JVS-vascular insights最新文献

{"title":"Plumber, scientist, entrepreneur, teacher: can one really do all?","authors":"Trisha L. Roy MD, PhD","doi":"10.1016/j.jvsvi.2024.100169","DOIUrl":"10.1016/j.jvsvi.2024.100169","url":null,"abstract":"","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100169"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"0.35-mm lead-equivalent aprons provide similar protection to interventionalists compared to 0.5-mm lead-equivalent aprons during fluoroscopically guided interventions","authors":"Antonio Solano MD ,&nbsp;Alejandro Pizano MD ,&nbsp;Bala Ramanan MBBS, MS ,&nbsp;Michael C. Siah MD ,&nbsp;Khalil Chamseddin MD ,&nbsp;Gerardo Gonzalez-Guardiola MD ,&nbsp;Vivek Prakash MD ,&nbsp;Michael Shih MD ,&nbsp;M. Shadman Baig MD ,&nbsp;Carlos H. Timaran MD ,&nbsp;Jeffrey Guild PhD ,&nbsp;Melissa L. Kirkwood MD","doi":"10.1016/j.jvsvi.2024.100154","DOIUrl":"10.1016/j.jvsvi.2024.100154","url":null,"abstract":"<div><h3>Objective</h3><div>Protective garments are part of the routine radiation safety equipment used during fluoroscopically guided interventions (FGIs). New elements and lead equivalences have been introduced by manufacturers, which may influence protection for interventionalists from ionizing radiation. We sought to determine the performance of different lead-equivalent apron vests during FGIs in clinical and simulated scenarios.</div></div><div><h3>Methods</h3><div>Our primary endpoint was to evaluate the effectiveness of radiation dose attenuation of two different protective leaded apron vests, one with nominal 0.5-mm lead equivalence and a second with 0.35-mm lead equivalence, which were evaluated in clinical and simulated settings. In the clinical setting, optically stimulated luminescence nanoDot™ detectors were placed at the upper outer quadrant (UOQ) chest wall (CW) position, both over and under the apron vests on one vascular surgeon performing FGIs over a 21-month period. All interventions were performed in hybrid rooms with Allura Clarity (Phillips Healthcare) C-arms with state of-the-art software for vessel navigation, digital subtraction angiography, digital magnification, and collimation. Dosimeters were placed on either side of the primary operator’s body, located on the side closest to the X-ray source. In the simulation, fluorography was performed on a 30-inch-thick acrylic scatter phantom at 68, 80, 100, and 120 kVp for an exposure of 2000 mGy reference air kerma. Experiments were performed on the 0.35-mm and 0.5-mm lead-equivalent aprons. Paired Wilcoxon, χ², and analysis of variance tests were performed to identify statistical significance of radiation attenuation dose rates.</div></div><div><h3>Results</h3><div>Operator UOQ CW radiation dose was measured during 32 FGIs: 16 were performed with the 0.5-mm lead-equivalent apron and 16 with the 0.35-mm lead-equivalent apron. Median procedure reference air kerma was 167 mGy (interquartile range, 99-437 mGy) when the 0.5-mm apron vest was worn vs 250 mGy (interquartile range, 144-410 mGy) with the 0.35-mm vest. There was no significant difference in UOQ CW radiation dose attenuation between the two lead equivalencies: thick 89% vs thin 86%; <em>P</em> = .2. In the simulated scenario, radiation dose attenuation was similar for all measured kVp, with no significant differences for both apron vests (94% thick vs 95% thin; <em>P</em> = .49).</div></div><div><h3>Conclusions</h3><div>Heavier leaded aprons do not offer clinically significant increased protection over thinner lead. Due to the long-term musculoskeletal strain on interventionalists, it is safe to consider lightweight lead protection.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100154"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future of vascular surgery and the general surgery resident","authors":"Kevin Leong MD ,&nbsp;Susan Basharkhah MD ,&nbsp;Jose Chavez MD ,&nbsp;Caili Pierro DO ,&nbsp;Rajesh Malik MD ,&nbsp;Nicole Ilonzo MD","doi":"10.1016/j.jvsvi.2024.100152","DOIUrl":"10.1016/j.jvsvi.2024.100152","url":null,"abstract":"<div><div>By 2030, there will be a shortage of approximately 400 vascular surgeons. Patients with vascular disease will rely heavily on nonvascular specialists, such as cardiologists, general surgeons, and advanced care providers, for care. It is imperative that general surgery residents are educated on vascular pathology to best meet the needs of patients with vascular disease.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143105202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of ischemia by a biosensor measuring tissue carbon dioxide tension","authors":"Johanne Korslund MD ,&nbsp;Rasmus D. Thorkildsen MD, PhD ,&nbsp;Espen Lindholm MD, PhD ,&nbsp;Runar Strand-Amundsen MS, PhD ,&nbsp;Tor Inge Tønnessen MD, PhD ,&nbsp;Magne Røkkum MD, PhD","doi":"10.1016/j.jvsvi.2024.100166","DOIUrl":"10.1016/j.jvsvi.2024.100166","url":null,"abstract":"<div><h3>Objective</h3><div>We investigated a miniaturized biomedical sensor that can be inserted into any tissue or organ to measure partial gas pressure of carbon dioxide (pCO₂) and temperature continuously in real time. Numerous animal studies have shown that pCO₂ is a sensitive and specific marker of ischemia. The present study was designed to examine the feasibility and safety of the device in patients scheduled for limb orthopedic (arm/leg) surgery with tourniquet.</div></div><div><h3>Methods</h3><div>We performed an observational, prospective, cohort study at a single center in Norway. The primary and secondary endpoints were to evaluate the ability of the biosensor to measure pCO₂ and corresponding temperature levels in ischemic and nonischemic limb musculature and subcutaneous tissue. Additional secondary objectives were to assess the safety/efficacy of using the device.</div></div><div><h3>Results</h3><div>Forty-five patients received the sensor in this study from May 2021 to June 2022. The mean difference between the pCO₂ levels in ischemia and nonischemia limbs was 29.4 mmHg (95% confidence interval [CI], 25.8-33.0; <em>P</em> &lt; .001). When examining intramuscular tissue exclusively, the mean total difference between the pCO₂ levels in ischemic and nonischemic limb was 32.7 mmHg; 95% CI [27.5; 37.9], <em>P</em> &lt; .001. The mean difference between the temperature levels in intramuscular and subcutaneous tissue in ischemic and nonischemic limb was 2.5 ^oC (95% CI, 2.0-2.9; <em>P</em> &lt; .001) and 2.6 ^oC (95% CI, 2.1-3.2; <em>P</em> &lt; .001), respectively. Four patients experienced minor bleeding (less than 5 mL) during insertion of the sensors. No other bleeding was reported during the study period. None of the subjects experienced any kind of clinical infections/inflammations or pain (numeric rating scale score, 0) at the insertion sites during the entire study period. No serious adverse events related to the study procedure or device were noted.</div></div><div><h3>Conclusions</h3><div>The device provides a safe and dependable way to continuously and instantly track pCO₂ levels in muscular and subcutaneous tissues, thereby offering a means to detect and monitor ischemia.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100166"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study exploring the acceptability of the TEXTPAD telehealth and virtual supervised exercise intervention and trial for patients with peripheral arterial disease living in socioeconomically disadvantaged areas","authors":"Maddey Patterson MPH ,&nbsp;Letitia Sermin-Reed MSc ,&nbsp;James Prentis MBBS ,&nbsp;Arathi Radhakrishnan MBBS ,&nbsp;Eileen Kaner PhD ,&nbsp;Sandip Nandhra MBBS ,&nbsp;Maisie Rowland BSc ,&nbsp;Gabriel Cucato PhD ,&nbsp;Mackenzie Fong PhD","doi":"10.1016/j.jvsvi.2024.100175","DOIUrl":"10.1016/j.jvsvi.2024.100175","url":null,"abstract":"<div><h3>Background</h3><div>UK clinical guidelines recommend supervised exercise training and support for health behavior change for patients with peripheral arterial disease (PAD). Despite this, supervised exercise programs are largely unavailable and unfunded across the UK. Remote, virtual support may overcome some barriers to attending facilities in person experienced by PAD patients, such as poor mobility and financial cost. The TEXTPAD pilot randomized controlled trial investigated the impact of the 12-week TEXTPAD intervention that involved weekly phone calls for behavioral counselling and twice-weekly virtual, supervised exercise sessions. Both TEXTPAD and control group participants were encouraged to engage in an unsupervised walking program and were provided with an activity tracker. This qualitative study aimed to explore participants' acceptance of the TEXTPAD and unsupervised walking programs and trial procedures.</div></div><div><h3>Methods</h3><div>Participants were recruited from the vascular department of Newcastle-upon-Tyne Hospitals Trust. Eligibility for the pilot randomized controlled trial included age ≥40 years, a diagnosis of PAD, and living in an area in the lowest 30% of super output area based on the Office for National Statistics. Interview participants were sampled purposively based on study group allocation. A focus group was conducted with three health improvement practitioners who delivered the TEXTPAD intervention. Interview and focus group audio recordings were transcribed verbatim and thematic analysis was applied to data.</div></div><div><h3>Results</h3><div>A total of 18 participants were interviewed, comprising 9 participants each in the TEXTPAD and control groups (mean age, 66.2 years). Fifteen patients were male and three were female. Overall, the TEXTPAD and walking programs were highly acceptable to and positively perceived by participants. Some participants were not confident in using the various aspects of technology needed to engage in the TEXTPAD and walking programs and sought support from family, friends, or practitioners. TEXTPAD participants wanted more interaction with other participants to share experiences, advice, and information (theme 1). Participants in both groups perceived a range of benefits to their health and well-being (theme 2) and considered the study procedures to be acceptable and not overly burdensome (theme 3).</div></div><div><h3>Conclusions</h3><div>Providing exercise training and behavioral counselling virtually using digital technologies to people with PAD from lower socioeconomic backgrounds can be considered as an acceptable way to deliver care. However, people who have poorer digital skills must be provided with adequate support to use the technologies needed to engage with these virtual interventions. Enabling intervention participants to interact with each other would help to nurture social support which was perceived to be lacking in the current program.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100175"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143105157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review of STABILISE technique for treatment of type B aortic dissection","authors":"Daniele Mascia MD,&nbsp;Sarah Tinaglia MD,&nbsp;Annarita Santoro MD,&nbsp;Benedetta Mangili MD,&nbsp;Roberto Chiesa MD,&nbsp;Germano Melissano MD","doi":"10.1016/j.jvsvi.2024.100170","DOIUrl":"10.1016/j.jvsvi.2024.100170","url":null,"abstract":"<div><h3>Objective</h3><div>The Stent-Assisted Balloon-Induced Intimal Disruption and Relamination in Aortic Dissection Repair (STABILISE) technique was proposed for treating type B aortic dissections (TBADs), using bare metal stents and balloon inflation to intentionally rupture the lamella and allow full expansion of the true lumen (TL) and finally promote aortic remodeling. A systematic review was conducted to assess the current evidence and treatment indications and compare outcomes of the STABILISE technique.</div></div><div><h3>Methods</h3><div>A literature search in PUBMED and Cochrane Library was performed, and articles that were published up to June 2024 reporting on the STABILISE technique were included (randomized controlled trials, prospective and retrospective studies). Case series with less than four patients were excluded. Titles, abstracts, and full texts were evaluated by two authors independently. Primary outcomes included technical success and 30-day mortality. Secondary outcomes were mortality and complications during the available follow-up. Continuous variables were presented as means ± standard deviation or median and interquartile range, and categorical variables were expressed as numbers (percentages).</div></div><div><h3>Results</h3><div>Twenty-nine studies were evaluated: 10 studies, totaling 284 patients, were included. Of these patients, 92 of 284 (32%) were acute, 61 of 284 (21.4%) were subacute, and 65 of 284 (22.8%) were chronic TBADs. In 66 of 284 cases (23.2%), the setting of TBAD was not available. Two hundred thirty-six patients were male (236/284; 83.1%). In 85 patients (85/284; 29.9%), supra-aortic trunk debranching was required to provide an appropriate proximal landing zone. Carotid to carotid bypass debranching was performed in all Ishimaru’s zone 1 cases, whereas left carotid-subclavian bypass was performed in 42 of 64 cases (42/65; 65.6%) who underwent aortic zone 2 coverage. One patient died intraoperatively, with an estimated mortality rate of 0.3% (1/284). In 10 studies, nine deaths overall were recorded (9/284; 3.1%). The type of balloon used, the number of inflations, and any additional maneuvers that were carried out during the procedure were never mentioned in the literature. The reintervention rate was 16.9% (48/284 patients). Spinal cord ischemia rate was available in eight studies, resulting in eight patients (8/261; 3.1%). All studies reported on the available follow-up for a median of 29 months. Technical success was reported in all studies, accounting for 280 patients (280/284; 98.6%), for an overall follow-up in 247 patients (247/284; 86.9%).</div></div><div><h3>Conclusions</h3><div>The STABILISE technique is safe and effective in promoting aortic remodeling over time. Additional research is required to investigate the technique’s safety in a larger patient population and to assess the long-term behavior of the post-dissected aorta.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100170"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"True deep femoral artery aneurysms: Case series and review of the literature","authors":"Hiroyoshi Komai MD, PhD ,&nbsp;Nobuko Yamamoto MD, PhD ,&nbsp;Prem C. Gupta MBBS, MS ,&nbsp;Palma M. Shaw MD, FACS, RPVI","doi":"10.1016/j.jvsvi.2024.100182","DOIUrl":"10.1016/j.jvsvi.2024.100182","url":null,"abstract":"<div><div>True deep femoral artery (DFA) aneurysm is a rare disease for which treatment strategies and surgical indications have not yet been precisely determined. Symptoms of true DFA aneurysms often include a pulsatile mass and tenderness in the thigh, but may be asymptomatic and incidentally diagnosed by computed tomography scan. True aneurysms are extremely rare, making up approximately 0.5% of peripheral arterial aneurysms. They are often found in elderly men and are associated with aneurysms in other areas. Indications for surgery for DFA aneurysm have not yet been determined. Whenever possible, it is important to reconstruct the DFA, because this serves as an important collateral source in case there is future development of atherosclerotic occlusive disease of the lower limb. When simple ligation of a DFA aneurysm is performed, ligation of feeding branches is important to avoid perfusion and expansion. We present a case series and review of the literature of this rare pathology.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100182"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot study of a comprehensive multidisciplinary inpatient-based approach to smoking cessation in patients with vascular disease","authors":"Tanner Kim MD ,&nbsp;Anand Brahmandam MBBS ,&nbsp;Dana Alameddine MD ,&nbsp;Rachel Forman MD ,&nbsp;Amin Hardik MD ,&nbsp;Lisa Fucito PhD ,&nbsp;Carlos Mena-Hurtado MD ,&nbsp;Raul Guzman MD ,&nbsp;Cassius Iyad Ochoa Chaar MD, MS, MPH","doi":"10.1016/j.jvsvi.2024.100174","DOIUrl":"10.1016/j.jvsvi.2024.100174","url":null,"abstract":"<div><h3>Objective</h3><div>Smoking cessation remains a significant challenge in the care of patients with vascular disease. This pilot study aims to evaluate the efficacy of a multidisciplinary inpatient smoking cessation intervention that leverages surgery as a teachable moment and the postoperative inpatient recovery period to initiate smoking cessation counseling and pharmacotherapy.</div></div><div><h3>Methods</h3><div>Adult smokers with occlusive or aneurysmal arterial disease admitted after vascular surgery in a tertiary care center were enrolled. Patients received brief counselling sessions regarding smoking cessation from specialties including vascular surgery, cardiology, neurology, and the smoking cessation program during the hospitalization using the gain-frame approach. Subjects completed surveys related to smoking habits and mental health, including the Fagerstrom test for nicotine dependence and Patient-Reported Outcomes Measurement Information System questionnaire, respectively. Patients were provided free nicotine replacement therapy for 4 weeks. Any additional medication deemed necessary for quitting was prescribed upon discharge. Patients were given appointments for a smoking cessation program visit and routine provider follow-up was scheduled. The primary end points were smoking cessation rates at 3 months and 1 year.</div></div><div><h3>Results</h3><div>A total of 48 patients were enrolled. The mean number of cigarettes consumed before enrollment was 17 ± 9 per day over a mean period of 40 ± 11 years. All patients had previously attempted to quit smoking and 97% had received advice from their surgeons or interventionalists to quit smoking in the prior year. Most patients (94%) had tried to stop smoking before and 50% had more than three attempts at smoking cessation before enrollment. The mean quitting period was 9 months (range, 4-20 months) before relapse. Stress was the most common reason for relapse and continued smoking in 50% of patients. A minority of patients knew that smoking was taking years off their life (42%), made them worry about developing heart disease (34%), and reduced their quality of life (31%). At 1 year, the smoking cessation rate was 45% (n = 19/42) with 59% (n = 25/42) reduced smoking quantity. The carbon monoxide breath test was not conducted owing to the coronavirus disease 2019 pandemic.</div></div><div><h3>Conclusions</h3><div>This pilot study demonstrates that an inpatient, multidisciplinary approach to smoking cessation is effective with a durable impact up to 1 year. Inpatient strategies leveraging multidisciplinary teams and teachable moments should be incorporated into smoking cessation programs.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100174"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arch Branch Devices and Clinical Trials in Treatment of Aortic Arch Pathology","authors":"Brandon N. Glousman MD ,&nbsp;Jeanwan Kang MD ,&nbsp;Javairiah Fatima MD","doi":"10.1016/j.jvsvi.2024.100164","DOIUrl":"10.1016/j.jvsvi.2024.100164","url":null,"abstract":"<div><div>Aortic arch endografting will undoubtedly expand in the population suitable for aortic arch repair. Currently, there are four endografts under investigation to treat aortic arch pathology including Gore's Thoracic Branch Endoprosthesis, Endospan's NEXUS Aortic Arch Stent Graft System, Terumo's RelayBranch Thoracic Stent-Graft System, and Cook's Zenith Arch Branched Graft. Despite advances in deployment technique, self-aligning features to mitigate aortic arch manipulation, and distal embolic protection, perioperative stroke continues to be high, limiting the devices from commercial availability. Here we discuss current devices under trial in the United States, limitations of aortic arch endografting, and future directions.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100164"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143105196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing multidisciplinary mobile outreach clinics to provide comprehensive diabetic foot care to patients experiencing homelessness","authors":"Kris M. Boelitz MD ,&nbsp;Jaeyoung Lee BS ,&nbsp;Michael D. Pepin BS ,&nbsp;Yiming Zhang MS ,&nbsp;Mallory Gibbons MSN, NP ,&nbsp;Frances J. Lagana DPM ,&nbsp;Shahida Balaparya EdD, MBA, RVT ,&nbsp;Lindsey Carr ,&nbsp;Jessin Varghese BS, NP ,&nbsp;Caitlin Sorensen MD ,&nbsp;Jessica P. Simons MD, MPH ,&nbsp;Douglas Jones MS, MD ,&nbsp;Andres Schanzer MD ,&nbsp;Tammy T. Nguyen MD, PhD","doi":"10.1016/j.jvsvi.2024.100183","DOIUrl":"10.1016/j.jvsvi.2024.100183","url":null,"abstract":"<div><h3>Background</h3><div>Social determinants of health (SDoH) challenges can limit health care access and impose significant barriers to care, which have been amplified during the COVID-19 pandemic. We sought to evaluate the feasibility of implementing a multidisciplinary mobile outreach clinic for unhoused individuals with a focus on diabetic foot care and screening to overcome the SDoH-associated barriers to care.</div></div><div><h3>Methods</h3><div>The multidisciplinary mobile clinic (MMC) model focused on a physician-driven volunteer initiative to recruit medical specialties in diabetic foot care from a large academic medical center. The MMC focused on providing diabetic foot ulcer care and screening because it is a complex medical problem that disproportionately impacts unhoused individuals and requires multidisciplinary care. Our group of academic-affiliated medical professionals partnered with existing community services to build relationships and trust with our target patient population. To determine whether MMCs are a feasible and sustainable model to improve health care access for communities impacted by limited SDoH resources, we measured the number of volunteers and medical services who participated in seven outreach clinic events over a 3-year period. SDoH-related factors impacting access to healthcare were evaluated using a Barriers to Access and Care Survey administered to MMC patient participants.</div></div><div><h3>Results</h3><div>From June 2020 to November 2023, a total of 241 patients were seen at seven multidisciplinary mobile clinics. All patients received health resources and donated items including new socks and shoes. Each clinic was fully staffed with over 50 volunteer medical providers. Additionally, we completed Barriers to Access and Care Surveys that showed personal resources and community stigma as being the largest barriers to care. By using the physical infrastructure established by partner organizations, the MMCs were able to integrate, at low cost, into existing community services to reach the target population.</div></div><div><h3>Conclusions</h3><div>We report a feasible methodology for leveraging hospital-based resources to build MMCs in partnership with local community programs to provide multidisciplinary care to populations impacted by SDoH risks. This study reflects the valuable lessons we learned in optimizing MMC events for maximum community benefit.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143331833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}