12th Annual Current Concepts in Vascular Therapies

• 5:45 pm
  WECOME RECEPTION

• 7:55 am
  INTRODUCTION AND WELCOME

Session 1: PERIPHERAL ARTERY DISEASE

Moderator: Christpher D. Murter, MD - Panelist: S. Kent Marcuson, MD

• 8:00 am
  Primary Care of PAD: Prevention, Screening, and Initial Evaluation
• 8:20 am
  Classifying PAD: Who Needs an Intervention and When?
• 8:40 am
  The Acute vs Chronically Ischemic Limb - When is This an Emergency?
• 9:00 am
  Open Versus Endovascular Therapy for PAD: An Ongoing Debate
• 9:20 am
  Technological Advances in PAD: What's New?
• 9:40 am
  Hyperbarics/Complex Wound Care Strategies
• 10:00 am
  QUESTIONS & ANSWERS
• 10:20 am
  20 Minute Break

Session 2: CAROTID DISEASE

Moderator: Priyam K. Vyas, MD - Panelist: S. Kent Marcuson, MD

• 10:40 am
  The Primary Care Perspective on Carotid Disease: Who Needs Screening and Referral
• 11:00 am
  Carotid Occlusions- What do We do Now?
• 11:20 am
  Uncommon Carotid Disease: FMD, Carotid Web, and Women with Carotid Disease
• 11:40 am
  CMS Updates for Carotid Managment- Discussion of CEA, TCAR, and Transfemoral CAS
• Noon
  Stroke Management: Emergency Workup and Stroke Treatments
• 12:20 pm
  QUESTIONS & ANSWERS
• 12:40 pm
  LUNCH
• 1:15 pm
  KEYNOTE - TBD

Session 3: AORTIC DISEASE

Moderator: Animesh Rathore, MBBS - Panelist: Ted M. Kubicki, MD

• 2:00 pm
  What Are the Guidelines for Referral, Monitoring and Intervention for Aortic Aneurysms and Dissection
• 2:20 pm
  Medical Management, Inhibiting Aneurysm Growth, What's the Data?
• 2:40 pm
  The Eyeball Test and Aortic Surgery: What's the Optimal Pre-Op Work Up
• 3:00 pm
  Postoperative Care of Aortic Pathology: Inpatient and Outpatient
• 3:20 pm
  Total Endovascular Aortic Care. Are We There Yet?!
• 3:40 pm
  QUESTIONS & ANSWERS
• 4:00 pm
  Break

Session 4: MULTIDISCIPLINARY APPROACH TO CARE

Moderator: Hosam F. El Sayed, MBBCh - Panelist: Zachary Raser, MD

• 4:20 pm
  Timing of Surgery After Percutaneous Coronary Intervention
• 4:40 pm
  Caring for the Infected Diabetic Foot Is a Team Sport
• 5:00 pm
  Managing Comorbidities in Atherosclerosis Patients
• 5:20 pm
  Multidisciplinary Surgical Approach to Limb Salvage
• 5:40 pm
  QUESTIONS & ANSWERS
• 6:00 pm
  Adjourn
• 6:00 pm
  NETWORKING RECEPTION
• 7:30 pm
  FACULTY DINNER

• 7:00 am
  REGISTRATION / BREAKFAST
• 7:55 am
  WELCOME

Session 5: VENOUS DISEASE

Moderator: David J. Dexter, II MD - Panelist: David M. Wallace, MD

• 8:00 am
  Pulmonary Embolism Management. How Important is a PERT?
• 8:20 am
  Work-Up and Treatment Plan for Edema. Not Everything is Venous Disease
• 8:40 am
  DVT - Acute. Who do We Treat, How do We do It and When Should These Patients be Seen?
• 9:00 am
  Who, What, Where, Why, and How of Superficial Venous Disease
• 9:20 am
  Management of Post Thrombotic Syndrome. What are the Current Options in Care?
• 9:40 am
  QUESTIONS & ANSWERS
• 10:00 am
  Break

Session 6: DEBATES IN CLINICAL CARE

Moderator: David J. Dexter, II MD

• 10:20 am
  CEA, TF CAS and TCAR are Clinically Equal and the CMS Decision to Deregulate was Correct
• 10:40 am
  CEA Remains Superior to TF CAS and TCAR. We Need to Limit Who and Where Procedures are Done
• 11:00 am
  Frontiers in Salvaging the Desert Foot.. No Holds Barred
• 11:20 am
  Enough is Enough. Time for an Amputation
• 11:40 am
  One Branch, Two Branch, Fenestration
• 12:00 pm
  Branches Smanches. Open Aortic Surgery Remains Durable and Right for Most Patients
• 12:20 pm
  QUESTIONS & ANSWERS and CLOSING REMARKS
• 12:40 pm
  ADJOURN

SESSION 1

Moderators: Robin Anderson, MD

• Claudication: My Legs Hurt When I Walk:The Patient's Perspective
• Podiatric Evaluation of Atherosclerosis
• PAD: Time to Treat: Optimal Medical Management and When to Refer
• Acute Blue Toes: Diagnosis and Plan
• Gangrene/Tissue Loss/Critical Ischemia/End of Road PAD
• My Patient is About to Become an Amputee: What Can I Tell Them to Expect? (Part 1)
• My Patient is About to Become an Amputee: What Can I Tell Them to Expect? (Part 2)

KEYNOTE

• Vascular Care in a Rural Environment

SESSION 2

Moderators: Robin Anderson, MD

• Patient's Perspective-Epidemiology and Risks
• Primary Care Perspective: Who Gets Screened and When to Refer to Vascular Surgery
• Stroke Management: Emergency Workup and Stroke Treatments
• Intracranial Aneurysms Update
• How to Discuss Surgical Risk to Patients Who Need Carotid Revascularization

SESSION 3

Moderators: Colette Lo, MO

• I Was Just Told I have an Aortic Aneurysm: What Should I Expect?
• Monitoring the Ascending Aorta
• Not all aneurysms are the same - Discussing risks
• Where Do I Refer My Aneurysm?
• Acute Aortic Syndrome

SESSION 4

Moderators: Stephen Vandenhoff, MD

• Who Should Manage My Patient's Atheroslerotic Risk Factors?
• Which Patients Need Cardiovascular Screening Tests?
• Is PVL an Order or a Location?
• Advanced Vascular Imaging: Angiography CTA MRA and More

SESSION 5

Moderators: Anthony Hardt, MD

• Clinical, Etiology, Anatomy, Pathophysiology: Comprehensive Venous Classifications
• I Have Vericose Veins - My Mom had Vericose Veins: What Should I Expect?
• I Was Diagnosed with a DVT by My PCP: Hospital or Home Treatment?
• My DVT was Treated - Years Later I Still have Pain and Swelling: What to do with Post Thrombotic Syndrome?

SESSION 6

Moderators: Anthony Hardt, MD

• TCAR is Set to Replace CEA as a Standard of Care in Standard Risk Asymptomatic Patients
• CEA Should Remain the Gold Standard for Standard Risk Surgical Asymptomatic Patients
• There is no Role for Surgery in the Treatment of Asymptomatic Carotid Stenosis
• Open Thoracoabdominal Surgery: Every Procedure-Endovascular Surgery Will Remain Experimental
• The Future is Here Now: There is Nearly No Role for Open Thoracoabdominal Aortic Surgery
• PAD Should Be Managed with an Open Surgery Approach
• Endovascular First for the Management of PAD

TOPIC: PAD

Moderators: Samuel N. Steerman, MD and Christopher Stout, MD

• Defining the Critical Limb Epidemic
• Clinical Signs of Critical Limb Ischemia
• Comparing Options for Open or Endovascular Surgery in Critical LI
• Paclitaxel for PAD: Safety and Efficacy
• Managing Complications of Arterial Access
• Radial Access for PAD
• Pedal Access for PAD

TOPIC: VASCULAR MEDICINE

Moderators: Richard J. DeMasi, MD and Deepak R. Talreja, MD

• Living Related Renal Donor Program
• Renovascular Hypertension
• Alternative Therapties for PAD
• New Frontiers in Hypercholesterolemia
• Alternative Endo Approach to Bypass
• Need PDF - DM and Amputation

TOPIC: VENOUS DISEASE

Moderators: David J. Dexter, II, MD and S. Sadie Ahanchi, MD

• New Frontiers in Thrombectomy: Can We Do This Without Thrombolysis?
• Need PDF - Understanding Deep Venous Reflux: How Can This Be Treated?
• Central Venous Obstructions: Surgical and Endovascular Options for Care
• Spider Veins to Venous Ulcers: What Is Going on with My Patient?
• Tumescent Based Therapy for SVI
• Non-Thermal/Non-Tumescent Therapy for Superficial Venous Insufficiency (SVI)

TOPIC: GREAT DEBATES

Moderators: Animesh Rathore, MBBS and Todd W. Gensler, MD

• Small Abdominal Aortic Aneurysms (4.5 to 5.5 cm) Should Be Left Alone
• Small Abdominal Aortic Aneurysms (4.5 to 5.5 cm) Should Be Managed Surgically
• All Submassive Pulmonary Embolisms Should Be Treated with Medical Therapy Only
• All Submassive Pulmonary Embolisms Should Be Treated with Catheter Directed Therapy
• Asyptomatic Critical Carotid Stenosis Should Be Treated with Medical Therapy Only
• Asymptomatic Critical Carotid Stenosis Should Always Be Treated Surgically

TOPIC: AORTIC

Moderators: Hosam F. El Sayed, MBBCh, PhD and Animesh Rathore, MBBS

• Should Aortic Care Be Regionalized?
• Open Arch Reconstruction
• Collaboration Between Vascular Surgery and Cardiothoracic Surgery (CTS): How They Do It
• History of Open Aortic Surgery
• Need PDF - Acute Aortic Syndromes: How I Manage This Emergency
• Need PDF - When Is Endovascular Aneurysm Repair (EVAR) A Bad Choice For Abdominal Aortic Aneurysm (AAA) Repair And Why?

TOPIC: CEREBROVASCULAR / NEW TECH

Moderators: Rasesh M. Shah, MD and Justin Milligan MD

• Women and Carotid Disease
• Vertebrobasilar Insufficiency
• Stroke Interventions: Timing
• Robotic Intervention
• TransCarotid Artery Revascularization (TCAR)
• Vasculitis
• Need PDF - Updates in Neuro Intervention
• Bioabsorbable Stents
• Percut Fistulas

TOPIC: SUPERFICIAL VENOUS DISEASE

Moderators: C. Scott McEnroe, MD; F. Noel Parent, III, MD

• Do We Undertreat or Overtreat Varicose Veins: What Is the Natural History?
• Treatment of Truncal Veins in 2019
• Debate 1: Varicose Veins Should Be Removed at the Primary Procedure
• Debate 1: Varicose Veins Should Be Allowed to Decompress and Treated at a Second Procedure
• Treatment of Reticular and Spider Veins in 2019
• Uterine Fibroids, Ovarian Veins, Testicular Veins, Prostate Artery: Treatment Options

TOPIC: DEEP VENOUS DISEASE

Moderators: David J. Dexter, II, MD; Jessica A. Buchner, MD

• Pulmonary Embolism Response Teams: What Are the Key Components?
• Debate 2: Submassive Pulmonary Embolism: There Is a Role for Routine Catheter Directed Therapy
• Debate 2: Submassive Pulmonary Embolism: Anticoagulation Is All You Need
• New Tools in Thromboectomy
• Diagnosis and Treatment of May-Thumer Syndrome
• Klippel-Trenaunay, Park-Weber, Nutcracker Renal Vein, and Other Rare Venous Syndromes, Diagnosis and Treatment
• Keynote Address

TOPIC: PERIPHERAL ARTERY DISEASE

Moderators: Manuela Schuksz, MD, PhD; Samuel N. Steerman, MD

• Optimizing Medical Therapy for Patients with Claudication
• Supervised Exercise Therapy for Patients with Claudication
• Debate 3: 55-Year-Old Smoker with 2 Block Claudication and SFA Occlusion Should Have Medical Therapy Only
• Debate 3: 55-Year-Old Smoker with 2 Block Claudication and SFA Occlusion Should Be Offered Endovascular Therapy
• Debate 3: 55-Year-Old Smoker with 2 Block Claudication and SFA Occlusion Femoral-Popliteal Vein Bypass Is Still the Gold Standard
• The Paclitaxel Controversy: Limb Over Life

TOPIC: PERIPHERAL ARTERY DISEASE

Moderators: Gordon K. Stokes, MD; Richard J. DeMasi, MD

• The Acutely Ischemic Leg: What Is the Decision Tree for Anglo vs OR?
• Limb Salvage Is a Team Sport
• Infected Lower Extremity Prosthetic Grafts: Tips and Tricks for Getting Out of This Mess
• Complex Surgical Approaches to CLI: Pedal Bypass, Retrograde Interventions, etc.
• Atypical Claudication: External Iliac Artery Endofibrosis / Popliteal Entrapment - Diagnosis and Treatment

Topic: AORTIC DISEASE

Moderators: Jean M. Panneton, MD; Ken Cherry, MD

• Key Concepts in Successful Complex Endovascular Aortic Surgery
• Key Concepts in Successful Complex Open Abdominal Aortic Surgery
• Management Decisions in Type B Dissection, Medical Endovascular and Surgical Timing
• Management of Ruptured AAA: Pathways and Institutional Guidelines
• Debate 4: Aneurysm Involving the Visceral Vessels (Paravisceral / Thoracoabdominal Aneurysms) Should Have Open Repair
• Debate 4: Aneurysm Involving the Visceral Vessels (Paravisceral / Thoracoabdominal Aneurysms) Can Now Be Repaired With Endovascular Techniques (TAMBE)

Topic: VASCULAR POTPOURRI

Moderators: Rasesh M. Shah, MD; Animesh Rathore, MBBS

• “Early” Carotid Intervention for the Patient With TIA or Small Stroke and Good Recovery
• Critical Care Management of the Patient With Acute Stroke
• TCAR in 2019: Current Status
• Vertebral Artery Revascularization: When and How?
• Repeated Interventions for AVF / AVG: When Do We Quit and Make Another Access?
• Endovascular Treatment of the Entire Arterial System Is Now Possible (Aortic Valve to Pedal Vessels)

TOPIC: SUPERFICIAL VENOUS DISEASE

Moderators: C. Scott McEnroe, MD; S. Sadie Ahanchi, MD

• Introduction to Saphenous Vein Ablations: When/Why/How?
• Debate 1: Why Is Tumescent-Based Therapy The Gold Standard?
• Debate 1: Why Tumescent-Free Therapy Will Replace RF and Laser
• Save the Saphenous Vein: Why All Patients with Saphenous Reflux Don’t Need an Ablation
• Medical Management of Venous Ulcers: When Vascular Consult Isn’t Enough
• Signs, Symptoms and Treatment of Heart Failure: What to Do with the Cardiogenic LE Edema
• Advanced Wound Care: What Will Improve Venous Wound Healing?

TOPIC: DEEP VENOUS DISEASE

Moderators: David J. Dexter, II, MD; Rafael D. Malgor, MD

• VTE Prevention Strategies: Is a One-Size-Fits-All Approach Correct?
• VTE Treatment Algorithm: Diagnosis and Treatment
• Debate 2: There Is No Role for Surgical Therapy for DVT
• Debate 2: There Is a Role for Surgical Therapy for DVT
• Pulmonary Embolism Literature Review: What Is New?
• Venous Claudication: Diagnosis and Treatment Options
• Keynote Address

TOPIC: PERIPHERAL ARTERY DISEASE

Moderators: Samuel N. Steerman, MD; Manuela Schuksz, MD, PhD

• Cardiovascular Biomarkers
• Claudication: Is Vascular Rehab for Real?
• Assessment of Lower Extremity Perfusion: What Do the Test Results Mean?
• Medical Management of Limb Threatening Ischemia: What to Do When Surgery Isn’t an Option?
• Debate 3: Surgery Is and Remains the Gold Standard for Limb-Threatening Ischemia
• Debate 3: Endovascular Therapies Have Surpassed Surgical Bypass for Limb-Threatening Ischemia

TOPIC: PERIPHERAL ARTERY DISEASE

Moderators: Samuel N. Steerman, MD; Huiting “Tina” Chen, MD

• Lose a Toe, Save a Limb: The Value of Complex Foot Reconstructions
• Podiatry if I’m Not a Podiatrist: Cutting Nails to the Charcot Foot
• Endovascular Widgets: What Are the New Toys, and Do They Work?
• Amputation: How to Manage the Ultimate Vascular Endpoint
• Popliteal Artery Aneurysms, Diagnosis and Repair Options

Topic: AORTIC DISEASE

Moderators: Jean M. Panneton, MD; Animesh Rathore, MBBS

• Aortic Imaging Studies: Guidelines for Detection, Surveillance and Follow-Up
• Aneurysm Repair Techniques: An Overview of Indicators for and Types of Repair
• Debate 4: Complex Endovascular Repairs Will Make Open Surgery Obsolete
• Debate 4: Open Surgery Will Always Have a Role in Complex Aortic Repair
• Understanding Aortic Dissections

Topic: CAROTID DISEASE

Moderators: Rasesh M. Shah, MD; Todd W. Gensler, MD

• Screening Studies for Carotid Disease: Who Should Be Screened and What Do We Do with the Results?
• Carotid Debate: High-Grade Asymptomatic Disease Should NEVER Get Repaired; Medical Management Is Enough
• Carotid Debate: High-Grade Asymptomatic Disease Should Get Repaired Selectively; Medical Management Is NOT Enough
• The Debate Is Wrong: TCAR Will Revolutionize the Carotid Disease Decision Tree

Topic: RENAL FAILURE

Moderators: John O. Colonna, II, MD; Siddarth K. Bhende, MD

• Dialysis Access Review: Understanding the Access Options Our Patients Face
• Periotoneal Dialysis as an Option for ERSD Patients
• Renal Transplant Surgery Update

TOPIC: AORTIC SESSION

Moderators: Jean M. Panneton, MD; Animesh Rathore, MBBS

• Arch Pathology: Surgery Is The Gold Standard
• Arch Pathology: The Endovascular Era Is Here
• Keynote Address
• Penetrating Atherosclerotic Ulcers of the Aorta
• Peripheral Complications Of TAVR
• The Multidisciplinary Aortic Clinic: Why The Care Is Better
• Valvular Heart Disease: Surgery Is The Gold Standard
• Valvular Heart Disease: The Endovascular Era Is Here

TOPIC: DEEP VENOUS THERAPY

Moderators: C. Scott McEnroe MD; Todd W. Gensler MD

• Phlegmasia Cerulea Dolens Is A Limb Threatening Problem
• The Transformation of Deep Venous Therapies
• Thrombolysis For DVT: Everyone Should Get It
• Thrombolysis For DVT: Nobody Needs It
• When The Clot Breaks Free: Treating Pulmonary Embolus

Topic: INNOVATIONS IN VASCULAR THERAPIES

Moderators: David J. Dexter, II, MD; Samuel N. Steerman, MD

• Case Presentation
• PQ Bypass: The Endovascular Fem-Pop
• Renal Denervation For Hypertension: Status Update
• ROX Endovascular System For Hypertension: A Novel Concept
• Shockwave Lithotripsy For The SFA
• Spy Angioscopy: Vascular Uses
• Vagal Nerve Stimulation: Indications and Technique

TOPIC: THE DIABETIC PATIENT WITH CLI

Moderators: Michael J. Marcinczyk, MD; Michael T. Chung, DPM

• Caring for the Infected Diabetic Foot Is A Team Sport
• Endovascular Is The Way To Go: Revascularize As Many Vessels As You Can
• My Diabetic Patient Has No Pulses; What Should I Do?
• Referral for Leg Ulcer
• To Achieve Limb Salvage, The Wounds Must Be Healed
• Vein Bypass Is The Way To Go: Direct Flow To The Foot

Topic: THE GREAT DEBATES

Moderators: Rasesh M. Shah, MD; Animesh Rathore, MBBS

• #1 – 65yo Man With High Grade, Asymptomatic Carotid Stenosis: The Case for CEA
• #1 – 65yo Man With High Grade, Asymptomatic Carotid Stenosis: The Case for CAS
• #2 – 45yo Man With Uncomplicated Acute TBAD: The Case For Medical Management
• #2 – 45yo Man With Uncomplicated Acute TBAD: The Case For TEVAR
• #3 – 50yo Executive With Bilateral Symptomatic 8mm Varicose Veins: The Case for Thermal Ablation
• #3 – 50yo Executive With Bilateral Symptomatic 8mm Varicose Veins: The Case for Glue

TOPIC: VASCULAR MEDICINE SESSION

Moderators: Rasesh M. Shah, MD; Deepak Talreja, MD

• All Vascular Patients Should Be On High Dose Statin Therapy
• Cell and Gene Therapy For CLI: A Status Update
• Implications of 50-69% Carotid Stenosis
• Referral for Leg Ulcer
• Should Everyone Have Their Carotid IMT Measured?
• Supervised Exercise Improves Claudication: Everyone Needs A Fitbit
• Timing of Surgery After Percutaneous Coronary Intervention

TOPIC: Aortic Session

Moderators: Jean M. Panneton, MD; Gordon K. Stokes, MD

• Acute Aortic Dissection, Indications for Intervention
• Blue Toe Syndrome, Should You Do EVAR?
• Can Anything Slow Down the Growth of AAA, Statins?
• Case Presentation
• Chronic Aortic Dissection, Indications for Intervention
• Should We Repair Some Small AAA?

TOPIC: Carotid

Moderator: Rasesh M. Shah, MD; Daniel A. Cohen, MD

• Cognitive Function and Carotid Disease
• Current Recommendations for Treatment of Asymptomatic Carotid Stenosis
• Current Recommendations for Treatment of Symptomatic Carotid Stenosis
• Emergency Carotid Intervention for Stroke-in-Evolution / Dissection / Other Unusual Indications

Topic: Peripheral

Moderators: Samuel N. Steerman, MD; Michael J. Marcinczyk, MD

• Acute Limb Ischemia: Evaluation and Treatment; Open or Endo
• Acute Mesenteric Ischemia: Optimal Therapy
• Alternate Access for Peripheral Intervention
• Case Presentation
• Chronic Limb Ischemia: Evaluation and Treatment; Open or Endo
• Chronic Mesenteric Ischemia: Optimal Therapy

Topic: Vascular Debates

Moderators: Jean M. Panneton, MD; Rasesh M. Shah, MD

• 50 Year-Old Female with Claudication/SFA Occlusion: The Case for SFA Intervention
• 50 Year-Old "Healthy Man" with 6cm AAA. The Case for EVAR
• The Case for Fem-Pop Bypass
• The Case for Open Repair

TOPIC: Vascular Potpourri

Moderators: F. Noel Parent III, MD; Peter M. Moy, MD

• SVC Syndrome
• TOS / Paget-Shroetter
• UE DVT from Lines
• Why the Patient's Primary Care Provider is As Responsible As You Are For Patient's Outcome

TOPIC: Venous

Moderators: David J. Dexter II, MD; C. Scott McEnroe, MD

• AngioVac
• Case Presentation
• IVC Filters: When Should They Be Used
• Nutcracker Syndrome
• PERT