March/April Issue of Vein Specialist
VENOUS2023 Gala
Allie Woodward
Past Presidents Bill Marston, Marc Passman, and Rob McLafferty performing at the Gala.
On Friday evening at the annual meeting, over 150 meeting attendees were able to “kick off their boots” at the Tex-Mex themed VENOUS2023 Gala. From a live mariachi band to cowboy hats and bandanas, to ceviche shooters and warm churros, the AVF threw a fiesta that we are still talking about.
The evening started out with house made margaritas and a fun photo booth. The highlight of the night was AVF Past Presidents Bill Marston, Marc Passman, and Rob McLafferty performing several hit songs. The band previously played at VENOUS2020 in Amelia Island, FL. They even invited Kirsten Myers, Mikel Sadek, and other guests to join them for their encore song! Following the live musical performance, the crowd hit the dance floor while the DJ played on.
It was a fun evening that highlights the one-of-a-kind camaraderie found at the AVF and AVF-hosted events. Thank you to all who joined us! We can’t wait for the VENOUS2024 Gala in Tampa, FL.
Return of the Sumner Book:
Hemodynamics for Surgeons
Jose Almeida, MD
Member, AVF
Hemodynamics for Surgeons edited by Strandness and Sumner was published in 1975. The original edition had long gone out of print. Used copies that remained in circulation were changing hands– an unmistakable sign of the enduring popularity of the book published 4 decades earlier! It has long been apparent that an updated edition was sorely needed.
The three editors of the new edition were honored when asked by Dr Raju to resurrect a venous edition of Hemodynamics for Surgeons in honor of his longtime friend Dr David Sumner. The goal was to preserve the spirit of the original edition while at the same time introducing some modern concepts. Section A focuses on the biomechanics foundation of hemodynamics including biofluid and biosolid mechanics. Section B concentrates on the pathophysiology of reflux and obstruction from the hemodynamics perspective. Section C summarizes current imaging modalities used for venous disease diagnosis, with a hemodynamic twist. Finally, section D attempts to integrate the whole by describing the diagnosis and treatment of clinical syndromes (from the lens of hemodynamics) observed every day by venous disease practitioners.
The journey began in the fall of 2018 when the team met in St. Louis and visited Mrs Marty Sumner. We visited her home and over a bottle of cabernet sauvignon we discussed the intent of the project. During the visit, we received a complimentary tour of Dr Sumner’s artwork displayed on the walls. After a brief stall due to the Covid pandemic, our team was able to push through and complete the writing in the fall of 2021, with digital copies ready for 2nd quarter of 2023.
Readers will notice some consistency of style from the original work, some original figures and tables, and Dr Sumner’s artwork at the beginning of each new chapter. The contemporary information has been weaved in to offer a body of work which is understandable by a wide audience. It is our hope that this will be a valuable reference source for clinicians, biomedical engineers, industry folks, students, and residents. We think there is something herein for everyone interested in venous disease.
Fig. 1
Sumner’s Hemodynamic Guide to Venous Diagnosis and Intervention; Editors: Jose Almeida, Ghassan Kassab and Fedor Lurie is modeled to perpetuate the essence and style of the original book. It is named after Dr Sumner to honor his contributions to the venous field.
Fig. 1
Sumner’s Hemodynamic Guide to Venous Diagnosis and Intervention; Editors: Jose Almeida, Ghassan Kassab and Fedor Lurie is modeled to perpetuate the essence and style of the original book. It is named after Dr Sumner to honor his contributions to the venous field.
Fig. 2
From left to right: Dr Raju, Dr Kassab, Dr Almeida, Marty Sumner, Mary Panagrosso, Dr Lurie
Book Coming Soon!
Earning the Ability to
Ensure Quality Care for Post-thrombotic Syndrome:
The C-TRACT Trial
Suresh Vedantham, MD
AVF
Many AVF members are leaders in the use of stents to relieve venous obstruction in patients with post-thrombotic syndrome (PTS). Attendees of the February 2023 AVF Annual Meeting heard an important update on the NIH-sponsored C-TRACT (Chronic Venous Thrombosis: Relief with Adjunctive Catheter-Directed Therapy) Trial from Dr Suresh Vedantham, the trial’s national principal investigator (1,2).
C-TRACT is a multicenter randomized trial that is evaluating the ability of iliac vein stent placement to reduce PTS severity in patients with moderate or severe PTS. The study was initiated in 2018 and is currently active in 20 US centers. In his presentation, Dr Vedantham summarized the challenges faced by the investigators and the distinctive opportunity afforded by this study. As of February 7, 2023, the study had enrolled 164 of the targeted 374 patients, prompting concern about its viability from the NIH and the study’s data safety monitoring board. Measures taken to promote enrollment have included a protocol amendment to enable remote study visits, additional encouragement for site investigators and coordinators, advertisements in public transportation venues and on social media, and an upcoming investigator meeting.
Dr Vedantham emphasized that only a tiny minority of PTS patients are ever referred for focused care to a knowledgeable subspecialist. Changing this will require medical physicians to become convinced of the importance of referral. Because of its NIH imprimatur and its randomized design that can enable demonstration of benefit for stented patients over and above a non-intervened control group, C-TRACT stands alone in its ability to satisfy medical physicians that stent placement helps patients. As such, the potential for C-TRACT to transform PTS care by enabling many thousands of additional patients to receive focused treatment is enormous. The study is endorsed by AVF leadership. It is hoped that every AVF member will support this unique time-limited opportunity by referring their PTS patients to study sites.
Acknowledgments
The C-TRACT Clinical Trial is supported by NHLBI grants UH3-HL138325 (clinical coordinating center, Dr Suresh Vedantham at Washington University in St Louis) and U24-HL137835 (data coordinating center, Dr Sameer Parpia at McMaster University). The content in this article is solely the responsibility of the author, and not the NHLBI or NIH. The author wishes to thank the study’s Steering Committee and other leaders: Drs David Cohen, Anthony J. Comerota, Samuel Z. Goldhaber, Michael R. Jaff, Jim Julian, Susan R. Kahn, Clive Kearon (deceased), Andrei Kindzelski, Elizabeth Magnuson, Elaine Majerus, Dan Marcus, William Marston, Sameer Parpia, Mahmood K. Razavi, Akhilesh K. Sista, Suman Wasan, and Ido Weinberg.
References
- Vedantham S, Kahn SR, Goldhaber SZ, Comerota AJ, Parpia S, Meleth S, Earp D, Williams R, Sista AK, Marston W, Rathbun S, Magnuson EA, Razavi MK, Jaff MR, Kearon C. Endovascular therapy for advanced post-thrombotic syndrome: proceedings from a multidisciplinary consensus panel. Vasc Med2016; 21:400-407.
- Vedantham S, Parpia S, Kahn SR. A clinical trial of venous stent placement for post-thrombotic syndrome: current status and pandemic-related changes. Vascular & Endovascular Review 2022; 5:e06.
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