The Division of Vascular Surgery continues to develop its mission of clinical service, teaching and research under the leadership of Dr. Michel Makaroun who was appointed chief of the division in September of 1999. Prior to that, Dr. Marshall W. Webster was the Chief of the Division.

The members of our division continue to provide high quality primary and referral patient care for the region. Consultation and vascular surgical intervention is provided in the treatment of aneurysms, atherosclerotic occlusive disease, cerebrovascular disease, thoracic outlet syndrome, venous disease and visceral vascular problems. Our Division has been and continues to be the regional leader in the application of endoluminal interventions that are expanding rapidly in the treatment of both aneurysmal and occlusive disease.

Our clinical service continues to increase in volume and complexity. Abdominal aneurysm disease is common , and repairs have seen the most dramatic increase, having quadrupled in volume over the last five years. Although we perform many traditional open surgeries, endovascular repair, which we pioneered in the region and the state, has fueled this dramatic increase. In 2003, we repaired nearly 70% of our aneurysms with the endovascular technique, and we continue to implement new procedures to apply it to more patients. We continue to study new devices that may offer added benefits to patients including endovascular treatment for thoracic aneurysms provided by Dr. Michel Makaroun and Dr. Robert Rhee. This project complements the substantial progress made by Dr. Rhee and Dr. Jae-Sung Cho in providing treatment of thoracoabdominal aneurysms. We are now the main provider of care for these complex procedures in the region.

The outpatient clinic has shown a dramatic increase in activity, and we anticipate it will continue to thrive. The Wound Healing Clinic, under the direction of Dr. David Steed, is a leading center for the treatment and research in wound healing. Here diabetic arterial disease and limb ischemia are commonly seen. The work of Dr. Steed in this field has been recognized by his peers in electing him as president of the Wound Health Society and the editor of the Journal of Wound Healing.

Dr. Stanley Hirsch is the director of the Varicose Vein Clinic and he provides comprehensive varicose vein care both in the office and through our same-day surgery facility ay Shadyside Hospital. Dr. Hirsch provides complete services for the diagnosis and management of circulatory disorders such as varicose veins from spider veins to large bulging veins or venous ulcers. Included in the treatment options are endovenous laser ablation as well as sclerotherapy and vein stripping. Dr. Hirsch also treats arterial problems such as pain on walking, arterial ulcers, swollen limbs from lymphedema, deep vein thrombosis as well other causes.

In addition to the hospitals that we traditionally covered we also provide clinical services to St.Clair Hospital at the request of their medical staff. Dr. Navyash Gupta and Dr. Jae-Sung Cho provide comprehensive vascular and endovascular services to St. Clair as well as see patients at the University of Pittsburgh Hospitals. At UPMC Passavant Dr. Robert Rhee and Dr. Luke Marone cover all aspects of vascular surgery and vascular interventions. They also perform procedures in the angiography suite and offer all services in this realm. At UPMC St. Margarets Dr. Jonathan Woody sees consults, performs vascular surgeries and performs angiographic interventions. Recently joining our our group, is Dr. Ellen Dillavou, a former vascular surgery fellow at UPMC. Dr. Dillavou offers the full range of vascular and interventional procedures and practices at UPMC Presbyterian, UPMC Shadyside and the Oakland VA Hospital. Some of the procedures offered by all of these surgeons are carotid endarterectomy and stenting, angioplasty and stenting, aneurysm repair, treatment for peripheral vascular disease, and placement of dialysis access.

Dr. Edith Tzeng, our first vascular surgery resident, joined our faculty as an assistant professor 6 years ago. Her extensive experience in basic research, gene transfer and the vascular effects of nitric oxide add an exciting research dimension to the division. She has been successful in obtaining NIH funding for her research that funds advanced work in elucidating the mechanism of action of nitric oxide. She also participated in a program grant application with other researchers, with a project that will use iNOS gene transfer for the first time in humans to control intimal hyperplasia in a dialysis graft model.

The clinical vascular fellows for Academic Year 2004-05 are Drs. Maureen Sheehan and Christopher Comton (2005) as well as Drs. Tamer Boules and Stephen Stanziale (2006).

The research activities of the division continue to expand. Both Dr. Tzeng and Dr. David Vorp were successful in obtaining funding from the NIH for their ongoing research. Within the past year Drs. Cho, Rhee, Dillavou, Marone, Makaroun, Woody and Gupta have all published clinically-based research papers in respected peer-review journals.

Dr. David Vorp continues to focus investigative efforts in three primary areas, including development of a biomechanics-based tool to evaluate abdominal aortic aneurysm (AAA) disease severity for the clinical prediction of rupture potential, biomechanical forces on vascular biology and pathology, and vascular tissue engineering.

A new format for academic activities and teaching has been well received beginning with a one-hour combined Vascular Surgery/Interventional Radiology Conference, a topic-specific case presentation and discussion with review of the literature. This lecture is attended by interventional radiologists and vascular surgeons, local vascular surgeons, visiting physicians, vascular surgery fellows, general surgery resident and medical students. The conference is approved for one hour of Category I CME credit by the UPMC Health System. In addition, a bimonthly Basic and Clinical Research conference, supported by topics related to bench research and clinical trial investigations, is held. Morbidity & Mortality Review and Journal Club are also included in the curricula. On a business level, coding and reimbursement meetings to keep abreast of the latest issues are held on a regular basis.