Two Regina-based medical students recently presented studies conducted as part of last year’s Summer Student Research program at the Canadian Society for Vascular Surgery (CSVS) annual meeting in Halifax. The CSVS gives two awards each year for the top papers presented at the meeting, and the two students swept the awards, beating out papers presented by students, residents, fellows and academic vascular surgeons from across Canada.
Daniel Meyer received the Josephus C. Luke Award for “the best clinical or basic research abstract presented at the annual meeting.” Abdalla Butt won the
Sigvaris President’s Award for “the most outstanding abstract dealing with venous disease presented at the Annual Scientific Meeting.”
The awards were presented at the Citadel in Halifax by CSVS president Dr. Greg Browne. Both papers are reviewed below:
Daniel Meyer receives his award.
Investigating Factors that Delay Carotid Endarterectomy in Patients with Symptomatic Carotid Artery Stenosis
Principal investigator: Daniel Meyer
Supervisor: Dr. David Kopriva
Carotid atherosclerosis is an important cause of ischemic stroke. Patients with severe carotid stenosis are recommended to undergo carotid endarterectomy
(CEA), a surgical procedure to open the carotid artery, within 14 days of the onset of neurologic symptoms. This study found 30 per cent of patients
receive CEA within the recommended timeframe.
We found the following factors to be significant in meeting the guideline: delayed patient presentation, the nature of the first provider seen, the number
of contacts and referrals prior to vascular surgery, and the nature of the patient’s index neurologic event. The primary delay to care was which provider
was seen first; however, further analysis revealed an apparent inequity in expeditiousness of investigations and consults based on the ordering provider,
which may indicate a significant system issue. Having identified these factors, interventions can be identified to correct them and increase the number
of patients meeting the guideline.
Abdalla Butt receive his award.
Economic Implications of publically funded endovascular saphenous vein ablation
Principal Investigator: Abdalla Butt
Supervisor: Dr. David Kopriva
Health regions across Canada have slowly been delisting public health coverage for varicose vein ablation. However, a synergistic co-operation between
vascular surgeons and the health regions in Saskatchewan resulted in a first of its kind, a publically funded Endovenous Ablation (EVA) program
in the province.
The goals of this study were to compare health system costs of EVA and surgical stripping and determine if the availability of EVA changed the utilization
rate of historical controls undergoing long saphenous vein stripping (LSVS). The study found that utilization rates for the LSVS procedure did
not change from pre-EVA to post-EVA eras. Surgical stripping by general surgeons decreased from 52 cases per year to 7.2, while surgical stripping
by vascular surgeons decreased, from 38 to 13 a year.
Case costs of surgical stripping ($1965.12/case) were higher than of Endovenous Laser Treatment, ($1358.79/case) and Radiofrequency Ablation ($1410.54/case).
Total annual costs of LSVS decreased from $176,860.35 to $134,524.88. Thus, the introduction of publically funded EVA has reduced rates of LSVS
and reduced costs to our health system by roughly $42,335.47 per year.