outcomes for people with chronic limb threatening ischaemia and improving outcomes following major lower limb amputation.

Prevention of amputation and other major adverse cardiovascular events is vital when caring for patients with chronic limb threatening ischemia. Antithrombotic therapy (such as aspirin) plays a vital role in preventing these events. Our research has given insight into antithrombotic use by vascular specialists for areas where the practice is not always evidence based, and our interest in meta-analysis has clarified and compared the benefits and harms of different antithrombotic regimens. This work has informed a major guideline from the European Society for Vascular Surgery (https://www.ejves.com/article/S1078-5884(23)00284-8/fulltext) which I chaired. The work also informed the design of the NIHR HTA funded CLARITY (CLopidogrel, Aspirin and RIvaroxaban after revascularIsation with angioplasTY) randomised trial examining antithrombotic regimens after peripheral arterial endovascular intervention led by myself as Chief Investigator. 

Major lower limb amputation is a devastating consequence of peripheral arterial disease leading to significant morbidity and mortality. Our research looks into various ways to improve outcomes around a major amputation. The PLACEMENT randomised feasibility trial showed new ways pain relief following amputation are feasible to study in randomised trials, and we developed a core outcome set alongside the trial to reduce variability and aid the applicability of future randomised amputation research. We have examined risk prediction tools for outcomes after amputation and collaborated in developing and validating new tools to aid shared decision making to improve patient centred outcomes. This work has informed the design of the NIHR HTA funded PLACEMENT randomised control trial led by a collaborating team in Cardiff.

External positions

Systematic Review Section Editor, EJVES, European Society for Vascular Surgery

2022 → …

Editorial Board Member, EJVES VF, European Society for Vascular Surgery

2022 → …

European Society for Vascular Surgery Guidelines Steering Committee member, European Society for Vascular Surgery

2019 → …

Lead for intervention, Special Interest Research Group for Peripheral Arterial Disease, The Vascular Society for Great Britain and Ireland

2018 → …

Consultant Vascular Surgeon, North Bristol NHS Trust (NBT)

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Collaborations and top research areas from the last five years

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