European Society for Vascular Surgery

Three trials walk into an aorta and ask what the house recommends. The bartender shrugs: “Sorry, we’re randomising tonight.”
Three trials. Three leading investigators. One of the biggest unresolved questions in aortic surgery: should patients with uncomplicated type B aortic dissection undergo thoracic endovascular aortic repair (TEVAR), or is best medical therapy the better strategy?
In this episode of the ESVS Podcast, Safa Riahi brings together Professor Jacob Budtz-Lilly (SUNDAY), Professor Firas Mussa (IMPROVE-AD) and Professor Colin Bicknell (EARNEST), for an in-depth roundtable exploring the rationale, design, and challenges behind three major randomised controlled trials. From differences in patient selection and timing of intervention to aortic remodelling, procedural safety, long-term outcomes, and cost-effectiveness, we examine what each trial hopes to establish and why their results could reshape the management of uncomplicated type B aortic dissection.
We also discuss the meaning of “uncomplicated,” the limitations of our current evidence, the importance of best medical therapy, and the challenge of communicating genuine clinical uncertainty to patients. Will these trials finally help us identify who benefits from early TEVAR, when to intervene, and whether improved aortic remodelling translates into better outcomes for patients?
Three trials walk into an aorta. The answers, for now, remain anything but straightforward.
With: Professor Firas Mussa, Professor Colin Bicknell, and Professor Jacob Budtz-Lilly.
Trials discussed:
IMPROVE-AD: https://clinicaltrials.gov/study/NCT06087029
EARNEST: https://www.isrctn.com/ISRCTN30838068
SUNDAY: https://clinicaltrials.gov/study/NCT05215587

In this special episode of the ESVS Podcast, we sit down with Professor Kak Khee Yeung as she begins her term as President of the European Society for Vascular Surgery.
Professor Yeung talks openly about her journey as a vascular surgeon and researcher, her passion for aneurysm biology and personalised vascular care, and the curiosity that has driven her throughout her career. From her Chinese heritage and the calligraphy featured in her inaugural lecture to artificial intelligence, teamwork and the future of vascular surgery, the conversation goes beyond the CV to explore the person behind the surgeon and scientist.
Professor Yeung also shares her thoughts on leadership, diversity, the next generation of vascular surgeons and her ambitions for the ESVS. Her passion for vascular surgery is contagious, and this conversation offers a personal glimpse into the ideas and energy she brings to her presidency.
Links:
Inaugural lecture: https://pure.amsterdamumc.nl/ws/portalfiles/portal/143254652/oratie_final_KKY.pdf

Recorded live from Belgrade at the ESVS course on complex aortic surgery.
In this episode, Joanna Halman is joined by Professors Marko Dragaš, Igor Končar and Nikola Ilić for a practical discussion on complex aortic surgery.
They discuss how to choose between open and endovascular repair, whether aortic surgery should become further subspecialised, and their approaches to aortic clamping, visceral perfusion and organ protection during open repair.
At the end of the episode, special guest Professor Germano Melissano joins the discussion to share his perspective on training and education in complex aortic surgery.

In this episode of the ESVS Podcast, we discuss one of the oldest yet most effective treatments in vascular medicine: compression therapy.
Our guest is Professor Melina Vega de Ceniga, Head of the Department of Angiology and Vascular Surgery at Galdakao-Usansolo University Hospital, Spain, and an internationally recognised expert in chronic venous disease. She is an active member of the European Society for Vascular Surgery (ESVS), she has been involved in the creation and development of the ESVS Podcast programme.
Together, we explore the physiological basis of compression therapy, its indications across a wide range of vascular conditions, the different compression systems available, and practical aspects of their application. We also discuss pressure selection, contraindications, compression therapy in patients with peripheral arterial disease and heart failure, and the management of venous leg ulcers.
Finally, Professor Vega de Ceniga shares practical strategies to improve patient adherence, prevent ulcer recurrence, and optimise long-term outcomes.
This episode provides practical guidance for vascular specialists, trainees, wound-care professionals, and all clinicians involved in the management of patients with chronic venous disease and lower-limb oedema.

This episode has been supported by Urgo Medical
References
De Maeseneer MGR, Kakkos SK, Aherne T, et al. ESVS 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022;63:184–267.
O'Meara S, Cullum N, Nelson EA, Dumville JC. Compression for venous leg ulcers. Cochrane Database Syst Rev. 2021;9.
Gohel MS, Heatley F, Liu X, et al. A Randomized Trial of Early Endovenous Ablation in Venous Ulceration. N Engl J Med. 2018;378:2105–2114.

Join us for another ESVS podcast where we discuss the important but often neglected topic of pain management in patients undergoing amputation. In this episode, we are joined by consultant vascular surgeon Mr David Bosanquet from Cardiff, UK to discuss why these patients can be very difficult to manage. During the discussion, the importance of multi-model analgesia is highlighted and also the role of peri-neural nerve blockade both pre and post operatively. What is the evidence for intra-operative nerve catheters and are there any new techniques evolving to solve chronic post amputation pain? Does Targeted Muscle Re-innervation (TMR) and Regenerative Peripheral Nerve Interface (RPMI) have a role? All will be answered!