3 Interview
From Brazil to Baylor: Oderich lands at powerhouse
10 BEST-CLI Landmark trial validated in singleinstitution retrospective review
8 Presidential addresses SCVS and AVF presidents each offer vascular surgery leadership perspectives during recent annual meetings
13 VAM 2025 Vascular Annual Meeting set to feature dedicated session on AI In
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or
A survey recently went out to SVS members asking them to contribute their voice to an opinion poll over whether the VSB should remain a constituent board of the ABS— or become free-standing.
By Bryan Kay
Federated or
and can call upon a far greater pool of resources as
Both sides were articulated during a recent focused session at the 2025 Society for Clinical Vascular Surgery
the Vascular Surgery Board, or VSB—of the American Board of Surgery (ABS)?
On the one hand, advocates of a fully independent board advocate the strengthened voice the specialty would have with its own seat at the table of key decision-making bodies like the American Board of Medical Specialties (ABMS), or on the American Medical Association (AMA) RVS Update Committee (RUC) when recommendations are made over Medicare reimbursement. On the other, proponents of the status quo VSB-ABS structure argue that vascular surgery’s voice is more powerful under the much larger ABS umbrella,
nated Society for Vascular Surgery (SVS) survey which puts the question directly to the SVS membership.
In Austin, Alan Dietzek, MD, a vascular surgeon at Hackensack Meridian Health in Edison, New Jersey, put the case forward for a free-standing board, saying that the current VSB has done “an outstanding job” in the role it currently performs but is limited owing to the need for approval of its work in conjunction with the ABS. “There have been no issues to date, but who can predict tomorrow,” he said.
“A desire for an independent board is not a vote against the current VSB. It is a vote to change where the
Medical Editor Malachi Sheahan III, MD
Associate Medical Editors
Bernadette Aulivola, MD | O. William Brown, MD | Elliot L. Chaikof, MD, PhD
| Carlo Dall’Olmo, MD | Alan M. Dietzek MD, RPVI, FACS | John F. Eidt, MD | Robert Fitridge, MD | Dennis R. Gable, MD | Linda Harris, MD | Krishna Jain, MD | Larry Kraiss, MD | Joann Lohr, MD
| James McKinsey, MD | Joseph Mills, MD | Erica L. Mitchell, MD, MEd, FACS | Leila Mureebe, MD | Frank Pomposelli, MD | David Rigberg, MD | Clifford Sales, MD | Bhagwan Satiani, MD | Larry Scher, MD | Marc Schermerhorn, MD | Murray L. Shames, MD | Niten Singh, MD | Frank J. Veith, MD | Robert Eugene Zierler, MD
Resident/Fellow Editor
Saranya Sundaram, MD
Executive Director SVS
Kenneth M. Slaw, PhD
Senior Director for Public Affairs and Advocacy
Megan Marcinko, MPS Communications Specialist
Marlén Gomez
By Arthur E. Palamara, MD
“Where have all the doctors gone?” is the headline on the cover article of the January/February 2025 edition of the AARP Bulletin. Perhaps it should include, “or are going?” The article, which is quite extensive, explores why patients have a difficult time finding a physician, let alone seeing a specialist. The article is quite sympathetic to physicians. Admitting that primary care doctors make $250,000 per year, and specialists twice that, it explores the harsh financial realities of becoming a physician: that students graduate with educational debt of over $250,000—added to the number of years of study needed to achieve mastery of their specialty—make success quite an achievement. One-in-four students drop out before graduation, finding the demands, pressures and lifestyle just too onerous. These negative impediments result in an America burdened with a physician shortage. Our aging population will keenly appreciate this loss of expertise since their avuncular family physician will exist only in faded yellow copies of the Saturday Evening Post.
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Vascular Specialist is the official newspaper of the Society for Vascular Surgery and provides the vascular specialist with timely and relevant news and commentary about clinical developments and about the impact of healthcare policy. Content for Vascular Specialist is provided by BIBA News. Content for the news from SVS is provided by the Society for Vascular Surgery. | The ideas and opinions expressed in Vascular Specialist do not necessarily reflect those of the Society or the Publisher. The Society for Vascular Surgery and BIBA News will not assume responsibility for damages, loss, or claims of any kind arising from or related to the information contained in this publication, including any claims related to the products, drugs, or services, or the quality or endorsement of advertised products or services, mentioned herein. | The Society for Vascular Surgery headquarters is located at 9400 W. Higgins Road, Suite 315, Rosemont, IL 60018. | POSTMASTER: Send changes of address (with old mailing label) to Vascular Specialist, Subscription Services, 9400 W. Higgins Road, Suite 315, Rosemont, IL 60018. | RECIPIENT: To change your address, e-mail subscriptions@bibamedical.com | For missing issue claims, e-mail subscriptions@bibamedical. com. | Vascular Specialist (ISSN 1558-0148) is published monthly for the Society for Vascular Surgery by BIBA News. | Printed by Ironmark | ©Copyright 2025 by the Society for Vascular Surgery
We will explore the significance of this article later, but it is notable that the AARP Bulletin chose to publish the piece as its cover article.
One would think that a generous salary and comfortable lifestyle would attract more young people to pursue medicine, but the exact opposite has happened. Those bright young students discovered that they could make more money at a younger age without the painful years of medical school, on-call nights in residency, and emotional burdens of patient care (not all cases go well). The need to postpone customary milestones, such as getting married, buying a home, and raising a family, disincentivizes many students who might otherwise be attracted to the profession.
My youngest son experienced the challenge. As a third-year college student at a major Florida university, he had all the attributes necessary to be a great physician: intelligence, drive, motivation and compassion. I arranged for him to spend the day with the dean of a medical school to discover if he would find the profession appealing. The dean was both hospitable and gracious. My son had a very enjoyable day. At about 4:30 p.m., as I was finishing a difficult case, my phone rang. It was him. I asked how it went. His voice was polite but non-committal. He thoroughly enjoyed the day, raved about how nicely the dean treated him, and found the visit interesting.
fault, lose everything that you’ve worked for all these years. Why would I want to do that?”
Why indeed? Perhaps it’s a calling from which we enjoy tremendous gratification. For the sake of completion, my son is a very successful attorney who is married with children and thoroughly enjoys his life (and his profession). His story exemplifies life choices that are available to young people without the rigors and sacrifice that we accept as part of our profession.
For those who have become doctors, the most attractive alternative after completing residency is to become employed. This guarantees a steady income and more predicable hours. Student debt weighs heavily on their choices. Close to 80% of recent doctors are now employed. But employment comes at a price. They have never enjoyed physician autonomy. In terms of this article, physician autonomy is doing what you believe is best for the patient, without a corporate entity telling you how to practice. But that is changing.
The December assassination of the UnitedHealth Group executive exposed a deep undercurrent of dissatisfaction among patients. There was no outpouring of sympathy for the deceased but rather public ennui, reflecting little concern for the loss of a rich executive who only made life worse for millions of people. I am sure Austria felt the same way when Archduke Franz Ferdinand was assassinated. Andrew Witty, the president of UnitedHealth, admitted that the system needs to function better, as reported in his remarks Jan. 12, 2025, in Fortune magazine. He went on to add: “Ultimately, improving healthcare means addressing the root cause of healthcare costs,” which he blames on over-usage and high pharmacy prices. Going further, he offered, “Seniors recognize value, which is why the majority of them choose Medicare Advantage.” He ignored the fact that seniors cannot afford co-insurance and the deductibles that come with it, and have no alternative. He also ignored the fact that the Federal Trade Commission (FTC) revealed that UnitedHealth severely overcharged cancer patients for life-saving drugs. And UnitedHealth owns its own pharmacy benefit managers, which allows the company to make a huge profit from pharmaceuticals.
Administrative types and corporate leaders have little knowledge of—or regard for—how medicine is practiced. Their concern is for efficiency, RVUs and number of cases
Well, I asked, did you find your experience stimulating enough to pursue medicine? His response was blunt. “It would take me another year of college, four years of medical school and at least another four years of residency. That’s nine years.”
“Dad,” he went on, “I’ve seen how hard you’ve worked, sacrificing time with us, Saturdays, Sundays, leaving at night, and I appreciate your dedication. I’ve seen you upset when you’ve lost a patient, or someone didn’t take good care of your patient. And, after working all those years, you could have a patient go bad, get sued and, even if it’s not your
Arthur
E. Palamara
He theorizes that too many people want too much care, and we can’t afford to provide that level of care for everyone. Absent from his assertion is the financial reality that America spends twice as much as any developed country, yet our outcomes are worse than many other countries, having the highest infant mortality rate and the lowest life expectancy among 11 high-income countries, according to a Lancet report from Dec. 7, 2024. Our government is reluctant to spend more. Physician Medicare reimbursement has not risen in 25 years, while physician payments have been drastically reduced. Since hospitals are not likely to lower their fees, and GLP-1 agonists are not going to be discounted, physicians should not expect increased compensation. We who actually deliver care—doctors—have been poorly compensated. What this means for the employed physician is that employers place more demands on them.
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Following in the footsteps of some of the pioneers of cardiovascular surgery, Gustavo Oderich, MD, recently stepped into position as the Michael E. DeBakey distinguished chair in surgery, professor of surgery, chief of vascular and endovascular surgery and director for the Center for Aortic Surgery at Baylor College of Medicine and Texas Heart Institute in Houston. Steeped in history, the Baylor and Texas Heart Institute names add to an already illustrious career for Oderich that has crossed countries and climates, reports Jocelyn Hudson
FROM MEDICAL SCHOOL IN BRAZIL through the Mayo Clinic in Rochester, Minnesota, to his most recent post at the University of Texas (UT) Houston, Oderich has followed in the pioneering footsteps of some of vascular surgery’s most noted forefathers. Now he has landed at the place where two of its finest, Michael E. DeBakey, MD, the name behind his distinguished chairmanship, and Denton Cooley, MD, minted Houston’s status as a cardiovascular powerhouse. In this interview, Oderich tells Vascular Specialist what the Baylor College of Medicine and Texas Heart Institute legacy means to him and the mark he hopes to make through his clinical and research endeavors.
Baylor represents the holy grail of U.S., if not world, cardiovascular surgery through its association with the likes of pioneers like DeBakey and Cooley. What does their legacy mean to you?
GO: It’s a privilege and honor to work at the Baylor College of Medicine and Texas Heart Institute. I’m very much attached to the legacy of these giants and what has been accomplished here during the last century. In terms of cardiovascular surgery, Baylor College of Medicine and Texas Heart Institute have consistently been a powerhouse, and a lot of the things we do nowadays started here in the late 1950s with the work of Drs. DeBakey and Cooley and, subsequently, Drs. Stanley Crawford and Joseph Coselli, among so many prominent surgeons. I am so grateful for the work of Dr. Joseph Mills, our immediate past chief of vascular surgery at Baylor, who successfully established the division at the institution. The aorta is where I spend most of my time clinically and is also the focus of my research, so working in the place where the first of these operations were performed, where modern aortic surgery was really invented, is an incredible honor. It is an honor beyond anything I could have imagined holding the title of inaugural Michael E. DeBakey distinguished chair in surgery. Dr. DeBakey was arguably one of the most accomplished and influential surgeons the world has ever seen.
What do you hope to bring to the Michael E. DeBakey Department of Surgery at Baylor?
GO: The department has 280 full-time faculty and 18 divisions or sections and, under the leadership of Dr. Todd Rosengart, has seen the number of clinical cases, research grants, scientists, and highimpact publications skyrocket over the last decade. Dr. Rosengart was able to show me a clear vision of what we could accomplish at Baylor College of Medicine and Texas Heart Institute, which I was most excited to learn in the interview process. Baylor College of Medicine has played a leading role in contemporary complex open surgical aortic repair, largely due to the massive experience of Dr. Coselli and remarkable improvements in clinical outcomes. Yet, the endovascular aortic program had not yet been fully developed into a premier, advanced endovascular program capable of handling most complex cases and leading future developments in this field. That’s the know-how that I can bring to the department, in addition to continue to advance the work of Dr. Mills. The way I see it, Drs. DeBakey, Cooley, Crawford and Coselli climbed a huge mountain, they wrote many chapters and formed the foundations for what we do today; I’m here to continue this climb, write new chapters, as well as preserve, maintain and be loyal to the work that they have done.
We have seen you go from the Mayo Clinic to UT Houston and now Baylor. Could you speak a bit about these career moves?
I was very fortunate to be accepted for general surgery and vascular training at the Mayo Clinic in the late 1990s and to join the faculty in 2006. Becoming a Mayo surgeon was the highest accolade of my career. Only a few are cut out to meet the true Mayo surgeon definition. At Mayo, I was trained to be a “navy seal” of open surgical vascular surgery. Later, working with Drs. Roy Greenberg, Dan Clair and colleagues at the Cleveland Clinic, I perfected endovascular skills and broadened my horizons to complex endovascular work. At Mayo, I witnessed a place that went from offering traditional, classic open surgery, to a hub of advanced endovascular surgery. To give you an idea of the scale of the shift, when I started at Mayo, we were in one or two device trials; when I left, we were in 26. For most of those, we were the number one enroller. Mayo is the best hospital in the world; it has mastered clinical practice and is very patient-focused. But I am a native of Brazil and, culturally, it was very difficult to live in the Midwest. And the weather... if you imagine cold, you don’t know what cold is. We had a polar vortex more than once, and it’s a very long winter. There are two seasons in Rochester: July and winter. UT offered a great opportunity, but there was not a complex endovascular program and so I had several concerns. One of them was whether I could reproduce our outcomes from Mayo at UT, but I soon learned that we could. And I learned that it’s not only about the surgeon, it’s about the team and the infrastructure. We created all that at UT and, in fact, recently published our outcomes, with a 1% mortality for thoracoabdominal aortic aneurysms [TAAAs], both at Mayo and UT, among more than 600 patients. I now have to reproduce that here at Baylor, but I’m confident we can do it.
GO: I’m originally from Brazil and finished my medical school there in 1995. However, after completing two years of surgery in the country, it became clear to me that I wanted to advance my career and become involved in academic surgery and complex endovascular techniques. I realized this would be very difficult to accomplish in Brazil at that time.
and by limited access to devices. In fact, there was no commercially approved device for TAAAs in the U.S. at the time. All that changed with ARC. Offering probably the highest level of evidence for complex aortic work, this is a prospective, monitored and adjudicated registry of 10 ongoing prospective non-randomized physician-sponsored investigational device exemption [IDE] studies that annually report outcomes to the Food and Drug Administration [FDA]. The 10 physicians involved are at the top of their game and have well overcome the learning curve. I think it shows the world what can be done when you have an experienced team, centralization, skill, access to technology and volume, and the work is remarkable. Some of our most important work to date was published last year in Circulation This was a series of over 1,100 elective TAAA repairs, with a mortality of 2.7%. That is a three-fold reduction in early mortality compared to the best open surgical series of a single center, and about a five-fold reduction on large data from Medicare.
What’s next on the horizon for U.S. ARC?
Homing in on your current work, you are at the forefront of endovascular aneurysm repair (EVAR) advancements and pushing the envelope with complex devices through the U.S. Aortic Research Consortium (ARC). What is some of the key evidence that has been coming out of this project?
GO: I was part of the American Heart Association (AHA) writing committee for management of aortic diseases that was published in 2022. When we started discussions for how to treat TAAAs, complex endovascular repair was not even on the radar of several members of the writing committee. There were several reasons for this, mostly due to the fact that the body of literature was all single-center experiences, with short follow-up, plagued by reinterventions
GO: There is a lot of room for improvement. There are still many patients who die from other, non-aortic diseases and reintervention rates remain an issue. That’s where I think new research has to focus. Looking to the future, ARC 2.0 is going to be when we have all the digital and clinical data immediately available at our fingertips so that we can use artificial intelligence [AI] algorithms to look at phenotypes of patients to plan appropriate procedures and assess likely outcomes. There will be several challenges when we reach this stage, including HIPAA [Health Insurance Portability and Accountability Act]. This currently prevents us from having access to many aspects of personalized data points, such as dates for example, which are needed for time-dependent outcomes. Also, we don’t have easy access to imaging or other personalized data, and, given we’re moving towards personalized medicine, that’s going to be a big challenge.
Can you talk a little more about some of the work that’s being done on the journey toward precision care?
GO: AI will be used in the entire patient experience, from preoperative diagnosis to treatment planning, operation,
“I’m very much attached to the legacy of these giants and what has been accomplished here during the last century”
GUSTAVO ODERICH
vessel wall to drag the thrombus back into a funnel. Those technologies are beneficial as well, but I would say there is an increased potential for vessel wall injury. The CAVT technology allows you to maintain wire access if need be and limits the amount of repeat interventions that we have had to do. This means that after 15–20 minutes of application, we’ve been able to clean out the clot enough to allow perfusion and retention of the limb with just anticoagulation after that.
How do you see the future of vascular surgery evolving as endovascular devices and techniques continue to advance?
Daniel Clair, MD, reflects on the STRIDE study of 30-day outcomes in patients who undergo first-line use of the Indigo Aspiration System and Lightning® (Penumbra) device portfolios for acute limb ischemia (ALI). He also weighs in on the growing weight of evidence in favor of percutaneous mechanical thrombectomy with the computer-assisted vacuum thrombectomy (CAVT™).
Labeling STRIDE “an effective limb salvage study of patients presenting with ALI,” Clair, chair of the Department of Vascular Surgery at Vanderbilt University Medical Center in Nashville, Tennessee, charts the move from open surgery to endovascular intervention, through thrombolysis and mechanical thrombectomy, and the emergence of CAVT’s suction technology.
Overall, says Clair, the effectiveness of CAVT is underscored by a “very low rate of embolization— a key benefit of using aspiration technology in the management of patients with ALI.”
What are the primary factors that have influenced your practice’s shift from traditional open surgical embolectomies to more endovascular interventions?
For most procedures that involve the vascular system, there is an understanding among vascular specialists—and vascular surgeons in particular—that minimally invasive techniques are easier and quicker for patients to recover from and, in most instances, they limit the impact of the procedure. In addition, historically, even through the 1990s, studies looking at thrombolysis alone have shown similar outcomes between patients who had an initial approach with minimally invasive technologies and procedures versus open surgical thrombectomy. Those data influence people extensively, and the fact there have been improvements with continued advancement in the mechanical thrombectomy world has made it even safer for these patients to have thrombus and embolic lesions treated with a primary approach that involves percutaneous mechanical thrombectomy.
How have improvements in percutaneous thrombectomy devices impacted the efficacy and safety of endovascular procedures compared to open surgery?
Without question, in the past this percutaneous approach involved the use of thrombolysis, but enhancement in aspiration technology—and mechanisms to apply that aspiration—to identify thrombus, and when the aspiration device is within the thrombus, has dramatically improved. It enhances the clot removal power while limiting the amount of blood loss that occurs.
What are the results of the STRIDE study showing and how are such data impacting patient selection and treatment planning?
STRIDE is an important study because, if you compare the historical outcomes of patients with ALI, the expected acute limb loss—that is within 30 days—is usually somewhere between 7–12%, or even 15%.1 And in the STRIDE study, that 30-day limb salvage was 98%.1 It is an effective limb salvage study for patients presenting with ALI. Even out to 12 months, the STRIDE data show limb salvage close to 90%.2 Right now, in our practice, the vast majority of patients who present with ALI are treated primarily with percutaneous approaches, and we think the aspiration technology is a very good way to deal with those patients and also enhance limb salvage rates—particularly in the periprocedural period.
Can you provide an overview of STRIDE II and how it differs from STRIDE?
STRIDE looked at 119 patients who presented with ALI. STRIDE II is an expansion of that population to 300 patients, with broader target vessel criteria, and
“[STRIDE] is an effective limb salvage study for patients presenting with acute limb ischemia”
DANIEL CLAIR
will be done globally. It will incorporate an enhanced clot identification technology within the Lightning Bolt catheters. Within that 300-patient group, there will be a 50-patient subset where we will be looking at the use of this technology in previously stented or intervened-upon segments of the peripheral vasculature. That is important because, currently, there really is no wellstudied mechanism to assess outcomes for percutaneous thrombectomy through areas of stenting.
In what ways does the use of CAVT contribute to a shift from open surgery to endovascular treatments?
For the vast majority of our patients with ALI, we see aspiration as great to use. We experience limited impact to the endothelium from these catheters because they are flexible and very compliant. The Bolt technology has a mechanism by which suction is rapidly modulated. This provides a benefit in that there is some disruption to the thrombus or embolus as we aspirate. It enhances the ability to break this clot up and bring it into the catheter. In many instances, we’re not using the addition of the clot disruptor [Separator] that comes with the catheter, just because of how effective the Bolt technology is on its own.
How is CAVT different from other endovascular technologies?
Other technologies involve application of a stent-like structure to the
I would venture to guess that we are going to see enhancements in, and application of, the aspiration technology in such a way that it will allow lengthy clot segments to be treated effectively, without the need for lysis at all. Right now, we are seeing the expansion of this application. One other area that, at times, is a struggle is dealing with chronic embolic material. But, here again, the use of modulated aspiration that comes with CAVT is very beneficial and has been helpful in breaking up these clots in the catheter. Advancements of these CAVT algorithms are going to be more helpful— even enhance the aspiration.
This interview was sponsored by Penumbra, Inc. Daniel Clair is a consultant for Penumbra. Procedural and operative techniques and considerations are illustrative examples from physician experience. Physicians’ treatment and technique decisions will vary based on their medical judgment. The clinical results presented herein are for informational purposes only and may not be predictive for all patients. Individual results may vary depending on patient-specific attributes and other factors.
Caution: Federal (USA) law restricts these devices to sale by or on the order of a physician. Prior to use, please refer to the Instructions for Use for complete product indications, contraindications, warnings, precautions, potential adverse events, and detailed instructions for use. For the complete Penumbra IFU Summary Statements, please visit www.peninc.info/ risk. Please contact your local Penumbra representative for more information.
References
1. Norgren L, Hiatt WR, Dormandy JA, et al. Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg. 2007;45(suppl S):S5-S67. doi: 10.1016/j.jvs.2006.12.037
2. Maldonado TS, Powell A, Wendorff H. et al. One-year limb salvage and quality of life following mechanical aspiration thrombectomy in patients with acute lower extremity ischemia. J Vasc Surg. 2024; 80 1159-1168 E5
VSB sits.” That would include “a permanent seat on the ABMS” and “a critical seat” on the AMA RUC, he noted. In addition, Dietzek called out the need for such an independent board to have its own Accreditation Council for Graduate Medical Education (ACGME) Residency Review Committee (RRC), as do the 44 current boards of the ABMS. This would enable sub-specialization, the creation of new programs, the recruitment of more medical students and trainees, and possibly increase the number of diplomates, he said.
As a currently serving director of the VSB, Rabih Chaer, MD, chief of vascular surgery at the University of Pittsburgh, laid out the role of the board as it currently operates. “The VSB essentially defines and oversees all the requirements and processes required for vascular surgery certification—all of it,” he said. “By being affiliated with the ABS, vascular surgery has a larger voice; we speak with the ABS voice in terms of ACGME and ABMS affairs. In addition, we clearly take advantage of their resources.” The VSB only requires ABS approval when the issue at hand involves “a large financial situation,” Chaer continued. The VSB plays no part in issues such as the Match, reimbursements, hospital credentialing and turf wars, he added. Of current representation on the ACGME
continued from page 1
Surgery RRC, Chaer said three vascular surgeons serve on the committee “and this hasn’t really hampered our ability to get things done.”
For some, at odds is the question of what the present VSB does, or can do. Kellie Brown, MD, a session moderator, chair of the VSB and a professor of surgery at the Medical College of Wisconsin in Milwaukee, argued during discussion that many of the perceived benefits of a free-standing board are conflated with the responsibilities of other vascular surgical bodies. Malachi Sheahan III, MD, the current VSB vice chair and chair of surgery at Louisiana State University in New Orleans, outlined the VSB’s function in the session introduction. “What does the Board actually do?” he posed. “It’s dull and boring, but we define and oversee certification.” He explained: “When you think about
continued from page 2
Relative value units (RVUs) will be taken seriously, and the 95th percentile will be the new standard. Fifteen minutes a visit computes to four patients an hour, placing a premium on speed rather than meeting patients’ needs. New patients require significantly more time to provide good care. Past records and computed tomography (CT) images have to be checked. While an orthopedic surgeon can do a cast check in 15 minutes, delivering proper care requires time, conversation and compassion—attributes not found in artificial intelligence (AI). Those essentials will not be possible in the enhanced corporate medical world. How many bypasses or aneurysms can a vascular surgeon perform in a day without jeopardizing care of the patient? Our specialty has already debated who should police unnecessary venous ablations. The pressure to maintain income (and profit margins) will lead to marginally indicated procedures. Administrative types and corporate leaders have little knowledge of—or regard for—how medicine is practiced. Their concern is for efficiency, RVUs and number of cases. As long as outcomes are acceptable and their bottom line is robust, they have accomplished their goal.
In an effort to increase efficiency (and profitability), mid-level providers have been substituted with negligible success. Nurse practitioners (NPs) and physician assistants (PAs) are utterly unqualified to diagnose and treat patients without supervision. They actually increase healthcare costs, as demonstrated in a 2022 study by Mississippi’s
Members of an SCVS focus session panel discuss the subject of VSB status with meeting attendees during the Society’s recent 2025 Annual Symposium
what we need as a specialty—more training programs—that’s probably going to come from the ACGME. Addressing burnout? That’s probably coming from the SVS. Increasing our workforce? That’s complicated—multiple institutions would need to be involved. Our public profile? That’s probably the SVS. Government advocacy, that’s the SVS and the ACS [American College of Surgeons]. None of these things is really what a board does, and it gets conflated a lot in what we would gain.”
It was left to Keith Calligaro, MD, SVS president-elect and chief of vascular surgery at Pennsylvania Hospital in Philadelphia, to explain the context behind the findings of the SVS Task Force on Free-Standing or Federated Board Certification, which were recently disseminated to SVS members along with the survey that seeks their input. An eight-month process yielded a report that summarizes
Hattiesburg Clinic. Replacing physicians with PAs and NPs resulted in higher costs of more than $28 million annually. Increased costs came from tests, specialist referrals and patients sent to emergency departments. Beyond that, are we fulfilling our responsibility to a patient when a PA or NP performs the initial consultation and then is signed off with a cursory physician review?
Currently, hospitals are able to sustain high physician salaries since a portion of their compensation is derived from hospital reimbursement. As healthcare dollars become scarce, the net result is that physician incomes are expected to decrease. And those doctors employed by private equity firms had better expect demands to work “harder,” see more patients, do more procedures, and maximize their billing. High-level executives in boardrooms care little about patient outcomes. As insurers, hospitals and pharmaceuticals try to protect their shares, these entities refuse to yield. Doctors and patients are caught in the middle.
The December assassination in New York pulled the scab off the purulent healthcare wound and exposed intense patient dissatisfaction.
The challenge to doctors looms large. Having lost leadership in healthcare, what remedies can physicians avail our patients and ourselves to correct this monstrously distorted delivery system? While the American Medical Association (AMA) has proposed a strong legislative initiative, it is unlikely to be successful
equivocal findings, among which it is stated that the ACGME “is not in a financial posi tion to grant a separate RRC to any group”; findings that favor the current VSB structure, including financial costs associated with cre ating an independent board structure; and findings that favor a free-standing board, such as the standalone votes such an entity would cast at the ABMS and the fact it would have its own seat at the AMA RUC.
The specter of cardiology’s recent Amer ican Board of Cardiovascular Medicine (AB CVM) application for independent board status to the ABMS, subsequently rejected, also consumed considerable task force delib eration, explained Calligaro. “This one factor we have now moved away from the list of things favoring a free-standing board [to be ing an equivocal factor] because, on the one hand it got turned down, but, on the other hand, if they re-apply in two years, and they get it, will all SVS members be saying, ‘What the heck are you guys doing? How can car diology have their own board, but vascular surgery does not?’”
The results garnered from the survey sent to SVS members will form part of the process by which the SVS Executive Board will come to a final decision on whether to recommend to the VSB that the status quo continue or a free-standing board should be sought, Calligaro added.
since the bipartisan AMA bill has no Senate sponsor. Some medical leaders opine that the AMA should become more “muscular.” What those muscular approaches include are yet to be defined.
Unionization has been discussed at the highest levels. Consideration is being given to class action lawsuits against health insurance companies, specifically targeting the prior authorization process, low compensation and downcoding, to name a few. Again, using the powerful legal arm of the AMA, initialing a class action lawsuit against pharmacy benefit managers is also on the table. Advocacy against hospitals that have engaged in oppressive practices is necessary. Their abhorrent facility fees create hardship for patients and obstacles to physicians trying to provide care.
To be successful, physicians have to be cognizant that our success depends solely on advocacy for our patients. Patients lack the organizational structure to challenge these trillion-dollar adversaries, and are utterly without resources when sick and confronted with enormous expense.
Which is why it was refreshing to see the article in the AARP Bulletin sympathetic to physicians. Perhaps the story was a journalistic nudge for physicians to cross healthcare’s Rubicon and strongly advocate for the needs of their patients and themselves.
ARTHUR E. PALAMARA, MD, is a vascular surgeon practicing in Hollywood, Florida, for 44 years. He is active in county, state and national medical organizations.
How likely are your surgical patients to have disruptive bleeding?
‘The leader must own everything in his or her world, own every mistake and credit the team for successes’
A pair of presidential addresses recently delivered at national annual meetings delved into leadership lessons for the vascular specialty, offering attendees forward-looking perspectives on the growth of its organizations and the individuals who practice it.
By Bryan Kay
“WE CAN ALMOST BE CONSIDERED A SPECIALTY OF colonizers, acquiring borrowed techniques. Why, then, do we see ourselves as the keepers of vascular care? Why do we think that we are the ones that can deliver the best vascular care? Without losing our identity, should we not look to partner with the other specialties providing vascular care?”
Those were some of the words uttered by outgoing Society for Clinical Vascular Surgery (SCVS) President Jean Bismuth, MD, as he delivered the 2025 SCVS presidential address under a theme of challenging the vascular surgical specialty to provide better and greater leadership.
Bismuth, the Tampa General Hospital and University of South Florida chief of vascular surgery, told those gathered that “the leader must own everything in his or her world, own every mistake and credit the team for successes” during the organization’s Annual Symposium in Austin, Texas (March 29–April 2).
Recalling national media coverage in recent years that placed inappropriate vascular interventions in the mainstream spotlight, he argued that vascular surgery “cannot blame every other specialty for our problems” and that “we need to own the solutions.”
“We need to own our own destiny and be accountable for what we do,” Bismuth continued. “There are bad players in every specialty. Let’s not think we are above reproach.”
His plea to reach beyond specialty lines was accompanied by a call for greater unity within the vascular surgery tent. “No different than our cardiology and radiology colleagues, the private
INTERVIEW FROM BRAZIL TO BAYLOR: ODERICH ASSUMES COVETED ROLE AT CARDIOVASCULAR ‘POWERHOUSE’continued from page 3
postoperative care and surveillance. We could talk about several examples. Randy Moore’s work with the ViTAA technology is certainly landmark, but it does involve access to very detailed imaging data from patients, which is something we have to work on— how we make data-sharing and image-
practice vascular surgeon carries a huge load of vascular work and is generally doing excellent work,” he said. “We need to stop alienating our partners in vascular care.
“It is imperative that we appreciate that leaders are responsible for nurturing the growth of their teams, along with fostering in dividual strengths, over being threatened by honors not attributed to themselves.”
The imperative is mathematical, Bismuth pointed out: while there are 350 million people in the U.S., there are just 3,000 practicing vas cular surgeons. “There is no way we can manage all of the vascular disease, so why are we so preoccupied with the noise of what other specialties are doing?”
Vascular surgery grew to become a specialty in its own right in the 1980s, with its forefathers cardiothoracic surgeons, Bismuth observed. “So, as we see how vascular surgery has evolved over the last 50-plus years, we could say that we have developed out of multiple specialties, including radiology with the innovations of Charles Dotter,” he said.
“To think that we alone can provide appropriate vascular care is probably somewhat misguided.”
To be a specialty that inspires, “provides safety and fosters fulfillment,” strong, capable leadership is required to make this vision a reality, Bismuth said, noting that the rising generation of vascular surgeons and future leaders, millennials, are more effective, transparent and open communicators than the generations who came before them. “If we truly embrace and prior itize effective communication, we could reshape both the perception and reality of personality dysfunction, leading to greater satisfaction, improved outcomes and a stronger ability to attract the best and brightest from then next generation.”
By Marlén Gomez
THE SOCIETY FOR VASCULAR Surgery (SVS) has launched a search for a new editor-in-chief (EIC) for its flagship publication, the Journal of Vascular Surgery (JVS).
The selected EIC will oversee the academic and editorial quality of JVS and collaborate closely with key editorial staff, including the senior managing editor, publisher, executive editor and fellow editors-in-chief. Candidates interested in the position must submit a cover letter, curriculum vitae, a vision statement for JVS and confirmation of institutional support. More information is available at vascular.org/EICRFA
As the specialty confronts “a frontal assault” on reim bursements and associated “administrative harms,” unity across practice settings is necessary, which emboldens the need for effective leaders, Bismuth said.
“We must become better ambassadors for our specialty,” he added.
AVF: From good to great Ruth Bush, MD, used her 2025 American Venous Forum (AVF) presidential address to highlight the organization’s elevation and path to “level 5 leadership.”
“We need to own our destiny and be accountable for what we do”
JEAN BISMUTH
sharing agreements between centers more streamlined. I’m working now with the International Multicenter Aortic Research Group [IMARG], which has 30 sites worldwide and is going to be the United Nations version of the U.S. ARC for the entire world, but it’s a mountain of work to make all the countries and regulatory agencies happy.
I’m also very enthusiastic about the work of Drs. David Murdock and Dianna Milewicz at UT with facial phenotypes. Basically, this would involve taking a photograph of the patient and knowing with extreme accuracy whether they have Loeys-Dietz or Marfan syndrome, or in fact any genetic disorder. That is going to be very important because these patients show up in the emergency department
Level 5 leadership is seen across the organiza tion’s activities, the University of Texas Medical Branch, Galveston, professor of surgery and asso ciate dean, told AVF 2025, held in Atlanta, Geor gia (Feb. 16–19). The concept, which describes the highest level of leadership, as detailed in the book
AVF, which is “ambitious and forward-thinking but with humility and a giving spirit,” she said.
JVS—a hybrid subscription and openaccess monthly title—receives nearly 2,000 submissions annually.
The new EIC is expected to begin his or her term in July 2025, with an initial fouryear appointment and the potential for a two-year renewal. Responsibilities will average 12–20 hours per week, including managing the editorial workflow and participating in regular meetings.
Additionally, the EIC will have support from the editorial leadership, including current EIC Thomas Forbes, MD, and the JVS family of peer-review titles Executive Editor Ronald Dalman, MD.
To fulfill the position, attendance at the Vascular Annual Meeting (VAM) and an EIC retreat at SVS headquarters each fall is required. The SVS Executive Board will decide the successful candidate.
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CLI trial results, ‘suggesting generalizability’
By Bryan Kay
A NEW PROPENSITY-MATCHED ANALYSIS OF MORE than 1,100 lower extremity revascularization procedures carried out in patients with chronic limb-threatening ischemia (CLTI)—which aimed to help solve the puzzle of why the BEST-CLI trial did not lead to a pick-up in the rate of surgical bypass in the year after its publication—validated the landmark study’s results, according to the senior author.
The Beth Israel Deaconess Medical Center (BIDMC) retrospective review showed that, like in BEST-CLI cohort 1, the primary outcome measure of major adverse limb events (MALE) and MALE/death was noted to be significantly decreased following a bypass with single-segment great saphenous vein (GSV) as compared to percutaneous transluminal angioplasty with or without stenting at five years (51% vs. 60% and 75% vs. 79%, respectively). “These findings correlated with a 29% and 20% reduction in the aforementioned events,” first author Jeremy Darling, MD, reported as he delivered the findings during the 2025 Society for Clinical Vascular Surgery (SCVS) Annual Symposium in Austin, Texas
(March 29–April 2). And, similar to BEST-CLI cohort 2, in which patients did not have a suitable GSV for conduit, significant differences in MALE and MALE/death were not noted.
The analysis grew out of a prior Vascular Quality Initiative (VQI) study conducted by Boston-based BIDMC researchers in which they discovered that there had been no increase in bypasses placed for CLTI 12 months on from BEST-CLI, despite the trial demonstrating that surgical bypass with adequate single-segment GSV is a more effective revascularization strategy in those who are deemed suitable for either an open or endovascular approach.
Darling and colleagues, led by Marc Schermerhorn, MD, BIDMC chief of vascular surgery and the analysis’ senior author, theorized that the lack of pick-up could have been influenced by specialists not believing that the BEST-CLI results were generalizable. “We were able to mimic cohorts 1 and 2 from the study, we matched all of the outcomes,”
“Knowledge of whether there is a good single-segment saphenous vein available should have a significant impact on the choice to attempt an endovascular revascularization, as opposed to going right to bypass”
MARC SCHERMERHORN
A NEW SUBANALYSIS OF THE
SAVVE (Surgical antireflux venous valve endoprosthesis) trial found that there was no difference in the level of improvement in clinical outcomes and quality-of-life measures between patients who have either primary or thrombotic deep venous reflux.
The data were presented during SCVS 2025 by Cassius Iyad Ochoa Chaar, MD, associate professor at Yale School of Medicine in New Haven, Connecticut, one of the trial’s site principal investigators and a consultant for the company behind the device.
SAVVE enrolled 75 patients with deep venous reflux in CEAP (Clinical, Etiological, Anatomical and Pathophysiological) categories C4b, C4c, C5 and C6 who were implanted with the novel bioprosthetic venous valve replacement, known as VenoValve (enVVeno Medical), across 21 U.S. sites.
The overall one-year SAVVE trial data were first revealed during the 2024 VEITHsymposium in New York City (Nov. 19–23), showing that 85% of the patients achieved a clinically meaningful benefit of a three-or-more-point improvement in revised Venous Clinical Severity Score (rVCSS); a 7.91-point average rVCSS
explained Schermerhorn in an interview with Vascular Specialist. “All of the proportions are fairly similar to BEST-CLI. We did have more dialysis patients than they had in BEST-CLI, but otherwise it was fairly similar.” The results, he said, validate the differences BESTCLI demonstrated, with just one exception. “The only thing that they saw in BEST-CLI that we did not see in cohort 1 was the difference in amputation rates, where we had an amputation rate that was just as low in the angioplasty patients as in the bypass patients.”
The correlation “suggests generalizability” of BEST-CLI, Schermerhorn said. He hopes the results of the analysis stimulate more specialists to consider a bypass-first strategy when they are confronted with a patient who has extensive CLTI and a viable single-segment GSV. “I do think people should re-think their treatment protocol,” he argued. “They should routinely evaluate the saphenous vein before they go to the angiosuite, and that knowledge of whether there is a good single-segment saphenous vein available should have a significant impact on the choice to attempt an endovascular revascularization, as opposed to going right to bypass.”
In a similar vein, the research group have also tackled the results from BASIL-2 in an analysis due to be presented at this year’s Vascular Annual Meeting (VAM). “We re-structured the cohort and to tied to mimic the BASIL-2 trial,” Schermerhorn added. “That is also one of the reasons why people may not be changing their practice patterns based on the BEST-CLI trial, because there were somewhat conflicting results from BASIL-2.” The latter trial, which included 345 patients, showed that a best endovascular treatment-first revascularization strategy was associated with better amputation-free survival than a vein bypass-first strategy in those who required an infrapopliteal repair.
improvement among the rVCSS responder cohort; a clinically meaningful benefit in all CEAP diagnostic classes of patients enrolled; and a 97% target vein patency rate. Additionally, patients also experienced a median reduction in pain of 75% at one year as measured by Visual Analog Scale (VAS).
Among patients with venous ulcers (C6), the median ulcer area was reduced by 87% at 12 months. Patient-reported outcomes demonstrated improvements in quality of life and disease symptoms (VEINESQOL/Sym).
The latest SAVVE subanalysis compared chronic venous insufficiency patients with primary reflux to those who presented with thrombotic reflux—with the latter defined as those who had a history of venous thromboembolism (VTE), with 80% of the participants bearing a thrombotic etiology.
The only “real difference between the two subgroups of patients was that the thrombotic patients were more likely to be on anticoagulation,” Chaar told SCVS 2025.
More than 50% of trial participants had ulcerations, with the average ulcer area 17cm2. The subanalysis showed that there was no difference between the two groups. At baseline, the mean reflux time among the entire cohort was three seconds, with an rVCSS score of 16, Chaar continued.
“There was no difference between the two groups. Looking at the outcomes of the patients enrolled at one year, there was a significant decrease in the mean rVCSS score in both groups, both the thrombotic and the primary, with an average 6.2- and 8.7-point drop, respectively.
“If you look at the clinically meaningful improvement in rVCSS score, you can see that 85% of the patients achieved that, with an average improvement of 7.5 [thrombotic] and 9.3 [primary] points, respectively,” he said.
“The pain improvement in VAS was significantly increased at one year, with an average of 2.5 points [for both groups], and patient-reported quality-of-life and symptomatic reports also significantly improved at one year in both groups,” Chaar said, adding that, in terms of ulcer area, “the primary reflux group seemed to have a little better reduction in their venous ulceration, with a decrease of 6.6cm2 [thrombotic] and 14.2cm2 [primary], respectively.”
Chaar concluded: “The VenoValve is an effective treatment for patients with deep venous reflux with no other options for treatment. Improvement starts at three months and is persistent at one year, and improvement in clinical patient-reported outcomes and quality of life seems comparable between patients who have thrombotic or primary reflux.”—Bryan Kay
By Bryan Kay
The 40-year history of endovascular aneurysm repair (EVAR) of the aorta wends a circuitous route, from behind the Iron Curtain in Soviet Ukraine, to Buenos Aires, Argentina, points east and west in the U.S., and far beyond. It’s a journey being illuminated during the 2025 Charing Cross (CX) International Symposium in London, England (April 23–25), to honor EVAR’s founding fathers four decades on from their trail-blazing work, with some of the key figures among the assembled faculty at CX.
Marking four decades of development, the session will chart the course of EVAR with a historical perspective provided by interventional radiologist Krassi Ivancev, MD, of Lund, Sweden, who himself figures in EVAR development after he produced a stent graft system that incorporated the iliac arteries in early 1993.
The origins of EVAR in the aorta recalls two seminal figures: the late leading vascular surgeon in the Soviet Union, Nicolai L. Volodos, MD, of Kharkiv, Ukraine, and Argentinian vascular surgeon Juan C. Parodi, MD, of Buenos Aires. The former was the first to treat a thoracic aortic aneurysm with a stent graft and the latter performed the first EVAR on an abdominal aortic aneurysm (AAA).
Founding father Parodi will be one of the faculty taking part in the panel discussion that follows Ivancev’s presentation. Interventional radiologist Michael Dake, MD, of Tucson, Arizona, who led the first aortic endograft placement for treatment of a thoracic aortic aneurysm in the U.S. in 1992, will also be present, and joined by former Society for Vascular Surgery (SVS) President Frank Veith, MD, of New York City, the surgeon behind the first stent graft placed for AAA in the U.S., also in 1992.
In a write-up of their European Society for Vascular Surgery (ESVS) 2019 Volodos Honorary Lecture in Hamburg, Germany, in the May 2020 issue of the European Journal for Vascular and Endovascular Surgery (EJVES), Ivancev and co-author Robert Vogelzang, MD, from Chicago, commented on how multiple centers and individuals spread out across the world had made independent contributions to the development of EVAR, pointing out that “the contributors to this concept came from different areas of subspecialties, such as interventional radiologists and cardiovascular surgeons, thus underlining the critical step of repurposing knowledge from one area, interventional radiology, to another area, vascular surgery.”
Veith remembers the revolutionary period after the first U.S. AAA case he performed alongside Parodi, fellow vascular surgeon Michael Marin, MD, also of New York City, and interventional radiologist Claudio Schonholz, MD, of Charleston, South Carolina, on Nov. 22, 1992. “Remarkably his aneurysm was excluded, and his severe pain was totally relieved,” he recalls of the patient.
Veith says he realized vascular surgeons had to carry out these procedures in patients who could not undergo open surgery. “Our treatment was surprisingly successful in these patients, and by 1994 we had used our surgeon-made endografts to treat more than 150 patients,” he says.
At the helm of the Eastern Vascular Society (EVS) in 1994, then the Society for Vascular Surgery (SVS) in 1996, he used his presidential addresses to compel his colleagues to become “endocompetent or they would become extinct as vascular doctors.”
The other assembled faculty will be vas-
cular surgeon Rodney White, MD, of Torrance, California, who contributed to the early development of hand-made endoluminal stent grafts and worked to help spur adoption, and Christopher Zarins, MD, another former SVS president, of Stanford, California, who also made contributions to EVAR technology development and understanding of vascular mechanics. Themes the panel were set to discuss include some of the challenges faced during EVAR’s early stages, game-changing moments, key contributions, and where they feel the field may be headed next.
Zarins recalls arriving at Stanford shortly after Dake had completed the first U.S. aortic endograft in 1992, describing a time of great innovation. “I worked with Tom Fogarty who was developing a stent graft—later to become the AneuRx device—and we were all together in the Stanford Vascular Center where collaboration and innovation was the name of the game,” he says.
“Collaboration and innovation was the name of the game”
CHRISTOPHER ZARINS
By Marlén Gomez
IN 2018, A GROUP OF DEDICATED VASCULAR surgery trainees recognized a notable gap in educational resources within their specialty. This realization sparked the creation of the Audible Bleeding podcast, a platform designed to enhance vascular surgery education through engaging discussions and insights. Fast forward to 2024, and the podcast has achieved notable success, with an average listenership of 100,000 per year, the acquisition of a dedicated industry sponsor and a steady flow of new episodes.
The podcast’s inception can be traced back to the original team of editors from the New York-Presbyterian vascular surgery program, including Kevin Kniery, MD, Matt Smith, MD, Adam Johnson, MD, Nicole Rich, MD and Sharif Ellozy, MD, the latter of whom served as fellowship director at the time and provided mentorship throughout the project.
Initially, the episodes featured interviews with various vascular surgeons, focusing on unique stories that listeners might find engaging and insightful. Ellozy emphasized the podcast’s role as a vital resource, particularly for trainees in the field, offering a behind-the-scenes look at groundbreaking papers and the experts behind them.
In 2020, the Society for Vascular Surgery (SVS) partnered with Audible Bleeding, enhancing the podcast’s management and expanding its reach. As part of this partnership, Imani McElroy, MD, was appointed senior editor overseeing episode distribution.
“What I’m excited about is that the podcast has partnered not just financially with the SVS, but fundamentally to highlight the great work happening across the vascular community,” said Johnson of the initial partnership.
“The four of us were excited about the project and started together because we were local to each other, and then Dr. Sharif Ellozy helped us launch our initial episodes through his extensive network,” said Johnson.
Though Johnson has stepped back from active participation in the podcast, he remains an avid listener, eager to explore new episodes.
“The episodes amplify and build on the great work already happening in our vascular society, providing it in a different format and showcasing the incredible efforts within our community,” he commented.
“As Audible Bleeding continues to evolve, it stands as a shining example of how a simple idea can transform into a vital educational tool, enriching the vascular surgery community and inspiring future generations of surgeons,” said McElroy. “Our team is dedicated to releasing content relevant to our listeners who want to be at the forefront of vascular surgery education.”
To learn more, visit audiblebleeding.com.
THE SVS INTERNATIONAL RELATIONS Committee (IRC) has announced the recipients of the 2025 International Scholars Program, recognizing the achievements of three distinguished professionals: Sohei Matsuura, MD, from Japan; Rahel Abebayehu Assefa, MD, from Ethiopia; and Prajna Kota, MD, from India.
They will spend approximately two weeks in the U.S., visiting various universities and clinics, as well as attending the 2025 Vascular Annual Meeting (VAM), being held June 4–7 in New Orleans.
Throughout their time in the U.S., the recipients will work closely with their mentors, gaining critical insights and knowledge from institutions and hospitals in the U.S. and Canada. Wei Zhou, MD, the International Relations Committee chair, hopes this immersive experience enhances their professional development and strengthens global connections in vascular surgery.
Upon completing their tours, each scholar must submit a comprehensive report detailing their experiences and will participate in the International Forum during VAM, where they will formally receive their awards.
Assefa’s application to the program stood out for the IRC, which resulted in her selection as a recipient of the award, being the first female vascular surgeon in Ethiopia.
“I was initially in shock because I expected to possibly reapply next year, because this was my first attempt at applying for this program. I was in disbelief and extremely honored,” said Assefa.—Marlén Gomez
By Marlén Gomez
THE UPCOMING VASCULAR ANNUAL Meeting (VAM), taking place June 4–7 in New Orleans, will see Jason T. Lee, MD, and Claudie Sheahan, MD, at the forefront of educational programming. Both have stepped into pivotal roles, with Lee serving as VAM program chair and Sheahan taking on the position of Postgraduate Education Committee (PGEC) chair following the conclusion of last year’s conference.
Lee, chief of vascular surgery at Stanford, has been attending VAM since his time as a medical student and continues to show enthusiasm for the latest scientific discoveries within the specialty.
“I’ve had the fortunate opportunity to be on the Program Committee in various positions for over a decade and have watched this meeting continue to get better at providing education, larger in scope and more inclusive for all members,” said Lee. “I’m honored to have the chance to work on the program directly this year with many amazing volunteers and the support staff from the SVS.”
In 2025, Lee will celebrate his 25th anniversary of attending VAM. Over the years, he has felt a strong desire to be present at the meeting, not only to witness the advancements in cutting-edge science and technology that can impact practices and research, but also to emphasize the importance of highlighting and networking with
the younger, up-and-coming professionals in the field.
According to Lee, themes to expect at VAM 2025 are essential for the “modern and contemporary vascular surgeon.” Topics submitted by SVS members will shape the programming, including new innovations and outcomes related to aortic disease, peripheral arterial disease (PAD), carotid disease, hemodialysis access, venous disease, wound care and the application of artificial intelligence (AI) and machine learning, the latter of which will be featured in a set of papers on Saturday morning.
“The VAM program is only as good as what the membership submits. This year, we received 849 submissions for the 62 available spots in the program. We take our responsibility seriously to ensure that the program is current, and the process is fair and transparent, and reflects the important clinical and research work our members are engaged in,” said Lee.
The abstract selection for VAM is a blinded, peer-reviewed process that allows for the submission of a wide range of scientific topics covering the entirety of the vascular specialty.
Beyond the scientific abstracts present-
ed, this year’s VAM program will include innovative networking and social events, including “SVS Connect@VAM: Welcome to New Orleans!” The event is scheduled for the Wednesday night of VAM.
“I want VAM to be the can’t-miss event of the year for all individuals connected to vascular surgery, and I hope our membership will all make plans to attend and encourage other partners and mentees to attend. Our committee’s vision for VAM 2025 builds on the years of creative changes to the annual meeting and to have something meaningful for every attendee,” said Lee.
Sheahan, from New Orleans’ own Louisiana State University School of Medicine, has been a part of the PGEC for the last three years and has a similar sentiment to Lee on her vision for enhancing the science at VAM while serving as PGEC chair.
In addition to this year’s core topics, educational issues are being featured on such platforms as a Dialysis Summit, and in sessions on deep venous ob-
“Making a complex topic appear simple and concise is very difficult to do, and you have here some of the leading experts in our country on vascular trauma who will be able to do that”
CLAUDIE SHEAHAN
By Marlén Gomez
JIM CRAIG, A LONGTIME SUPPORTER AND vascular advocate, will deliver the annual keynote address at VAM 2025. Craig is known as the goaltender for the 1980 U.S. Olympic hockey team and has been praised for his pivotal role in the “Miracle on Ice” victory.
“I’m delighted and honored to have an icon like Jimmy Craig as our speaker,” said Jason T. Lee, MD, chief of vascular surgery at Stanford University and chair of the SVS Program Committee. “We can learn much from him about adversity, leadership, vulnerability and creating a positive culture. In today’s operating rooms, our vascular teams can draw valuable lessons from successful leaders in other industries.”
This year’s keynote is titled “Inside the winning
operating room: Building trust, leading under pressure, and achieving excellence as a team.” The presentation will utilize a TED Talk interview format, which Lee hopes will help provide valuable insights and inspiration to attendees.
After years in the vascular space for personal reasons and collaboration with numerous vascular surgeons, Craig considers being selected as this year’s keynote “the highest honor” and an opportunity to be part of a larger team. To Craig, success in the operating room relies on the entire team’s efforts, rather than on any single person’s rank.
struction, “My Worst Cases” and aortic dissection. New this year is an educational summit on trauma similar in style to a Ted Talk presentation. Sheahan anticipates that this session, “Critical and Current Issues in the Management of Vascular Trauma,” as a standout session for attendees.
“It’s very effective when you have a speaker so passionate about a topic. Making a complex topic appear simple and concise is very difficult to do, and you have here some of the leading experts in our country on vascular trauma who will be able to do that,” she said.
Sheahan pinpoints a parenthood session, “Carrying the Weight: Parenthood in Vascular Surgery,” as one of the top-rated submissions gaining early traction. Topics will cover all aspects of parenthood from the perspective of the vascular surgeon and trainees, including insight from same-sex couples and from those working in different type of clinical practice.
“This interview style session is, no doubt, going to provide a lot of great discussions that will make the audience get very involved and, hopefully, learn a lot,” said Sheahan. “I feel it will be tough to keep the session on time because the discussion will be robust.”
As the PGEC chair, Sheahan aims to ensure that everyone attending VAM can find a topic that resonates with them, regardless of their experience level. Her objective is to ensure that the time, money and effort invested by attendees are meaningful.
“During my tenure as PGEC chair, my goal is to make sure that we give our membership expert content at our annual meeting,” said Sheahan. “Expert content delivered by diverse experts is the overriding principle, and the material should be the most up-to-date information available.”
For more information on VAM’s programming, visit vascular.org/ OnlinePlanner
“It’s not just the vascular surgeon; it’s a whole team of people who must be prepared, organized and able to work together. They must also hold each other accountable and have the courage to speak up,” said Craig.
Craig’s commitment to the vascular community is rooted in family. Eight years after the 1980 Olympics, his father, Don, passed away from an undetected ruptured abdominal aortic aneurysm (AAA). After experiencing this tragedy, Craig dedicated his life to advocating for awareness and screenings for AAA. By educating himself about the disease, Craig encouraged his brother to get screened, leading to successful early detection of the condition in his sibling. Ultimately, Craig’s efforts played a crucial role in saving his brother’s life.
Since 2007, he has been a leading spokesman for the Saving Abdominal Aortic Aneurysm Very Effectively campaign, or the Ultimate SAAAVE. Craig stresses the importance of conferences like VAM in creating proper programming to educate medical professionals and keep them informed, ultimately saving lives.
VINCENT ROWE, MD, FROM THE University of California, Los Angeles (UCLA), became the 2025–26 Society for Clinical Vascular Surgery (SCVS) president during the Society’s 52nd Annual Symposium in Austin, Texas (March 29–April 2).
Falling in line behind him are Peter Faries, MD, from Icahn School of Medicine at Mount Sinai in New York City, as president-elect; Alik Farber, MD, from Boston Medical Center in Boston, as vice president; Audra Duncan, MD, from Western University in London, Ontario, Canada, as secretary; and Leila Mureebe, MD, from the Duke University Health System in Durham, North Carolina, as a member-at-large.
Jean Bismuth, MD, from the University of South Florida in Tampa, completed his presidency at the close of the SCVS meeting in Austin.
THE SVS YOUNG SURGEON SECTION (YSS) has selected Nathan Liang, MD, of the University of Pittsburgh, to receive its 2025 visiting professorship. Liang will present his research on the application of artificial intelligence (AI) in managing patients with complex aortic disease at the University of Chicago, with the exact date of his presentation to be confirmed.
Each year, the YSS Award Selection Committee honors a recipient within the first 10 years of their practice with a $1,000 travel stipend and a $1,500 honorarium to support their activities as a visiting professor.
For more information on how to join the YSS, visit vascular.org/YSS
REGISTRATION FOR THE COMPLEX Wound Care Masterclass—part of a new multispecialty Wound Care Curriculum— following the 2025 Vascular Annual Meeting (VAM) in New Orleans on June 7 is now open.
Developed in collaboration with the Society for Vascular Surgery (SVS), the Society for Vascular Nursing (SVN) and the American Podiatric Medical Association (APMA), it aims to enhance the skills of vascular care teams through an interprofessional Wound Care Curriculum.
Registration for the wound care workshop is separate from VAM 2025 registration. To register, visit vascular.org/WoundCare
THE SOCIETY FOR VASCULAR SURGERY (SVS) WILL HOLD A virtual Highway to Health informational session exclusively for members on Wednesday, April 30, at 8 p.m. Central Standard Time. This session aims to provide members with a comprehensive overview of the Highway to Health campaign.
Last October, the Highway to Health initiative was launched in conjunction with the SVS’s patient-focused website, YourVascularHealth.org. It seeks to educate the public on the symptoms and risk factors associated with vascular disease. During the session, SVS members will learn how to effectively leverage the Highway to Health member toolkit to promote the campaign.
To register, visit vascular.org/H2Hsession.
GORE RECENTLY ANNOUNCED the expansion of the Gore Tag conformable thoracic stent graft with Active Control system product line, following Food and Drug Administration (FDA) approval of four new large-diameter tapered designs: 34x28mm, 37x31mm, 40x34mm and 45x37mm.
News of the approval comes in conjunction with the first U.S. commercial implant, completed at Keck School of Medicine of USC in Los Angeles by Sukgu Han, MD, chief of the Division of Vascular Surgery and Endovascular Therapy. For Han, the new large-diameter tapers “provide a welcome addition to the available treatment options for patients and expands applicability for the existing Gore technology,” he shared in a Gore press release.
Real-world data show Zilver PTX leads to lower rates of in-stent occlusion than Eluvia COOK MEDICAL REVEALED THAT ITS ZILVER PTX drug-eluting stent (DES) has lower rates of in-stent occlusions among patients with restenosis at three years than the Eluvia DES (Boston Scientific), according to real-world data from the REALDES study. The company notes that the data, published by Tsuyoshi Shibata, MD, from Sapporo Medical University Hospital in Sapporo, Japan, et al in the European Journal of Vascular and Endovascular Surgery (EJVES), are the first to compare Zilver PTX and Eluvia in real-world practice at three years.
REALDES is an investigator-initiated multicenter, prospective, observational study designed to compare the Zilver PTX DES and Eluvia DES in a real-world setting for treating symptomatic femoropopliteal lesions. Overall, 200 limbs with native femoropopliteal artery disease were treated with Zilver PTX (96 limbs) or Eluvia (104 limbs) at eight Japanese hospitals between February 2019 and September 2020. The primary outcome measure was primary patency at three years, defined as freedom from restenosis or occlusion without reintervention.
Key three-year study outcomes include no significant difference in primary patency (Zilver PTX, 70% vs. Eluvia, 65.2%; p=0.74) or freedom from clinically driven target lesion revascularization (CD-TLR; 79.4% vs. 76.3%; p=0.27), despite the Zilver PTX arm having longer lesions (185.7±92mm vs. 160±99mm; p<0.005).
In patients with restenosis at three years, there was a significantly higher rate of in-stent occlusions (Tosaka class III) for those treated with Eluvia (57.7%) compared to Zilver PTX (29.2%; p=0.041).
REGISTRATION IS OPEN FOR the sixth cohort of the Leadership Development Program (LDP), tailored specifically for vascular surgeons. This comprehensive program offers tools and strategies to tackle challenges within professional practices and hospital settings. Participants can look forward to two in-person sessions, including a kickoff at the upcoming VAM.
Register at vascular.org/LDP.
THE SVS INVITES USERS TO participate in a brief survey regarding their experiences with the sixth edition of the Vascular Education and SelfAssessment Program (VESAP6)— which bears 600 questions—on mobile devices. The insights gathered will aid the SVS in understanding customer access to the program as plans are made for the next edition.
To learn more, visit vascular.org/ VESAP6survey
Pounce XL goes to market SURMODICS ANNOUNCED the commercial release of the Pounce XL thrombectomy system for endovascular removal of acute or chronic clot from peripheral arteries. Intended for removal of thrombi and emboli from peripheral arteries ranging from 5.5–10mm in diameter, sizes typical of iliac and femoral arteries, the system accompanies the Pounce and Pounce lowprofile thrombectomy platforms.
Cagent Vascular initiates patient enrollment in Serranator vs. plain balloon angioplasty OCT study
CAGENT VASCULAR INITIATED ITS first patient enrollment in the Serranator versus plain balloon angioplasty optical coherence tomography (OCT) study.
This prospective, randomized (2:1 treatment to control) study will enroll up to 60 patients. It will utilize intravascular OCT imaging to demonstrate the mechanism of action (MOA) of the Serranator and compare the serration MOA to conventional angioplasty across a wide range of lesion morphologies in belowthe-knee arteries. The study is taking place at Columbia University Medical Center and Weill Cornell Medicine, led by coprincipal investigators Sahil Parikh, MD, an interventional cardiologist, and vascular surgeon Brian DeRubertis, MD.
Imperative Care expands Symphony thrombectomy portfolio IMPERATIVE CARE announced Food and Drug Administration (FDA) 510(k) clearance of the 82cm version of its Symphony 16F catheter for patients with venous thrombosis. The company also announced the completion of initial patient cases using the catheter. This latest innovation expands the Symphony thrombectomy system offering to include 16F 82cm, 16F 117cm and 24F 85cm catheters.
The Symphony catheter
