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CX Short takes: Day 1
Saturday, 04 Apr 2009 19:41
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Marc Bosiers, AZ St Blasius, Dendermonde, Belgium
"I saw the debate between Frank [Veith] and Bill Gray [Surgery is a minor part of vascular disease management]. Frank wasn’t cheating! We all know that the answer is that a good vascular practice should combine vascular and endovascular surgery, what’s debatable is how many cases you send for endovascular treatment and how many you send to classical surgery. As techniques progress, over time, you will see a shift, which is already ongoing, from classical to endovascular surgery. But I’m convinced that classical surgery will remain necessary for certain patients. Classical surgery will never die, it will always be there.
"This is by far one of my preferred congresses, because it’s a good combination of giving an overview of what is going on in the market. From an educational standpoint, it’s a compromise between debates, which makes things a bit more lively, and state-of-the-art lectures, and on the other hand, this congress has also moved from being, 20 years ago, a good old-fashioned vascular surgery congress, to a congress which is open for every innovation. If you look around here, all the companies are here presenting their new products. That’s what a vascular surgeon also wants to see. How doesn’t only want to see debates or lectures on how to or how not to do it, what to use and what not to use, he wants to go to the booths and see what is new on the market; what he might be using in his practice in the future.
"London is a perfect city!... Well, actually I prefer Paris by far!"
Lindsay Machan, University of British Columbia, Vancouver, Canada
"I think the forum reflects this year’s theme ‘Controversies in Vascular and Endovascular medicine’ really well. Professor Roger Greenhalgh has set up an excellent format, as he is getting active debate and reflection about all points of view, including not intervening, which I think is extremely healthy.
I saw a lively discussion in the session addressing treatment of superior femoral artery disease [Superficial femoral artery stents are an expensive luxury with no advantage over angioplasty - Colin Bicknell, Imperial College London, UK, vs. Shaun Samuels, Baptist Cardiac and Vascular Institute, Miami, USA]. That was an excellent and comprehensive discussion from all aspects of treatment.
What came out was that data has not changed on best medical management and that was helpful for me. It was a good reflecting point, as it reinforced for me, that we are providing patients with state-of-the-art care.
"So far, the only new trial data that I have heard has been the update on the Zilver PTX trial. It is the first time the data has ever been presented anywhere, and it demonstrated continuing efficacy from previous datapoints. That was very interesting to know, as it is the first time any drug-eluting stent in superficial femoral artery has shown efficacy beyond 18 months. So that does constitute a breakthrough in endovascular medicine.
"I’m really devastated that I lost my debate [Drug-eluting superficial femoral artery stents are dead in the water]. I’ve already called my therapist but I want a second chance! I knew that debating against Marc Bosiers was a formidable task, as he is an extremely knowledgeable and well-respected opponent, but given the topic and position, I thought it was impossible to mess it up. So I’m a little bit embarrassed that I managed not to persuade the crowd to agree with me!"
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