European Society for Vascular Surgery

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.

Join us for another episode in our journey into the secret lives of vascular machines and devices. In this episode, we look at the ubiquitous vascular stent. Ever wondered who invented them and when they were first used to treat vascular disease? Ever thought about why they are made of stainless steel or nitinol? In fact, what actually is Nitinol? All your burning questions answered in this podcast that delves into the world of vascular bioengineering. Presented by Justin Woolgar.

Only about 50% of patients with chronic diseases adhere to treatment recommendations, and the consequences can be devastating. In this thought-provoking episode of the ESVS Podcasts, we delve into this important and under-discussed issue. Together with Professor Khadija Hafidh, we analyse some factors that help explain why so many patients struggle with adherence, as well as some strategies that have proved effective in improving patient compliance. Spoiler: empathy, communication, shared decision making, and simplifying the treatment regime are key elements. Join us in this episode that can really help your clinical practice.

As vascular surgeons, we all use various pieces of equipment and technology in our day jobs. Everything from the hand-held Doppler to complex ultrasound machines, CT and MRI scanners. Every time we treat vascular disease we use some form of technology, be it an angioplasty balloon, stent or a vascular graft. We are surrounded by technology and use it all the time, but how many of us actually have any clue as to how it works? In this series of podcasts, we will take a slightly light-hearted look at the biomedical engineering involved in some of the pieces of kit that most of us take for granted. Nothing too overwhelming, but enough to explain the science behind the machine.In the first episode, we will take a look at the humble hand-held Doppler machine and explain how this frequently used machine does what it does. We will explain how the Doppler and piezoelectric effects combine to make an essential tool for clinicians and allied healthcare professionals in the field of vascular surgery.Presented by Justin Woolgar.

In this episode, we’re joined by Prof. Alberto Settembrini and Associate Professor Ashley K. Vavra to discuss the application of Enhanced Recovery After Surgery (ERAS) protocols in the treatment of abdominal aortic aneurysms.We explore how ERAS principles are adapted for both open and endovascular AAA repair, covering key elements such as preoperative risk assessment, anaesthetic management, early mobilisation, and discharge planning.The conversation underscores the importance of bridging the gap between evidence and clinical practice, as well as the central role of the entire multidisciplinary team, comprising surgeons, anesthesiologists, nurses, physiotherapists, and dietitians.

In this episode, we’re joined by Prof. Kate McGinigle – vascular surgeon, researcher, and expert in Enhanced Recovery After Surgery (ERAS).We explore the role of ERAS protocols in optimising outcomes for vascular surgery patients, with a focus on preoperative risk assessment, nutritional support, and structured prehabilitation.Drawing on clinical data and implementation experience, Prof. McGinigle outlines practical strategies that surgical teams can adopt to reduce complications, support recovery, and personalise care pathways.This is Part 1 of a two-part series on perioperative optimisation in vascular surgery.Recommended for surgeons, anesthesiologists, dietitians, physiotherapists, and all healthcare professionals involved in perioperative care.

In Part 2 of our wound care series, we shift focus to what happens on the wound bed itself. From negative pressure therapy to advanced dressings and skin grafts – this episode is all about local treatment strategies.Our expert guests, dermatologist Dr. Magdalena Antoszewska and wound care nurse Kamila Mazuryk, walk us through practical solutions, clinical tips, and the logic behind what works (and what doesn’t) in complex wound care, especially when perfusion is compromised. This episode covers:Skin grafts: when, how, and why they succeed or failThe do’s and don’ts of NPWT in ischemic and grafted woundsHow to approach wound bed preparation with limited vascular supplyDressing selection: infection control, moisture balance, and biofilm managementWhen to avoid debridement – and what to do insteadIncorporating patient quality of life and mental health into long-term wound plansAdvanced materials and smart bandage technologyIf you’re dealing with diabetic feet, graft failures, or wounds that just won’t close, this episode brings frontline advice from the people who live in the wound world every day.Whether you're in theatre, clinic, or at the bedside, this is the practical wound wisdom you need.

In a short series of podcasts, we are going to explore the evolving field of complex thoracic aortic repair, with a particular focus on complex endovascular devices implanted in the aortic arch or even the ascending aorta, that is, zones 0 to 2. In today’s episode, we are going to dig into proximal landing zone 2, that is, the need to place the TEVAR device between the left carotid and the left subclavian arteries, so over the origin of the LSA, and strategies to preserve left subclavian artery perfusion.

In this thought-provoking episode of the ESVS Podcast we delve into an important and under-discussed issue in vascular surgery: Are women left behind in carotid stenosis treatment?Carotid stenosis is a contributor to ischemic strokes, and some papers show women may experience delays or suboptimal care in comparison to men. In this episode, we will listen to Professor Barbara Rantner, a senior consultant vascular surgeon from Munich, Germany, and Dr Claudia Schrimpf, a leading expert from Zurich, Switzerland. Together, they explore sex-related differences in carotid disease treatment and share their insights on the latest research and clinical experiences.Join us in this episode!References:Naylor R, Rantner B, Ancetti S, de Borst GJ, De Carlo M, Halliday A, Kakkos SK, Markus HS, McCabe DJH, Sillesen H, van den Berg JC, Vega de Ceniga M, Venermo MA, Vermassen FEG. European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease. Eur J Vasc Endovasc Surg. 2023;65(1):7–111. doi:10.1016/j.ejvs.2022.04.011van Dam-Nolen DHK, van Egmond NCM, Koudstaal PJ, van der Lugt A, Bos D. Sex differences in carotid atherosclerosis: a systematic review and meta-analysis. Stroke. 2023;54(2):315–326. doi:10.1161/STROKEAHA.122.041046Skowronska M, Piorkowska A, Czlonkowska A. Differences in carotid artery atherosclerosis between men and women in the early phase after ischemic event. Neurol Neurochir Pol. 2018;52(1):35–40. doi:10.1016/j.pjnns.2017.09.002Schmid S, Tsantilas P, Knappich C, Kallmayer M, König T, Breitkreuz T, Zimmermann A, Kuehnl A, Eckstein H-H. Risk of in-hospital stroke or death is associated with age but not sex in patients treated with carotid endarterectomy for asymptomatic or symptomatic stenosis in routine practice: secondary data analysis of the nationwide German statutory quality assurance database from 2009 to 2014. J Am Heart Assoc. 2017;6(10):e004764. doi:10.1161/JAHA.116.004764Behrendt CA, Ten Bosch JA, Cronenwett JL, Dick F, Guekht A, Halliday A, et al. Sex-related differences in indication and procedural outcomes of carotid interventions in VASCUNET. Eur J Vasc Endovasc Surg. 2023;66(1):7–14. doi:10.1016/j.ejvs.2023.04.022

What role will AI, smart bandages, and regenerative therapies play in the future of wound care? Dr. Kirsi Isoherranen (Immediate Past President of the European Wound Management Association) joins us to explore how advanced technology is reshaping diagnostics, wound bed preparation, and chronic wound treatment, especially for diabetic and ischaemic ulcers. This conversation covers both frontline clinical insights and forward-looking perspectives from one of Europe’s leading wound healing centres.Dr. Isoherranen shares with us how collaboration between vascular surgeons and wound care specialists improves outcomes in managing ischemic and diabetic wounds. They discuss diagnostic delays, treatment planning, and how a multidisciplinary approach, including dermatologists, podiatrists, and nutritionists, can make or break complex wound care cases.

Join us for a compelling episode of the ESVS Podcast as we explore the sex disparities in aortic disease with two experts in aortic surgery in women — Dr. Carlota Fernandez-Prendes and Dr. Anna-Louise Pouncey.In this episode, we discuss why women remain under-represented in clinical trials, which subgroups may benefit most from targeted screening, and why women face higher complication rates after both open and endovascular aneurysm repair in the immediate perioperative period. We also examine the underlying causes of these differences and how vascular surgeons can optimise outcomes for their female patients.This episode underscores the importance of heightened clinical awareness and tailored research. Stay tuned until the end for key insights on aortic aneurysm in women.Referenced articles:Talvitie M, Åldstedt-Nyrønning L, Stenman M, Roy J, Cohnert T, Hultgren R. Women with large intact abdominal aortic aneurysms remain untreated. J Vasc Surg. 2023;78(3):657–667. doi:10.1016/j.jvs.2023.05.025.O’Donnell TFX, Patel PB, Marcaccio CL, Dansey KD, Swerdlow NJ, Rastogi V, Patel VI, Beck AW, Zettervall SL, Schermerhorn ML. Outcomes of complex endovascular treatment of post-dissection aneurysms. Eur J Vasc Endovasc Surg. 2023;66(1):58–66. doi:10.1016/j.ejvs.2023.04.013.Gorgatti F, Nana P, Panuccio G, Rohlffs F, Torrealba JI, Kölbel T. Post-dissection thoraco-abdominal aortic aneurysm managed by fenestrated or branched endovascular aortic repair. Eur J Vasc Endovasc Surg. 2024;68(3):325–334. doi:10.1016/j.ejvs.2024.04.041.Huckaby LV, Sultan I, Trimarchi S, Leshnower B, Chen EP, Brinster DR, et al. Sex-based aortic dissection outcomes from the International Registry of Acute Aortic Dissection. Ann Thorac Surg. 2022;113(2):498–505. doi:10.1016/j.athoracsur.2021.03.100.Tenorio ER, Oderich GS, Farber MA, Schneider DB, Timaran CH, Schanzer A, et al. Outcomes of endovascular repair of chronic postdissection compared with degenerative thoracoabdominal aortic aneurysms using fenestrated-branched stent grafts. J Vasc Surg. 2020;72(3):822–836. doi:10.1016/j.jvs.2019.10.091.Lo RC, Bensley RP, Hamdan AD, Wyers M, Adams JE, Schermerhorn ML; Vascular Study Group of New England. Gender differences in abdominal aortic aneurysm presentation, repair, and mortality in the Vascular Study Group of New England. J Vasc Surg. 2013;57(5):1261–1268.e5. doi:10.1016/j.jvs.2012.11.039.Lancaster EM, Gologorsky R, Hull MM, Okuhn S, Solomon MD, Avins AL, et al. The natural history of large abdominal aortic aneurysms in patients without timely repair. J Vasc Surg. 2022;75(1):109–117. doi:10.1016/j.jvs.2021.07.125.Bulder RMA, Tedjawirja VN, Hamming JF, Koelemay MJ, Balm R, Lindeman JHN; on behalf of the study group collaborators. Hypothesis of the high mortality of female patients following elective open abdominal aortic aneurysm repair. Eur J Vasc Endovasc Surg. 2022;63(5):773–774. doi:10.1016/j.ejvs.2022.01.018.Pouncey AL, David M, Morris RI, Ulug P, Martin G, Bicknell C, Powell JT. Systematic review and meta-analysis of sex-specific differences in adverse events after open and endovascular intact abdominal aortic aneurysm repair: consistently worse outcomes for women. Eur J Vasc Endovasc Surg. 2021;62(3):367–378. doi:10.1016/j.ejvs.2021.05.029.O’Donnell TFX, Verhagen HJ, Pratesi G, Pratesi C, Teijink JAW, Vermassen FEG, et al. Female sex is associated with comparable 5-year outcomes after contemporary endovascular aneurysm repair despite more challenging anatomy. J Vasc Surg. 2019;70(6):1782–1792.e2. doi:10.1016/j.jvs.2019.05.065.

With today's guests, Koen Vree Egberts and Desiree van Noord, we dive into this open-access paper. The study revealed that a stenosis exceeding 50% in the superior mesenteric (SMA) or inferior mesenteric artery on pre-operative computed tomography (CT) scan correlates with an elevated risk of anastomotic leakage (AL) after colorectal surgery. These findings suggest the potential for more personalised risk assessment regarding AL in patients undergoing a colorectal resection by pre-operative screening for mesenteric artery stenosis by duplex ultrasound or CT scan. For cases of SMA stenosis, alternative surgical approaches such as primary stoma creation or (endovascular) revascularisation of the stenosis before colorectal resection could be considered, as well as close post-operative surveillance of patients at risk.

Welcome to the final episode of our ESVS Vascular Fundamentals podcasts. In the last episode, we looked at some basic venous physiology. In this podcast, we will be looking at the haemodynamics of specific venous disorders such as acute venous thrombosis, primary varicose veins and chronic venous insufficiency. Ever wondered why exactly a DVT causes limb swelling? What happens to the venous physiology in phlegmasia? Why do people get varicose veins? What are the haemodynamic consequences of chronic venous insufficiency? Lots more burning questions that we will answer! Stay tuned!With Justin Woolgar and Joanna Halman.

Welcome to Part 3 of our ESVS Vascular Fundamentals series of podcasts. In the last two podcasts we concentrated on arterial haemodynamics; now it's the turn of the venous system.In this episode we look at what constitutes venous pressure and flow. How does blood flow in this low pressure system with what are effectively collapsible tubes. We explain what happens to venous pressure on standing and during exercise. What is ambulatory venous pressure? How does the cardiac cycle affect venous pressure? We will also explain how important the calf muscle pump is in reducing venous pressure and returning blood to the heart. What role do venous valves play? All basic principles in understanding venous patho-physiology.With Justin Woolgar and Joanna Halman.

Welcome to the second episode of our ESVS Vascular Fundamentals podcast series. In the last episode, we looked at the relationship of pressure, flow and resistance and how they interact in the circulation. In part 2, we will be examining how these parameters are affected during exercise, intermittent claudication and limb ischaemia. We will also examine the haemodynamics of vascular grafts and aortic aneurysms. Some of the questions we will explore include why exercise is recommended for claudication, flow dynamics at the graft-arterial anastomosis and why aneurysms rupture. With Justin Woolgar and Joanna Halman.

Join us for the first of our series of Vascular Fundamentals podcasts. In our first episode, we will be breaking down the basics of arterial haemodynamics looking at the physiology of the circulation and how an understanding of it aids our decision making as vascular surgeons. We will attempt to explain the relationship between pressure, flow and peripheral resistance and how they are affected in vascular disease. What role does blood viscosity and Poiseuille's Law play in affecting blood flow? What actually is peripheral resistance? At what point does a stenosis become a significant stenosis and why? Some of the important questions we will explain. With Justin Woolgar and Joanna Halman.

In this podcast, Prof. Matthew Popplewell, lead investigator, discusses the BASIL-3 RCT, diving into the trial's design, the recruitment challenges, the statistical power, and the relevance of its findings to current clinical practice. The discussion also touches on the demographics of the patient population involved in the trial, the underrepresentation of women in vascular trials, the mortality toll of these patients, the recurrent nature of chronic limb-threatening ischemia and the implications for generalizability of the results. Unmissable!Read the full text- article open access through this link:https://www.bmj.com/content/bmj/388/bmj-2024-080881.full.pdf And check out the companion BASIL Prospective Cohort Study mentioned in the podcast:https://www.ejves.com/action/showPdf?pii=S1078-5884%2823%2900804-3

Nationally and internationally, there is a growing awareness of radiation exposure, safety, and protection. In 2023, the ESVS issued a new guideline on radiation safety. In addition, there is growing attention to pregnant healthcare workers. This paper openly discusses the intersection of radiation safety and pregnancy. It was published as an Editor’s Choice paper in EJVES December 2024. Find the original article here:https://www.ejves.com/article/S1078-5884(24)00802-5/abstract

In this episode of our series of podcasts looking at the new ESVS Vascular Trauma Guidelines, Laurence Bertrand and Justin Woolgar interview Professor Bala Pillay, Head of the Durban Metropolitan Vascular Service and Professor Damian Clarke, Head of the Pietermaritzburg Trauma Service, to find out what the guidelines mean and the challenges faced by vascular and trauma surgeons in developing countries such as South Africa. Enjoy!