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Education

Vascular Surgery Fellowship Program

Program director:  Satish Muluk, MD
Accreditation:  ACGME
Program length:  2 years (PGY6-PGY7)
Fellows per year: 1
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About the Program

In our 2-year (PGY6-PGY7) Vascular Surgery Fellowship Program, we provide the added skills that a trained general surgery resident will need to become an excellent vascular surgeon. Below is a description of each year of the program.

First Year

In the first year, the trainee will focus on five areas:

  • Endovascular rotation (12 weeks) – It is essential for the vascular surgeon of the 21st century to be very skilled in endovascular surgery techniques.  Our faculty surgeons have very strong endovascular skills. We also have a strong collaborative relationship with our colleagues in interventional radiology. Each vascular surgery fellow will have a dedicated 3-month endovascular block during the first year. The time will be spent primarily with attending vascular surgeons performing endovascular cases. The trainee will also have the opportunity to work with IR attendings. The skills learned during this time are often not taught to the general surgery resident, and they will serve as a foundation for the endovascular surgical procedures that the fellow will perform with greater autonomy in the 2nd year.
  • Vascular lab (12 weeks) – No vascular surgery training program is complete without a solid foundation in vascular laboratory training. Each vascular surgery fellow will have a dedicated 3-month block in the vascular laboratory during the first year. The trainee will learn the basis of modern noninvasive vascular lab testing, and he/she will get to the point of being able to perform the studies independently. At a minimum, each trainee will get enough experience to sit for the recently introduced physician interpretation examination. We expect that some trainees will seek to get enough experience to take the RVT examination as well.
  • Wound Healing and Lymphedema Center (1-2 weeks)– Our vascular surgeons often take the lead role in treating wound healing and lymphedema. The first-year vascular surgery fellow will have the opportunity to learn up-to-date management techniques for non-healing wounds and lymphedema in our  Wound Healing and Lymphedema Center, which has over 4500 patient visits per year.
  • Clinical research (12 weeks) – Each vascular surgery fellow will choose three to four research projects, based on the large clinical volume of our division. The expectation is that each fellow will have a strong enough project to submit a competitive abstract to the one of the major vascular surgery meeting, with a plan of ultimate publication in a leading vascular surgery journal.
  • Clinical training (12 weeks) – The first-year fellow will spend 12 weeks doing a clinical rotation at West Penn and Forbes hospitals, gaining exposure to a broad spectrum of vascular surgery cases, including lower extremity peripheral artery disease, hemodialysis access surgery, carotid occlusive disease, and aortic aneurysm repair.

 

Second Year

During the second year of the program, the fellow will perform as an operative surgeon on a wide variety of both endovascular and open vascular surgical cases. Our program performs over 2,000 operations per year. The resident will be closely involved with the pre- and postoperative care of each patient. In addition, the fellow will see patients in the outpatient setting. 

The program offers experience with the entire spectrum of vascular surgery cases, including routine and complex arterial surgery, open and endovascular surgery, hemodialysis access and venous interventions.

Details on the spectrum of cases performed by our group are as follows:

  • We performed 2009 cases in the 12‐month period ending June 30, 2010, including 150 elective infrarenal aortic aneurysm repairs (82% endovascular), 15 ruptured AAA repairs (27% endovascular), 15 thoraco‐abdominal aneurysm repairs (73% endovascular),  225 carotid interventions (5% carotid stent, rest were done by endarterectomy)
  • We perform a large number of lower extremity revascularization cases, roughly 60% by endovascular techniques.
  • We have a substantial practice in hemodialysis access and venous insufficiency
    cases.
  • We have access at each of three hospitals to fixed‐unit hybrid suites, suitable for performing endovascular and/or open surgery.
  • We have access to the latest endovascular “toys”, including orbital atherectomy, cutting balloons, re‐entry devices (e.g. Outback), recanalization devices (e.g. Crosser, Avinger), cryogenic angioplasty
  • We are constructing a new hybrid OR using the Siemens Artis Zeego unit. At a cost of $5 million, this room will have state‐of‐the art imagaing, including on‐the‐fly 3D  reconstruction, bolus‐chasing, and overlay of prior patient imaging. We plan to use this new room for virtually all our endovascular cases.

 

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