Enhancing patient care, attracting research funds

University Hospital's new endovascular operating suite is outfitted with digital fluoroscopic imaging equipment, allowing surgeons to "mix modalities" and perform advanced minimally invasive endovascular procedures while maintaining open surgical capabilities, Professor and Section Chief of Vascular Surgery William D. Jordan, MD, says.

The endovascular suite's flexibility and advanced technology enhance patient care, allow cutting-edge development and refinement of endovascular procedures, and provide a training ground for physicians to learn new techniques, he says.

"The need for enhanced revascularization techniques is increasing along with an expanding elderly population," Dr. Jordan says. "An estimated 20% of people older than age 70 have lower extremity vascular disease, and 50% of those are symptomatic, experiencing severe leg pain when walking. The elderly also suffer high rates of cerebrovascular disease. As Alabama's population ages along with the rest of the nation, the prevalence of vascular disease and stroke continues to grow."

Endarterectomy, bypass procedures, and aneurysm repair can improve the health of patients suffering from vascular disease, but not all elderly patients can tolerate open surgery. Consequently, minimally invasive endovascular techniques are becoming more common, Dr. Jordan says. "Often, we combine stent technology and bypass procedures for optimal results. In the new suite, we can perform 'hybrid revascularizations' in a single setting."

Research

"Although some endovascular treatments, such as abdominal aortic aneurysm repair, reduce morbidity and mortality, compared with the open procedures, other areas of endovascular therapy require intense research and clinical evaluation to improve results," Dr. Jordan says. "The endovascular suite greatly enhances our ability to conduct such research and attract government and industry research funds."

Dr. Jordan is principal investigator for the UAB arm of the 51-site CREST study (Carotid Revascularization with Endarterectomy versus Stenting Trial) that will help determine the appropriate role for carotid stenting. He also has begun recruitment for a trial evaluating use of thoracic aortic stents for endovascular repair of thoracic aneurysms.

The Section of Vascular Surgery recently recruited two vascular specialists to advance minimally invasive techniques and facilitate research projects: Gilberto C. Russo, MD, PhD, who combines clinical interests in vascular surgery and evidence-based medicine with research focusing on applications of modern engineering in surgery, and Steven M. Taylor, MD, whose research focuses on alternative conduits for lower extremity bypass and combination endovascular and open procedures for treatment of vascular diseases.

A $1.4 state economic development grant funded construction of the endovascular suite and recruitment of additional vascular surgery faculty, explains UAB Chief Planning and Strategy Officer Martin Nowak. "UAB's Department of Surgery has played a leading role in developing minimally invasive techniques for treatment of vascular disease. The new suite and faculty will continue that progress, bringing economic multipliers of research and clinical care to Alabama and greatly enhancing medical services for our citizens."