Audible Bleeding

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 (vaivadabravolskaite@gmail.com) 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/fulltext Nash, 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.

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.  

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 <50% stenosis cases. Imaging Modalities Ultrasound: Noninvasive, cost-effective, potential overestimation of stenosis. CTA: Fast, high resolution, contrast exposure risks. MRA: Contrast-free plaque analysis, possible overestimation of stenosis. Angiography: Gold standard, expensive, stroke risk. Assessing Degree of Stenosis via CDUS Parameters for 50-69% stenosis: Peak Systolic Velocity (PSV) 125-229 cm/sec, End Diastolic Velocity (EDV) 40-100 cm/sec, Internal/Common Carotid peak systolic velocity Ratio 2-4. Parameters for 70-99% stenosis: PSV ≥ 230 cm/sec, EDV > 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: <50% stenosis, no revascularization; 50-69% stenosis, follow-up and surveillance; >70% stenosis, considering life expectancy. Surgical Indications and Contraindications Indications: symptomatic patients, life expectancy considerations. Contraindications: Stenosis <50%, severe comorbidities, 100% occlusion. Medical Management for All CAS Patients Lifestyle changes, high-intensity statin therapy, antiplatelet therapy. Decision Factors for Surgical Approaches TCAR, stenting, endarterectomy: situational preferences. Carotid Endarterectomy: Surgical Procedure Incision along anterior border of sternocleidomastoid muscle. Electrocautery through platysma muscle and subcutaneous tissues. Protecting the great auricular nerve, dividing the external jugular vein. Retracting sternocleidomastoid muscle, exposing carotid sheath. Dissecting internal jugular vein, ligating facial vein. Avoiding injury to the vagus nerve, dissecting the common carotid artery. Identifying and mobilizing the hypoglossal nerve, addressing the external carotid artery. Extending dissection from common carotid artery to beyond the internal and external carotid bifurcation. Longitudinal arteriotomy, plaque removal using a Freer elevator. Ensuring a smooth transition between endarterectomized artery and normal distal extent. Patch angioplasty for arteriotomy closure, sequential clamp release for de-airing. Neuromonitoring and Plaque Removal Neuromonitoring methods: EEG, SSEPs, TCD, cerebral oximetry, awake patient monitoring. Shunting and Vessel Closure Shunting indications: neurological status changes, EEG alterations. Carotid stump pressure measurement. Postoperative Complications and Management Common complications: stroke, hyperperfusion syndrome, myocardial infarction, cervical hematoma, nerve injuries, infection. Managing hyperperfusion syndrome: blood pressure control, antiepileptic drugs. Cranial nerve injuries:  Hypoglossal Nerve (CN XII): Injury leads to tongue deviation towards the injured side. Glossopharyngeal Nerve (CN IX): Injury results in swallowing difficulties and aspiration risk. Vagus Nerve (CN X): Injury causes hoarseness due to laryngeal muscle involvement. Marginal Mandibular Branch of Facial Nerve: Injury leads to ipsilateral lip droop.   Follow us @audiblebleeding   Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

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

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.  

Dr. Matt Chia and Dr. Ezra Schwartz (@ezraschwartz10) continue the exploration of how vascular surgeons and patients communicate. They discuss how we share stories with one another and what may get lost in translation.   We are excited to welcome Katie Wright (@Translucentone) and Dr. Sherene Shalhub (@ShereneShalhub) to discuss the patient experience of living with Vascular Ehlers-Danlos Syndrome or vEDS.   Katie Wright is the vEDS Natural History Study project coordinator in the Division of Vascular Surgery at Oregon Health & Science University, a podcaster, and a patient advocate. They served as the Director of the Marfan Foundation’s vEDS Division, The VEDS Movement until this past March, and they sit on the VEDS Collaborative (@vEDSCollabo) and Aortic Dissection Collaborative (@ADCollab) advisory board. Katie was diagnosed with vEDS in 2017 at the age of 28. Shortly after diagnosis, they started raising awareness and fostering community through YouTube videos. Katie then began a podcast titled Staying Connected, a space to share the stories of other patients and patient families. In 2018, Katie started volunteering on the advisory board of the vEDS Collaborative, a patient-centered research collaborative group led by Dr. Sherene Shalhub.    Dr. Sherene Shalhub is the inaugural John M. Porter Chair in Vascular Surgery and Division Head of the Division of Vascular and Endovascular Surgery at Oregon Health & Science University. She is also the Vice Chair of Regional Strategy & Surgical Operations for the Department of Surgery. Dr. Shalhub’s research interests focus on improving healthcare and outcomes for those with genetic vascular conditions. She is the lead investigator for the vEDS Collaborative Natural History Study and the PCORI-funded Aortic Dissection Collaborative. Dr. Shalhub obtained an MPH followed by her medical degree at the University of South Florida. Dr. Shalhub completed her general surgery training at the University of Washington. She then pursued fellowships in trauma research and vascular surgery at the University of Washington.   Resources:   The VEDS Movement  VEDS Collaborative & Natural History Study If you are interested in taking part in the study or would like more information, please contact the study team VEDSColl@ohsu.edu Donate to the vEDS Natural History Study here. Aortic Dissection Collaborative for Patient-Centered Research | BeCertain.org Staying connected Episode: What Medical Professionals Should Know about VEDS Splenic artery pathology presentation, operative interventions, and outcomes in 88 patients with vascular Ehlers-Danlos syndrome Open repair of abdominal aortic aneurysms in patients with vascular Ehlers-Danlos syndrome Audible Bleeding Exam Prep Aortopathies Episode with Dr. Shalhub Free Chime Sound Effects Download - Pixabay   Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

Vascular Team Talk is back with our second episode! This podcast mini-series is brought to you by the Society of Vascular Surgery Physician Assistant Section and Audible Bleeding. How does your Vascular team communicate or organize the day? Teams can consist of many people who have different responsibilities and due to the busy nature of vascular surgery services, it may be difficult to ensure urgent matters get passed on. In this episode, we focus on the importance of communication and relationships between vascular surgery students, residents, APPs, fellows and attendings.    Jessica Fernandes, PA-C, a Vascular Surgery physician assistant at Boston Medical Center (BMC), interviews Dr. Katie Shean, a vascular surgeon at St. Elizabeth's Medical Center, regarding the importance of communication and the transition from a fellowship to an attending position. Both Jessica and Dr. Shean discuss how they worked together at BMC and compare how Dr. Shean runs her current vascular team at St. Elizabeth's Medical Center.    Show Guests: - Jess Fernandes, PA-C, is an inpatient physician assistant in the Division of Vascular and Endovascular Surgery at Boston Medical Center. She is also a member of the SVS PA committee and NESVS PA committee. She graduated with her bachelor degree and Master in Physician Assistant Studies from MCPHS University in 2016.    - Katie Shean, MD is a vascular surgeon in the Division of Vascular and Endovascular Surgery at St. Elizabeth's Medical Center in Brighton, Massachusetts. She completed medical school at University of Vermont Medical School in 2013, followed by her general surgery residency at St. Elizabeth's Medical Center and vascular surgery fellowship at Boston Medical Center which she completed in 2022.    Show Links: SVS Physician Assistant Section St. Elizabeth's Medical Center Vascular and Endovascular Division  

Audible Bleeding editors Wen Kawaji (@WenKawaji), Yasong Yu (@YasongYuMD), and Imani McElroy (@IEMcElroy) are joined by Seth Sankary to discuss their experiences this past year going through the fellowship match process. They discuss the pearls and pitfalls of the interview trail and what influenced their final rank list decisions.    Show Guests: Seth Sankary, MD - General Surgery Chief Resident at the University of Chicago   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 Wen (@WenKawaji) and Matt (@chia_md) are joined by Lara Lopes (@laralopesMD), Nitin Jethmalani (@nijethmalani), JVS editor-in-chief Thomas Forbes (@TL_Forbes), and JVS-VS Associate Editor Gale Tang, to discuss two great articles in the JVS family of journals.  This month’s articles discuss the outcomes of aortic repair after Medicaid expansion, and the process of developing a novel device for repair of aortic injury.  Don’t miss this fantastic discussion with the authors and editors at the forefront of vascular surgery!   Articles: Impact of Medicaid expansion on outcomes after abdominal aortic aneurysm repair by Ramadan et al. A dumbbell rescue stent graft facilitates clamp-free repair of aortic injury in a porcine model by Kenawy et al.   Show Guests: Omar Ramadan, MD - Chief General Surgery Resident at University of Pennsylvania Grace Wang, MD MSCE FACS - Director of the Vascular Lab and Associate Professor of Surgery in the Division of Vascular and Endovascular Surgery at the Hospital of the University of Pennsylvania Bryan Tillman, MD PhD - Vascular Surgeon Wexner Medical Center, Associate Professor of Surgery and Director of vascular research at the Ohio State College of Medicine   Audible Bleeding Contributors: Lara Lopes, MD - Vascular Surgery Integrated Resident, Northwestern University Nitin Jethmalani, MD - General Surgery Resident, Vascular Surgery Research Fellow, NYP Cornell   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 the International Series, we interview international vascular surgeons and trainees with the focus of learning and exploring how vascular surgery is practiced around the world and by doing so, gain new insight into how we practice vascular surgery in the United States. In today’s episode, Ezra Schwartz interviews Dr. Ahmed Kayssi, a vascular surgeon in Canada.    Dr. Ahmed Kayssi is a vascular surgeon at Sunnybrook Health Sciences Centre, an Assistant Professor at the University of Toronto and an associate scientist in evaluative clinical sciences at the Sunnybrook Research Institute. Dr. Kayssi completed his general surgery residency and vascular surgery fellowship at the University of Toronto and a limb preservation and wound care fellowship under the supervision of Dr. Richard Neville. Dr. Kayssi holds a Master’s degree in Public Health from the Harvard Chan School of Public Health and is currently pursuing a Doctorate of Public Health in Health Policy and Management from the Johns Hopkins School of Public Health under the supervision of Dr. Lilly Engineer. Dr. Kayssi recently joined the editorial board of Seminars in Vascular Surgery.  Contact Information:  Dr. Ahmed Kayssi  Email: ahmed.kayssi@sunnybrook.ca Twitter: Dr. Ahmed Kayssi (@ahmedkayssi) Dr. Ezra Schwartz (@ezraschwartz10) Dr. Morgan Gold (@morgansgold) University of Toronto Division of Vascular Surgery Articles, resources, and societies referenced in the episode: Canadian Society of Vascular Surgery Research Committee Wounds Canada and Wounds Canada Research Committee Canadian Medical Protective Association Dr. Charles de Mestral University of Toronto Limb Preservation Fellowship Dr. Heather Gill,  The PREHAAAB Trial, and Preoperative Exercise Rehabilitation in Cardiac and Vascular Interventions International Symposium on the Diabetic Foot SVS Vascular Annual Meeting 2024 Canadian Society of Vascular Surgery Annual Conference Health Canada. Canada’s Health Care System - Canada.ca.   Canada: Health system review. Health Systems in Transition

Today, Dr. Ezra Schwartz and Dr. Nakia Sarad continue exploring how vascular surgeons and patients communicate. They discuss how we share stories and what may get lost in translation. Dr. Rita Charon is a general internist, professor of medicine, and professor and founding chair of medical humanities at Columbia University. Dr. Charon originated the field of narrative medicine and is the founder and executive director of the Program in Narrative Medicine at Columbia. A literary scholar, Dr. Charon completed a Ph.D. in English at Columbia, concentrating on narratology and the works of American-British author Henry James. She is the author of Narrative Medicine: Honoring the Stories of Illness, co-author of Principles and Practice of Narrative Medicine, and co-editor of Stories Matter: The Role of Narrative in Medical Ethics and Psychoanalysis and Narrative Medicine. Dr. Abraham Fuks is a clinical immunologist, a Professor in the Department of Medicine and Division of Experimental Medicine at McGill University, a Professor of Oncology at the Goodman Cancer Institute, and served as Dean of the McGill University Faculty of Medicine from 1995 to 2006.  Dr. Fuks’ has published on the metaphors of medicine and ethics in clinical research. In 2021, Dr. Fuks published a book, The Language of Medicine, in which he explores the ability of language to heal or harm and the potent metaphors prevalent in clinical care, especially military metaphors. Dr. Anahita Dua is a vascular surgeon at the Massachusetts General Hospital, an associate professor of surgery at Harvard Medical School, and a frequent guest on Audible Bleeding.  Resources: Dr. Charon’s related works: Narrative Medicine: Honoring the Stories of Illness The Principles and Practice of Narrative Medicine Stories Matter: The Role of Narrative in Medical Ethics and Psychoanalysis and Narrative Medicine TEDx Talk Dr. Fuks’ related works: The Language of Medicine The Mindful Medical Learner Podcast featuring Dr. Fuks Arthur Frank, The Wounded Storyteller: Body, Illness, and Ethics  Dr. Dua’s related works:  Epidemiology of Peripheral Arterial Disease and Critical Limb Ischemia Peripheral Artery Disease: Where We Are and Where We Are Going Validated QOL surveys and Patient Reported Outcome Measures: PORTRAIT (Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories): Overview of Design and Rationale of an International Prospective Peripheral Arterial Disease Study Patient-Reported Outcomes for Peripheral Vascular Interventions for the Vascular Quality Initiative Eric Cassell & Functionality Vasc QOL Questionnaire  PAD QOL Questionnaire Vasc QL-6 Questionnaire European QL 5D 5L Questionnaire X Handles (previously known as Twitter): Dr. Anahita Dua (@AnahitaDua) Dr. Rita Charon (@RitaCharon) Dr. Abraham Fuks (@Abe_McGill) Dr. Ezra Schwartz (@ezraschwartz10) Dr. Nakia Sarad (@NakSaradDO)

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 editor Wen (@WenKawaji) is joined by first-year vascular surgery fellow Zach (@ZMatthay), 5th year integrated vascular surgery resident Kaitlyn (@DunphyKaitlyn), 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 machine learning in carotid endarterectomy and abdominal aortic aneurysm. This episode hosts Dr.Li (@ben_li123), Dr. De Mestral (@vasc_surg), Dr. Kiang (@sharon_Kiang_MD), and Dr. Tomihama (@roger_tomihama), the authors of the following papers: Articles: Using Machine Learning to predict outcomes following carotid endarterectomy by Li et al. Machine learning analysis of confounding variables of a convolutional neural network specific for abdominal aortic aneurysms by Tomihama et al    Show Guests: Dr. Li is a vascular surgery resident and PhD candidate at the University of Toronto Dr. De Mestral is an associate professor of vascular surgery at the University of Toronto who also has a PhD in health services research and focuses on clinical effectiveness, cost, and quality of surgical care. Dr. Sharon Kiang is the chief of vascular surgery at the Loma Linda Veteran’s affairs hospital as well as an associate professor and vice-chair of research of surgery at Loma Linda University. She is also the PI for the Center for Artificial Intelligence and Vascular Engineering. Dr. Roger Tomihama is an associate professor of interventional radiology with 18+ years of experience in clinical medicine, biomedical research, graduate medical education, and professional organizations. He was a former officer in the United States Navy and recipient of the Navy Commendation Medal. As a clinician scientist, he has procured $1.4 million dollars of extramural research grant funding, have 22 peer-reviewed publications, 4 invited publications, and 4 book chapters. His current research focus includes artificial intelligence in imaging for vascular disease.  Lastly, he is currently pursuing a Master's of Business Administration at the Wharton School of Business at the University of Pennsylvania. 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 integrated vascular surgery resident Kaitlyn (@DunphyKaitlyn), JVS Assistant Editor Dr. Paul Dimuzio (@pdimuziomd) and JVS-VL assistant editor Dr. Dua (@AnahitaDua) to discuss two great articles in the JVS family of journals regarding Post-operative stroke risk after carotid endarterectomy and use of Varithena in treating venous leg ulcers. This episode hosts Dr. Levin, Dr. Siracuse and Dr. Shao, the authors of the following papers:   Articles:  Postoperative disability and one-year outcomes for patients suffering a stroke after carotid endarterectomy by Levin et al. VIEW-VLU observational study of the effect of Varithena on wound healing in the treatment of venous leg ulcers by Shao et al.     Show Guests: Dr. Siracuse- Professor of surgery and radiology at Boston University Dr. Shao—vascular surgeon at Swedish hospital, Northshore University Healthsystem in Chicago, IL Dr. Levin—plastic and reconstructive surgery fellow at the University of California Davis     Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.  

Modern-day evidence-based medicine mandates a strong understanding of current local and international guidelines. Surgeons rely heavily on these reports, but what to do when they differ? We have partnered with the ESVS podcast in creating the Transatlantic Series, where we compare and contrast our respective society guidelines. In this inaugural episode, we explore the SVS carotid artery disease guidelines published in 2022 and the recently updated ESVS guidelines published in 2023. Representing the American perspective, we are excited to speak with Dr. Ali AbuRahma. Dr. AbuRahma is the former president of the Society of Vascular Surgery, the Chief of Vascular and Endovascular Surgery at the Charleston Area Medical Centre at West Virginia University, and the corresponding author of the latest SVS guidelines on extracranial cerebrovascular disease. Representing the European perspective, we are delighted to speak with Dr. Barbara Rantner. Dr. Rantner is the co-chair of the 2023 European Society of Vascular Surgery Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease and a leading physician at the Ludwig-Maximillian University Hospital in Munich, Germany. Further reading and links: The North American Symptomatic Carotid Endarterectomy Trial (NASCET) & Audible Bleeding Landmark Papers NASCET Episode  Randomized trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST) The 2nd European Carotid Surgery Trial (ECST-2): rationale and protocol for a randomized clinical trial comparing immediate revascularisation versus optimized medical therapy alone in patients with symptomatic and asymptomatic carotid stenosis at low to intermediate risk of stroke European Stroke Organisation (ESO) guideline on endarterectomy and stenting for carotid artery stenosis A comparative effectiveness study of carotid intervention for long-term stroke prevention in patients with severe asymptomatic stenosis from a large integrated health system SVS Patient Safety Organization (PSO) TCAR Surveillance Project SVS Vascular Quality Initiative (VQI) & VQI TCAR Registry Important recommendations of the German-Austrian S3 guidelines on the management of extracranial carotid artery stenosis (Paper only available in German)  Hosts: Laurence Bertrand is a 5th-year vascular surgery resident at the Ludwig Maximilian University Hospitals of Munich, Germany.  She is a medical graduate from KULeuven, Belgium, and has a Master of Science in International Health from the London School of Hygiene and Tropical Medicine.    Ezra Schwartz (@EzraSchwartz10) is a medical graduate from McGill University pursuing a Master of Medical Science in Medical Education at Harvard Medical School. He is applying to integrated vascular residency programs this year.  Please share your feedback through our Listener Survey! Follow us on Twitter (@audiblebleeding) and learn more about us at https://www.audiblebleeding.com/about-1/.