Overview
The acquisition of the technical skills, knowledge, and attitudes necessary for the successful management of patients with complex vascular disorders requires a high level of commitment and dedication from all involved in the process. The educational goals of the Vascular Surgery Residency Program at the UAMS College of Medicine are intended to clearly delineate the specific responsibilities of both houseofficers and teaching faculty. These objectives have been developed in conjunction with all members of the teaching faculty, previous vascular surgery fellows, and the Association of Program Directors in Vascular Surgery (APDVS).
One of the strengths of the program is the combination of excellent endovascular training and simultaneous extensive experience in complex open vascular surgery. In the last two years of residency and fellowship, the trainee has well over 400-500 major cases.
During vascular surgery training, the experience is divided with rotations between the UAMS Medical Center, the John L. McClellan Memorial Veteran’s Hospital and the Baptist Health hospital. The UAMS Medical Center is the only academic referral center in the state and surrounding region, attracting complex cases from the three surrounding states. The trainee is exposed to a variety of complex vascular reconstructions, involving all vascular beds, with cases involving a combined open and endovascular approach; all supported by a brand-new hybrid operating suite opened in 2016. The experience at the VA hospital boasts a very streamlined and state-of-the-art hybrid operating room that operates five days a week, not only rich in “bread-and-butter” vascular cases, but also index cases, such as renal and visceral bypasses, abdominal aortic aneurysm repairs, fenestrated endografts, NAIS and complex lower extremity reconstructions. Baptist Health is one of the state’s largest community hospital systems and the Little Rock Baptist hospital is the referral center for this medical system. This attracts both common and very complex cases from around the state. The large hybrid operating room, opened in 2014 allows for all advanced vascular surgical imaging and treatment.
Endovascular Surgery
We ensure you master basic endovascular skills, and the vascular residents and fellows will subsequently develop expertise by performing and assisting on advanced endovascular interventions, such as:
- Cerebral diagnostic and therapeutic intervention
- Percutaneous atherectomy and re-entry of occlusions
- Percutaneous catheter-directed lysis
- Catheter-directed mechanical thrombolysis (AngioJet, EKOS etc) and the use of percutaneous thrombectomy catheters
- Endografts for abdominal aortic aneurysm (all manufacturers, including Cook fenestrated)
- Thoracic aortic endografting (aneurysmal, dissection and in particular emergent traumatic aortic injuries)
- Intravascular Ultrasound for complex venous reconstructions, re-entry devices, EVAR and aortic dissections
- Visceral procedures (renal, SMA, etc.)
- Subintimal angioplasty, re-entry and retrograde tibial approaches
- Intraoperative lytic therapy
- Aortoiliac and femoral angiography
- Coil embolization
- Other miscellaneous advanced therapies such as aortic stapling, directional guiding sheaths, hybrid remote endarterectomy and vena cava reconstructions in cases of IVC filter thrombosis.
Open Vascular Surgery
During both UAMS and CAVHS rotations, you will have extensive and balanced experience in open vascular surgery that is rarely found in a modern vascular surgery program. Exposure to a variety of basic and complex open vascular cases is present at all three hospitals. We have one of the largest experiences involving deep femoral vein reconstructions for complex aortic and peripheral cases in the country. Dr. Mohammed Moursi, Chief of Vascular Surgery and the Vascular Surgery Residency and Fellowship program director, is the only surgeon in the region who performs this procedure. Additionally, UAMS is the only center in the State of Arkansas to perform open thoracoabdominal surgery.
Vascular Laboratory
Experience in the vascular diagnostic laboratory is an essential component of an overall training program in vascular surgery. During the course of the fellowship, you will expand your knowledge regarding vascular diagnostic tests, the wide range of diagnostic principles and limitations of each technique. You will be asked to sign off on vascular studies at the CAVHS after you have gained sufficient experience. You will be supervised in this process by the director of the vascular lab at both hospitals. Your experience will allow you to do the following:
- Accurately order appropriate diagnostic tests for the entire spectrum of vascular disorders
- Understand the role of carotid duplex in evaluation of asymptomatic and symptomatic carotid artery disease
- Interpret the result obtained by carotid duplex, including ultrasound image and Doppler velocities
- Discuss the limitations of carotid duplex
- Understand the use of duplex in evaluation of visceral vessels
- Understand the noninvasive test to investigate the extremity arteries
Clinical Research
Our group is proud to be a center that is enrolling for a large number of clinical trials, including the CREST II and as of 2016 remains the only center in Arkansas that has access to the Cook fenestrated aortic endograft. Many opportunities exist to present and publish in clinical research with all of our faculty.