Our recent editorial on the status of the interview, one of the Presidential Addresses from the Vascular Annual Meeting (VAM), a slew of new science news from VAM—including well-received results on transcarotid revascularization (TCAR)—and the digital flipbook version of our August issue featured among the most-read stories on the Vascular Specialist website in August.
Our medical editor, Malachi Sheahan II, MD, writes on the conventional concept of the interview and how it doesn’t work. More than one-third of vascular applicants in the 2020 Match were asked about marital status and family planning, he reports, and females experienced a significantly higher proportion of these inquiries than their male counterparts: “Speak with a few female surgeons, and it becomes clear that bias in interviews extends far beyond training. As a specialty, our answer to this issue can’t be ‘try to stop asking sexist questions.’ Don’t worry though—as usual, I have a solution. And you (as usual?) will probably hate it. The answer? Stop interviewing.”
It was supposed to occur at the canceled 2020 VAM, but finally given his time at the podium, 2019–2020 Society for Vascular Surgery (SVS) President Kim Hodgson, MD, wasted little time in conveying the message he has long sought to convey to SVS members during his Presidential Address at VAM 2021 in San Diego: that the threat posed to vascular surgery by “bad actors” carrying out inappropriate procedures is real—and that it is long past time to address the issue.
Silk Road Medical announced positive results from an independent analysis of standard surgical risk patients undergoing carotid endarterectomy (CEA) and TCAR for atherosclerotic carotid disease after the data were presented at VAM.
4. VOYAGER PAD: Rivaroxaban plus aspirin should be considered after lower-extremity bypass regardless of conduit type
“A strategy of adding rivaroxaban 2.5mg twice daily to aspirin should be considered after lower-extremity bypass regardless of conduit type,” Nicholas Govsyeyev, MD, told those gathered during the William J. von Liebig Forum at VAM 2021. Govsyeyev was giving an update on the VOYAGER PAD trial, addressing the efficacy of rivaroxaban and aspirin in peripheral arterial disease (PAD) patients with venous and prosthetic surgical bypass conduits.
News on the then upcoming VAM festivities, an area of study little-seen in the vascular literature—prosthetic referral and possible survival benefits—and news of the latest meta-analysis on paclitaxel use in PAD patients were among the features of the August issue of Vascular Specialist.
How the COVID-19 pandemic impacted vascular surgery was the subject of a special session in San Diego. Topics covered included impacts of delays to scheduled vascular operations, venous complications, effects on PAD patients and the financial repercussions for vascular service lines.
Over the course of more than a year, diversity, equity and inclusion (DEI) have been brought into sharp focus by a compendium of events inside and outside of medicine. As U.S. society has reckoned with the socioeconomic and cultural consequences of racial and gender disparities, so too has vascular surgery. Against this backdrop, a special DEI session was convened at VAM.
8. ‘Let’s move on to solutions,’ keynote speaker tells diversity, equity and inclusion focus session
Opening up the DEI session, Lee Kirksey, MD, issued an unapologetic apology of sorts: “If I ruffle any feathers I apologize, but I think it’s a conversation that’s important to have,” said Society for Vascular Surgery (SVS) member Kirksey, of the Cleveland Clinic. ”Let’s move beyond the problem we understand exists and let’s move on to solutions.”
Promising two-year results for Hancock Jaffe Laboratories’ VenoValve device—an emerging potential prosthetic venous valve replacement about to commence a U.S. pivotal trial—were announced at VAM 2021.
TCAR produces similar outcomes to the gold standard treatment for carotid stenosis—CEA—but comes at a greater cost. This was among the conclusions presented by Sheila M. Coogan, MD, at VAM, drawn from analysis of the cost-effectiveness of treatment modalities for non-emergent significant carotid artery stenosis. The analysis also showed that TCAR was incrementally more cost-effective than carotid artery stenting (CAS).