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In this episode, we spotlight editorials and abstracts from the Journal of Vascular Surgery Cases, Innovations, and Techniques (JVS-CIT). Editorials and Abstracts are read by Authors as well as members of the SVS Social Media Ambassadors.
Guests:
Isabel Banks, MS4, SLU
Best of 2025 - rare, high-risk, and unforgettable vascular cases
Best of 2025: Venous disease
Hemodynamic and patient-level considerations in inferior mesenteric artery aneurysm management
Reply
Ultra-distal bypass remains a valuable option for tibial disease with tissue loss
Stewart Treves syndrome as a catastrophic sequela of chronic lymphedema: Clinical spectrum, management challenges, and outcomes
The best of 2025 - peripheral and splanchnic aneurysms and mesenteric vascular disease
Hosts:
John Culhane (@JohnCulhaneMD)
Follow us @audiblebleeding, @JVS-CIT
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
*Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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CORE RESOURCES:
Rutherford's Vascular and Endovascular Therapy 10th Edition, Chapters 88, 89, 91, and 94
Atlas of Vascular Surgery and Endovascular Therapy 2nd Edition, Chapter 9
ADDITIONAL RESOURCES:
Audible Bleeding Episodes
Holding Pressure - Carotid Endarterectomy: https://www.audiblebleeding.com/2024/02/27/holding-pressure-carotid-endarterectomy/
Holding Pressure Case Prep - Endovascular Basics: https://www.audiblebleeding.com/2023/04/23/holding-pressure-case-prep-endovascular-basics/
Videos
TCAR Technical Video: https://jnis.bmj.com/content/14/8/842
Articles
Society for Vascular Surgery clinical practice guidelines for management of extracranial cerebrovascular disease: https://www.jvascsurg.org/article/S0741-5214%2821%2900893-4/fulltext
Technical aspects of transcarotid artery revascularization using the ENROUTE transcarotid neuroprotection and stent system: https://www.jvascsurg.org/action/showPdf?pii=S0741-5214%2816%2931862-6
Referenced Studies
ROADSTER-1
https://pubmed.ncbi.nlm.nih.gov/30611582/
ROADSTER-2
https://pubmed.ncbi.nlm.nih.gov/32811386/
https://pubmed.ncbi.nlm.nih.gov/35381327/
TCAR Surveillance Project
https://jamanetwork.com/journals/jama/fullarticle/2757579?utm_source=openevidence&utm_medium=referral
https://pubmed.ncbi.nlm.nih.gov/36172943/
OUTLINE:
CAROTID ARTERY DISEASE
1. Pathophysiology/etiology
Carotid artery disease is primarily driven by atherosclerotic plaque deposition.
Risk factors: hypertension, hyperlipidemia, diabetes, smoking, and advanced age.
Nonatherosclerotic etiologies: fibromuscular dysplasia, carotid dissection, vasculitic disease, carotid webs, and trauma.
When the endothelium is damaged, monocytes migrate to the site and differentiate into macrophages that take up oxidized LDL particles to become foam cells. Meanwhile, an inflammatory response occurs where activated platelets release thromboxane A2, platelet derived growth factor, and inflammatory cytokines that promote further platelet aggregation and vascular inflammation. Smooth muscle cells migrate and proliferate, forming the structural framework of the atheroma.
Within the lesion, necrotic debris and lipid accumulate, creating a vulnerable plaque. Plaque rupture exposes this material to the bloodstream, serving as a nidus for thrombus formation which can lead to ischemic events.
Carotid bifurcation is particularly prone to plaque formation due to turbulent blood flow. Embolization of plaque from this area can result in TIA or ischemic stroke.
2. Presentation
Patients are often asymptomatic and stenosis is incidentally found on imaging.
Symptomatic patients present with neurologic symptoms including unilateral motor and sensory loss, aphasia (difficulty finding words), dysarthria (difficulty speaking), amaurosis fugax (temporary monocular vision loss due to embolus to the ophthalmic artery), transient ischemic attacks
Physical exam findings may be notable for auscultation of a carotid bruit. Patients may also have evidence of retinal artery embolization on fundoscopic examination (Hollenhorst plaque) or asymptomatic cerebral infarction.
3. Diagnosis
USPTF recommends against screening for asymptomatic carotid artery stenosis.
In patients with no risk factors, SVS recommends against screening for asymptomatic carotid artery stenosis. However, they do recommend screening for asymptomatic clinically significant carotid bifurcation in certain groups of patients with multiple risk factors.
These risk factors include patients with clinically significant peripheral vascular disease, patients 65 and older with history of CAD, smoking, hypercholesterolemia, and patients prior to coronary artery bypass.
Relevant findings on physical exam or imaging findings may warrant screening, but screening is not recommended for the presence of neck bruit alone without other risk factors, as this finding has a low sensitivity and specificity for detecting clinically significant carotid artery stenosis.
Carotid duplex ultrasound: first-line imaging modality for both screening and initial evaluation of stenosis, noninvasive, low-cost
CTA: rapid, high-resolution, three-dimensional imaging of vascular anatomy, risk of contrast and radiation exposure
MRA: high-quality, three-dimensional imaging without radiation or contrast, expensive with longer acquisition time, can overestimate stenosis in severe disease
DSA/angiography: gold standard, expensive, invasive, not generally recommended for routine diagnostic evaluation or screening
4. Classification
Carotid artery stenosis is classified by degree of luminal narrowing.
NASCET method: standard in current practice. Compares the minimal residual lumen at the point of greatest stenosis to the diameter of the normal distal internal carotid artery.
Classification of stenosis:
Mild: 70 bpm, and ACT >250 seconds to optimize cerebral perfusion and minimize thrombotic risk.
Clamp the carotid artery just proximal to the arterial sheath to establish active flow reversal.
Flow controller settings:
Low setting
High setting
Flow-stop button: allows for temporary cessation of flow (used when we inject contrast).
Confirm flow reversal via two different ways:
The first way is to stop flow to the venous return sheath with the stopcock, clearing the line with hep saline injection, and then opening the stopcock and seeing the blood returning to the controller in a reverse fashion.
The second way is to perform an angiogram with a small amount of contrast injection while holding the flow-stop button. Using the angio we want to make sure that contrast is flowing retrograde in the cervical ICA thereby confirming flow reversal.
Carotid artery stenting, balloon angioplasty, and completion angiogram
At this point, a standard carotid angioplasty and stenting procedure is performed.
ENROUTE transcarotid Neuroprotection System device:
inner diameter of 8F and an outer diameter of 10F
Has its own carotid artery stent system but is also compatible with all FDA-approved carotid stents.
Final angiogram is performed to confirm stent position, vessel patency, and absence of complications including vasospasm at the distal end of the stent and filling defects from protrusion of atheromatous material through the stent
Cessation of flow reversal and sheath removal
Allow the flow reversal to run for a few minutes after the final balloon angioplasty to clear any debris.
Antegrade flow is restored by releasing the carotid clamp and closing the stopcocks on the neuroprotection system.
The patient is auto-transfused the blood from the flow line back to the venous system.
As the arterial access system is removed and the puncture site is closed with the U-stitch.
IV protamine is administered to reverse the heparin.
Standard closure is performed at the incision site. Meanwhile, hemostasis is achieved after removal of the femoral vein sheath with brief manual compression.
Postop care/complications
Postop care
All patients after a TCAR should be monitored in the ICU setting for 24 hours, as an embolic stroke, hypotension with or without bradycardia, or hypertension can occur.
Should a TIA or stroke be observed, a carotid duplex scan and CT angiogram should be immediately obtained to assess the stent site and the presence of an embolic or thrombotic filling defect, dissection, or occlusion.
Dual antiplatelet therapy: continue for 45 days to 12 months
Aspirin and statin therapy: continued indefinitely
Surveillance duplex imaging: 4 weeks, 6 months, and 12 months, and annually thereafter.
Postop complications
Hematoma
Stroke
Myocardial infarction
Cerebral hyperperfusion syndrome
Sudden and excessive increase in cerebral blood flow to previously hypoperfused brain tissue is met with vasculature that cannot constrict appropriately from chronic vasodilation
Leads to breakthrough hyperperfusion. This results in cerebral edema, intracerebral hemorrhage, and neurological symptoms.
Cranial nerve injury
Hypoglossal nerve (CN XII) injury: ipsilateral tongue deviation. It is the most commonly injured cranial nerve.
Vagus nerve (CN X) injury: hoarseness and possible vocal cord paralysis.
Glossopharyngeal nerve (CN IX) injury: soft palate dysfunction.
Recurrent laryngeal nerve injury: voice hoarseness and inability to cough as it innervates all of the voice box muscles except for the cricothyroid muscle
Marginal mandibular nerve injury: ipsilateral lip droop, injury is rare in TCAR.
Stent restenosis
Pseudoaneurysm
Access site infection
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Saknas det avsnitt?
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Welcome back to the Audible Bleeding series: Landmark Papers in Vascular Surgery. In this episode, co-hosts John and Dr. Jesse Columbo are joined by our guest, Dr. Caitlin Hicks, to discuss one of the most studied—and most debated—topics in vascular surgery: asymptomatic carotid stenosis.
In this episode, we'll trace that evolution through three pivotal trials: ACAS and ACST-1, which established carotid endarterectomy as the standard of care; and the newly published CREST-2, which challenges us to reconsider everything we thought we knew. Along the way, we'll explore how advances in statin therapy, blood pressure control, and antiplatelet agents have fundamentally changed the natural history of this disease—and what that means for our patients today."
Links to Landmark Papers:
(ACAS) Endarterectomy for Asymptomatic Carotid Artery Stenosis
(ACST-1) 10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis: a multicentre randomised trial
(CREST-2) Medical Management and Revascularization for Asymptomatic Carotid Stenosis
Guests:
Dr. Caitlin Hicks, MD (@CaitlinWHicks); Associate Fellowship Program Director, Vascular Surgery & Endovascular Therapy at Johns Hopkins and Director of Research
Hosts:
John Culhane, MD (@JohnCulhaneMD); General Surgery Resident, Abrazo Health
Dr. Jesse Columbo, MD; Assistant Professor of The Dartmouth Institute, Geisel School of Medicine, Dartmouth
Follow us @audiblebleeding,
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
*Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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Audible Bleeding editors Falen Demsas, an integrated vascular surgery resident at Massachusetts General Hospital, and Sasank Kalipatnapu (@ksasank), a fifth-year general surgery resident at UMass Chan Medical School, are joined by Megan Tracci (@MeganTracci), James Black (@JamesHBlackMD), and Lauren West-Livingston (LWestLivingston) for a discussion following the inaugural SVS Leadership and Advocacy Summit.
In this episode, the group reflects on the importance of surgeon advocacy, highlights key takeaways from the Summit, and discusses how vascular surgeons throughout training and practice can engage in policy, leadership, and organized medicine at local and national levels. The conversation explores the evolving role of advocacy within the Society for Vascular Surgery, including the work of the SVS Advocacy Council and its collaboration across Government Relations, Coding, VA advocacy, and quality and policy initiatives.
Dr. Tracci shares insights from her leadership roles within SVS advocacy efforts and her work as ACS Medical Director for Surgeon Engagement. Dr. Black discusses his longstanding advocacy work on behalf of patients and physicians, including numerous trips to Capitol Hill over the course of his career. Dr. West-Livingston reflects on her experience attending the recent Advocacy & Leadership Conference as a trainee and the importance of resident involvement in advocacy work.
Show Guests Megan Tracci
Leader within the SVS Advocacy Council, which includes Government Relations, Coding, VA advocacy, and quality and policy collaboration efforts. She also serves as the ACS Medical Director for Surgeon Engagement. James Black
Chief of Vascular Surgery and Endovascular Therapy at Johns Hopkins University and longtime advocate who has made countless trips to Capitol Hill to advocate for patients and physicians. Lauren West-Livingston
Integrated vascular surgery resident at Duke University and member of the SVS Government Relations Committee who attended the recent Advocacy & Leadership Conference. Notable Mentions The inaugural SVS Leadership and Advocacy Summit Advocacy efforts within the Society for Vascular Surgery, including Government Relations, Coding, VA advocacy, and quality and policy collaboration. Learn more here SVS Advocacy Council Opportunities for vascular surgeons to engage in advocacy throughout all stages of training and practice. Sign up for updatesFollow us @audiblebleeding
Learn more about us at Audible Bleeding and provide us with your feedback through our listener survey.
Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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Audible Bleeding editor Wen (@WenKawaji) discusses international vascular surgery fellowships with Dr. Judith Lin (@JudithLin4), Dr. Adam Johnson, and Dr. Robbie Aru (@AruRobbie). Together, they reflect on what drove them abroad, what the experience actually looked like on the ground, and the professional, financial, and personal challenges that came with it. Whether you're a resident exploring your options or simply curious about roads less traveled in surgical training, this conversation offers a candid and practical look at what international fellowships in vascular surgery really entail. A must-listen for anyone considering fellowship training outside the U.S.
Articles:
A contemporary guide to an international aortic super-fellowship for surgical trainees and surgeons in the United States
Show Guests
Dr. Judith Lin: professor and chief of vascular surgery in the Department of Surgery at Michigan State University's College of Human Medicine
Dr. Adam Johnson: assistant professor of surgery and assistant professor in population health science at Duke university school of medicine
Dr. Robbie Aru: assistant professor of surgery at Thomas Jefferson university medical college
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
*Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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In this episode, we spotlight editorials and abstracts from the Journal of Vascular Surgery Cases, Innovations, and Techniques (JVS-CIT). Editorials and Abstracts are read by Authors as well as members of the SVS Social Media Ambassadors.
Guests:
Isabel Banks, MS4, SLU
Selected publications regarding lower extremity chronic ischemia and the diabetic foot from the Journal of Vascular Surgery: Cases and Innovative Reports 2025, Volume 11 Best of 2025—abdominal aortic and iliac aneurysm Double anonymous peer review in JVSCIT—lessons from our pilot trial and next steps Endovascular stapling with Aortoseal as an adjunct for the hostile neck The transcaval approach may be the new route vascular surgeons need in their arsenal Intraoperative positioning system-guided antegrade in situ laser fenestration in an aortic model Single-center experience using Endologix anatomically fixated endograft device for treatment of aortoiliac occlusive disease Short-term analysis of botulinum toxin A for functional popliteal artery entrapment syndrome Comparing neurological complications between endovascular and open surgical repair of the descending thoracic aortaHosts:
John Culhane (@JohnCulhaneMD)
Follow us @audiblebleeding, @JVS-CIT
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
*Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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Audible Bleeding editor Wen Kawaji (@WenKawaji) is joined by integrated vascular surgery resident Falen Demsas, 5th-year general surgery resident Sasank Kalipatnapu (@ksasank), JVS editor Dr. Duncan (@ADuncanVasc), and JVS-VL editor Dr. Ruth Bush to discuss some of our favorite articles in the JVS family of journals. This episode hosts Dr. Weaver, student doctor Finn, Dr. Sridharan, and Dr. Anan.
Articles:
Evaluating the Vascular Quality Initiative's role in advancing minority health and health disparities research―a scoping review
Catheter-directed interventions versus surgical embolectomy in massive pulmonary embolism
Show Guests
Dr. Weaver: assistant professor of surgery and associate program director of the vascular surgery fellowship at the University of Utah. She is also the director of clinical operations efficiency at the University of Utah.
Finn Repella: rising 4th medical student at the University of Virginia
Dr. Sridharan: associate professor at the University of Pittsburgh Medical Center (UPMC). Site Chief of vascular surgery at UPMC Mercy.
Dr. Anan: research fellow in the division of vascular surgery at the University of Pittsburgh Medical Center (UPMC). She earned her MD from the American University of Beirut.
Notable mentions:
From Bench to Bill: How a Transplant Nuance Became 1 of Only 57 Laws Passed in 2013
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
*Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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Audible Bleeding Editor and vascular surgery fellow Richa Kalsi (@KalsiMD) is joined by 5th year general surgery resident Amol Kamat, JVS editor Dr. Audra Duncan (@ADuncanVasc), and JVS-VS editor Dr. John Curci (@CurciAAA) to discuss two great articles in the JVS family of journals. This episode hosts medical student Neha Shetty (LinkedIn), Dr. Katherine Reitz (@MollReitz), Dr. Yasir Alsiraj, and Dr. Linda Cassis.
Articles:
Part 1: Prioritizing high-volume repair hospitals with ruptured abdominal aortic aneurysms, for rural and nonrural patients (Shetty & Reitz) Part 2: Role of adipocyte angiotensinogen or angiotensin type 1a receptors in the development of diet-induced atherosclerosis or angiotensin II-induced abdominal aortic aneurysms (Alsiraj & Cassis)Show Guests
Neha Shetty is currently a medical student within the University of Pittsburgh School of Medicine's Class of 2027 Dr. Katherine Reitz is an Associate Professor of Surgery at the University of Pittsburgh School of Medicine. Dr. Yasir Alsiraj is an Assistant Professor of Pharmacology and Nutritional Sciences, Pediatrics, at the Saha Aortic Center at the University of Kentucky. Dr. Cassis is the Vice President of Research at the University of Kentucky College of Medicine.Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
*Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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Jacob Soucy (@JacobWSoucy) hosts an inside look at a timely and thought-provoking editorial published in The Vascular Specialist, the official news magazine of the Society for Vascular Surgery.
In this episode, we explore the evolving conversation around surgical call and compensation through the lens of the editorial "A Call for Call Pay." The discussion challenges the traditional framing of call as simply part of the job and instead examines it as a measurable burden of availability that carries legal, financial, and personal implications. This conversation highlights why the valuation of call may represent one of the defining structural issues in modern vascular surgery practice.
Jacob speaks with Dr. Malachi G. Sheahan III about the motivation behind the piece, how hospital systems value call, what the true cost of call coverage is, and what the future may hold if the current model remains unchanged.
Show Guest
Dr. Malachi G. Sheahan III is Professor and Chair of Surgery at Louisiana State University Health Sciences Center and Chief of the Division of Vascular Surgery. He previously served as Program Director for both the fellowship and integrated residency in vascular surgery at LSU. Nationally, Dr. Sheahan serves as Secretary of the Society for Vascular Surgery and as Chief Medical Editor of The Vascular Specialist. With more than two decades in academic surgery, he is a recognized leader in vascular education, workforce policy, and advocacy within the specialty.
Resources and Social Media
X (Twitter): @lsuvascular
Read the editorial: "A Call for Call Pay" – The Vascular Specialist
Special thanks to Dr. Malachi G. Sheahan III for sharing his time and insight and for his ongoing contributions to vascular surgery.
Follow us @audiblebleeding for updates on upcoming episodes and new research features. Learn more about us at audiblebleeding/about and share your feedback through our listener survey.
*Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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Audible Bleeding editor Wen Kawaji (@WenKawaji) and 5th-year general surgery resident Sasank Kalipatnapu (@ksasank) from UMass Chan Medical School host SVS QPMC leadership Dr. Shutze, Dr. Hicks and Carrie McGraw to take a deep dive into the Vascular Surgery–specific Merit Based Incentive Payment System Value Pathway or MVP.
Show Guests
Dr. William Shutze: Associate Professor at Texas A&M College of Medicine at Texas A&M Health Science Center in Dallas Texas. He is a managing partner at Texas Vascular Associates. He is the co-chair for the SVS Vascular Center Verification and Quality Improvement program, vice chair for the SVS QPMC committee
Dr. Caitlin Hicks: Associate professor at Johns Hopkins University school of medicine, vice chair of research in the department of surgery. Chair for the SVS QPMC committee
Carrie McGraw: SVS manager of Quality Improvement and Practice
Important resources
2026 Vascular MVP PDF: https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3100/Vascular-Surgery-MVP-Candidate.pdf
SVS Quality improvement contact email:
Vascular Specialist article:
https://vascularspecialistonline.com/introducing-the-vascular-surgery-mips-value-pathway-a-new-era-for-meaningful-specialty-driven-quality-reporting/
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
*Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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Audible Bleeding editor Wen Kawaji (@WenKawaji) is joined by Dr. Danielle Garcia, Dr. James Martinson, JVS editor Dr. Duncan (@ADuncanVasc), JVS-CIT editor Dr. Smeds (@MattSmeds) to discuss some of our favorite articles in the JVS family of journals. This episode hosts Dr. Ullery, Dr. Bath, Dr. Lee, and Dr. Satam.
Articles:
Laser in situ fenestrated endograft (LIFE) repair of complex aortic arch pathology: Early outcomes from the multicenter LIFE registry
A novel approach to thoracic endovascular aortic repair using "zone 1.5" deployment of the Gore thoracic branched endoprosthesis device
Show Guests
Dr. Ullery has served as the medical director of vascular and endovascular surgery at the Providence heart and vascular institute since 2017 and is the co-founder of the Laser In-Situ Fenestration of Aortic Endografts (LIFE) Registry
Dr. Bath is a practicing Vascular Surgeon at the University Hospital of the University of Missouri
Dr. Lee is the chief of vascular surgery at Stanford Medicine
Dr. Satam is a current vascular surgery resident in her PGY3 year at Stanford
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
*Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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Audible Bleeding editor Wen Kawaji (@WenKawaji) is joined by integrated vascular surgery resident Falen Demsas, JVS editor Dr. Duncan (@ADuncanVasc), JVS-VI editor-in-chief Dr. Dua (@AnahitaDua) to discuss some of our favorite articles in the JVS family of journals. This episode hosts Dr. Huber, Dr. Fassler, Nishanth Konduru (@n_konduru), and Dr. Rao.
Articles:
Outcomes of open bypass and superior mesenteric artery endarterectomy for patients with chronic mesenteric ischemia resulting from long-segment superior mesenteric artery occlusive disease
Retrograde tibiopedal access as an alternative procedural technique for genicular artery embolization
Show Guests
Dr. Huber
Former Division Chief (served as Chief for 13 years) of Vascular Surgery at the University of Florida and the Edward R. Woodward Professor of Surgery at the University of Florida College of Medicine. He was also the chair of the writing committee for the SVS Guidelines on Chronic Mesenteric Ischemia.
Dr. Fassler
PGY-4 General Surgery resident at the University of Florida.
Nishanth Konduru
Fourth year undergraduate at the University of North Carolina Chapel Hill
Dr. Rao
Interventional cardiologist with Vascular Solutions of North Carolina.
Founder of Rao Clinic https://www.raoclinic.org/
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
*Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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In this episode, we explore the Society for Vascular Surgery (SVS) Quality Improvement (QI) Consulting Program, a free member benefit that supports vascular surgeons in designing, executing, and refining QI projects across all stages—from problem identification to dissemination.
We're joined by Dr. Samantha Minc, a vascular surgeon and faculty member at Duke University, and Dr. Ashley Vavra, an Associate Professor of Surgery at Northwestern Feinberg School of Medicine and chair of the SVS Quality Improvement Committee. Both bring extensive experience in vascular care and quality-focused clinical practice.
Together, they break down how the QI Consulting Program helps clinicians:
Develop SMART goals and clear project aims
Identify stakeholders and select appropriate methodologies
Organize timelines and communication plans
Track process measures and assess intervention impact
Troubleshoot challenges and prepare presentation or publication materials
They also outline what the program does not provide—such as data analysis, formal instruction, or long-term mentorship—to help members understand its intended scope. The application process is straightforward: SVS members may apply during the first two weeks of each month, with up to five projects accepted per cycle.
This episode stresses the value of QI in vascular surgery and offers a practical, accessible overview of how the QI Consulting Program can support meaningful improvement efforts in vascular practices.
Learn more:
https://vascular.org/vascular-specialists/practice-and-quality/quality/quality-improvement-consulting-program*Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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Audible Bleeding Editor and vascular surgery fellow Richa Kalsi (@KalsiMD) is joined by 4th year general surgery resident Sasank Kalipatnapu (@ksasank), JVS editor Dr. Audra Duncan (@ADuncanVasc), and JVS-VL editor Dr. Ruth Bush (@RuthLBush) to discuss two great articles in the JVS family of journals. Today's episode hosts Dr. Lowenkamp, Dr. Sridharan (@domenickna1), and Dr. Lin.
Articles:
Part 1:Female patients at increased risk for adverse outcomes after acute limb ischemia (Dr. Lowenkamp & Dr. Sridharan)
Part 2: Evaluation of factors underlying differences in venous thromboembolism rates between Black and White patients (Dr. Lin)
Show Guests
Dr. Mikayla Lowenkamp - PGY4 Integrated Vascular Surgery Resident at the University of Pittsburgh
Dr. Natalie Sridharan - Associate Professor of Surgery at the University of Pittsburgh School of Medicine
Dr. Mary Lin - PGY3 General surgery resident at the University of Maryland School of Medicine applying into vascular surgery
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
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In this episode, we spotlight editorials and abstracts from the Journal of Vascular Surgery Cases, Innovations, and Techniques (JVS-CIT). Editorials and Abstracts are read by Authors as well as members of the SVS Social Media Ambassadors.You can
Guests:
Grant Lewin, MD, PGY4 SLU
Postoperative changes of wrist-brachial index following arteriovenous fistula implantation correlate with steal syndrome, a prospective study
Early and late outcomes of patient-specific endografts with retrograde outer branches for complex aortic aneurysms involving cranially oriented target vessels
Early reintervention for hemostasis following open abdominal aortic aneurysm repair using Ifabond surgical glue
Laser fenestration and shape memory polymer embolization of type II endoleaks
Thoracic aortic injury as a complication of spinal surgery: A new case and systematic review (1991-2024)
Benefit of virtual reality during visceral artery aneurysms open and endovascular surgery planning
Bioengineered human blood vessels to treat hospital-acquired vascular complicationsHosts:
John Culhane (@JohnCulhaneMD)
Follow us @audiblebleeding, @JVS-CIT
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
*Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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Audible Bleeding editor Wen (@WenKawaji) is joined by 5th-year general surgery resident Sasank Kalipatnapu (@ksasank) from UMass Chan Medical School, and JVS editor Dr. Duncan (@ADuncanVasc) to discuss some of our favorite articles in the JVS family of journals. This episode hosts Dr. Newton and Dr. Goodney, the authors of the following paper.
Articles:
Association between imaging surveillance compliance and long term outcomes after endovascular abdominal aortic aneurysm repair at Veterans Affairs Hospitals
Show Guests
Dr. Goodney- section Chief of vascular surgery at Dartmouth Hitchcock Medical Center as well as associate Professor at Dartmouth. Chair of the research advisory committee within the SVS quality improvement program.
Dr. Newton- General Surgery resident at Dartmouth Health in New Hampshire.
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
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Jacob Soucy (@JacobWSoucy) hosts an inside look at one of the most active and collaborative vascular surgery research teams in the country, the Vascular Surgery Outcomes Research Team (VSORT) at Penn State College of Medicine.
VSORT is a dynamic academic group that brings together vascular surgery attendings, residents, postdoctoral fellows, and medical students to conduct impactful outcomes-based research. Meeting every Friday at 4 PM, the team has produced dozens of peer-reviewed manuscripts, podium presentations, and national collaborations, embodying the power of mentorship and structure in academic medicine.
In this episode, Jacob speaks with two of the key figures behind VSORT's success, Dr. Faisal Aziz and Dr. Ahsan Zil-E-Ali, to discuss how the program was founded, how it operates, and what other institutions can learn from its model.
Show Guests
Dr. Faisal Aziz (@FA_VascularMD) is the Chief of Vascular Surgery and Program Director of the Integrated Vascular Surgery Residency at Penn State Milton S. Hershey Medical Center, where he also serves as the Gilbert and Elsie Sealfon Endowed Professor of Surgery. A nationally recognized leader in vascular surgery, Dr. Aziz has authored more than 150 peer-reviewed publications and holds multiple national leadership roles. His work focuses on advancing surgical education, outcomes research, and mentorship within academic vascular surgery.
Dr. Ahsan Zil-E-Ali (@ahsanzileali) is a Postdoctoral Research Fellow at Penn State Milton S. Hershey Medical Center and a driving force behind VSORT's research productivity. A graduate of the University of Health Sciences in Lahore, Punjab, he has co-authored nearly 100 peer-reviewed publications and plays a central role in coordinating VSORT's data infrastructure, mentorship framework, and project pipeline. His passion for research efficiency and education continues to inspire medical students and trainees across the institution.Resources and Social Media
Twitter: @VsortVasc, @PennStVascular
Instagram: @vsortvasc, @pennstatevascularSpecial thanks to Dr. Faisal Aziz and Dr. Ahsan Zil-E-Ali for sharing their time and insight, and to the entire VSORT team for their ongoing contributions to vascular surgery research and mentorship.
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*Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.
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Audible Bleeding Editor and vascular surgery fellow Richa Kalsi (@KalsiMD) is joined by 4th year general surgery resident Joe El Badaoui (@JosephBadaouiMD), JVS editor Dr. Audra Duncan (@ADuncanVasc), and JVS-VS editor Dr. John Curci (@CurciAAA) to discuss two great articles in the JVS family of journals. The first article discusses an extensive experience using cryopreserved arterial allografts for vascular reconstruction after major oncologic surgery. The second article sheds light on nanoplastics in atherosclerotic plaques. This episode hosts Dr. Sebastian Cifuentes, Dr. Randall DeMartino (@randydemartino), Dr. Pierce Massie, and Dr. Ross Clark, the first and senior authors of these two papers.
Articles:
Part 1:Ten-year experience using cryopreserved arterial allografts for vascular reconstruction during major oncologic surgery (Drs. Cifuentes & DeMartino)
Part 2: Micro- and nanoplastics are elevated in femoral atherosclerotic plaques compared with undiseased arteries (Drs. Clark & Massie)
Show Guests
Dr. Sebastian Cifuentes is a first year integrated vascular surgery resident at University of Michigan in Ann Arbor, MI
Dr. Randall DeMartino is a Professor of Surgery and the chair of the Division of Vascular and Endovascular Surgery at the Mayo Clinic in Rochester, MN
Dr. Pierce Massie is a general surgery resident in his research time at the University of New Mexico School of Medicine in Albuquerque, NM
Dr. Ross Clark is an Assistant Professor of Vascular Surgery and Assistant Professor of Cell Biology and Physiology at the University of New Mexico School of Medicine in Albuquerque, NM
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
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Audible Bleeding editor Wen (@WenKawaji) is joined by 4th year medical student Nishi (@Nishi_Vootukuru), JVS editor Dr. Duncan (@ADuncanVasc), JVS-CIT associate editor Dr. Jimenez to discuss some of our favorite articles in the JVS family of journals. This episode hosts Dr. Darling, Dr. Banks and Dr. Beck.
Articles:
Outcomes following drug-coated balloons and drug-eluting stents in patients with peripheral arterial disease
Fiber Optic RealShape (FORS) and three-dimensional overlay technology in preemptive segmental artery embolization to reduce the risk of spinal cord ischemia prior to fenestrated endovascular aortic aneurysm
Show Guests
Dr. Jeremy Darling- integrated vascular surgery resident at BIDMC
Dr. Charles Banks - integrated vascular surgery resident at UAB
Dr. Adam Beck- Director of the division of vascular surgery and endovascular therapy, professor of surgery, director of quality and associate chief medical quality officer at the University of Alabama.
Follow us @audiblebleeding
Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
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SAVC (Section on Ambulatory Vascular Care) formed a GPO to help SVS members in private practice access competitive pricing on medical supplies, devices, pharmaceuticals, and services. The podcast episode explores the history of the collaboration, the benefits for SVS private practice members, and how they can become involved.
Guest Info
Dr. Anil Hingorani is a previous President of the Eastern Vascular Society. He is currently the Chair of the Section on Ambulatory Vascular Care (SAVC) of the Society for Vascular Surgery.
Dr. Naveed A. Rahman, Editor, is a Vascular Surgery Fellow at the University of Maryland.
Website Links
SVS launches partnership to help private practice vascular surgeons cut costs
Section on Ambulatory Vascular Care in SVS.
How to Join the SVS - Group Purchasing Organization
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