Audible Bleeding

Dr. Julie Freischlag is the dean of the Wake Forest University School of Medicine and the CEO of the Wake Forest University Baptist Medical Center. She did her general surgery training and vascular surgery fellowship at the University of California, Los Angeles where she later served as the Chief of the Section of Vascular Surgery. She went on to become the Chair of Surgery at Johns Hopkins University from 2003 - 2014. In 2013 she was elected as the first woman president of the Society for Vascular Surgery. She is the author of nearly 300 peer-reviewed journal articles and over 50 book chapters and has given over 250 invited lectures on a variety of topics in vascular surgery. Clinically, she has developed significant expertise in the management of thoracic outlet syndrome.  Throughout her career, she has demonstrated a notable dedication to teaching and mentoring the next generation of general and vascular surgeons.

Thoracic Outlet Syndrome:

• A decade of excellent outcomes after surgical intervention in 538 patients with thoracic outlet syndrome. Orlando MS et al. J Am Coll Surg. 2015.
• The Art of Caring in Thoracic Outlet Syndrome. Editorial. Freischlag JA. Diagnostics. 2018, 8, 35.
• Remaining or Residual First Ribs are the Cause of Recurrent Thoracic Outlet Syndrome. Likes K et al. Annals of Vascular Surgery. 2014; 28: 939-945. 

Video: Transaxillary First Rib Resection - Dr. Freischlag’s approach

Aortic Aneurysm - The OVER trial:

• The Aneurysm Detection and Management Study Screening Program: Validation Cohort and Final Results. Lederle FA et al. Arch Intern Med. 2000;160(10):1425–1430. 
• Open versus Endovascular Repair of Abdominal Aortic Aneurysm. Lederle FA et al. NEJM. May 30, 2019.

Leadership and Diversity in Healthcare:

• Developing Diverse Leaders at Academic Health Centers. A Prerequisite to Quality Health Care? Shaikh U et al. Am J of Medical Quality. 2018.

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Dr. Caitlin Hicks is an assistant professor of surgery in the division of vascular and endovascular therapy at Johns Hopkins University in Baltimore, MD.  She is already an accomplished researcher but is also an appointed member of a CMS Clinical Expert Subcommittee tasked with refining peripheral vascular disease cost measures for implementation in the Quality Payment Program.

We discuss the fundamentals of claudication management and her recent paper presented at VAM in June 2019, Overuse of early peripheral vascular interventions in claudication. Her work was recently highlighted in the Wall Street Journal in an article entitled Doctors Sound an Alarm Over Leg-Stent Surgery.

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In this episode, we present the third installment to the Audible Bleeding - JVS Editor's Choice collaboration as Adham Elmously discusses the JVS articles selected for the October 2019 edition of the Editor's Choice with JVS Senior Editor, Dr. Peter Lawrence. 

JVS Editor’s Choice Video with Dr. Peter Lawrence

Articles featured in this month’s discussion:

• Survival After Major Lower Extremity Amputation in Patients with End Stage Renal Disease
• Association of Opioid Use and Peripheral Arterial Disease
• The Contribution of 30-Day Readmissions to the Rising Costs of Care for the Diabetic Foot
• Spot Stenting versus Full Coverage Stenting After Endovascular Therapy for Femoropopliteal Artery Lesions

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Episode 1 of 5 for our vascular trauma series.

Dr. Rasmussen is a Colonel in the United States Air Force and is a Professor of Surgery and Associate Dean of Research at the Uniformed Services University of Health Sciences and an attending vascular surgeon at Walter Reed National Military Medical Center.

Dr. Rasmussen has been deployed numerous times to Iraq and Afghanistan, and cared for many traumatic vascular injuries at Walter Reed Medical Center, through his experience and research he has become one of the foremost leaders on the management of vascular trauma and recently published the third edition of Rich’s Vascular Trauma.

Episode 1: Damage control vascular surgery of the injured extremity
Episode 2: Damage control vascular surgery surgery of the torso
Episode 3: Endovascular techniques to manage vascular injury
Episode 4: REBOA
Episode 5: Cervical carotid and vertebral artery management

We are partnering with Behind The Knife for this 5 part series. Let u know what you want to hear more of. 

Dr. Meltzer is an associate professor of surgery and chair of vascular surgery at the Mayo Clinic in Arizona where in addition to a busy clinical practice, he researches cost drivers in medicine along with the safety and efficacy of new technology in Vascular surgery.    Dr. Meltzer received his undergraduate degree from Yale, completed medical school at Jefferson University in Philadelphia followed by a general surgery residency at the Massachusetts general hospital in Boston and finally vascular surgery fellowship at New York-Presbyterian hospital Columbia/Cornell where he stayed on as faculty at Cornell for 6 years prior to his appointment at the Mayo Clinic in Arizona.

• (08:01) Administrative expansion in healthcare 
• (08:30) Administrative costs in healthcare
• (10:50 Defensive medicine and IVC filter placement
• (12:45) Philip Goodney and the Dartmouth institute publications
• (14:20) Variation in health care utilization
• (15:25) Defensive medicine physician surveys
• • National Costs Of The Medical Liability System
  • Ending Defensive Medicine Is Key To Containing Health Care Costs
  • Perception of Resources Spent on Defensive Medicine and History of Being Sued Among Hospitalists
• (20:00) Association of medical liability reform with coronary artery disease management
• (20:30) Impact of provider characteristics on endovenous ablation procedures
• (35:00) Oligopoly in aortic grafts and costs
• • Variation in hospital costs and reimbursement for endovascular aneurysm repair
  • Hospital cost of endovascular versus open repair of abdominal aortic aneurysms
• (42:00) Regulatory Capture
• (45:00) Dr. Meltzer’s view on Paclitaxel

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Dr. Jessica Mayor is a general surgery resident at the Baylor College of Medicine in Houston, TX who is the first author of a recent paper, selected as the Editor’s choice in the September issue of the JVS:

• Using the Society for Vascular Surgery (SVS) Wound, Ischemia, and foot Infection (WIfI) Classification to Identify Patients Most Likely to Benefit from Revascularization. https://bit.ly/2R0TcCx

We discuss how this project came about, some stumbling blocks along the way and the wonderful mentorship she received.

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In this episode, we present the second installment to the Audible Bleeding - JVS Editor's Choice collaboration as Adham Elmously discusses the JVS articles selected for the September 2019 edition of the Editor's Choice with JVS Editor-in-Chief, Dr. Peter Gloviczki. 

JVS Editor’s Choice Video with Editor-in-Chief, Dr. Peter Gloviczki

Articles featured in this month’s discussion:

• Editors' Choice.  Using the Society for Vascular Surgery (SVS) Wound, Ischemia, and foot Infection (WIfI) Classification to Identify Patients Most Likely to Benefit from Revascularization. https://bit.ly/2R0TcCx
• JVS-D-18-00628. CME. Practice Patterns in Arteriovenous Fistula Ligation among Kidney Transplant Recipients in the United States Renal Data Systems https://bit.ly/2X2O85K
• Hybrid Surgery for Bilateral Lower Extremity Inflow Revascularization. https://bit.ly/2WYolfc
• Multidisciplinary clinics reduce treatment costs and improve patient outcomes in diabetic foot disease. https://bit.ly/2K6CIbf

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Best Endovascular vs. best Surgical Therapy in patients with Critical Limb Ischemia (BEST-CLI) is a prospective, multicenter, randomized, open-label (two-arm), comparison to evaluate the effectiveness of best surgical to best endovascular revascularization in patients with CLI.

Dr. Alik Farber is a Professor of Surgery and Radiology at Boston University School of Medicine and the Chief of Vascular and Endovascular Surgery at Boston Medical Center.

Dr. Matthew Menard is an Associate Professor of Surgery at Harvard Medical School and is Co-Director of Endovascular Surgery and Program Director of the vascular surgery fellowship at Brigham and Women’s Hospital.

Topics Discussed

• History of the trial - mentors involved, interactions with the NIH
• Context of the literature - limitations of the BASIL trial
• Barriers to enrollment and strategies of successful institutions
• Choosing the endpoint of Major Adverse Limb Event (Male)-free survival
• Implications of cost-effectiveness component
• Impact of paclitaxel controversy on the trial
• Early lessons learned and much, much, more!!

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In this episode, we present our first Audible Bleeding - JVS Editor's Choice collaboration as Adam Johnson discusses the JVS articles selected for the August 2019 edition of the Editor's Choice with JVS Senior Editor, Dr. Peter Lawrence. 

JVS Editor’s Choice Video with Senior Editor Dr. Lawrence - YouTube

Articles Featured in this month's discussion:

• Statin use Improves Limb Salvage after Intervention for Peripheral Arterial Disease http://bit.ly/2J6EwQ9
• Technical Aspects and 30-day Outcomes of the Prospective Early Feasibility Study of the GORE® EXCLUDER® Thoracoabdominal Branched Endoprosthesis (TAMBE) to treat pararenal and Extent IV thoracoabdominal aortic aneurysms. http://bit.ly/2ZN1FwZ
  • Episode 7 - Gustavo Oderich, MD - branched and fenestrated endovascular treatment of complex aortic aneurysms
• Validation of a Preoperative Prediction Model for Mortality within One Year after  Endovascular Aortic Aneurysm Repair of Intact Aneurysms.http://bit.ly/2Whz0xZ
  • Information about QxMD App: https://qxmd.com/
• The State of Complex Endovascular Abdominal Aortic Aneurysm Repairs in the Vascular Quality Initiative. http://bit.ly/2J30Yd4
  • The Vascular Quality Initiative https://www.vqi.org/

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This episode is the next installment of our collaboration with the Society for Vascular Surgery Young Surgeons Advisory Committee aimed to provide resources to develop the careers of young surgeons in vascular surgery.

For the early career point of view, we have Dr. Angela Kokkosis.  Dr. Kokkosis is an associate professor at Stony Brook University Medical Center.  She did her undergraduate and medical training at Stony Brook, then completed a Vascular Surgery Integrated Residency at Mt Sinai Medical Center in New York City in 2014.

For the mid-career point of view, we have Dr. Faisal Aziz.  Dr. Aziz is the Gilbert, and Elsie H. Sealfon Endowed Associate Professor in Surgery, the chief of the division of vascular surgery and the program director of the vascular surgery residency at Penn State University College of Medicine where he has been on faculty for the past eight years.  He completed his medical school at King Edward Medical University in Lahore, Pakistan, general surgery residency at New York Medical College in Valhalla, NY and vascular surgery fellowship at the Jobst Vascular Institute in Toledo, OH.