Podcasts about Vascular surgery

My conversation with Dr Dua begins at about 35 mins Stand Up is a daily podcast. I book,host,edit, post and promote new episodes with brilliant guests every day. This show is Ad free and fully supported by listeners like you! Please subscribe now for as little as 5$ and gain access to a community of over 750 awesome, curious, kind, funny, brilliant, generous souls Healthcare For Action was founded in 2022 to support healthcare workers running for Congress. Dr. Anahita Dua, Chair of Healthcare for Action, is a Vascular Surgeon at Massachusetts General Hospital and an Associate Professor of Surgery at Harvard University. As a surgeon, she knows that in order to get things done and save lives, the surgery team has to work together and take action. Our politics shouldn't be any different.  In 2023, Healthcare For Action merged with Doctors In Politics, founded in 2020 by a group of physicians specializing in psychiatry, family medicine, OBGYN, and neurology. They were committed to patient-centered and equitable political change at all levels of government and grew to a membership of nearly 10,000. We believe fundamentally that all policy is health policy.  There are too many existential threats facing our democracy. From reversing climate change, preserving access to abortion, and curbing the epidemic of gun violence we must take action now and play the long game. From acute care to prevention, healthcare workers know how to get the job done. That is the guiding vision of the largest Democratic healthcare workers PAC in the country - Join our community at Healthcare For Action! Anahita Dua, MD, MS, MBA, FACS, is a vascular surgeon at Massachusetts General Hospital and an associate professor of Surgery at Harvard Medical School. At Mass General, she is the director of the Vascular Lab, co-director of the Peripheral Artery Disease Center and Limb Evaluation and Amputation Program (LEAPP), associate director of the Wound Care Center, director of the Lymphedema Center and associate director of the Vascular Surgery Clerkship and director of clinical research for the division of vascular surgery. She specializes in advanced endovascular (minimally invasive) and traditional (open) limb salvage techniques for treating peripheral arterial disease and critical limb ischemia, diabetic limb disease, aortic disease, carotid disease, thoracic outlet syndrome and venous disease. Dr. Dua completed her vascular surgery fellowship at Stanford University Hospital, her general surgery residency at the Medical College of Wisconsin and her medical school in the United Kingdom. She has also completed a master's degree in trauma sciences, a master's in business administration in health care management and has a certificate in health economics and outcomes research as well as a certificate in drug and device development from the Massachusetts Institute of Technology. She is board-certified in vascular surgery, general surgery and advanced wound care and management. Dr. Dua has published over 140 peer reviewed papers and has edited five vascular surgery medical textbooks. She serves on multiple national vascular surgery committees through the Society for Vascular Surgery and other vascular organizations including the South Asian-American Vascular Society and American College of Surgeons. Dr. Dua's lab focuses on anticoagulation and biomarkers that are predictive of thrombosis and hemostasis in patients that have undergone revascularization. She is interested in creation precision, point of care medical approaches to anticoagulation for patients post revascularization. Her clinical and outcomes research focuses primarily on diseases involving peripheral vascular disease, limb salvage and critical limb ischemia. She is part of a technology development team that creates tools to increase walking distance and wound healing while decreasing pain in patients with peripheral vascular disease. Dr. Dua is also involved heavily in surgical outcomes-based research using large medical databases to generate both quality outcomes and cost effectiveness data. Dr. Dua is a self-described animal lover and rescuer of pitbulls. At one point, she housed 14 pitbull puppies and their mother at once. Nowadays, her spare time is spent with her husband, son, daughter and dog Leo. Join us Monday and Thursday's at 8EST for our  Bi Weekly Happy Hour Hangout!  Pete on Blue Sky Pete on Threads Pete on Tik Tok Pete on YouTube  Pete on Twitter Pete On Instagram Pete Personal FB page Stand Up with Pete FB page All things Jon Carroll  Follow and Support Pete Coe Buy Ava's Art  Hire DJ Monzyk to build your website or help you with Marketing  

Host Kersten Rettig and Stephen Hohmann, MD, do a deep dive into vascular disease, coronary disease and renal disease.  Listeners will learn more about the risk factors for these diseases, prevention tools and tips, and how caregivers can help loved ones suffering from illness.  Additionally, Dr. Hohmann describes various types of vascular disease and approaches to care from a clinical and at home perspective.  You can learn more about vascular disease and find additional resources at the Society for Vascular Surgery.

Send us a textDr. Nicole Gensicke, PCI Vascular Surgeon with St. Luke's Vascular Surgery, returns to the podcast to discuss Peripheral Artery Disease (PAD).To learn more about services offered at St. Luke's Heart and Vascular Center, visit unitypoint.org/cr-heart.Do you have a question about a trending medical topic? Ask Dr. Arnold! Submit your question and it may be answered by Dr. Arnold on the podcast! Submit your questions at: https://www.unitypoint.org/cedarrapids/submit-a-question-for-the-mailbag.aspxIf you have a topic you'd like Dr. Arnold to discuss with a guest on the podcast, shoot us an email at stlukescr@unitypoint.org.

Send us a textLily Johnston, MD, MPH, is board-certified in both vascular and general surgery. Dr. Johnston obtained her undergraduate education at Princeton University in New Jersey and received her Medical Doctorate from the University of California, San Diego; she completed her residency in general surgery at the University of Virginia in Charlottesville and then completed a fellowship in vascular surgery at the Mayo Clinic in Rochester, MN.After several years of practicing vascular surgery full-time, Dr. Johnston witnessed too many people losing their limbs and even their lives to preventable and reversible diseases - this inspired her to found Vascular Health Institute in an effort to forward cardiovascular health and wellness. Dr. Johnston has now dedicated her career to addressing the root cause of cardiovascular disease and is passionate about bringing the principles of functional medicine and metabolic health to her patients.Dr. Johnston's clinic: www.nexushealthspan.comDr. Greg's clinic: www.fitrxwellnessok.com

In this episode, Audible Bleeding Editors Sasank Kalipatnapu (@ksasank), Falen Demsas sit down with Dr. Rabih Chaer (@rchaer2), Dr. Michael Conte(@MichaelSConteMD), Dr. Sherene Shalhub and Dr. Malachi Sheahan III, the four SVS secretary candidates for this year to learn more about them as part of the ongoing election process.    Show links: SVS 2025 Meet the Secretary Candidates—Home Page—provides a comprehensive overview of all the candidates. Their professional biographies and answers to questions about their plans for the future are available in both text and video formats.   Show Guests: Dr. Rabih Chaer, Professor of Surgery and Chief of the Division of Vascular Surgery at Stony Brook University Dr. Michael Conte, Professor and Chief of the Division of Vascular & Endovascular Surgery at the University of California, San Francisco. Dr. Sherene Shalhub, Professor and Chief of the Division Vascular and Endovascular Surgery at Oregon Health & Science University (OHSU). Dr. Malachi Sheahan, Professor and Chair of the Division of Vascular and Endovascular Surgery at Louisiana State University Health Sciences Center in New Orleans. Sasank Kalipatnapu - PGY4 general surgery resident, University of Massachusetts Falen Demsas- PGY 3 integrated vascular surgery resident, Massachusetts General Hospital    Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

In this episode of Deep Cuts: Exploring Equity in Surgery, Dr. Ross Milner and Kathy Kaluhiokalani on what patients can expect before, during, and after surgery. We'll also explore new ways technology may be able to support patients when it comes to accessing necessary surgeries.Dr. Ross Milner is a Professor of Surgery and the Chief of Vascular Surgery at UChicago Medicine. He is an internationally recognized expert in vascular surgery, specializing in the treatment of complex aortic diseases. He has published over 100 abstracts and manuscripts. In addition to his work as an expert clinician, Dr. Milner is also a dedicated mentor to medical students, residents, and fellows. Kathy Kaluhiokalani is the CEO and co-founder of Pip Care, a surgical optimization company aimed at supporting patients in their surgical journeys. Pip Care helps guide surgery patients through their journey with supportive personal health coaches, digitalized evidence-based care program, and a consumer-friendly mobile app designed to maximize surgical outcomes such as post-operative infections, hospital length of stay, and ER visits. Pip Care was founded in 2022.Deep Cuts: Exploring Equity in Surgery comes to you from the Department of Surgery at the University of Chicago, which is located on Ojibwe, Odawa and Potawatomi land.Our executive producer is Tony Liu. Our senior producers are Alia Abiad, Caroline Montag, and Chuka Onuh. Our production team includes Megan Teramoto, Ria Sood, Ishaan Kumar, and Daniel Correa Buccio. Our senior editor and production coordinator is Nihar Rama. Our editorial team also includes Beryl Zhou. The intro song you hear at the beginning of our show is “Love, Money Part 2” from Chicago's own Sen Morimoto off of Sooper Records. Our cover art is from Leia Chen.A special thanks this week to Dr. Jeffrey Matthews — for his leadership, vision, and commitment to caring for the most vulnerable in our communities. Let us know — what have you most enjoyed about our podcast. Where do you see room for improvement? You can reach out to us on Instagram. @deepcutssurgery. Find out more about our work at deepcuts.surgery.uchicago.edu.

Dean's Chat hosts, Drs. Jeffrey Jensen and Johanna Richey welcome Dr. David Armstrong to the podcast.  This discussion wasn't about the "Diabetic Foot" as much as it was getting to know what makes the world leader in "Diabetic Foot" click.  His background and fascination with technology, intro to podiatry (he considered law) to transforming clinical opportunities at Kern Hospital and UT- San Antonio.   Dr. Armstrong is Distinguished Professor of Surgery and Neurological Surgery with Tenure at the University of Southern California. Dr. Armstrong holds a Master of Science in Tissue Repair and Wound Healing from the University of Wales College of Medicine and a PhD from the University of Manchester College of Medicine, where he was appointed Visiting Professor of Medicine. He is founder and co-Director of the Southwestern Academic Limb Salvage Alliance (SALSA).  Dr. Armstrong has produced more than 720 peer-reviewed research papers in dozens of scholarly medical journals as well as over 120 books or book chapters. He is founding co- Editor of the American Diabetes Association's (ADA) Clinical Care of the Diabetic Foot, now in its fourth edition.  Armstrong is Director of USC's National Science Foundation (NSF) funded Center to Stream Healthcare in Place (C2SHiP) which places him at the nexus of the merger of consumer electronics, wearables, and medical devices in an effort to maximize hospital-free and activity-rich days. Dr. Armstrong was selected as one of the first six International Wound Care Ambassadors and is the recipient of numerous awards and degrees by universities and international medical organizations including the inaugural Georgetown Distinguished Award for Diabetic Limb Salvage. In 2008, he was the 25th and youngest-ever member elected to the Podiatric Medicine Hall of Fame. He was the first surgeon to be appointed University Distinguished Outreach Professor at the University of Arizona. He was also the first podiatric surgeon to be selected as President of Faculty at Keck School of Medicine of USC. Furthermore, he was the first podiatric surgeon to become a member of the Society of Vascular Surgery, and the first US podiatric surgeon named fellow of the Royal College of Surgeons, Glasgow. He is the 2010 and youngest ever recipient of both the ADA's Roger Pecoraro Award and 2023 recipient of the ISDF's Karel Bakker Award, the highest awards given in the field. Dr. Armstrong is past Chair of Scientific Sessions for the ADA's Foot Care Council, and a past member of the National Board of Directors of the American Diabetes Association. He sits on the Infectious Disease Society of America's (IDSA) Diabetic Foot Infection Advisory Committee and is the US appointed delegate to the International Working Group on the Diabetic Foot (IWGDF). Dr. Armstrong is the founder and co-chair of the International Diabetic Foot Conference (DF-Con), the largest annual international symposium on the diabetic foot in the world. He is also the Founding President of the American Limb Preservation Society (ALPS), a medical and surgical society dedicated to building interdisciplinary teams to eliminate preventable amputation in the USA and worldwide. https://limbpreservationsociety.org/ https://bakodx.com/ https://bmef.org/ www.explorepodmed.org https://podiatrist2be.com/  

We think of varicose veins as something that happens mostly to older people. It turns out the slow-moving condition usually begins at a much younger age. Dr. Varun Kapila is a vascular surgeon and president of the Canadian Society for Vascular Surgery. He says there are a few lifestyle factors that can reduce the chances of getting varicose veins — or at least slow their progression.For transcripts of The Dose, please visit: lnk.to/dose-transcripts. Transcripts of each episode will be made available by the next workday. For more episodes of this podcast, click this link.

Audible Bleeding editor Wen (@WenKawaji) is joined by 3rd year medical student Nishi (@Nishi_Vootukuru), 2nd year vascular fellow Donna, JVS editor Dr. Forbes (@TL_Forbes), and JVS-CIT editor Dr. Matt Smeds (@mattsmeds) to discuss some of our favorite articles in the JVS family of journals. This episode hosts Dr. Aridi, Dr. Motaganahalli, Dr. Nagarsheth, and Dr. Madabhushi, the authors of the following papers.    Articles:   Physicians preference for carotid revascularization impacts postoperative stroke and death outcomes Simultaneous percutaneous transmural arterial bypass and deep venous arterialization for treatment of critical limb ischemia    Show Guests  Dr. Hanaa Aridi (@aridi_hanaa)- PGY3 at Indiana University School of Medicine  Dr. Raghu L. Motaganahalli (@Rmotaganahalli)- Professor of Surgery at the Indiana University School of Medicine and an attending Surgeon at the Indiana University Methodist Hospital. He is the Division Chief of Vascular Surgery and the Program Director of vascular surgery training program Dr. Nagarsheth (@KNagarshethMD) -Associate Professor of Surgery and Associate Program Director of Vascular Surgery Fellowship Program at the University of Maryland Medical Center in Baltimore. Program director of the integrated vascular surgery program. Dr. Madabhushi -Vascular Surgery Fellow at the University of Maryland Medical Center in Baltimore Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.  

Focus Issue on Cardiac and Vascular Surgery and Arrhythmias

Nationally and internationally, there is a growing awareness of radiation exposure, safety, and protection. In 2023, the ESVS issued a new guideline on radiation safety. In addition, there is growing attention to pregnant healthcare workers. This paper openly discusses the intersection of radiation safety and pregnancy. It was published as an Editor's Choice paper in EJVES December 2024. Find the original article here:https://www.ejves.com/article/S1078-5884(24)00802-5/abstract

In this episode, Dr Bleri CELMETA takes us on a powerful journey through the history of open-heart surgery — from the pioneering work of John Gibbon and C. Walton Lillehei to the evolution of minimally invasive and robotic approaches. Discover how cardiac surgery progressed from experimental beginnings to life-saving daily procedures, and how innovation continues to shape the operating room. Dr. Bleri Celmeta is a cardiac surgeon operating on the Minimally Invasive Cardiac Surgery Unit in Galeazzi-Sant'Ambrogio Hospital (Milan, Italy). He graduated in Medicine and Surgery at the University of Padova-Italy in 2014, then completed his residency program in Cardiac Surgery in the same university in 2020. His professional background included also a fellowship in Cardiac and Thoracic Surgery in the University Hospital of Nantes-France (2019-2020).   He is the author of numerous publications and conference presentations with particular interest in minimally invasive cardiac surgery, and review editor of various international Journals (Frontiers in Cardiovascular Medicine, Frontiers in Surgery, Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, Journal of Cardiothoracic Surgery, among others). Dr. Celmeta is a member of the Working Group on Cardiovascular Surgery - European Society of Cardiology (ESC), Italian Cardiac Surgery Society (SICCH) and Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI).  LinkedIn profile: Bleri Celmeta | LinkedIn     About Behind the OR Behind the OR is the official podcast channel by Peters Surgical. Here, we invite you to step into the world of surgery, where we uncover what happens behind the closed doors of the operating room and beyond. Each episode features in-depth conversations with expert surgeons, providing insights into the latest surgical techniques, innovations, and the daily lives of those who dedicate themselves to saving lives. Founded in 1926, Peters Surgical is a French company with a global presence in over 90 countries. As a reference group for surgical practices worldwide, we are dedicated to improving surgical outcomes through innovative medical devices, including surgical sutures, hemostatic clips, and surgical glue. Our expertise lies in designing, manufacturing, and distributing these devices.  Visit our website here : https://peters-surgical.com/

The Vascular Surgery Subspecialty Team dives into the pressing issue of burnout among vascular surgery trainees. Unveiling surprising statistics and expert insights, they explore the alarming prevalence of burnout, its causes like work-home conflict and physical discomfort, and the protective role of mentorship and a supportive learning environment. With research-backed discussions, they navigate strategies to combat burnout and enhance the well-being of medical professionals. Hosts:  Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan and the Program Director of the Integrated Vascular Surgery Residency Program as well as the Vascular Surgery Fellowship Program at the University of Michigan. Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. Drew Braet is a PGY-5 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives -  Review the definition and prevalence of burnout - Understand the risk factors, including both modifiable and non-modifiable risk factors, for burnout  - Review the effects of burnout on trainees and attending surgeons References 1.    Hekman KE, Sullivan BP, Bronsert M, Chang KZ, Reed A, Velazquez-Ramirez G, Wohlauer MV; Association of Program Directors in Vascular Surgery Issues Committee. Modifiable risk factors for burnout in vascular surgery trainees. J Vasc Surg. 2021 Jun;73(6):2155-2163.e3. doi: 10.1016/j.jvs.2020.12.064. https://pubmed.ncbi.nlm.nih.gov/33675887/ 2.    Cui CL, Reilly MA, Pillado EB, Li RD, Eng JS, Grafmuller LE, DiLosa KL, Conway AM, Escobar GA, Shaw PM, Hu YY, Bilimoria KY, Sheahan MG 3rd, Coleman DM. Burnout is not associated with trainee performance on the Vascular Surgery In-Training Exam. J Vasc Surg. 2025 Jan;81(1):243-249.e4. doi: 10.1016/j.jvs.2024.08.057. https://pubmed.ncbi.nlm.nih.gov/39233022/ 3.    Chia MC, Hu YY, Li RD, Cheung EO, Eng JS, Zhan T, Sheahan MG 3rd, Bilimoria KY, Coleman DM. Prevalence and risk factors for burnout in U.S. vascular surgery trainees. J Vasc Surg. 2022 Jan;75(1):308-315.e4. doi: 10.1016/j.jvs.2021.06.476.  https://pubmed.ncbi.nlm.nih.gov/34298120/ 4.    Davila VJ, Meltzer AJ, Hallbeck MS, Stone WM, Money SR. Physical discomfort, professional satisfaction, and burnout in vascular surgeons. J Vasc Surg. 2019 Sep;70(3):913-920.e2. doi: 10.1016/j.jvs.2018.11.026.  https://pubmed.ncbi.nlm.nih.gov/31279532/ 5.    Pillado E, Li RD, Chia MC, Eng JS, DiLosa K, Grafmuller L, Conway A, Escobar GA, Shaw P, Sheahan MG 3rd, Bilimoria KY, Hu YY, Coleman DM. Reported pain at work is a risk factor for vascular surgery trainee burnout. J Vasc Surg. 2024 May;79(5):1217-1223. doi: 10.1016/j.jvs.2024.01.003.  https://pubmed.ncbi.nlm.nih.gov/38215953/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Focus Issue on Acute Cardiovascular Care and Cardiac and Vascular Surgery

Tweetorials: Bridging Connections in Medical Education with Nano Learning (EP.39)  With Catherine S.W. Albin, MD How can we distill complex medical concepts into bite-sized, engaging content? What role does social media play in revolutionizing education? Can nano learning connect learners and foster a community of shared knowledge? Join host Stacy Craft and guest Dr. Catherine Albin, a neurointensivist and clinical educator at Emory University School of Medicine to delve into the innovative world of "tweetorials" and nano-learning, exploring how these bite-sized educational tools are transforming medical education and all education. Special Thanks to Dr. Andrea Leep Hunderfund Questions? Feedback? Ideas? Contact us at edufi@mayo.edu Audio Editing: Celina Bertoncini Additional Resources: Albin, C. S., Ma, T., Pucci, G. F., Zelikovich, A. S., Lawson, E. C., Dhruva, N., ... & Jones Jr, L. K. (2024). Education research: making a tweetorial fly: features of educational social media posts associated with high sharing and engagement. Neurology® Education, 3(4), e200160.  Anthony C. Breu, Hannah R. Abrams, Kimberly D. Manning, Avraham Z. Cooper; Tweetorials for Medical Educators. J Grad Med Educ 1 October 2021; 13 (5): 723–725. doi: https://doi.org/10.4300/JGME-D-21-00767.1 Luzón, M. J. (2024). “Come along for a tweetorial!”: Recontextualization strategies in biomedical publication-promoting tweetorials. English for Specific Purposes, 74, 132-148. Logan, M. S., & O'Banion, L. A. (2022). Webinars, podcasts, Tweetorials, oh my!. Journal of Vascular Surgery, 76(4), 853-854. Video: CardioNerds Academy Tweetorials Bootcamp with Dr. Tony Breu  

Guest: Dr. Christian de Virgilio is the Chair of the Department of Surgery at Harbor-UCLA Medical Center. He is also Co-Chair of the College of Applied Anatomy and a Professor of Surgery at UCLA's David Geffen School of Medicine. He completed his undergraduate degree in Biology at Loyola Marymount University and earned his medical degree from UCLA. He then completed his residency in General Surgery at UCLA-Harbor Medical Center followed by a fellowship in Vascular Surgery at the Mayo Clinic.   Resources:  Rutherford Chapters (10th ed.): 174, 175, 177, 178 Prior Holding Pressure episode on AV access creation: https://www.audiblebleeding.com/vsite-hd-access/ The Society for Vascular Surgery: Clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access: https://www.jvascsurg.org/article/S0741-5214%2808%2901399-2/fulltext  KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update: https://pubmed.ncbi.nlm.nih.gov/32778223/    Outline: Steal Syndrome Definition & Etiology Steal syndrome is an important complication of AV access creation, since access creation diverts arterial blood flow from the hand. Steal can be caused by multiple factors—arterial occlusive disease proximal or distal to the AV anastomosis, high flow through the fistula at the expense of distal arterial perfusion, and failure of the distal arterial networks to adapt to this decreased blood flow.  Incidence and Risk Factors The frequency of steal syndrome is 1.6-9%1,2, depending on the vessels and conduit choice Steal syndrome is more common with brachial and axillary artery-based accesses and nonautogenous conduits. Other risk factors for steal syndrome are peripheral vascular disease, coronary artery disease, diabetes, advanced age, female sex, larger outflow conduit, multiple prior permanent access procedures, and prior episodes of steal.3,4  Long-standing insulin-dependent diabetes causes both medial calcinosis and peripheral neuropathy, which limits arteries' ability to vasodilate and adjust to decreased blood flow. Patient Presentation, Symptoms, Grading Steal syndrome is diagnosed clinically.  Symptoms after AVG creation occurs within the first few days, since flow in prosthetic grafts tend to reach a maximum value very early after creation. Native AVFs take time to mature and flow will slowly increase overtime, leading to more insidious onset of symptoms that can take months or years. The patient should have a unilateral complaint in the extremity with the AV access. Symptoms of steal syndrome, in order of increasing severity, include nail changes, occasional tingling, extremity coolness, numbness in fingertips and hands, muscle weakness, rest pain, sensory and motor deficits, fingertip ulcerations, and tissue loss.  There could be a weakened radial pulse or weak Doppler signal on the affected side, and these will become stronger after compression of the AV outflow. Symptoms are graded on a scale specified by Society of Vascular Surgery (SVS) reporting standards:5  Workup Duplex ultrasound can be used to analyze flow volumes. A high flow volume (in autogenous accesses greater than 800 mL/min, in nonautogenous accesses greater than 1200 mL/min) signifies an outflow issue. The vein or graft is acting as a pressure sink and stealing blood from the distal artery. A low flow volume signifies an inflow issue, meaning that there is a proximal arterial lesion preventing blood from reaching the distal artery. Upper extremity angiogram can identify proximal arterial lesions. Prevention Create the AV access as distal as possible, in order to preserve arterial inflow to the hand and reduce the anastomosis size and outflow diameter.  SVS guidelines recommend a 4-6mm arteriotomy diameter to balance the need for sufficient access flow with the risk of steal. If a graft is necessary, tapered prosthetic grafts are sometimes used in patients with steal risk factors, using the smaller end of the graft placed at the arterial anastomosis, although this has not yet been proven to reduce the incidence of steal.  Indications for Treatment Intervention is recommended in lifestyle-limiting cases of Grade II and all Grade III steal cases. If left untreated, the natural history of steal syndrome can result in chronic limb ischemia, causing gangrene with loss of digits or limbs. Treatment Options Conservative management relies on observation and monitoring, as mild cases of steal syndrome may resolve spontaneously. Inflow stenosis can be treated with endovascular intervention (angioplasty with or without stent) Ligation is the simplest surgical treatment, and it results in loss of the AV access. This is preferred in patients with repetitive failed salvage attempts, venous hypertension, and poor prognoses. Flow limiting procedures can address high volumes through the AV access. Banding can be performed with surgical cutdown and placement of polypropylene sutures or a Dacron patch around the vein or graft. The Minimally Invasive Limited Ligation Endoluminal-Assisted Revision (MILLER) technique employs a percutaneous endoluminal balloon inflated at the AVF to ensure consistency in diameter while banding Plication is when a side-biting running stitch is used to narrow lumen of the vein near the anastomosis. A downside of flow-limiting procedures is that it is often difficult to determine how much to narrow the AV access, as these procedures carry a risk of outflow thrombosis. There are also surgical treatments focused on reroute arterial inflow. The distal revascularization and interval ligation (DRIL) procedure involves creation of a new bypass connecting arterial segments proximal and distal to the AV anastomosis, with ligation of the native artery between the AV anastomosis and the distal anastomosis of the bypass. Reversed saphenous vein with a diameter greater than 3mm is the preferred conduit. Arm vein or prosthetic grafts can be used if needed, but prosthetic material carries higher risk of thrombosis. The new arterial bypass creates a low resistance pathway that increases flow to distal arterial beds, and interval arterial ligation eliminates retrograde flow through the distal artery.  The major risk of this procedure is bypass thrombosis, which results in loss of native arterial flow and hand ischemia. Other drawbacks of DRIL include procedural difficulty with smaller arterial anastomoses, sacrifice of saphenous or arm veins, and decreased fistula flow. Another possible revision surgery is revision using distal inflow (RUDI). This procedure involves ligation of the fistula at the anastomosis and use of a conduit to connect the outflow vein to a distal artery. The selected distal artery can be the proximal radial or ulnar artery, depending on the preoperative duplex. The more dominant vessel should be spared, allowing for distal arterial beds to have uninterrupted antegrade perfusion. The nondominant vessel is used as distal inflow for the AV access. RUDI increases access length and decreases access diameter, resulting in increased resistance and lower flow volume through the fistula. Unlike DRIL, RUDI preserves native arterial flow.  Thrombosis of the conduit would put the fistula at risk, rather than the native artery.  The last surgical revision procedure for steal is proximalization of arterial inflow (PAI). In this procedure, the vein is ligated distal to the original anastomosis site and flow is re-established through the fistula with a PTFE interposition graft anastomosed end-to-side with the more proximal axillary artery and end-to-end with the distal vein. Similar to RUDI, PAI increases the length and decreases the diameter of the outflow conduit. Since the axillary artery has a larger diameter than the brachial artery, there is a less significant pressure drop across the arterial anastomosis site and less steal. PAI allows for preservation of native artery's continuity and does not require vein harvest.  Difficulties with PAI arise when deciding the length of the interposition graft to balance AV flow with distal arterial flow. 2. Ischemic Monomelic Neuropathy Definition Ischemic monomelic neuropathy (IMN) is a rare but serious form of steal that involves nerve ischemia. Severe sensorimotor dysfunction is experienced immediately after AV access creation. Etiology IMN affects blood flow to the nerves, but not the skin or muscles because peripheral nerve fibers are more vulnerable to ischemia. Incidence and Risk Factors IMN is very rare; it has an estimated incidence of 0.1-0.5% of AV access creations.6 IMN has only been reported in brachial artery-based accesses, since the brachial artery is the sole arterial inflow for distal arteries feeding all forearm nerves. IMN is associated with diabetes, peripheral vascular disease, and preexisting peripheral neuropathy that is associated with either of the conditions. Patient Presentation Symptoms usually present rapidly, within minutes to hours after AV access creation. The most common presenting symptom is severe, constant, and deep burning pain of the distal forearm and hand. Patients also report impairment of all sensation, weakness, and hand paralysis. Diagnosis of IMN can be delayed due to misattribution of symptoms to anesthetic blockade, postoperative pain, preexisting neuropathy, a heavily bandaged arm precluding neurologic examination. Treatment Treatment is immediate ligation of the AV access. Delay in treatment will quickly result in permanent sensorimotor loss.   3. Perigraft Seroma Definition A perigraft seroma is a sterile fluid collection surrounding a vascular prosthesis and is enclosed within a pseudomembrane. Etiology and Incidence Possible etiologies include: transudative movement of fluid through the graft material, serous fluid collection from traumatized connective tissues (especially the from higher adipose tissue content in the upper arm), inhibition of fibroblast growth with associated failure of the tissue to incorporate the graft, graft “wetting” or kinking during initial operation, increased flow rates, decreased hematocrit causing oncotic pressure difference, or allergy to graft material. Seromas most commonly form at anastomosis sites in the early postoperative period. Overall seroma incidence rates after AV graft placement range from 1.7–4% and are more common in grafts placed in the upper arm (compared to the forearm) and Dacron grafts (compared to PTFE grafts).7-9 Patient Presentation and Workup Physical exam can show a subcutaneous raised palpable fluid mass Seromas can be seen with ultrasound, but it is difficult to differentiate between the types of fluid around the graft (seroma vs. hematoma vs. abscess) Indications for Treatment Seromas can lead to wound dehiscence, pressure necrosis and erosion through skin, and loss of available puncture area for hemodialysis Persistent seromas can also serve as a nidus for infection. The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines10 recommend a tailored approach to seroma management, with more aggressive surgical interventions being necessary for persistent, infected-appearing, or late-developing seromas.   Treatment The majority of early postoperative seromas are self-limited and tend to resolve on their own Persistent seromas have been treated using a variety of  methods-- incision and evacuation of seroma, complete excision and replacement of the entire graft, and primary bypass of the involved graft segment only. Graft replacement with new material and rerouting through a different tissue plane has a higher reported cure rate and lower rate of infection than aspiration alone.9     4. Infection Incidence and Etiology The reported incidence of infection ranges 4-20% in AVG, which is significantly higher than the rate of infection of 0.56-5% in AVF.11  Infection can occur at the time of access creation (earliest presentation), after cannulation for dialysis (later infection), or secondary to another infectious source. Infection can also further complicate a pre-existing access site issue such as infection of a hematoma, thrombosed pseudoaneurysm, or seroma. Skin flora from frequent dialysis cannulations result in common pathogens being Staphylococcus, Pseudomonas, or polymicrobial species. Staphylococcus and Pseudomonas are highly virulent and likely to cause anastomotic disruption. Patient Presentation and Workup Physical exam will reveal warmth, pain, swelling, erythema, induration, drainage, or pus. Occasionally, patients have nonspecific manifestations of fever or leukocytosis. Ultrasound can be used to screen for and determine the extent of graft involvement by the infection.   Treatments In AV fistulas: Localized infection can usually be managed with broad spectrum antibiotics.  If there are bleeding concerns or infection is seen near the anastomosis site, the fistula should be ligated and re-created in a clean field. In AV grafts: If infection is localized, partial graft excision is acceptable. Total graft excision is recommended if the infection is present throughout the entire graft, involves the anastomoses, occludes the access, or contains particularly virulent organisms Total graft excision may also be indicated if a patient develops recurrent bacteremia with no other infectious source identified. For graft excision, the venous end of the graft is removed and the vein is oversewn or ligated. If the arterial anastomosis is intact, a small cuff of the graft can be left behind and oversewn. If the arterial anastomosis is involved, the arterial wall must be debrided and ligation, reconstruction with autogenous patch angioplasty, or arterial bypass can be pursued. References   1. Morsy AH, Kulbaski M, Chen C, Isiklar H, Lumsden AB. Incidence and Characteristics of Patients with Hand Ischemia after a Hemodialysis Access Procedure. J Surg Res. 1998;74(1):8-10. doi:10.1006/jsre.1997.5206 2. Ballard JL, Bunt TJ, Malone JM. Major complications of angioaccess surgery. Am J Surg. 1992;164(3):229-232. doi:10.1016/S0002-9610(05)81076-1 3. Valentine RJ, Bouch CW, Scott DJ, et al. Do preoperative finger pressures predict early arterial steal in hemodialysis access patients? A prospective analysis. J Vasc Surg. 2002;36(2):351-356. doi:10.1067/mva.2002.125848 4. Malik J, Tuka V, Kasalova Z, et al. Understanding the Dialysis access Steal Syndrome. A Review of the Etiologies, Diagnosis, Prevention and Treatment Strategies. J Vasc Access. 2008;9(3):155-166. doi:10.1177/112972980800900301 5. Sidawy AN, Gray R, Besarab A, et al. Recommended standards for reports dealing with arteriovenous hemodialysis accesses. J Vasc Surg. 2002;35(3):603-610. doi:10.1067/mva.2002.122025 6. Thermann F, Kornhuber M. Ischemic Monomelic Neuropathy: A Rare but Important Complication after Hemodialysis Access Placement - a Review. J Vasc Access. 2011;12(2):113-119. doi:10.5301/JVA.2011.6365 7. Dauria DM, Dyk P, Garvin P. Incidence and Management of Seroma after Arteriovenous Graft Placement. J Am Coll Surg. 2006;203(4):506-511. doi:10.1016/j.jamcollsurg.2006.06.002 8. Gargiulo NJ, Veith FJ, Scher LA, Lipsitz EC, Suggs WD, Benros RM. Experience with covered stents for the management of hemodialysis polytetrafluoroethylene graft seromas. J Vasc Surg. 2008;48(1):216-217. doi:10.1016/j.jvs.2008.01.046 9. Blumenberg RM, Gelfand ML, Dale WA. Perigraft seromas complicating arterial grafts. Surgery. 1985;97(2):194-204. 10. Lok CE, Huber TS, Lee T, et al. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis. 2020;75(4):S1-S164. doi:10.1053/j.ajkd.2019.12.001 11. Padberg FT, Calligaro KD, Sidawy AN. Complications of arteriovenous hemodialysis access: Recognition and management. J Vasc Surg. 2008;48(5):S55-S80. doi:10.1016/j.jvs.2008.08.067

Dr. Clark Fuller talks about the changes in vascular surgery in addition to Brandon Ingram's past surgery.

In this special series, core faculty members of the SVS Leadership Development Program, Dr. Manuel Garcia-Toca, Dr. Kenneth Slaw, and Steve Robischon, discuss the program origins, research regarding good leadership, and how to join.    Manuel Garcia-Toca, MD completed his MD at the Universidad Anahuac in Mexico (1999) and MS in Health Policy at Stanford University (2020). Dr. Garcia-Toca completed his residency in General Surgery at Brown University (2008) and a fellowship in Vascular Surgery at Northwestern University (2010). He will serve within the Department of Surgery in the Division of Vascular Surgery and Endovascular Therapy and the Division of Emory Surgery at Grady based primarily at Grady Memorial Hospital. Kenneth Slaw, PhD is the executive director of the Society for Vascular Surgeons.  Dr. Slaw received his master's and doctoral degrees in educational psychology from the University of Illinois. He has over 35 years of executive leadership experience in the medical society and philanthropic communities, having served in numerous previous roles, including as president of the American Association of Medical Society Executives, as chairman of the board of Make A Wish Illinois, and as senior staff member at the Academy of Pediatrics, where he assisted in efforts with the Pediatric Leadership Alliance Program, which has provided leadership skill building sessions for approximately 3, 000 physicians. Steve Robischon, PA-C is a Physician Assistant with the Division of Vascular and Endovascular Surgery at the Medical College of Wisconsin in Milwaukee, Wisconsin, and is also a member of the PA Section Steering Committee.   More about the SVS PA Section More about the SVS Leadership Program   Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

Want to add a healthy habit to your daily routine that is absolutely free and incredibly effective? Looking to reduce insulin resistance and lose visceral fat? Want to boost mental health and improve cognitive function? Look no further than walking! Tune in to hear us unpack the myriad of research-supported benefits.   In this episode, we discuss the incredible benefits of walking, from lowering blood pressure to improving heart rate variability to reducing stress and so much more. Learn about the magic number when it comes to step count, our thoughts on walking in nature vs. on a treadmill, and get practical tips for getting those steps!    Also in this episode:  Naturally Nourished Teas are buy 3 get 1 FREE, use code FREETEA Gift cards at Naturally Nourished Detox Masterclass 1/8 Keto Masterclass 1/15 Walking Pad C2 use code ALIMILLERRD for savings Health Benefits of Walking Lowers Blood Pressure Hypertension: Brisk walking for 30 minutes, five days a week reduces blood pressure (Hypertension, 2020). Improves Cholesterol Levels Cholesterol: Effects on LDL and HDL cholesterol (Journal of the American Heart Association, 2021). Lipid Profiles: Walking improves triglycerides and HDL (Atherosclerosis, 2021). Reduces the Risk of Coronary Artery Disease Coronary Artery Disease Risk: 150 minutes of walking weekly (Circulation, 2022). Enhances Cardiorespiratory Fitness Reduces Systemic Inflammation Systemic Inflammation: Walking lowers CRP and IL-6 (Arteriosclerosis, Thrombosis, and Vascular Biology, 2020). Systemic Inflammation: Walking reduces inflammatory cytokines (The Journal of Endocrinology, 2022). Helps Maintain Healthy Weight and Prevent Obesity Improves Heart Rate Variability Heart Rate Variability: HRV improvement with regular walking (Heart, 2022). Prevents Peripheral Artery Disease Peripheral Artery Disease: Walking improves circulation and function in PAD patients (Journal of Vascular Surgery, 2021). Reduces Resting Heart Rate Enhances Endothelial Function Supports Recovery After Cardiac Events Improves Insulin Sensitivity Insulin Sensitivity: Improvements with post-meal walks (Diabetes Care, 2021). Enhances Glucose Regulation Boosts Fat Oxidation Fat Oxidation: Brisk walking boosts fat metabolism (Journal of Applied Physiology, 2022). Reduces Visceral Fat Reduction of visceral fat after 10,000 steps/day (Obesity, 2021). Promotes Energy Balance Energy Balance: 12,000 steps/day for maintaining weight (Medicine & Science in Sports & Exercise, 2020). Regulates Hormones Related to Metabolism Increases Mitochondrial Efficiency Improves Metabolic Flexibility Prevents Metabolic Syndrome Helps Manage Type 2 Diabetes Mental health Stress Reduction: Nature walks lower cortisol more than treadmill (Environmental Research, 2022). Stimulates Neurogenesis and Brain Plasticity Brain Connectivity: Walking improves default mode network activity (Journal of Aging Research, 2021). Enhances Neurotransmitter Balance Supports Autonomic Nervous System Regulation Improves Sensory Integration Vestibular Function: Enhancing balance and stability with walking (Frontiers in Neuroscience, 2021). Strengthens Cognitive Function Neurogenesis and Cognitive Function: Exercise-induced brain growth (Nature Neuroscience, 2021). Promotes Myelination and Nerve Health Enhances Emotional Regulation via the Vagus Nerve Reduces Neurological Disease Risk Synchronizes the Nervous System Through Rhythmic Movement Improves Sleep and Circadian Rhythm Bone and Joint Health Immune System Support Longevity and Reduced Mortality Gut Health Gut Health: Positive effects on microbiota diversity (Gut Microbes, 2020). The Science of Step Counts Thoughts on Nature vs. Treadmill Walking Cognitive Benefits: Nature walking improves attention restoration (Nature Neuroscience, 2021). Proprioception: Benefits of uneven terrain in natural settings (Journal of Sports Medicine, 2023). Motivation: Outdoor walkers maintain habits better than treadmill users (Behavioral Medicine, 2022). Immune Boosting: Increased NK cell activity in forest walkers (International Journal of Environmental Health Research, 2021).   Sponsors for this episode:  According to extensive research by the Environmental Working Group, virtually every home in America has harmful contaminants in its tap water. That's why you've got to check out AquaTru. AquaTru purifiers use a 4-stage reverse osmosis purification process, and their countertop purifiers work with NO installation or plumbing. It removes 15x more contaminants than ordinary pitcher filters and are specifically designed to combat chemicals like PFAS in your water supply. Naturally Nourished Podcast listeners can use code ALIMILLERRD at AquaTru.com to save 20% off. 

In this episode of The Life of Flow Podcast, Dr. Eli Lutske takes us on a journey through his career as a vascular surgeon. From starting a vascular program from scratch to navigating the complexities of private practice versus hospital-based employment, Dr. Lutske shares invaluable insights into the medical profession, entrepreneurship, and personal growth. He also opens up about his foray into social media with his popular Instagram account, "Veins and Gains," highlighting how humor and creativity help him connect with others in the field. Whether you're a medical professional, an aspiring entrepreneur, or simply curious about the behind-the-scenes life of a surgeon, this episode is packed with thought-provoking discussion and practical advice. What You'll Learn in This Episode: How Dr. Lutske and his partner started a vascular program from the ground up. The pros and cons of private practice versus hospital-based employment. Why clear partnership paths in private practice contracts are critical for surgeons. Insights into hospital revenue models and surgeon compensation structures. The challenges and rewards of entrepreneurship in the medical field. Dr. Lutske's personal take on evolving medical culture and teamwork in the OR. How Instagram has become a creative outlet and connection tool for surgeons. Notable Quotes: “You can build something incredibly successful by focusing on what you love and letting the system handle the rest.” “If you're not tickled by entrepreneurship, don't go down that path—it's taxing and requires constant attention to detail.” “Social media has been a surprising outlet for connection and creativity in what can otherwise be a very lonely profession.”

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A 67 year old woman with a history of hypertension, hyperlipidemia, diabetes, and a 25 pack year smoking history is referred your clinic and is referred for evaluation of her peripheral arterial disease. She reports pain with walking that has limited her doing some daily activities. How can you optimally manage this patient? Does she need an operation? In this episode, we will cover the basics of peripheral arterial disease, discuss the specifics of optimal medical management and dive into the nuances of when (or if) you should offer these patients an operation.  Hosts:  Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan and the Program Director of the Integrated Vascular Surgery Residency Program as well as the Vascular Surgery Fellowship Program at the University of Michigan. Dr. Drew Braet is a PGY-5 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives - Review the definition, prevalence, and risk factors for peripheral arterial disease - Understand the specifics of optimal medical management of patients with peripheral arterial disease  - Discuss the controversy regarding operative management of patients with claudication and review indications for an operation in patients with peripheral arterial disease - Review the appropriate anti-platelet and anti-coagulation strategies after interventions in patients with peripheral arterial disease References 1.    Woo K, Siracuse JJ, Klingbeil K, Kraiss LW, Osborne NH, Singh N, Tan TW, Arya S, Banerjee S, Bonaca MP, Brothers T, Conte MS, Dawson DL, Erben Y, Lerner BM, Lin JC, Mills JL Sr, Mittleider D, Nair DG, O'Banion LA, Patterson RB, Scheidt MJ, Simons JP; Society for Vascular Surgery Appropriateness Committee. Society for Vascular Surgery appropriate use criteria for management of intermittent claudication. J Vasc Surg. 2022 Jul;76(1):3-22.e1. doi: 10.1016/j.jvs.2022.04.012. Epub 2022 Apr 22. PMID: 35470016. https://pubmed.ncbi.nlm.nih.gov/35470016/ 2.    Nordanstig J, Behrendt CA, Baumgartner I, Belch J, Bäck M, Fitridge R, Hinchliffe R, Lejay A, Mills JL, Rother U, Sigvant B, Spanos K, Szeberin Z, van de Water W; ESVS Guidelines Committee; Antoniou GA, Björck M, Gonçalves FB, Coscas R, Dias NV, Van Herzeele I, Lepidi S, Mees BME, Resch TA, Ricco JB, Trimarchi S, Twine CP, Tulamo R, Wanhainen A; Document Reviewers; Boyle JR, Brodmann M, Dardik A, Dick F, Goëffic Y, Holden A, Kakkos SK, Kolh P, McDermott MM. Editor's Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Claudication. Eur J Vasc Endovasc Surg. 2024 Jan;67(1):9-96. doi: 10.1016/j.ejvs.2023.08.067. Epub 2023 Nov 10. PMID: 37949800. https://pubmed.ncbi.nlm.nih.gov/37949800/ 3.    Gornik HL, Aronow HD, Goodney PP, Arya S, Brewster LP, Byrd L, Chandra V, Drachman DE, Eaves JM, Ehrman JK, Evans JN, Getchius TSD, Gutiérrez JA, Hawkins BM, Hess CN, Ho KJ, Jones WS, Kim ESH, Kinlay S, Kirksey L, Kohlman-Trigoboff D, Long CA, Pollak AW, Sabri SS, Sadwin LB, Secemsky EA, Serhal M, Shishehbor MH, Treat-Jacobson D, Wilkins LR. 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024 Jun 11;149(24):e1313-e1410. doi: 10.1161/CIR.0000000000001251. Epub 2024 May 14. PMID: 38743805. https://pubmed.ncbi.nlm.nih.gov/38743805/ 4.    Belch JJ, Dormandy J; CASPAR Writing Committee; Biasi GM, Cairols M, Diehm C, Eikelboom B, Golledge J, Jawien A, Lepäntalo M, Norgren L, Hiatt WR, Becquemin JP, Bergqvist D, Clement D, Baumgartner I, Minar E, Stonebridge P, Vermassen F, Matyas L, Leizorovicz A. Results of the randomized, placebo-controlled clopidogrel and acetylsalicylic acid in bypass surgery for peripheral arterial disease (CASPAR) trial. J Vasc Surg. 2010 Oct;52(4):825-33, 833.e1-2. doi: 10.1016/j.jvs.2010.04.027. Epub 2010 Aug 1. Erratum in: J Vasc Surg. 2011 Feb;53(2):564. Biasi, B M [corrected to Biasi, G M]. PMID: 20678878. https://pubmed.ncbi.nlm.nih.gov/20678878/ 5.    Eikelboom JW, Connolly SJ, Bosch J, Dagenais GR, Hart RG, Shestakovska O, Diaz R, Alings M, Lonn EM, Anand SS, Widimsky P, Hori M, Avezum A, Piegas LS, Branch KRH, Probstfield J, Bhatt DL, Zhu J, Liang Y, Maggioni AP, Lopez-Jaramillo P, O'Donnell M, Kakkar AK, Fox KAA, Parkhomenko AN, Ertl G, Störk S, Keltai M, Ryden L, Pogosova N, Dans AL, Lanas F, Commerford PJ, Torp-Pedersen C, Guzik TJ, Verhamme PB, Vinereanu D, Kim JH, Tonkin AM, Lewis BS, Felix C, Yusoff K, Steg PG, Metsarinne KP, Cook Bruns N, Misselwitz F, Chen E, Leong D, Yusuf S; COMPASS Investigators. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. N Engl J Med. 2017 Oct 5;377(14):1319-1330. doi: 10.1056/NEJMoa1709118. Epub 2017 Aug 27. PMID: 28844192. https://pubmed.ncbi.nlm.nih.gov/28844192/ 6.    Bonaca MP, Bauersachs RM, Anand SS, Debus ES, Nehler MR, Patel MR, Fanelli F, Capell WH, Diao L, Jaeger N, Hess CN, Pap AF, Kittelson JM, Gudz I, Mátyás L, Krievins DK, Diaz R, Brodmann M, Muehlhofer E, Haskell LP, Berkowitz SD, Hiatt WR. Rivaroxaban in Peripheral Artery Disease after Revascularization. N Engl J Med. 2020 May 21;382(21):1994-2004. doi: 10.1056/NEJMoa2000052. Epub 2020 Mar 28. PMID: 32222135. https://pubmed.ncbi.nlm.nih.gov/32222135/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

In this episode of Audible Bleeding, editor Dr. Imani McElroy (@IEMcElroy) is joined by General Surgery PGY-4 Sasank Kalipatnapu(@ksasank) along with Dr.David Rigberg, MD (@drigberg), and Dr. Guillermo Escobar, MD (@GAEscobarMD) to discuss the Society for Clinical Vascular Surgery (SCVS) Rising Seniors / Incoming Fellows Program. This episode brings out a conversation exploring the history behind the development of the program, the current state of the program, and the overwhelming importance of the program in the current day. The episode also provides a broad overview of the content presented in the program and the reasoning behind the talks.    Guests: Dr. David Rigberg - Professor of Surgery, Division of Vascular and Endovascular Surgery, Gonda Vascular Center, Program Director for the Vascular fellowship and integrated vascular surgery residency at the David Geffen School of Medicine, UCLA, Los Angeles, California Dr. Guillermo Escobar- Associate Professor, Division of Vascular Surgery and Endovascular Therapy, Program Director for the Vascular Surgery Fellowship and Residency at Emory University School of Medicine   Relevant links: Rising Seniors / Incoming Fellows Program - Program Details SCVS - Fellows & Chief Residents Program SCVS - Young Vascular Surgeons Program   To apply for the Rising Seniors / Incoming Fellows Program, go to apply now! Audible Bleeding team: Dr. Imani McElroy is 1st year vascular surgery fellow at USC/LA and editor at Audible Bleeding Dr. Sasank Kalipatnapu, PGY-4 general surgery resident, Dept of Surgery, UMass Chan Medical School, Worcester, MA Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

Many significant medical discoveries were accidents, such as Fleming's discovery of penicillin in 1929. Similarly, in 1958, Dr. Mason Sones from the Cleveland Clinic accidentally injected contrast into a patient's right coronary artery, leading to a cardiac arrest. However, this incident allowed the first detailed visualization of the coronary artery, eventually leading to the development of coronary angiography, which remains the gold standard today. Dr Bleri CELMETA highlight these advancements, and explains the evolutions from open procedures to minimally invasive and robotic techniques.   Dr. Bleri Celmeta is a cardiac surgeon operating on the Minimally Invasive Cardiac Surgery Unit in Galeazzi-Sant'Ambrogio Hospital (Milan, Italy). He graduated in Medicine and Surgery at the University of Padova-Italy in 2014, then completed his residency program in Cardiac Surgery in the same university in 2020. His professional background included also a fellowship in Cardiac and Thoracic Surgery in the University Hospital of Nantes-France (2019-2020).   He is the author of numerous publications and conference presentations with particular interest in minimally invasive cardiac surgery, and review editor of various international Journals (Frontiers in Cardiovascular Medicine, Frontiers in Surgery, Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, Journal of Cardiothoracic Surgery, among others). Dr. Celmeta is a member of the Working Group on Cardiovascular Surgery - European Society of Cardiology (ESC), Italian Cardiac Surgery Society (SICCH) and Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI).  LinkedIn profile: Bleri Celmeta | LinkedIn     About Behind the OR Behind the OR is the official podcast channel by Peters Surgical. Here, we invite you to step into the world of surgery, where we uncover what happens behind the closed doors of the operating room and beyond. Each episode features in-depth conversations with expert surgeons, providing insights into the latest surgical techniques, innovations, and the daily lives of those who dedicate themselves to saving lives. Founded in 1926, Peters Surgical is a French company with a global presence in over 90 countries. As a reference group for surgical practices worldwide, we are dedicated to improving surgical outcomes through innovative medical devices, including surgical sutures, hemostatic clips, and surgical glue. Our expertise lies in designing, manufacturing, and distributing these devices.  Visit our website here : https://peters-surgical.com/

This episode of VHHA's Patients Come First podcast features Bernie Ammons, a nurse and the Clinical Program Coordinator for Vascular Surgery at UVA Health, for a conversation about her work, the importance of heart and vascular screenings, and more. Send questions, comments, feedback, or guest suggestions to pcfpodcast@vhha.com or contact on X (Twitter) or Instagram using the #PatientsComeFirst hashtag.

Contributor: Aaron Lessen MD Educational Pearls: Aortic injury occurs in 1.5-2% of patients who sustain blunt thoracic trauma Majority are caused by automobile collisions or motorcycle accidents Due to sudden deceleration mechanism accidents Clinical manifestations Signs of hypovolemic shock including tachycardia and hypotension, though not always present Patients may have altered mental status Imaging Widened mediastinum on chest x-ray, though not highly sensitive CT is more sensitive and specific, and signs of thoracic injury include an intimal flap, aortic wall outpouching, and aortic contour abnormalities In hemodynamically unstable or otherwise unfit for CT patients, transesophageal echocardiogram may be used Four types of aortic injury (in order of ascending severity) I: Intimal tear or flap II: Intramural hematoma III: Pseudoaneurysm IV: Rupture Management Hemodynamically unstable: immediate OR for exploratory laparotomy and repair Hemodynamically stable: heart rate and blood pressure control with beta-blockers Minor injuries are treated with observation and hemodynamic control Severe injuries may receive surgical management Some patients benefit from delayed repair An endovascular aortic graft is a surgical option Mortality 80-85% of patients die before hospital arrival 50% of patients that make it to the hospital do not survive References Fox N, Schwartz D, Salazar JH, et al. Evaluation and management of blunt traumatic aortic injury: a practice management guideline from the Eastern Association for the Surgery of Trauma [published correction appears in J Trauma Acute Care Surg. 2015 Feb;78(2):447]. J Trauma Acute Care Surg. 2015;78(1):136-146. doi:10.1097/TA.0000000000000470 Lee WA, Matsumura JS, Mitchell RS, et al. Endovascular repair of traumatic thoracic aortic injury: clinical practice guidelines of the Society for Vascular Surgery. J Vasc Surg. 2011;53(1):187-192. doi:10.1016/j.jvs.2010.08.027 Osgood MJ, Heck JM, Rellinger EJ, et al. Natural history of grade I-II blunt traumatic aortic injury. J Vasc Surg. 2014;59(2):334-341. doi:10.1016/j.jvs.2013.09.007 Osman A, Fong CP, Wahab SFA, Panebianco N, Teran F. Transesophageal Echocardiography at the Golden Hour: Identification of Blunt Traumatic Aortic Injuries in the Emergency Department. J Emerg Med. 2020;59(3):418-423. doi:10.1016/j.jemermed.2020.05.003 Steenburg SD, Ravenel JG, Ikonomidis JS, Schönholz C, Reeves S. Acute traumatic aortic injury: imaging evaluation and management. Radiology. 2008;248(3):748-762. doi:10.1148/radiol.2483071416 Summarized by Jorge Chalit, OMS3 | Edited by Meg Joyce & Jorge Chalit Donate: https://emergencymedicalminute.org/donate/  

In this engaging episode of the Life of Flow Podcast, hosts Dr. Lucas Rey and Dr. Miguel Montero-Baker welcome Dr. Jeffrey Dikis, a podiatrist specializing in sports and reconstructive surgery, to explore the intersection of podiatry and vascular surgery. The conversation dives into the practical challenges, collaboration opportunities, and the future of integrated medical care, with a focus on limb salvage, vascular screening, and multidisciplinary patient care models. They also share personal insights from their podcasting journey, including the humorous story of how two vascular surgeons decided to start a podcast over drinks. Resources Mentioned: Amputation Nation Documentary: amputationnation.org SALSA Model: Southern Arizona Limb Salvage Alliance (University of Arizona) Back Table Podcast – A podcast for vascular professionals.

Chief paper discussed: T Parkington, T Maden-Wilkinson, D Broom, S Nawaz... (2023). Low-Intensity Resistance Exercise with Blood Flow Restriction for Patients with Claudication: A Randomised Controlled Feasibility Trial. Vascular Medicine . Position statement on managing PAD: Askew, C. D., Parmenter, B., Leicht, A. S., Walker, P. J., & Golledge, J. (2014). Exercise & Sports Science Australia (ESSA) position statement on exercise prescription for patients with peripheral arterial disease and intermittent claudication. Journal of Science and Medicine in Sport / Sports Medicine Australia, 17(6), 623–629. Additional papers referenced: Bentzen, A., Nisgaard, L. B., Mikkelsen, R. B. L., Høgh, A., Mechlenburg, I., & Jørgensen, S. L. (2023). Blood flow restricted walking in patients suffering from intermittent claudication: a case series feasibility and safety study. Annals of Medicine and Surgery (2012), 85(5), 1430–1435. Saes, G. F., Zerati, A. E., Wolosker, N., Ragazzo, L., Rosoky, R. M. A., Ritti-Dias, R. M., Cucato, G. G., Chehuen, M., Farah, B. Q., & Puech-Leão, P. (2013). Remote ischemic preconditioning in patients with intermittent claudication. Clinics , 68(4), 495–499. Ahmed, K. M., Hernon, S., Mohamed, S., Tubassum, M., Newell, M., & Walsh, S. R. (2018). Remote ischemic preconditioning in the management of intermittent claudication: a pilot randomized controlled trial. Annals of Vascular Surgery. https://doi.org/10.1016/j.avsg.2018.07.046 Podcast w/ Jamie Burr we referenced: https://owensrecoveryscience.com/podcasts/owens-recovery-science-podcast-bfr-ipc-for-performance-rehab-and-health-w-jamie-burr-phd

We welcome Dr. Adriana Laser to answer our listeners' questions about vascular surgery. Ray Graf hosts.

In this episode, Dr. Eric Martin, Chief of Vascular Surgery at OSF Saint Francis Medical Center, discusses groundbreaking advances in limb salvage and regenerative reconstruction. He shares the cutting-edge techniques and technologies that help treat complex vascular diseases, offering life-changing outcomes for patients facing chronic limb-threatening ischemia and severe infections.

Genicular Artery Embolization (GAE) Unlock the Power of Pain-Free Living with Genicular Artery Embolization (GAE) Are you or someone you love struggling with chronic knee pain? Say goodbye to the limitations of knee osteoarthritis and embrace a life of mobility and comfort with Genicular Artery Embolization (GAE)! Why Choose GAE? NonSurgical: GAE is a minimally invasive procedure, meaning no major surgery and no scars. Immediate Relief: Experience significant pain reduction almost immediately after the procedure. Long-Lasting Results: Enjoy durable pain relief that can last for years. Outpatient Procedure: GAE is performed on an outpatient basis, allowing you to return home the same day. Delay or Avoid Surgery: GAE can delay or even eliminate the need for more invasive knee surgeries. Improved Mobility: Regain your ability to move freely and perform daily activities without pain. Personalized Treatment: Tailored to your specific needs, ensuring the best possible outcome. Join Vascular Surgeon, Dr Edward Arous and Biochemist Phil George as they explore this game changing procedure. Join us for an enlightening media presentation where we'll dive deep into the science behind GAE, share patient success stories, and answer all your questions. Don't let knee pain hold you back any longer—discover the transformative benefits of… Meet Dr. Edward J. Arous, a distinguished Boardcertified vascular surgeon with vast experience in endovascular and open surgery. Born in Worcester, MA, he earned his medical degree from the University of Massachusetts Medical School and a master's in public health from Harvard. Dr. Arous served as an Assistant Professor and Director of the Limb Preservation Center at UMass, and has received numerous accolades, including the Alpha OmegaAlpha induction, Darling Award, and Chancellor's Award. He is affiliated with several prestigious societies, including the Society for Vascular Surgery and the New England Society for Vascular Surgery. Join us to learn more about his remarkable journey and expertise. Please feel free to email him at philgeorge@charter.net with any health/nutrition/exercise questions. https://www.wellnesswave.net/

In this episode of Life of Flow, we are honored to welcome Dr. Juan Parodi, the innovator who transformed the field of vascular surgery. Dr. Parodi shares his journey, from the early days of his medical career to the groundbreaking development of endovascular surgery techniques that revolutionized the treatment of aneurysms. With his unique blend of curiosity, innovation, and perseverance, Dr. Parodi discusses the challenges he faced and the incredible successes that followed, including his first successful surgery using a self-designed endoprosthesis. We also delve into his personal philosophy on medical innovation, the transition from scientific to commercial success, and the importance of persistence in achieving breakthroughs. He provides insights into how medical professionals can foster creativity, bring ideas to life, and impact healthcare on a global scale. Whether you're a healthcare professional, a medical student, or someone interested in the intersection of technology and health, this episode is filled with wisdom and inspiration.

Audible Bleeding editor Wen (@WenKawaji) is joined by 1st year vascular surgery fellow Richa Kalsi (@KalsiMD), 3rd year medical student Nishi (@Nishi_Vootukuru), 4th-year general surgery resident Sasank Kalipatnapu (@ksasank) from UMass Chan Medical School, JVS editor Dr. Forbes (@TL_Forbes), JVS-VLD associate editor Dr. Arjun Jayaraj and JVS social media liaison Dr. Haurani to discuss some of our favorite articles in the JVS family of journals.   This episode hosts Dr. Amy Felsted, Dr. Salvatore Scali, and Dr. Arjun Jayaraj, the authors of the following papers. Dr. Arjun Jayaraj and Dr. Haurani will also spend time discussing a virtual special issue, centered around iliofemoral venous stenting published in the Journal of Vascular Surgery, Venous and Lymphatic Disorders that includes six articles published between August 2023 and May 2024.    Articles: Part 1: A patient-centered textbook outcome measure effectively discriminates contemporary elective open abdominal aortic aneurysm repair quality by Dr. Felsted, Dr. Scali and colleagues.    Part 2: Virtual special issues on contemporary role of iliofemoral venous stenting    Show Guests  Dr. Amy Felsted (@aefelsted): Completed fellowship at Dartmouth-Hitchcock, Currently an assistant professor of surgery at Boston University School of Medicine and practicing vascular surgeon at the VA in Boston   Dr. Salvatore Scali: Professor of Surgery at University of Florida Division of Vascular Surgery and Endovascular Therapy, program director of the vascular fellowship at University of Florida.   Dr. Arjun Jayaraj: Vascular surgeon at the RANE Center in Jackson, Mississippi with a focus on the management of venous and lymphatic diseases, Associate Editor of JVS-VL.  Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

In today's episode, supported by AstraZeneca, we had the pleasure of speaking with Sandip P. Patel, MD, and Brendon M. Stiles, MD, about the FDA approval of perioperative durvalumab (Imfinzi) for patients with resectable non–small cell lung cancer (NSCLC). Dr Patel is a professor of medicine in the Department of Medicine at the University of California, San Diego. Dr Stiles is a professor of cardiothoracic surgery and chief of the Divisions of Thoracic Surgery and Surgical Oncology in the Department of Cardiothoracic & Vascular Surgery, as well as the associate director of Surgical Oncology at the Montefiore Einstein Comprehensive Cancer Center in Bronx, New York. On August 15, 2024, the FDA approved durvalumab plus platinum-containing chemotherapy in the neoadjuvant setting, followed by durvalumab monotherapy in the adjuvant setting, for the treatment of adult patients with resectable NSCLC with no known EGFR mutations or ALK rearrangements. This regulatory decision was backed by findings from the phase 3 AEGEAN trial (NCT03800134), in which the median event-free survival was not reached (95% CI, 31.9 months-not estimable [NE]) in patients who received the durvalumab regimen vs 25.9 months (95% CI, 18.9-NE) in those who received placebo plus chemotherapy (stratified HR, 0.68; 95% CI, 0.53-0.88; P = .0039). In our exclusive interview, Drs Patel and Stiles discussed the significance of this approval, key efficacy and safety findings from AEGEAN, and how the clinical use of perioperative treatment regimens reinforces the importance of involving multidisciplinary teams in every step of a patient's treatment plan.

     Join us for an enlightening discussion with Dr. Darrin Clouse, a retired Air Force Colonel and esteemed vascular surgeon, as we explore the modernization of military medicine. With over two decades of experience, including deployments to Iraq and Afghanistan, Dr. Clouse shares his invaluable insights on the complexity and multiplicity of vascular injuries in combat settings. Hear about his role in developing endovascular platforms, and the challenges he faced treating severe blast injuries with extensive vascular damage. Dr. Clouse also highlights the unmet needs in vascular surgery, emphasizing the necessity for infection-resistant conduits and advancements in temporary shunting techniques.    We also delve into Human Acellular Vessels (HAV) 's exciting potential in medical and military applications. Dr. Clouse discusses the successful implementation of HAVs in Ukraine and the upcoming FDA adjudication that could bring these life-saving technologies to trauma centers across the U.S. The conversation extends to the logistical challenges of deploying HAVs in battlefield settings and the future of regenerative medicine. Additionally, discover the significance of the WarDocs and OpMed TV partnership, which aims to document and preserve the rich history of military medicine. Don't miss Dr. Clouse's valuable advice for young individuals considering a career in military medicine, highlighting the unparalleled learning experiences and opportunities for growth in this field.   Chapters: (00:04) Optimizing Military Medicine Through Modernization (11:02) Advances in Military Medicine Technology   Chapter Summaries: (00:04) Optimizing Military Medicine Through Modernization This chapter features a conversation with Dr. Darrin Clouse, a retired Air Force Colonel and vascular surgeon currently leading the Vascular and Endovascular Surgery Division at the University of Virginia Health. We explore his military career, which spanned over two decades and included deployments to Iraq and Afghanistan, where he played a crucial role in developing endovascular platforms and addressing complex vascular injuries. Dr. Clouse contrasts the differences between military and civilian vascular injuries, emphasizing the complexity and multiplicity of wounds in a combat setting. He recounts a particularly challenging case involving a severe blast injury with extensive vascular and hollow viscous damage. Additionally, we discuss unmet needs in vascular surgery, such as the necessity for an off-the-shelf, infection-resistant conduit, highlighting the importance of timely revascularization and advancements in temporary shunting techniques.   (11:02) Advances in Military Medicine Technology This chapter focuses on the current status and future potential of acellular vessels (HAV) in medical and military applications. We explore the promising results from recent uses in Ukraine, where HAVs have been successfully implemented in 18 patients with severe arterial injuries. The discussion touches on the regulatory landscape, highlighting an upcoming FDA adjudication that could make HAVs widely available in trauma centers across the U.S. We also consider the logistical aspects of deploying HAVs in battlefield settings, particularly within different roles of military medical care. The conversation extends to the future of regenerative medicine, envisioning a world where lab-grown vessels can seamlessly replace damaged arteries and veins. Finally, valuable advice is offered for young individuals considering a career in military medicine, emphasizing unparalleled learning experiences and opportunities for growth within the field.     Take Home Messages: Advancements in Battlefield Vascular Surgery: The episode highlights the unique challenges of treating vascular injuries in combat zones, particularly those caused by blasts. Significant progress has been made in developing endovascular platforms and temporary shunting techniques, which are critical for timely revascularization and improving patient outcomes in military settings. Innovative Use of Acellular Vessels: The discussion covers the promising future of human acellular vessels (HAV) in both military and civilian medical applications. These vessels, which are engineered to be infection-resistant and conducive to cell infiltration, have shown positive results in recent uses in Ukraine, with potential for broader application pending FDA approval. Logistical Challenges and Solutions: Deploying advanced medical technologies like HAVs in battlefield scenarios presents logistical hurdles. The episode explores how these technologies could be integrated into different roles of military medical care, emphasizing the need for definitive vascular reconstructions to be performed at more resourced medical facilities. Regenerative Medicine's Potential: The episode envisions a future where lab-grown vessels could seamlessly replace damaged arteries and veins, marking a significant leap in regenerative medicine. The potential for bioengineered veins and arteries could revolutionize vascular surgery and trauma care. Career Insights in Military Medicine: For those considering a career in military medicine, the episode offers invaluable advice on the unique learning opportunities and personal growth it provides. The collaborative efforts and technological advancements discussed highlight the dynamic and impactful nature of this field.   Episode Keywords: Military Medicine, Modernization, Vascular Surgery, Combat Injuries, Endovascular Platforms, Blast Injuries, Infection-Resistant Conduits, Temporary Shunting Techniques, Acellular Vessels, Regenerative Medicine, WarDocs, OpMed TV, Partnership, History, Legacy, Future Generations, Collaborative Project, Learning Experiences, Personal Growth Hashtags: #MilitaryMedicine, #Modernization, #VascularSurgery, #CombatInjuries, #EndovascularPlatforms, #BlastInjuries, #Infection-ResistantConduits, #TemporaryShuntingTechniques, #AcellularVessels, #RegenerativeMedicine, #WarDocs, #OpMedTV, #Partnership, #History, #Legacy, #FutureGenerations, #CollaborativeProject, #LearningExperiences, #PersonalGrowth   Honoring the Legacy and Preserving the History of Military Medicine The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation.   Find out more and join Team WarDocs at https://www.wardocspodcast.com/ Check our list of previous guest episodes at https://www.wardocspodcast.com/our-guests Subscribe and Like our Videos on our YouTube Channel: https://www.youtube.com/@wardocspodcast Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you. WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield,demonstrating dedication to the medical care of fellow comrades in arms.     Follow Us on Social Media Twitter: @wardocspodcast Facebook: WarDocs Podcast Instagram: @wardocspodcast LinkedIn: WarDocs-The Military Medicine Podcast YouTube Channel: https://www.youtube.com/@wardocspodcast

In this episode, Sasank Kalipatnapu (@ksasank) and Leana Dogbe (@ldogbe4) sit down with Dr.Joseph Mills(@jmills1955), Dr. Douglas Jones and Dr. Premchand Gupta (@pcvasc) to discuss the origin of the SVS Step Challenge. This episode features a conversation about the history behind the SVS Step challenge and the role of walking in treating peripheral artery disease (PAD). It also covers the origin of “Walkathon”, the Indian equivalent of SVS Step Challenge.    Dr. Joseph Mills is Professor and Chief of the Division of Vascular Surgery and Endovascular Therapy at Michael E DeBakey Department of Surgery at Baylor College of Medicine in Houston, Texas. He is also the John W. Reid and Josephine L. Reid Endowed Professorship in Surgery and is currently the chair of the SVS Foundation.    Dr. Douglas Jones is an associate professor of Vascular Surgery at UMass Chan Medical School, Worcester, MA. He currently leads the Limb Preservation Center at UMass Memorial Health.    Dr. PC Gupta is the clinical director of vascular and endovascular surgery and vascular interventional radiology at the Care Hospitals in Hyderabad, India. He is President of the Vascular Society of India and now President of the World Federation of Vascular Societies.   Relevant links:    SVS Step Challenge - Home Page - Link to look up the details of the Step Challenge vascular.org/step2024 - Link to sign up for the Step Challenge 2024   Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

In this episode of the Life of Flow podcast, hosts dive deep into the cutting-edge world of limb salvage surgery with Dr. Michael Theodoulou, a podiatrist, Assistant Professor of Surgery at Harvard Medical School, and Chief of Foot and Ankle Surgery at Cambridge Health Alliance. Dr. Theodoulou introduces listeners to an innovative approach called distraction angiogenesis, which is helping patients with severe lower extremity conditions that have left them with "no option" for treatment. Dr. Theodoulou on the Impact of Distraction Angiogenesis:"We've seen significant improvements in blood flow and healing in patients with no other options. The angiogenesis response from controlled fractures can be remarkable." Hosts on the Future of Vascular Surgery:"There's a real intellectual curiosity here, and the results are exciting. Techniques like this could change how we approach limb salvage."

 In this highly engaging episode of The Life of Flow Podcast, two experienced vascular surgeons, Miguel and Lucas, take listeners on an unscripted journey through a challenging case involving a patient with a complex cardiovascular history. They discuss the importance of collaboration among colleagues and highlight their thought processes while troubleshooting difficult cases. The episode touches on decision-making under pressure, clinical improvisation, and the unique challenges of vascular surgery. Expect transparency, candid opinions, and an in-depth look into the realities of medical practice.

Get caught up on the current best practices and guidelines in venous interventions. Dr. Adam Raskin covers this and more, with host Dr. Sabeen Dhand in this discussion of DVT and PE treatments. Dr. Raskin is an interventional cardiologist, medical director of Cardiac ICU, and Co-Director of the PERT program at Mercy Health in Cincinnati, Ohio. --- CHECK OUT OUR SPONSOR Imperative Care https://imperativecare.com/vascular/ --- SYNPOSIS Dr. Raskin shares his comprehensive approach for treating patients with DVT and PE, highlighting recent advancements in thrombectomy systems, as well as underscoring the need for more randomized trials to further build on current venous disease treatment guidelines. The doctors also touch on the significance of accurate diagnostic tools and thorough follow-up to improve patient outcomes. --- TIMESTAMPS 00:00 - Introduction 10:58 - Approaching DVT & PE Patients 19:04 - Thrombectomy Advancements 24:02 - Iliofemoral Interventions & Standard Practices 26:32 - Accessing Tibial Veins & Clearing Clots 38:59 - Follow-Up & Data Collection 41:09 - Future of Venous Interventions --- RESOURCES The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II Endorsed by the Society of Interventional Radiology and the Society for Vascular Medicine: https://www.jvsvenous.org/article/S2213-333X(23)00322-0/fulltext

Dr Adam Power Co-Founder and CEO of Front Line Medical Technologies is a leader in innovative medical devices for trauma and emergency care who is committed to lowering the barriers to bleeding control and resuscitation, having previously worked as a vascular surgeon he quickly realised that there needed to be a better way for haemorrhage control so went on to co-found Front Line Medical Technologies in 2017. In this episode, we delve into the fascinating world of trauma care and the groundbreaking innovations in haemorrhage control, Dr. Powers journey from general surgery to vascular surgery, the importance of preventive medicine alongside the role of new technologies in healthcare and the effect of the pandemic on global healthcare systems. Timestamps: [00:02:38] Quick haemorrhage control techniques. [00:07:00] Gearing up for European CE Mark [00:09:30] From Physician to entrepreneur in med tech. [00:12:51] Shortage of physicians, focus on prevention. [00:15:39] Impact of pandemic on healthcare [00:18:49] Uses for telehealth [00:22:21] Barriers in telehealth Get in touch with Dr Adam Power - https://www.linkedin.com/in/adamhpower/ https://frontlinemedtech.com/ Get in touch with Karandeep Badwal - https://www.linkedin.com/in/karandeepbadwal/ Follow Karandeep on YouTube - https://www.youtube.com/@KarandeepBadwal Subscribe to the Podcast --- Support this podcast: https://podcasters.spotify.com/pod/show/themedtechpodcast/support

In this episode, we discuss the challenges of explanting aortic grafts, the diagnosis and management of infected aortic grafts, as well as tips and tricks for once we're in the operating room.   Interviewers/Editors: Mark Basilious, MD Candidate (@markrbasilious) Eva Urrechaga, MD (@urrechisme) Sharif Ellozy, MD (@SharifEllozy)   Guests: Dr. Francis Caputo (@FrankCaputoMD) is an Associate Professor of Surgery at the Cleveland Clinic Lerner College of Medicine, Vascular Surgery Director of the Aorta Center, and Program Director of the Vascular Surgery Training Programs. His clinical interests include complex open and endovascular repair of thoracic, thoracoabdominal, and abdominal aortic aneurysms, management of thoracic dissection, and endovascular and open repair of failed endograft. Dr. Caputo earned his medical degree from the University of Medicine and Dentistry New Jersey, Newark, NJ, where he also served his surgical residency and two years as a National Institutes of Health research fellow. He completed his fellowship in vascular surgery at Barnes-Jewish Hospital of Washington University, St. Louis, MO and joined the Cleveland Clinic medical staff in 2018.    Dr. Peter Rossi (@peterjrossi) is a Professor of Surgery, Radiology, and Orthopedic Surgery, and Chief of the Division of Vascular and Endovascular Surgery at the Medical College of Wisconsin. His primary research and clinical interests are in complex  “re-do” and revision surgery, including for thoracoabdominal and abdominal aortic aneurysms, carotid artery surgery, and renal and mesenteric arterial disease, as well as vascular reconstruction for complicated soft tissue sarcomas. Dr. Rossi completed medical school at the University of Illinois College of Medicine before completing his general surgery training at the University of Chicago and his vascular surgery training at the Medical College of Wisconsin, where he has been a member of the faculty since 2009.  Dr. Xavier Berard (@XavierBerardMD)  is a French vascular surgeon who has been a Consultant in the Department of Vascular Surgery and Professor of Vascular and Endovascular Surgery in Bordeaux University Hospital in Bordeaux, France since 2010 and a full Professor of Vascular Surgery at the University of Bordeaux since 2016. He has also completed a PhD in Vascular Biomaterials and in 2010 worked as a research fellow at Lausanne University Hospital in Switzerland. He has been board certified by the French College of Vascular and Endovascular Surgeons since 2008 and by the European Society for Vascular and Endovascular Surgery since 2010. He has served as an examiner for the FEBVS exam since 2014 and as a reviewer for the European Journal of Vascular and Endovascular Surgery since 2016. Additionally, he is a member of the ESVS guidelines writing group for vascular graft infection and AAA.  His personal surgical interests include open surgery of (thoraco)abdominal aneurysms, redo aortic surgery, infections in vascular surgery, EVAR explantation, and biomaterials. He works closely with Institut Bergonié Bordeaux Cancer Center for sarcomas. You can see educational videos and learn more about Dr. Xavier Berard here. Helpful links and resources: Video of explantation of infected chimney EVAR with duodenal fistula (courtesy of Dr. Berard) Video of reimplanting the IMA after explanting an infected graft Video of explantation of infected graft with suprarenal fixation Videos of using the syringe technique to remove an aortic stent graft here and here (courtesy of Dr. Berard) References Kim YW. Aortic Endograft Infection: Diagnosis and Management. Vasc Specialist Int. 2023 Sep 21;39:26. doi: 10.5758/vsi.230071. PMID: 37732343; PMCID: PMC10512004. Papas TT. Patient Selection Is Essential for Explantation of Infected Abdominal Aortic Endografts. Angiology. 2023 Nov 23:33197231218622. doi: 10.1177/00033197231218622. Epub ahead of print. PMID: 37995099. Anagnostopoulos A, Mayer F, Ledergerber B, Bergadà-Pijuan J, Husmann L, Mestres CA, Rancic Z, Hasse B; VASGRA Cohort Study. Editor's Choice - Validation of the Management of Aortic Graft Infection Collaboration (MAGIC) Criteria for the Diagnosis of Vascular Graft/Endograft Infection: Results from the Prospective Vascular Graft Cohort Study. Eur J Vasc Endovasc Surg. 2021 Aug;62(2):251-257. doi: 10.1016/j.ejvs.2021.05.010. Epub 2021 Jun 14. PMID: 34140225. Lumsden AB. Explant of the Aortic Endograft: Today's Solutions, Tomorrow's Problems. Methodist Debakey Cardiovasc J. 2023 Mar 7;19(2):38-48. doi: 10.14797/mdcvj.1176. PMID: 36936357; PMCID: PMC10022536. Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.  

Dr. Melina Kibbe, the Dean of the University of Virginia's School of Medicine, is our latest guest for the podcast. She is an active, practicing vascular surgeon who has maintained an independently funded basic science/translational research laboratory since 2003. Her clinical practice is focused on the care of patients with vascular disease. As a surgeon-scientist, she has been performing independent research and mentoring trainees in the conduct of hypothesis-driven research. To date, she has mentored 41 postdoctoral fellows, 9 graduate students, 13 medical students, and 21 undergraduate students in research. She also has had significant experience with clinical research and clinical trials, having served as national PI or site PI of gene-and cell-based therapies for critical limb ischemia and peripheral artery disease. She previously held the Colin G. Thomas Jr. Distinguished Professorship and Chair of the Department of Surgery at UNC School of Medicine. Kibbe is also the editor-in-chief for the journal JAMA Surgery, and past president for the Association for Academic Surgery, Midwestern Vascular Surgical Society, and the Association of VA Surgeons. Eli and Sofia greatly enjoyed their conversation with Dr. Kibbe. She exhibited a strong energy of excitement and enthusiasm throughout the interview, which made for a great episode. We hope you enjoy listening to our conversation!

We are excited to bring back part two of our discussion on Robotic Vascular Surgery. Yasong (@yasongyumd) and Eva (@urrechisme) are joined by Dr. Lumsden and Dr. Bavare from Houston Methodist Hospital Show Guests: Alan Lumsden: Chair of Cardiovascular Surgery at Houston Methodist and DeBakey Heart and Vascular Center Charu Bavare: Vascular Surgeon at Houston Methodist and Debakey Heart and Vascular Center Hosts: Eva Urrechaga - Vascular fellow at University of Pennsylvania Yasong Yu - Vascular fellow at University of Chicago Robotic Vascular Surgery Episode 1 with Dr. Judith Lin and Dr. Petr Stadler Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

How can physicians and industry partners collaborate effectively to enhance patient care? Dr. Adam Tanious, Assistant Professor of Vascular Surgery at the Medical University of South Carolina, joins host Dr. Aaron Fritts to explore strategies for navigating physician-industry relationships. --- SYNPOSIS The doctors share their experiences in partnering with the medical device industry. The conversation covers the benefits of industry partnerships, the challenges of avoiding conflicts of interest, and the critical role of education in preparing new physicians for these interactions. Dr. Tanious also delves into his thought-provoking TED Talk on big business in surgery, and discusses the value of business education for physicians. --- TIMESTAMPS 00:00 - Introduction 02:12 - Medicine and Business 05:01 - Business Knowledge for Physicians 15:05 - Physician-Industry Relationships 27:26 - Industry Relationships in Medical Training 33:08 - Ethical Considerations and Influence in the OR 35:00 - Leveraging Industry Resources for Better Training 43:24 - Future of Medical Technology and Collaboration --- RESOURCES Big Business and Surgery: Who Belongs in Your Operating Room?: https://youtu.be/kksVjF0fI_w?si=LADwqrbXPz3VsFm4 Quantic MBA Program: https://quantic.edu/blog/category/fields-of-study/accounting/ The price of a cup of coffee: https://vascularspecialistonline.com/the-price-of-a-cup-of-coffee/

A 60-ish year-old client with a history of surgery for aortic aneurysm insists—INSISTS—that his 21-year-old massage therapist work with him, in spite of his new onset severe leg pain. What are the practitioner's options in this literally life-or-death scenario? This story, that looks cut-and-dried on the surface, is more complex than it appears. Plus, we get to talk about bulges in the aorta, bleeding ruptures, migrating devices, new surgical innovations, and much much more. Listen in to find out how it all turns out. Resources: Pocket Pathology: https://www.abmp.com/abmp-pocket-pathology-app Ameli, F.M. et al. (1987) ‘Etiology and management of aorto-femoral bypass graft failure', The Journal of Cardiovascular Surgery, 28(6), pp. 695–700. Choi, E. et al. (2021) ‘Risk Factors for Early and Late Iliac Limb Occlusions of Stent Grafts Extending to the External Iliac Artery after Endovascular Abdominal Aneurysm Repair', Annals of Vascular Surgery, 70, pp. 401–410. Available at: https://doi.org/10.1016/j.avsg.2020.06.028. Daye, D. and Walker, T.G. (2018) ‘Complications of endovascular aneurysm repair of the thoracic and abdominal aorta: evaluation and management', Cardiovascular Diagnosis and Therapy, 8(Suppl 1), pp. S138–S156. Available at: https://doi.org/10.21037/cdt.2017.09.17. Endovascular repair of complex aortic aneurysms - Mayo Clinic (no date). Available at: https://www.mayoclinic.org/medical-professionals/cardiovascular-diseases/news/endovascular-repair-of-complex-aortic-aneurysms/mac-20429867 (Accessed: 31 July 2024). Ivancev, K. and Vogelzang, R. (2020) ‘A 35 Year History of Stent Grafting, and How EVAR Conquered the World', European Journal of Vascular and Endovascular Surgery, 59(5), pp. 685–694. Available at: https://doi.org/10.1016/j.ejvs.2020.03.017. Modern History of Aortic Surgery, by Hazim J. Safi, MD | McGovern Medical School (no date). Available at: https://med.uth.edu/cvs/2020/08/25/modern-history-of-aortic-surgery-by-hazim-j-safi-md/ (Accessed: 31 July 2024). Park, K.-M. et al. (2017) ‘Long Term Outcomes of Femorofemoral Crossover Bypass Grafts', Vascular Specialist International, 33(2), pp. 55–58. Available at: https://doi.org/10.5758/vsi.2017.33.2.55. Sponsors: Anatomy Trains: www.anatomytrains.com  MassageBook: www.massagebook.com Elements Massage: www.elementsmassage.com/abmp

 In this episode of the Life of Flow Podcast, our hosts delve into a fascinating vascular case from December 2023. They provide a thorough analysis of the patient's condition, the procedures undertaken, and the challenges faced along the way. This episode also marks the introduction of Dr. Luis Felipe Cabrera to the podcast's scientific editorial board. Join us for an engaging discussion on vascular surgery, patient care, and the intricacies of medical decision-making.

Our Vascular Surgery Oral Board Audio Review includes 72 high-yield scenarios that cover the majority of the VSCORE topics designed for Vascular Surgeons by Vascular Surgeons.   Scenarios are 5 to 7 minutes long and include a variety of tactics and styles. If you are able to achieve this level of performance in your preparation you are sure to pass the oral exam with flying colors. The second part introduces high-yield commentary to each scenario. This commentary includes tips and tricks to help you dominate the most challenging scenarios in addition to practical, easy-to-understand teaching that covers the most confusing topics we face as vascular surgeons. We are confident you will find this unique, dual format approach a highly effective way to prepare for the test. Learn more about the full set of 72 scenarios here: https://app.behindtheknife.org/course-details/vascular-surgery-oral-board-audio-review Our Vascular Surgery Oral Board Book is available on Amazon here: https://www.amazon.com/dp/B0CZ8ZBF83 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  

A 70 year old healthy female is referred to you with a 5.7 cm abdominal aortic aneurysm. As an astute clinician you are aware that current guidelines support surgical repair for her AAA. What if there was new data to suggest this patient may not benefit from repair? What would be the optimal size threshold that she would benefit from AAA repair? Tune into this episode of Behind the Knife, where the vascular surgery subspecialty team discusses a paper that challenges current size threshold guidelines for AAA repair.  Hosts:  Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan and the Program Director of the Integrated Vascular Surgery Residency Program as well as the Vascular Surgery Fellowship Program at the University of Michigan. Dr. Frank Davis is an Assistant Professor of Vascular Surgery at the University of Michigan Dr. Drew Braet is a PGY-5 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives - Review the current size threshold guidelines for surgical repair of abdominal aortic aneurysms - Understand the limitations of the aforementioned guidelines - Understand the methodology, findings, limitations, and clinical applications of the manuscript “Size thresholds for repair of abdominal aortic aneurysms warrant reconsideration.” References 1.    Columbo JA, Scali ST, Jacobs BN, et al. Size thresholds for repair of abdominal aortic aneurysms warrant reconsideration. Journal of Vascular Surgery. 2024;79(5):1069-1078.e8. doi:10.1016/j.jvs.2024.01.017 https://pubmed.ncbi.nlm.nih.gov/38262565/ 2.    Chaikof EL, Dalman RL, Eskandari MK, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. Journal of Vascular Surgery. 2018;67(1):2-77.e2. doi:10.1016/j.jvs.2017.10.044 https://pubmed.ncbi.nlm.nih.gov/29268916/ 3.    Wanhainen A, Van Herzeele I, Bastos Goncalves F, et al. Editor's Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms. European Journal of Vascular and Endovascular Surgery. 2024;67(2):192-331. doi:10.1016/j.ejvs.2023.11.002 https://pubmed.ncbi.nlm.nih.gov/38307694/ 4.    The UK Small Aneurysm Trial Participants, Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms.  Lancet 1998;352 (9141) 1649- 1655 https://pubmed.ncbi.nlm.nih.gov/9853436/ 5.    Lederle  FAWilson  SEJohnson  GR  et al. Aneurysm Detection and Management Veterans Affairs Cooperative Study Group, Immediate repair compared with surveillance of small abdominal aortic aneurysms.  N Engl J Med 2002;346 (19) 1437- 1444 https://pubmed.ncbi.nlm.nih.gov/12000813/ 6.    United Kingdom EVAR Trial Investigators; Greenhalgh RM, Brown LC, Powell JT, Thompson SG, Epstein D. Endovascular repair of aortic aneurysm in patients physically ineligible for open repair. N Engl J Med. 2010 May 20;362(20):1872-80. doi: 10.1056/NEJMoa0911056. Epub 2010 Apr 11. PMID: 20382982. https://pubmed.ncbi.nlm.nih.gov/20382982/ 7.    Lederle FA, Johnson GR, Wilson SE, Ballard DJ, Jordan WD Jr, Blebea J, Littooy FN, Freischlag JA, Bandyk D, Rapp JH, Salam AA; Veterans Affairs Cooperative Study #417 Investigators. Rupture rate of large abdominal aortic aneurysms in patients refusing or unfit for elective repair. JAMA. 2002 Jun 12;287(22):2968-72. doi: 10.1001/jama.287.22.2968. PMID: 12052126. 8.    Lancaster EM, Gologorsky R, Hull MM, Okuhn S, Solomon MD, Avins AL, Adams JL, Chang RW. The natural history of large abdominal aortic aneurysms in patients without timely repair. J Vasc Surg. 2022 Jan;75(1):109-117. doi: 10.1016/j.jvs.2021.07.125. Epub 2021 Jul 26. PMID: 34324972. https://pubmed.ncbi.nlm.nih.gov/34324972/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

The American Board of Surgery In-Training Examination will officially be switching from reporting percentile scores by year level to percent of questions correct. What does this change mean for residents? Podcast hosts Dr. Ananya Anand, Dr. Joe L'Huillier, and Dr. Rebecca Moreci are joined by three fellow CoSEF members for this discussion: Dr. Gus Godley, Dr. Colleen McDermott, and Dr. Josh Roshal.  Hosts: –Dr. Ananya Anand, Stanford University, @AnanyaAnandMD, ananya_anand@stanford.edu –Dr. Joseph L'Huillier, University at Buffalo, @JoeLHuillier101, josephlh@buffalo.edu –Dr. Rebecca Moreci, Louisiana State University, @md_moreci, morecir@med.umich.edu –COSEF: @surgedfellows Special guests:  -Dr. Gus Godley, University of Chicago, frederick.godley@uchicagomedicine.org, @GusGodley -Dr. Colleen McDermott, University of Utah, colleen.mcdermott@hsc.utah.edu -Dr. Josh Roshal, Brigham and Women's Hospital, jaroshal@utmb.edu, @Joshua_Roshal Learning Objectives:  Listeners will:  – Understand the changes to the ABSITE score reporting by the American Board of Surgery  – Describe both positive impacts and limitations of this change from the resident perspective – List possible ideas for further refinements to standardized exams in medicine   References:  -Yeo HL, Dolan PT, Mao J, Sosa JA. Association of Demographic and Program Factors With American Board of Surgery Qualifying and Certifying Examinations Pass Rates. JAMA Surg. Jan 1 2020;155(1):22-30. doi:10.1001/jamasurg.2019.4081 https://pubmed.ncbi.nlm.nih.gov/31617872/ -Sathe TS, Wang JJ, Yap A, Zhao NW, O'Sullivan P, Alseidi A. Proposed Reforms to the American Board of Surgery In-Training Examination (ABSITE). https://www.ideasurg.pub/proposed-absite-reforms/ -Miller AT, Swain GW, Midmar M, Divino CM. How Important Are American Board of Surgery In-Training Examination Scores When Applying for Fellowships? J Surg Educ. 2010;67(3):149-151. doi:10.1016/j.jsurg.2010.02.007  https://pubmed.ncbi.nlm.nih.gov/20630424/ -Savoie KB, Kulaylat AN, Huntington JT, Kelley-Quon L, Gonzalez DO, Richards H, Besner G, Nwomeh BC, Fisher JG. The pediatric surgery match by the numbers: Defining the successful application. J Pediatr Surg. 2020;55(6):1053-1057. doi:10.1016/j.jpedsurg.2020.02.052 https://pubmed.ncbi.nlm.nih.gov/32197826/ -Alnahhal KI, Lyden SP, Caputo FJ, Sorour AA, Rowe VL, Colglazier JJ, Smith BK, Shames ML, Kirksey L. The USMLE® STEP 1 Pass or Fail Era of the Vascular Surgery Residency Application Process: Implications for Structural Bias and Recommendations. Annals of Vascular Surgery. 2023;94:195-204. doi:10.1016/j.avsg.2023.04.018  https://pubmed.ncbi.nlm.nih.gov/37120072/ -Williams M, Kim EJ, Pappas K, Uwemedimo O, Marrast L, Pekmezaris R, Martinez J. The impact of United States Medical Licensing Exam (USMLE) step 1 cutoff scores on recruitment of underrepresented minorities in medicine: A retrospective cross‐sectional study. Health Sci Rep. 2020;3(2):e2161. doi:10.1002/hsr2.161 https://pubmed.ncbi.nlm.nih.gov/32318628/ -Lucey CR, Saguil A. The Consequences of Structural Racism on MCAT Scores and Medical School Admissions: The Past Is Prologue. Academic Medicine. 2020;95(3):351. doi:10.1097/ACM.0000000000002939 https://pubmed.ncbi.nlm.nih.gov/31425184/ -Natanson H, Svrluga S. The SAT is coming back at some colleges. It's stressing everyone out. Washington Post. https://www.washingtonpost.com/education/2024/03/18/sat-test-policies-confuse-students/. Published March 19, 2024. Accessed April 5, 2024. -de Virgilio C, Yaghoubian A, Kaji A, Collins JC, Deveney K, Dolich M, Easter D, Hines OJ, Katz S, Liu T, Mahmoud A, Melcher ML, Parks S, Reeves M, Salim A, Scherer L, Takanishi D, Waxman K.. Predicting Performance on the American Board of Surgery Qualifying and Certifying Examinations: A Multi-institutional Study. Archives of Surgery. 2010;145(9):852-856. doi:10.1001/archsurg.2010.177 https://pubmed.ncbi.nlm.nih.gov/20855755/ -Weighted test content from the ABS:  https://www.absurgery.org/wp-content/uploads/2023/01/GS-ITE.pdf -USMLE program announces upcoming policy changes | USMLE. Accessed April 9, 2024. https://www.usmle.org/usmle-program-announces-upcoming-policy-changes   Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

In this episode of Behind the Knife the vascular surgery subspecialty team discusses a few case scenarios of patients with dialysis associated hand ischemia (or steal syndrome). Although a rare, steal syndrome can be detrimental to patients with end stage renal disease and result in not only risk of losing dialysis access but even their limb.  What options do you have to fix this problem? In this episode, we will cover the who is at risk of this, and what options you have to fix it. Hosts:  Dr. Bobby Beaulieu is an Assistant Professor of Vascular Surgery at the University of Michigan and the Program Director of the Integrated Vascular Surgery Residency Program as well as the Vascular Surgery Fellowship Program at the University of Michigan. Dr. David Schectman is a Vascular Surgery Fellow at the University of Michigan Dr. Drew Braet is a PGY-4 Integrated Vascular Surgery Resident at the University of Michigan Learning Objectives - Review high-yield topics regarding hemodialysis access - Understand the incidence of and the relevant risk factors for dialysis associated steal syndrome - Review the spectrum of presenting symptoms and relevant workup for dialysis associated steal syndrome - Understand surgical treatment options for dialysis associated steal syndrome References Please review the journal article below for helpful pictures and depictions of the operations we describe in this episode. - Al Shakarchi J, et al. Surgical techniques for haemodialysis access-induced distal ischaemia. J Vasc Access. 2016 Jan-Feb;17(1):40-6. https://pubmed.ncbi.nlm.nih.gov/26349875/ Other helpful references - Kordzadeh A, Parsa AD. A Systematic review of distal revascularization and interval ligation for the treatment of vascular access-induced ischemia. J Vasc Surg 2019; 70:1364. https://pubmed.ncbi.nlm.nih.gov/31153703/ - Huber TS, Larive B, Imprey PB, et al. Access-related hand ischemia and the Hemodialysis Fistula Maturation Study. J Vasc Surg 2016;64:1050. https://pubmed.ncbi.nlm.nih.gov/27478007/ - Sidawy An, Spergel LM, Besarab A, et al. The Society for Vascular Surgery: clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access. J Vasc Surg 2008; 48:2S. https://pubmed.ncbi.nlm.nih.gov/19000589/ ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9*** Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen