Vascular Surgeons Present New Research at SVS Meeting

Surgeon-scientists from the Department of Surgery Division of Vascular Surgery presented new research at the 2007 Society for Vascular Surgery (SVS) Vascular Annual Meeting (VAM) in Baltimore, June 6-10. Authors included: Leila Mureebe, MD, Roman Nowygrod, MD, James F. McKinsey, MD, Peter L. Faries, MD, K. Craig Kent, MD, Nicholas J. Morrissey, MD, as well as Annetine Gelijns, PhD, from the Department's InChoir Division.

Presentations included:

• Surgeon Experience Predicts Outcomes for Elective Endovascular Aortic Abdominal Aneurysm Repair: Results from the National Medicare Database
  Authors: Drs. Leila Mureebe, Peter L. Faries, Roman Nowygrod, K. Craig Kent, James F. McKinsey, et al.
  Thursday, June 7, 1:30-3:30 p.m.
  
  Endovascular repair of abdominal aortic aneurysm (EVAR) was introduced in 2000, however little research has been done on the relationship between physician experience in performing EVAR and clinical outcomes. According to senior author Dr. James McKinsey, this study looked at whether mortality and adverse events are predicted by the experience of the surgeon. EVAR procedures included in the analysis were from the Medicare Database (2000-2004). This study revealed a significant reduction in perioperative complications and mortality with increased surgeon experience in EVAR.
  
  Click here to view text of abstract.
• Insurance Status Predicts Access to Care and Outcomes of Vascular Disease
  Authors: Drs. Leila Mureebe, Roman Nowygrod, James F. McKinsey, Peter L. Faries, K. Craig Kent and Nicholas J. Morrissey.
  Friday, June 8, 8:30-9:50 a.m.
  
  Investigators assessed insurance status as a predictive measure of the severity of vascular disease at the time of treatment as well as the effect insurance status had on the clinical outcome of various vascular interventions. Patients without insurance or with Medicaid are at a greater than twofold risk of presenting with ruptured abdominal aortic aneurysm compared to those patients insured under health maintenance organizations (HMO), Medicare, Medicare HMO, commercial insurers, Medicaid HMO, the Department of Veterans Affairs, Blue Cross or other federal programs. The study concluded that insurance status is a predictor of vascular disease severity at the time of presentation, however once treatment occurs the outcomes are similar in both categories, with the exception of lower extremity revascularization which resulted in a much greater amputation rate in the Medicaid and uninsured populations. According to study author Dr. Peter L. Faries, this study suggests that underinsured patients are often at a disadvantage for care, both at the time of treatment and, in some cases, following intervention.
  
  Click here to view abstract.
• Carotid Angioplasty and Stenting and Carotid Endarterectomy in the Community: Analysis of Outcomes Using Large Data Sets
  Authors: Drs. Leila Mureebe, James F. McKinsey, Peter L. Faries, Annetine Gelijns, Alan J. Moskowitz, K. Craig Kent, et al.
  Sunday, June 10, 10:00-11:30 a.m.
  
  The role of carotid stenting in treating carotid disease remains controversial. This study analyzed a large population dataset–2005 hospital inpatient discharge data from California and New York–to identify and compare the rates of death and stroke following Carotid Angioplasty and Stenting (CAS) and Carotid Endarterectomy (CEA) (the surgical removal of plaque or blood clots in an artery) procedures. Dr. Leila Mureebe will be presenting research about these two procedures' mortality and post-procedure stroke rates. The analysis of this dataset revealed that mortality for patients undergoing carotid angioplasty and stenting was double that of carotid endarterectomy. Carotid endarterectomy remains a safe option for most patients with significantly lower mortality and lower risk of stroke.
  
  Click here to view abstract.

Other activities of Vascular Surgery Division surgeons included the following:

• K. Craig Kent, MD, president of the Society for Vascular Surgery (SVS), gave the SVS Presidential Address on Friday, June 8.
• James McKinsey, MD, spoke on atherectomy, a relatively new technique for clearing blocked arteries in the lower extremity, during a breakfast session entitled: "Infrainguinal Endovascular Therapy: State of the Art 2007" on Friday, June 8.
• Nicholas J. Morrissey, MD, moderated a Plenary Session on Vascular Disease Treatments on Friday, June 8, 2007.