Welcome to the final episode of the Q&A series of the 2025 ESVS Clinical Practice Guidelines on the Management of Diseases of the Mesenteric and Renal Arteries and Veins. The final episode completes the Q&A series by addressing several important and often rare vascular conditions covered in the 2025 ESVS guidelines.

Topics include acute and chronic mesenteric venous thrombosis, anticoagulation strategies and the role of DOACs, and indications for endovascular or surgical intervention. The discussion then turns to renal vascular disease, including renal artery stenosis, fibromuscular dysplasia, and Nutcracker syndrome. The episode concludes with an overview of visceral artery aneurysms and spontaneous isolated dissections of the mesenteric and renal arteries, focusing on diagnosis, risk stratification, and treatment thresholds. This concluding episode offers a comprehensive overview of the remaining guideline chapters and practical insights for clinical decision-making.

Full names of guests:

Dr. Mark Koelemay

Professor Dr. Bob Geelkerken

Dr. Nicola Leone

Dr. Jussi Kärkkäinen (Part 2)

Shownotes:

https://www.ejves.com/article/S1078-5884(25)00516-7/fulltext

https://open.spotify.com/episode/45Hk77hIyikYNcWklAyVMA

https://open.spotify.com/episode/58yEYHdIdh7IgVQY13gcmk

Welcome to part 2 of the Q&A series of the 2025 ESVS Clinical Practice Guidelines on the Management of Diseases of the Mesenteric and Renal Arteries and Veins. In this podcast, we will highlight the new, complex and most controversial recommendations in this guideline. In episode two, the discussion moves to Median Arcuate Ligament Syndrome (MALS), acute mesenteric ischaemia (AMI), and non-occlusive mesenteric ischaemia (NOMI)—three challenging and clinically relevant conditions.

The experts explore patient selection and diagnostic criteria for MALS, ongoing controversies in treatment, and current research. The episode also covers the clinical presentation, imaging findings, and updated diagnostic approach to acute mesenteric ischaemia, including why biomarkers such as lactate and D-dimer are no longer recommended for diagnosis. Finally, management strategies for NOMI, including multidisciplinary care and intra-arterial vasodilator therapy, are discussed.

Guests:

Dr. Mark Koelemay

Professor Dr. Bob Geelkerken

Dr. Nicola Leone

Dr. Jussi Kärkkäinen (Part 2)

Shownotes:

https://www.ejves.com/article/S1078-5884(25)00516-7/fulltext

https://open.spotify.com/episode/45Hk77hIyikYNcWklAyVMA

https://open.spotify.com/episode/58yEYHdIdh7IgVQY13gcmk

This is part 1 of the Q&A series of the 2025 ESVS Clinical Practice Guidelines on the Management of Diseases of the Mesenteric and Renal Arteries and Veins. In this podcast, we will highlight the new, complex and most controversial recommendations in this guideline. Today, for the first episode of this 3-part series, we will specifically talk about chronic mesenteric ischaemia.

Topics include the definition and diagnosis of chronic mesenteric ischaemia, the role of duplex ultrasound and CT angiography, indications for treatment in symptomatic and asymptomatic patients, and decision-making around endovascular versus open revascularisation. New evidence on stent choice and surgical strategies is also discussed. This episode provides practical guidance and expert insight into the updated recommendations for managing chronic mesenteric ischaemia in daily clinical practice.

Guests:

Dr. Mark Koelemay

Professor Dr. Bob Geelkerken

Dr. Nicola Leone

Dr. Jussi Kärkkäinen (part 2)

Shownotes:

https://www.ejves.com/article/S1078-5884(25)00516-7/fulltext

https://open.spotify.com/episode/45Hk77hIyikYNcWklAyVMA

https://open.spotify.com/episode/58yEYHdIdh7IgVQY13gcmk

In this episode of the ESVS Podcast, host Vaiva Dabravolskaite speaks with Judith Gilroy (Ireland), a medical educator and clinician working on training culture, psychological safety, and fairness in career progression. They reflect on everyday discrimination, belonging, allyship, and the hidden curriculum in surgery. Inspired by research on sexual misconduct and microaggressions, this conversation invites honest self-reflection on how culture shapes careers and how we can do better for each other.

Literature sources to be shared if possible (divided into two groups) :

1. Key Report & Ongoing Work

• Breaking the Silence: Addressing Sexual Misconduct Prof Carrie Newlands, Ms Tamzin Cuming, Ms Philippa Jackson University of Surrey / RCSI presentation (2024) https://openresearch.surrey.ac.uk/esploro/fulltext/report/BREAKING-THE-SILENCE-Addressing-Sexual-Misconduct/99944566102346

• Workplace Sexual Misconduct in Surgery (WPSMS) – updates & research https://www.wpsms.org.uk/

2. Reflection & Allyship Videos

• “That Little Voice” https://www.youtube.com/watch?v=Ll56imVATLk

• What is Intersectionality? – Peter Hopkins https://www.youtube.com/watch?v=O1islM0ytkE

• How are Microaggressions Like Mosquitoes? https://www.youtube.com/watch?v=emz49wSnNcs

• Heartbreaking Moment When Kids Learn About White Privilege https://www.youtube.com/watch?v=1I3wJ7pJUjg

Want to know why Prof. Tsilimparis says “the dissection membrane is not always your enemy”? Tune in to this ESVS Podcast for an in-depth discussion on indications, decision-making, technical tips and tricks, and what the future may hold for the evolving field of aortic dissection management.

Recorded live at LMU University Hospital in Munich, this episode of the ESVS Podcast features host Laurence Bertrand in conversation with Prof. Tsilimparis, Head of Vascular Surgery and an internationally recognised expert in aortic dissection management.

Can exercise really make a difference after deep vein thrombosis? We talk with Professor Marie José van Rijn from Erasmus University Medical Center about how physical activity can influence recovery, reduce complications like post-thrombotic syndrome, and improve quality of life. From early mobilisation to long-term exercise strategies, discover how “get moving” may change the way we manage DVT.

Join us for this insightful conversation!

References:

1. Martins, A; Junior L; Oliveira, J. (2023). Benefits of early mobilization in patients with deep venous thrombosis: a scope review. Heart, Vessels and Transplantation.

2. Rook B, van Rijn MJE, Jansma EP, van Montfrans C. Effect of exercise after a deep venous thrombosis: A systematic review. J Eur Acad Dermatol Venereol.

3. Kahn SR. The post-thrombotic syndrome. Hematology Am Soc Hematol Educ Program.

4. Liu Z, Tao X, Chen Y, Fan Z, Li Y. Bed rest versus early ambulation with standard anticoagulation in the management of deep vein thrombosis: a meta-analysis. PLoS One.

5. Anderson CM, Overend TJ, Godwin J, Sealy C, Sunderji A. Ambulation after deep vein thrombosis: a systematic review. Physiother Can.

6. Kahn SR, Comerota AJ, Cushman M, Evans NS, Ginsberg JS, Goldenberg NA, Gupta DK, Prandoni P, Vedantham S, Walsh ME, Weitz JI; American Heart Association Council on Peripheral Vascular Disease, Council on Clinical Cardiology, and Council on Cardiovascular and Stroke Nursing. The postthrombotic syndrome: evidence-based prevention, diagnosis, and treatment strategies: a scientific statement from the American Heart Association.

Circulation. 2014 Oct 28;130(18):1636-61. doi: 10.1161/CIR.0000000000000130. Epub 2014 Sep 22. Erratum in: Circulation.

7. Kakkos SK, Gohel M, Baekgaard N, Bauersachs R, Bellmunt-Montoya S, Black SA, Ten Cate-Hoek AJ, Elalamy I, Enzmann FK, Geroulakos G, Gottsäter A, Hunt BJ, Mansilha A, Nicolaides AN, Sandset PM, Stansby G, Esvs Guidelines Committee, de Borst GJ, Bastos Gonçalves F, Chakfé N, Hinchliffe R, Kolh P, Koncar I, Lindholt JS, Tulamo R, Twine CP, Vermassen F, Wanhainen A, Document Reviewers, De Maeseneer MG, Comerota AJ, Gloviczki P, Kruip

MJHA, Monreal M, Prandoni P, Vega de Ceniga M. Editor's Choice – European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis. Eur J Vasc Endovasc Surg.

8. Jasionowska S, Turner BRH, Machin M, Onida S, Gwozdz AM, Shalhoub J, Davies AH. Systematic review of exercise therapy in the management of post-thrombotic syndrome. Phlebology.

9. Steiner D, Nopp S, Pabinger I, Dassler E, Koppensteiner R, Müller M, Weber B, Ay C, Schlager O. Impact of thrombosis location on walking capacity: a cohort study of patients with acute deep vein thrombosis. Res Pract Thromb Haemost.

10. Wu C, Li X, Zhao H, Ling Y, Ying Y, He Y, Zhang S, Liang S, Wei J, Gan X. Resistance exercise promotes the resolution and recanalization of deep venous thrombosis in a mouse model via SIRT1 upregulation. BMC Cardiovasc Disord.

11. Mota GR, Simim MAM, Dos Santos IA, Sasaki JE, Marocolo M. Effects of Wearing Compression Stockings on Exercise Performance and Associated Indicators: A Systematic Review. Open Access J Sports Med.

In our special holiday podcast we take a look at the current controversy surrounding PFAS or Forever chemicals. Were you aware that one of the most commonly used compounds in vascular surgery, PTFE, actually falls into this category of substances? Is there anything to worry about? What should we be telling patients? All of these burning questions will be answered. With Justin Woolgar.

In this episode, we focus on the trainee perspective in vascular surgery across Europe.

Trainees and young vascular surgeons share what works in training, what doesn’t, and what they would change if they could, touching on structure, mentorship, autonomy, soft skills, and everyday challenges.

We’re also joined by Dr David Wippel, who presents insights from his research on the training experience of young vascular surgeons, including burnout, fulfilment, and professional development.

Get involved

If you’re a trainee or young vascular surgeon and would like to take part in the survey discussed in this episode, you can join here:

Link to the Trainee Survey: https://redcap.link/8ubj206v

If you’re a consultant in vascular surgery with over 5 years of experience and would like to take part in the survey discussed in this episode, you can join here:

Link to the Trainer Survey: https://redcap.link/shp8nthl

Your input helps shape the future of vascular surgery training.

In Part 1 of our ESVS training series, we speak with Professor Elena Iborra and Professor Igor Končar about the realities of training young vascular surgeons across Europe. They discuss expectations, mentorship, and how to shape safe, effective learning environments for the next generation.

A concise, insightful look at what defines good vascular training today.

How can a global, imaging-rich registry powered by AI reshape surveillance and quality of life after EVAR and TEVAR?

In this episode of the ESVS Podcast, host Egle Kavaliunaite speaks with Prof. Kak Khee Yeung (Amsterdam UMC, ESVS President 2026–27-elect) and Prof. Timothy Resch (Copenhagen University Hospital) about the TOGETHER Registry, a large, prospective, long-term aortic registry capturing real-world data on EVAR, TEVAR and iliac branch devices, including hostile as well as standard anatomy.

In this conversation, they explore:

• What makes TOGETHER different from previous aortic registries (central imaging, longer follow-up, global scope)
• How advanced imaging and AI-ready data may help predict which patients need intensive surveillance – and who may safely need less
• The clinical meaning of sac regression, endoleaks and durability when viewed through patient quality of life
• The strengths and limitations of a single-brand registry in a multi-device treatment landscape
• How remote monitoring, mobile tools and future biomarkers could transform aortic follow-up

Listen now, and subscribe to the ESVS Podcast on Spotify, Apple Podcasts or SoundCloud, and explore more aortic content in the ESVS Library.