Since its formation in 1994, the Greenville Health System (GHS) Division of Vascular Surgery has worked to build a team that encompasses "all things vascular." There are nine vascular surgeons, plus four vascular medicine physicians who specialize in endovascular procedures, venous disease and risk reduction management. The division started the state's only vascular residency program in 2002 and then launched the state's first vascular medicine fellowship in 2007.
The Vascular Surgery division has an excellent track record of outcomes in a range of vascular disease procedures. It's treatment of carotid stenosis with angioplasty and stents has greatly surpassed national standards with a stroke risk of <1 percent. Repairs needed to endovascular stent grafts for abdominal aortic aneurysm (AAA) are one-third to one-half of those reported in the current literature. The division's claudication procedures enable 97 percent of patients to avoid amputations.. Innovative Treatments,Successful Outcomes
Surgeons in the Division of Vascular Surgery have been responsible for surgical firsts in the Greenville area and beyond. They were the first in the state to implant aortic stent grafts,including grafts to treat both abdominal aortic aneurysms (AAA) and thoracic aneurysms. They also were pioneers in performing combined open and endovascular surgeries.
GHS built the state's first endovascular operating room,which became a model for other systems across the Southeast. Since then,GHS has invested in converting four of its interventional radiology suites into endovascular ORs. These rooms have a laminar flow of oxygen circulating so that surgeons can perform open surgery with anesthesia as well as endovascular procedures,or a combination of the two,with imaging capability at all times.
Early innovations in the Division of Vascular Surgery at GHS have paved the way for ongoing advances. GHS vascular surgeon David Cull,M.D.,FACS,is a national expert on arteriovenous (AV) access for dialysis patients. Among other developments,he invented the CreatiVasc Hemoaccess Valve System,which reduces complications associated with AV graft operations. He also has a patent pending for the FistulaFinder®,a device that helps dialysis technicians visualize and stabilize a patient's fistula site. The device greatly reduces the need for repeated "needle sticks," and has decreased complications caused by failed AV access attempts by 83 percent.
GHS interventionalists from endovascular surgery,radiology and cardiology recently formed a Carotid Stenting Service,a collaborative practice model designed to ensure optimal patient care while centralizing research and outcomes data.
Bruce Gray,D.O.,FSVM,FSCAI,is the GHS director of Endovascular Services and co-director of the American Board of Vascular Medicine. He was the first physician in the state to enroll patients in the Embolic Protection Device in Carotid Artery Stenting (EPIC) trial. The trial involves a new system to capture particles that could be dislodged during the carotid stenting procedure. The carotid stenting procedure,performed through a catheter inserted into the groin,is an alternative to open surgery through a neck incision.
The GHS vascular specialists also are using catheter treatments to address varicose veins and other venous diseases. These progressive treatments,performed on an outpatient basis,have replaced vein stripping. "The patient is walking as soon as it's done," said Marcus Stanbro,D.O.,FSVM,director of the GHS Vein Center and program director for Vascular Medicine. "We have board-certified vascular physicians,and this is their core focus."