Pub Date : 2025-12-01DOI: 10.1053/j.semvascsurg.2025.10.004
John Gaspich, Monica Majumdar, Karthik Thangappan, Matthew Menard
Optimal care of peripheral arterial disease and chronic limb threatening ischemia hinges upon multispecialty collaboration. A comprehensive team should include vascular specialists, Primary Care Providers (PCPs), podiatry/orthopedics, plastic surgery, infectious disease, endocrinology, social work and rehabilitation professionals, among others. Special attention should be paid to the unique considerations of underrepresented patient populations, such as minorities and geriatric patients, in managing their associated risks.
{"title":"Team-based approach to limb salvage","authors":"John Gaspich, Monica Majumdar, Karthik Thangappan, Matthew Menard","doi":"10.1053/j.semvascsurg.2025.10.004","DOIUrl":"10.1053/j.semvascsurg.2025.10.004","url":null,"abstract":"<div><div>Optimal care of peripheral arterial disease and chronic limb threatening ischemia hinges upon multispecialty collaboration. A comprehensive team should include vascular specialists, Primary Care Providers (PCPs), podiatry/orthopedics, plastic surgery, infectious disease, endocrinology, social work and rehabilitation professionals, among others. Special attention should be paid to the unique considerations of underrepresented patient populations, such as minorities and geriatric patients, in managing their associated risks.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"38 4","pages":"Pages 368-375"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1053/j.semvascsurg.2025.10.001
Shiavax J. Rao , Esther S.H. Kim , Christopher Mitromaras , Christopher R. Leon Guerrero , Minhaj S. Khaja , Aditya M. Sharma
The diagnosis and treatment of fibromuscular dysplasia (FMD) is challenging due to its heterogeneous clinical presentations and variable vascular involvement. Although there has been an increase in published research from large international registries to aid in the care of patients with FMD, the complexity of disease management necessitates multidisciplinary collaboration to optimize patient outcomes. Multidisciplinary teams, often including vascular medicine specialists, vascular surgeons, primary care providers, cardiologists, nephrologists, neurologists, noninvasive vascular laboratory, radiology, interventionalists, cardiovascular genetic counselors, pharmacists, and mental health care providers, collaborate using team-based models composed of coordinated visits for comprehensive and efficient evaluation, systematic imaging, and individualized management. Patient advocacy organizations also play a key role in the care of patients. Clinical care coordinators are instrumental in reinforcing individualized care plans and patient education. Vascular care centers are strongly encouraged to adopt such multidisciplinary, team-based care models using structured workflows, care coordination, and patient-centered approaches to advance FMD knowledge and care.
{"title":"Team-based approach to fibromuscular dysplasia","authors":"Shiavax J. Rao , Esther S.H. Kim , Christopher Mitromaras , Christopher R. Leon Guerrero , Minhaj S. Khaja , Aditya M. Sharma","doi":"10.1053/j.semvascsurg.2025.10.001","DOIUrl":"10.1053/j.semvascsurg.2025.10.001","url":null,"abstract":"<div><div>The diagnosis and treatment of fibromuscular dysplasia (FMD) is challenging due to its heterogeneous clinical presentations and variable vascular involvement. Although there has been an increase in published research from large international registries to aid in the care of patients with FMD, the complexity of disease management necessitates multidisciplinary collaboration to optimize patient outcomes. Multidisciplinary teams, often including vascular medicine specialists, vascular surgeons, primary care providers, cardiologists, nephrologists, neurologists, noninvasive vascular laboratory, radiology, interventionalists, cardiovascular genetic counselors, pharmacists, and mental health care providers, collaborate using team-based models composed of coordinated visits for comprehensive and efficient evaluation, systematic imaging, and individualized management. Patient advocacy organizations also play a key role in the care of patients. Clinical care coordinators are instrumental in reinforcing individualized care plans and patient education. Vascular care centers are strongly encouraged to adopt such multidisciplinary, team-based care models using structured workflows, care coordination, and patient-centered approaches to advance FMD knowledge and care.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"38 4","pages":"Pages 395-403"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1053/j.semvascsurg.2025.10.005
Eric A. Secemsky MD, MSc (Guest Editor)
{"title":"Better together: The future of team-based approaches to vascular care","authors":"Eric A. Secemsky MD, MSc (Guest Editor)","doi":"10.1053/j.semvascsurg.2025.10.005","DOIUrl":"10.1053/j.semvascsurg.2025.10.005","url":null,"abstract":"","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"38 4","pages":"Page 339"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1053/j.semvascsurg.2025.10.003
Nathan J. Reinert , M. Shazam Hussain , Sean P. Lyden
Patients presenting with complex carotid artery disorders require diligent care and decision making to achieve positive outcomes. With advancements in endovascular techniques and the ongoing need for surgical intervention in some patients, multiple specialties share in the responsibility of treating these patients. At the Cleveland Clinic, a multidisciplinary, team-based approach to caring for complex carotid disorders has been established to provide patients with comprehensive care. Collaboration at the Cleveland Clinic is accomplished, in part, by means of structured multidisciplinary discussions. Monthly, a carotid-focused conference is held to review complex patients and reinforce concepts of complex disease among several specialties, including vascular surgery, neurology, neurosurgery and interventional neuroradiology. Furthermore, quarterly conferences review outcomes for stroke, myocardial infarction, and death for each of the specialties. The accredited vascular ultrasound laboratory assists in maintaining accurate detection of carotid disease, while providing an educational component for both vascular laboratory technicians and those interpreting the results. A team-based approach to managing complex carotid disorders has proven to be beneficial for both patients and physicians. Discussion among departments encourages thoughtfulness in developing care plans and has routed patients to providers who are best suited to address their disease process.
{"title":"Team-based approach to complex carotid disorders","authors":"Nathan J. Reinert , M. Shazam Hussain , Sean P. Lyden","doi":"10.1053/j.semvascsurg.2025.10.003","DOIUrl":"10.1053/j.semvascsurg.2025.10.003","url":null,"abstract":"<div><div>Patients presenting with complex carotid artery disorders require diligent care and decision making to achieve positive outcomes. With advancements in endovascular techniques and the ongoing need for surgical intervention in some patients, multiple specialties share in the responsibility of treating these patients. At the Cleveland Clinic, a multidisciplinary, team-based approach to caring for complex carotid disorders has been established to provide patients with comprehensive care. Collaboration at the Cleveland Clinic is accomplished, in part, by means of structured multidisciplinary discussions. Monthly, a carotid-focused conference is held to review complex patients and reinforce concepts of complex disease among several specialties, including vascular surgery, neurology, neurosurgery and interventional neuroradiology. Furthermore, quarterly conferences review outcomes for stroke, myocardial infarction, and death for each of the specialties. The accredited vascular ultrasound laboratory assists in maintaining accurate detection of carotid disease, while providing an educational component for both vascular laboratory technicians and those interpreting the results. A team-based approach to managing complex carotid disorders has proven to be beneficial for both patients and physicians. Discussion among departments encourages thoughtfulness in developing care plans and has routed patients to providers who are best suited to address their disease process.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"38 4","pages":"Pages 340-346"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shared decision making is a cornerstone of person-centered care, yet its integration into the management of patients with lower extremity peripheral arterial disease (PAD) remains limited. Effective and responsive communication is critical for shared decision making. This study explored patients’ experiences of patient-clinician communication in PAD care to identify barriers and opportunities for improvement through a secondary qualitative analysis of semi-structured interviews with 16 patients with PAD. The following 3 key themes were identified: (1) the challenge of being in tune, where patients emphasized the need to feel heard and acknowledged, with technical jargon and unempathetic interactions often causing disengagement; (2) sound and logic explanations, underscoring the importance of clear, relatable, and personalized communication to build trust; and (3) limited time and fragmented care, highlighting the negative impact of rushed consultations and fragmented care on communication and trust. Patients valued approachable clinicians; the use of visual aids; and consistent, meaningful interactions. These findings revealed significant barriers to effective communication at patient, clinician, and system levels, challenging shared decision making in PAD care.
{"title":"Patients’ perspectives of patient-clinician communication in peripheral arterial disease care: “I didn't feel like I was in tune with him”","authors":"Anette Arbjerg Højen , Marie Dahl , Chalotte Winther Nicolajsen , Christian-Alexander Behrendt , Mette Søgaard","doi":"10.1053/j.semvascsurg.2025.04.010","DOIUrl":"10.1053/j.semvascsurg.2025.04.010","url":null,"abstract":"<div><div>Shared decision making is a cornerstone of person-centered care, yet its integration into the management of patients with lower extremity peripheral arterial disease (PAD) remains limited. Effective and responsive communication is critical for shared decision making. This study explored patients’ experiences of patient-clinician communication in PAD care to identify barriers and opportunities for improvement through a secondary qualitative analysis of semi-structured interviews with 16 patients with PAD. The following 3 key themes were identified: (1) the challenge of being in tune, where patients emphasized the need to feel heard and acknowledged, with technical jargon and unempathetic interactions often causing disengagement; (2) sound and logic explanations, underscoring the importance of clear, relatable, and personalized communication to build trust; and (3) limited time and fragmented care, highlighting the negative impact of rushed consultations and fragmented care on communication and trust. Patients valued approachable clinicians; the use of visual aids; and consistent, meaningful interactions. These findings revealed significant barriers to effective communication at patient, clinician, and system levels, challenging shared decision making in PAD care.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"38 4","pages":"Pages 376-379"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1053/j.semvascsurg.2025.09.003
Gabriel M. Knight, Kush R. Desai
Thrombotic lower extremity venous disease is associated with significant diagnostic and therapeutic complexity. Not only do venous occlusion and upstream venous hypertension lead to symptoms for patients, but their sequelae, including venous reflux, lymphedema, and wound formation, contribute to significant morbidity for patients and are difficult to separate from one another. Therapeutically, much of the complexity in the management of these patients stems from the fact that each individual management strategy may treat some, but not all, of the pathophysiology and associated symptoms. Given the complexity in diagnosing and managing the treatment of these patients, a multidisciplinary, multimodal approach is thus necessary to provide patients optimal and durable symptom relief in most cases. A multidisciplinary team composed of interventional radiologists and/or vascular surgeons, vascular medicine and hematology physicians, wound care providers, pelvic pain specialists, lymphedema therapists, and others, has the power to comprehensively diagnose and treat patients, improve patient access, decrease health care utilization and costs, and afford numerous other benefits to patients with thrombotic lower extremity venous disease.
{"title":"Team-based approach to deep venous disease: A multidisciplinary approach to the multifaceted problem of thrombotic lower extremity venous disease","authors":"Gabriel M. Knight, Kush R. Desai","doi":"10.1053/j.semvascsurg.2025.09.003","DOIUrl":"10.1053/j.semvascsurg.2025.09.003","url":null,"abstract":"<div><div>Thrombotic lower extremity venous disease is associated with significant diagnostic and therapeutic complexity. Not only do venous occlusion and upstream venous hypertension lead to symptoms for patients, but their sequelae, including venous reflux, lymphedema, and wound formation, contribute to significant morbidity for patients and are difficult to separate from one another. Therapeutically, much of the complexity in the management of these patients stems from the fact that each individual management strategy may treat some, but not all, of the pathophysiology and associated symptoms. Given the complexity in diagnosing and managing the treatment of these patients, a multidisciplinary, multimodal approach is thus necessary to provide patients optimal and durable symptom relief in most cases. A multidisciplinary team composed of interventional radiologists and/or vascular surgeons, vascular medicine and hematology physicians, wound care providers, pelvic pain specialists, lymphedema therapists, and others, has the power to comprehensively diagnose and treat patients, improve patient access, decrease health care utilization and costs, and afford numerous other benefits to patients with thrombotic lower extremity venous disease.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"38 4","pages":"Pages 380-385"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1053/j.semvascsurg.2025.09.001
Rebecca Sorber , Peter H. Byers , Ulrike Schwarze , Yonatan Buber , James N. Kirkpatrick , Catherine M. Otto , Scott C. DeRoo , Sara L. Zettervall , Christopher R. Burke , Matthew P. Sweet
Background
Multidisciplinary aortic teams (MAT) are integral to the management of aortic pathology. This study quantifies the effects of MAT implementation on aortic case volumes, practice patterns and surgical productivity at a single academic institution.
Methods
Patients receiving aortic procedures were identified using CPT codes. Three time periods were defined: 2 years prior to MAT (2018), the first year with MAT (2020), and 2 years post implementation of MAT (2022). Full MAT was defined as having aortic-focused providers from cardiothoracic surgery, vascular surgery, cardiology and genetics.
Results
Total aortic case volume increased over 300 over the study period. Increased volume was seen for both cardiothoracic and vascular cases with a significant increase in the proportion of ascending aortic replacements as well as thoracic endografting (P < .01). Patients receiving multiple procedures significantly increased from 2018 to 2020 (70.3% vs. 84.9%) as well as mean number of procedures per patient (1.98 vs. 2.42, both P < .05). While the number of patients receiving genetic testing and followed by the institutional cardiology team remained constant during the study period, the number of patients receiving joint cardiothoracic and vascular evaluation increased significantly (23.8% 2018 vs 41.1% 2020, P = .02). Overall procedural RVUs increased from 6.8k in 2018 to 21.1k in 2022 (310% increase).
Conclusions
Implementation of MAT correlated with increased aortic case volumes for cardiothoracic and vascular surgeons as well as increased overall productivity. These data suggest that robust multidisciplinary involvement is crucial to expand complex aortic volume and develop comprehensive treatment plans for patients with thoracoabdominal pathology.
{"title":"Institutional impact of multidisciplinary aortic team implementation on practice patterns and surgical productivity","authors":"Rebecca Sorber , Peter H. Byers , Ulrike Schwarze , Yonatan Buber , James N. Kirkpatrick , Catherine M. Otto , Scott C. DeRoo , Sara L. Zettervall , Christopher R. Burke , Matthew P. Sweet","doi":"10.1053/j.semvascsurg.2025.09.001","DOIUrl":"10.1053/j.semvascsurg.2025.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Multidisciplinary aortic teams (MAT) are integral to the management of aortic pathology. This study quantifies the effects of MAT implementation on aortic case volumes, practice patterns and surgical productivity at a single academic institution.</div></div><div><h3>Methods</h3><div>Patients receiving aortic procedures were identified using CPT codes. Three time periods were defined: 2 years prior to MAT (2018), the first year with MAT (2020), and 2 years post implementation of MAT (2022). Full MAT was defined as having aortic-focused providers from cardiothoracic surgery, vascular surgery, cardiology and genetics.</div></div><div><h3>Results</h3><div>Total aortic case volume increased over 300 over the study period. Increased volume was seen for both cardiothoracic and vascular cases with a significant increase in the proportion of ascending aortic replacements as well as thoracic endografting (<em>P</em> < .01). Patients receiving multiple procedures significantly increased from 2018 to 2020 (70.3% vs. 84.9%) as well as mean number of procedures per patient (1.98 vs. 2.42, both <em>P</em> < .05). While the number of patients receiving genetic testing and followed by the institutional cardiology team remained constant during the study period, the number of patients receiving joint cardiothoracic and vascular evaluation increased significantly (23.8% 2018 vs 41.1% 2020, <em>P</em> = .02). Overall procedural RVUs increased from 6.8k in 2018 to 21.1k in 2022 (310% increase).</div></div><div><h3>Conclusions</h3><div>Implementation of MAT correlated with increased aortic case volumes for cardiothoracic and vascular surgeons as well as increased overall productivity. These data suggest that robust multidisciplinary involvement is crucial to expand complex aortic volume and develop comprehensive treatment plans for patients with thoracoabdominal pathology.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"38 4","pages":"Pages 347-354"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1053/j.semvascsurg.2025.10.002
Roberto G. Aru , Adam W. Beck , Stéphan Haulon
Fenestrated and branched technology for endovascular aortic repair of the thoracoabdominal aorta and aortic arch has evolved significantly over the last decade. The spectrum of these devices is largely available outside the United States (US), while patient-specific company manufactured devices are limited to ten sites in the US, with ongoing expanding use of market-approved off-the-shelf devices. The necessary environment for appropriate education to ensure safe dissemination of these technologies is limited, and the current centralization of both device availability and skillsets affects trainee education. In order to refine their endovascular treatment algorithm and planning/implantation skillsets at these multidisciplinary aortic centers, senior-level surgical trainees and early-to-mid career surgeons have looked transatlantic to gain exposure to this technology. This international aortic training is available as both formal and informal super-fellowships but limited in number. Significant clinical and professional benefits can ensue from such an experience, however there are challenges that must be overcome. Herein, we describe the right candidate, ideal program and mentor, goals of the fellowship, and funding opportunities for a US-based, senior-level surgical trainee or early-to-mid career vascular or cardiothoracic surgeon interested in a nonaccredited aortic super-fellowship abroad.
{"title":"A contemporary guide to an international aortic super-fellowship for surgical trainees and surgeons in the United States","authors":"Roberto G. Aru , Adam W. Beck , Stéphan Haulon","doi":"10.1053/j.semvascsurg.2025.10.002","DOIUrl":"10.1053/j.semvascsurg.2025.10.002","url":null,"abstract":"<div><div>Fenestrated and branched technology for endovascular aortic repair of the thoracoabdominal aorta and aortic arch has evolved significantly over the last decade. The spectrum of these devices is largely available outside the United States (US), while patient-specific company manufactured devices are limited to ten sites in the US, with ongoing expanding use of market-approved off-the-shelf devices. The necessary environment for appropriate education to ensure safe dissemination of these technologies is limited, and the current centralization of both device availability and skillsets affects trainee education. In order to refine their endovascular treatment algorithm and planning/implantation skillsets at these multidisciplinary aortic centers, senior-level surgical trainees and early-to-mid career surgeons have looked transatlantic to gain exposure to this technology. This international aortic training is available as both formal and informal super-fellowships but limited in number. Significant clinical and professional benefits can ensue from such an experience, however there are challenges that must be overcome. Herein, we describe the right candidate, ideal program and mentor, goals of the fellowship, and funding opportunities for a US-based, senior-level surgical trainee or early-to-mid career vascular or cardiothoracic surgeon interested in a nonaccredited aortic super-fellowship abroad.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"38 4","pages":"Pages 355-359"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1053/j.semvascsurg.2025.09.002
Firas Hentati , Kevin Donohoe , Jeffery Weinstein , Katja N. De Paepe , Kathleen E. Shillue , Dhruv Singhal , Brett J. Carroll
Lymphedema is a chronic, progressive condition characterized by the accumulation of protein-rich interstitial fluid due to impaired lymphatic transport. It significantly impairs quality of life and presents complex diagnostic and therapeutic challenges. Despite its prevalence, lymphedema remains underdiagnosed and undertreated, in part due to limited provider education and a lack of access to coordinated care. For this reason, a multidisciplinary approach to lymphedema management is crucial. Early diagnosis is critical and requires collaboration across primary care, oncology, vascular medicine, radiology, lymphatic therapy, and surgery. There are increasing imaging techniques available, but require unique skill sets to perform and interpret. Similarly, there are growing surgical treatment options, but conservative therapy remains the mainstay for most patients. A structured, collaborative model is essential for high-quality, patient-centered lymphedema care. Establishing multidisciplinary lymphedema centers can enhance outcomes, reduce delays, and promote innovation in treatment strategies.
{"title":"Multidisciplinary approach to lymphedema diagnosis and management","authors":"Firas Hentati , Kevin Donohoe , Jeffery Weinstein , Katja N. De Paepe , Kathleen E. Shillue , Dhruv Singhal , Brett J. Carroll","doi":"10.1053/j.semvascsurg.2025.09.002","DOIUrl":"10.1053/j.semvascsurg.2025.09.002","url":null,"abstract":"<div><div>Lymphedema is a chronic, progressive condition characterized by the accumulation of protein-rich interstitial fluid due to impaired lymphatic transport. It significantly impairs quality of life and presents complex diagnostic and therapeutic challenges. Despite its prevalence, lymphedema remains underdiagnosed and undertreated, in part due to limited provider education and a lack of access to coordinated care. For this reason, a multidisciplinary approach to lymphedema management is crucial. Early diagnosis is critical and requires collaboration across primary care, oncology, vascular medicine, radiology, lymphatic therapy, and surgery. There are increasing imaging techniques available, but require unique skill sets to perform and interpret. Similarly, there are growing surgical treatment options, but conservative therapy remains the mainstay for most patients. A structured, collaborative model is essential for high-quality, patient-centered lymphedema care. Establishing multidisciplinary lymphedema centers can enhance outcomes, reduce delays, and promote innovation in treatment strategies.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"38 4","pages":"Pages 386-394"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1053/j.semvascsurg.2025.08.003
Francisco Ujueta , Stanislav Henkin , Minakshi Biswas , Aishat Mustapha , Leili Behrooz , Andrew Gonzalez , Patrick Heindel , Shayna Brathwaite , Olamide Alabi
Individuals with peripheral artery disease (PAD) often have risk factors including, but not limited to, multiple comorbidities, lower extremity wounds, limb amputation, and poor quality of life. PAD has been shaped by advancements in medical technology, evolving treatment paradigms, and a growing focus on patient-reported health status and patient-centered outcomes. Collaborative care models with multidisciplinary teams including primary care physicians and vascular medicine, vascular surgery, interventional radiology, interventional cardiology, physical therapy, podiatry, infectious diseases, endocrinology, pain management, and mental health specialists continue to evolve. Because individuals with PAD have multiple comorbidities, a team-based approach has been recommended by societal guidelines to ensure optimal medical, social, and possibly interventional options. This article will review the importance of a multidisciplinary team approach for individuals with PAD.
{"title":"Multidisciplinary management of peripheral artery disease","authors":"Francisco Ujueta , Stanislav Henkin , Minakshi Biswas , Aishat Mustapha , Leili Behrooz , Andrew Gonzalez , Patrick Heindel , Shayna Brathwaite , Olamide Alabi","doi":"10.1053/j.semvascsurg.2025.08.003","DOIUrl":"10.1053/j.semvascsurg.2025.08.003","url":null,"abstract":"<div><div>Individuals with peripheral artery disease (PAD) often have risk factors including, but not limited to, multiple comorbidities, lower extremity wounds, limb amputation, and poor quality of life. PAD has been shaped by advancements in medical technology, evolving treatment paradigms, and a growing focus on patient-reported health status and patient-centered outcomes. Collaborative care models with multidisciplinary teams including primary care physicians and vascular medicine, vascular surgery, interventional radiology, interventional cardiology, physical therapy, podiatry, infectious diseases, endocrinology, pain management, and mental health specialists continue to evolve. Because individuals with PAD have multiple comorbidities, a team-based approach has been recommended by societal guidelines to ensure optimal medical, social, and possibly interventional options. This article will review the importance of a multidisciplinary team approach for individuals with PAD.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"38 4","pages":"Pages 360-367"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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