エピソード
-
In this episode, Sasank Kalipatnapu (@ksasank), John Culhane and Leana Dogbe (@ldogbe4) sit down along with Dr. Dalman (@RLDalmanMD) as chair of the SVS Nominating Committee for this year, along with the two vice presidential candidates Dr. Harris and Dr Shaw to learn more about them as part of the ongoing election process.
Show links:
SVS 2024 Meet the VP Candidates—Home Page—provides a comprehensive overview of all the candidates. Their professional biographies and answers to questions about their plans for the future are available in both text and video formats.
Show Guests:
Dr. Linda Harris, Professor of Surgery at Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, NY
Dr. Palma Shaw, Professor of Surgery at State University of New York, Syracuse, NY
Dr. Ronald L. Dalman, Elsa R. and Walter C. Chidester Professor and Division Chief Emeritus of Vascular Surgery at Stanford University, CA, Associate Dean for Market Development and Outreach for Stanford Medicine and Vice Chair for Clinical Affairs in the Department of Surgery
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
-
Audible Bleeding contributor and 5th year general surgery resident Richa Kalsi (@KalsiMD) is joined by first-year vascular surgery fellow Zach Mattay (@ZMatthay), fifth-year general surgery resident Naveed Rahman (@naveedrahmanmd), JVS editor Dr. Thomas Forbes (@TL_Forbes), and JVS-CIT editor Dr. Matthew Smeds (@mattsmeds) to discuss two great articles in the JVS family of journals. The first article discusses national trends in surgeon-modified graft utilization for complex and thoracoabdominal aortic aneurysms. The second article discusses a novel technique, transcatheter electrosurgical aortic septotomy, to treat chronic dissecting aortoiliac aneurysms. This episode hosts Dr. Thomas O’Donnell (@tfxod) and Dr. Carlos Timaran (@ch_timaran), the authors of these two papers.
Articles:
Part 1:“National Trends in utilization of surgeon-modified grafts for complex and thoracoabdominal aortic aneurysms” by Dr. O’Donnell and colleagues.
Mentioned during the discussion:
“Application of Investigational Device Exemptions regulations to endograft modification” by Abel and Farb.
Part 2: “Early results of transcatheter electrosurgical aortic septotomy for endovascular repair of chronic dissecting aortoiliac aneurysms” by Dr. Timaran and colleagues.
Mentioned during discussion:
“Transcatheter Electrosurgery: JACC State-of-the-Art Review” by Khan and colleagues.
“A Novel Way to Fenestrate a Type B Dissection Flap Using Endovascular Electrocautery” by Dr. Kabbani and colleagues.
Show Guests
Dr. Thomas O’Donnell: Assistant professor of surgery in the aortic center at New York Presbyterian/Columbia University Irving Medical Center.
Dr. Carlos Timaran: Professor and Chief of Endovascular Surgery at University of Texas Southwestern Medical Center’s Department of Surgery.
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
-
エピソードを見逃しましたか?
-
This episode of Audible Bleeding features Drs. Adam Johnson and Jeniann Yi, members of the Society for Vascular Surgery Health Information Technology Committee, to discuss the application of large language models in vascular surgery with two experts in the field, Dr. Andrew Gonzalez and one of his collaborators, Shantanu Dev. The episode promises a conversation exploring machine learning and large language models with insights from the guests' diverse expertise in vascular surgery, health informatics, and artificial intelligence.
Dr. Andrew Gonzalez, an assistant professor in vascular surgery at Indiana University School of Medicine and also an SVS HITC committee member, has clinical and research interests in peripheral arterial disease and artificial intelligence applications for amputation prevention.
Shantanu Dev, a computer science PhD student at Ohio State, focusing on multimodal modeling for clinical applications in AI. Shantanu worked at PWC for eight years in their AI R&D division and co-owns Satsang.ai (www.satsang.ai) Digital Health, an AI company addressing healthcare inequities and quality of care.
Relevant links:
AI Revolution in Medince: GPT4 and Beyond by Peter Lee
Artificial Intelligentce in Surgery: Understanding the Role of Ai in Surgical Practice by Dan Hashimoto
Data Skeptic Podcast
Deep Medicine: How Artificial Intelligence can make Helathcare Human Again by Eric Topel
Co-Hosts:
Dr. Jennian Yi is an Assistant Professor of Surgery at the University of Colorado.
Dr. Adam Johnson is an Assistant Professor of Surgery at Duke University, and editor at Audible Bleeding.
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
-
Audible Bleeding editor Wen (@WenKawaji) is joined by 5th year general surgery resident Richa Kalsi (@KalsiMD) from University of Maryland Medical Center, 4th year general surgery resident Nitin Jethmalani from New York Presbyterian Hospital-Weill Cornell, JVS (@JVascSurg) editor Dr. Forbes (@TL_Forbes) and JVS-VL (@jvsvl) editor Dr. Bush (@ruthlbush) to discuss two great articles in the JVS family of journals regarding chronic pain and resident burnout and SFJ reflux and its implication in C2 and C3 chronic venous insufficiency. This episode hosts Dr. Pillado (@drpillado), Dr. Coleman (@ColemanDM_vasc) and Dr. Lal.
Articles:
Reported pain at work is a risk factor for vascular surgery trainee burnout by Dr. Pillado and colleagues.
Effect of junctional reflux on the Venous Clinical Severity Score in Patients with Insufficiency of the great saphenous vein (JURY study) by Dr. Lal and colleagues.
Show Guests:
Dr. Coleman: Professor of Surgery at Duke University and Division Chief of Vascular and Endovascular Surgery at Duke University Medical Center.
Dr. Pillado: vascular surgery resident at Northwestern Hospital in Chicago, IL
Dr. Lal: Professor of Surgery at the University of Maryland, Professor of neurology at Mayo clinic, and professor of biomedical engineering at George Mason University. and Director of Center for Vascular Research at University of Maryland Medical Center
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
-
In this episode, we spotlight editorials and abstracts from the Journal of Vascular Surgery Cases, Innovations, and Techniques (JVS-CIT). Editorials and Abstracts are read by members of our SVS Social Media Ambassadors and Editor in Chief of JVS CIT, Dr. Matthew Smeds.
Readers:
Matthew Smeds (@mattsmeds)
Christopher DeHaven (@ChrisDeHavenPSU)
Ethan Vieira
Litton Whittaker
Nicholas Schaper
Nishi Vootukuru (@Nishi_Vootukuru)
Editorials:
Accomplishments and goals: Review of 2023 and previous of 2024 for the Journal of Vascular Surgery Cases, Innovations, and Techniques.
The enduring success of the DRIL technique and new advances in dialysis access.
Abstracts:
Intraprocedural application of a peripheral blood flow monitoring system during endovascular treatment for femoropopliteal disease.
Thoracic outlet syndrome: single-center experience on the transaxillary approach with the aid of the TRIMANO Arthrex arm.
Inferior vena cava hemangioma resected using a novel Toumai robotic surgical platform.
Surgical release of anterior tibial artery entrapment with associated popliteal artery entrapment.
Revisiting Heinz-Lippman disease as a complication of chronic venous insufficiency.
Utilization of coronary computed tomography angiography and computed tomography-derived fractional flow reserve in a critical limb-threatening ischemia cohort.
A rare case of Bannayan-Riley-Ruvalcaba syndrome with concurrent arteriovenous malformation.
Autologous and synthetic pediatric iliofemoral reconstruction: A novel technique for pediatric iliofemoral artery reconstruction.
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
-
In this episode Abena Appah-Sampong (@abenasamp) and Leana Dogbe (@leanadogbe) partner with Vaiva Dabravolskaite ([email protected]) from ESVS to host an episode discussing social deprivation in vascular surgery. Dr. Tara Mastracci and Dr. Olamide Alabi join us to offer insights into how social deprivation drives disparities in outcomes and steps to how we can shift practice paradigms to better address our patient needs.
Dr. Tara Mastracci (@aorticsurgeon) is a vascular surgeon with over 15 years of experience treating and managing complex aortic pathologies. She is currently working at St. Bartholomew’s Hospital in London, UK, on the Cardiothoracic Team doing complex aortic surgery. On top of her clinical duties, Dr. Mastracci is dedicated to studying the social and non-clinical factors influencing vascular outcomes.
Dr. Olamide Alabi (@OAlabiMD) is an Associate Professor of Surgery in the Department of Surgery at Emory University School of Medicine. Her clinical effort focuses on the full scope of vascular disease for patients at Emory University Hospital and the Atlanta VA HealthCare System, however, her academic portfolio and funded research is focused primarily on the intersection of peripheral artery disease, quality, and health equity.
References:
Social Deprivation and the Association With Survival Following Fenestrated Endovascular Aneurysm Repair/2021 https://www.annalsofvascularsurgery.com/article/S0890-5096(21)00872-4/fulltext
Is social deprivation an independent predictor of outcomes following cardiac surgery? An analysis of 240,221 patients from a national registry. BMJ/2015 https://bmjopen.bmj.com/content/5/6/e008287.long
Survival Disparity Following Abdominal Aortic Aneurysm Repair Highlights Inequality in Ethnic and Socio-economic Status/ https://www.ejves.com/article/S1078-5884(17)30521-X/fulltextNash, D., McClure, G., Mastracci, T. M., & Anand, S. S. (2022). Social deprivation and peripheral artery disease. Canadian Journal of Cardiology, 38(5), 612-622.
Vart, P., Coresh, J., Kwak, L., Ballew, S. H., Heiss, G., & Matsushita, K. (2017). Socioeconomic status and incidence of hospitalization with lower‐extremity peripheral artery disease: atherosclerosis risk in communities study. Journal of the American Heart Association, 6(8), e004995.
Henry, A. J., Hevelone, N. D., Belkin, M., & Nguyen, L. L. (2011). Socioeconomic and hospital-related predictors of amputation for critical limb ischemia. Journal of vascular surgery, 53(2), 330-339.
Demsas, F., Joiner, M. M., Telma, K., Flores, A. M., Teklu, S., & Ross, E. G. (2022, June). Disparities in peripheral artery disease care: A review and call for action. In Seminars in vascular surgery (Vol. 35, No. 2, pp. 141-154). WB Saunders.
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
-
Join Audible Bleeding team Matthew Chia, Nitin Jethmalani, and Leana Dogbe and editors from the JVS family of publications Thomas Forbes and Gale Tang as we discuss two of the latest highlights in vascular research. First, we welcome Mary McDermott, MD to discuss the discordance between patient-reported outcomes and objective PAD measures in the latest episode of the JVS. The episode finishes with a stimulating discussion with Alex Chan, PhD to discuss the effect of nicotine on angiogenesis in a murine model of PAD.
Articles:
Discordance of patient-reported outcome measures with objectively assessed walking decline in peripheral artery disease by McDermott et al. https://doi.org/10.1016/j.jvs.2023.12.027
Chronic nicotine impairs the angiogenic capacity of human induced pluripotent stem cell-derived endothelial cells in a murine model of peripheral arterial disease by Chan et al. https://doi.org/10.1016/j.jvssci.2023.100115
Related Articles:
Clinical characteristics and response to supervised exercise therapy of people with lower extremity peripheral artery disease by Patel et al. https://doi.org/10.1016/j.jvs.2020.04.498
Effects of supervised exercise therapy on blood pressure and heart rate during exercise, and associations with improved walking performance in peripheral artery disease: Results of a randomized clinical trial by Slysz et al. https://doi.org/10.1016/j.jvs.2021.05.033
Show Guests:
Mary McDermott, MD is the Jeremiah Stamler Professor of Medicine and Preventive Medicine at the Feinberg School of Medicine at Northwestern Medicine. Among her many accolades and titles, she serves as deputy editor of the Journal of the American Medical Society, and has an extensive career focused on improving our understanding of peripheral arterial disease.
Alex Chan, PhD is a researcher who studied regenerative medicine and cell therapeutics as a postdoctoral fellow in the lab of Dr. Ngan Huang, PhD at the Stanford Cardiovascular Institute.
-
In today’s episode, Dr. Rachael Forsythe (@ROForsythe), consultant vascular surgeon at NHS Lothian, leads a fictional case-based discussion with leaders in managing diabetic foot ulcers. Joining the conversation are Professor Andrew Boulton, Mr. Patrick Coughlin, Dr. David Armstrong, Dr. Dane Wukich, and Dr. Edgar Peters.
Professor Boulton is a professor of medicine at Manchester University in England and is co-chair of the Malvern Diabetic Foot Conference meeting. He served as president of numerous distinguished societies, including the International Diabetes Federation.
Dr. Coughlin (@Coughlin_pa) is a consultant vascular surgeon in Leeds, England. He is a very active member of the Vascular Society of Great Britain and Ireland Council and has a special academic and clinical interest in peripheral artery disease.
Dr. Armstrong (@DGArmstrong) is a podiatric surgeon and professor of surgery at Keck School of Medicine of the University of California and director of the Southwestern Academic Limb Salvage Alliance. Dr. Armstrong is very well known for his work on amputation prevention, the diabetic foot and wound healing.
Dr. Wukich (@DaneWukich) is a professor and chair of the Department of Orthopedics at the University of Texas, Southwestern and Medical Director of Orthopedic Surgery at UT Southwestern University Hospitals. Dr. Wich has an interest in foot and ankle surgery, including the management of diabetes-related complications.
Dr. Edgar Peters is an associate professor of internal medicine, infectious diseases, and acute medicine at Amsterdam University Medical Centers, Dr. Peter's main interest is infection of the musculoskeletal system, particularly in patients with diabetes and is the Scientific Secretary of the International Symposium on the Diabetic Foot.
Malvern Diabetic Foot Conference info:
https://www.facebook.com/MalvernDiabeticFootConference/
https://eu.eventscloud.com/website/8151/
If this episode was of interest to you, please take a listen to this Transatlantic Series episode where we speak with the authors of the SVS, ESVS, and IWGDFU joint guidelines on the management of peripheral arterial disease (PAD) in patients with diabetes.
Articles, resources, and societies referenced in the episode:
DF Blog. “Oral Is the New IV. Challenging Decades of Blood and Bone Infection Dogma: A Systematic Review @bradspellberg @lacuscmedcenter @usc,” January 1, 2022. https://diabeticfootonline.com/2022/01/01/oral-is-the-new-iv-challenging-decades-of-blood-and-bone-infection-dogma-a-systematic-review-bradspellberg-lacuscmedcenter-usc/.
Gariani, Karim, Truong-Thanh Pham, Benjamin Kressmann, François R Jornayvaz, Giacomo Gastaldi, Dimitrios Stafylakis, Jacques Philippe, Benjamin A Lipsky, and Lker Uçkay. “Three Weeks Versus Six Weeks of Antibiotic Therapy for Diabetic Foot Osteomyelitis: A Prospective, Randomized, Noninferiority Pilot Trial.” Clinical Infectious Diseases 73, no. 7 (October 5, 2021): e1539–45. https://doi.org/10.1093/cid/ciaa1758.
Li, Ho-Kwong, Ines Rombach, Rhea Zambellas, A. Sarah Walker, Martin A. McNally, Bridget L. Atkins, Benjamin A. Lipsky, et al. “Oral versus Intravenous Antibiotics for Bone and Joint Infection.” New England Journal of Medicine 380, no. 5 (January 31, 2019): 425–36. https://doi.org/10.1056/NEJMoa1710926.
Magliano, Dianna, and Edward J. Boyko. IDF Diabetes Atlas. 10th edition. Brussels: International Diabetes Federation, 2021.
Østergaard, Lauge, Mia Marie Pries-Heje, Rasmus Bo Hasselbalch, Magnus Rasmussen, Per Åkesson, Robert Horvath, Jonas Povlsen, et al. “Accelerated Treatment of Endocarditis—The POET II Trial: Ration
ale and Design of a Randomized Controlled Trial.” American Heart Journal 227 (September 2020): 40–46. https://doi.org/10.1016/j.ahj.2020.05.012.
Price, Patricia. “The Diabetic Foot: Quality of Life.” Clinical Infectious Diseases 39 (2004): S129–31.
Sharma, S., C. Kerry, H. Atkins, and G. Rayman. “The Ipswich Touch Test: A Simple and Novel Method to Screen Patients with Diabetes at Home for Increased Risk of Foot Ulceration.” Diabetic Medicine: A Journal of the British Diabetic Association 31, no. 9 (September 2014): 1100–1103. https://doi.org/10.1111/dme.12450.
Shin, Laura, Frank L. Bowling, David G. Armstrong, and Andrew J.M. Boulton. “Saving the Diabetic Foot During the COVID-19 Pandemic: A Tale of Two Cities.” Diabetes Care 43, no. 8 (August 1, 2020): 1704–9. https://doi.org/10.2337/dc20-1176.
Tone, Alina, Sophie Nguyen, Fabrice Devemy, Hélène Topolinski, Michel Valette, Marie Cazaubiel, Armelle Fayard, Éric Beltrand, Christine Lemaire, and Éric Senneville. “Six-Week Versus Twelve-Week Antibiotic Therapy for Nonsurgically Treated Diabetic Foot Osteomyelitis: A Multicenter Open-Label Controlled Randomized Study.” Diabetes Care 38, no. 2 (February 1, 2015): 302–7. https://doi.org/10.2337/dc14-1514.
Wukich, Dane K., Katherine M. Raspovic, and Natalie C. Suder. “Patients With Diabetic Foot Disease Fear Major Lower-Extremity Amputation More Than Death.” Foot & Ankle Specialist 11, no. 1 (February 2018): 17–21. https://doi.org/10.1177/1938640017694722.
-
Audible Bleeding editor Wen (@WenKawaji) is joined by 5th integrated vascular resident Yang (@YangYang_MD) and Moira 3rd year medical student discussing the International Society for Women Vascular Surgeons and Women’s Vascular Summit with Dr. Linda Harris.
Show Guests:
Dr. Linda Harris: Dr. Harris joined University of Buffalo in 1995 and currently sits as Professor of Surgery with tenure in the Department of Surgery. She is also the Program Director for the Vascular Fellowship and Vascular Residency Programs. She is the president of the international society for women vascular surgeons.
SVS Women's section episodes
SVS Women’s Section with Dr. Duncan and Dr. Shaw
SVS Women's Section: Advice for Young Surgeons
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
-
In this episode of Audible Bleeding, editor Dr. Adam Johnson is joined by General Surgery PGY-3 Sasank Kalipatnapu, MS2 Nishi Vootukuru, along with Dr. Anton Sidawy, MD, and Dr. William Schutze to discuss the nuances of the recently launched Society for Vascular Surgery (SVS) Outpatient Verification Program, in collaboration with the American College of Surgeons.
This episode brings out a conversation exploring the history behind the development of the program, the current state of the program, and the overwhelming importance of the program in the current day. The episode will also cover the broad steps that need to be taken by a facility looking to become verified and will also show the value added by being verified by this joint ACS/SVS Vascular Verification program.
Dr. Anton Sidawy, MD, MPH, FACS is the Lewis B. Saltz Chair and Professor of Surgery at George Washington School of Medicine, Washington DC. He is the chair of the Vascular Verification Program steering committee and oversees the development and implementation of inpatient and outpatient vascular verification programs.
Dr. William Patrick Shutze is a Vascular Surgeon from Texas Vascular Associates in Plano, TX, and Chair of the Outpatient Committee. He is also the secretary for the Society for Vascular Surgery and is also the chair of the Communications Committee. He has led the efforts with the implementation of the recently launched Outpatient Verification Program.
Relevant links:
Official page of the Vascular Verification Program
Co-Hosts:
Dr. Adam Johnson is an Assistant Professor of Surgery at Duke University and editor at Audible Bleeding.
Dr. Sasank Kalipatnapu is a PGY-3 General Surgery resident at UMass Chan Medical School, Worcester, MA.
Nishi Vootukuru is a 2nd-year medical student at Rutgers NJMS University, Newark, NJ.
-
Audible Bleeding editor Wen (@WenKawaji) is joined by 3rd year general surgery resident Ryan Ellis discussing robotic vascular surgery with Dr. Judith Lin (@JudithLin4) and Dr. Petr Stadler. Dr. Lin and Dr. Stadler will share their personal journey in robotic vascular surgery, cases they have done, and what think the future looks like. This is part one of our robotic vascular series. Our next episode will feature Dr. Lumsden and Dr. Bavare from Houston Methodist.
Show Guests:
Dr. Judith Lin: professor and chief of vascular surgery in the Department of Surgery at Michigan State University’s College of Human Medicine
Dr. Petr Stadler: Professor of Surgery, Head of Vascular Surgery Department, Na Homolce Hospital, Prague, Czech Republic
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
-
Audible Bleeding editor Wen (@WenKawaji) is joined by second year medical student Nishi (@Nishi_Vootukuru), 3rd year general surgery resident Sasank Kalipatnapu (@ksasank) from UMass Chan Medical School, JVS editor Dr. Forbes (@TL_Forbes) and JVS-CIT associate editor Dr. O’Banion (@limbsalvagedr) to discuss two great articles in the JVS family of journals regarding endovascular management of acute limb ischemia and ultrasound-based femoral artery calcification score. This episode hosts Dr. Thomas Maldonado (@TomMaldonadoMD) and Dr. Raul J. Guzman, the authors of the following papers:
Articles:
Safety and efficacy of mechanical aspiration thrombectomy at 30 days for patients with lower extremity acute limb ischemia by Dr. Maldonado and colleagues.
An ultrasound-based femoral artery calcification score by Dr. Raul Guzman and colleagues.
Show Guests:
Dr. Thomas Maldonado is the Schwartz - Buckley endowed professor of surgery in the Vascular Division at New York University Langone Medical Center in New York, Co-Director of Center for Complex Aortic Disease
Dr. Raul J. Guzman is the Donald Guthrie Professor of Vascular Surgery, Chief of Division of Vascular Surgery at Yale New Haven Hospital. He is also Surgeon-in-Chief of Vascular Surgery, Heart and Vascular Center for the Yale New Haven Health System. ([email protected])
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
-
Authors:
Sebouh Bazikian - MS4 at Keck School of Medicine of University of Southern California
Gowri Gowda - PGY1 at the University of California Davis Integrated Vascular Surgery Program
Steven Maximus- Vascular surgery attending at the University of California Davis, Director of the Aortic Center
Resources:
Rutherford’s 10th Edition Chapters: 88, 89, and 91
The North American Symptomatic Carotid Endarterectomy
Asymptomatic Carotid Atherosclerosis Study
Audible Bleeding’s eBook chapter on cerebrovascular disease
Houston Methodist CEA Dissection Video:
Part 1: https://www.youtube.com/watch?v=wZ8PzhwmSXQ
Part 2: https://www.youtube.com/watch?v=E_wWpRKBy4w
Outline:
1. Etiology of Carotid Artery Stenosis
Risk factors: advanced age, tobacco use, hypertension, diabetes.
Atherosclerosis as the primary cause.
Development of Atherosclerotic Disease and Plaque Formation
LDL accumulation in arterial walls initiating plaque formation.
Inflammatory response, macrophage transformation, smooth muscle cell proliferation.
Role of turbulent blood flow at carotid bifurcation in plaque development.
Clinical Features of Carotid Artery Stenosis
Asymptomatic nature in many patients.
Symptomatic presentation: Transient ischemic attacks, amaurosis fugax, contralateral weakness/sensory deficit.
Carotid bruit as a physical finding, limitations in diagnosis.
Importance of Evaluating CAS
Assessing stenosis severity and stroke risk.
Revascularization benefits dependent on stenosis severity.
Classification of Stenosis Levels
Clinically significant stenosis: ≥ 50% narrowing.
Moderate stenosis: 50%–69% narrowing.
Severe stenosis: 70%–99% narrowing.
Stroke Risk Associated with Carotid Stenosis
Annual stroke rate: ~1% for 50-69% stenosis, 2-3% for 70-99% stenosis.
Diagnosis and Screening
No population-level screening recommendation.
Screening for high-risk individuals as per SVS guidelines.
Carotid Duplex Ultrasound as primary diagnostic tool.
Additional tools: CT angiography, Magnetic Resonance Angiography.
Handling of 100 cm/sec, Internal/Common Carotid peak systolic velocity Ratio > 4.
Revascularization Criteria
Symptomatic Patients: 50-69% or 70-99% stenosis, life expectancy at least three or two years, respectively.
Asymptomatic Patients: 70% stenosis, considering life expectancy.
Surgical Indications and Contraindications
Indications: symptomatic patients, life expectancy considerations.
Contraindications: Stenosis
-
Welcome to the Transatlantic series, a co-production of Audible Bleeding (a publication of the SVS) and the ESVS podcast. In today’s episode, we explore the intersocietal guidelines on peripheral arterial disease in patients with diabetes and foot ulcers authored by the International Working Group on the Diabetic Foot (IWGDF), the European Society for Vascular Surgery (ESVS), and the Society for Vascular Surgery (SVS).
Dr. Robert Fitridge is a Professor of Vascular Surgery at University of Adelaide in Australia. He is a member of the IWGDF and is also a member of the steering committee for the Global Vascular Guideline on the management of Chronic Limb-threatening Ischaemia.
Dr. Vivienne Chuter is a Professor in the Department of Podiatry at Western Sydney University and Honorary Professor in the School of Health Science at The University of NewCastle. She is a member of the IWGDF. She has published extensively on diabetic foot disease and leads a clinically based research program focusing on the prevention and management of diabetes-related foot disease for Aboriginal and Torres Strait Islander people and for non-Indigenous Australians.
Dr. Nicolaas Schaper is an emeritus professor of Endocrinology at Maastricht University Hospital in the Netherlands. Dr. Schaper was the coordinator of the European diabetic foot research consortium, Eurodiale. He is Chair of the 2023 Diabetic Foot Symposium (ISDF 2023) and is Chair of the IWGDF.
Dr. Joseph L. Mills is a Professor of Vascular Surgery at Baylor in Houston, Texas. He is a member of the IWGDF. Dr. Mills is a leader in the vascular surgery global community, has served as president of the Peripheral Vascular Surgery Society, and is currently a member of the Surgery Residency Review Committee of the ACGME.
Further reading and links:
The intersocietal IWGDF, ESVS, SVS guidelines on peripheral artery disease in people with diabetes mellitus and a foot ulcer.
Global vascular guidelines for CLTI
Best-CLI
Engaging patients and caregivers to establish priorities for the management of diabetic foot ulcers
A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers
A vein bypass first versus a best endovascular treatment first revascularisation strategy for patients with chronic limb threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal revascularisation procedure to restore limb perfusion (BASIL-2): an open-label, randomised, multicentre, phase 3 trial
Release of the National Scheme's Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025; the impacts for podiatry in Australia: a commentary
Editor's Choice - European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on Antithrombotic Therapy for Vascular Diseases
Results of the CAPRIE trial: efficacy and safety of clopidogrel. Clopidogrel versus aspirin in patients at risk of ischaemic events
Low-Dose Aspirin for the Primary Prevention of Cardiovascular Disease in Diabetic Individuals: A Meta-Analysis of Randomized Control Trials and Trial Sequential Analysis
Diabetes, Lower-Extremity Amputation, and Death
Outcomes in patients with chronic leg wounds in Denmark: A nationwide register‐based cohort study
Pedal arch patency and not direct-angiosome revascularization predicts outcomes of endovascular interventions in diabetic patients with critical limb ischemia
Effectiveness of bedside investigations to diagnose peripheral artery disease among people with diabetes mellitus: A systematic review.
Performance of non-invasive bedside vascular testing in the prediction of wound healing or amputation among people with foot ulcers in diabetes: A systematic review.
Effectiveness of revascularisation for the ulcerated foot in patients with diabetes and peripheral artery disease: A systematic review.
The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: Risk stratification based on Wound, Ischemia, and foot Infection (WIfI).
Surgery or Endovascular Therapy for Chronic Limb-Threatening Ischemia.
A vein bypass first versus a best endovascular treatment first revascularisation strategy for patients with chronic limb threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal revascularisation procedure to restore limb perfusion (BASIL-2): an open-label, randomised, multicentre, phase 3 trial.
Mobile Applications:
Society for Vascular Surgery Mobile App for Staging of Chronic Limb-Threatening Ischemia.
European Society for Vascular Surgery Clinical Practice Guidelines Mobile Edition.
Hosts:
Dr. Naveed A. Rahman is a chief surgery resident at SUNY Upstate in Syracuse, NY. He will pursue a vascular surgery fellowship at the University of Maryland starting in 2024. His Doximity profile is https://www.doximity.com/pub/naveed-rahman-md. Twitter: @naveedrahmanmd
Dr. Suzanne Stokmans is a fifth-year vascular surgery resident at the Isala Hospital in Zwolle, the Netherlands.
Dr. Ezra Schwartz is a medical graduate from McGill University currently completing a Master of Medical Science in Medical Education at Harvard Medical School. He is an aspiring vascular surgeon and surgical education researcher. Twitter: @ezraschwartz10
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
-
In today’s episode, Dr. Sharif Ellozy, Gowri Gowda, Ezra Schwartz, and Kundanika Lakkadi interview Dr. Premchand “PC” Gupta, a vascular surgeon in India.
Dr. Gupta is the clinical director of vascular and endovascular surgery and vascular interventional radiology at the Care Hospitals in Hyderabad, India. He is President of the Vascular Society of India and Vice President of the World Federation of Vascular Societies. He is actively involved in research, sits on numerous editorial boards and has had many publications and awards.
Dr. Gupta received his medical degree from the Armed Forces Medical College in Pune, India and completed his MS in Surgery at the Postgraduate Institute of Medical Education and Research in Chandigarh, India. He completed his vascular surgery fellowship at Nagoya University School of Medicine, Japan. Dr. Gupta pursued additional training in carotid surgery at the University of North Carolina at Chapel Hill as well as in complex aortic surgery at Houston Methodist Hospital.
Twitter:
Dr. PC Gupta (@pcvasc)
Dr Sharif Ellozy (@sharifellozy)
Dr. Ezra Schwartz (@ezraschwartz10)
Dr. Gowri Gowda (@gowrigowda11)
Kundanika Lakkadi (@kundanikalakka1)
Articles, resources, and societies referenced in the episode:
Indian healthcare system summary
George R, Gupta PC. Vascular Surgery in India - the Challenge and the Promise.
Indian Journal of Vascular and Endovascular Surgery
Vascular Society of Kerala
Vascular Society of India and Vascular Society of India Annual Conference (VSICON)
Aortic Rupture in the Indian Context
Indian National Vascular Day and Amputation Free India and Walkathon
Vascular Awareness In India: What More Needs to be Done
CDC Disinfection & Sterilization Guide
-
Audible Bleeding editor Matt Chia (@chia_md) is joined by Nishi Vootukuru (@Nishi_Vootukuru) and Lili Sadri (@lilisadri) are joined by Drs. Joel Ramirez, James Iannuzzi, and James Pavel Kibrik to discuss their latest publications in the JVS family of journals. Along with insight from JVS Assistant Editor Dr. Paul Dimuzio and JVS-VL Editor-in-Chief Dr. Ruth Bush (@RuthLBush), hear about the latest trends in AAA repair and the value of postoperative duplex after venous thermal ablation. Don't miss it!
Articles:
Decreasing prevalence of centers meeting the Society for Vascular Surgery abdominal aortic aneurysm guidelines in the United States, by Ramirez et al.
Value and limitations of postoperative duplex scans after endovenous thermal ablation, by Kibrik et al.
Additional Links:
Factors associated with ablation-related thrombus extension following microfoam versus radiofrequency saphenous vein closure, by Chin et al.
Outcomes of a single-center experience in eliminating routine postoperative duplex ultrasound screening after endovenous ablation, by Woodhouse et al.
Show guests:
Joel Ramirez, MD - Integrated Vascular Surgery Resident at the University of California, San Francisco
James C. Iannuzzi, MD MPH - Assistant Professor, Division of Vascular and Endovascular Surgery at the University of California, San Francisco
Pavel Kibrik, DO - Graduate of New York Institute of Technology Osteopathic School of Medicine and current vascular surgery researcher at the NYU Langone School of Medicine
Ruth Bush, MD JD MPH FACS - Professor of Vascular Surgery and Associate Dean of Educational Affairs at the University of Texas, Medical Branch and Editor-in-Chief of the Journal of Vascular Surgery Venous and Lymphatic Disorders
-
Audible Bleeding editor Wen (@WenKawaji) is joined by second year medical student Nishi (@Nishi_Vootukuru), third year medical student Leana Dodge (@ldogbe4), JVS editor Dr. Forbes (@TL_Forbes) and JVS-VS associate editor Dr. Curci (@CurciAAA) to discuss two great articles in the JVS family of journals regarding Medicare reimbursement for complex endovascular aortic aneurysm repair and novel drug delivery method involving tissue factor targeting peptides in reducing vascular injury response. This episode hosts Dr.Brinster, Dr. Conte, and Dr. Kim, the authors of the following papers:
Articles:
Current Medicare reimbursement for complex endovascular aortic repair is inadequate based on results from a multi-institutional cost analysis by Brinster et al.
Tissue factor targeting peptide enhances nanoparticle binding and delivery of a synthetic specialized pro-resolving lipid mediator to injured arteries by Dr. Levy et al.
Show Guests:
Dr. Clayton Brinster: Associate Professor of Surgery at University of Chicago, and Co-Director of Center for Aortic Diseases, Department of Vascular Surgery and Endovascular Therapy
Dr. Michael Conte: E.J. Wylie Chair, professor and chief of the division of Vascular and Endovascular Surgery at UCSF. Co-Directot of Heart and Vascular Center, Co-Director of UCSF Center for Limb Preservation and Diabetic Foot.
Dr. Alexander Kim: Vascular surgery fellow and research fellow at UCSF
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
-
Audible Bleeding editor Wen (@WenKawaji) is joined by 5th year general surgery resident Richa Kalsi (@KalsiMD) from University of Maryland Medical Center, 3rd year general surgery resident Sasank Kalipatnapu (@ksasank) from UMass Chan Medical School, JVS editor Dr. Forbes (@TL_Forbes), and JVS-CIT editor Dr. Smeds (@matsmeds) to discuss two great articles in the JVS family of journals regarding endosuture aneurysm repair mid-term follow-up and endovascular repair of thoracic aortic aneurysm with aberrant subclavian artery. This episode hosts Dr. Frank Arko (@farkomd), Dr. Sukgu Han (@SukguH), and Dr. Fernando Fleischman, authors of the following papers:
Articles:
Five-year outcomes of endosuture aneurysm repair in patients with short neck abdominal aortic aneurysm from the ANCHOR registry by Arko et al
Sandwich thoracic branch endoprosthesis technique for endovascular repair of thoracic aortic aneurysm with aberrant right subclavian artery by Fleischman and Han et al
Show Guests:
Dr. Arko is the Chief of Vascular and Endovascular Surgery with Atrium Health, Siverling Endowed Chair of vascular surgery clinical professor at Wake Forest University, and co-director of Center for Aortic Disease at Sanger Heart and Vascular Institute.
Dr. Sukgu Han is an Associate Professor of Surgery and Program Director for the residency/fellowship in the Division of Vascular Surgery and Endovascular Therapy at Keck School of Medicine of USC. He is also the Co-Director of the Comprehensive Aortic Center at Keck Hospital of USC.
Dr Fernando Fleischman is a cardiothoracic surgeon with extensive aortic expertise at Keck Hospital of USC. He is an Associate Professor of Surgery and Associate Program Director of cardiac surgery at USC. He is also the Co-Director of the Comprehensive Aortic Center.
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
-
Audible Bleeding editors Matt (@chia_md) and Gowri (@GowriGowda11) are joined by 3rd year General Surgery resident Sasank Kalipatnapu (@ksasank), 2nd year medical student Nishi Vootukuru (@Nishi_Vootukuru), JVS editor-in-chief Dr. Thomas Forbes (@TL_Forbes), and JVS-VL Associate Editor Dr. Meryl Logan (@ProleneQueen), to discuss two great articles in the JVS family of journals regarding treatment of asymptomatic carotid artery disease and comparison of venous insufficiency treatment via radiofrequency ablation and microfoam ablation. This episode hosts Dr. Robert Chang, Dr. Stephanie Talutis, and Dr. Juan Carlos Jimenez, the authors of the following papers:
Articles:
JVS: A comparative effectiveness study of carotid intervention for long-term stroke prevention in patients with severe asymptomatic stenosis from a large integrated health system by Chang et al.
JVS-VL: Comparison of outcomes following polidocanol microfoam and radiofrequency ablation of incompetent thigh great and accessory saphenous veins by Talutis et al.
Additional article discussed for JVS-VL: Adjunctive techniques to minimize thrombotic complications following microfoam sclerotherapy of saphenous trunks and tributaries by Jimenez et al.
Show Guests:
Dr. Robert Chang – Assistant Chair of Vascular Surgery, Adjunct Investigator, KP Division of Research Northern California
Dr. Stephanie Talutis - Assistant Professor of Vascular Surgery, Tufts Medical Center
Dr. Juan Carlos Jimenez, Clinical Professor of Surgery, Director, Gonda Venous Center, Vice-Chair for Justice, Equity, Diversity, and Inclusion at UCLA
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
-
In this episode, Imani (@iemcelroy) sits down with Dr. Lyssa Ochoa, vascular surgeon and founder of The San Antonio Vascular and Endovascular (SAVE) Clinic, discussing her efforts to decrease diabetic foot amputations in South Texas. Dr. Ochoa was born and raised along the Texas-Mexico border and attended medical school, general surgery residency, and vascular surgery residency at Baylor College of Medicine in Houston, TX. Understanding that collaboration is key to change health outcomes, Dr. Ochoa has partnered with hospitals, managed care organizations, universities, non-profit organizations, local school districts, city council districts, and clinicians of all kinds to develop amputation prevention programs, awareness platforms, and additional resources.
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
- もっと表示する