European Society for Vascular Surgery

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!

In this episode, Professor Santi Trimarchi discusses the ESVS Clinical Practice Consensus Statement on Ascending Thoracic Endovascular Aortic Repair (aTEVAR). He provides a comprehensive scientific overview of the document, helping listeners gain a concise yet thorough understanding of its key recommendations and expert consensus.
During the episode, we explore the unique anatomical challenges of the ascending aorta for endovascular repair, patient selection, and situations in which conservative management may be preferred over intervention. We also discuss landing zone requirements, stent graft sizing strategies, vascular access considerations, cardiac output control during stent graft deployment, contraindications for aTEVAR, the prevention and management of endoleaks, post-procedural surveillance, and future research priorities.
For a detailed review of the recommendations and supporting evidence, listeners are encouraged to consult the full consensus document.

References:
Trimarchi S, Czerny M, Haulon S, van Herwaarden JA, de Kort JF, Roselli EE, Schermerhorn ML, Upchurch GR Jr, Wanhainen A, on behalf of the ESVS Guidelines Steering Committee. European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Consensus Statement on Ascending Thoracic Endovascular Aortic Repair. European Journal of Vascular and Endovascular Surgery. 2025;70:10–23. doi:10.1016/j.ejvs.2025.05.023

The publication of CREST-2 has reignited one of the longest-standing debates in vascular medicine: should asymptomatic carotid stenosis still be treated invasively in the era of modern best medical therapy? In this episode, Laurence Bertrand and Rosalinda D'Amico discuss the trial with Barbara Rantner and Caitlin Hicks, exploring its methodology, controversial findings, and the implications for the management of asymptomatic carotid stenosis.
Full name of guests:
Dr. Barbara Rantner – TUM University Hospital, Munich, Chair of ESVS and DGG guideline writing committee
Dr. Caitlin Hicks, Johns Hopkins University School of Medicine, Member of the writing committee ESVS and SVS guidelines
Shownotes:
Brott TG, Howard G, Lal BK, Voeks JH, Turan TN, Roubin GS, Lazar RM, Brown RD Jr, Huston J 3rd, Edwards LJ, Jones M, Clark WM, Chamorro Á, Llull L, Mena-Hurtado C, Heck D, Marshall RS, Howard VJ, Moore WS, Barrett KM, Demaerschalk BM, Sangha N, Aronow H, Foster M, Sternbergh WC 3rd, Shawl F, Lanzino G, Rapp J, Tran HS, Ecker R, Mackey A, Ali V, Given C 2nd, Teal P, Kashyap VS, Mukherjee D, Harrigan M, Silverman S, Koopmann M, Wadley VG, Zhang Y, Rhodes JD, Chaturvedi S, Meschia JF; CREST-2 Investigators. Medical Management and Revascularization for Asymptomatic Carotid Stenosis. N Engl J Med. 2026 Jan 15;394(3):219-231. doi: 10.1056/NEJMoa2508800. Epub 2025 Nov 21. PMID: 41269206; PMCID: PMC13148431.
Halliday A, Bulbulia R, Bonati LH, Chester J, Cradduck-Bamford A, Peto R, Pan H; ACST-2 Collaborative Group. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy. Lancet. 2021 Sep 18;398(10305):1065-1073. doi: 10.1016/S0140-6736(21)01910-3. Epub 2021 Aug 29. PMID: 34469763; PMCID: PMC8473558.