European Society for Vascular Surgery

In this episode of the ESVS Podcast, supported by Servier, we explore the importance of therapy adherence in chronic venous disease (CVD). The episode opens with short patient testimonies, highlighting real-world reasons for non-adherence.To explore this further, we are joined by Professor Denisa Celovska and Professor Atul Pathak. Professor Celovska is an Associate Professor of Angiology and Internal Medicine at the University Hospital and Comenius University in Bratislava, Slovakia. She is currently the President of the Slovak Angiology Society. Professor Pathak is the Head of the National Institute of Cardiology, Cardiac Surgery and Interventional Cardiology in Luxembourg.In this episode, they share their clinical perspective on why patients frequently disengage from treatment, the most common barriers to adherence in daily practice, and practical strategies to improve long-term treatment persistence.The episode also includes insights from a community pharmacist, offering a complementary view on what happens between prescription and real-life use, particularly regarding venoactive drugs. We conclude by emphasising that effective CVD management extends beyond prescribing treatment. Patient education, shared decision-making, follow-up, and human connection are essential to improve adherence and long-term outcomes in CVD.References:Kim H, Cho S, Lee K, Lee SH, Joh JH. A nationwide study of compliance of venoactive drugs in chronic venous disease patients. Ann Surg Treat Res. 2023 May;104(5):288-295. doi: 10.4174/astr.2023.104.5.288. Epub 2023 Apr 28. PMID: 37179697; PMCID: PMC10172027.Burnier M. The role of adherence in patients with chronic diseases. Eur J Intern Med. 2024 Jan;119:1-5. doi: 10.1016/j.ejim.2023.07.008. Epub 2023 Jul 20. PMID: 37479633.Mezalek ZT, Feodor T, Chernukha L, Chen Z, Rueda A, Sánchez IE, Ochoa AJG, Chirol J, Blanc-Guillemaud V, Lohier-Durel C, Ulloa JH. VEIN STEP: A Prospective, Observational, International Study to Assess Effectiveness of Conservative Treatments in Chronic Venous Disease. Adv Ther. 2023 Nov;40(11):5016-5036. doi: 10.1007/s12325-023-02643-6. Epub 2023 Sep 20. Erratum in: Adv Ther. 2024 Jan;41(1):464-465. doi: 10.1007/s12325-023-02722-8. Erratum in: Adv Ther. 2024 Jun;41(6):2540-2541. doi: 10.1007/s12325-024-02857-2. PMID: 37728696; PMCID: PMC10567827.Bogachev, V., Arribas, J.M.J., Baila, S. et al. Management and evaluation of treatment adherence and effectiveness in chronic venous disorders: results of the international study VEIN Act Program. Drugs Ther Perspect 35, 396–404 (2019). https://doi.org/10.1007/s40267-019-00637-5Golna C, Poimenidou C, Giannoukari EE, Saridi M, Liberopoulos E, Souliotis K. Assessing a pharmacist-enabled intervention to improve adherence to medication for hypertension, dyslipidemia, and chronic venous circulation disorders in Greece. Patient Prefer Adherence. 2023;17:3341–3352. doi:10.2147/PPA.S4208116. Branisteanu DE, Munteanu AE, Dolofan BM, Popescu EG, Vittos O. Adherence to pharmacological treatment in chronic venous disease: results of a real-world, prospective, observational cohort study. Life (Basel). 2025;15(3):377. doi:10.3390/life15030377.7. Ulloa JH, Guerra D, Cadavid LG, Fajardo D, Villarreal R, Bayona G, Hoyos AS, Garcia G. Nonoperative approach for symptomatic patients with chronic venous disease: results from the VEIN Act program. Phlebolymphology. 2018;25(2):123Servier is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Servier. Always consult the Instructions for Use (IFU) prior to using any medical device.

In this episode of the ESVS Podcast, we tackle one of medicine’s most deceptively simple challenges : agreeing on what we’re actually talking about. Vascular graft and endograft infections (VGEI) are rare, serious, and universally dreaded, but when it comes to defining them, classifying them, and reporting outcomes, it turns out the vascular world hasn’t always been speaking the same language. Safa Riahi is joined by Dr Thomas Wyss and Dr Karl Sörelius to discuss a recent international Delphi consensus that brought together 43 multidisciplinary experts to do something surprisingly difficult: agree on definitions. From the long-standing debate over early versus late infection, to the subtle but clinically important difference between graft-enteric erosion and fistula, to the brave attempt to define what “cure” actually means in a disease that likes to relapse when you least expect it, this episode explores how a shared vocabulary might finally help researchers compare studies, registries make sense, and multidisciplinary teams argue a little more productively. As it turns out, building a common language might be one of the most important steps toward better science; and better care; in VGEI.The Delphi consensus discussed in this episode can be accessed here:https://www.ejves.com/article/S1078-5884(25)00707-5/

How common are aortic dissections in Asia, and why do some patients appear to present nearly a decade earlier than in Western cohorts? Laurence Bertrand speaks with Dr. Peter Robless, founder of vascular surgery at the national university hospital of Singapore and former President of the Asian Society for Vascular Surgery, about Asian epidemiology, treatment approaches, and evolving endovascular practice.

Join us for another episode in our Secret Lives series of podcasts, where we delve into the science behind some of the everyday tools and equipment we use in the field of vascular surgery. In this episode, we will be taking a look at what is probably one of the most fearfully complicated pieces of equipment out there, the Magnetic Resonance Imaging or MRI scanner. A true marvel of applied physics and engineering that combines super-conducting magnets and radio-frequency to produce some of the most detailed medical imaging available. We will also take a look at how MR angiography works and how to interpret those grainy MRA images. No need to get confused with those T1 and T2 imaging sequences anymore; All will be explained! With Justin Woolgar.

Welcome to the final episode of the Q&A series of the 2025 ESVS Clinical Practice Guidelines on the Management of Diseases of the Mesenteric and Renal Arteries and Veins. The final episode completes the Q&A series by addressing several important and often rare vascular conditions covered in the 2025 ESVS guidelines.Topics include acute and chronic mesenteric venous thrombosis, anticoagulation strategies and the role of DOACs, and indications for endovascular or surgical intervention. The discussion then turns to renal vascular disease, including renal artery stenosis, fibromuscular dysplasia, and Nutcracker syndrome. The episode concludes with an overview of visceral artery aneurysms and spontaneous isolated dissections of the mesenteric and renal arteries, focusing on diagnosis, risk stratification, and treatment thresholds. This concluding episode offers a comprehensive overview of the remaining guideline chapters and practical insights for clinical decision-making.Full names of guests:Dr. Mark Koelemay Professor Dr. Bob Geelkerken Dr. Nicola Leone Dr. Jussi Kärkkäinen (Part 2)Shownotes:https://www.ejves.com/article/S1078-5884(25)00516-7/fulltexthttps://open.spotify.com/episode/45Hk77hIyikYNcWklAyVMAhttps://open.spotify.com/episode/58yEYHdIdh7IgVQY13gcmk

Welcome to part 2 of the Q&A series of the 2025 ESVS Clinical Practice Guidelines on the Management of Diseases of the Mesenteric and Renal Arteries and Veins. In this podcast, we will highlight the new, complex and most controversial recommendations in this guideline. In episode two, the discussion moves to Median Arcuate Ligament Syndrome (MALS), acute mesenteric ischaemia (AMI), and non-occlusive mesenteric ischaemia (NOMI)—three challenging and clinically relevant conditions.The experts explore patient selection and diagnostic criteria for MALS, ongoing controversies in treatment, and current research. The episode also covers the clinical presentation, imaging findings, and updated diagnostic approach to acute mesenteric ischaemia, including why biomarkers such as lactate and D-dimer are no longer recommended for diagnosis. Finally, management strategies for NOMI, including multidisciplinary care and intra-arterial vasodilator therapy, are discussed.Guests:Dr. Mark Koelemay Professor Dr. Bob Geelkerken Dr. Nicola Leone Dr. Jussi Kärkkäinen (Part 2) Shownotes:https://www.ejves.com/article/S1078-5884(25)00516-7/fulltexthttps://open.spotify.com/episode/45Hk77hIyikYNcWklAyVMAhttps://open.spotify.com/episode/58yEYHdIdh7IgVQY13gcmk

This is part 1 of the Q&A series of the 2025 ESVS Clinical Practice Guidelines on the Management of Diseases of the Mesenteric and Renal Arteries and Veins. In this podcast, we will highlight the new, complex and most controversial recommendations in this guideline. Today, for the first episode of this 3-part series, we will specifically talk about chronic mesenteric ischaemia. Topics include the definition and diagnosis of chronic mesenteric ischaemia, the role of duplex ultrasound and CT angiography, indications for treatment in symptomatic and asymptomatic patients, and decision-making around endovascular versus open revascularisation. New evidence on stent choice and surgical strategies is also discussed. This episode provides practical guidance and expert insight into the updated recommendations for managing chronic mesenteric ischaemia in daily clinical practice.Guests:Dr. Mark Koelemay Professor Dr. Bob Geelkerken Dr. Nicola Leone Dr. Jussi Kärkkäinen (part 2) Shownotes:https://www.ejves.com/article/S1078-5884(25)00516-7/fulltexthttps://open.spotify.com/episode/45Hk77hIyikYNcWklAyVMAhttps://open.spotify.com/episode/58yEYHdIdh7IgVQY13gcmk

In this episode of the ESVS Podcast, host Vaiva Dabravolskaite speaks with Judith Gilroy (Ireland), a medical educator and clinician working on training culture, psychological safety, and fairness in career progression. They reflect on everyday discrimination, belonging, allyship, and the hidden curriculum in surgery. Inspired by research on sexual misconduct and microaggressions, this conversation invites honest self-reflection on how culture shapes careers and how we can do better for each other.Literature sources to be shared if possible (divided into two groups) : 1. Key Report & Ongoing Work• Breaking the Silence: Addressing Sexual Misconduct Prof Carrie Newlands, Ms Tamzin Cuming, Ms Philippa Jackson University of Surrey / RCSI presentation (2024) https://openresearch.surrey.ac.uk/esploro/fulltext/report/BREAKING-THE-SILENCE-Addressing-Sexual-Misconduct/99944566102346• Workplace Sexual Misconduct in Surgery (WPSMS) – updates & research https://www.wpsms.org.uk/2. Reflection & Allyship Videos• “That Little Voice” https://www.youtube.com/watch?v=Ll56imVATLk• What is Intersectionality? – Peter Hopkins https://www.youtube.com/watch?v=O1islM0ytkE• How are Microaggressions Like Mosquitoes? https://www.youtube.com/watch?v=emz49wSnNcs• Heartbreaking Moment When Kids Learn About White Privilege https://www.youtube.com/watch?v=1I3wJ7pJUjg

Want to know why Prof. Tsilimparis says “the dissection membrane is not always your enemy”? Tune in to this ESVS Podcast for an in-depth discussion on indications, decision-making, technical tips and tricks, and what the future may hold for the evolving field of aortic dissection management.Recorded live at LMU University Hospital in Munich, this episode of the ESVS Podcast features host Laurence Bertrand in conversation with Prof. Tsilimparis, Head of Vascular Surgery and an internationally recognised expert in aortic dissection management.

Can exercise really make a difference after deep vein thrombosis? We talk with Professor Marie José van Rijn from Erasmus University Medical Center about how physical activity can influence recovery, reduce complications like post-thrombotic syndrome, and improve quality of life. From early mobilisation to long-term exercise strategies, discover how “get moving” may change the way we manage DVT.Join us for this insightful conversation!References:1. Martins, A; Junior L; Oliveira, J. (2023). Benefits of early mobilization in patients with deep venous thrombosis: a scope review. Heart, Vessels and Transplantation.2. Rook B, van Rijn MJE, Jansma EP, van Montfrans C. Effect of exercise after a deep venous thrombosis: A systematic review. J Eur Acad Dermatol Venereol. 3. Kahn SR. The post-thrombotic syndrome. Hematology Am Soc Hematol Educ Program. 4. Liu Z, Tao X, Chen Y, Fan Z, Li Y. Bed rest versus early ambulation with standard anticoagulation in the management of deep vein thrombosis: a meta-analysis. PLoS One. 5. Anderson CM, Overend TJ, Godwin J, Sealy C, Sunderji A. Ambulation after deep vein thrombosis: a systematic review. Physiother Can. 6. Kahn SR, Comerota AJ, Cushman M, Evans NS, Ginsberg JS, Goldenberg NA, Gupta DK, Prandoni P, Vedantham S, Walsh ME, Weitz JI; American Heart Association Council on Peripheral Vascular Disease, Council on Clinical Cardiology, and Council on Cardiovascular and Stroke Nursing. The postthrombotic syndrome: evidence-based prevention, diagnosis, and treatment strategies: a scientific statement from the American Heart Association.Circulation. 2014 Oct 28;130(18):1636-61. doi: 10.1161/CIR.0000000000000130. Epub 2014 Sep 22. Erratum in: Circulation. 7. Kakkos SK, Gohel M, Baekgaard N, Bauersachs R, Bellmunt-Montoya S, Black SA, Ten Cate-Hoek AJ, Elalamy I, Enzmann FK, Geroulakos G, Gottsäter A, Hunt BJ, Mansilha A, Nicolaides AN, Sandset PM, Stansby G, Esvs Guidelines Committee, de Borst GJ, Bastos Gonçalves F, Chakfé N, Hinchliffe R, Kolh P, Koncar I, Lindholt JS, Tulamo R, Twine CP, Vermassen F, Wanhainen A, Document Reviewers, De Maeseneer MG, Comerota AJ, Gloviczki P, KruipMJHA, Monreal M, Prandoni P, Vega de Ceniga M. Editor's Choice – European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis. Eur J Vasc Endovasc Surg. 8. Jasionowska S, Turner BRH, Machin M, Onida S, Gwozdz AM, Shalhoub J, Davies AH. Systematic review of exercise therapy in the management of post-thrombotic syndrome. Phlebology. 9. Steiner D, Nopp S, Pabinger I, Dassler E, Koppensteiner R, Müller M, Weber B, Ay C, Schlager O. Impact of thrombosis location on walking capacity: a cohort study of patients with acute deep vein thrombosis. Res Pract Thromb Haemost. 10. Wu C, Li X, Zhao H, Ling Y, Ying Y, He Y, Zhang S, Liang S, Wei J, Gan X. Resistance exercise promotes the resolution and recanalization of deep venous thrombosis in a mouse model via SIRT1 upregulation. BMC Cardiovasc Disord. 11. Mota GR, Simim MAM, Dos Santos IA, Sasaki JE, Marocolo M. Effects of Wearing Compression Stockings on Exercise Performance and Associated Indicators: A Systematic Review. Open Access J Sports Med.

In our special holiday podcast we take a look at the current controversy surrounding PFAS or Forever chemicals. Were you aware that one of the most commonly used compounds in vascular surgery, PTFE, actually falls into this category of substances? Is there anything to worry about? What should we be telling patients? All of these burning questions will be answered. With Justin Woolgar.

In this episode, we focus on the trainee perspective in vascular surgery across Europe.Trainees and young vascular surgeons share what works in training, what doesn’t, and what they would change if they could, touching on structure, mentorship, autonomy, soft skills, and everyday challenges.We’re also joined by Dr David Wippel, who presents insights from his research on the training experience of young vascular surgeons, including burnout, fulfilment, and professional development.Get involvedIf you’re a trainee or young vascular surgeon and would like to take part in the survey discussed in this episode, you can join here: Link to the Trainee Survey: https://redcap.link/8ubj206vIf you’re a consultant in vascular surgery with over 5 years of experience and would like to take part in the survey discussed in this episode, you can join here: Link to the Trainer Survey: https://redcap.link/shp8nthlYour input helps shape the future of vascular surgery training.

In Part 1 of our ESVS training series, we speak with Professor Elena Iborra and Professor Igor Končar about the realities of training young vascular surgeons across Europe. They discuss expectations, mentorship, and how to shape safe, effective learning environments for the next generation.A concise, insightful look at what defines good vascular training today.

How can a global, imaging-rich registry powered by AI reshape surveillance and quality of life after EVAR and TEVAR?In this episode of the ESVS Podcast, host Egle Kavaliunaite speaks with Prof. Kak Khee Yeung (Amsterdam UMC, ESVS President 2026–27-elect) and Prof. Timothy Resch (Copenhagen University Hospital) about the TOGETHER Registry, a large, prospective, long-term aortic registry capturing real-world data on EVAR, TEVAR and iliac branch devices, including hostile as well as standard anatomy.In this conversation, they explore:What makes TOGETHER different from previous aortic registries (central imaging, longer follow-up, global scope)How advanced imaging and AI-ready data may help predict which patients need intensive surveillance – and who may safely need lessThe clinical meaning of sac regression, endoleaks and durability when viewed through patient quality of lifeThe strengths and limitations of a single-brand registry in a multi-device treatment landscapeHow remote monitoring, mobile tools and future biomarkers could transform aortic follow-upListen now, and subscribe to the ESVS Podcast on Spotify, Apple Podcasts or SoundCloud, and explore more aortic content in the ESVS Library.

We explore the challenges of Peripheral Arterial Disease (PAD) in women, with two renowned experts: Professor Maarit Venermo and Professor Mirjami Laivuori.Together, we discuss why PAD continues to be underdiagnosed in women despite equal or even higher prevalence, the limitations of the ankle–brachial index (ABI) in female patients, the intricate interplay between estrogen, menopause, and vascular health, the growing trend toward endovascular-first strategies in women, and the conflicting evidence surrounding revascularisation outcomes.An evidence-based and clinically relevant conversation awaits.ReferencesDivakaran S, Krawisz AK, Secemsky EA, Kant S. Sex and Racial Disparities in Peripheral Artery Disease. 2023Jelani QU, Petrov M, Martinez SC, Holmvang L, Al-Shaibi K, Alasnag M. Peripheral Arterial Disease in Women: an Overview of Risk Factor Profile, Clinical Features, and Outcomes. 2018Kozak M, Poredoš P, Blinc A, Kaja Ježovnik M, Poredoš P. Peripheral arterial disease in women. 2024Porras CP, Bots ML, Teraa M, van Doorn S, Vernooij RWM. Differences in Symptom Presentation in Women and Men with Confirmed Lower Limb Peripheral Artery Disease: A Systematic Review and Meta-Analysis. 2022Kavurma MM, Boccanfuso L, Cutmore C, Passam F, Patel S, Hennessy A, Loa J, Figtree GA, Golledge J, Robinson DA, Aitken S. A hidden problem: peripheral artery disease in women. 2023Srivaratharajah K, Abramson BL. Women and Peripheral Arterial Disease: A Review of Sex Differences in Epidemiology, Clinical Manifestations, and Outcomes. 2018Pabon M, Cheng S, Altin SE, Sethi SS, Nelson MD, Moreau KL, Hamburg N, Hess CN. Sex Differences in Peripheral Artery Disease. 2022Twine CP, Kakkos SK, Aboyans V, Baumgartner I, Behrendt CA, Bellmunt-Montoya S, Jilma B, Nordanstig J, Saratzis A, Reekers JA, Zlatanovic P; ESVS Guidelines Committee; Antoniou GA, de Borst GJ, Bastos Gonçalves F, Chakfé N, Coscas R, Dias NV, Hinchliffe RJ, Kolh P, Lindholt JS, Mees BME, Resch TA, Trimarchi S, Tulamo R, Vermassen FEG, Wanhainen A; Document Reviewers; Koncar I, Fitridge R, Matsagkas M, Valgimigli M. European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on Antithrombotic Therapy for Vascular Diseases. 2023Nordanstig J, Behrendt CA, Baumgartner I, Belch J, Bäck M, Fitridge R, Hinchliffe R, Lejay A, Mills JL, Rother U, Sigvant B, Spanos K, Szeberin Z, van de Water W; ESVS Guidelines Committee; Antoniou GA, Björck M, Gonçalves FB, Coscas R, Dias NV, Van Herzeele I, Lepidi S, Mees BME, Resch TA, Ricco JB, Trimarchi S, Twine CP, Tulamo R, Wanhainen A; Document Reviewers; Boyle JR, Brodmann M, Dardik A, Dick F, Goëffic Y, Holden A, Kakkos SK, Kolh P, McDermott MM. European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Claudication. 2024

In this episode, with Prof. Tilo Kölbel, we discuss the significant risks associated with air embolism during aortic surgery, the innovative technique of CO2 flushing of aortic endografts, and the practical tips and tricks of implementing this technique in clinical practice. The conversation also touches on current guidelines and the future of CO2 flushing in endovascular protocols, emphasising its potential to improve patient outcomes. Unmissable!Also, check out these papers that we mentioned in the podcast:https://www.ejves.com/action/showPdf?pii=S1078-5884%2825%2900409-5https://journals.sagepub.com/doi/10.1177/1526602816633705https://pmc.ncbi.nlm.nih.gov/articles/PMC10151986/https://www.ejves.com/action/showPdf?pii=S1078-5884%2818%2930692-0

The war in Gaza has been described as a humanitarian catastrophe. Ever since the war began 2 years ago, following the October 7th attack by Hamas it is estimated that over 68,000 people have been killed, with a further 180,000 injured. Thousands have been displaced, and many have suffered starvation and famine because of the Israeli blockade. The plight of medics trying to treat civilians has also been extremely challenging and dangerous, with health care facilities often targeted by the IDF airstrikes. In this podcast, we talk to Mr Ed Brown, a consultant vascular surgeon from the UK who has recently returned from Gaza and describes his experiences working in a warzone. What does it take to work in such an environment? What are the challenges facing surgeons and other health professionals in Gaza? Ever thought of humanitarian work yourself? These are the questions we hope to answer. With Justin Woolgar.

Aortic stent infections remain among the most feared and complex complications in vascular surgery—rare but devastating when they occur. In episode, recorded live in ESVS Istanbul, Dr. Laurence Bertrand speaks with Dr. Anne Le Jay, about complex aortic reconstruction and graft infection management. Together, they examine how vascular specialists are redefining best practice: from early recognition and imaging to multidisciplinary treatment planning, surgical decision-making, and long-term outcomes.

Recorded live during the ESVS Annual Meeting, this episode brings together two experts shaping the field of oncovascular surgery Dr. Pirkka Vikatmaa and Dr. Stefano Ancetti. We explore how multidisciplinary oncovascular teams are transforming cancer surgery, the expanding role of vascular surgeons in complex tumour resections, and the use of endovascular techniques in oncovascular surgery.

In this episode, recorded live at the 39th ESVS Annual Meeting, we sit down with Prof. Javier Pascual, a podiatrist specialised in diabetic foot care and wound biomechanics. Together, we explore the biomechanical principles behind the most common diabetic foot ulcers (DFUs) — why they develop, how abnormal pressure and gait contribute to tissue breakdown, and what clinicians can do to enhance healing and to prevent ulcer recurrence. Dr. Pascual breaks down complex concepts into practical insights, making this a must-listen for vascular specialists, podiatrists, wound-care nurses, and anyone involved in multidisciplinary diabetic foot management.