Explore every episode of the podcast European Society for Vascular Surgery

Recorded live at the ESVS podcast booth during the 40th ESVS Annual Meeting in Belgrade, Dimitrios Liakopoulos talks with Dr Lorenzo Patrone about taking revascularisation below the ankle.

They cover when pedal arch treatment is truly indicated, and why Lorenzo aims for in-line flow to the wound rather than a complete arch. He explains how he defines success, from the on-table angiogram to wound healing, and why thrombosis is the complication to fear in the foot. He also lays out the essential toolkit for any unit starting BTK and BTA work.

Lorenzo also talks frankly about when to re-intervene and when to accept a stable ulcer in a frail patient whose pain has gone. He explains why a CTO wire is a drill rather than a crossing wire, and how trainees can build competence below the ankle. Above all, his message is that sharing experience with peers is how all of us get better.

And before you scrub for your first pedal access, listen for his one-minute rule. It may save you, and your patient, a three-hour afternoon.

Diabetic heel ulcers have a notorious reputation for being difficult to treat. There's nothing worse for a patient than having a chronic festering wound on their heel which makes weight bearing difficult if not impossible and is frequently associated with osteomyelitis and infection. Many of these patients often end up with a major limb amputation. In this episode we are joined by Dr Giacomo Clerici, diabetic foot specialist from Italy who tells us how he approaches this difficult problem. A must listen for all vascular professionals working with diabetic patients!

Prof. Christian Behrendt (head of the German research association) and Prof. Joy Roy

(Karolinska Institute) take us on a look back chronologically at the journey

Paclitaxel has taken us on, from the original mortality scare to landmark trials, we follow

the twists and turns of the evidence.

We ask if safety is only half the story and whether it makes sense to judge every

drug-coated balloon and stent as one big, paclitaxel-coated family, what the emerging

Limus technologies might bring to the table, and whether industry influence has helped

shape a debate in which the stakes are anything but theoretical.

Because ultimately, a beautiful angiogram is lovely. But if our patients aren't walking

further, living longer, or feeling better, what exactly are we celebrating?

Join us as we separate the signal from the noise and ask all the uncomfortable

questions at the heart of it all.

This episode is supported by Cook Medical

PAPERS MENTIONED

1. Katsanos et al. (2018) — Risk of Death Following Application of Paclitaxel-

Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A

Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Read the paper — Journal of the American Heart Association

2. IMPERIAL trial (2018) — Gray et al. A polymer-coated, paclitaxel-eluting stent

(Eluvia) versus a polymer-free, paclitaxel-coated stent (Zilver PTX) for

endovascular femoropopliteal intervention: a randomised, non-inferiority trial.

Read the paper — The Lancet

3. Katsanos et al. (2026) — Dynamic Risk of Death following Application of

Paclitaxel Coated Devices in the Femoropopliteal Artery: A Contemporary Meta-

analysis of Randomised Controlled Trials.

Read the paper — European Journal of Vascular and Endovascular Surgery

4. SWEDEPAD 1 (2025) — Paclitaxel-coated versus uncoated devices for

infrainguinal endovascular revascularisation in chronic limb-threatening

ischaemia: a multicentre, participant-masked, registry-based, randomised

controlled trial.

Read the paper — The Lancet

5. SWEDEPAD 2 (2025) — Paclitaxel-coated versus uncoated devices for

infrainguinal endovascular revascularisation in patients with intermittent

claudication: a multicentre, participant-masked, registry-based, randomised

controlled trial.

Read the paper — The Lancet

6. REALDES — 3-year outcomes (2025) — Shibata et al. Comparative Analysis of

Three Year Results of Two Paclitaxel Related Stents for the Management of

Femoropopliteal Disease in a Real World Setting.

Read the paper — European Journal of Vascular and Endovascular Surgery

7. REALDES — 1-year outcomes — Shibata et al. One Year Outcomes of Zilver

PTX Versus Eluvia for Femoropopliteal Disease in Real-World Practice:

REALDES Study.

Read the paper — Journal of Endovascular Therapy

8. Behrendt et al. (2020) — Long Term Survival after Femoropopliteal Artery

Revascularisation with Paclitaxel Coated Devices: A Propensity Score Matched Cohort

Analysis. A large German health-insurance database study comparing long-term

outcomes after paclitaxel-coated and uncoated devices.

9.Read the paper — European Journal of Vascular and Endovascular Surgery

10. Nordanstig et al. (2026) — Editor's Choice – Focused Update on Paclitaxel Coated

Technologies, from the 2024 ESVS Guidelines

on the Management of Asymptomatic Peripheral Arterial Disease and Intermittent

Claudication. The updated recommendations reconsider the role of paclitaxel-coated

devices in intermittent claudication in light of SWEDEPAD 2 and the emerging evidence

on clinical benefit and long-term safety.

Read the paper — European Journal of Vascular and Endovascular Surgery

Three trials walk into an aorta and ask what the house recommends. The bartender shrugs: “Sorry, we’re randomising tonight.”

Three trials. Three leading investigators. One of the biggest unresolved questions in aortic surgery: should patients with uncomplicated type B aortic dissection undergo thoracic endovascular aortic repair (TEVAR), or is best medical therapy the better strategy?

In this episode of the ESVS Podcast, Safa Riahi brings together Professor Jacob Budtz-Lilly (SUNDAY), Professor Firas Mussa (IMPROVE-AD) and Professor Colin Bicknell (EARNEST), for an in-depth roundtable exploring the rationale, design, and challenges behind three major randomised controlled trials. From differences in patient selection and timing of intervention to aortic remodelling, procedural safety, long-term outcomes, and cost-effectiveness, we examine what each trial hopes to establish and why their results could reshape the management of uncomplicated type B aortic dissection.

We also discuss the meaning of “uncomplicated,” the limitations of our current evidence, the importance of best medical therapy, and the challenge of communicating genuine clinical uncertainty to patients. Will these trials finally help us identify who benefits from early TEVAR, when to intervene, and whether improved aortic remodelling translates into better outcomes for patients?

Three trials walk into an aorta. The answers, for now, remain anything but straightforward.

With: Professor Firas Mussa, Professor Colin Bicknell, and Professor Jacob Budtz-Lilly.

Trials discussed:

• IMPROVE-AD: https://clinicaltrials.gov/study/NCT06087029
• EARNEST: https://www.isrctn.com/ISRCTN30838068
• SUNDAY: https://clinicaltrials.gov/study/NCT05215587

In this special episode of the ESVS Podcast, we sit down with Professor Kak Khee Yeung as she begins her term as President of the European Society for Vascular Surgery.

Professor Yeung talks openly about her journey as a vascular surgeon and researcher, her passion for aneurysm biology and personalised vascular care, and the curiosity that has driven her throughout her career. From her Chinese heritage and the calligraphy featured in her inaugural lecture to artificial intelligence, teamwork and the future of vascular surgery, the conversation goes beyond the CV to explore the person behind the surgeon and scientist.

Professor Yeung also shares her thoughts on leadership, diversity, the next generation of vascular surgeons and her ambitions for the ESVS. Her passion for vascular surgery is contagious, and this conversation offers a personal glimpse into the ideas and energy she brings to her presidency.

Links:

Inaugural lecture: https://pure.amsterdamumc.nl/ws/portalfiles/portal/143254652/oratie_final_KKY.pdf

Recorded live from Belgrade at the ESVS course on complex aortic surgery.

In this episode, Joanna Halman is joined by Professors Marko Dragaš, Igor Končar and Nikola Ilić for a practical discussion on complex aortic surgery.

They discuss how to choose between open and endovascular repair, whether aortic surgery should become further subspecialised, and their approaches to aortic clamping, visceral perfusion and organ protection during open repair.

At the end of the episode, special guest Professor Germano Melissano joins the discussion to share his perspective on training and education in complex aortic surgery.

In this episode of the ESVS Podcast, we discuss one of the oldest yet most effective treatments in vascular medicine: compression therapy.

Our guest is Professor Melina Vega de Ceniga, Head of the Department of Angiology and Vascular Surgery at Galdakao-Usansolo University Hospital, Spain, and an internationally recognised expert in chronic venous disease. She is an active member of the European Society for Vascular Surgery (ESVS), she has been involved in the creation and development of the ESVS Podcast programme.

Together, we explore the physiological basis of compression therapy, its indications across a wide range of vascular conditions, the different compression systems available, and practical aspects of their application. We also discuss pressure selection, contraindications, compression therapy in patients with peripheral arterial disease and heart failure, and the management of venous leg ulcers.

Finally, Professor Vega de Ceniga shares practical strategies to improve patient adherence, prevent ulcer recurrence, and optimise long-term outcomes.

This episode provides practical guidance for vascular specialists, trainees, wound-care professionals, and all clinicians involved in the management of patients with chronic venous disease and lower-limb oedema.

This episode has been supported by Urgo Medical

References

1. De Maeseneer MGR, Kakkos SK, Aherne T, et al. ESVS 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022;63:184–267.
2. O'Meara S, Cullum N, Nelson EA, Dumville JC. Compression for venous leg ulcers. Cochrane Database Syst Rev. 2021;9.
3. Gohel MS, Heatley F, Liu X, et al. A Randomized Trial of Early Endovenous Ablation in Venous Ulceration. N Engl J Med. 2018;378:2105–2114.

Join us for another ESVS podcast where we discuss the important but often neglected topic of pain management in patients undergoing amputation. In this episode, we are joined by consultant vascular surgeon Mr David Bosanquet from Cardiff, UK to discuss why these patients can be very difficult to manage. During the discussion, the importance of multi-model analgesia is highlighted and also the role of peri-neural nerve blockade both pre and post operatively. What is the evidence for intra-operative nerve catheters and are there any new techniques evolving to solve chronic post amputation pain? Does Targeted Muscle Re-innervation (TMR) and Regenerative Peripheral Nerve Interface (RPMI) have a role? All will be answered!

In this episode, Professor Santi Trimarchi discusses the ESVS Clinical Practice Consensus Statement on Ascending Thoracic Endovascular Aortic Repair (aTEVAR). He provides a comprehensive scientific overview of the document, helping listeners gain a concise yet thorough understanding of its key recommendations and expert consensus.

During the episode, we explore the unique anatomical challenges of the ascending aorta for endovascular repair, patient selection, and situations in which conservative management may be preferred over intervention. We also discuss landing zone requirements, stent graft sizing strategies, vascular access considerations, cardiac output control during stent graft deployment, contraindications for aTEVAR, the prevention and management of endoleaks, post-procedural surveillance, and future research priorities.

For a detailed review of the recommendations and supporting evidence, listeners are encouraged to consult the full consensus document.

References:

Trimarchi S, Czerny M, Haulon S, van Herwaarden JA, de Kort JF, Roselli EE, Schermerhorn ML, Upchurch GR Jr, Wanhainen A, on behalf of the ESVS Guidelines Steering Committee. European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Consensus Statement on Ascending Thoracic Endovascular Aortic Repair. European Journal of Vascular and Endovascular Surgery. 2025;70:10–23. doi:10.1016/j.ejvs.2025.05.023

The publication of CREST-2 has reignited one of the longest-standing debates in vascular medicine: should asymptomatic carotid stenosis still be treated invasively in the era of modern best medical therapy? In this episode, Laurence Bertrand and Rosalinda D'Amico discuss the trial with Barbara Rantner and Caitlin Hicks, exploring its methodology, controversial findings, and the implications for the management of asymptomatic carotid stenosis.

Full name of guests:

Dr. Barbara Rantner – TUM University Hospital, Munich, Chair of ESVS and DGG guideline writing committee

Dr. Caitlin Hicks, Johns Hopkins University School of Medicine, Member of the writing committee ESVS and SVS guidelines

Shownotes:

Brott TG, Howard G, Lal BK, Voeks JH, Turan TN, Roubin GS, Lazar RM, Brown RD Jr, Huston J 3rd, Edwards LJ, Jones M, Clark WM, Chamorro Á, Llull L, Mena-Hurtado C, Heck D, Marshall RS, Howard VJ, Moore WS, Barrett KM, Demaerschalk BM, Sangha N, Aronow H, Foster M, Sternbergh WC 3rd, Shawl F, Lanzino G, Rapp J, Tran HS, Ecker R, Mackey A, Ali V, Given C 2nd, Teal P, Kashyap VS, Mukherjee D, Harrigan M, Silverman S, Koopmann M, Wadley VG, Zhang Y, Rhodes JD, Chaturvedi S, Meschia JF; CREST-2 Investigators. Medical Management and Revascularization for Asymptomatic Carotid Stenosis. N Engl J Med. 2026 Jan 15;394(3):219-231. doi: 10.1056/NEJMoa2508800. Epub 2025 Nov 21. PMID: 41269206; PMCID: PMC13148431.

Halliday A, Bulbulia R, Bonati LH, Chester J, Cradduck-Bamford A, Peto R, Pan H; ACST-2 Collaborative Group. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy. Lancet. 2021 Sep 18;398(10305):1065-1073. doi: 10.1016/S0140-6736(21)01910-3. Epub 2021 Aug 29. PMID: 34469763; PMCID: PMC8473558.

How should we approach intervention thresholds, repair strategies, and lifelong surveillance in patients with genetic aortopathies? Prof. Sherene Shalhub (Oregon Health & Science University) and Prof. Rana Afifi (McGovern Medical School at UTHealth Houston) discuss the practical challenges, controversies, and unanswered questions that shape decision-making in the management of these complex patients.

Shownotes:

Lian T, Pai CW, Woznicki E, et al. Nonsyndromic familial type B aortic dissection exhibits distinct clinical profiles and operative outcomes. J Vasc Surg. 2026. doi:10.1016/j.jvs.2026.04.022.

MacCarrick G, Afifi RO, Allen R, et al. Loeys-Dietz Syndrome: 2026 updated care management primer. Genet Med. 2026. doi:10.1016/j.gim.2026.102577.

Lian T, Bhandari A, Shalhub S. What Every Vascular Surgeon Should Know About Vascular Ehlers-Danlos Syndrome. Ann Vasc Surg. 2026. doi:10.1016/j.avsg.2026.03.032.

Calderon-Martinez E, Velasco WV, Guo D, et al. Differences in Arterial Events in Vascular Ehlers-Danlos, Loeys-Dietz, and Marfan Syndrome. J Am Coll Cardiol. 2025;85:2355-2367. doi:10.1016/j.jacc.2025.04.023.

Shalhub S. The aortic and arterial vulnerability spectrum: A conceptual biological framework for risk stratification and precision surgical decision-making in aortopathy and arteriopathy. J Vasc Surg. 2025;82:722-739.e4. doi:10.1016/j.jvs.2025.04.028.

Dittman JM, Prakash SK, Gupta PC, et al. Practice Patterns and Barriers to Vascular Genetic Testing Among Vascular Surgeons. Ann Vasc Surg. 2024;105:140-149. doi:10.1016/j.avsg.2024.01.032.

Shalhub S, Byers PH. Endovascular repair of a common iliac artery aneurysm with an iliac branch device in a patient with vascular Ehlers-Danlos syndrome due to a null COL3A1 variant. J Vasc Surg Cases Innov Tech. 2023;9:101192. doi:10.1016/j.jvscit.2023.101192.

Dittman JM, Saldana-Ruiz N, Newhall K, et al. Open repair of abdominal aortic aneurysms in patients with vascular Ehlers-Danlos syndrome. J Vasc Surg Cases Innov Tech. 2023;9:101194. doi:10.1016/j.jvscit.2023.101194.

Shalhub S, Nkansah R, El-Ghazali A, et al. Splenic artery pathology presentation, operative interventions, and outcomes in 88 patients with vascular Ehlers-Danlos syndrome. J Vasc Surg. 2023;78:394-404. doi:10.1016/j.jvs.2023.04.007.

Regalado ES, Morris SA, Braverman AC, et al. Comparative Risks of Initial Aortic Events Associated With Genetic Thoracic Aortic Disease. J Am Coll Cardiol. 2022;80:857-869. doi:10.1016/j.jacc.2022.05.054.

Recorded live at the ESVS Vascular Graft and Endograft Infection Workshop in Groningen, this episode explores one of the most challenging complications in vascular surgery. We spoke with Prof. Ben Saleem, Prof. Xavier Berard, and workshop participants about diagnosis, treatment strategies, difficult clinical decisions, and the key lessons learned from this unique hands-on course. A practical discussion on managing vascular graft infections, featuring expert insights and real-world experience from across Europe.

In this podcast, we are joined by Dr Alex Crichton, researcher at the Trisha Roy Vascular laboratory at Houston Methodist Hospital, Texas, to discuss how QISS MRA can be used to image tibial vessels that are often missed by more conventional forms of imaging such as CT angiography, ultrasound duplex imaging or digital subtraction angiography. Diabetic patients can be especially challenging in selecting target vessels for treatment because of the presence of calcium in the vessel wall and the distal nature of the disease. Furthermore, many of these patients have impaired renal function where the use of contrast media can be detrimental. In this episode, Dr Crichton explains the work being done with QISS MRA to enable visualisation of these so called “hibernating vessels” and also how it can be used to characterise plaque morphology and the suitability for endovascular intervention.

Rosalinda D’Amico interviews Prof. Kevin Mani on one of the key controversies in EVAR follow-up: is aneurysm sac shrinkage truly a marker of success, or can it sometimes provide false reassurance? They discuss the current definition of sac regression, the importance of timing and sac stability and whether sac shrinkage should influence surveillance strategies. The episode also explores the role of CTA versus duplex ultrasound and the future potential of volumetric and AI-based assessment in EVAR surveillance

References:

Tinelli G, D'Oria M, Sica S, Mani K, Rancic Z, Resch TA, Beccia F, Azizzadeh A, Da Volta Ferreira MM, Gargiulo M, Lepidi S, Tshomba Y, Oderich GS, Haulon S; SLIM F-U EVAR, Collaborative Study Group. The sac evolution imaging follow-up after endovascular aortic repair: An international expert opinion-based Delphi consensus study. J Vasc Surg. 2024 Sep;80(3):937-945. doi: 10.1016/j.jvs.2024.03.007. Epub 2024 Mar 8. PMID: 38462062.

In this episode of the ESVS Podcast, we explore air pollution as an often-overlooked risk factor for peripheral arterial disease (PAD).

We are joined by Professor Alberto Maria Settembrini. Professor Settembrini is a vascular surgeon in Milan in MultiMedica and Professor of vascular surgery at Unicamillus University in Rome. He is a co-author of a large Rome-based longitudinal study involving over 1.7 million individuals. The study shows that long-term exposure to PM2.5, NO₂, and black carbon is associated with increased PAD incidence, with stronger effects in males and people aged 55–69.

Professor Settembrini discusses the links between different pollutants and PAD, how pollution interacts with traditional risk factors (obesity, diabetes, smoking, hypertension), the underlying mechanisms, and practical advice for vascular specialists in daily practice.

During the episode, we also hear from Porto’s City Councillor for the Mobility and Transportation, Engineer Hugo Beirão, who shares the city’s efforts to improve urban health.

References:

1- Ravalli S, Musumeci G, et al. Chelation therapy in patients with cardiovascular disease: a systematic review. Journal of Clinical Medicine. 2022;11(4):1033. doi:10.3390/jcm11041033

2- Serra R, Abramo A, Ielapi N, Procopio S, Marino P. Environmental pollution and peripheral artery disease. Risk Manag Healthc Policy. 2021;14:2181–2190.

3- Liao SH, Chiu CS, Jang LH, Hu SY, How CK, Hsieh VCR, et al. Long-term exposures to air pollutants and risk of peripheral arterial occlusive disease: a nationwide cohort study in Taiwan. Front Cardiovasc Med. 2022;9:796423.

4- Gwon JG, Park JH, Kim JS, Seo HM. Exposure to long-term air pollution and incidence of peripheral arterial disease in the general population: a national population-based retrospective cohort study. [Preprint]. 2021.

5- Deng Z, Duan L, Wang K. Revisiting the association between air pollution and peripheral artery disease: evidence from Mendelian randomization analysis. Eur J Intern Med. 2025;132:164–166.

6- Di Blasi C, Nobile F, Settembrini AM, Stafoggia M, Davoli M, Michelozzi P, et al. Association between long-term exposure to air pollution and incidence of peripheral artery disease: evidence from a longitudinal study. Eur J Intern Med. 2025;132:113–117.

In this episode, we’ll focus on the final sections of the guideline, which deal with rupture, trauma, and post-operative complications. These are scenarios where decisions are often made under time pressure, evidence is limited, and outcomes can be profoundly affected by organisation of care, experience, and judgement.

Guests:

Prof. Anders Wanhainen

Dr. Carlota Fernández-Prendes

Prof. Athanasios Katsargyris

Welcome back to the ESVS Podcasts. This is Suzanne Stokmans, and you are listening to part 2 of the Q&A series on the ESVS 2026 Clinical Practice Guidelines on the Management of Descending Thoracic and Thoraco-Abdominal Aortic Diseases.

In this episode, we move from the general principles discussed in part 1 to disease-specific management. We’ll focus on acute thoracic aortic syndromes, chronic type B aortic dissection, and degenerative descending thoracic and thoraco-abdominal aortic aneurysms, conditions that make up a large part of daily aortic practice, where decision-making is often nuanced and time-critical.

Full names of guests:

Prof. Anders Wanhainen

Dr. Carlota Fernández Prendes

Prof. Athanasios Katsargyris.

In today’s episode, the first of this three-part series, we will discuss the opening section of the guideline: service standards and general considerations. Before moving to specific disease entities or operative strategies, the guideline deliberately starts with the fundamentals — how care should be organised, how patients should be assessed, and which general principles should guide our decision making.

Full names of guests:

Prof. Anders Wanhainen

Dr. Carlota Fernández Prendes

Prof. Athanasios Katsargyris.

In this episode of the ESVS Podcast, supported by Servier, we explore the importance of therapy adherence in chronic venous disease (CVD). The episode opens with short patient testimonies, highlighting real-world reasons for non-adherence.

To explore this further, we are joined by Professor Denisa Celovska and Professor Atul Pathak. Professor Celovska is an Associate Professor of Angiology and Internal Medicine at the University Hospital and Comenius University in Bratislava, Slovakia. She is currently the President of the Slovak Angiology Society. Professor Pathak is the Head of the National Institute of Cardiology, Cardiac Surgery and Interventional Cardiology in Luxembourg.

In this episode, they share their clinical perspective on why patients frequently disengage from treatment, the most common barriers to adherence in daily practice, and practical strategies to improve long-term treatment persistence.

The episode also includes insights from a community pharmacist, offering a complementary view on what happens between prescription and real-life use, particularly regarding venoactive drugs. We conclude by emphasising that effective CVD management extends beyond prescribing treatment. Patient education, shared decision-making, follow-up, and human connection are essential to improve adherence and long-term outcomes in CVD.

References:

1. Kim H, Cho S, Lee K, Lee SH, Joh JH. A nationwide study of compliance of venoactive drugs in chronic venous disease patients. Ann Surg Treat Res. 2023 May;104(5):288-295. doi: 10.4174/astr.2023.104.5.288. Epub 2023 Apr 28. PMID: 37179697; PMCID: PMC10172027.
2. Burnier M. The role of adherence in patients with chronic diseases. Eur J Intern Med. 2024 Jan;119:1-5. doi: 10.1016/j.ejim.2023.07.008. Epub 2023 Jul 20. PMID: 37479633.
3. Mezalek ZT, Feodor T, Chernukha L, Chen Z, Rueda A, Sánchez IE, Ochoa AJG, Chirol J, Blanc-Guillemaud V, Lohier-Durel C, Ulloa JH. VEIN STEP: A Prospective, Observational, International Study to Assess Effectiveness of Conservative Treatments in Chronic Venous Disease. Adv Ther. 2023 Nov;40(11):5016-5036. doi: 10.1007/s12325-023-02643-6. Epub 2023 Sep 20. Erratum in: Adv Ther. 2024 Jan;41(1):464-465. doi: 10.1007/s12325-023-02722-8. Erratum in: Adv Ther. 2024 Jun;41(6):2540-2541. doi: 10.1007/s12325-024-02857-2. PMID: 37728696; PMCID: PMC10567827.
4. Bogachev, V., Arribas, J.M.J., Baila, S. et al. Management and evaluation of treatment adherence and effectiveness in chronic venous disorders: results of the international study VEIN Act Program. Drugs Ther Perspect 35, 396–404 (2019). https://doi.org/10.1007/s40267-019-00637-5
5. Golna C, Poimenidou C, Giannoukari EE, Saridi M, Liberopoulos E, Souliotis K. Assessing a pharmacist-enabled intervention to improve adherence to medication for hypertension, dyslipidemia, and chronic venous circulation disorders in Greece. Patient Prefer Adherence. 2023;17:3341–3352. doi:10.2147/PPA.S420811

6. Branisteanu DE, Munteanu AE, Dolofan BM, Popescu EG, Vittos O. Adherence to pharmacological treatment in chronic venous disease: results of a real-world, prospective, observational cohort study. Life (Basel). 2025;15(3):377. doi:10.3390/life15030377.

7. Ulloa JH, Guerra D, Cadavid LG, Fajardo D, Villarreal R, Bayona G, Hoyos AS, Garcia G. Nonoperative approach for symptomatic patients with chronic venous disease: results from the VEIN Act program. Phlebolymphology. 2018;25(2):123

Servier is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Servier. Always consult the Instructions for Use (IFU) prior to using any medical device.

In this episode of the ESVS Podcast, we tackle one of medicine’s most deceptively simple challenges : agreeing on what we’re actually talking about. Vascular graft and endograft infections (VGEI) are rare, serious, and universally dreaded, but when it comes to defining them, classifying them, and reporting outcomes, it turns out the vascular world hasn’t always been speaking the same language. Safa Riahi is joined by Dr Thomas Wyss and Dr Karl Sörelius to discuss a recent international Delphi consensus that brought together 43 multidisciplinary experts to do something surprisingly difficult: agree on definitions. From the long-standing debate over early versus late infection, to the subtle but clinically important difference between graft-enteric erosion and fistula, to the brave attempt to define what “cure” actually means in a disease that likes to relapse when you least expect it, this episode explores how a shared vocabulary might finally help researchers compare studies, registries make sense, and multidisciplinary teams argue a little more productively. As it turns out, building a common language might be one of the most important steps toward better science; and better care; in VGEI.

The Delphi consensus discussed in this episode can be accessed here:

https://www.ejves.com/article/S1078-5884(25)00707-5/

How common are aortic dissections in Asia, and why do some patients appear to present nearly a decade earlier than in Western cohorts? Laurence Bertrand speaks with Dr. Peter Robless, founder of vascular surgery at the national university hospital of Singapore and former President of the Asian Society for Vascular Surgery, about Asian epidemiology, treatment approaches, and evolving endovascular practice.

Join us for another episode in our Secret Lives series of podcasts, where we delve into the science behind some of the everyday tools and equipment we use in the field of vascular surgery. In this episode, we will be taking a look at what is probably one of the most fearfully complicated pieces of equipment out there, the Magnetic Resonance Imaging or MRI scanner. A true marvel of applied physics and engineering that combines super-conducting magnets and radio-frequency to produce some of the most detailed medical imaging available. We will also take a look at how MR angiography works and how to interpret those grainy MRA images. No need to get confused with those T1 and T2 imaging sequences anymore; All will be explained! With Justin Woolgar.

Welcome to the final episode of the Q&A series of the 2025 ESVS Clinical Practice Guidelines on the Management of Diseases of the Mesenteric and Renal Arteries and Veins. The final episode completes the Q&A series by addressing several important and often rare vascular conditions covered in the 2025 ESVS guidelines.

Topics include acute and chronic mesenteric venous thrombosis, anticoagulation strategies and the role of DOACs, and indications for endovascular or surgical intervention. The discussion then turns to renal vascular disease, including renal artery stenosis, fibromuscular dysplasia, and Nutcracker syndrome. The episode concludes with an overview of visceral artery aneurysms and spontaneous isolated dissections of the mesenteric and renal arteries, focusing on diagnosis, risk stratification, and treatment thresholds. This concluding episode offers a comprehensive overview of the remaining guideline chapters and practical insights for clinical decision-making.

Full names of guests:

Dr. Mark Koelemay

Professor Dr. Bob Geelkerken

Dr. Nicola Leone

Dr. Jussi Kärkkäinen (Part 2)

Shownotes:

https://www.ejves.com/article/S1078-5884(25)00516-7/fulltext

https://open.spotify.com/episode/45Hk77hIyikYNcWklAyVMA

https://open.spotify.com/episode/58yEYHdIdh7IgVQY13gcmk

Welcome to part 2 of the Q&A series of the 2025 ESVS Clinical Practice Guidelines on the Management of Diseases of the Mesenteric and Renal Arteries and Veins. In this podcast, we will highlight the new, complex and most controversial recommendations in this guideline. In episode two, the discussion moves to Median Arcuate Ligament Syndrome (MALS), acute mesenteric ischaemia (AMI), and non-occlusive mesenteric ischaemia (NOMI)—three challenging and clinically relevant conditions.

The experts explore patient selection and diagnostic criteria for MALS, ongoing controversies in treatment, and current research. The episode also covers the clinical presentation, imaging findings, and updated diagnostic approach to acute mesenteric ischaemia, including why biomarkers such as lactate and D-dimer are no longer recommended for diagnosis. Finally, management strategies for NOMI, including multidisciplinary care and intra-arterial vasodilator therapy, are discussed.

Guests:

Dr. Mark Koelemay

Professor Dr. Bob Geelkerken

Dr. Nicola Leone

Dr. Jussi Kärkkäinen (Part 2)

Shownotes:

https://www.ejves.com/article/S1078-5884(25)00516-7/fulltext

https://open.spotify.com/episode/45Hk77hIyikYNcWklAyVMA

https://open.spotify.com/episode/58yEYHdIdh7IgVQY13gcmk

This is part 1 of the Q&A series of the 2025 ESVS Clinical Practice Guidelines on the Management of Diseases of the Mesenteric and Renal Arteries and Veins. In this podcast, we will highlight the new, complex and most controversial recommendations in this guideline. Today, for the first episode of this 3-part series, we will specifically talk about chronic mesenteric ischaemia.

Topics include the definition and diagnosis of chronic mesenteric ischaemia, the role of duplex ultrasound and CT angiography, indications for treatment in symptomatic and asymptomatic patients, and decision-making around endovascular versus open revascularisation. New evidence on stent choice and surgical strategies is also discussed. This episode provides practical guidance and expert insight into the updated recommendations for managing chronic mesenteric ischaemia in daily clinical practice.

Guests:

Dr. Mark Koelemay

Professor Dr. Bob Geelkerken

Dr. Nicola Leone

Dr. Jussi Kärkkäinen (part 2)

Shownotes:

https://www.ejves.com/article/S1078-5884(25)00516-7/fulltext

https://open.spotify.com/episode/45Hk77hIyikYNcWklAyVMA

https://open.spotify.com/episode/58yEYHdIdh7IgVQY13gcmk

In this episode of the ESVS Podcast, host Vaiva Dabravolskaite speaks with Judith Gilroy (Ireland), a medical educator and clinician working on training culture, psychological safety, and fairness in career progression. They reflect on everyday discrimination, belonging, allyship, and the hidden curriculum in surgery. Inspired by research on sexual misconduct and microaggressions, this conversation invites honest self-reflection on how culture shapes careers and how we can do better for each other.

Literature sources to be shared if possible (divided into two groups) :

1. Key Report & Ongoing Work

• Breaking the Silence: Addressing Sexual Misconduct Prof Carrie Newlands, Ms Tamzin Cuming, Ms Philippa Jackson University of Surrey / RCSI presentation (2024) https://openresearch.surrey.ac.uk/esploro/fulltext/report/BREAKING-THE-SILENCE-Addressing-Sexual-Misconduct/99944566102346

• Workplace Sexual Misconduct in Surgery (WPSMS) – updates & research https://www.wpsms.org.uk/

2. Reflection & Allyship Videos

• “That Little Voice” https://www.youtube.com/watch?v=Ll56imVATLk

• What is Intersectionality? – Peter Hopkins https://www.youtube.com/watch?v=O1islM0ytkE

• How are Microaggressions Like Mosquitoes? https://www.youtube.com/watch?v=emz49wSnNcs

• Heartbreaking Moment When Kids Learn About White Privilege https://www.youtube.com/watch?v=1I3wJ7pJUjg

Want to know why Prof. Tsilimparis says “the dissection membrane is not always your enemy”? Tune in to this ESVS Podcast for an in-depth discussion on indications, decision-making, technical tips and tricks, and what the future may hold for the evolving field of aortic dissection management.

Recorded live at LMU University Hospital in Munich, this episode of the ESVS Podcast features host Laurence Bertrand in conversation with Prof. Tsilimparis, Head of Vascular Surgery and an internationally recognised expert in aortic dissection management.

Can exercise really make a difference after deep vein thrombosis? We talk with Professor Marie José van Rijn from Erasmus University Medical Center about how physical activity can influence recovery, reduce complications like post-thrombotic syndrome, and improve quality of life. From early mobilisation to long-term exercise strategies, discover how “get moving” may change the way we manage DVT.

Join us for this insightful conversation!

References:

1. Martins, A; Junior L; Oliveira, J. (2023). Benefits of early mobilization in patients with deep venous thrombosis: a scope review. Heart, Vessels and Transplantation.

2. Rook B, van Rijn MJE, Jansma EP, van Montfrans C. Effect of exercise after a deep venous thrombosis: A systematic review. J Eur Acad Dermatol Venereol.

3. Kahn SR. The post-thrombotic syndrome. Hematology Am Soc Hematol Educ Program.

4. Liu Z, Tao X, Chen Y, Fan Z, Li Y. Bed rest versus early ambulation with standard anticoagulation in the management of deep vein thrombosis: a meta-analysis. PLoS One.

5. Anderson CM, Overend TJ, Godwin J, Sealy C, Sunderji A. Ambulation after deep vein thrombosis: a systematic review. Physiother Can.

6. Kahn SR, Comerota AJ, Cushman M, Evans NS, Ginsberg JS, Goldenberg NA, Gupta DK, Prandoni P, Vedantham S, Walsh ME, Weitz JI; American Heart Association Council on Peripheral Vascular Disease, Council on Clinical Cardiology, and Council on Cardiovascular and Stroke Nursing. The postthrombotic syndrome: evidence-based prevention, diagnosis, and treatment strategies: a scientific statement from the American Heart Association.

Circulation. 2014 Oct 28;130(18):1636-61. doi: 10.1161/CIR.0000000000000130. Epub 2014 Sep 22. Erratum in: Circulation.

7. Kakkos SK, Gohel M, Baekgaard N, Bauersachs R, Bellmunt-Montoya S, Black SA, Ten Cate-Hoek AJ, Elalamy I, Enzmann FK, Geroulakos G, Gottsäter A, Hunt BJ, Mansilha A, Nicolaides AN, Sandset PM, Stansby G, Esvs Guidelines Committee, de Borst GJ, Bastos Gonçalves F, Chakfé N, Hinchliffe R, Kolh P, Koncar I, Lindholt JS, Tulamo R, Twine CP, Vermassen F, Wanhainen A, Document Reviewers, De Maeseneer MG, Comerota AJ, Gloviczki P, Kruip

MJHA, Monreal M, Prandoni P, Vega de Ceniga M. Editor's Choice – European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the Management of Venous Thrombosis. Eur J Vasc Endovasc Surg.

8. Jasionowska S, Turner BRH, Machin M, Onida S, Gwozdz AM, Shalhoub J, Davies AH. Systematic review of exercise therapy in the management of post-thrombotic syndrome. Phlebology.

9. Steiner D, Nopp S, Pabinger I, Dassler E, Koppensteiner R, Müller M, Weber B, Ay C, Schlager O. Impact of thrombosis location on walking capacity: a cohort study of patients with acute deep vein thrombosis. Res Pract Thromb Haemost.

10. Wu C, Li X, Zhao H, Ling Y, Ying Y, He Y, Zhang S, Liang S, Wei J, Gan X. Resistance exercise promotes the resolution and recanalization of deep venous thrombosis in a mouse model via SIRT1 upregulation. BMC Cardiovasc Disord.

11. Mota GR, Simim MAM, Dos Santos IA, Sasaki JE, Marocolo M. Effects of Wearing Compression Stockings on Exercise Performance and Associated Indicators: A Systematic Review. Open Access J Sports Med.

In our special holiday podcast we take a look at the current controversy surrounding PFAS or Forever chemicals. Were you aware that one of the most commonly used compounds in vascular surgery, PTFE, actually falls into this category of substances? Is there anything to worry about? What should we be telling patients? All of these burning questions will be answered. With Justin Woolgar.

In this episode, we focus on the trainee perspective in vascular surgery across Europe.

Trainees and young vascular surgeons share what works in training, what doesn’t, and what they would change if they could, touching on structure, mentorship, autonomy, soft skills, and everyday challenges.

We’re also joined by Dr David Wippel, who presents insights from his research on the training experience of young vascular surgeons, including burnout, fulfilment, and professional development.

Get involved

If you’re a trainee or young vascular surgeon and would like to take part in the survey discussed in this episode, you can join here:

Link to the Trainee Survey: https://redcap.link/8ubj206v

If you’re a consultant in vascular surgery with over 5 years of experience and would like to take part in the survey discussed in this episode, you can join here:

Link to the Trainer Survey: https://redcap.link/shp8nthl

Your input helps shape the future of vascular surgery training.

In Part 1 of our ESVS training series, we speak with Professor Elena Iborra and Professor Igor Končar about the realities of training young vascular surgeons across Europe. They discuss expectations, mentorship, and how to shape safe, effective learning environments for the next generation.

A concise, insightful look at what defines good vascular training today.

How can a global, imaging-rich registry powered by AI reshape surveillance and quality of life after EVAR and TEVAR?

In this episode of the ESVS Podcast, host Egle Kavaliunaite speaks with Prof. Kak Khee Yeung (Amsterdam UMC, ESVS President 2026–27-elect) and Prof. Timothy Resch (Copenhagen University Hospital) about the TOGETHER Registry, a large, prospective, long-term aortic registry capturing real-world data on EVAR, TEVAR and iliac branch devices, including hostile as well as standard anatomy.

In this conversation, they explore:

• What makes TOGETHER different from previous aortic registries (central imaging, longer follow-up, global scope)
• How advanced imaging and AI-ready data may help predict which patients need intensive surveillance – and who may safely need less
• The clinical meaning of sac regression, endoleaks and durability when viewed through patient quality of life
• The strengths and limitations of a single-brand registry in a multi-device treatment landscape
• How remote monitoring, mobile tools and future biomarkers could transform aortic follow-up

Listen now, and subscribe to the ESVS Podcast on Spotify, Apple Podcasts or SoundCloud, and explore more aortic content in the ESVS Library.

We explore the challenges of Peripheral Arterial Disease (PAD) in women, with two renowned experts: Professor Maarit Venermo and Professor Mirjami Laivuori.

Together, we discuss why PAD continues to be underdiagnosed in women despite equal or even higher prevalence, the limitations of the ankle–brachial index (ABI) in female patients, the intricate interplay between estrogen, menopause, and vascular health, the growing trend toward endovascular-first strategies in women, and the conflicting evidence surrounding revascularisation outcomes.

An evidence-based and clinically relevant conversation awaits.

References

• Divakaran S, Krawisz AK, Secemsky EA, Kant S. Sex and Racial Disparities in Peripheral Artery Disease. 2023
• Jelani QU, Petrov M, Martinez SC, Holmvang L, Al-Shaibi K, Alasnag M. Peripheral Arterial Disease in Women: an Overview of Risk Factor Profile, Clinical Features, and Outcomes. 2018
• Kozak M, Poredoš P, Blinc A, Kaja Ježovnik M, Poredoš P. Peripheral arterial disease in women. 2024
• Porras CP, Bots ML, Teraa M, van Doorn S, Vernooij RWM. Differences in Symptom Presentation in Women and Men with Confirmed Lower Limb Peripheral Artery Disease: A Systematic Review and Meta-Analysis. 2022
• Kavurma MM, Boccanfuso L, Cutmore C, Passam F, Patel S, Hennessy A, Loa J, Figtree GA, Golledge J, Robinson DA, Aitken S. A hidden problem: peripheral artery disease in women. 2023
• Srivaratharajah K, Abramson BL. Women and Peripheral Arterial Disease: A Review of Sex Differences in Epidemiology, Clinical Manifestations, and Outcomes. 2018
• Pabon M, Cheng S, Altin SE, Sethi SS, Nelson MD, Moreau KL, Hamburg N, Hess CN. Sex Differences in Peripheral Artery Disease. 2022
• Twine CP, Kakkos SK, Aboyans V, Baumgartner I, Behrendt CA, Bellmunt-Montoya S, Jilma B, Nordanstig J, Saratzis A, Reekers JA, Zlatanovic P; ESVS Guidelines Committee; Antoniou GA, de Borst GJ, Bastos Gonçalves F, Chakfé N, Coscas R, Dias NV, Hinchliffe RJ, Kolh P, Lindholt JS, Mees BME, Resch TA, Trimarchi S, Tulamo R, Vermassen FEG, Wanhainen A; Document Reviewers; Koncar I, Fitridge R, Matsagkas M, Valgimigli M. European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on Antithrombotic Therapy for Vascular Diseases. 2023
• Nordanstig J, Behrendt CA, Baumgartner I, Belch J, Bäck M, Fitridge R, Hinchliffe R, Lejay A, Mills JL, Rother U, Sigvant B, Spanos K, Szeberin Z, van de Water W; ESVS Guidelines Committee; Antoniou GA, Björck M, Gonçalves FB, Coscas R, Dias NV, Van Herzeele I, Lepidi S, Mees BME, Resch TA, Ricco JB, Trimarchi S, Twine CP, Tulamo R, Wanhainen A; Document Reviewers; Boyle JR, Brodmann M, Dardik A, Dick F, Goëffic Y, Holden A, Kakkos SK, Kolh P, McDermott MM. European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Asymptomatic Lower Limb Peripheral Arterial Disease and Intermittent Claudication. 2024

In this episode, with Prof. Tilo Kölbel, we discuss the significant risks associated with air embolism during aortic surgery, the innovative technique of CO2 flushing of aortic endografts, and the practical tips and tricks of implementing this technique in clinical practice. The conversation also touches on current guidelines and the future of CO2 flushing in endovascular protocols, emphasising its potential to improve patient outcomes. Unmissable!

Also, check out these papers that we mentioned in the podcast:

https://www.ejves.com/action/showPdf?pii=S1078-5884%2825%2900409-5

https://journals.sagepub.com/doi/10.1177/1526602816633705

https://pmc.ncbi.nlm.nih.gov/articles/PMC10151986/

https://www.ejves.com/action/showPdf?pii=S1078-5884%2818%2930692-0

The war in Gaza has been described as a humanitarian catastrophe. Ever since the war began 2 years ago, following the October 7th attack by Hamas it is estimated that over 68,000 people have been killed, with a further 180,000 injured. Thousands have been displaced, and many have suffered starvation and famine because of the Israeli blockade. The plight of medics trying to treat civilians has also been extremely challenging and dangerous, with health care facilities often targeted by the IDF airstrikes. In this podcast, we talk to Mr Ed Brown, a consultant vascular surgeon from the UK who has recently returned from Gaza and describes his experiences working in a warzone. What does it take to work in such an environment? What are the challenges facing surgeons and other health professionals in Gaza? Ever thought of humanitarian work yourself? These are the questions we hope to answer. With Justin Woolgar.

Aortic stent infections remain among the most feared and complex complications in vascular surgery—rare but devastating when they occur. In episode, recorded live in ESVS Istanbul, Dr. Laurence Bertrand speaks with Dr. Anne Le Jay, about complex aortic reconstruction and graft infection management. Together, they examine how vascular specialists are redefining best practice: from early recognition and imaging to multidisciplinary treatment planning, surgical decision-making, and long-term outcomes.

Recorded live during the ESVS Annual Meeting, this episode brings together two experts shaping the field of oncovascular surgery Dr. Pirkka Vikatmaa and Dr. Stefano Ancetti. We explore how multidisciplinary oncovascular teams are transforming cancer surgery, the expanding role of vascular surgeons in complex tumour resections, and the use of endovascular techniques in oncovascular surgery.

In this episode, recorded live at the 39th ESVS Annual Meeting, we sit down with Prof. Javier Pascual, a podiatrist specialised in diabetic foot care and wound biomechanics. Together, we explore the biomechanical principles behind the most common diabetic foot ulcers (DFUs) — why they develop, how abnormal pressure and gait contribute to tissue breakdown, and what clinicians can do to enhance healing and to prevent ulcer recurrence. Dr. Pascual breaks down complex concepts into practical insights, making this a must-listen for vascular specialists, podiatrists, wound-care nurses, and anyone involved in multidisciplinary diabetic foot management.

Join us for another episode in our journey into the secret lives of vascular machines and devices. In this episode, we look at the ubiquitous vascular stent. Ever wondered who invented them and when they were first used to treat vascular disease? Ever thought about why they are made of stainless steel or nitinol? In fact, what actually is Nitinol? All your burning questions answered in this podcast that delves into the world of vascular bioengineering. Presented by Justin Woolgar.

Only about 50% of patients with chronic diseases adhere to treatment recommendations, and the consequences can be devastating. In this thought-provoking episode of the ESVS Podcasts, we delve into this important and under-discussed issue. Together with Professor Khadija Hafidh, we analyse some factors that help explain why so many patients struggle with adherence, as well as some strategies that have proved effective in improving patient compliance. Spoiler: empathy, communication, shared decision making, and simplifying the treatment regime are key elements. Join us in this episode that can really help your clinical practice.

As vascular surgeons, we all use various pieces of equipment and technology in our day jobs. Everything from the hand-held Doppler to complex ultrasound machines, CT and MRI scanners. Every time we treat vascular disease we use some form of technology, be it an angioplasty balloon, stent or a vascular graft. We are surrounded by technology and use it all the time, but how many of us actually have any clue as to how it works? In this series of podcasts, we will take a slightly light-hearted look at the biomedical engineering involved in some of the pieces of kit that most of us take for granted. Nothing too overwhelming, but enough to explain the science behind the machine.

In the first episode, we will take a look at the humble hand-held Doppler machine and explain how this frequently used machine does what it does. We will explain how the Doppler and piezoelectric effects combine to make an essential tool for clinicians and allied healthcare professionals in the field of vascular surgery.

Presented by Justin Woolgar.

In this episode, we’re joined by Prof. Alberto Settembrini and Associate Professor Ashley K. Vavra to discuss the application of Enhanced Recovery After Surgery (ERAS) protocols in the treatment of abdominal aortic aneurysms.

We explore how ERAS principles are adapted for both open and endovascular AAA repair, covering key elements such as preoperative risk assessment, anaesthetic management, early mobilisation, and discharge planning.

The conversation underscores the importance of bridging the gap between evidence and clinical practice, as well as the central role of the entire multidisciplinary team, comprising surgeons, anesthesiologists, nurses, physiotherapists, and dietitians.

In this episode, we’re joined by Prof. Kate McGinigle – vascular surgeon, researcher, and expert in Enhanced Recovery After Surgery (ERAS).

We explore the role of ERAS protocols in optimising outcomes for vascular surgery patients, with a focus on preoperative risk assessment, nutritional support, and structured prehabilitation.

Drawing on clinical data and implementation experience, Prof. McGinigle outlines practical strategies that surgical teams can adopt to reduce complications, support recovery, and personalise care pathways.

This is Part 1 of a two-part series on perioperative optimisation in vascular surgery.

Recommended for surgeons, anesthesiologists, dietitians, physiotherapists, and all healthcare professionals involved in perioperative care.

In Part 2 of our wound care series, we shift focus to what happens on the wound bed itself. From negative pressure therapy to advanced dressings and skin grafts – this episode is all about local treatment strategies.

Our expert guests, dermatologist Dr. Magdalena Antoszewska and wound care nurse Kamila Mazuryk, walk us through practical solutions, clinical tips, and the logic behind what works (and what doesn’t) in complex wound care, especially when perfusion is compromised.

This episode covers:

• Skin grafts: when, how, and why they succeed or fail
• The do’s and don’ts of NPWT in ischemic and grafted wounds
• How to approach wound bed preparation with limited vascular supply
• Dressing selection: infection control, moisture balance, and biofilm management
• When to avoid debridement – and what to do instead
• Incorporating patient quality of life and mental health into long-term wound plans
• Advanced materials and smart bandage technology

If you’re dealing with diabetic feet, graft failures, or wounds that just won’t close, this episode brings frontline advice from the people who live in the wound world every day.

Whether you're in theatre, clinic, or at the bedside, this is the practical wound wisdom you need.

In a short series of podcasts, we are going to explore the evolving field of complex thoracic aortic repair, with a particular focus on complex endovascular devices implanted in the aortic arch or even the ascending aorta, that is, zones 0 to 2. In today’s episode, we are going to dig into proximal landing zone 2, that is, the need to place the TEVAR device between the left carotid and the left subclavian arteries, so over the origin of the LSA, and strategies to preserve left subclavian artery perfusion.

In this thought-provoking episode of the ESVS Podcast we delve into an important and under-discussed issue in vascular surgery: Are women left behind in carotid stenosis treatment?

Carotid stenosis is a contributor to ischemic strokes, and some papers show women may experience delays or suboptimal care in comparison to men. In this episode, we will listen to Professor Barbara Rantner, a senior consultant vascular surgeon from Munich, Germany, and Dr Claudia Schrimpf, a leading expert from Zurich, Switzerland. Together, they explore sex-related differences in carotid disease treatment and share their insights on the latest research and clinical experiences.

Join us in this episode!

References:

Naylor R, Rantner B, Ancetti S, de Borst GJ, De Carlo M, Halliday A, Kakkos SK, Markus HS, McCabe DJH, Sillesen H, van den Berg JC, Vega de Ceniga M, Venermo MA, Vermassen FEG. European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease. Eur J Vasc Endovasc Surg. 2023;65(1):7–111. doi:10.1016/j.ejvs.2022.04.011

van Dam-Nolen DHK, van Egmond NCM, Koudstaal PJ, van der Lugt A, Bos D. Sex differences in carotid atherosclerosis: a systematic review and meta-analysis. Stroke. 2023;54(2):315–326. doi:10.1161/STROKEAHA.122.041046

Skowronska M, Piorkowska A, Czlonkowska A. Differences in carotid artery atherosclerosis between men and women in the early phase after ischemic event. Neurol Neurochir Pol. 2018;52(1):35–40. doi:10.1016/j.pjnns.2017.09.002

Schmid S, Tsantilas P, Knappich C, Kallmayer M, König T, Breitkreuz T, Zimmermann A, Kuehnl A, Eckstein H-H. Risk of in-hospital stroke or death is associated with age but not sex in patients treated with carotid endarterectomy for asymptomatic or symptomatic stenosis in routine practice: secondary data analysis of the nationwide German statutory quality assurance database from 2009 to 2014. J Am Heart Assoc. 2017;6(10):e004764. doi:10.1161/JAHA.116.004764

Behrendt CA, Ten Bosch JA, Cronenwett JL, Dick F, Guekht A, Halliday A, et al. Sex-related differences in indication and procedural outcomes of carotid interventions in VASCUNET. Eur J Vasc Endovasc Surg. 2023;66(1):7–14. doi:10.1016/j.ejvs.2023.04.022

What role will AI, smart bandages, and regenerative therapies play in the future of wound care?

Dr. Kirsi Isoherranen (Immediate Past President of the European Wound Management Association) joins us to explore how advanced technology is reshaping diagnostics, wound bed preparation, and chronic wound treatment, especially for diabetic and ischaemic ulcers. This conversation covers both frontline clinical insights and forward-looking perspectives from one of Europe’s leading wound healing centres.

Dr. Isoherranen shares with us how collaboration between vascular surgeons and wound care specialists improves outcomes in managing ischemic and diabetic wounds. They discuss diagnostic delays, treatment planning, and how a multidisciplinary approach, including dermatologists, podiatrists, and nutritionists, can make or break complex wound care cases.

Join us for a compelling episode of the ESVS Podcast as we explore the sex disparities in aortic disease with two experts in aortic surgery in women — Dr. Carlota Fernandez-Prendes and Dr. Anna-Louise Pouncey.

In this episode, we discuss why women remain under-represented in clinical trials, which subgroups may benefit most from targeted screening, and why women face higher complication rates after both open and endovascular aneurysm repair in the immediate perioperative period.

We also examine the underlying causes of these differences and how vascular surgeons can optimise outcomes for their female patients.

This episode underscores the importance of heightened clinical awareness and tailored research. Stay tuned until the end for key insights on aortic aneurysm in women.

Referenced articles:

Talvitie M, Åldstedt-Nyrønning L, Stenman M, Roy J, Cohnert T, Hultgren R. Women with large intact abdominal aortic aneurysms remain untreated. J Vasc Surg. 2023;78(3):657–667. doi:10.1016/j.jvs.2023.05.025.

O’Donnell TFX, Patel PB, Marcaccio CL, Dansey KD, Swerdlow NJ, Rastogi V, Patel VI, Beck AW, Zettervall SL, Schermerhorn ML. Outcomes of complex endovascular treatment of post-dissection aneurysms. Eur J Vasc Endovasc Surg. 2023;66(1):58–66. doi:10.1016/j.ejvs.2023.04.013.

Gorgatti F, Nana P, Panuccio G, Rohlffs F, Torrealba JI, Kölbel T. Post-dissection thoraco-abdominal aortic aneurysm managed by fenestrated or branched endovascular aortic repair. Eur J Vasc Endovasc Surg. 2024;68(3):325–334. doi:10.1016/j.ejvs.2024.04.041.

Huckaby LV, Sultan I, Trimarchi S, Leshnower B, Chen EP, Brinster DR, et al. Sex-based aortic dissection outcomes from the International Registry of Acute Aortic Dissection. Ann Thorac Surg. 2022;113(2):498–505. doi:10.1016/j.athoracsur.2021.03.100.

Tenorio ER, Oderich GS, Farber MA, Schneider DB, Timaran CH, Schanzer A, et al. Outcomes of endovascular repair of chronic postdissection compared with degenerative thoracoabdominal aortic aneurysms using fenestrated-branched stent grafts. J Vasc Surg. 2020;72(3):822–836. doi:10.1016/j.jvs.2019.10.091.

Lo RC, Bensley RP, Hamdan AD, Wyers M, Adams JE, Schermerhorn ML; Vascular Study Group of New England. Gender differences in abdominal aortic aneurysm presentation, repair, and mortality in the Vascular Study Group of New England. J Vasc Surg. 2013;57(5):1261–1268.e5. doi:10.1016/j.jvs.2012.11.039.

Lancaster EM, Gologorsky R, Hull MM, Okuhn S, Solomon MD, Avins AL, et al. The natural history of large abdominal aortic aneurysms in patients without timely repair. J Vasc Surg. 2022;75(1):109–117. doi:10.1016/j.jvs.2021.07.125.

Bulder RMA, Tedjawirja VN, Hamming JF, Koelemay MJ, Balm R, Lindeman JHN; on behalf of the study group collaborators. Hypothesis of the high mortality of female patients following elective open abdominal aortic aneurysm repair. Eur J Vasc Endovasc Surg. 2022;63(5):773–774. doi:10.1016/j.ejvs.2022.01.018.

Pouncey AL, David M, Morris RI, Ulug P, Martin G, Bicknell C, Powell JT. Systematic review and meta-analysis of sex-specific differences in adverse events after open and endovascular intact abdominal aortic aneurysm repair: consistently worse outcomes for women. Eur J Vasc Endovasc Surg. 2021;62(3):367–378. doi:10.1016/j.ejvs.2021.05.029.

O’Donnell TFX, Verhagen HJ, Pratesi G, Pratesi C, Teijink JAW, Vermassen FEG, et al. Female sex is associated with comparable 5-year outcomes after contemporary endovascular aneurysm repair despite more challenging anatomy. J Vasc Surg. 2019;70(6):1782–1792.e2. doi:10.1016/j.jvs.2019.05.065.

With today's guests, Koen Vree Egberts and Desiree van Noord, we dive into this open-access paper. The study revealed that a stenosis exceeding 50% in the superior mesenteric (SMA) or inferior mesenteric artery on pre-operative computed tomography (CT) scan correlates with an elevated risk of anastomotic leakage (AL) after colorectal surgery. These findings suggest the potential for more personalised risk assessment regarding AL in patients undergoing a colorectal resection by pre-operative screening for mesenteric artery stenosis by duplex ultrasound or CT scan. For cases of SMA stenosis, alternative surgical approaches such as primary stoma creation or (endovascular) revascularisation of the stenosis before colorectal resection could be considered, as well as close post-operative surveillance of patients at risk.

Welcome to the final episode of our ESVS Vascular Fundamentals podcasts. In the last episode, we looked at some basic venous physiology. In this podcast, we will be looking at the haemodynamics of specific venous disorders such as acute venous thrombosis, primary varicose veins and chronic venous insufficiency. Ever wondered why exactly a DVT causes limb swelling? What happens to the venous physiology in phlegmasia? Why do people get varicose veins? What are the haemodynamic consequences of chronic venous insufficiency? Lots more burning questions that we will answer! Stay tuned!

With Justin Woolgar and Joanna Halman.