European Society for Vascular Surgery

by European Society for Vascular Surgery

Genetic Aortopathies: Navigating Complex Decisions in Practice with R. Afifi & S. Shalhub

How should we approach intervention thresholds, repair strategies, and lifelong surveillance in patients with genetic aortopathies? Prof. Sherene Shalhub (Oregon Health & Science University) and Prof. Rana Afifi (McGovern Medical School at UTHealth Houston) discuss the practical challenges, controversies, and unanswered questions that shape decision-making in the management of these complex patients. Shownotes: Lian T, Pai CW, Woznicki E, et al. Nonsyndromic familial type B aortic dissection exhibits distinct clinical profiles and operative outcomes. J Vasc Surg. 2026. doi:10.1016/j.jvs.2026.04.022. MacCarrick G, Afifi RO, Allen R, et al. Loeys-Dietz Syndrome: 2026 updated care management primer. Genet Med. 2026. doi:10.1016/j.gim.2026.102577. Lian T, Bhandari A, Shalhub S. What Every Vascular Surgeon Should Know About Vascular Ehlers-Danlos Syndrome. Ann Vasc Surg. 2026. doi:10.1016/j.avsg.2026.03.032. Calderon-Martinez E, Velasco WV, Guo D, et al. Differences in Arterial Events in Vascular Ehlers-Danlos, Loeys-Dietz, and Marfan Syndrome. J Am Coll Cardiol. 2025;85:2355-2367. doi:10.1016/j.jacc.2025.04.023. Shalhub S. The aortic and arterial vulnerability spectrum: A conceptual biological framework for risk stratification and precision surgical decision-making in aortopathy and arteriopathy. J Vasc Surg. 2025;82:722-739.e4. doi:10.1016/j.jvs.2025.04.028. Dittman JM, Prakash SK, Gupta PC, et al. Practice Patterns and Barriers to Vascular Genetic Testing Among Vascular Surgeons. Ann Vasc Surg. 2024;105:140-149. doi:10.1016/j.avsg.2024.01.032. Shalhub S, Byers PH. Endovascular repair of a common iliac artery aneurysm with an iliac branch device in a patient with vascular Ehlers-Danlos syndrome due to a null COL3A1 variant. J Vasc Surg Cases Innov Tech. 2023;9:101192. doi:10.1016/j.jvscit.2023.101192. Dittman JM, Saldana-Ruiz N, Newhall K, et al. Open repair of abdominal aortic aneurysms in patients with vascular Ehlers-Danlos syndrome. J Vasc Surg Cases Innov Tech. 2023;9:101194. doi:10.1016/j.jvscit.2023.101194. Shalhub S, Nkansah R, El-Ghazali A, et al. Splenic artery pathology presentation, operative interventions, and outcomes in 88 patients with vascular Ehlers-Danlos syndrome. J Vasc Surg. 2023;78:394-404. doi:10.1016/j.jvs.2023.04.007. Regalado ES, Morris SA, Braverman AC, et al. Comparative Risks of Initial Aortic Events Associated With Genetic Thoracic Aortic Disease. J Am Coll Cardiol. 2022;80:857-869. doi:10.1016/j.jacc.2022.05.054.

Jun 11, 2026

40:46

Vascular Graft and Endograft Infection Workshop with B. Saleem & X. Berard

Recorded live at the ESVS Vascular Graft and Endograft Infection Workshop in Groningen, this episode explores one of the most challenging complications in vascular surgery. We spoke with Prof. Ben Saleem, Prof. Xavier Berard, and workshop participants about diagnosis, treatment strategies, difficult clinical decisions, and the key lessons learned from this unique hands-on course. A practical discussion on managing vascular graft infections, featuring expert insights and real-world experience from across Europe.

Jun 4, 2026

18:47

Imaging Of Distal Tibial Vessels In Diabetics With Quiescent Interval Single Shot (QISS ) MRA with A. Crichton

In this podcast, we are joined by Dr Alex Crichton, researcher at the Trisha Roy Vascular laboratory at Houston Methodist Hospital, Texas, to discuss how QISS MRA can be used to image tibial vessels that are often missed by more conventional forms of imaging such as CT angiography, ultrasound duplex imaging or digital subtraction angiography. Diabetic patients can be especially challenging in selecting target vessels for treatment because of the presence of calcium in the vessel wall and the distal nature of the disease. Furthermore, many of these patients have impaired renal function where the use of contrast media can be detrimental. In this episode, Dr Crichton explains the work being done with QISS MRA to enable visualisation of these so called “hibernating vessels” and also how it can be used to characterise plaque morphology and the suitability for endovascular intervention.

May 21, 2026

25:33

Sac shrinkage after EVAR: a true marker of success or a misleading signal? with K. Mani

Rosalinda D’Amico interviews Prof. Kevin Mani on one of the key controversies in EVAR follow-up: is aneurysm sac shrinkage truly a marker of success, or can it sometimes provide false reassurance? They discuss the current definition of sac regression, the importance of timing and sac stability and whether sac shrinkage should influence surveillance strategies. The episode also explores the role of CTA versus duplex ultrasound and the future potential of volumetric and AI-based assessment in EVAR surveillance References: Tinelli G, D'Oria M, Sica S, Mani K, Rancic Z, Resch TA, Beccia F, Azizzadeh A, Da Volta Ferreira MM, Gargiulo M, Lepidi S, Tshomba Y, Oderich GS, Haulon S; SLIM F-U EVAR, Collaborative Study Group. The sac evolution imaging follow-up after endovascular aortic repair: An international expert opinion-based Delphi consensus study. J Vasc Surg. 2024 Sep;80(3):937-945. doi: 10.1016/j.jvs.2024.03.007. Epub 2024 Mar 8. PMID: 38462062.

May 14, 2026

15:20

The Invisible Risk Factor for PAD: Air Pollution with A. Settembrini

In this episode of the ESVS Podcast, we explore air pollution as an often-overlooked risk factor for peripheral arterial disease (PAD). We are joined by Professor Alberto Maria Settembrini. Professor Settembrini is a vascular surgeon in Milan in MultiMedica and Professor of vascular surgery at Unicamillus University in Rome. He is a co-author of a large Rome-based longitudinal study involving over 1.7 million individuals. The study shows that long-term exposure to PM2.5, NO₂, and black carbon is associated with increased PAD incidence, with stronger effects in males and people aged 55–69. Professor Settembrini discusses the links between different pollutants and PAD, how pollution interacts with traditional risk factors (obesity, diabetes, smoking, hypertension), the underlying mechanisms, and practical advice for vascular specialists in daily practice. During the episode, we also hear from Porto’s City Councillor for the Mobility and Transportation, Engineer Hugo Beirão, who shares the city’s efforts to improve urban health. References: 1- Ravalli S, Musumeci G, et al. Chelation therapy in patients with cardiovascular disease: a systematic review. Journal of Clinical Medicine. 2022;11(4):1033. doi:10.3390/jcm11041033 2- Serra R, Abramo A, Ielapi N, Procopio S, Marino P. Environmental pollution and peripheral artery disease. Risk Manag Healthc Policy. 2021;14:2181–2190. 3- Liao SH, Chiu CS, Jang LH, Hu SY, How CK, Hsieh VCR, et al. Long-term exposures to air pollutants and risk of peripheral arterial occlusive disease: a nationwide cohort study in Taiwan. Front Cardiovasc Med. 2022;9:796423. 4- Gwon JG, Park JH, Kim JS, Seo HM. Exposure to long-term air pollution and incidence of peripheral arterial disease in the general population: a national population-based retrospective cohort study. [Preprint]. 2021. 5- Deng Z, Duan L, Wang K. Revisiting the association between air pollution and peripheral artery disease: evidence from Mendelian randomization analysis. Eur J Intern Med. 2025;132:164–166. 6- Di Blasi C, Nobile F, Settembrini AM, Stafoggia M, Davoli M, Michelozzi P, et al. Association between long-term exposure to air pollution and incidence of peripheral artery disease: evidence from a longitudinal study. Eur J Intern Med. 2025;132:113–117.

May 7, 2026

18:49

ESVS 2026 Clinical Practice Guidelines on the Management of Descending Thoracic and Thoraco-Abdominal Aortic Diseases - Part 3

In this episode, we’ll focus on the final sections of the guideline, which deal with rupture, trauma, and post-operative complications. These are scenarios where decisions are often made under time pressure, evidence is limited, and outcomes can be profoundly affected by organisation of care, experience, and judgement. Guests: Prof. Anders Wanhainen Dr. Carlota Fernández-Prendes Prof. Athanasios Katsargyris

Apr 23, 2026

18:49

ESVS 2026 Clinical Practice Guidelines on the Management of Descending Thoracic and Thoraco-Abdominal Aortic Diseases - Part 2

Welcome back to the ESVS Podcasts. This is Suzanne Stokmans, and you are listening to part 2 of the Q&A series on the ESVS 2026 Clinical Practice Guidelines on the Management of Descending Thoracic and Thoraco-Abdominal Aortic Diseases. In this episode, we move from the general principles discussed in part 1 to disease-specific management. We’ll focus on acute thoracic aortic syndromes, chronic type B aortic dissection, and degenerative descending thoracic and thoraco-abdominal aortic aneurysms, conditions that make up a large part of daily aortic practice, where decision-making is often nuanced and time-critical. Full names of guests: Prof. Anders Wanhainen Dr. Carlota Fernández Prendes Prof. Athanasios Katsargyris.

Apr 16, 2026

28:21

ESVS 2026 Clinical Practice Guidelines on the Management of Descending Thoracic and Thoraco-Abdominal Aortic Diseases - Part 1

In today’s episode, the first of this three-part series, we will discuss the opening section of the guideline: service standards and general considerations. Before moving to specific disease entities or operative strategies, the guideline deliberately starts with the fundamentals — how care should be organised, how patients should be assessed, and which general principles should guide our decision making. Full names of guests: Prof. Anders Wanhainen Dr. Carlota Fernández Prendes Prof. Athanasios Katsargyris.

Apr 9, 2026

20:17

Chronic Venous Disease: The Treatment is Clear… But Do Patients Follow It? - with D. Celovska & A. Pathak

In this episode of the ESVS Podcast, supported by Servier, we explore the importance of therapy adherence in chronic venous disease (CVD). The episode opens with short patient testimonies, highlighting real-world reasons for non-adherence. To explore this further, we are joined by Professor Denisa Celovska and Professor Atul Pathak. Professor Celovska is an Associate Professor of Angiology and Internal Medicine at the University Hospital and Comenius University in Bratislava, Slovakia. She is currently the President of the Slovak Angiology Society. Professor Pathak is the Head of the National Institute of Cardiology, Cardiac Surgery and Interventional Cardiology in Luxembourg. In this episode, they share their clinical perspective on why patients frequently disengage from treatment, the most common barriers to adherence in daily practice, and practical strategies to improve long-term treatment persistence. The episode also includes insights from a community pharmacist, offering a complementary view on what happens between prescription and real-life use, particularly regarding venoactive drugs. We conclude by emphasising that effective CVD management extends beyond prescribing treatment. Patient education, shared decision-making, follow-up, and human connection are essential to improve adherence and long-term outcomes in CVD. References: Kim H, Cho S, Lee K, Lee SH, Joh JH. A nationwide study of compliance of venoactive drugs in chronic venous disease patients. Ann Surg Treat Res. 2023 May;104(5):288-295. doi: 10.4174/astr.2023.104.5.288. Epub 2023 Apr 28. PMID: 37179697; PMCID: PMC10172027. Burnier M. The role of adherence in patients with chronic diseases. Eur J Intern Med. 2024 Jan;119:1-5. doi: 10.1016/j.ejim.2023.07.008. Epub 2023 Jul 20. PMID: 37479633. Mezalek ZT, Feodor T, Chernukha L, Chen Z, Rueda A, Sánchez IE, Ochoa AJG, Chirol J, Blanc-Guillemaud V, Lohier-Durel C, Ulloa JH. VEIN STEP: A Prospective, Observational, International Study to Assess Effectiveness of Conservative Treatments in Chronic Venous Disease. Adv Ther. 2023 Nov;40(11):5016-5036. doi: 10.1007/s12325-023-02643-6. Epub 2023 Sep 20. Erratum in: Adv Ther. 2024 Jan;41(1):464-465. doi: 10.1007/s12325-023-02722-8. Erratum in: Adv Ther. 2024 Jun;41(6):2540-2541. doi: 10.1007/s12325-024-02857-2. PMID: 37728696; PMCID: PMC10567827. Bogachev, V., Arribas, J.M.J., Baila, S. et al. Management and evaluation of treatment adherence and effectiveness in chronic venous disorders: results of the international study VEIN Act Program. Drugs Ther Perspect 35, 396–404 (2019). https://doi.org/10.1007/s40267-019-00637-5 Golna C, Poimenidou C, Giannoukari EE, Saridi M, Liberopoulos E, Souliotis K. Assessing a pharmacist-enabled intervention to improve adherence to medication for hypertension, dyslipidemia, and chronic venous circulation disorders in Greece. Patient Prefer Adherence. 2023;17:3341–3352. doi:10.2147/PPA.S420811 6. Branisteanu DE, Munteanu AE, Dolofan BM, Popescu EG, Vittos O. Adherence to pharmacological treatment in chronic venous disease: results of a real-world, prospective, observational cohort study. Life (Basel). 2025;15(3):377. doi:10.3390/life15030377. 7. Ulloa JH, Guerra D, Cadavid LG, Fajardo D, Villarreal R, Bayona G, Hoyos AS, Garcia G. Nonoperative approach for symptomatic patients with chronic venous disease: results from the VEIN Act program. Phlebolymphology. 2018;25(2):123 Servier is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Servier. Always consult the Instructions for Use (IFU) prior to using any medical device.

Mar 26, 2026

24:28

Vascular Graft and Endograft Infection – Building a Common Language with T. Wyss and K. Sörelius

In this episode of the ESVS Podcast, we tackle one of medicine’s most deceptively simple challenges : agreeing on what we’re actually talking about. Vascular graft and endograft infections (VGEI) are rare, serious, and universally dreaded, but when it comes to defining them, classifying them, and reporting outcomes, it turns out the vascular world hasn’t always been speaking the same language. Safa Riahi is joined by Dr Thomas Wyss and Dr Karl Sörelius to discuss a recent international Delphi consensus that brought together 43 multidisciplinary experts to do something surprisingly difficult: agree on definitions. From the long-standing debate over early versus late infection, to the subtle but clinically important difference between graft-enteric erosion and fistula, to the brave attempt to define what “cure” actually means in a disease that likes to relapse when you least expect it, this episode explores how a shared vocabulary might finally help researchers compare studies, registries make sense, and multidisciplinary teams argue a little more productively. As it turns out, building a common language might be one of the most important steps toward better science; and better care; in VGEI. The Delphi consensus discussed in this episode can be accessed here: https://www.ejves.com/article/S1078-5884(25)00707-5/

Mar 19, 2026

21:13

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