NO POWER, NO PROBLEM! VAM 2025 PIVOTS AS EARLY-MORNING POWER OUTAGE DELAYS MEETING OPENING
By Bryan Kay
THE VASCULAR SURGERY world is used to pivoting on a dime. So it was as VAM 2025 was about to commence yesterday morning, and power outage problems led to a delayed start to this year’s SVS annual meeting.
“We talk in vascular surgery about having to have multiple plans as we go into the operating room,” quipped SVS President Matthew Eagleton, MD, as attendees corralled into an alternative meeting room due to the technical difficulties besetting the main plenary hall.
“Welcome to plan C,” he added to a chorus of audience laughter.
“This is just a test to see if you can get your steps in for the [SVS] Step Challenge. So, in about 30 seconds, we are going to walk back to the other room. Welcome to VAM 2025, our new motto: No power, no problem!”
On a more serious note, Eagleton reminded members that voting in this year’s leadership elections for SVS vice president and secretary ends at midday on Thursday. “If you have not voted, stop by one of the QR places and register your vote,” he said.
Across VAM’s four days of programming, a total of 62 plenary papers and 21 postgraduate education sessions populate the program. “The vision of the VAM program is to provide all of you with the best science impacting vascular surgical care for all of the membership,” said SVS Program Committee chair Jason Lee, MD.
“We are committed to making sure this program is fair and that the process remains transparent to allow everybody’s voice to be heard.”
15 Women’s Section Navigating issues in aortic dissection In
12 Gallery Day one at VAM 2025 in pictures
6 CMS Medicare reimbursement and vascular care
www.vascularspecialistonline.com
One-year TAMBE data highlight low mortality, importance of renal branch assessment
By Jocelyn Hudson
The four-branch Gore Excluder thoracoabdominal branch endoprosthesis (TAMBE) device demonstrated low mortality at one year with renal artery occlusion being the predominant device-related event associated with small renal arteries and pararenal aneurysms. So concluded Mark A. Farber, MD, presenting the latest TAMBE data during yesterday’s William J. von Liebig Forum.
Drawing a take-home message from the new findings—which were simultaneously published online in the Journal of Vascular Surgery (JVS)— Farber advised: “During follow-up, attention should be focused on renal branch assessment to identify patients at risk for occlusion.”
The chief of the Division of Vascular Surgery and professor of surgery at the University of North Carolina at Chapel Hill was presenting one-year results from the pivotal trial of the Gore TAMBE to treat extent IV thoracoabdominal aortic aneurysms (TAAAs) and pararenal aortic
aneurysms (PRAAs). Farber detailed that this prospective, non-randomized, multicenter study included 102 patients, 59 of whom had an extent IV TAAA and 43, a PRAA, adding that the mean maximum aneurysm diameter was 59.4mm.
The presenter shared that, at one year, eight patients were lost to follow-up and six patients died, specifying that one death was device-related, one was procedure-related, and four were due to unrelated causes. He stated that, in total, 88 patients completed a follow-up visit at one year.
Moving on to key results, Farber revealed that freedom from all-cause mortality at one year was 94.1% and that target vessel occlusions occurred in 14.7% of patients. This figure included one celiac artery, one superior mesenteric artery (SMA), eight right renal and six left renal artery occlusions.
Farber continued that reintervention was
See page 2
The second day of VAM 2025 starts in earnest at 6:30 a.m. with a series of sessions through 8 a.m., including a General Surgery Resident Session, the International Chapter Education Session, two Medical Student Sessions and a breakfast for the SVS sections. Special session Innovation and Entrepreneurship in Vascular Surgery—Everything You Need to Know, from Innovative Idea to Intellectual Property kicks off at 7 a.m., as does JVS Confidential Revise vs. Reject The Society for Vascular Nursing (SVN) Annual Conference continues into its second day, taking place from 7–11:30 a.m. At the same time, the day’s new science starts with Plenary Session 3, running until 9:30 a.m. with a series of papers that include opener, “Endovascular aortic arch repair with the Nexus endografts: Results from the Italian Nexus Aortic Arch Endovascular Repair Registry (INARCHER).”
Crossroads@VAM activities begin at 8 a.m. and all run with some of the vascular surgery world’s largest device companies, while the muchanticipated Roy Greenberg Distinguished Lecture on Innovation, to be delivered by Sherene Shalhub, MD, kicks off at 9:30 a.m.
The annual Awards Ceremony follows at 10 a.m. and the Career Fair starts at 10:15 a.m. The Exhibit Hall makes its grand opening today, swinging open to attendees also at 10:15 a.m. Plenary Session 4 is up at 10:45 a.m. Into the afternoon the “How I Do It” Video Session begins at 1:30 p.m., which is also when the Managing Vascular Graft Infections Without Loss of Limb or Life! session kicks off. The Women’s Section: Challenges in Current Aortic Dissection Management session also takes place at 1:30 p.m., while the Young Surgeons Section has its own slot at 3:30 p.m. Turn to page p. 8 for the full day’s schedule.
VON LEIBIG
OPENING CEREMONY
Mark Farber delivers VAM 2025’s opening plenary paper
Transcatheter arterialization of the deep veins: Comparative analysis probes whether emerging modality is worth pursuing
By Bryan Kay
“WE’RE LIVING IN A NEW WORLD ORDER” WHEN it comes to “no-option” chronic limb-threatening ischemia (CLTI) patients, says Anahita Dua, MD. In recent years, into this arena has stepped transcatheter arterialization of the deep veins (TADV), raising hopes of reducing amputation rates amid a rise in diabetes and other disease affecting microvascular dissemination. Yesterday morning, the vascular surgeon at Massachusetts General Hospital in Boston put forward data from a new study comparing no-option CLTI patients enrolled in the PROMISE studies treated with TADV to a CLariTI study cohort who were treated using standard of care (SoC). So, “is TADV worth it?” she pondered. The oneyear comparative data she presented—during the William J. von Liebig Forum—seemed to provide an answer in the
FROM THE COVER ONE-YEAR TAMBE DATA HIGHLIGHT LOW MORTALITY, IMPORTANCE OF RENAL BRANCH ASSESSMENT
continued from page 1
attempted in six of the renal arteries and involved additional target vessel stenting in three patients, thrombolysis and embolectomy in two, and angioplasty in one. “Although branch vessel occlusion events were more common in pararenal aneurysms compared to extent IV TAAAs, this was not significant,” he said.
Looking at renal patency, Farber reported that renal artery patency was influenced by renal artery diameter, with renal arteries of less than 5mm in diameter being three times more likely to occlude. He also noted that acute kidney injury requiring dialysis occurred in 1.96% of patients and that renal deterioration— defined as a greater than 25% decrease in glomerular filtration rate (GFR) over two consecutive visits—was 18.9% through one year. Additionally, Farber revealed that renal artery primary patency at one year was 91.8% and “nearly identical between the right and left renal arteries.” Primary patency with respect to renal
affirmative.
Positive PROMISE I and II data have seen TADV, also known as deep vein arterialization (DVA), gain traction, Dua told VAM 2025, but the “real question remains,” she said. “If you’re going to do a [TADV] procedure on a patient, then go forward with all the wound care, all the phone calls, and all the pain for the next six months to try to salvage the limb, does it really lead to better wound healing, better limb salvage rates and better amputation-free survival?”
With no randomized clinical trial data to call upon in the space to measure a difference between TADV and standard of care, Dua and colleagues compared the combined patient groups from PROMISE I and II to the real-world CLariTI group to “see whether or not limb salvage rates genuinely decrease” when the former modality is deployed.
The data showed limb salvage rates of 82.2% vs. 51.3% in the TADV/ PROMISE I/II group and CLariTI, respectively; and amputation-free survival (AFS) rates of 71% for TADV vs. 34.1% for standard of care.
“We did CLariTI after PROMISE, so we were able to design the study to match the PROMISE studies so that we could ensure we had matching across groups,” she explained. “As you can see, most importantly this is, again, a real-world study, with a significant number who were Black or African American, had Rutherford 5/6, and a significant history of CKD [chronic kidney disease].”
arteries greater than 5mm in diameter, he continued, was 95.1%, while for those less than 5mm it was 82.5%.
Farber shared that 94.2% of target vessels were free from target vessel instability events through one year. At the individual vessel level, he noted that Kaplan-Meier estimates for freedom from target vessel instability were 99%, 97.1%, 90.8% and 89.8% for the celiac, SMA, right renal and left renal arteries, respectively.
Furthermore, Farber outlined device effectiveness data at one year, which included no major endoleaks, aortic enlargement in 5.4% of patients, and loss of device integrity in 16.3%, which he specified included wire fractures in 3.6% and compression in 12.2%. Farber reiterated that renal deterioration was seen in 18.9%, and that reintervention occurred in 15.6%.
“With respect to the reinterventions,” Farber outlined, “approximately onequarter were major and included thrombectomy or thrombolysis in five, [and] one exploratory laparotomy for aortic bifurcation rupture to control bleeding.”
Minor reinterventions, the presenter continued, included treatment of target vessel stenosis in eight patients, target vessel occlusion in two and branch-related endoleak treatment in three.
Revealing overall device performance data, Farber shared that combined device effectiveness was achieved in 60.5% and 78.7% of the pararenal and type 4 TAAAs,
“Does it really lead to better wound healing, better limb salvage rates and better amputation-free survival.”
ANAHITA DUA
respectively. “This difference was mainly driven by a higher incidence of target lesion growth and branch vessel occlusion in pararenal aortic aneurysms,” the presenter commented.
In the discussion following Farber’s presentation, Wes Moore, MD, of David Geffen School of Medicine at UCLA in Los Angeles, asked how the new data might weigh up to those for physician-modified endovascular grafts (PMEGs).
“It’s hard to compare those results because we’re talking about a four-branch off-the-shelf device, and the majority of the PMEGs are probably fenestrations or
“During follow-up, attention should be focused on renal branch assessment to identify patients at risk for occlusion”
MARK FARBER
laser fenestrations depending upon where you are, and so it’s hard to compare those,” Farber responded. “The important part about the manuscript is that we know that there are renal events that occur and that the goal of this manuscript is to talk about how you can help select your patients better. We have some renal events and 95%
“For wound healing, 78% of patients at one year were either fully healed or healing in the DVA group versus the standard of care,” said Dua. “Going out, because durability matters, in the patient cohort for CLariTI—we are still collecting our data, because that was after the PROMISE study—but for the PROMISE data, we are at two years now and the limb salvage rate is still at 68%, which is excellent compared, already, to the 51% at one year for the standard of care.”
Overall, Dua concluded, “I think the data is relatively clear. Even though we don’t have an RCT, we have an excellent matched set from CLariTI compared to patients that have DVA and it is clear that DVA does have clinical benefit in patients selected appropriately. These benefits are consistent, especially if you use the LimFlow system [Inari Medical], which is kind of like the TCAR [transcarotid artery revascularization] of the leg in that you are able to do the same thing every time. The off-the-shelf DVA that exist—and the data around that—is very variable so that is not included in any of this.”
patency if you’re greater than 5mm at a year. If you have a patient who has small renal arteries, you need to think about how this might impact them since renal function is linked to survival.”
A subsequent question from Dawn Coleman, MD, of Duke University in Durham, North Carolina, homed in on the reliability of the device in question. “I was struck by the data around the loss of integrity of 16% at one year,” she remarked. “That’s a striking number.” Coleman went on to ask Farber how he would interpret this figure, and whether he has any insights on which patients were at most risk.
Farber first addressed the 3.6% rate of wire fractures. “Where they have the constraining sleeve, Gore identified a manufacturing issue which was corrected during the study, so that number should go down and we’ll have to look at that in the future because this issue involves both primary and secondary arm patients,” Farber commented.
Moving on to address the 12.2% rate of device compression, he detailed that the trial saw 11 compressions in total, including nine in the branch vessels. “Of those, about half of them had an occlusion and were reintervened upon such that at one year, seven of the nine compressions were patent.”
Farber advised conducting a “3D spin” at the end of a procedure to look for compressions and “fix those problems as they occur.”
*Designed to remove acute to chronic arterial clots According to benchtop testing compared to control Internal data on file Narula et al JACC 2018;72:2153-63 Indications for Use: The Artix Thin-Walled Sheath is indicated for: (1) The non-surgical removal of emboli and thrombi from blood vessels (2) Injection, infusion, and/or aspiration of contrast media and other fluids into or from a blood vessel (3) Use as a conduit for endovascular devices (4) Use in facilitating the insertion and guidance of an intravascular catheter into a selected blood vessel The funnel provides temporary vascular occlusion during these and other angiographic procedures The Artix Thin-Walled Sheath is intended for use in the peripheral vasculature The Artix MT thrombectomy device is indicated for (1) the non-surgical removal of emboli and thrombi from a blood vessel; and (2) injection, infusion, and/or aspiration of contrast media and other fluids into or from a blood vessel The Artix MT thrombectomy device is intended for use in the peripheral vasculature The FlowSaver Blood Return System is used with Inari Medical catheters and sheaths for autologous blood transfusion Review complete Instructions for Use, Indications for Use, Warnings, Precautions, Possible Adverse Effects and Contraindications prior to use of the product For all non-Inari products, please refer to manufacturer Instructions for Use/Intended Purpose for complete indications for use, contraindications, warnings and precautions Caution: Federal (USA) law restricts this device to sale by or on the order of a physician All trademarks are property of their respective owners PRO-2045-USA-EN-v1
VESS Lower extremity access appears preferable in real-world study of patients undergoing BEVAR
By Will Date
Upper extremity access for branched endovascular aneurysm repair (BEVAR) is associated with increased postoperative mortality and myocardial infarction (MI) when compared to a transfemoral approach, research conducted by the Multicenter Aortic Research Group and presented during yesterday’s SVS-VESS Scientific Session have shown.
HOWEVER, THE RESEARCH GROUP, COMPRISING academics at centers in Bologna, Italy and Houston, Texas, found that there was no significant association with the access route used and the occurrence of cerebrovascular events, contrary to expectations.
Andrea Vacirca, MD, of the University of Bologna in Bo logna, Italy, presented the findings of the analysis of data from more than 1,400 patients undergoing BEVAR at 29 international centers between 2006–2024.
PREVIEW CAROTID STENOSIS
Drilling into controversies in field of asymptomatic severe carotid
stenosis management CMS
SOME OF THE ENDURING controversies in the management of asymptomatic severe carotid stenosis will underpin an educational session set to take place today
The session tackles debate around the deployment of carotid revascularization strategies in both standard- and high-risk patient populations. It takes place on the Morial Convention Center’s Second Floor (Room 208–210) from 3:30–5 p.m. and will be hosted by carotid disease luminaries Ali AbuRahma, MD, former SVS president and chief of vascular surgery at West Virginia University/Charleston Area Medical Center, alongside Raghu Motaganahalli, MD, chief of vascular surgery at Indiana University School of Medicine in Indianapolis. AbuRahma will open the session with an introduction to controversies in the field.
Bruce Perler, MD, another former SVS president and vascular chief emeritus at Johns Hopkins University School of Medicine in Baltimore, Maryland, will argue that carotid endarterectomy (CEA) should be the first-line therapy in standard-risk patients, before Marc Schermerhorn, MD,
chief of vascular surgery at Beth Israel Deaconess Medical Center in Boston, makes the case for transcarotid artery revascularization (TCAR). Peter Schneider, MD, professor of surgery at the University of California, San Francisco will argue for transfemoral carotid artery stenting (TFCAS).
Brajesh Lal, MD, professor of vascular surgery at the University of Maryland in Baltimore, will update attendees on the status of the much-anticipated CREST-2 trial. Similarly, three vascular surgeons will make the respective cases for the same three carotid revascularization strategies as the first-line therapy in high-risk asymptomatic patients: Wei Zhou, MD, chief of vascular surgery at the University of Arizona in Tucson, for CEA; Caitlin Hicks, MD, associate professor of surgery at the Johns Hopkins, for TCAR; and Sean Lyden, MD, chairman of vascular surgery at the Cleveland Clinic in Cleveland, Ohio, for TFCAS. The session will finish with a specific look at female patients by Yana Etkin, MD, associate professor of surgery at Zucker School of Medicine at Hofstra/Northwell in New York.—Bryan Kay
“The use of the upper extremity approach significantly increased the risk of postoperative mortality”
ANDREA VACIRCA
IMPACT REPORT FINDS NO MAJOR CHANGE IN BALANCE BETWEEN CAS AND CEA FOLLOWING MEDICARE EXPANSION
AN EVALUATION OF TRENDS IN THE UTILIZATION OF CAROTID ARTERY stenting (CAS) versus carotid endarterectomy (CEA) has found there to be “no major change” to tip the balance following the 2023 US Centers for Medicare and Medicaid Services (CMS) expansion of CAS coverage to include standard-risk patients with symptomatic ≥50% and asymptomatic ≥70% carotid artery stenosis.
Courtenay M. Holscher, MD, at Johns Hopkins Hospital in Baltimore, Maryland, presented her team’s findings during yesterday’s Plenary Session 2.
Using 100% Medicare fee-for-service claims data to identify patients who underwent CAS or CEA between January 2017 and December 2024, Holscher and colleagues identified 385,067 carotid revascularizations—45% symptomatic vs. 55% asymptomatic disease, and 77.1% CEA vs. 22.9% CAS.
The proportion of carotid revascularization procedures performed by vascular surgeons versus other specialties increased from 46% in 2017 to 55% in 2024. Holscher detailed that CEA was mainly performed by vascular surgeons, cardiothoracic surgeons, and general surgeons, and CAS was commonly performed by vascular surgeons, cardiologists and interventional radiologists.
The proportion of carotid revascularizations performed using CAS significantly increased over time (2017: 13% vs. 2024: 37.5%), 25% in symptomatic and 31% in asymptomatic patients. Holscher reported a slight decrease in CEA use after the expansion of CAS in 2023, but this was not found to be statistically significant.
“The utilization of stenting has significantly increased over time and it’s quite reassuring that there is an increasing share of vascular surgeons performing these revascularization procedures,” said Holscher. “It’s difficult to see how the CMS-required ‘shared decision-making’ discussion between CEA and CAS procedures can realistically occur when a physician cannot offer both procedures.”—Éva Malpass
Andrea Vacirca
SPEAKING IN CODE: HOW A DECLINE IN MEDICARE REIMBURSEMENT AFFECTS
By Éva Malpass
VASCULAR CARE
CONCERNS WERE RAISED DURING yesterday’s Plenary Session 2 over the recent decline in Medicare reimbursement at a national level. Querying current figures, speakers revealed discrepancies which highlight the importance of accurate reporting to ensure sustainable provision for the future of vascular care.
Opening the session, Kirthi S. Bellamkonda, MD, and colleagues at the Darthmouth-Hitchcock Medical Center in Lebanon, New Hampshire, briefed the VAM audience on the foundations of their research, outlining that hospitals are reimbursed by Medicare based on diagnostic related groups (DRGs) stratified based on existing comorbidities or in-hospital complications. Medicare severity (MS-DRGs) is used to code each admission as those with comorbidities or complications (CC) or major comorbidities or complications (MCC).
“If a CC or MCC is missed by coding teams, the result is under coding, which substantially reduces hospital payment,” said Bellamkonda. The research team hypothesized that data harnessed from the Medicare-linked Vascular Quality Initiative (VQI) Peripheral Vascular Intervention (PVI) Registry could be used to identify cases appropriate for DRGs with CC or MCC, to
VESS
Optimal CLTI care demands proficiency in both open and endovascular treatment, study finds’
By Jocelyn Hudson
avoid underbilling by hospitals.
The research team analyzed 40,822 admissions for Medicare beneficiaries who underwent PVI treatment at 231 VQI centers from 2010–2019. The research team then created a multivariable model to predict whether standard MS-DRG or MS-DRG with CC/MCC was billed for the admission.
Reporting a 0.816 C-statistic for the model, Bellamkonda and team believe they found a “strong predictive association” between the VQI data and current MS-DRG billing. Among key VQI variables associated with CC/MCC MS-DRG billing were dialysis dependence, dependent functional status and congestive heart failure.
In-hospital events included renal and pulmonary complication, amputation during admission and length of stay exceeding six days. “We saw fewer CC/MCC admissions billed than expected in 39% of hospitals, which would have resulted in an estimated total of $9 million in lost reimbursement,” stated Bellamkonda.
She continued: “Based on the accuracy of this model, VQI hospitals could receive a report that estimates the probability that each PVI admission might qualify for DRG billing with CC or MCC. Hospitals could then set their own probability level to select indica -
tions for coding review.”
From the audience in encouragement, Linda Harris, MD, SVS president-elect and professor of surgery at the University at Buffalo in Buffalo, New York, urged the team to take this “another step” by prospectively trialing their model in a handful of centers.
“If you can show in say five centers that we have saved you a million dollars here and there that would really make a big difference in promoting the benefits of our C-suite,” said Harris.
Shifting focus to examine Medicare billing as it varies by region and physician specialty, Daniel J. Koh, MD, and colleagues at the Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, specified that Medicare Part B reimbursements have been declining at the national level.
Seeking to identify trends in Medicare reimbursement for endovascular lower extremity interventions, the team consulted the 2018–2022 Medicare Physician and Other Practitioners by Provider and Service dataset for eight lower extremity CPT codes. The data were stratified by setting (facility, hospital vs. non-facility), Centers for Medicare and Medicaid Services (CMS) region, and physician specialty.
In the study period, reimbursement decreased in all but three regions; the Southeast, South and West Coast saw an increase of 1%, 7%, and 9%, respectively. Mountain
and top quartiles. He put forward that these findings highlight the need for quality metrics that better differentiate center-level performance and suggest that optimal care for chronic limb-threatening ischemia (CLTI) patients demands proficiency in both open and endovascular treatment.
Jones began by noting that the impact of center-level variation within the BEST-CLI trial, which compared surgical bypass and endovascular treatment in patients with CLTI, has not been explored. In addition, he stated that traditional quality metrics often fail to adequately discriminate center-level performance.
A NEW RESEARCH PAPER—PRESENTED DURING SVS-VESS Scientific Session—has found that top-performing BEST-CLI centers consistently achieved above-average outcomes in both open and endovascular treatment, while centers excelling in only one modality were less likely to be top performers.
Submitting and presenting author Douglas W. Jones, MD, associate professor of surgery at UMass Chan Medical School in Worcester, Massachusetts, shared further conclusions that major adverse limb event (MALE) and death rates “varied considerably” among BEST-CLI centers, with a difference of approximately 30% seen at two years between bottom
In the present study, Jones and colleagues introduce cumulative, probability-based quality metrics similar to those employed in professional sports—specifically earned outcomes (EO) and wins above average (WAA)—to evaluate center-level performance in both open and endovascular treatment of CLTI. The research team hypothesized that centers excelling in both modalities would demonstrate superior overall outcomes.
Jones detailed that participating BEST-CLI centers were evaluated by composite MALE or death, for all patients treated at a given site. He noted that WAA was calculated as a risk-adjusted, volume-sensitive measure derived from MALE and death using EO methods and that risk adjustment accounted for patient-level differences using a Cox proportional hazards model, excluding patients with incomplete data.
West and Pacific Northwest regions had the largest declines in facility reimbursements at -19% each. For non-facility locations the average reimbursement was declined in all ten regions, while facility reimbursements declined by an average of -7%.
Out of the eight included procedures, only iliac stent placement (2%), femoropopliteal atherectomy (10%), and infrapopliteal atherectomy (14%) had an increase in facility reimbursements. Intravascular ultrasound (IVUS) and femoropopliteal stent placement had the largest declines at -19% and -17%, respectively. In non-facility settings, the average reimbursement declined by -24%, with femoral-popliteal atherectomy (-43%) and IVUS (-36%) having the largest decreases. Physician specialties all experienced a similar decline in facility and non-facility reimbursements.
Discussant Omid Jazaeri, MD, vascular surgeon at Advent Health in Denver, Colorado added that these data reveal the “disproportionate effect on populations already facing barriers to vascular care” such as those in underserved and rural regions.
He continued, pointing out that Koh’s conclusions “stop short of proposing solutions or policy considerations to mitigate inequities in reimbursement,” advising their research team to recommend areas for “CMS reform, support for providers in high-risk areas or targeted funding opportunities to ensure equity of patient care.”
The presenter continued that centers were ranked and divided into WAA quartiles from bottom (Q1) to top (Q4), with patient-level demographics and outcomes compared across quartiles. Centers were then further categorized based on WAA performance into above average (WAA>0) or below average (WAA<0) in open, endovascular, or both.
The analyses included a total of 1,440 patients, representing 79% of randomized patients, treated at 146 centers.
At VAM, Jones reported that two-year unadjusted MALE and death rates varied significantly by quartile, ranging from 58% in Q1 to 29% in Q4.
The presenter added that centers were evenly distributed based on WAA: both modalities above average (25%), open above average only (29%), endovascular above average only (21%), and both below average (25%).
Among top centers (Q4), Jones revealed that 84% achieved above average outcomes in both modalities, while 62% of bottom centers (Q1) were below average in both. Additionally, he conveyed that centers excelling in only one modality constituted 17% of top centers (3% open above average only, 14% endo above average only) and 38% of bottom centers (27% open above average only, 11% endo above average only).
Douglas W. Jones
Andres Schanzer, professor of surgery at UMass Chan Medical School, was the senior author for this paper.
Kristi S. Bellamkonda
How likely are your surgical patients to have disruptive bleeding?
6:00 a.m. – 6:00 p.m. Registration Morial CC, First Floor, Great Hall Lobby
6:30 a.m. – 8:00 a.m. International Chapter Education Session Morial CC, Second Floor, Room 228-230
6:30 a.m. – 8:00 a.m. General Surgery Resident/Medical Student Program: How to Succeed as a Vascular Surgery Fellowship Applicant
Morial CC, Second Floor, Room 214
6:30 a.m. – 8:00 a.m. International Chapter education Session Morial CC, Second Floor, Room 228-230
6:30 a.m. – 8:00 a.m. Medical Student Session (MS1-2): Introduction to Vascular Surgery
Morial CC, Second Floor, Room 224
6:30 a.m. – 8:00 a.m. Medical Student Session (MS3-4): How to Succeed as a Vascular Surgery Residency Applicant Morial CC, Second Floor, Room 220-222
6:30 a.m. – 8:00 a.m. Sections Breakfast
7:00 a.m. – 8:00 a.m. Educational Session: JVS Confidential, or Revise vs. Reject: Interactive, Case-based Review of Editorial Best Practices in Vascular Scientific Publishing
7:00 a.m. – 8:00 a.m. Educational Session: Innovation And Entrepreneurship in Vascular Surgery –Everything you Need to Know from Innovative Idea to Intellectual Property
8:00 a.m. – 11:30 a.m. SVN Annual Meeting
8:00 a.m. – 9:30 a.m. Plenary Session 3
9:00 a.m. – 5:00 p.m.
9:00 a.m. – 5:00 p.m.
9:00 a.m. – 5:00 p.m.
9:00 a.m.
9:00 a.m.
Morial CC, First Floor, Rivergate Terrace
Morial CC, Second Floor, Room 208-210
Morial CC, Second Floor, Room 217-219
Morial CC, Second Floor, R02-R03
Morial CC, First Floor, Great Hall A
Crossroads@VAM: Boston Scientific Morial CC, Second Floor, Room 207
Crossroads@VAM: Cook Medical
Morial CC, Second Floor, Room 202
Crossroads@VAM: Gore Morial CC, Second Floor, Room 206
5:00 p.m. Crossroads@VAM: Medtronic
5:00 p.m.
Crossroads@VAM: Surmodics- By Appointment Only
CC, Second Floor, Room 205
Morial CC, Second Floor, Room 203/204
9:00 a.m. – 6:00 p.m. SVS Central@VAM Morial CC, First Floor, Great Hall Pre-Function
9:30 a.m.
3:30 p.m. – 5:00 p.m. Educational Session: Deep Venous Obstruction- Evaluation, Management, Tips, and Tricks
Compiled by Marlén Gomez
Crossroads@VAM
CROSSROADS@VAM, TAKING place through Friday from 8 a.m.–5 p.m., offers attendees the chance to connect with industry leaders and explore advancements in vascular technology. Located on the second level of the convention center, Crossroads@ VAM will feature representatives from major industry partners, including: Boston Scientific (Room 207), Cook Medical (Room 202), Gore (Room 206), Medtronic (Room 205) and Surmodics (appointments required, visit vascular. org/Surmodics, Room 203/204).
Bingo!
Attendees can pick up a bingo card at registration or the SVS Foundation booth and visit participating exhibitors during the Exhibit Hall opening hours on today and tomorrow to collect stamps to participate in the Exhibit Hall Bingo event.
Exhibit Hall hours are from 10:15 a.m.–6:30 p.m. today and 9:30 a.m.–2 p.m. tomorrow. Completed bingo cards must be submitted at the SVS Foundation booth at SVS Central by 2 p.m. tomorrow for a chance to win. Bingo is open to all attendees at no cost.
LARRY W. KRAISS ANNOUNCED AS PSO MEDICAL DIRECTOR
LARRY W. KRAISS, MD, FSVS, WAS ANNOUNCED AS THE NEW medical director of the Patient Safety Organization (PSO) during the Vascular Quality Initiative (VQI) annual meeting held June 3–4, in New Orleans.
Kraiss, who served as the division chief of vascular surgery at the University of Utah from 2003–2018, also chaired the SVS-VQI PSO Arterial Quality Committee from 2011–2014 and served as chair of the Governing Council from 2014–2018.
“Being part of the VQI has been one of the most rewarding aspects of my vascular surgery career, apart from taking care of patients and doing research,” Kraiss said. “I am deeply humbled and, at the same time, honored. Thank you all. It takes a village and a family to do good quality improvement.”
Kraiss succeeds Jens Eldrup-Jorgensen, MD, who has served as medical director since 2017. Kraiss’s extensive knowledge and experience in vascular care, along with his dedication and impact on the field, inspired the PSO to establish a Quality Award in his honor.
SVS CENTRAL AVAILABLE TO ANSWER ALL YOUR #VAM25 QUESTIONS
SVS Central is the place to go for all inquiries related to VAM. Open through Friday (9 a.m.–7 p.m.), the SVS professional staff can provide answers to a wide array of topics including, but not limited to, the SVS mobile app, onsite and streaming logistics, information for international attendees, as well as details on continuing medical education (CME) and credit. In addition, SVS Central has information on future meetings and educational opportunities, such as the Vascular Education and Self-Assessment Program (VESAP).
Experience the future of vascular surgery at Touchpoint@VAM
STEP INTO THE FUTURE OF vascular surgery at Touchpoint during VAM 2025, where innovation meets hands-on learning. This year’s “Touchpoint: Hands On Simulation Lab” will test cutting-edge devices, explore immersive simulations and engage with state-of-theart virtual reality technology designed to sharpen your surgical skills and provide exposure to the tools shaping tomorrow’s vascular care.
Experience this interactive lab by scheduling a 30-minute product demonstration with the participating companies at vascular.org/Touchpoint. Return to book additional sessions as desired. Particpating companies include Argon Medical, Boston Scientific, Cook Medical, Endologix, Gore, Haemonetics, Johnson & Johnson MedTech, Medtronic, Penumbra, Reflow Medical and Teleflex Attendees are encouraged to reserve their appointments, with limited spots available.
Long-term VQI-VISION analysis sheds light on PVI versus bypass in aortoiliac occlusive disease
By Jamie Bell
TODAY’S PLENARY SESSION 4—HOSTED IN GREAT Hall A, First Floor from 10:45 a.m.–12 p.m.—will feature a presentation of five-year findings from the VQI-VISION database indicating that aortobifemoral bypass (ABF) remains a more durable long-term treatment option compared to endovascular intervention for aortoiliac occlusive disease.
Elonay Yehualashet, BA, a medical student at Georgetown School of Medicine in Washington, D.C., is presenting these findings, which are also being discussed by senior author Natalie Sridharan, MD, assistant professor of surgery at the University of Pittsburgh Medical Center (UPMC) in Pittsburgh, Pennsylvania.
“In medically appropriate patients, ABF may be beneficial and should be considered given its long-term results,” Yehualashet told VS@VAM
For the present analysis, researchers queried the Vascular Quality Initiative (VQI) database for de novo aortoiliac interventions—ABF or supra-inguinal peripheral endovascular intervention (PVI)—and linked them to Medicare claims from 2010–2019. Emergent cases and interventions for aneurysm or dissection were excluded.
The researchers’ primary endpoint was five-year estimates of freedom from major adverse limb events (MALE; major amputation or reintervention) or death, while a notable secondary endpoint consisted of freedom from major amputation or death. Kaplan-Meier analysis compared outcomes between patients undergoing ABF versus PVI and, additionally, subgroup analyses compared patients presenting with chronic limb-threatening ischemia (CLTI) versus claudication.
A total of 4,282 cases were identified—931 of which were ABFs (21.7%), 3,351 PVIs (78.2%). Over the study period, there was a trend toward increased PVI utilization, including 32.2% from 2010–2014 and 67.8% from 2015–2019 (p=0.01).
“In medically appropriate patients, ABF may offer CLTI patients improved limb preservation, while patients with claudication may experience reduced reintervention rates”
ELONAY YEHUALASHET ET AL
Patients undergoing PVI were more likely to be older, live in urban areas and have higher rates of cardiovascular comorbidities, and had a greater likelihood of presenting with claudication, the researchers found.
As per their primary endpoint, the fiveyear rate of freedom from MALE or death was 58.7% in the ABF group and 38.2% in the PVI group (p<0.0001). Sequential Cox regression analysis demonstrated that the observed difference in the MALE/death rate between groups favoring ABF “persisted and remained significant” after adjustment for covariates of known clinical significance (adjusted hazard ratio [aHR] for PVI, 1.889; 95% confidence interval [CI], 1.648–2.166; p<0.0001)—a trend that remained true for patients undergoing treatment for both claudication (aHR, 1.807; 95% CI, 1.498–2.18; p<0.001) and CLTI (aHR, 1.959; 95% CI, 1.605–2.392; p<0.0001).
Freedom from major amputation or death at five years was 70.5% in the ABF group and 60.1% in the PVI group (p<0.0001), and—as per subgroup analyses—PVI was only associated with increased risks of major amputation or death among CLTI patients (aHR, 1.665; 95% CI, 1.311–2.114; p<0.0001), but not among those with claudication. The researchers speculate based on this finding that more prevalent MALE in patients undergoing PVI for claudication is related specifically to increased numbers of reinterventions.
“Despite the shift toward an endovascular-first approach for aortoiliac occlusive disease, the durability of suprainguinal PVI may not persist long-term,” Yehualashet and colleagues conclude. “In medically appropriate patients, ABF may offer CLTI patients improved limb preservation, while patients with claudication may experience reduced reintervention rates.”
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VAM THROUGH THE LENS » 25
Wednesday was a day for connections, new and renewed, a time to reflect on obstacles summited and challenges ahead. New Orleans, a melting pot of culture and cuisine, proves the ideal setting for this spirit of fraternity and curiosity.
“Be the hero of your story, not the victim of your circumstances”
JIM CRAIG
An interruption in the power did not dim enthusiasm for VAM 2025 day one, which showcased the best that the vascular community has to offer. The day’s content was capped by Olympic legend Jim Craig (right), pictured below with Claudie Sheahan (middle) and Jason Lee in the latest SVS Keynote Speaker Series.
OPEN MEDIAN ARCUATE LIGAMENT RELEASE FARES BETTER AT MALS
SYMPTOM RELIEF, BUT COMPLICATIONS RARER WITH LAPAROSCOPIC APPROACH
LAPAROSCOPIC MEDIAN ARCUATE ligament release (MALR)—a minimally invasive alternative to open release for the treatment of median arcuate ligament syndrome (MALS)—is associated with fewer complications and a shorter length of hospital stay for patients, but open surgery is more effective at relieving symptoms, researchers have shown.
Yaman Alsabbagh, a research fellow at Mayo Clinic in Jacksonville, Florida, presented data from more than two decades’ worth of cases performed at his institution during yesterday’s William J. von Liebig Forum, comparing the open and laparoscopic approaches.
MALS is a condition caused by external compression of the celiac artery or neve plexus by the median arcuate ligament, contributing to a “constellation” of gastrointestinal symptoms for patients, Alsabbagh explained, detailing that telltale symptoms typically include abdominal pain, nausea, vomiting and unintentional weight loss.
“Open release has traditionally been favored, especially in cases with challenging anatomy, extensive neurolysis or complex vascular reconstruction requirements,” he
said, adding that the perceived advantage of this strategy is that it offers direct visualization and may allow for more comprehensive decompression.
In recent years laparoscopic MALR has gained momentum due to its minimally invasive approach, Alsabbagh said, with this technique increasingly being utilized in centers with advanced laparoscopic expertise.
“Studies have shown that laparoscopy is associated with shorter hospital stays, reduced postoperative pain and faster recovery.”
Alsabbagh and colleagues reviewed data of 271 patients undergoing MALR, either laparoscopically (55.7%) or with open surgery (44.3%), at their institution from 2001 to 2024, focusing on patients diagnosed with MALS based on clinical and imaging findings. Those who had had a prior release or who had undergone surgery for non-MALS indications were excluded from the study.
Patients undergoing laparoscopic surgery typically were younger (35.7±16.7 years), Alsabbagh detailed, than those undergoing open surgery (40.1±15.9 years), whilst there was comparable body mass index (BMI) and gender distribution among the two groups.
Seven cases converted from laparoscopic to open surgery over the course of the study, three due to bleeding and four due to reconstruction.
Patients underwent a variety of vascular imaging to confirm the presence of MALS, he noted, with dynamic duplex ultrasound (DUS), magnetic resonance angiography (MRA), provocative mesenteric angiogram, and celiac plexus block (CPB) used significantly more frequently in the laparoscopic group. However, positivity rates did not differ between groups.
Detailing the study’s main findings, Alsabbagh reported that the open surgical group had a higher rate of symptom relief than the laparoscopic approach, which was observed to be significantly higher for both pain (84.2% vs. 71.5%, p=0.014) and nausea (94.8% vs. 84.9%, p=0.23).
Additionally, the researchers found that the open group had a higher rate of intraoperative interventions (12.5% vs. 2%, p<0.001), including aorto-to-celiac bypass and celiac patch angioplasty. Open MALR was associated with a higher rate of postoperative ileus (9.2% vs. 0.7%, p<0.001) and a longer hospital length of stay (4.6±1.7 days vs. 1.7±1.3 days, p<0.001).
To account for any potential learning curve associated with the laparoscopic procedures, the investigators performed a comparative analysis taking out the first three laparoscopic cases, which showed that the difference between the two groups for pain relief was no longer significant, although the open approach maintained its statistical significance for nausea relief.—Will Date
COMPLEX AORTIC
NEW DATA UNDERLINE SAFETY OF AORTIC STENT GRAFT PLATFORMS
PREVIEW By Will Date
ATTENDEES OF THIS MORNING’S
Plenary Session 3 (8–9:30 a.m., First Floor, Great Hall A) will hear new data on the safety and efficacy of the Nexus and Nexus Duo (Endospan) stent graft systems for treating aortic arch dissection and aneurysms.
Presented by Michele Antonello, MD, of the Department of Vascular and Endovascular Surgery at the University of Padua Faculty of Medicine and Surgery, Padua, Italy, the prospective data from the INARCHER registry, collected from eight centres across Italy, underline the safety profile of the Nexus and Nexus Duo systems, Antonello’s data will suggest.
are consistent with those seen in the existing literature for similar high-complexity cases.
During his presentation, Antonello will report that complication rates seen following endovascular treatment of aortic dissection and arch aneurysm cases with the Nexus systems, which include an off-theshelf, bimodular single-branch endograft and a custom-made double-branch device
Looking at a total of 31 cases—including 13 aneurysm and 12 dissection cases— investigators looked at primary endpoints of 30-day major adverse events (MAEs), disabling neurological events and mortality, alongside secondary endpoints including the need for device-related reintervention and the presence of endoleaks. Statistical analyses were performed to identify factors associated with adverse outcomes and to assess the overall performance of the endografts.
The analysis demonstrates a high rate of technical success and a low rate of perioperative mortality. Disabling neurological events occurred in 6.5% of cases, with MAEs in around a quarter, Antonello’s data will show. Beyond 30 days there were no reported incidences of aortic-related mortality, Antonello will detail, with no unplanned devicerelated reinterventions also reported.
PREVIEW PMEG
Low-profile
endografts associated
with increased risk of type I/III endoleak in physician-modified
endovascular repair
THE LARGEST DATASET ON PHYSICIAN-MODIFIED ENDOGRAFTS (PMEG) to date has found that the use of low-profile devices facilitated safe PMEG repair with reduced need for an access conduit, although showed higher rates of type I/III and branch-related endoleaks, raising concerns over their long-term durability.
These are the findings of a retrospective analysis set to be presented during today’s Plenary Session 3 taking place from 8:52–8:59 a.m. in Morial CC, First Floor, Great Hall A. Speaking to VS@VAM, presenter Sukgu M. Han, MD, professor of surgery at the Keck Medical Center of University of Southern California in Los Angeles comments that: “These findings underscore the importance of rigorous, critical evaluation of real-world data to illustrate the value of multicenter collaboration in advancing our understanding of complex endovascular techniques.”
Han and colleagues’ analysis included patients who underwent PMEG at 19 international centers from 2009 to 2022, distinguishing between cases in which a LP or standardprofile (SP) aortic endograft was used. At 30-day follow-up, both groups showed a similar rate of technical success, mortality, major adverse events and access-site difficulties, but there was a significantly higher rate (23 vs. 13%) of type I or III endoleaks at 20-month follow-up in the LP group.—Éva Malpass
Nexus stent graft system
Sukgu M.
Yaman Alsabbagh
CRAWFORD FORUM HIGHLIGHTS NEED FOR UNIFIED VOICE IN ADDRESSING LITANY OF CHALLENGES FACING VASCULAR SURGERY
Vascular surgeons must present a unified front to address structural and financial challenges facing the specialty, SVS PresidentElect Keith Calligaro, MD, said in summing up this year’s E. Stanley Crawford Critical Issues Forum, which explored ways to empower the vascular community to confront these head on. The wide-ranging session covered topics ranging from vascular surgery’s position within heart and vascular centers, to unionization and fair financial reimbursement. SVS@VAM picks out key talking points from each of the speakers below. By Will Date
A need for unity
Vascular: On the periphery of heart and vascular centers?
Departments of surgery: Worth fighting for?
The value of vascular: SVS Population Health Task Force report
“The overriding theme from this whole session is that we need to be unified. There are disagreements on certain issues, but we really need to speak as one voice, get together and try to figure out what we can by working together”
KEITH CALLIGARO, MD , SVS President-Elect
“If we cohabitate heart and vascular, I just see no way we are going to come out on top. For most of us here, we are at too much of a disadvantage for this to be a successful paradigm for our care”
MALACHI SHEAHAN III, MD , chair of surgery at the Louisiana State University Health Sciences Center, New Orleans
DIALYSIS ACCESS
Education session to highlight ‘the bad and the ugly’ of hemodialysis access
A SERIES OF SPEAKERS ARE SET TO ADDRESS SOME OF the most pressing hemodialysis (HD) access challenges during an education session this afternoon.
Moderators Loren Masterson, MD, of Cleveland Clinic Akron General in Akron, Ohio, and Pallavi Manvar-Singh, MD, of Zucker School of Medicine at Hofstra/Northwell Health in Jericho, New York, will oversee six podium presentations and a debate in HD Access: The Bad and the Ugly (3:30–5 p.m., Second Floor, Room 217-219).
“Hemodialysis access cases are [some] of the most commonly performed vascular surgical procedures, encompassing about 30% of the total case volume of the average vascular surgeon,” Masterson tells VS@VAM ahead of this year’s meeting. “This session looks to explore both common and uncommon complications of AV [arteriovenous] access, as well as discuss strategies to maintain long-term access.”
Going into the specifics of what delegates can expect, ManvarSingh shares: “This session will delve into the complex and often challenging scenarios vascular surgeons encounter in preserving functional hemodialysis access, particularly when faced with some of the most severe complications. Delegates will hear from a panel of experts as they present their strategies for addressing difficult problems, such as salvage of failing access, megafistulas, stent erosion, graft infections, access site blowouts, and ischemic complications.” Jocelyn Hudson
“The best interests of vascular surgery are not served by being a part of heart and vascular institutes, or by departments of surgery—I think it is about time that we declare our independence”
FAISAL AZIZ, MD , Penn State University, Hershey, Pennsylvania
AV FISTULA
“The financial advantage of a vascular surgeon to healthcare is severely underestimated and very difficult to measure”
Can vascular surgeons unionize?
“As issues with full time employees and patients increase, the topic of unionization is not going to go away, it is just going to become deeper and [more] robust”
SUNITA SRIVASTAVA,MD, Massachusetts General Hospital, Boston
ENRICO ASCHER,MD, New York University, New York City
PATIENT AGE, DIABETES STATUS AND SEX ‘SHOULD BE CONSIDERED’ WHEN SELECTING SNUFFBOX AVF
A RECENT SINGLE-CENTER, RETROSPECTIVE study—presented during yesterday’s William J. von Liebig Forum—provides insights into the comparative benefits of endovascular supported radiocephalic arteriovenous fistulas (ES-RCAVFs) and snuffbox AVFs (SB-AVFs) for dialysis patients.
Submitting and presenting author Mohamad A. Hussain, MD, vascular and endovascular surgeon and assistant professor of surgery of Brigham and Women’s Hospital and Harvard Medical School in Boston, revealed to the VAM 2025 audience that ESRCAVFs were associated with improved maturation and cannulation rates with higher long-term patency than SB-AVFs. However, he further reported that younger, non-diabetic and female patients reported equivalent outcomes of both access types, suggesting these factors “should be considered when choosing SB-AVF.”
Hussain shared that he and co-author Robert Shahverdyan, MD, head of vascular access medicine at the Vascular Institute (Gefäßinstitut) Petridis in Hamburg, Germany, had retrospectively analyzed data for primary RCAVFs created in patients from November 2017 until October 2024 at a single center in Hamburg. A total of 394 patients undergoing primary RCAVF creation were included in the study, Hussain detailed, specifying that 50.3% were
on hemodialysis at the time of access creation. Furthermore, he noted that the ES-RCAVF group (n=246) included “significantly more” female, elderly and diabetic patients than the SB-AVF group (n=148).
The presenter informed the VAM 2025 audience that ESRCAVFs saw higher rates of four-week maturation, total maturation, six-month unassisted cannulation, six-month total cannulation and catheter removal rates. He added that secondary patency trended to be higher for ES-RCAVF versus SB-AVF over the follow-up. Continuing, Hussain shared that he and Shahverdyan identified older age and diabetes as significant factors negatively associated with all metrics except for secondary patency. And, in a subgroup analysis of younger (<65 years), nondiabetic and male patients, the researchers found ESRCAVF “still reported comparatively higher rates of maturation and cannulation, than SB-AVF,” while <65 years old, non-diabetic and female patients reported equivalent outcomes for both access types. Hussain concluded that although ES-RCAVFs demonstrate superior outcomes, SB-AVFs should be considered as a valuable option for select patients.—Jocelyn Hudson
Mohamad A. Hussain
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
WOMEN’S SECTION
Navigating challenges in aortic dissection management: Insights from the SVS Women’s Section
By Marlén Gomez
VAM 2025 will feature a session from the SVS Women’s Section—Challenges in Current Aortic Dissection Management—today from 1:30-3 p.m. on the Second Floor (Room 228–230) that aims to shed light on the complexities of managing aortic dissection particularly as it affects women and individuals with connective tissue disorders.
Moderated by Sunita Srivastava, MD, and Javairiah Fatima, MD, the session will address critical gaps in understanding in the treatment of aortic dissection, which, while affecting all genders, sees women often face unique challenges due to biological differences and healthcare disparities.
“The complexities of diagnosing and managing aortic dissection in women, especially those with underlying connective tissue disorders, require tailored approaches,” Srivastava said. “Addressing these challenges is crucial for improving patient outcomes.”
The session will be high-impact aortic dissection management, with a focus on complex and underrepresented patient populations.
Sherene Shalhub, MD, from Oregon Health & Science University in Portland, will open with a talk on “Diagnosis and management of type B dissection in patients with connective tissue disorders,” highlighting the vascular risks posed by these genetic conditions. Sara L. Zettervall, MD, from the University of Washington in Seattle, will follow with “Manage -
“Attending this session will be valuable for those dedicated to improving surgical outcomes and addressing gender-based disparities in medical treatment”
SUNITA SRIVASTAVA
Published by BIBA News, which is a subsidiary of BIBA Medical Ltd.
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Managing Editor Bryan Kay bryan@bibamedical.com
Editorial contribution Jocelyn Hudson, Will Date, Jamie Bell and Éva Malpass
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Advertising Nicole Schmitz nicole@bibamedical.com
Letters to the editor vascularspecialist@vascularsociety.org
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Jim Craig inspires in keynote sprinkled with messages of leadership, teamwork
“BE THE HERO OF YOUR STORY, NOT THE VICTIM OF YOUR circumstances,” began Jim Craig as he delivered the 2025 keynote speaker address yesterday evening. Craig—widely recognized for his pivotal role as a member of the “Miracle on Ice” Team USA hockey team that clinched victory at the 1980 Olympics—shared a personal narrative that underscored his commitment to advocacy.
The loss of his father, Don, due to an undetected ruptured abdominal aortic aneurysm (AAA), steered him toward a mission of raising awareness and promoting screenings for this potentially fatal condition. In his address, “Inside the winning operating room: Building trust, leading under pressure and achieving excellence as a team,” Craig employed a TED Talk interview format, engaging in a thought-provoking dialogue with Program Committee chair Jason Lee, MD, and Postgraduate Education Committee chair Claudie Sheahan, MD. Together, they explored the parallels between the worlds of sports and surgery, highlighting the importance of preparation, teamwork and a strong culture in the operating room.
“You can’t just show up and be prepared; you have to be prepared,” said Craig. He emphasized that effective leadership entails creating an environment where everyone feels valued and accountable, regardless of their role.
As he shared insights from both his athletic and professional experiences, Craig addressed the dynamics of leadership in high-pressure situations. He noted that authentic leadership can sometimes result in unpopular decisions and emphasized the necessity of having one clear leader in critical moments, particularly in the operating room. “You can’t have 10 leaders. You need to have one person in charge, and when you’re in the game, it’s essential to focus on what that requires,” said Craig. He also stressed the importance of mentorship and continuous learning, encouraging participants to seek help from others in areas where they may have weaknesses.—Marlén Gomez
ment of type B dissection during pregnancy and labor,” a timely topic as more women of childbearing age are diagnosed with aortic disease. Eanas Yassa, MD, from Corewell Health in Grand Rapids, Michigan, will discuss “Highrisk features of dissections,” focusing on their clinical implications and treatment strategies.
Trissa Babrowski, MD, from the University of Chicago, will examine the potential benefits of treating uncomplicated type B dissections. Anil Hingorani, MD, from NYU Langone Brooklyn, will offer practical guidance on “Managing acute dissections in the community setting,” especially for providers outside major referral centers.
The session concludes with Shabab Toursavadkohi, MD, from the University of Maryland School of Medicine in Baltimore, presenting “Optimizing outcomes for acute dissections,” emphasizing collaborative care and timely intervention. A moderated panel discussion led by Srivastava will wrap up the session, inviting audience engagement and synthesizing key insights. Srivastava will then summarize actionable takeaways, with particular attention to improving care for women with aortic dissection. “Attending this session will be valuable for those dedicated to improving surgical outcomes and addressing gender-based disparities in medical treatment,” said Srivastava. “Insights shared at VAM 2025 are poised to shape future practices and enhance patient care.”
SMOKING CESSATION BEFORE VASCULAR SURGERY KEY TO BETTER OUTCOMES, STUDY FINDS
ENCOURAGING PATIENTS to quit smoking before undergoing vascular surgery is critical for both surgical success and long-term health, according to Julie Mason, MD, of the Jobst Vascular Institute, presenting findings from smoking cessation program study yesterday morning during the 2025 Vascular Quality Initiative (VQI) Annual Meeting.
Her presentation emphasized the detrimental impact of smoking on vascular disease.
Mason and her team conducted a self-audit using VQI data to assess how well providers were educating patients on smoking cessation.
The study reviewed data from April 2013–December 2024, covering more than 6,000 patients. Of those, 29% were smokers at the time of surgery. Long-term follow-up data (nine to 21 months post-op) showed a 42% decrease in smoking among those patients.
The team also analyzed the impact of a national Smoking
Cessation program launched in 2022. Among 877 patients treated between 2022 and 2024, 35% were smokers before surgery. Followup data revealed a 40% quit rate, highlighting the effectiveness of structured education and support. The analysis spanned 10 VQI modules. The suprainguinal bypass graft module had the highest rate of preoperative smokers at 56%.
The highest quit rates were observed in the bypass graft module (25%) and the amputation module (23%). Regionally, the Midwest reported the highest regional smoking rate at 14%, underscoring the need for effective intervention.
Despite encouraging results, Mason acknowledged ongoing challenges. Referral rates to smoking cessation programs remain low: vascular surgeons referred 44% of patients, vascular medicine providers 49%, and advanced practice providers (APP) reported the highest referral rates at approximately 67%.—Marlén Gomez
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