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  • 1. The Division of Vascular Surgery George H. Meier III, MD Joseph S. Giglia, MD Professor of Surgery Associate Professor of Surgery Director, Division of Vascular Interim Director, Division of Surgery [effective 9/1/07] Vascular Surgery George.Meier@uc.edu Joseph.Giglia@uc.edu 513.558.5367 513.558.5367 The Division of Vascular Surgery is a multi-faceted tenure before joining Eastern Virginia Medical School as regional referral center treating the full range of arterial Chief of Vascular Surgery. Dr. Meier is certified by the and venous disease. The Division’s substantial clinical American Board of Surgery in both general and vascular volume is accommodated by significant investments in surgery and he also holds a certificate of added qualifica- technology and a comprehensive team approach for tion in surgical critical care. Dr. Meier's professional inter- evaluation and post-operative care. The Division pursues ests include the management of diabetic vascular disease, innovation in vascular care for the improvement of patient wound healing, stroke prevention, and vascular education. outcomes and creation of new scholarship in the field. Patient Care The Division has announced the recruitment of Dr. George H. Meier III to become the next Director of the Members of the Division offer treatment of vascular Division of Vascular Surgery. Dr. Meier received his M.D. disorders at The University Hospital, University Pointe, degree cum laude from Emory University School of University Pointe Ambulatory Surgical Hospital, The Christ Medicine. He completed his Surgical Internship, Residency Hospital, and the Veterans Affairs Medical Center. They are in Surgery, and Fellowship in General Vascular Surgery at also part of the multidisciplinary team of UC Heart & Massachusetts General Hospital. He then completed a year Vascular Center. Dr. Amy Reed will soon begin seeing of postdoctoral training in General, Thoracic, and Vascular patients at the Redbank Surgery Center, a partner with The Surgery at Massachusetts General Hospital while also serv- Christ Hospital. ing as Assistant in Surgery at Harvard University School of The Division of Vascular Surgery offers a full range of Medicine. Dr. Meier then joined the faculty at Yale minimally invasive procedures in the treatment of arterial University School of Medicine as Assistant Professor of and venous disease, and operates as a regional center for Surgery, rising to Associate Professor during his 10-year the treatment of complex vascular problems. The Division The Division of Vascular Surgery | Page 104
  • 2. also performs standard open vascular operations for aneurysms in the chest and abdomen, reoperative aortic repair, and lower extremity revascularization. In addition, the Division remains a recognized leader in the clinical applications of endovascular surgery. Innovations in vascu- lar care include laparoscopic aortic procedures, novel endovascular approaches for thoracic transection and trauma, and minimally invasive approaches for critical limb ischemia. The expanded clinical base provides an excellent educational experience for vascular surgery fellows and the general surgery residents. Dr. Joseph Giglia is one of only a few surgeons in the country who perform laparoscopic aortobifemoral bypass to treat aortoiliac arterial occlusive disease. The procedure is a key innovation in the treatment of peripheral arterial disease (PAD), a condition where large blood vessels in the abdomen and limbs become narrowed. Dr. Giglia’s work provides the benefit of minimally invasive techniques, University Hospital and has the potential to minimize the namely faster recovery time and less pain, with the durabil- significant morbidity and mortality associated with the ity of the traditional gold standard by-pass procedure. standard open surgical repair in these multiply injured Dr. Giglia’s laparoscopic approach is one step on the road patients. toward robotic-assisted treatment of aortoiliac occlusive Dr. Amy Reed performed the Cincinnati Veterans Affairs disease and eventually for laparoscopic treatment of Medical Center’s first cryoplasty (Boston Scientific, aneurysms. PolarCath™) in a patient with peripheral arterial disease Dr. Giglia received the 2006 American Vascular (PAD). Traditional treatment for PAD includes balloon Association’s annual E.J.Wylie Traveling Fellowship Award, a angioplasty and stenting, which often need to be repeated. professional development grant that allowed him to visit Preliminary studies have shown that 85% of treated arter- established vascular centers across the world. This experi- ies remained open for nearly a year following cryoplasty. ence and resulting collaborations will help Dr. Giglia create The Division offers a full range of treatment for venous a laparoscopic vascular surgery center at UC. He attended disease. Many minimally invasive therapies including an advanced laparoscopic aortic vascular course in percutaneous mechanical thrombectomy, venoplasty, and Strasbourg, France, a Laparoscopic Vascular Course in stenting have been utilized to treat patients with superior Quebec, Canada, and the International Endovascular vena cava syndrome and extensive deep vein thromboses. Laparoscopic Congress held in New York City. Dr. Giglia also For many the pain associated with varicose veins is related was named as an Alternate for the American College of to venous reflux which often forces dramatic lifestyle Surgeons Traveling Fellowship to Germany for 2007. changes. Dr. Reed has introduced a minimally invasive Dr. Giglia has pioneered a novel endovascular treat- treatment for venous reflux to the Division. It uses a special- ment of blunt aortic trauma with a self-expanding stent ly designed radio frequency ablation catheter (Closure®, lined with aortic extender cuffs that was published in VNUS) to occlude the saphenous vein and prevent reflux March 2006 in the Annals of Vascular Surgery, co-authored without the painful and often disfiguring standard by Dr. Amy Reed. This procedure is available at The stripping procedures. The Division of Vascular Surgery in conjunction with the UC Heart & Vascular Center expanded its Vascular Surgery Lab at University Pointe in West Chester in September, 2004. The vascular lab continues to grow and offer referring physicians and patients in the Butler/Warren county area the most technologically advanced diagnostic tests and minimally invasive procedures, including: • Diagnosis and treatment of varicose veins • Carotid ultrasound • Abdominal aortic ultrasound • Upper and lower extremity arterial non-invasive testing, including ABI (ankle brachial indices) to test for proper blood flow • Upper and lower venous ultrasound to evaluate for DVT (deep venous thrombosis) • AAA (abdominal aortic aneurysm) screening • Peripheral vascular disease (PVD) screening The Division of Vascular Surgery | Page 105
  • 3. Education The University of Cincinnati College of Medicine’s Vascular Surgery Fellowship Program offers conventional and endovascular training in addition to comprehensive non-invasive vascular lab training. To assist general surgery residents in learning vascular anatomy, cadaver labs were set up this year with significant input from graduating vas- cular surgery fellow, Dr. John Hutto.This allowed trainees to perform dissections, aortic exposures and endarterec- tomies without the time constraint of the operating room. The Division’s strong commitment to state-of-the-art surgical training in endovascular and complex open surgical techniques has allowed the Division to attract top candidates from across the country. This year the Division was delighted to match its second female trainee in vascular surgery, Dr. Vechvitvarakul, who will start in 2008. Dr. Giglia is Co-Principal Investigator of a research Top general surgery resident, Dr. Carlos Rosales, entered the project on “In vitro model of arterial aneurysms with wall two year vascular surgery fellowship this July 2007. stress sensing capability” sponsored by the Minimally Dr. Amy Reed remains the Director of the Vascular Invasive Medical Technologies Center (MIMTeC) at the Surgery Fellowship Program. Under her guidance the University of Cincinnati Colleges of Medicine and program has received full accreditation for 3 years and Engineering. passed the Internal Review. In addition to a full standard Dr. Amy Reed presented her research, “Major Lower operative caseload, all of the fellows performed more than Extremity Amputation after Multiple Revasularizations:Was 400 endovascular procedures during their fellowship and It Worth It?” at the New England Vascular Surgery Society thus met all credentialing standards for endovascular meeting in September 2007 in Boston. The paper is privileging. Academic and scholarly pursuits are critical to currently in press in Annals of Vascular Surgery. Dr. Reed a fellow’s development and future career. Each fellow is was an invited moderator for the Vascular Video Session at expected to publish two papers and/or chapters during the American College of Surgeons Meeting in Chicago in their clinical fellowship. October 2006. Dr. Reed was also a recipient of the A standardized reading program, which repeats on a University of Cincinnati Faculty Development Grant which two-year cycle, has been developed and the fellows meet helped fund her travel to the American College of monthly with the faculty to review the assigned material. A Surgeons Outcomes Course in Chicago in November 2006. formal lecture series has been developed in collaboration She authored “Advanced Training in Vascular Surgery: How with other departments at the College of Medicine to Does It Need to Change” published in Seminars of Vascular enhance the fellows’ understanding of vascular physiology, Surgery in December 2006. Dr. Reed along with second anatomy, embryology and pathology. year vascular surgery fellow, Dr. John Hutto, published “Endovascular Repair of Blunt Popliteal Artery Injury” in the Dr. Amy Reed has chaired the Education Committee of January 2007 edition of Journal of Vascular Surgery. the American Program Directors of Vascular Surgery (APDVS) this past year. Under her guidance, the APDVS Dr. Reed was appointed to the Society for Vascular will be rolling out the first Vascular Surgery In-Training Surgery Women’s Issues Committee in 2006 and was an Examination (VSITE), set to be administered in spring 2008. invited speaker to Miami University on “Women in She continues in her fourth year as a consultant to the Medicine” in November 2006 and invited panelist for the American Board of Surgery Vascular Surgery Examination. University of Cincinnati College of Medicine’s “Women Physicians: Changing the Face of Medicine” in January Research 2007. She was invited to be the Keynote Speaker at the University of Cincinnati Women’s Leadership Conference, Dr. Joseph Giglia is the local Principal Investigator for “Women in Surgery: Cutting Into the Glass Ceiling,” in the Open versus Endovascular Repair of Abdominal Aortic March 2007. Dr. Reed was also asked to participate in the Aneurysm Trial, and received a Certificate of Achievement Society for Vascular Surgery’s DVD project that included for his work in the trial. This 8-year multimillion dollar her commentary on life as a vascular surgeon and which Veterans Affairs Cooperative Study critically compares has been distributed nationwide to medical students and morbidity, mortality, quality of life, and cost between the general surgery residents. two methods of abdominal aortic aneurysm repair. Dr. Giglia is working with the Department of Biomedical Engineering to develop techniques to decrease ischemia during thoracoabdominal aneurysm repair. He continues to work on laparoscopic techniques for aortic surgery. The Division of Vascular Surgery | Page 106
  • 4. Community Connections Dr. Giglia has a special interest in complex aortic surgery, laparoscopic aortic surgery and in minimally invasive treat- A goal of the Division is to increase public awareness ment of thoracic and abdominal aortic pathology. He is and understanding of vascular disease. The Division of board certified in Vascular Surgery, General Surgery, and Vascular Surgery holds several free screenings per year at Surgical Critical Care. University Pointe and The University Hospital in conjunc- tion with the American Vascular Association’s annual Amy B. Reed, MD, FACS nationwide early detection education program. During Assistant Professor of Surgery Vascular Awareness Month, participants are screened for Director, Vascular Surgery Fellowship Program peripheral arterial disease, abdominal aortic aneurysms, Director, Non-Invasive Vascular Laboratory, University Pointe and carotid artery stenosis.The vascular screening program targets men and women aged 60 and older with a history Dr. Reed specializes in percutaneous treatment of aortic of high blood pressure, smoking, diabetes or heart disease. aneurysms and peripheral vascular disease including com- Vascular surgeons meet individually with each participant plex lower extremity revascularization for limb salvage. She to review their screening results. Participants also receive a is board certified in Vascular Surgery and General Surgery. vascular report card outlining their test results to share with their family physician. George H. Meier III, MD, FACS Professor of Surgery The Division sponsored a free vascular screening for Director, Division of Vascular Surgery the Cincinnati Police Department in February 2007. Not Director, Vascular Services, The University Hospital only did this provide valuable information to the police force, but also an opportunity for education about abdom- Dr. Meier specializes in the management of diabetic vascu- inal aortic aneurysms, stroke from carotid artery disease lar disease, wound healing, and stroke prevention. He is and peripheral vascular disease. board certified in General Surgery and General Vascular Both Drs. Reed and Giglia actively educate the commu- Surgery. nity about vascular disease and treatment through screen- ings, public lectures and media interviews. Further information on the Division of Vascular Surgery, including presentations and publications, can be Dr. Giglia was a 2007 “Health Care Hero” Finalist in the viewed on our website http://surgery.uc.edu. Innovator Category for his laparoscopic approach to aorto- bifemoral bypass, sponsored by the Cincinnati Business Courier. Both Drs. Giglia and Reed were listed among “Top Doctors” in vascular surgery by Cincinnati Magazine in April 2007. Faculty (To view the full CV, visit our website at http://surgery.uc.edu) Joseph S. Giglia, MD, FACS Associate Professor of Surgery Interim Director, Division of Vascular Surgery Chief, Vascular Surgery, Veterans Affairs Medical Center Cincinnati Director, Noninvasive Vascular Laboratory, Veterans Affairs Medical Center Cincinnati Director, Noninvasive Vascular Laboratory, The University Hospital 2000 1000 500 3000 1500 800 400 2500 1200 1500 2000 600 300 900 1000 1500 400 200 600 1000 500 300 200 100 500 0 0 0 0 0 The Division of Vascular Surgery | Page 107