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Points/Counterpoint: Should surgeons operate on functional tricuspid regurgitation?
Yes, functional TR is worth repairing (David H. Adams, MD) Functional tricuspid regurgitation is a common finding in patients undergoing degenerative mitral valve repair. Severe tricuspid regurgitation is unusual, and clearly there is little debate on the merits of concomitant…
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…
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…
Should clopidogrel be discontinued prior to open vascular procedures?
The continued use of perioperative clopidogrel is appropriate Surgeons have always worried about bleeding risks for procedures we do. Complex vascular procedures are further complicated by the myriad of available antiplatelet agents designed to reduce ischemic events from cardiovascular disease…
Commentary: INR instability in the NOAC era
Progress in the development of new oral anticoagulants (NOACs), as well as agents for their reversal, has lowered the threshold to use these therapeutics as first line agents for the management of nonvalvular atrial fibrillation and venous thromboembolism.1,2 Despite this…
Dr. Julie Ann Freischlag inducted into Royal College of Surgeons of Edinburgh
Julie Ann Freischlag, MD, FACS, vice-chancellor for human health sciences; dean, University of California (UC) Davis School of Medicine; and Past-Chair, American College of Surgeons Board of Regents, and former President of the Society for Vascular Surgery was inducted into…
General surgeons getting less vascular training
Vascular surgery fellow case logs reflect an increase in endovascular interventions, but general surgery residents may be missing out on training opportunities, according to a study of national case data. In addition, general surgery residents saw a decrease in open…
Transitions
A few years ago I accepted an offer to work in a small community hospital. It was the only medical facility in a small town and was located in a semirural area. The nearest referral center was about 75 miles…
Vascular Surgery Chronicles: Charles Lindbergh and Alexis Carrel: Strange Bedfellows
How does one of the smartest and most well-known men of his time become almost forgotten in history? Dr. Alexis Carrel’s contributions to medicine brought him to the height of fame in the worlds of surgery and science. By designing…