Vascular Connections–August 2021 (Preview Edition)

Vascular Connections

The Official Newspaper of the Vascular Annual Meeting

SOCIETY FOR VASCULAR SURGERY

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VESS

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VQI

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VRIC

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AVF

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SVN

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SVU

The vasculature united: Bringing together competing specialties for better patient care

By Bryan Kay Incoming Society for Vascular Surgery (SVS) President Ali AbuRahma, MD, knows the topic of this year’s E. Stanley Crawford Critical Issues Forum at the Vascular Annual Meeting (VAM) might make him as many enemies as it will friends. “You are going to find some people who will love me and some people who will hate me,” he laughs, “Because some of the surgeons on the extremes don’t want anyone to touch the vascular specialty.

On the other side, many cardiologists and interventional radiologists think vascular surgeons are doing some stuff they are not qualified to do.”

B

ut AbuRahma is not dissuaded by any notion of warring tribes in the angiosuite. He picked this year’s issue quite deliberately—the role of multispecialty practice in vascular and endovascular surgery—with a burning question in mind: “Can we work together?”

“The reason I picked ‘Can we work together?’ is because, presently, it’s not uncommon in many centers, hospitals and universities to find the vascular surgeon not only in competition but even in political battles with others. Specialists are fighting each other because everybody thinks they will do a better job for vascular patients,” AbuRahma tells

Ali AbuRahma

Vascular Connections in a recent interview.

That’s why the lineup of the forum includes not only AbuRahma providing the vascular surgeon perspective, but also viewpoints from interventional cardiology, interventional radiology and interventional vascular medicine.

From the vascular surgeon’s vantage point, the storied history of the specialty has deep roots.

“The reality is vascular surgery started with our specialty, and, as you know, that’s why we are celebrating 75 years of our existence as the SVS this year,” AbuRahma explains. “Our specialty goes back a very long time in the United States.

“In the last couple of decades, other specialists began to enter the field.

Sometimes they are justified, sometimes they are not.

Sometimes they are trained to do a great job for patient care, sometimes they are not— and that’s the reason that I felt, perhaps if I could get a session

Preview edition AUGUST 18–AUGUST 21, 2021

where we spend time and listen to one another, we could make progress.”

The three other speakers who will talk during the forum each come from multispecialty practices carrying out some type of vascular or endovascular work.

“Mark Bates, MD, happens to be one of my associates in my multidisciplinary group within my practice at West Virginia University School of Medicine/Charleston Area Medical Center in Charleston, West Virginia, where various specialists work together for vascular patient care, and I am the head of that group,” says AbuRahma. “He is a leader in the interventional cardiology field.

“From interventional radiology, we have James F. Benenati, MD, of Miami Cardiac & Vascular Institute. He was the president of the Society of Interventional Radiology, and he will discuss that perspective and what they can do in the vascular field.

And we have Bruce Gray, DO, from the University of South Carolina in Greenville, who is very well respected for interventional vascular medicine.” Each speaker will deliver a 15- to 20-minute talk after which a panel discussion with opportunities for questions and answers will take place.

There is a stark backdrop to the very concept of multidisciplinary vascular care: Vascular surgeons are a relative minority in a crowded field of specialists who treat vascular disease, AbuRahma points out.

“Why are we a relative minority?”, asks

“Specialists are fighting each other because everybody thinks they will do a better job for vascular patients”— ALI ABURAHMA

continued on page 2

'COVID-19 sparks diabetic macrophage inflammation' ­– award-winning paper

By Bryan Kay When patients with diabetes are infected with coronavirus, specialized macrophage cells—already primed to develop excessive inflammation in this population—are further transformed into a pathologically inflammatory state by a decrease in the enzyme histone methyltransferase, or SETDB2, this year’s SVS Foundation Resident Research Award-winning paper reveals.

RESULTS TO BE PRESENTED BY LEAD author W. James Melvin, MD, a general surgery resident at the University of Michigan in Ann Arbor, describe a potential mechanism for the increased macrophagemediated “cytokine storm” in patients with type-2 diabetes in response to COVID-19, suggesting that therapeutic targeting of an interferon-beta (IFNß) mechanism “may decrease pathologic inflammation associated with COVID-19.”

The work—entitled “Coronavirus induces diabetic macrophage-mediated inflammation via IFNß regulation of SETDB2”—emerged out of the University of Michigan lab led

by Melvin’s mentor on the investigation, Katherine A. Gallagher, MD. Prior to the pandemic, lab researchers had investigated why people with diabetes experience worsening wound healing in the context of peripheral arterial disease (PAD), discovering it was due in part to epigenetic changes in macrophages in the patients with diabetes.

As the pandemic took hold last year, continued on page 2

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The vasculature united: Bringing together competing specialties for better patient care continued from page 1

AbuRahma. “Numbers wise, our SVS membership is around 6–7,000, but the number of surgeons who are active in the United States is somewhere between 3-4,000 people, and we see this relative minority doing probably over 30% of the vascular practice. Yet, there are almost 50,000 cardiologists, around 50,000 general surgeons, 20–30,000 cardiac surgeons, and 10–15,000 interventional radiologists. So the other specialties are much more in number, and they are doing a good percentage of vascular procedures.”

Which raises another of the main

“There is a shortage of vascular surgeons, therefore they think they can do it”— ALI ABURAHMA motivating factors behind the forum focus, AbuRahma continues. “Many of these specialists put themselves in the field because there is a shortage of vascular surgeons, therefore they think they can do it. This is somewhat understandable—but what we are hoping with this session is to demonstrate that those doing so should be qualified, and have the competency and training to do these procedures.

“Some procedures might be done 20–30% of the time by a non-vascular surgeon, but others are done almost over 50% of the time by non-vascular surgeons—some of them might be qualified, some might not

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be qualified.”

Appropriateness in care figures heavily at this juncture. “We’re going to be emphasizing not only appropriateness but also if the individuals doing the procedures are qualified and competent to do them,” AbuRahma says. “Because if you have the competency, and the training, then most of the time you might be following appropriateness in care.

That is something that needs to be addressed.”

The aim is to drive home the importance of vascular centers of excellence like the one he operates at Charleston Area Medical Center in West Virginia. “We understand the drivers behind the specialties attracted to performing vascular procedures,” AbuRahma will tell VAM attendees during his segment. But so too the consequences, he will add: “There are quality challenges, including increased complications landing on vascular surgery practices; payment inefficiencies; and overutilization and unnecessary procedures.”

AbuRahma will end by posing some questions around how to tackle these issues going forward.

Does the remedy take the form of defense and stopping others from doing procedures outside of their competency? Or, does the strategy look more like offence, demanding quality and competency, and enforcing training and education in order to facilitate competency in other specialties? “Of course, we need both to win,” AbuRahma will argue, “but the balance may have shifted strongly to needing an elite offense to win for patients and our specialty.”

Patient care is paramount, he adds. “I’m trying to find a somewhat middle ground where both will do the right thing for the right patient quality. I think it will be beneficial for the Society and patient care all over the country, whether they are being treated by x or y or z.”

When: Wednesday, Aug. 18, 10:45 a.m.–12:15 p.m. E. Stanley Crawford Critical Issues Forum

First multidisciplinary center in US Part of the genesis of the multispecialty practice of vascular surgery rests in the home state of SVS President-elect Ali AbuRahma, MD. The Charleston, West Virginia-based vascular chief will take VAM attendees on a virtual journey 120 miles down state to the Greenbrier luxury resort in West Sulphur Springs to give a little bit of the history of multispecialty treatment of vascular disease. The first multidisciplinary vascular center in the U.S., AbuRahma will tell the Crawford Forum, was located on the site of the Greenbrier, better known today as a stopping point for the likes of U.S. presidents and professional golfers. But during World War II, the Greenbrier was the site of a U.S. Army hospital and multidisciplinary vascular center dealing with trauma and vascular injuries.—Bryan Kay

'COVID-19 sparks diabetic macrophage inflammation'—award-winning paper continued from page 1

Coronavirus infection IFNα/β receptor IFNβ

diabetic

MΦ

JAK1/3 STAT3

SETDB2

Study: Diabetic macrophage inflammatioon is further induced by COVID-19

NFκB PR O

Melvin and colleagues developed a hypothesis stating some of the same epigenetic enzymes may cause diabetic patients to have worse outcomes in response to COVID-19 infection.

“We infected diabetic mice with coronavirus, and analyzed samples from our COVID ICU [intensive care unit] at Michigan, and then looked at those macrophages and the enzyme in question,” explained Melvin. “We found that it plays a very big role, causing an increase in inflammation, known as the cytokine storm.

“Essentially, the main finding was that when patients with diabetes—who already have macrophages that are primed to develop too much inflammation or pathologic inflammation—get infected with coronavirus, those macrophages are further turned into a pathologically inflammatory state owing to a decrease in the enzyme SETDB2.

“One of the reasons COVID has been difficult for so many patients is that it causes your cells to make less of this interferon, even though it’s what you’re supposed to make in response to the virus. We found that this loss of interferons causes the epigenetic enzyme, SETDB2, to be decreased, which then tells the macrophages to go haywire and release way more inflammation. This is especially true in diabetic patients.”

The research team then attempted to reverse this process, Melvin continued. “We actually treated diabetic macrophages with interferons, the molecule decreased by coronavirus, discovering that, if we treated cells with it, we could actually reverse the inflammation. What that tells us is that—and there are active trials right now where they are looking at patients in the hospital and treating them with interferons—maybe we should really focus those trials especially on our vascular patients that have diabetes.”

Looking ahead, Melvin and colleagues plan to carry out further tests on therapeutics.

“We’re looking to give mice interferons to see if we can make mice do better in response to coronavirus,” he said. “We can then further investigate that pathway, where we can see when we give interferons to

MOTE R

ON

Inflammatory cytokines

mice—either in inhaled or injected form, especially diabetic mice—whether that can make them do better in response to coronavirus. There are also a lot of questions about the timing of administration of the drug and safety, and which specific patients would benefit more or less.”

Melvin, a native of Columbus, Ohio, is currently completing a two-year research fellowship under National Institutes of Health (NIH) funding before returning to complete his general surgery residency, and plans to apply for vascular surgery fellowship on completion.

“I was really drawn to surgery based on being able to help patients and get them through difficult times, difficult problems, and drawn to Michigan due to the opportunities for research, excellent clinical training, and to work with a mentor like Dr. Gallagher,” he said.

“I was originally drawn to vascular surgery as a resident early on because I really loved working with the patient population, dealing with a wide variety of different pathologies all across the body, being able to manage that both surgically and also minimally invasively—I think endovascular techniques are really cool and vascular surgery is always innovating.”

From a research point of view, Melvin described a longtime interest in epigenetics and the immune system, telling Vascular Connections: “I think it’s fascinating how two patients who are maybe twins, and, depending on what kind of life they both live, can have totally different body types, outcomes and diseases,” he said.

“There’s a lot we don’t know about epigenetics, and as we strive in the future to deliver more personalized care, and try to predict which patient would do well with surgery, and which wouldn’t, I have found my experience working with Dr. Gallagher on research like the one that won this award is preparing me to be a surgeon-scientist of the future who can investigate those pathways.”

W. James Melvin

When: Wednesday, Aug. 18, 8:41 a.m.– 8:51 a.m. William J. von Liebig Forum

AUGUST 2021 | www.vascularspecialistonline.com

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A message from the outgoing president Dear colleagues, After the challenging 15 months we’ve had, we share the desire of the vascular surgery community to be together, to reconnect with friends and colleagues, to celebrate the enduring value of our fellowship in the Society of Vascular Surgery (SVS). There are many reasons why this Vascular Annual Meeting (VAM), our 75th, is so important. We’ll have the science, the practice management tips, the sessions with the experts, all the meeting features you’ve come to expect from VAM. But most refreshingly, we’ll have each other, at our educational sessions, within the Exhibit Hall, our receptions, and in countless interactions across the four days of the meeting.

This will all happen within a schedule redesigned to improve your VAM experience. In an effort to minimize programming conflicts and missed educational opportunities, morning sessions are sequential and free of overlapping content, with fewer competing sessions in the afternoons. Even though every day is packed with interesting and valuable content—we cannot emphasize this enough—VAM officially starts on Wednesday. The Opening Ceremony, the William J. von Liebig Forum, the E. Stanley Crawford Critical Issues Forum and the second plenary all will take place on Wednesday, not Thursday as in previous years. Be sure to plan your travel accordingly.

Other considerations to keep in mind: Programming features celebrate and acknowledge the interests of the entire vascular team: for students and residents, vascular nurses, for physician assistants, those in community

as well as academic clinical practice, and basic and translational investigators as well. Underscoring that commitment, this year’s Vascular Research Initiatives Conference (VRIC) is being held jointly with VAM. Celebrating, as we are, 75 years of discovery, innovation and progress in vascular disease management, it is entirely appropriate to integrate VRIC and our basic and translational research community into VAM 2021.

THREE PRESIDENTS, ONE MEETING

For the first time since the merger of the American Association for Vascular Surgery (AAVS) and SVS in 2003, this year’s VAM will feature two presidential addresses. In light of the cancellation of last year’s VAM, Immediate Past President Kim Hodgson, MD, will give his address at 11 a.m. Thursday. As the 2021 president, I’ll give my own address at 11 a.m. the following day, Friday.

And at Saturday’s business meeting, we will celebrate the ascendency of Ali AbuRahma, MD, to this year’s presidency as we continue to recover and move forward from the pandemic.

Exhibitors are looking forward to seeing all of us.

You’ll all be in the Exhibit Hall for coffee and lunch breaks, plus the Opening Reception. Be sure to make time to browse the exhibits to explore devices and products—not only the tried-and-true but also the new and cutting-edge.

We have great collaborations on tap: The Society for Vascular Ultrasound (SVU) and the Society for Vascular

Nursing (SVN) both are holding their annual meetings in conjunction with ours. In addition, VAM offers special sessions in collaboration with the SVU and the American Venous Forum (AVF), and we will jointly hold the Aortic Summit with The Society of Thoracic Surgeons. As has been the case since 2016, the SVS Vascular Quality Initiative (VQI) will hold its annual meeting during VAM as well.

While our plenaries will be bringing you the latest science, other sessions will focus on practice management, clinical research trials, expert clinical advice, leadership and more. Telemedicine took on new importance during the pandemic, and we’ll discuss it Saturday in the final concurrent session, “Digital transformation in delivering comprehensive vascular care.” Postgraduate courses on pediatric vascular surgery and handling emergencies in community hospitals will present vital information to our members.

VAM isn’t VAM without chances to meet and greet each other—at breaks, outside the session rooms and, of course, at the Opening Reception. Several groups are planning alumni receptions; more information will be available on those and other gatherings as it is available.

I look forward with great pleasure to welcoming all of you to San Diego this August as we kick off the 75th anniversary celebration of the Society for Vascular Surgery. It is going to be a phenomenal meeting—we can’t wait to see you there!

Ronald L. Dalman, MD

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VAM schedule-at-a-glance What’s happening at the Vascular Annual Meeting (VAM)? With so many educational sessions, scientific presentations, exhibits and other offerings, it can be difficult to know where to be at what time. Plenaries, breakfast sessions, chances to ask the experts, the COVID-19 special session, the special session on diversity equity and inclusion (DEI) issues. Oh, and that concurrent session on research, too—not to mention the Opening Reception.

We’ve got you covered; it’s all here in one handy day-by-day list. So why not check out the VAM schedule-at-a-glance, below, for an overview on what's to come, as well as times and presentation titles.—Beth Bales Tuesday, August 17, 2021

3:30 PM - 5:30 PM

Outpatient & Office Vascular Care Section Session

12:00 PM - 6:30 PM

4:30 PM - 5:30 PM

A4: Occupational Hazards to the Vascular Surgeon

Wednesday, August 18, 2021

5:00 PM - 6:30 PM

Opening Reception

6:00 AM - 6:30 PM

Registration

5:00 PM - 6:30 PM

IP: Interactive Poster Session

7:30 AM - 8:00 AM

Opening Ceremony

6:30 PM - 7:30 PM

SVS Networking Reception for Women, Leadership, Diversity & Young Surgeons

8:00 AM - 9:30 AM

S1: William J. von Liebig Forum

7:45 PM - 9:30 PM

Women's Leadership Dinner

8:00 AM - 5:00 PM

SVN Annual Meeting

Friday, August 20, 2021

8:00 AM - 5:00 PM

VQI Annual Meeting

6:00 AM - 5:30 PM

Registration

9:30 AM - 9:45 AM

Coffee Break

6:30 AM - 8:00 AM

9:45 AM - 10:45 AM

S2: Plenary Session 2

10:45 AM - 12:15 PM

F1: E. Stanley Crawford Critical Issues Forum: The Role of Multispecialty Practice in Vascular/ Endovascular Surgery: Can We Work Together?

Breakfast Sessions B4: Last Ditch Effort at Limb Salvage: How to Manage What Seems Unsalvageable B5: “Congratulations, We Have Selected You as Our Next Leader”: Lessons Learned from Vascular Leaders at All Levels B6: Wound Complications & Management in Vascular Surgery

12:45 PM - 6:30 PM

VESS Paper Session

6:30 AM - 8:00 AM

General Surgery Resident/Medical Student Program - Mock Interviews Practice Session

1:00 PM - 2:30 PM

C1: Evolution and Transformation of the Journal of Vascular Surgery (JVS) Journals

7:00 AM - 6:00 PM

SVU Annual Conference

1:00 PM - 3:00 PM

IF: International Forum

8:00 AM - 9:30 AM

S4: Plenary Session 4

2:30 PM - 3:00 PM

Coffee Break

9:30 AM - 10:00 AM

Coffee Break and Vascular Live Presentation, sponsored by Advanced Oxygen Therapy, Inc.

3:00 PM - 4:00 PM

A1: Explanting Endografts: When, Why, How?

9:30 AM - 5:00 PM

Exhibits

3:00 PM - 4:00 PM

IFT: International Fast Talk

10:00 AM - 11:00 AM

Special Session: Diversity, Equity & Inclusion

4:00 PM - 5:00 PM

A2: Positioning Vascular Surgeons for Success as Community Leaders in Vascular Disease

11:00 AM - 12:15 PM

Presidential Introduction & Address (Dalman)

4:00 PM - 5:00 PM

Special Session: Bringing What’s New in Venous to You! in collaboration with the American Venous Forum

12:00 PM - 1:00 PM

Vascular Research Initiatives Conference Networking Luncheon

12:15 PM - 1:30 PM

Box Lunch in Exhibit Hall and Vascular Live Presentations, Sponsored by BD and Gore

1:00 PM - 3:00 PM

Vascular Research Initiatives Conference

1:30 PM - 3:00 PM

C4: Back to the Future: Patient Selection and Techniques in Open Infrainguinal Revascularization

1:30 PM - 3:00 PM

IYSC: International Young Surgeon Competition

1:30 PM - 4:30 PM

P2: Pediatric Vascular Care

3:00 PM - 3:30 PM

Coffee Break and Vascular Live Presentation, sponsored by Silk Road Medical

3:30 PM - 4:30 PM

A5: Mesenteric Artery Revascularization

3:30 PM - 5:00 PM

PC: Poster Competition

3:30 PM - 5:30 PM

Aortic Summit in collaboration with The Society of Thoracic Surgeons

4:30 PM - 5:30 PM

A6: Clinical Trials: Tools for Planning, Executing and Communicating

5:00 PM - 6:30 PM

General Surgery Resident/Medical Student Program - Residency Fair

VQI Annual Meeting

4:00 PM - 6:30 PM

IPC: International Poster Competition & Guest Reception

5:00 PM - 6:30 PM

C2: Lessons Learned from Managing Complex Vascular Problems: How to Prevent Complications

5:00 PM - 6:30 PM

Special Session: COVID-19

6:15 PM - 7:30 PM

General Surgery Resident/Medical Student Reception

Thursday, August 19, 2021 6:00 AM - 5:00 PM

SVU Annual Conference

6:00 AM - 6:00 PM

Registration

6:30 AM - 8:00 AM

6:30 AM - 8:00 AM

Industry Breakfast Symposia* B1: Why Clinical Trial Participants Need to Look Like Us and How We Can Improve Care for the Underserved Population Living with Peripheral Arterial Disease, Sponsored by Abbott B2: Paclitaxel Safety: A View from Multiple Perspectives, Co-Sponsored by Boston Scientific and Medtronic B3: Clinical Insights in Chronic CAD/PAD: Reducing the Risk of Major Cardiovascular Events, Sponsored by Janssen Pharmaceuticals *Industry breakfast symposia are not eligible for CME credit General Surgery Resident Program Breakfast

Saturday, August 21, 2021 6:00 AM - 5:30 PM

Registration

6:30 AM - 8:00 AM

Breakfast Sessions B7: Malpractice 101 B8: Update on the Kidney Disease Outcomes Quality Initiative (KDOQI) Guidelines for Vascular Access B9: Career Optimization Tips and Tricks for Young Vascular Surgeons

6:30 AM - 8:00 AM

Medical Student Program Breakfast (MS1-2)

6:30 AM - 8:00 AM

Medical Student Program Breakfast (MS3-4)

8:00 AM - 9:30 AM

S3: Plenary Session 3

8:00 AM - 5:00 PM

SVN Annual Meeting

8:00 AM - 9:30 AM

S5: Plenary Session 5

9:30 AM - 9:45 AM

Awards Ceremony

9:30 AM - 10:00 AM

E2: John Homans Lecture

9:45 AM - 10:15 AM

E1: Roy Greenberg Distinguished Lecture

10:00 AM - 10:30 AM

Coffee Break

10:00 AM - 6:30 PM

Exhibits

10:30 AM - 12:00 PM

S6: Plenary Session 6

10:15 AM - 10:45 AM

Coffee Break and Vascular Live Presentation, Sponsored by Abbott

12:00 PM - 1:30 PM

Member Business Luncheon

10:45 AM - 12:00 PM

Presidential Introduction & Address (Hodgson)

1:30 PM - 3:00 PM

12:00 PM - 1:00 PM

Physician Assistant Section Luncheon

C5: New Solutions for Old Problems in Vascular Ultrasound in collaboration with the Society for Vascular Ultrasound

12:00 PM - 1:30 PM

Box Lunch in Exhibit Hall and Vascular Live Presentations, Sponsored by BD and Gore

1:30 PM - 2:30 PM

VH: "How I Do It" Video Session

12:00 PM - 2:00 PM

The Leadership Lunch and LDP Graduation (also known as the Meet the Leaders Lunch)

1:30 PM - 4:30 PM

P3: Emergency Vascular Care in the Community Hospital: What is Safe and Reasonable?

1:00 PM - 3:00 PM

Vascular Research Initiatives Conference

1:30 PM - 5:00 PM

1:15 PM - 4:45 PM

Physician Assistant Section Session

Ultrasound Physics and Vascular Test Interpretation: Registered Physician Vascular Interpretation Examination Review

1:30 PM - 3:00 PM

C3: What is the Value of the Vascular Surgeon?

3:00 PM - 3:30 PM

Coffee Break

1:30 PM - 3:00 PM

International Chapter Forum

3:30 PM - 4:30 PM

Poster Runoff: Championship Round

1:30 PM - 4:30 PM

P1: Clinical Update in the Management of Aortic Dissections

3:30 PM - 5:00 PM

C6: Digital Transformation in Delivering Comprehensive Vascular Care

3:00 PM - 3:30 PM

Coffee Break and Vascular Live Presentation, Sponsored by Abbott

3:30 PM - 4:30 PM

A3: Keeping Your “Legs” above Water in a Quality Reporting for Payment World: Case Studies and Best Practices for Vascular Surgeons

* The schedule-at-a-glance was correct and up-to-date as of June 29, 2021. ** Any changes to the schedule will be reflected at vascular.org/Planner21. *** All times listed are Pacific Daylight Time.

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VESS session: ‘Concerted effort’ made to feature science, discussion from widest possible swath of US

By Bryan Kay At its very essence, says Vascular & Endovascular Surgery Society (VESS) President Jason T. Lee, MD, vascular surgery is a “social sport.” The specialty is built on the backs of not just the “alpha point guard,” or the surgeon, but burgeoning teams of nurses, hospitalists, trainees and administrative support staff as well. It’s that very notion of vascular surgery as a team sport that typifies just how important it is to get back live in a room together to share the collected wisdom of vascular surgical science, Lee tells Vascular Connections, as he looks ahead to the VESS Spring Meeting at the Vascular Annual Meeting (VAM).

“THE CARE THAT SHOULD BE DELIVERED TO our vascular patients has to be from a team-oriented approach,” he tells Vascular Connections. “At meetings such as VAM, the collective knowledge, energy and science brought forth is so wide-ranging and diverse that it becomes the ultimate arena for vascular surgery discussions. Meeting stakeholders all want attendees to go home to impact vascular care in their community based on new things learned while attending VAM. This is particularly important for the younger vascular surgeon, and opportunities within VESS help catapult earlier involvement in this. VAM is an opportunity to highlight the teamwork necessary for cutting-edge projects, science and clinical care.”

In a departure from previous iterations of VAM, the VESS session will be in the main plenary hall on Wednesday afternoon, featuring 26 presentations—17 of which are full-length papers—covering the breadth of vascular surgical practice. “What the pandemic taught us last year about vascular surgery academics— the collegiality, collaboration and education we gain by traveling in person to VAM and other national meetings—was that we lost a little bit of that in the virtual world,” Lee says. “I think virtual meetings were the best we could do at the time, but nothing beats the camaraderie and exchange of ideas that happen in person.”

As such, the VESS program delves into complex aortic outcomes, lower-extremity limb salvage, risk stratification, carotid interventions and stroke risk across a range of presentation styles, with research derived from big data, single centers, multicenter collaboratives and surveys. “The agenda represents the whole range of our specialty, through a lot of the most challenging endstage problems our patients face, including peripheral arterial disease [PAD], dialysis and trauma,” Lee says.

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“So, I think the program really mirrors the purpose of VAM in a teamwork-focused, high-impact event that has something for everyone in our specialty. We’ve gone out of our way to select papers we think will be interesting to all vascular surgeons and be able to increase knowledge.

“The other thing we’ve done, which is very purposeful, is to go out of our way for the papers that were selected to be from a wide variety of programs across the country. We’ve also invited discussants for the papers from places that are not already otherwise represented at VAM, and further focused on the young vascular surgeon in practice or nearing the end of training.” VESS Councilor-at-Large Shang Loh, MD, clinical associate professor and vascular surgery program director at Stony Brook University Medical Center in New York, will co-moderate the session along with Lee and a string of colleagues.

He describes the VESS portion as “not secondary” to VAM “but complementary,” drawing attention to two representative papers showcasing the full-circle nature of VESS’ emphasis on trainees and early-career surgeons.

Aortic dissection flap morphology

Kelsi K. Hirai MD, a fourth-year general surgery resident at Stony Brook University Medical Center who just matched into a vascular fellowship position at Oregon Health and Sciences University in Portland, is set to deliver findings on behalf of a research team mentored

by Loh himself, showing that “straight flap morphology is more common than spiral configurations and appears to cause larger false lumens with more true lumen compression.” Straight dissections overwhelmingly

perspective,” Loh says of the research. “What we’re doing is trying to identify some of the morphologic characteristics and how they may offer some insights into the nature, and, hopefully at some point in the future, the long-term prognosis and evolution of aortic dissection based on how they tear.”

TCAR and balloon dilation

Loh also points to the paper, “Balloon dilation strategy does not affect outcomes for transcarotid artery revascularization (TCAR) in prospective trials.” TCAR is a hot topic at the moment, Loh says. “Those of us who have done it since the inception have great experience in the procedure, but others are actively interested in exploring it.”

This paper slots in as a keen point of interest at this juncture, Loh points out, investigating the strategies of balloon dilation carried out during transfemoral carotid artery stenting—pre-stent dilation only, poststent dilation only, or both—and the concerns raised over higher neurological risk with the latter two dilation strategies. That may not be applicable to TCAR, which utilizes cerebral blood flow reversal during stent deployment and balloon angioplasty, posited presenting author Jones P. Thomas, MD, and colleagues. Jones, an integrated vascular surgery resident at University Hospitals Case Medical Center in Cleveland, Ohio, and his fellow researchers set out to analyze outcomes of the three balloon dilation strategies during TCAR. “Based on these prospective trial data, there is no difference in neurological complications due to balloon dilation

“Virtual meetings were the best we could do at the time, but nothing beats the camaraderie and exchange of ideas that happen in person” — JASON T. LEE

Jason T. Lee

dissect along the greater curve of zone 3 while spirals typically begin in zone 4 or 5 of the descending thoracic aorta, Hirai and colleagues found. “Visceral involvement is more common in spiral dissections. Initial shape of the dissection flap may have implications for aortic remodeling and decisions regarding early intervention,” Hirai will tell the VESS session. “If you look at the literature, this hasn’t previously been studied from this

Shang Loh

strategy during TCAR,” Thomas will tell VESS. “Balloon dilation technique best suited to the patient’s specific lesion should be utilized. Further studies are needed to evaluate the relationship of these dilation strategies to long-term outcome, including restenosis.”

When: Wednesday, Aug. 18, 12:45 p.m.–6:30 p.m.

VESS Paper Session

AUGUST 2021 | www.vascularspecialistonline.com

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SVN conference set to provide valuable information for all in vascular nursing practice

By Beth Bales The Society for Vascular Nursing (SVN) annual meeting this year will cover the gamut of information for all vascular nursing career stages—from novice to expert.

THE SVN 39TH ANNUAL Conference is set for Wednesday and Thursday in the San Diego Convention Center, to be held in collaboration with the Vascular Annual Meeting (VAM).

The program grew out of the idea that vascular nurses progress in their abilities and knowledge, and what occurs in the midst of this growth. “We will present content for all vascular nurses, from those just starting out to those who are seasoned experts,” said Nancy Crowell, BSN, program chair.

The SVN program is once again set up in learning tracks. Track one is entitled, “Creating vascular expertise … From novice to experts,” focusing on orientations for new nurses, core competencies and how nurses perform as change agents.

Track two—“Clinical applications: Knowledge to care delivery (from head to toe)”—focuses on taking knowledge learned to patient care, starting in the upper extremities and heading down to the legs and feet. And track three is “Advanced vascular applications,” including complex vascular care and trauma cases, advancements in wound care (with multidisciplinary care for limb salvage) and pharmacology, which includes current medical management for peripheral arterial disease (PAD).

The COVID-19 sessions follow track three, which will be followed by the closing session, “Self-care for the caregiver,” which Crowell will deliver. Thus, track one focuses on building blocks, while track two takes the information and presents

VQI@VAM: Celebrating science, quality and VQI’s 10th anniversary

By Beth Bales The Society for Vascular Surgery (SVS) Vascular Quality Initiative (VQI) will host a day and a half of sessions aimed at quality improvement at its annual meeting, held in conjunction with the SVS Vascular Annual Meeting (VAM).

V

QI@VAM runs from noon to 6:30 p.m. Tuesday and from 8 a.m. to 5 p.m. Wednesday. A separate registration fee applies. Organizers suggest that physicians with time constraints on Wednesday attend from noon to 5 p.m.

The meeting is designed to meet the needs of physicians, nurses, data managers, quality improvement professionals and administrators. Data managers, in particular, will find the Tuesday sessions beneficial, though all members may attend.

The VQI provides its members with benchmark data to help with improvement projects and let VQI members know how they are doing compared to others. The VQI provides forums for its members to meet and discuss their data via its 18 regional groups on a semi-annual

head-to-toe examples and scenarios, she said. Track three takes applications of knowledge even further.

The conference will kick off with a keynote address, “Conversations that matter: Early preoperative education to support positive prosthetic patient outcomes,” by Leslie Green, Ed.S. Day one ends with the SVN Welcome Reception from 5 Nancy Crowell to 6:15 p.m.

In addition, after more than a year defined by COVID-19, the SVN also will discuss what members have learned from the pandemic in a special session Thursday afternoon. Ali Moran, DNP, will present, “COVID and implications for practice changes,” starting at 2:30 p.m. Thursday.

“Worldwide, we were all literally flipped upside down, facing unprecedented challenges, and we’re still writing the history”— NANCY CROWELL

basis. Leaders also are exploring how to expand utilizing the VQI in support of tracking compliance with SVS clinical practice guidelines.

HIGHLIGHTS OF VQI@VAM INCLUDE: ● Tuesday’s interactive panel discussions on the carotid, aortic, lower-extremity and venous registries. VQI is holding registry education sessions through July as a basis for these discussions and attendees are asked to bring their questions to these expert panel presentations ● The Quality Improvement Poster Reception from 5 to 6:30 p.m. Tuesday. The reception features approximately 30 posters of quality improvement projects, cocktails and appetizers and the chance for meeting participants to visit with each other.

Attendees can meet the projects’ authors to understand how VQI data is being used to improve the quality of care ● An increased number of quality improvement (QI) case studies designed to help participants to initiate their own QI projects ● How to use VQI quality improvement tools and resources to initiate and sustain QI projects ● The annual meeting will also see the announcement of the VQI Trainee Program In addition, there were will be a series of presentations from the Food and Drug Administration (FDA) covering a range of topics. Robert Craig, DO, will deliver a talk entitled, “Medical device event reporting: Why your engagement is important!” Ronald Fairman, MD, will present, “Investigational device exemptions (IDEs) and physician-sponsored IDEs: Why they are required and what are the benefits?” Robert Lee, MD will speak on, “The role of post-market data in regulatory decisionmaking: How can registries help?”

That will segue directly into an open forum discussion, with organizers hoping audience members will step up to the microphone and share their stories so that everyone present can gain from the lessons learned, Crowell said.

“The pandemic changed our care delivery systems; we went to online care, tele-visits, phone calls.

Worldwide, we were all literally flipped upside down, facing unprecedented challenges, and we’re still writing the history,” she said. “It will be fun to share those stories and we hope many people will do so.”

One of the lessons learned, she said, is flexibility, which has come in handy while planning the program, and not knowing whether it would be virtual or in-person.

Now she’s taking the weeks leading up to the meeting a day at a time, as she has learned. After all, she said, “I know we can navigate with curveballs. We’ve met the challenges we’ve faced this past year with teamwork, perseverance and innovation.”

For more information on the SVN conference, visit vascular.org/SVN21.

When: Wednesday/Thursday, Aug. 18 and 19, 8 a.m–5 p.m. SVN Annual Meeting

Elsewhere, there will be a celebration of the VQI’s 10th anniversary, with program updates and participation awards, from 12 to 1:30 p.m. Wednesday.

Other topics on the program include ERAS (Enhanced Recovery After Surgery) guidelines and applications for VQI, tracking frailty, using the VQI to track opioid use, reporting and analytics, piloting patient-reported outcomes in the VQI, and VQI collaboration with the International Consortium of Vascular Registries.

“Our goal at the VQI annual meeting is to present education such that the team can better extract data to put in our registries and then understand and analyze that data to implement quality improvement initiatives,” said Medical Director Jens Eldrup-Jorgensen, MD. VQI@VAM debuted in 2016, with changes annually to present information of increased value, he said. “We make modifications based directly on attendee feedback,” he said. “In 2016, participants said they wanted networking and a chance to gather, so we added the poster reception, which has been hugely popular. We’ve added research, we’ve added abstraction. And we think it’s getting better and better.”

Registration fees for VQI@VAM are $295 for inperson attendance and $220 to view sessions remotely (streaming). Visit vascular.org/RegisterVAM21 for the registration site. Learn more at vascular.org/VQIVAM21.

When: Tuesday, Aug. 17, 12 p.m.–6:30 p.m., and Wednesday, Aug. 18, 8 a.m.–5 p.m. VQI Annual Meeting

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Postgraduate courses stacked with key content

By Beth Bales Selecting topics for postgraduate courses, concurrent and breakfast sessions and “Ask the Experts” presentations is a careful, considered process, Society for Vascular Surgery (SVS) program organizers tell Vascular Connections.

“WE MAKE A VERY CONSCIOUS EFFORT TO identify and cover as many of the current important clinical topics as possible. A huge part of this is being responsive to feedback from the SVS members,” said William Robinson, MD, vice chair of the SVS Postgraduate Education Committee. This committee, currently chaired by Vikram Kashyap, MD, selects presentations for the educational sessions outside of the abstractbased plenaries. This year, that roundup includes six breakfast sessions, with three to choose from on both Friday and Saturday; six “Ask the Expert” sessions, from Wednesday through Friday afternoons; six concurrent sessions, Wednesday through Saturday afternoons; and three postgraduate education courses, Thursday through Saturday afternoons.

Beyond clinical topics, however, the committee also needs to address “the most pertinent issues related to practice management, wellness, advocacy and education—a broad range of topics that are applicable to the entire SVS membership,” said Robinson. “We want the program to be balanced between cutting-edge clinical

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topics and the newest information to help people manage their practices and work environments.” Thus, he said, half of the “Ask the Expert” and half the concurrent sessions focus on work environment.

Subjects such as the digital transformation of healthcare, how to define and articulate a vascular surgeon’s value to institutions, leadership, and the occupational hazards vascular surgeons face don’t address the management of vascular disease per se, Robinson said. “But they’re vitally important just the same. Our surgeons and other SVS members have an increasing need for information when it comes to practice management issues, and we want to as address those needs as best we can.” Of course, clinical topics remain front and center, as highlighted by the three postgraduate courses being offered at VAM 2021.

AORTIC DISSECTIONS

With rapid development in both the understanding of the disease process and vascular surgeons’ use of current treatment options, organizers expect a lot of interest in this course. “We have an understanding of how to better manage patients with uncomplicated acute dissection in order to prevent aneurysmal complications from dissection down the road, he said. “And we are learning to do these repairs more safely, whether they need to be done urgently or emergently.”

The SVS, with The Society of Thoracic Surgeons (STS), updated the reporting standards for type B aortic dissection in 2020, adding importance to the presentation of current thinking on the topic, he said.

PEDIATRIC VASCULAR CARE

It has been at least five years since the SVS addressed pediatric vascular care at VAM. “These cases are often a bit more difficult for many vascular surgeons, because vascular issues in pediatric patients are relatively

uncommon in many pratices, and because it’s a child. It’s extremely important we revisit this topic and that all have up-to-date knowledge on appropriate management,” said Robinson.

Pediatric disease involves a much different pathology— no atherosclerosis and a lifetime of comorbidities—than in patients of advanced age, he said. Vascular disease in children tends to be related to iatrogenic injury, trauma, sports, congenital issues and the complications of critically ill states, he said. The course will focus on providing appropriate care, or referring the patient to a center that offers that appropriate care.

COMMUNITY HOSPITAL

The session delving into what is safe and reasonable in the community hospital setting with regards to emergency vascular care will be “extremely valuable for all of our constituents,” said Robinson.

The course will highlight the most current management and help surgeons identify what extent of care can be provided in different environments, depending on the resources available.

Other than the breakfast sessions, the Postgraduate Education Committee content has been scheduled for the afternoon and will not conflict with the morning plenary programming or the invited lectures.

“Our surgeons and other SVS members have an increasing need for information when it comes to practice management issues”— WILLIAM ROBINSON

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VAM essentials

Map out your VAM experience with the Online Planner

By Anna Vecchio and Beth Bales Get a jump start on planning your way through the Vascular Annual Meeting (VAM) with the SVS Online Planner.

IT INCLUDES THE ENTIRE VAM SCHEDULE PLUS THOSE FOR THE SOCIETY for Vascular Nursing (SVN) Annual Conference, the Society for Vascular Ultrasound (SVU) Annual Conference and the Vascular Quality Initiative (VQI) meeting, VQI@VAM. While the planner (vascular.org/Planner21) is always available for viewing and browsing, by creating an account it also can be used as a scheduler and calendar. Once signed in, simply mark a session you want to attend as a favorite. The planner will populate your calendar and set reminders. To create an account, log in with your SVS credentials.

That “single sign-on” log-in and password credential is also used for registration and all ticketed events—such as breakfast sessions, workshops, postgraduate courses and special events—and will automatically transfer to the planner. When the mobile app is available and downloaded, all Online Planner details will transfer and be available on your phone or other mobile device. Non-SVS members or VQI attendees will need to create a guest account in order to take advantage of this functionality.

LIVE STREAMING OPTIONS

Those unable to attend VAM in person will have the opportunity to view programming in real time, courtesy of their computer. A handful of special sessions, the morning plenaries and international content will be streamed live, with up to 15 Continuing Medical Education (CME) credits available.

A remote and online registration fee applies and is available via the online registration portal (vascular.org/ RegisterVAM21). Additionally, most VAM sessions will be recorded and available in the new SVS OnDemand six to eight weeks after the event. Live-streaming sessions (all times are Pacific Time) are: WEDNESDAY, AUG. 18 8 to 9:30 a.m.

Plenary Session 1, William J. von Liebig Forum 9:45 to 10:45 a.m.

Plenary Session 2 10:45 to 12:15 p.m.

Crawford Forum, “The role of multispecialty practice in vascular/ endovascular surgery: Can we work together?”

1 to 3 p.m.

International Forum

9:45 to 10:15 a.m.

Roy Greenberg Distinguished Lecture, presented by Elsie Gyang Ross, MD 10:45 a.m. to 12 p.m.

Presidential Introduction and Address; address by SVS Immediate Past President Kim Hodgson, MD 1:30 to 3 p.m.

International Chapter Forum FRIDAY, AUG. 20 8 to 9:30 a.m.

Plenary Session 4 10 to 10:20 a.m.

Diversity, equity and inclusion invited speaker, Lee Kirksey, MD 10:20 to 11 a.m.

Diversity, Equity & Inclusion Special Scientific Session, abstract presentations 11 a.m. to 12:15 p.m.

Presidential Introduction and Address; address by SVS President Ronald L. Dalman, MD 1:30 to 3 p.m.

International Young Surgeons Competition

3 to 4 p.m.

International Fast Talk

SATURDAY, AUG. 21 8 to 9:30 a.m.

Plenary Session 5

THURSDAY, AUG. 19 8 to 9:30 a.m.

Plenary Session 3

9:30 to 10 a.m.

John Homans Lecture, presented by Jim Stanley, MD

9:30 to 9:45 a.m.

Awards Ceremony

10:30 a.m. to 12 p.m.

Plenary Session 6

EARN YOUR CME, MOC CREDITS

Physician registrants can get a big boost in collecting required CME and Maintenance of Certification (MOC) Self-Assessment credits at VAM. The Society for Vascular Surgery (SVS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The SVS designates this live course for 35.25 AMA PRA Category 1 Credit(s), commensurate with the extent of a physician’s participation in the activity.

Multiple sessions also permit the earning of MOC credits (16 available). See the adjacent list for credit availability.

Participants must first complete session evaluations.

SESSIONS OFFERING CME, MOC CREDITS: ●P ostgraduate courses (CME+MOC) ● I nternational Forum ● I nternational Fast Talk ● VESS Paper Session ●A sk the Experts sessions 1–6 ●B reakfast sessions 1–6 (CME+MOC) ●C oncurrent sessions 1–6 ●V on Liebig Forum (CME+MOC) ●P lenary 2–6 (CME+MOC) ●V RIC sessions 1–2 ●A ortic Summit ●C rawford Forum ●R oy Greenburg Lecture ● J ohn Homans Lecture ●R PVI Course (CME+MOC) ●S VS/AVF special collaborative session ● Outpatient-based lab program ●P hysician assistant program ● “ How I Do It Video” session ●A bstract invited sessions—COVID-19 and diversity, equity and inclusion sessions (MOC to be determined) FOCUS ON OFFICE-BASED CARE

This year’s VAM will feature a session geared specifically to clinicians who work in office and outpatient settings.

The Section on Outpatient and Office Vascular Care (SOOVC) will share the importance of office-based labs to vascular patients, payors and physicians.

The special presentation will include tips on how to start an office-based lab, a business-pro forma for an office-based lab, coding and advocacy information, how to identify cases to avoid, and the

role of an office-based lab in an academic practice. The SVS created SOOVC in 2019 for clinicians who work in outpatientand office-based vascular care centers. It serves as a forum where members can advance the care of patients in outpatient settings through enhancing SVS efforts in education, advocacy, quality practice, ethics and research. Activities in the past have included a special breakfast section on outpatient facilities at VAM 2019 and a question-and-answer session on SVSConnect. Members are invited to share

SAN DIEGO CONVENTION CENTER FLOORPLAN

AUGUST 2021 | www.vascularspecialistonline.com

feedback about how SOOVC can help advance individual practices at the SOOVC Business Meeting taking place Thursday, Aug. 19.

The special sessions are: THURSDAY, AUG. 19 2:30 to 3:30 p.m.

Section on Outpatient and Office Vascular Care (SOOVC) Business Meeting 3:30 to 6 p.m.

“The OBL: A component of future vascular care that requires engagement from all vascular surgeons” To register for VAM, visit vascular.org/ RegisterVAM21. Registration for the SVN and SVU conferences are also available at this location.

VAM TO HOST PROGRAMMING FOR PHYSICIAN ASSISTANTS

Physician assistants (PAs) want to showcase how important they are to the vascular team and learn more about vascular disease and medical management. Lunch will be from 12 to 1 p.m. Thursday, Aug. 19. The educational program will follow from 1 to 4:45 p.m. The

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meat of the program will feature introductions and updates from Erin Hanlon, PA-C, cochair of the SVS PA Section and a welcome from Matthew Eagleton, MD, SVS Program Committee co-chair. Highlights include a 60-minute session from the SVU that will highlight carotid, venous, abdominal and arterial cases, a 60-minute session on the vascular PA in practice that will cover training new PAs in vascular, opioid prescribing, vascular inpatient management, PA utilization in venous procedures and PA utilization in outpatient-based facilities. Additionally, PAs can expect a 60-minute “Ask the Experts” case presentation that will review cases on lowerextremity amputations, TCAR updates, aortic diseases, vascular emergencies, hypercoagulable patient and team practice.

SVS HAS HEALTH AND SAFETY PROTOCOLS IN PLACE

At this time, VAM attendees will need to provide either COVID-19 vaccine verification or a negative coronavirus test (within 72 hours of travel). This requirement may change as the meeting draws closer, with protocols constantly evolving. Stay up-to-date at our VAM Health and Safety Protocols web page, vascular.org/ VAMProtocols.

What's going on around San Diego this August: Making the most out of your trip to VAM 2021

By Anna Vecchio SAN DIEGO IS THE PERFECT PLACE TO BRING YOUR LONGdelayed travel dreams to life this August. Whether you are traveling on your own or bringing family along for the adventure, the Southern California beachfront city offers a destination for everyone. San Diego is the birthplace of California, and offers a mix of urban and coastal attractions to visit. From the beautiful shorelines of Coronado Beach to the bustling streets of the famous Gaslamp Quarter, there is much to explore.

Mission Beach and Pacific Beach are connected on the same shoreline in San Diego, but these coastal spots share considerable differences. For those seeking a more relaxed beach scene, be sure to visit Mission Beach. The area hosts more homes than hotels, and Mission Boulevard is a great place to shop, dine and have a drink. Coronado Beach is another relaxing getaway destination that is known for its picturesque sunsets and calm waters.

Visitors looking to experience the exciting nightlife San Diego has to offer should make their way to Pacific Beach and the historic Gaslamp Quarter, which is filled with more than 200 world-class boutiques, galleries, restaurants, bars, nightclubs and lounges. The district's southern end is conveniently located across the street from the San Diego Convention Center, where VAM sessions are being held.

Thrill-seekers should check out Belmont Park, a crowd favorite beachfront amusement park that borders the Mission and Pacific beaches. Another popular family destination is Balboa Park.

The 1,200-acre urban park includes museums, theaters and the world-famous San Diego Zoo. Beach-goers can catch a glimpse of wildlife outside of zoo limits and hangout with the seals at La Jolla Cove. Locals say this is a great place to try out snorkeling or take a kayak tour.

Sports fans travelling to San Diego the weekend of VAM can enjoy a baseball game at Petco Park after the conference.

The Phillies will travel to town for a three-game series with the Padres, kicking off Friday, Aug. 20. Petco Park is located right next to the city's Gaslamp Quarter and shows off views of San Diego's East Village.

San Diego offers plenty of tours around the city. Consider checking out the San Diego Harbor Cruise to get a one-of-a-kind view of San Diego's skyline and the Coronado Bridge. The San Diego Tour: Hop-on Hop-off Trolley is a great way to explore multiple spots at once. Consider extending your trip to VAM this summer and soak in everything that San Diego has to offer. To learn more about the city’s many attractions and tour options, visit www.sandiego.org.

San Diego features a number of cultural, leisure and sporting attractions during and around the dates of VAM

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Sponsors/Exhibitors

Who will you see in the Exhibit Hall this year?

By Anna Vecchio Be sure to schedule plenty of time to visit the Exhibit Hall during this year’s live and in-person Vascular Annual Meeting (VAM).

The Exhibit Hall will be open Thursday, Aug. 19, through Friday, Aug. 20, and will feature more than 125 companies showcasing the latest technology and services relative to vascular surgery, networking receptions, poster sessions, lunches and more.

WITH LIVE MEETINGS COMING back for the first time in more than a year, industry representatives are looking forward to the long-awaited opportunity to connect in-person with Society for Vascular Surgery (SVS) members at VAM. Vendors onsite are planning to present a wide range of products of interest to vascular surgeons and their teams.

The Exhibit Hall will feature an opening reception, scavenger hunt, the popular Vascular Live presentations from industry, as well as coffee breaks and box lunches. Grab a drink and catch up with colleagues and friends during lunch at the Exhibit Hall, and be sure to take advantage of non-continuing medical education (CME) learning opportunities, including training opportunities and networking potential.

“Industry participation in the VAM exhibits underwrites a significant portion of VAM, thereby allowing the Society to keep registration fees at a much lower rate than many other meetings in the vascular space,” said SVS Executive Director Kenneth M. Slaw, PhD. “Industry representatives have

responded enthusiastically to the invitation to appear at VAM, and dozens of vendors will be on hand to present a wide range of products of interest to vascular surgeons and their teams. Be sure to support our industry partners and make time to stop in!”

A complete list of exhibitors and their booth locations will be available as the dates of VAM approach.

Industry-sponsored symposia

By Anna Vecchio Industry-sponsored symposia will be presented Wednesday and Thursday evenings and at three breakfast sessions taking place Thursday morning.

INDUSTRY-SUPPORTED EVENING Satellite Symposia will be held from 6:30 to 8 p.m. Wednesday and Thursday.

Wednesday’s session is sponsored

by Gore; Thursday’s is sponsored by Medtronic. Industry Breakfast Symposia will be held from 6:30 to 8 a.m.

Thursday.

WEDNESDAY, AUG. 18 6:30 to 8 p.m.

To be determined, sponsored by Endologix THURSDAY, AUG. 19 6:30 to 8 a.m.

B1: “Why clinical trial participants need to look like us and how we can improve care for the underserved population living with peripheral arterial disease [PAD],” sponsored

by Abbott B2: “Paclitaxel safety: A view from multiple perspectives,” which is co-sponsored by Boston Scientific and Medtronic. Featured speakers: Venita Chandra, MD; Daniel Clair, MD; Anahita Dua, MD; Michael R. Jaff, DO; Darren B. Schneider, MD; Peter Schneider, MD; Simona Zannetti, MD

B3: “Clinical insights in chronic CAD/ PAD: Reducing the risk of major cardiovascular events,” sponsored

by Janssen Pharmaceuticals, Inc. Presenting: Sonya S. Noor, MD 6:30 to 8 p.m.

“Addressing the risk of neck dilatation in wide necks: The role of ESA,” sponsored by Medtronic Industry-sponsored symposia are not eligible for CME credit. (This listing is as of June 29, 2021.)

A SPECIAL THANK YOU TO OUR VAM 2021 SUPPORTERS (AS OF JUNE 29)

Vascular Annual Meeting Sponsorships ● 3 M Health Care ● BD ● Boston Scientific ●C ardiva Medical ●G ore ●M edtronic ●P hilips VASCULAR LIVE

The always-popular Vascular Live sessions include seven innovative segments about the latest products and developments related to vascular surgery, in a theater-in-the-round setting presented during coffee breaks and lunch in the Exhibit Hall on Thursday and Friday. This interactive experience

at VAM puts exhibitors face-to-face with vascular surgeons, technologists and all the members of a vascular team.

THURSDAY, AUG. 19 10:20 to 10:45 a.m. Sponsored by Abbott 12:20 to 12:45 p.m. Sponsored by BD 12:50 to 1:15 p.m. Sponsored by Gore 3:05 to 3:30 p.m. Sponsored by Abbott FRIDAY, AUG. 20 9:35 to 10 a.m. Sponsored by Advanced Oxygen Therapy, Inc. 12:35 to 1 p.m. Sponsored by BD 1:05 to 1:30 p.m. Sponsored by Gore 3:05 p.m. to 3:35 p.m. Sponsored by Silk Road Medical All Vascular Live events will take place at the Vascular Live stage in Exhibit Hall B, located on level one of the San Diego Convention Center.

Non-accredited Vascular Live presentations are not part of the Accreditation Council for Continuing Medical Education (ACCME)-accredited portion of VAM. (These details were correct as of June 29, 2021.)

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Carotid endarterectomy shows ‘improved longterm durability’ over transfemoral carotid artery stenting

By Suzie Marshall An increased postoperative stroke rate associated with transfemoral carotid artery stenting “seems to extend up to five years’ follow-up” compared to carotid endarterectomy.

This is the conclusion set to be presented by Kevin S. Yei, BS, of the University of California San Diego, at the Society for Vascular Surgery (SVS) Vascular Annual Meeting (VAM). Yei is delivering a talk on the long-term outcomes of carotid endarterectomy (CEA) vs. transfemoral carotid artery stenting in the Vascular Quality Initiative (VQI) Vascular Implant Surveillance and Interventional Outcomes Network (VISION).

CONTEXTUALISING THIS RESEARCH, YEI AND colleagues explain that CEA “remains the gold-standard revascularization procedure for patients with high-grade carotid artery stenosis.”

Transfemoral carotid artery stenting, he will tell SVS attendees, was introduced as a minimally invasive alternative procedure in patients who are deemed high-risk for endarterectomy.

While earlier studies had shown an increased risk of perioperative stroke in transfemoral carotid artery

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stenting versus endarterectomy, Yei says that, prior to his team’s recent work, the long-term implications of the perioperative differences of these two procedures “had not been completely studied.”

The investigators therefore analyzed all cases in the CEA and carotid artery stenosis files in VQI-VISION from 2003–2016. Kaplan-Meier analysis, log-rank tests, and Coxregression were utilized to compare stroke, death, and stroke/death at one, five, and 10 years.

In total, 58,840 carotid revascularizations were performed, 52,050 (87.8%) of which were endarterectomies, and 7,264 (12.2%) of which were transfemoral carotid artery stenting procedures. Patients undergoing the latter were more likely to be younger, male, and non-white. They were also more likely to have comorbidities, a history of prior vascular intervention, and symptoms at presentation.

On adjusted analysis, the researchers found that transfemoral carotid artery stenting had significantly higher rates of stroke/death across 10 years of follow-up (after one year: adjusted hazard ratio [aHR], 1.70; 95% confidence interval [CI], 1.53–1.87, p<0.001; after five years: aHR, 1.46; 95% CI, 1.32–1.62, p<0.001; after 10 years: aHR, 1.4, 95% CI, 1.28–1.57, p<0.001). Transfemoral carotid artery stenting also had higher rates of stroke at one-year (aHR, 1.74, 95% CI, 1.48–2.04, p<0.001) and fiveyear follow-up (aHR, 1.25, 95% CI, 1.02–1.54, p<0.001),

“Transfemoral carotid artery stenting is also associated with decreased survival compared to carotid endarterectomy up to 10 years of follow-up” — KEVIN S. YEI

but not at 10-year follow-up (aHR, 1.19, 95% CI, 0.97–1.47, p=0.096).

Furthermore, transfemoral carotid artery stenting also had higher rates of death across the 10 years of followup (one-year follow-up: aHR, 1.73, 95% CI, 1.55–1.94, p<0.001; five-year follow-up: aHR, 1.47, 95% CI, 1.33–1.62, p<0.001; 10-year follow-up: aHR, 1.4, 95% CI, 1.26–1.56, p<0.001).

“After adjusting for potential confounders, the increased postoperative stroke rate associated with transfemoral carotid artery stenting compared to carotid endarterectomy seems to extend up to five years of follow-up,” write Yei and colleagues in the abstract to be presented at VAM. “Transfemoral carotid artery stenting is also associated with decreased survival compared to carotid endarterectomy up to 10 years of follow-up.

“This study shows improved long-term durability of [CEA] compared to transfemoral carotid artery stenting for [the] treatment of carotid artery stenosis in a large-scale, real-world database.”

Yei et al add that future comparisons with transcarotid artery revascularization (TCAR) will be required as long-term follow-up data for this procedure becomes available.

When: Wednesday, Aug. 18, 8:12 a.m.–8:24 a.m. William J. von Liebig Forum

Kevin S. Yei

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The year in COVID: VAM to feature 10 talks probing pandemic-related vascular complications

hospital, suggesting PAD is an important risk factor for the short-term hospital admission rate amid COVID-19, Kim et al concluded.

The CLOT calculator

By Beth Bales After nearly 18 months of life dominated by a worldwide pandemic—one that canceled the 2020 Vascular Annual Meeting (VAM)— VAM 2021 highlights several aspects of COVID-19 in a special session.

T

he coronavirus session will be from 5 to 6:30 p.m. Wednesday and includes both invited talks on COVID-related topics and presentation of several COVID-related abstracts.

Vikram Kashyap, MD, Benjamin W. Starnes, MD, Maureen Sheehan, MD, Scott Damrauer, MD, Misty Humphries, MD, and Michael Rohrer, MD, will moderate.

“When we began planning sessions for this year’s meeting, we knew that the many impacts of COVID-19 that we saw during the course of the pandemic had to have a place at the podium,” said Andres Schanzer, MD, who co-chairs the Society for Vascular Surgery (SVS) Program Committee, which plans educational programming at VAM. “COVID affected virtually everything in our lives,” he said.

“There were significant worries about our health and that of our patients, families and colleagues. And on top of that, there were financial concerns.”

Then there were concerns about how this never-before-seen virus affected patients already suffering from vascular diseases, he said. “Did our patients delay seeking help for their conditions? Could institutions change protocols for the better?

Did catching COVID-19 further impact or exacerbate our patients negatively?

“There’s so much we and other physicians, surgeons, and researchers don’t know yet.

We wanted to shine a light on some of the ongoing research.”

Financial calamities

The first four presentations are discussions.

“Quantifying the financial impact of COVID on vascular surgery practices: How to recover,” by Francesco A. Aiello, MD, of the University of Massachusetts Medical School in Worcester, will kick things off.

“Global vascular surgeons’ experience, stressors and coping during the COVID-19 pandemic,” by Sherene Shalhub, MD, of the University of Washington in Seattle will follow. “Wellbeing of the vascular surgery workforce during the pandemic,”

will be delivered by Max Wohlauer, MD, COVID-19 and cardiovascular risk factors.” from the University of Colorado in Denver, This retrospective analysis tested if patients who is a member of the SVS Wellness Task who contracted COVID-19 while already Force. receiving outpatient chronic therapeutic “Arterial thrombotic complications of anticoagulation would see reduced COVID-19: What are they and how should complications. The study observed that they be managed?” are the questions being certain higher-risk individuals had notably posed by Peter L. Faries, MD, of Mount lower rates of hospital/ICU [intensive care Sinai Health System in New York. unit] admission, multi-system organ failure There then follows a series of scientific and ICU mortality. It is being delivered talks detailing various aspects of the

by Mohamed A. Zayed, MD, associate pandemic that hit professor of surgery vascular surgery radiology “There's so much we and practice. at Washington and other physicians, University School of The first is “Increased stroke Medicine in St. Louis. surgeons, and severity, ST-elevation researchers don't myocardial infarction, PAD and COVID-19 type A aortic know yet. We wanted Next up is “Clinical dissection, and deaths outcomes in to shine a light on at home in an early peripheral artery epicenter of the some of the ongoing disease [PAD] COVID-19 pandemic.”

COVID-19: A research”— ANDRES SCHANZER with Researchers, including multicenter research presenting author network study,” Clayton J. Brinster, from presenting MD, senior staff surgeon at Ochsner author Danielle J. Kim, PhD, of Penn State Medical Center in New Orleans, delved Hershey College of Medicine in Hershey, into the extended impact of delays in acute Pennsylvania, and colleagues. The team care during the pandemic, evaluating the of researchers examined the clinical ongoing effect on cardiovascular pathology. outcomes of COVID-19 patients with PAD This first analysis of ongoing stroke to determine if they are at increased risk severity during the pandemic showed of mortality, hospitalization and ventilator significantly worse stroke data throughout dependence. In general, COVID-19 patients a network of 50-plus hospitals. The with PAD have a lower survival probability, findings substantiated national concern a higher rate of hospital admission and a that patients continued to delay care in higher likelihood of being on a ventilator the COVID-19 era, leading to increasingly compared to COVID-19 patients without severe, acutely symptomatic presentations PAD, she will tell VAM attendees. Even and potentially preventable morbidity after adjusting for comorbidities and and mortality. The second is entitled confounding factors, COVID-19 patients “Outpatient chronic anticoagulation with PAD versus those without had improves outcomes in patients with a higher chance of being admitted to

“The CLOT (COVID-19 likelihood of thrombosis) calculator: Predicting venous thromboembolism (VTE) risk in hospitalized patients with COVID-19” will then be presented by Richard A. Meena, MD, an integrated vascular surgery resident at Emory University in Atlanta. Meena and a team of investigators developed a risk model (CLOT) to help clinicians predict which COVID-19 patients are more prone to VTE development, as such a development is independently associated with mortality in hospitalized COVID-19 patients. CLOT can help with risk stratification for VTE development among COVID-19 admissions and better inform clinical decision-making regarding institutional antithrombotic protocols to reduce bleeding risk and improve outcomes, Meena will inform attendees.

Jorge A. Miranda, MD, a resident at Baylor College of Medicine in Houston, will deliver a presentation entitled “Impact of COVID-19-related delays of scheduled operations in patients with chronic limb-threatening ischemia.” The talk is the result of work by Miranda and a team of researchers who sought to determine influential characteristics of a population with severe PAD/chronic limb threatening ischemia (CLTI) during the pandemic where postponement of scheduled procedures may have impacted outcomes. The delays for these patients led to “a low observed, yet unpredictable rate of decompensation,” they found. But outcomes were “catastrophic,” with a 50% risk of major amputation, for patients who saw their planned, elective surgeries converted to an emergency operation.

The last of the scientific talks is “Results of a modified lower-extremity venous duplex ultrasound protocol for patients with COVID-19,” being presented by Jessie Ho, MD, a resident at Northwestern University Feinberg School of Medicine in Chicago. COVID-19 can increase the risk of venous thromboembolism, for which timely and accurate diagnosis is crucial, Ho and colleagues report. Because sonographers performing lower-extremity venous duplex ultrasound (LEVDUS) in this setting are in close proximity to such patients for an extended length of time, sonographers subsequently face an increased risk for exposure. To balance patient care needs while minimizing sonographer risk, in March 2020 a division at Northwestern Medicine instituted a modified LEVDUS protocol for patients with suspected or confirmed COVID-19: If an acute deep vein thrombosis (DVT) was detected, the test could be terminated early.

Preliminary results showed the modified protocol reduces time sonographers spend with COVID-19 patients.

When: Wednesday, Aug. 18, 5 p.m.–6:30 p.m.

Special Session: COVID-19

AUGUST 2021 | www.vascularspecialistonline.com

Vascular Connections | 17

Just 16% of US centers in VQI offer SVS guidelinecompliant open repair for AAA, new study finds

(CMAG) designation. They also compared the proportion of CMAGs by region. The complete dataset for analysis included 67,865 patients (49,264 EVAR; 11,010 OAR; 7,591 aortic bypasses) and 336 institutions.

Analysis by region showed that, in 2019, the South had the lowest OAR CMAG availability (n=11, 13.1%), but this finding was not significantly different across regions.

By Urmila Kerslake

A turning point for training?

There is a stark downward trend in the number of U.S. centers in the Vascular Quality Initiative (VQI) that meet the Society for Vascular Surgery (SVS) clinical practice guidelines for open repair of abdominal aortic aneurysm (AAA), new research to be revealed at the 2021 Vascular Annual Meeting (VAM) finds. Data collected over an eight-year period suggest that patient access to guideline-conforming open repair was low to begin with and is steadily decreasing. The research is likely to spark thorny questions around the guideline criteria, and potential regionalization of aortic centers of excellence with implied funneling of patients to these, as well as vascular surgery training.

O

ver the eight years, the research tracks a glaring contrast in direction between the proportion of U.S. centers in the VQI meeting the SVS guidelines criteria to offer open aortic repair (OAR) with those able to offer endovascular aneurysm repair (EVAR).

While nearly 2% fewer centers per year met the recommended criteria to offer open repair, there was an almost identical jump in the number of centers able to offer EVAR. Between 2011–2019, this translates to a significant decline from 32% (n=21) to scarcely 16% (n=46) in the proportion of centers in the VQI localized to offer OAR in step with the guidelines. On the other hand, the upswing in the proportion of centers in the VQI able to offer guideline compliant EVAR increased significantly nationally from 51.6% (n=33) in 2011 to 67.1% (n=190) in 2019.

The investigators also found that centers in the VQI that met the SVS criteria for both EVAR and OAR were even less frequent and significantly decreased by 1.5% annually from 26.6% (n=17) in 2011 to 13.1% (n=37) in 2019.

The SVS guidelines, with their sights firmly set on the target of improving outcomes for AAA treatment, recommend that OAR be confined to centers that perform 10 or more open aortic operations annually and have a perioperative mortality of 5% or less.

Similarly, it directs that elective EVAR be restricted to centers that perform 10 or more operations annually and have a perioperative

mortality and conversion-to-open rate of 2% or less.

Joel L. Ramirez, MD, a vascular surgery resident from University of California, San Francisco (UCSF), who will present the research, told Vascular Connections: “The way AAA is managed has changed in the last 15-to-20 years, and we have moved away from open surgery to more endovascular surgery, which I think in most cases is probably a good thing for patients. That said, many of us also have concerns about training and access to open repair.

These data question whether we can safely offer OAR at most institutions and has implications about sufficient OAR exposure for trainees. Improved guidance on when OAR should be performed may help deter this alarming trend of decreasing guideline-compliant availability of surgical care.”

The researchers set out to capture the number and geographical distribution of centers meeting the SVS criteria. They queried the SVS VQI for all OAR, aortic bypasses, and EVAR from 2011 to 2019 and calculated annual open aortic and EVAR volume, 30-day elective operative mortality for OAR or EVAR, and EVAR conversion-to-open rate for all centers. The team then applied the SVS guidelines for OAR and EVAR, individually and in combination, to each institution leading to a Center Meeting the SVS Aortic Guidelines

2011-2019: decline from

32.68% to

16%

of centers localized to offer open repair in step with SVS guidelines

With such a small number of institutions meeting the recommended volumes and outcomes for open repair, there are certainly important implications for training. “The argument is trainees like myself are getting less access to open repair and are doing EVAR more frequently, which may be pushing the technology beyond what was intended. If we learn more about the long-term complications of EVAR and move towards performing open repair more frequently in the future, then we may be put in a position in which we complete our training with minimal exposure to OAR but are then expected to perform this procedure frequently,” Ramirez clarified.

“These data question whether we can safely offer OAR at most institutions”— JOEL L. RAMIREZ

The complex case for regionalization of open repair services Setting the scene for the study, Ramirez explained: “We really wanted to test whether the application of the SVS guidelines would lead to a low availability of OAR centers, particularly whether it would show decreasing availability nationally, because we know anecdotally that the volume of open repair patients is decreasing. So, does that then mean we are going to recommend, essentially, regionalization of open repair to centers of excellence?”

When quizzed on whether future regionalization, and the potential establishment and designation of open aortic services of excellence might place the onus on patients

Joel L. Ramirez

to travel further to receive guidelinecompliant care, Ramirez answered: “That is probably the next phase—determining the recommendation that we want to be giving. It remains to be debated whether, as a Society, we make it clearer to patients [by signposting] which institutions these are and whether they should be referred there for treatment. Potentially, that becomes a very contentious issue because there are several very controversial implications about access to providers. Who’s to say that a service provider, perhaps at a lower volume institution, cannot provide very good and appropriate care?

“Still, I think one of the things that we really want to keep a perspective on is that complex aortic surgical care is a team sport. It’s the surgeons, the hospital setup [systems and processes], the nursing staff … a whole group of folks. And when these groups perform OAR more frequently, their outcomes tend to be better.”

When: Thursday, Aug. 19, 8:34 a.m.–8:39 a.m.

Plenary Session 3

‘VSITE PREDICTS QUALIFYING EXAM SUCCESS’ The Vascular Surgery In-Training Examination (VSITE) is “highly predictive” of a Vascular Qualifying Examination pass for examinees following both the integrated vascular surgery (0+5) and vascular fellowship (5+2) training paradigms, Vincent L. Rowe, MD, professor of surgery at the University of Southern California Los Angeles will tell VAM attendees. “Program Directors and trainees should strive towards curricula improvements and study methods to maximize performance on this yearly examination,” Rowe and colleagues found. “Future correlative analysis on predictive value of VSITE scores during earlier years of training may provide needed data to support transition of board certification to the final year of training.” Although considered a low-stakes formative examination, correlation of the exam to pass/fail performance on the Vascular Surgery Board (VSB) qualifying and certifying exams could provide program directors and trainees stratification of passing probability. The ability of the VSITE to predict future board certification was evaluated, they report, using all first-time examinees of the VSB exams from 2016 to 2020.— Bryan Kay When: Saturday, Aug. 21, 8:44 a.m.–8:56 a.m.

Plenary Session 5

18

| Vascular Connections

Special session on diversity enters VAM agenda

AUGUST 2021 |

events but is seldom included in risk assessments among patients with Disadvantaged peripheral artery disease (PAD). She will deliver findings that emerged from patients presented the hypothesis that depression would with rAAAs 2.7 influence mortality among patients with PAD. Kim and colleagues explored the years younger than prevalence of major depression stratified

By Bryan Kay those from lessby race and gender, and associations deprived areas — with mortality. The researchers analyzed Over the course of more than a year, diversity, equity and inclusion (DEI) have been outpatients enrolled in a cardiovascular AMANDA R. PHILLIPS ET AL brought into sharp focus by a compendium of events inside and outside of medicine. As risk cohort study from May 2019 to U.S. society has reckoned with the socioeconomic and cultural consequences of racial December 2020. They found that and gender disparities, so too has vascular surgery. major depression is common among VASCULAR SURGERY HAS BEEN AT Racial disparities patients with PAD, Black patients with the vanguard as disparities in vascular in treatment of “and prevalence disease and outcomes have sharpened ruptured AAAs among women transported via air ambulance “as most rAAA are poorly minds on the need to address societal Thomas F. was nearly double representative of a wide variety of urban served by the imbalances.

O'Donnell, MD, that of men.” They and rural communities.” The research current systems of At this year’s Vascular Annual Meeting a vascular fellow will conclude: team discovered that patients with rAAA (VAM), a special DEI session has been at Beth Israel “Depression is were more likely to reside in more interhospital transfer associated with convened, featuring a broad cross-section Deaconess Medical disadvantaged neighborhoods, in part in the U.S. — of science delving into vascular disease Center in Boston, mortality among concluding that “the most disadvantaged disparities across racial, ethnic and gender will deliver data patients with PAD patients presented with rAAA 2.7 years THOMAS F. O'DONNELL ET AL lines. on transfer rates, who are not frail. younger than those from less deprived Moderated by Ronald L. Dalman, turndown rates, and Combining [major areas” and “one third of disadvantaged MD, the outgoing Society for Vascular outcomes in Black depressive disorder] patients ruptured before age 65— Surgery (SVS) president, Vincent Rowe, vs. white patients with more traditional the recommended age for initiating MD, chair of the SVS presenting comorbidity parameters may improve screening.”

DEI Committee, and with ruptured risk assessment in PAD.” Bernadette Aulivola, AAA (rAAA) in two Disparities of healthcare access Black and socially MD, a member of large databases.

‘Rupture before the age of AAA among Hispanics at risk of lowerdisadvantaged the committee, O’Donnell and screening—another example of extremity amputation the session is being colleague examined disparities in vascular surgery?’

Tze-Woei (Kevin) Tan, MD, associate patients tended to kicked off with an all repairs of rAAA “ADI is a validated measure of professor of surgery at the University of have more advanced in the VQI from experiential talk socioeconomic Arizona College of to be delivered by 2003 to 2020. disadvantage at the Medicine in Tucson, peripheral vascular Lee Kirksey, MD, “Black patients neighborhood level will deliver findings Hispanics are disease — the Walter W. with rAAA are and is increasingly demonstrating more likely to not Buckley-endowed poorly served by used to assess that Hispanics are CHLOE POWELL ET AL vice chairman of the current systems disparate outcomes disproportionately seek or delay care, vascular surgery of interhospital across a broad more likely possibly leading and co-director transfer in the variety of disease “to not seek or of the Center for U.S. as they less states,” Amanda delay medical to amputation rate Multicultural Cardiovascular Care at the often undergo transfer prior R. Phillips, MD, care than their disparities — Cleveland Clinic in Cleveland, Ohio. to repair,” O’Donnell will tell VAM a resident at the counterparts due attendees. “Although postoperative University of to socioeconomic TZE-WOEI (KEVIN) TAN ET AL Direct and indirect effects of race outcomes appear similar, this may be false Pittsburgh Medical reasons.” This and socioeconomic deprivation on optimism, as Black patients, especially Center, will inform could be leading vascular surgical presentation the underinsured, are more often turned VAM attendees. to disparities in and outcomes down for repair even lower-extremity Chloe Powell, MD, an integrated vascular after adjustment.

“Cardiovascular amputation, Tan and colleagues surgery resident at the University of Significant work is diseases present concluded after carrying out a study Major depression Michigan in Ann Arbor will present needed to better earlier among of Hispanic and non-Hispanic patients in on the association between race and understand the minority and the National Institutes of Health (NIH) is common among socioeconomic status, as measured by reasons underlying socioeconomically All of Us Research Program to identify PAD patients, and the area deprivation index (ADI), on these disparities and deprived patients. participants with PAD or diabetes. prevalence among outcomes following vascular surgery identify targets to Screening at 65 The analysis included 432 Hispanic procedures. Powell et al used a statewide improve the care of years of age, participants and 3,219 non-Hispanic women was nearly quality registry in order to investigate Black patients with diagnosis, and participants—2,551 of them white, 587 twice that of men— elective repair are patients who underwent abdominal aortic rAAA.” African American, 82 Asian, and 79 listed aneurysm (AAA) repair, open lowervital in mitigating as “other.” After multivariable analysis, GLORIA Y KIM ET AL extremity bypass, carotid endarterectomy Gender the risk of rAAA; the researchers’ results showed that and stenting from 2012 to 2019. The study disparities in however, the Hispanic participants were significantly demonstrated, the researchers will reveal, major depression association of ADI more likely to delay medical care (p<0.05) that Black race and socioeconomically among patients with rAAA is poorly due to employment, childcare issues, disadvantaged patients “tended to have with PAD and associations understood.” This was the backdrop worries about paying, and nervousness more advanced peripheral vascular with mortality for a retrospective observational study about seeing a doctor than non-Hispanic disease on initial presentation with less Gloria Y. Kim, MD, a vascular surgery of patients who underwent emergency participants. preoperative medical optimization, resident at the University of Michigan in surgery for rAAA at a multi-hospital indirectly leading to increased morbidity Ann Arbor, will tell VAM that depression institution from 2003–2019 by Phillips When: Friday, Aug. 20, 10 a.m.–11 a.m. and death.” is associated with adverse cardiovascular and colleagues. They probed patients Special Session: Diversity, Equity & Inclusion

AUGUST 2021 | www.vascularspecialistonline.com

Vascular Connections | 19

VRIC trainee award winners announced

By Beth Bales The SVS Foundation has announced the four recipients for the Vascular Research Initiatives Conference (VRIC) Trainee Award.

The SVS Basic and Translational Research Committee selected the awardees from the top-scoring abstracts that were submitted by trainees.

They will present their research and will be acknowledged at this year’s conference, popularly known as VRIC, which is dedicated to stimulating and encouraging interest in research among trainees who are aspiring academic vascular surgeons. Each also receives $1,000 to defray expenses of attending the conference.

VRIC is being held in two sessions during the 2021 Vascular Annual Meeting (VAM) in San Diego. The sessions will be from 1 to 3 p.m.

Pacific Time Thursday and Friday, Aug. 19 and 20.

Luke Brewster, MD, chair of the Basic and Translational Research Committee, said: “Kudos again to our resident trainee award recipients. The work submitted and to be presented by these stellar trainees and their mentors is terribly exciting and reinforces the

great tradition of vascular surgeon-scientists supported by our SVS.” This year’s awardees, their projects, institutions and mentors are: ● Elizabeth Andraska, MD, University of Pittsburgh, Pennsylvania “Early upregulation of elastolysis allows for collateral formation after arterial occlusion” Mentor: Ryan McEnaney, MD ● Luis Gonzalez, BS, Yale School of Medicine, New Haven, Connecticut “Role of tenascin-C in venous remodeling following AVF creation” Mentor: Alan Dardik, MD ● M argaret Nalugo, MD, Washington University School of Medicine in St. Louis “Towards a cure for diabetes: Pancreatic tissue encapsulation and implantation in a novel arteriovenous graft” Mentor: Mohamed Zayed, MD ●S riganesh Sharma, MD, Conrad Jobst Vascular Laboratories, University of Michigan, Ann Arbor “Induction of the epigenetic enzyme KMT2A/ MLL1 and urokinase in macrophages after murine coronavirus infection contributes to hyperfibrinolysis” Mentor: Andrea Obi, MD

When: Thursday/Friday, Aug. 19 and 20, 1 p.m.–3 p.m.

Vacular Research Initiatives Conference

Summit to discuss aortic arch: The ‘next new frontier’ This year’s Vascular Annual Meeting Aortic Summit will focus on the “next new frontier” in vascular surgery—endovascular treatment of the aortic arch.

“WE WANT TO PUSH THE FRONTIER TO TREAT more patients. The arch is the Achilles’ heel of everything we’re doing,” said co-moderator Sherene Shalhub, MD, associate professor of surgery at the University of Washington School of Medicine in Seattle.

The summit, 3:30 to 6:30 p.m. Friday, Aug. 20, is presented in collaboration with The Society of Thoracic Surgeons.

“The arch is a niche area with a lot of overlap, as well as many unique concepts,” said Gustavo Oderich, MD, session organizer and co-moderator. “We’ve planned the session to cover the hot topics involved with endovascular arch repair.”

The summit’s first half will cover benchmarked outcomes of both open and endovascular surgical repair, anatomical requirements for endovascular repair in Zone 0, neurological advances, controlled stent-graft deployment in Zone 0, upcoming testing of newly designed filters, and imaging requirements for optimal endovascular arch repair. The second half will cover actual techniques. “Most of the work currently being done—by the most seasoned surgeons and interventional surgeons and radiologists— will be discussed here,” said Oderich. “Traditionally, open surgery has been the gold standard of care for arch repair.”

“But outcomes vary tremendously even in large centers with experienced surgeons,” he added. “Perhaps we bear the cost of higher intervention rates to get lower complication rates.”

Additional attendance fees apply.—Beth Bales When: Friday, Aug. 20, 3:30 p.m.–6:30 p.m. Aortic Summit .