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Director: Center for Critical Limb Care Riverside Methodist Hospital
Treatment of Common Femoral Stenoses and Popliteal Disease: Endovascular First! Gary M Ansel MD Director: Center for Critical Limb Care Riverside Methodist Hospital Columbus Ohio
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Gary M. Ansel, MD Royalty Cook Medical Advisory Committee
Abbott Laboratories AccessClosure, Inc AngioSlide Atheromed, Inc Atrium Medical Corporation Bard Peripheral Vascular, Inc.
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Boston Scientific Corporation
ev3, Inc Flexible Stenting Solutions Lumen Biomedical, Inc Medical Simulation Medrad, Inc. Nexeion Nellix, Inc. Ostial Solutions Pathway Medical Technologies, Inc. Revascular SquareOne Vascular Think Tank/Becker Venture Services Veryan / Novate W. L. Gore and Associates, Inc.
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Consulting Fees Best Doctors Biocardia Cordis Corporation Gerson Lehrman Group W. L. Gore and Associates, Inc. Grants/Contracted Research Boston Scientific Corporation Cook Medical Invatec Technology Center, GmbH
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Ownership Interest (Stocks, Stock Options Ownership Interest)
AccessClosure, Inc Guidant ICON Interventional Systems Nexeion Omnisonics SimSuite Vascular Performance Products
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Top Ten Reasons that Endo tops Surgery for Com fem and popliteal treatment
- Surgeons are descendants of ‘barbers”
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10. Surgeons are Descendants of Barbers for God’s sake
Surgical endo training: The blind leading the blind!
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CUT OR DIE
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Top Ten Reasons that Endo tops Surgery for Com fem and popliteal treatment
- Endo can be repeated as an outpatient Surgeons are descendants of ‘barbers”
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It is hard to beat an outpatient therapy
moles Puncture site
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Top Ten Reasons that Endo tops Surgery for Com fem and popliteal treatment
- When surgery goes bad it goes real bad Endo can be repeated as an outpatient Surgeons are descendants of ‘barbers”
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Common Femoral Endart: Results
N = 65 limbs in 58 patients age 71 +/- 10; male 77% 44 (68%) claudication, 21 (32%) CLI 37 (57%) hybrid procedures 20 iliac (TASC II A-30%; B-35%; C-20%; D-15%) 25 femoropopliteal (TASC II A-24%; B-60%; C-12%; D-4%) Technical success 100% increase ankle-brachial index (ABI) of /- 0.24 Hospital stay was 3.2 days (range 1-12 days). 3 (5%) major complications requiring reintervention (early failure, hematoma, and wound infection) six (9%) minor complications which were treated conservatively (five wound infections, one lymph leak) Kang JL, Patel VI, Conrad MF, et al J Vasc Surg. 2008;48:872-7
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InfraInguinal Surgery
Wound Infection % Myocardial Infarction % Early graft failure % Acute leg ischemia % Op. Mortality % Surgical Revision rate > 20% TASC J Vasc Surg 2009 Gary Ansel, MD
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Top Ten Reasons that Endo tops Surgery for Com fem and popliteal treatment
- Cardiologists When surgery goes bad it goes real bad Endo can be repeated as an outpatient Surgeons are descendants of ‘barbers”
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Peripheral Vascular Disease
Natural History (5yr) Stable 55% Art. Procedure 25% Amputation 4% Sx increased 16% Mortality 29%
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Top Ten Reasons that Endo tops Surgery for Com fem and popliteal treatment
- Stents are staying patent and not breaking Cardiologists When surgery goes bad it goes real bad Endo can be repeated as an outpatient Surgeons are descendants of ‘barbers”
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Chris Rock’s Top Ten Reasons that Endo tops Surgery for Com fem and popliteal treatment
- Risk of death Stents are staying patent and not breaking Cardiologists When surgery goes bad it goes real bad Endo can be repeated as an outpatient Surgeons are descendants of ‘barbers”
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Government Warning: The surgeon general has found that vascular surgery is a major risk of death, Infection and maiming
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Top Ten Reasons that Endo tops Surgery for Com fem and popliteal treatment
- More effective atherectomy Risk of death Stents are staying patent and not breaking Cardiologists When surgery goes bad it goes real bad Endo can be repeated as an outpatient Surgeons are descendants of ‘barbers”
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pst
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6 mo follow up
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Chris Rock’s Top Ten Reasons that Endo tops Surgery for Com fem and popliteal treatment
- Makes future procedures tough or impossible More effective atherectomy Risk of death Stents are staying patent and not breaking Cardiologists When surgery goes bad it goes real bad Endo can be repeated as an outpatient Surgeons are descendants of ‘barbers”
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It is not the surgery, it is what is left behind
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Top Ten Reasons that Endo tops Surgery for Com fem and popliteal treatment
- The next president of SVS says so Makes future procedures tough or impossible More effective atherectomy Risk of death Stents are staying patent and not breaking Cardiologists When surgery goes bad it goes real bad Endo can be repeated as an outpatient Surgeons are descendants of ‘barbers”
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Top Ten Reasons that Endo tops Surgery for Com fem and popliteal treatment
- The next president of SVS says so Makes future procedures tough or impossible More effective atherectomy Risk of death Stents are staying patent and not breaking Cardiologists When surgery goes bad it goes real bad Endo can be repeated as an outpatient Surgeons are descendants of ‘barbers”
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The # 1 Reason Pittsuburgh is a LOSER
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Why not Open Surgical Repair
Its not that the surgery is not good It is what is left behind
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