Abstract
The Society for Vascular Medicine is a diverse community of talented scientists and clinicians dedicated to advancing vascular knowledge and care. In this feature, we shine the spotlight on our active SVM members and learn about their practice and Society involvement.
Creating teams to save limbs
Director, Interventional Cardiology
Director, Vascular Laboratory
Denver VA Medical Center
Associate Professor of Medicine, Division of Cardiology
University of Colorado School of Medicine
Tell us about your current vascular medicine ‘practice’
My clinical practice of vascular medicine is based at the Denver VA Medical Center, where I am the Director of Interventional Cardiology and the Director of the Vascular Laboratory. Much of my clinical time is focused on the medical and endovascular treatment of patients with severe claudication or critical limb ischemia. I staff a vascular disease focused clinic twice weekly, and read vascular studies daily. Because of the multidisciplinary nature of vascular disease, I also work closely with the podiatry service and interventional radiology colleagues to optimize the treatment of patients with advanced atherosclerotic vascular disease. In addition to occlusive peripheral artery disease (PAD), I also perform endovascular aortic aneurysm repair (EVAR) and carotid artery stenting in patients who require revascularization.
What was your pathway to vascular medicine?
As an interventional cardiologist, I completed my fellowship training in coronary and structural interventions. I then had the opportunity to spend a year of focused training with Dr John Laird, who is one of the pioneers of endovascular interventions. That training, including not just procedural skills but also longitudinal clinic and vascular imaging, really opened my eyes to the prevalence and severity of PAD. I found that I really enjoyed treating patients with PAD, and that the opportunity to prevent major amputation among patients with critical limb ischemia (CLI) was extremely gratifying. At the same time, I began conducting clinical research in PAD, which provided me with a greater understanding that the field has many opportunities to further the care of patients with vascular disease. Because of my focused experience in vascular disease, I then completed American Board of Vascular Medicine (ABVM) board certification in Vascular Medicine and Endovascular Intervention, as well as Registered Physician in Vascular Interpretation (RPVI) certification.
How have you been involved in the SVM?
My first experience with SVM was at the 2014 Scientific Sessions, where I applied for the Young Investigator Award. My presentation was on the association of angiotensin-converting enzyme inhibitors with reduced major adverse cardiovascular events in patients with CLI. I was fortunate to win the Young Investigator Award, and subsequently I began attending the annual SVM Scientific Sessions as an invited speaker on topics including the treatment of CLI, endovascular interventions, and optimal medical therapy of PAD. In recent years, I have also become involved with committees of the SVM, including co-chairing the Publications and Communications Committee and serving on the Membership Committee and the Vascular Medicine Editorial Board. Committee involvement has led me to really appreciate the dedication that SVM members have for the Society and the advancement of vascular disease.
From your perspective, what are the benefits of involvement in SVM?
The SVM is truly a multidisciplinary society that includes all practitioners involved in the treatment of vascular disease. As a cardiologist, I really appreciate attending a meeting where multiple specialties can meet under one ‘roof’ irrespective of egos or practice patterns. As a society, I believe that the SVM also has a unique voice for the treatment of vascular disease, whereas many other societies address vascular disease almost as an afterthought. Having credentials as a fellow in the SVM also provides some recognition to other physicians and the public about my commitment to vascular medicine.
Tell us how you foresee recruiting the next generation of vascular medicine specialists
Recruiting the next generation of vascular specialists is paramount to disease awareness and optimal treatment, especially in an environment where multiple specialties treat patients with vascular disease. The growth of vascular medicine as a specialty has often been hampered by the lack of defined fellowship training pathways and few formal fellowship positions. A few years ago, I established a Veterans Affairs-funded vascular medicine fellowship position, which provides 1 year of focused vascular medicine training. I also actively speak to residents and fellows about the importance of vascular medicine, with the goal of increasing disease awareness and understanding of disease management. Ultimately, more fellowship training spots are required nationally, so that we can train more physicians in vascular medicine!
Creating teams for vascular emergencies
Assistant Professor of Medicine, Cardiovascular Division
University of Minnesota
Tell us about your current vascular medicine ‘practice’
My passion lies in the intersection of critical care, cardiology, and vascular medicine. Thus, my areas of expertise include acute vascular emergencies with cardiac complications. I am Associate Director of our Aortopathy Clinic at the University of Minnesota (UMN), which is an integral component of the multidisciplinary aortic center, and an investigator with the International Registry of Aortic Dissection. In the acute setting, I am a part of the ‘Code Aorta’ team as cardiology consultant and transesophageal echocardiographer. I am also co-founder of UMNs Pulmonary Embolism Response Team (PERT) and an investigator in the Extract-PE trial. Close to a half of my time is spent in ultrasound imaging, in both cardiology and radiology departments. I have an interest in non-invasive hemodynamics and thus spend time reading echocardiograms, performing transesophageal echo, and reading in the non-invasive vascular lab. Currently I have several ongoing research projects in both aortic disease and venous thromboembolism (VTE).
What was your pathway to vascular medicine?
I was a resident in the cardiac ICU at Boston University working under the supervision of the late Dr Joseph Vita. As I was already doing thrombosis and anticoagulation research with Dr Elaine Hylek, he approached me with an opportunity to be a fellow in the NIH/NHLBI K12 training program in vascular medicine. As I had also known for most of my life I wanted to be a cardiologist, Dr Vita built a custom fellowship for me that combined vascular medicine, research training, a master’s program in epidemiology, and a cardiology fellowship. After that, I completed a 2-year cardiac clinical trials fellowship at Brigham and Women’s Hospital and Harvard Medical School with the TIMI trial group. I was able to work on vascular analyses with Dr Marc Bonaca. After my clinical training was complete, I knew I wanted to develop a unique niche in the intersection of vascular and cardiac diseases.
Who has been a great influence on your career?
In addition to Joe Vita and Elaine Hylek, Naomi Hamburg has been an invaluable resource for career and personal development. Dr Eugene Braunwald has also been an amazing mentor for me in my more recent research training.
How have you been involved in the SVM?
I have been an active member of SVM since 2014, starting early in fellowship. I found SVM an incredible resource for networking and opening doors to various opportunities for collaboration. At present, I am co-chair of the SVM’s new Next Generation Committee, which has a mission of helping our young faculty and fellows establish themselves in the field of vascular medicine, as well as bringing awareness to trainees in this unique specialty. We are organizing events to bring together early career members of SVM with senior faculty and to increase the social media presence of the SVM. You can follow me on twitter @DrCFanola, SVM @SVM_tweets, and the Next Gen group #SVMNextGen to see upcoming events. We have a yearly competition at the SVM Scientific Sessions for the top influencer on twitter that my Next Gen co-chair Dr Yogen Kanthi @YogenKanthi has won in the past. I am also joining the Organizing Committee of the highly successful yearly SVM Fellows course.
What are the greatest challenges to vascular medicine practice from your view point? What are the greatest benefits?
The greatest challenges in vascular medicine include bridging multiple departments together since our specialty is truly multidisciplinary. This challenge is also the greatest benefit in my mind, as once those bridges are built, collaborations become endless and the field becomes truly fun and rewarding as a result. I am always learning something new each day from my colleagues who span cardiac surgery, vascular surgery, interventional radiology, rheumatology, hematology and pulmonary/critical care. We have built a truly amazing vascular disease program.
Intersocietal Accreditation Commission Board of Directors
At the February 2018 Board of Directors meeting of the Intersocietal Accreditation Commission Vascular Testing (IAC-VT) division, Dr Paul Wennberg of Mayo Clinic was recognized by IAC-VT President Melissa Vickery for his years of service as a board member, representing the SVM. Dr Esther Kim of Vanderbilt University will join Dr Timothy Crimmins of Columbia University as SVM representatives to the IAC-VT. The SVM was a founding member of the IAC-VT (formerly ICAVL), and remains highly engaged in multiple IAC divisions including Vascular Testing, Carotid Stenting (Dr J Michael Bacharach, SVM representative), and Vein Centers (Dr Thom Rooke, SVM representative). SVM representatives to the IAC and IAC-VT Board Member and SVM President Dr Heather Gornik spent time together during the February IAC board meeting in Ft Lauderdale, Florida.
Dr Paul Wennberg and Ms Melissa Vickery
Drs Paul Wennberg, Michael Bacharach, Thom Rooke, and Heather Gornik
