Overview of Training for Individual Specialties
VASCULAR SURGERY
The Vascular Surgery Section, within the Division of General Surgery, is staffed by three full-time surgical faculty. A full-time advanced registered nurse practitioner works with the University teams to assist in patient management and scheduling. The University of Iowa Hospitals and Clinics offers a fully accredited two-year vascular surgery fellowship, which is designed to enhance rather than detract from the general surgical resident experience on the service.
The Vascular Surgery Section performs a wide spectrum of vascular procedures annually, providing adequate exposure in vascular surgery for both the vascular trainee and the surgical residents. General surgery residents and medical students obtain experience in vit and Clinics. The vascular fellow leads one team and a chief resident in general surgery leads the other team. A fourth year general surgery resident leads the vascular team at the Veterans Affairs Medical Center.
There is a well-equipped noninvasive vascular diagnostic laboratory at both medical facilities. A wide variety of noninvasive arterial and venous tests are performed with a heavy emphasis on the use of color duplex imaging.
The Vascular Surgery Section is involved in both clinical and basic science research projects. The Vascular Section has major clinical interests in gene therapy, internal hyperplasia, atherosclerotic risk factors, deep vein thrombosis, thrombolysis, vein bypass grafting, cardiac evaluation of vascular patients, vascular disease in the elderly, noninvasive postoperative bypass surveillance, cerebrovascular disease, aortic aneurysm surgery and endovascular surgical techniques.
Vascular surgery involves the evaluation and treatment of all arterial and venous problems excluding those of the coronary and intracranial circulation.
Vascular Surgery Staff
- W. John Sharp, MD, - Acting Director william-sharp@uiowa.edu
- Jamal Hoballah, MD, jamal-hoballah@uiowa.edu (On leave of absence through June 2009)
- Timothy F. Kresowik, MD, timothy-kresowik@uiowa.edu
- Melhem Sharafuddin, MD, mel-sharafuddin@uiowa.edu
Major areas of research interest include intimal hyperplasia, vascular stenting, thrombolytic therapy, lower extremity revascularization, endovascular surgery and cardiac assessment of peripheral vascular patients.
The Vascular Surgery Division performs approximately 800 operations each year. The vascular surgery team sees over 6,500 patients per year in the outpatient clinic. Every three months, the vascular team sees patients in the Keosauqua Outreach Clinic.
The clinic vascular laboratories at both hospitals have a full complement of noninvasive vascular diagnostic equipment. A wide variety of noninvasive test are performed with heavy emphasis on color duplex imaging. Over 8,000 tests are done annually between the two hospitals.
The Section has participated in the following clinical cooperative studies:
- Comparative evaluation of prosthetic, reversed and in situ vein bypass grafts in distal popliteal and tibial/peroneal revascularization (VA Cooperative Study 141)
- Symptomatic carotid stenosis: etiological importance in the development of stroke (VA Cooperative Study 167)
- Asymptomatic carotid atherosclerosis study (ACAS)
- North American symptomatic carotid endarterectomy trial (NASCET)
- Asymptomatic carotid artery plaque study (ACAPS)
- Oral anticoagulant therapy to improve patency of small caliber prosthetic bypass grafts (VA Cooperative Study 362)
- Thrombolysis in venous thrombosis
- Clinical evaluation of 2% Ketanserin ointment for the treatment of lower extremity diabetic ulcers
- Systemic thrombolysis in lower extremity - a prospective randomized trial of surgery and thrombolysis for ischemia of the lower extremity (STILE)
- A double-blind dose-ranging comparison of the safety and efficacy of subcutaneous RD Heparin versus Warfarin for the prevention of deep-vein thrombosis in patients undergoing knee replacement surgery
- A randomized, double-blind, placebo controlled study of Cilostazol in patients with intermittent claudication secondary to chronic occlusive arterial disease
- Evaluation of recombinant human platelet-derived growth factor in the healing of chronic, lower extremity, diabetic ulcers (PDGF-B)
- An evaluation of pentoxifylline on the healing of chronic venous leg ulcers treated with standard conservative therapy
- An open study of the chronic administration of Cilostazol in patients with intermittent claudication secondary to chronic occlusive arterial disease
- A multicenter, double-blind, parallel group efficacy and safety comparison of ifetroban and placebo in patients with venous leg ulcers
- A randomized, double-blind study of the effect of Cilostazol versus placebo on walking distances in patients with intermittent claudication secondary to peripheral vascular disease
- A double-blind, placebo-controlled study to evaluate the efficacy and safety of Vasoprost (Alprostadil) in the treatment of patients with severe intermittent claudication due to peripheral arterial occlusive disease (PAOD)
Current basic science research projects include work in the following areas:
- Anastomotic neointimal hyperplasia
- Gene transfer to human blood vessels
- Reperfusion injury.