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Mitigating Burnout – Part 3
It is easy to look at the changes required to mitigate burnout and improve compassionate care and see the burden being placed mainly on the physician. Many of the proposed modifications seem to require the one commodity surgeons lack most,…
Special Report II: Tackling Burnout
Last month, we introduced the epidemic of burnout and the adverse consequences for both our vascular surgery patients and ourselves. Today we will outline a framework for addressing these issues. The foundation of this framework is informed by the social…
Hard road disproving that statins make you dumb
The impact of lipid-lowering drugs on patients’ mental states was on the minds of many attendees at the American College of Cardiology’s annual meeting in March. The highest-profile report came from EBBINGHAUS (Evaluating PCSK9 Binding Antibody Influence on Cognitive Health…
Upper arm loop grafts
Many forearm loop grafts have multiple outflow interventions before failure. These angioplasties and outflow stents create inflammation around the vein just above the antecubital area. This inflammation makes arterial exposure difficult for a standard upper arm graft configuration. Accordingly, surgeons…
Taking a leap of faith
After a grueling first two years of surgical residency, I welcomed with open arms my surgical research years. Junior surgical residency was arguably the toughest years of my training to date. Long hours at the hospital; the uncertainty of being…
Point/Counterpoint: Is endograft PAA repair durable?
Endovascular repair is durable Endovascular repair of popliteal artery aneurysms is vastly superior to all other previous techniques of popliteal aneurysm repair. Half of all popliteal artery aneurysms are bilateral, and 40% are associated with abdominal aortic aneurysm; 1%-2% of…
Open vs. endovascular for chronic mesenteric ischemia
Chronic mesenteric ischemia is best treated in an open operation. Chronic mesenteric ischemia is a rare disorder accounting for about 1 out of 100,000 admissions.1 Because of the rarity of this disease, diagnosis is often delayed. Patients are often evaluated…
The PERT Movement – Vascular surgeons must answer the call
Pulmonary embolism (PE) is the third most common cause of cardiovascular death in the United States and remains the most common preventable cause of in-hospital death. One might think that, in 2017, such a life-threatening cardiovascular emergency would be managed…
Point/Counterpoint: Is limb salvage always best in diabetes?
Salvage limbs at all costs Aggressive limb salvage in people with diabetes leads to an overall reduction in cost not only economically, but also from the patient’s perspective. The vast majority of diabetic patients with critical ischemia are actually good…
SVS (Specialty of Vascular Surgery): Why, How, and When
The November 2016 issue of Annals of Vascular Surgery was devoted entirely to the history of the American Board of Vascular Surgery (ABVS) and the unsuccessful attempt to establish an independent specialty of Vascular Surgery. The manuscript is methodically detailed…