1. Gabriel Herscu, M.D. Washington Township Medical Foundation

2. Vascular Surgery Chronic Wound Care Venous Disease Aortic Disease Renal & Mesenteric Arterial Disease Peripheral Artery Disease Cerebrovascular Disease Vascular Medicine Hemodialysis Access Vascular Trauma

3. Atherosclerosis

15. Aortic Aneurysm Formation

16. Pathogenesis

17. Open Aortic Aneurysm Repair

18. Thoracic Aortic Replacement Involvement of the aorta in the chest is even higher risk

19. Stent Graft Theory

20. Endovascular Stent Grafts

21. Delivery System

23. Leg Vein Anatomy Your legs contain a network of veins that carry blood back to the heart The venous system is comprised of: Deep veins Superficial veins Perforator veins

24. Venous Reflux Disease Valve Open Valve Closed Leaky Valve Dilated VeinNormal Vein Heart Foot

25. Signs & Symptoms

26. Ligation & Stripping

28. Endovenous ablation

30. Before and After

32. Related and Complementary Procedures Phlebectomy Removal of diseased veins through a series of small incisions and use of specialized hooks to treat visible varicose veins

33. Related and Complementary Procedures Sclerotherapy External lasers and intense pulsed light Used to treat small superficial or “spider” veins

34. Reality What it takes to become a vascular surgeon… Dexterity Creativity Critical Thinking Ability to Conceptualize Patience Confidence Compulsive nature Determination What are you good at?

35. Freshman Class Average 2011 University California UC Irvine3.97271237 UC LA4.11301358 UC Riverside3.67251146 UC Merced3.56241215 UC SB3.97281260 UC Davis4.00281271 UC Berkeley4.14 301381 UC SC3.75 261185 UniversityGPAACTSAT

36. Medical School AAMC Data - 2011 MCAT Score 31.1 (80 percentile) GPA Science 3.61 GPA Non-Science 3.74 Mean GPA 3.67 19,230 new students/year

37. Residency Surgery Residency - 5 years Vascular Surgery Fellowship - 2 years OR.. Vascular Surgery Residency - 5 years Approximately 120 people/year become vascular surgeons in US

38. Timeline Grade/High school:13 years College:4 years Medical School:4 years Residency:5 years Fellowship:2 years Total:28 years