Audible Bleeding By cover art

Audible Bleeding

By: Powered by the SVS
Listen for free

  • Summary

  • Audible Bleeding is a resource for trainees and practicing vascular surgeons, focusing on interviews with leaders in the field, board preparation, and dissemination of best clinical practices and high impact innovations in vascular surgery.
    Show more Show less
activate_primeday_promo_in_buybox_DT
Episodes
  • Holding Pressure Case Prep - Fem Pop Bypass

    Holding Pressure Case Prep - Fem Pop Bypass
    Jul 28 2024
    Authors: Sebouh Bazikian - PGY1 at Emory School of Medicine Integrated Vascular Surgery Program Miguel F. Manzure - vascular surgery attending the University of Southern California Keck School of Medicine involved in complex limb preservation Core Resources: Rutherford Chapters: 107, 108, 109 (Includes further information on anatomy), 112 Additional Resources: Relevant trials BEST CLI: https://pubmed.ncbi.nlm.nih.gov/36342173/ BASIL 2: https://pubmed.ncbi.nlm.nih.gov/37116524/ Relevant Audible Bleeding episodes Audible Bleeding Endovascular Basics: https://open.spotify.com/episode/7jDpkhGMauBslk8SBklCyB?si=75f0931773d24b91 Audible Bleeding eBook, CLTI Chapter: https://adam-mdmph.quarto.pub/vascular-surgery-exam-prep/clti.html Anything else useful WIFI: https://pubmed.ncbi.nlm.nih.gov/24126108/ GLASS: https://pubmed.ncbi.nlm.nih.gov/31159978/ Monophasic, Biphasic, Triphasic Waveforms: https://pubmed.ncbi.nlm.nih.gov/32667274/ Underlying disease featured in episode - peripheral arterial disease Pathophysiology/etiology narrowing of peripheral arteries caused by atherosclerotic plaques causing arterial insufficiency distal to the point of occlusion. This reduces oxygen supply to the muscles. When oxygen demand increases but cannot be met, it leads to an imbalance such as pain and poor wound healing. Risks: smoking, diabetes, hypertension, dyslipidemia, and older age Equal prevalence in men and women, peak incidence age 60-80 Coexists with CAD, DM, stroke, Afib, and renal disease Patient Presentation 20-50% asymptomatic, rest can be intermittent claudication, rest pain, or tissue loss claudication=pain or discomfort felt in the legs due to a lack of blood flow, especially during physical activity. CLTI=chronic limb threatening ischemia: rest pain lasting greater than 2 weeks or nonhealing ulcers and gangrene Physical exam: decreased skin temperature, less hair on the legs, brittle nails, atrophied muscles, shiny skin, livedo reticularis. Absent or diminished pulses Buerger sign Diagnosis Ankle brachial index: <0.9=PAD. <0.4=multilevel disease associated with tissue loss. >1.3 can mean vessel calcification Toe pressures, toe brachial indexes, and transcutaneous oxygen measurement (TcPO2) if vessels calcified Duplex ultrasound: affordable and effective, can assess both anatomy and blood flow Can also assess degree of stenosis based on ratios of systolic and diastolic velocity Angiography: gold standard. Invasive and risks of infection, hematoma, pseudoaneurysms, and contrast nephropathy. Staging: WIFI - Wound, Ischemia, and Foot Infection (see additional resources) GLASS: Global Limb Anatomy Staging System (see additional resources) Treatment (Medical/Surgical) Lifestyle modification, smoking cessation, high-intensity statins, antiplatelet therapy, and management of other medial comorbidities like HTN and DM. Structured exercise program: 3 times weekly for 12 weeks Cilostazol: phosphodiesterase III inhibitor Endovascular and surgical revascularization Endovascular offer superior perioperative outcomes but lacks durability Surgical revascularization offer durability and less reinterventions, but more invasive Indications for surgery: CLTI and lifestyle limiting claudication Relevant anatomy: Femoral triangle inguinal ligament superior, the medial border of the sartorius muscle laterally, and the medial border of the adductor longus on the medially Contains neurovascular bundle (NAVEL) Adductor canal: bordered anteriorly by the sartorius, posteriorly by the adductor magnus and longus, and to the lateral side by the vastus medialis common femoral artery bifurcates into the profunda and the superficial femoral artery (SFA). SFA courses through adductor canal and turns into popliteal artery in the popliteal fossa GSV: originates at the ankle, tracts anterior to medial malleolus and then ascending the medial side of lower leg. Upon reaching the knee, it curves behind the medial condyles of the femur and tibia, continuing alongside the medial aspect of the thigh. Its journey culminates at the saphenofemoral junction Preoperative preparation: Identifying inflow and outflow vessels, both should be free of significant disease preop CTA or angiogram Picking a conduit Best patency=autogenous: reversed GSV most common, others are small saphenous vein, cephalic vein, etc Prosthetic: polytetrafluoroethylene (PTFE) Cryopreserved vein Surgical steps: Harvesting GSV (if GSV adequate as conduit) Dissected along its length, branches ligated, removed and reversed Can also be left insitu, so only proximal and distal aspects are mobilized, and valves are removed using valvulotome Should be at least 3mm in diameter and no significant disease (scarring, thickening) Arterial exposure Common femoral artery: lies in the medial third segment between the ASIS and the pubic symphysis. Longitudinal or oblique incision directly over the ...
    Show more Show less
    29 mins
  • JVS CIT Editorials and Abstracts - June 2024

    JVS CIT Editorials and Abstracts - June 2024
    Jul 24 2024

    In this episode, we spotlight editorials and abstracts from the Journal of Vascular Surgery Cases, Innovations, and Techniques (JVS-CIT). Editorials and Abstracts are read by members of our SVS Social Media Ambassadors and authors.

    Readers:

    Shourya Verma (@shourya__verma)

    Nabeeha Khan (@Nabeeha_Khan_)

    Miguel Fernandez (@MGfernandez21)

    Amit Chaudhary (@VascularKGMU)

    Dr. Jayer Chung (@Jayer_Chung)

    Hosts:

    Nishi Vootukuru (@Nishi_Vootukuru)

    John Culhane (@Johnculhanemd)

    Editorials (E) and Abstracts (A):

    E- Arteries of fibromuscular dysplasia tell a sympathetic story

    A- Transcarotid arterial revascularization is feasible and safe with concomitant inferior vena cava occlusion

    A- Surgical anteriorization of the left common iliac vein results in improved venous outflow and quality of life for May-Thurner syndrome

    E- Longer is better, discussing length of coverage and timing of intervention in type B aortic dissection

    A-Endovascular repair of ascending aortic pathologies in patients unfit for open surgery: Case series and literature review

    A-Improved gait parameters following surgical revascularization in patients with intermittent claudication

    A- Totally percutaneous endovascular renal allograft salvage for common iliac artery pseudoaneurysm

    A- Early results of transcatheter electrosurgical aortic septotomy for endovascular repair of chronic dissecting aortoiliac aneurysms

    E- Impact of the infrapopliteal bypass with distal arteriovenous fistula and distal cuffs in the management of small arterial disease

    Follow us @audiblebleeding

    Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
    Show more Show less
    35 mins
  • JVS Author Spotlight - O'Donnell and Timaran

    JVS Author Spotlight - O'Donnell and Timaran
    Jun 2 2024

    Audible Bleeding contributor and 5th year general surgery resident Richa Kalsi (@KalsiMD) is joined by first-year vascular surgery fellow Zach Mattay (@ZMatthay), fifth-year general surgery resident Naveed Rahman (@naveedrahmanmd), JVS editor Dr. Thomas Forbes (@TL_Forbes), and JVS-CIT editor Dr. Matthew Smeds (@mattsmeds) to discuss two great articles in the JVS family of journals. The first article discusses national trends in surgeon-modified graft utilization for complex and thoracoabdominal aortic aneurysms. The second article discusses a novel technique, transcatheter electrosurgical aortic septotomy, to treat chronic dissecting aortoiliac aneurysms. This episode hosts Dr. Thomas O’Donnell (@tfxod) and Dr. Carlos Timaran (@ch_timaran), the authors of these two papers.

    Articles:

    • Part 1:“National Trends in utilization of surgeon-modified grafts for complex and thoracoabdominal aortic aneurysms” by Dr. O’Donnell and colleagues.

      • Mentioned during the discussion:

        • “Application of Investigational Device Exemptions regulations to endograft modification” by Abel and Farb.

    • Part 2: “Early results of transcatheter electrosurgical aortic septotomy for endovascular repair of chronic dissecting aortoiliac aneurysms” by Dr. Timaran and colleagues.

      • Mentioned during discussion:

        • “Transcatheter Electrosurgery: JACC State-of-the-Art Review” by Khan and colleagues.

        • “A Novel Way to Fenestrate a Type B Dissection Flap Using Endovascular Electrocautery” by Dr. Kabbani and colleagues.

    Show Guests

    • Dr. Thomas O’Donnell: Assistant professor of surgery in the aortic center at New York Presbyterian/Columbia University Irving Medical Center.

    • Dr. Carlos Timaran: Professor and Chief of Endovascular Surgery at University of Texas Southwestern Medical Center’s Department of Surgery.

    Follow us @audiblebleeding

    Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
    Show more Show less
    44 mins
Physical Illness & Disease Hygiene & Healthy Living
Show more Show less

What listeners say about Audible Bleeding

Average customer ratings

Reviews - Please select the tabs below to change the source of reviews.

Audible.com reviews

Amazon reviews
No Reviews are Available