Vascular access

For first time, as part of the new CX Vascular Access course, delegates were able to have one-on-one tutorials with leading experts about vascular access techniques. The techniques discussed at the 20 “skills stations” ranged from “distal revascularisation-interval ligation” to fisuloplasty. CX Daily News, through interviews with the course directors, delegates attending the skills stations, and the expert giving the tutorials, discovered that the “skills course” day was a great success.

Course director Domencio Valenti (London, UK) commented that the main value of having one-to-one tuition was that delegates could gain practical experience directly from an expert in the field. He said: “Lectures are important because they provide information and data but, with this course, they are just one part of a holistic approach. At the skills stations, among other techniques, delegates will see how to scan a fistula, how to make the right indication, and how to identify a stenosis.”

David Kingsmore (Glasgow, UK) was an expert at a skills station, giving “tips and tricks” on using the Gore Acuseal graft. He said: “I have been teaching people how you can make the graft into something that is reliable and effective, and how to avoid pitfalls with it.” According to Kingsmore, compared to other meetings, the level of interest in the graft “has been a world apart”—“the feedback has been really exceptional.”

For Valenti, another benefit of the skills course, as well as its practical aspect, is that it had enough stations to interest “every type of specialist”, including vascular surgeons, interventional radiologists, transplant surgeons, and nurses. His co-course director, Nicholas Inston (Birmingham, UK) added: “I think the multidisciplinary aspect of the course has been really good. You have ultrasonographers, nurses, surgeons, interventional radiologists, and you have industry representatives. All of these people together make it a complete course.”  The multidisciplinary nature of the course was evident among the delegates who attended—CX Daily News was able to speak to a transplant surgeon, a vascular surgeon, and an interventional radiologist.

The transplant surgeon—M Ilham (Cardiff, UK)—said he comes “every year” to CX specifically for the vascular access information that is presented. He added that the skills stations gave him a “better opportunity to interact with the experts”, explaining: “After a lecture, a presenter only has a few minutes to answer questions; therefore, in these one-to-one tutorials, it is easier to ask more complex questions that may require a longer, more detail answer.” Ilham said he found the ultrasound-guided angioplasty skills station “very interesting” and “much better than just listening to a presentation”.

The opportunity to ask more detailed questions is also the reason vascular surgeon, Rakesh Kapur (Hull, UK), attended the skills course. He said: “Having one-to-one tutorials is good because I can ask questions on areas in which I want more information. These presentations are more to do with learning techniques than learning information.”

Prasanna Tirukonda (Singapore), an interventional radiologist, said he was particularly interested in attending the “EndoVenous arteriovenous fistula creation” skills station. “Creating fistulae is always challenging but particularly in the patients I treat in Singapore because they tend to be Asian and, therefore, have smaller vasculature. The technique (developed by TVA Medical) at this station is minimally invasive and is associated with promising outcomes. Therefore, I think it may be very suitable for my patients.”

Dheeraj Rajan (Toronto, Canada), who was manning the TVA Medical station and who presented data for the EndoVenous arteriovenous fistula creation technique during day one of the CX Vascular Access Course, commented: “With this technique, we can create a fistula without opening up the arm and without putting stitches in. Because it is percutaneous, we can get into much smaller (ie. in Asian patients) and deeper vessels.” He added: “Today, we have found that people are extremely interested in our technology. The majority of people who have come to the station have told us that they want to be involved in the ongoing post-approval study that we are doing.”

Inston said both days one and two of the course had gone “fantastically” well, adding: “They have gone better than we had hoped for. Yesterday [Wednesday], we had standing room only in the sessions and there were more questions about the presentations than we really had time for. But, the great thing about having a lecture-based day and a skills-course day is that people have been able to ask questions that they might not have been able to ask in a lecture the day before.” He explained that many of the skill stations featured techniques that were discussed during the previous day’s sessions.