FOR IMMEDIATE RELEASE
Brigham and Women’s Hospital
Boston Medical Center
Massachusetts General Hospital
Boston Hospital Trio Awarded $25 Million NIH Grant to Study Critical Limb Ischemia
Trial will provide guidance on cost-effective ways to treat this severe form of peripheral artery disease
Boston, MA – A team of researchers from Brigham and Women’s Hospital (BWH), Boston Medical Center (BMC) and Massachusetts General Hospital (MGH) has been awarded $25 million by the National Institutes of Health (NIH) to conduct a four-year, randomized clinical trial—the BEST-CLI Trial (Best Endovascular versus Best Surgical Therapy in Patients with Critical Limb Ischemia). The trial will compare traditional bypass surgery with the less invasive alternative of endovascular treatment for patients with critical limb ischemia (CLI).
The principal investigators of the BEST-CLI trial are Alik Farber, MD, division chief of Vascular and Endovascular Surgery at BMC; Matthew Menard, MD, co-director of Endovascular Surgery at BWH; and Kenneth Rosenfield, MD, section head of Vascular Medicine and Intervention at MGH.
CLI is the most severe form of peripheral arterial disease, which is caused by chronic inflammation and atherosclerotic plaque build-up in the arteries of the legs. Symptoms caused by reduced blood flow to the legs and feet include ischemic leg pain, non-healing wounds and gangrene. If untreated, CLI can often lead to leg amputation. The aging of the national population and the rising rate of diabetes have led to an increase in both peripheral arterial disease and CLI.
According to the study investigators, while both open surgery and endovascular interventions are used to treat CLI, it is not clear which approach works best in patients who are candidates for both treatment options.
“Currently, there is a lack of consistency and clarity as to what approach—minimally invasive endovascular or open surgery—is best for our patients,” said Farber. “The BEST-CLI Trial will provide answers to many unanswered questions, most importantly what treatment works best for whom.”
“The CLI population is an exceptionally complex and challenging group of patients to treat,” added Menard. “In addition to providing much needed information on the functional outcomes and cost-effectiveness of the two treatment strategies being tested, the BEST-CLI Trial will provide a unique opportunity for interdisciplinary collaboration between all of the subspecialties currently providing care to CLI patients.
Added Rosenfield: “The BEST-CLI Trial will be a robust and rigorously conducted clinical trial which promises to greatly enhance our understanding of CLI—a devastating disorder that affects millions of Americans. We are grateful to the National Institutes of Health for recognizing the enormous impact of this scourge and look forward to expanding the evidence base to optimize care and outcomes for these patients with advanced cardiovascular disease.”
The BEST-CLI trial will be highly innovative in both its design and its collaborative nature. It will provide, for the first time, urgently needed clinical guidance for CLI management by using:
- a pragmatic design comparing the effectiveness of established techniques while allowing for the introduction of newer therapies as they become available;
- a novel primary endpoint that includes limb amputation rates, repeat treatments and loss of life;
- a multi-disciplinary structure that fosters cooperation among vascular surgeons, interventional cardiologists, interventional radiologists and vascular medicine specialists; and
- novel techniques to evaluate the cost-effectiveness and quality-of-life outcomes of the two treatment strategies being tested.
The trial will enroll 2,100 participants and be conducted at 120 clinical centers in the United States and Canada. The New England Research Institutes (Watertown, MA) will be serving as the data coordinating center.
Brigham and Women’s Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 3.5 million annual patient visits, is the largest birthing center in New England and employs nearly 15,000 people. The Brigham’s medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, and has more than 1,000 physician-investigators and renowned biomedical scientists and faculty supported by nearly $650 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH continually pushes the boundaries of medicine, including building on its legacy in transplantation by performing a partial face transplant in 2009 and the nation’s first full face transplant in 2011. BWH is also home to major landmark epidemiologic population studies, including the Nurses’ and Physicians’ Health Studies and the Women’s Health Initiative. For more information and resources, please visit BWH’s online newsroom.
Boston Medical Center is a private, not-for-profit, 496-bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. Committed to providing high-quality health care to all, the hospital offers a full spectrum of pediatric and adult care services including primary and family medicine and advanced specialty care with an emphasis on community-based care. Boston Medical Center offers specialized care for complex health problems and is a leading research institution. Boston Medical Center and Boston University School of Medicine are partners in the Boston HealthNet—15 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit www.bmc.org.
Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $775 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, reproductive biology, systems biology, transplantation biology and photomedicine.
The following Department of Surgery faculty and residents participated in the 60th Annual Meeting of the Massachusetts Chapter of the American College of Surgeons (MCACS).
About 90 abstracts were submitted for the MCACS annual meeting. Only 6 were selected for oral presentation, and 36 for poster presentation.
Program and Abstracts | Posters – Awards
Michael Cassidy, MD, won the Clinical Abstract of Distinction Award for the abstract: Reducing Postoperative VTE Complications with a Risk-Stratified Protocol and Mobilization Program
Michael R Cassidy, MD, Pamela Rosenkranz, RN, BSN, MEd, David McAneny, MD, FACS
Department of Surgery, Boston University School of Medicine and Boston Medical Center, Boston, MA
Joanna Ng, MD, won the Joseph E. Murray Resident Research Basic Science Award for the project: A Photochemical Tissue Bonding Approach for Sutureless Microvascular Anastomosis in an Arterial Graft Model
Joanna H. Ng-Glazier, MD, Neil G. Fairbairn, MD, Amanda M. Meppelink, BS, Hatice Bodugoz-Senturk, PhD, Mark A. Randolph, MS, Orhun K. Muratoglu, PhD, Jonathan M. Winograd, MD, Robert W. Redmond, PhD
Massachusetts General Hospital and Harvard University, Boston, MA
Additional Program and Abstracts | Posters
Episomal Reprogramming of Amniotic Mesenchymal Stem Cells: A Step Towards Translational Application
Elliot C Pennington, MD, Fabienne L Gray, MD, Azra Ahmed, MD, Alexander L. DeVine, MD, Kelly Fitzgerald, MD, George Q Daley, MD1, Dario O Fauza, MD
Boston Children’s Hospital, Boston, MA
Valproic Acid (VPA), a Histone Deacetylase Inhibitor (HDACi) that Reduces Intraabdominal Adhesions
Matthew Brady, MD, Elizabeth King, MD, Michael Cassidy, MD, Stanley Heydrick, PhD, andArthur Stucchi, PhD
Department of Surgery, Boston University School of Medicine, Boston, MA
Sustaining Momentum in Quality Improvement: Lessons from a Postoperative Pulmonary Care Program
Michael R Cassidy, MD, Pamela Rosenkranz, RN, BSN, MEd, David McAneny, MD, FACS
Department of Surgery, Boston University School of Medicine and Boston Medical Center, Boston, MA
Miniaturization Does Not Impair the Ability of ESS to Assess Malignancy in Human Thyroid Nodules
Jennifer E. Rosen, MD, Nicholas J. Giordano, MD, Hyunsuk Suh, MD, Faris Azar, MD, Eladio Rodriguez-Diaz, MD, Ousama M. A’Amar, MD, Irving J. Bigio, MD, Stephanie L. Lee, MD
Department of Surgery, Department of Biomedical Engineering Department of Medicine, Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine, Department of Surgery, Boston, MA
Top Gun Competition
Matt Brady, MD, Melanie Gainsbury, MD and Jian Zheng, MD, represented BUSM/BMC in the Resident Top Gun Competition. The competition consisted of teams of three residents from each institution participating in a series of tests where laparoscopic skills such as intracorporeal knot tying, transferring of objects from one hand to another, and pattern cutting were timed and graded. They placed first in the qualifying round of ten teams and second place overall in the final standings.
A number of our faculty members also participated in the meeting:
Tracey Dechert, MD, FACS, and Jonathan Woodson, MD, FACS (Assistant Secretary of Defense for Health Affairs) participated on the panel devoted to: “Examining The Marathon Bombing Response – Why It Was Different Than Other Mass Casualty Events“.
David McAneny, MD, FACS, delivered the American College of Surgeons Board of Governors Report during the Business Meeting.
David McAneny, MD, FACS, discussed “Grassroots Advocacy in the American College of Surgeons” during a session devoted to MCACS highlights from 2013.
Jane Mendez, MD, FACS, presented a talk on the “ACS Foundation” as a designated Chapter Philanthropic Champion for Massachusetts.
Boston Magazine’s 2013 “Top Docs” issue recognizes 11 Boston Medical Center/Boston University School of Medicine Department of Surgery faculty members. Congratulations to the following providers for being recognized as “tops” in their respective fields:
Peter Burke, MD (Surgery)
Gerard Doherty, MD (Surgery)
Michael Ebright, MD (Thoracic & Cardiac Surgery)
Alik Farber, MD (Vascular Surgery)
Hiran Fernando, MBBS, FRCS (Thoracic & Cardiac Surgery)
Donald Hess Jr., MD (Surgery)
Russell Jennings, MD (Pediatric Surgery)
Maureen Kavanah, MD (Surgery)
Harold Lazar, MD (Thoracic & Cardiac Surgery)
David McAneny, MD (Surgery)
Stephen Sentovich, MD (Colon & Rectal Surgery)
Jeffrey Kalish was walking down Boylston Street to cheer for his wife as she heaved toward the finish line of the Boston Marathon. When the bombs detonated and the fleeing crowds began rushing toward him and his 9-year-old daughter, the doctor realized he had to get to work immediately.
The vascular surgeon found a friend to look after his daughter and hailed a pedicab, the only vehicles, aside from ambulances and police cruisers, moving down Massachusetts Avenue.
“I’m a surgeon at Boston Medical Center, and I need to get there very quickly,” he told the driver.
Dr. Hiran Fernando, Chief, Division of Thoracic Surgery at Boston Medical Center and Professor of Surgery at Boston University School of Medicine discusses a new acid reflux treatment now being offered at BMC.
Working at Boston’s largest Level One Trauma Center, the staff at Boston Medical Center care for patients with complicated medical issues every day. But as we all have come to understand, April 15, 2013, was not like any other day, and the events that our nation observed have forever changed the way many of us approach medicine.
All of us at BMC who were involved with Marathon Monday and its aftermath think about that day while moving forward with our daily lives and work. We all had different reactions and adjustments to the violence that transpired six months ago. While many of us are still working through our personal challenges associated with the tragedy, many more have likely placed the incident in a mental storage compartment in order to facilitate forward progress. However, not a day goes by when we do not think about the Marathon and how we can take the lessons learned and apply them to our future trauma victims and patients.
To read the full opinion, please click here.
Dr. David McAneny, Associate Professor of Surgery, Boston University School of Medicine and Associate Chair for Clinical Quality and Safety, Boston Medical Center Department of Surgery is the new Vice Chair in the Department of Surgery. In this role, he will also serve as Division Chief of General Surgery and Section Chief of Surgical Oncology.
A graduate of Georgetown University School of Medicine, Dr. McAneny completed his residency at Boston University Medical Center and Boston City Hospital and a Fellowship in Gastrointestinal Surgery at Lahey Clinic Medical Center. He is a member of the Board of Governors of the American College of Surgeons, and an active member of the American Association of Endocrine Surgeons, the Society of Surgical Oncology, the New England Surgical Society and the Boston Surgical Society. He is also a Past-President of the Medical-Dental Staff of Boston Medical Center, a Past-President of the Massachusetts Chapter of the American College of Surgeons and former Massachusetts state chairman of the Commission on Cancer.
Dr. McAneny’s practice is devoted to endocrine surgery, surgical oncology, and general surgery, especially gastrointestinal surgery. His fellowship training was in upper GI surgery, with emphasis on the pancreas and the biliary tract. His surgical expertise is in tumors and other diseases of the endocrine organs, gastrointestinal tract, pancreas, hepatobiliary system and spleen.
In addition to his clinical practice, Dr. McAneny has received numerous teaching awards. He is the recipient of the 2005 Grant V. Rodkey Award, bestowed by the Massachusetts Medical Society for “outstanding contributions to medical education and medical students.” He is the 2008 Boston University faculty selection for Alpha Omega Alpha, the national honor medical society, and he is currently Councilor of the AOA chapter at BUSM. He received the 2008-2009 Erwin F. Hirsch, MD Teaching Award from the graduating Boston University Surgery chief residents, The Stanley L. Robbins Award for Excellence in Teaching, conferred at the 2010 graduation to the “outstanding educator at the Boston University School of Medicine,” and the Educator of the Year Award in Clinical Sciences, conferred at the 2013 BUSM graduation ceremony.
David McAneny, MD, named councilor of the BU School of Medicine Chapter of Alpha Omega Alpha Honor Medical Society
David McAneny, MD, Associate Professor of Surgery, Boston University School of Medicine, has been named councilor of the BU School of Medicine Chapter of Alpha Omega Alpha Honor Medical Society (AOA).
A national honor society, AOA recognizes excellence in scholarship and supports high standards and ethics in the profession of medicine. Being elected to AOA identifies the member as committed to scholarship, leadership, professionalism and service. Along with the student officers, faculty councilors organize chapter functions, projects, meetings, and most importantly the annual selection of nominees for election to membership in AOA.
Boston Herald: Amid chaos of Marathon Monday, pedicab driver was just what the doctor ordered for BMC surgeon
BMC/BUSM vascular surgeon, Jeffrey Kalish, MD, was featured in a Boston Herald story about getting to campus on Marathon Monday. Click here to read the article.
Alik Farber, MD, was elected to distinguished fellow status of the Society for Vascular Surgery® (SVS) at the 67th Vascular Annual Meeting® on May 30, 2013. At Boston Medical Center he is the chief of the Division of Vascular and Endovascular Surgery, medical director of the Catheterization and Angiography Laboratories, and co-director of the Vascular Noninvasive Laboratory. He is an associate professor of surgery and radiology at the Boston University School of Medicine.
Dr. Farber graduated from Brown University with a degree in biology. He obtained his medical degree from Harvard Medical School and finished a residency in general surgery at the Massachusetts General Hospital. He completed his vascular surgery fellowship at Dartmouth and an endovascular surgery fellowship at the Southern Illinois School of Medicine. He has served as a principal investigator in a number of clinical trials and is a principal investigator of the Best Surgery versus Endovascular Therapy (BEST) clinical trial which will compare vascular surgery and endovascular therapy in patients with critical limb ischemia. BEST has been approved by the National Institutes of Health but is still awaiting funding.
He has written and published many articles about vascular and endovascular surgery; has served as a moderator for various vascular meetings, and developed a formal education program in vascular surgery while at Cedar-Sinai Medical Center in Los Angeles, Calif. which resulted in the Golden Apple Teaching Award for teaching and mentoring residents.
Ever since his arrival at Boston Medical Center, eight years ago, Dr. Farber has made it his goal and mission to foster continued clinical excellence and academic productivity. Dr. Farber is a director of a fourth year medical school elective (BMC Surgery Bootcamp) which is designed to prepare medical students who are going into surgery for their internship.
Dr. Farber is a fellow in the American College of Surgeons and is a member of the American Board of Surgery. He has been a leader in many national and regional medical and surgical societies including SVS, the Society of University Surgeons, the Western Vascular Surgery Society, the New England Society for Vascular Surgery, the International Society for Endovascular Surgery, and the Society for Clinical Vascular Surgery.
About the Society for Vascular Surgery®
The Society for Vascular Surgery® (SVS) is a not-for-profit professional medical society, composed primarily of vascular surgeons, that seeks to advance excellence and innovation in vascular health through education, advocacy, research, and public awareness. SVS is the national advocate for 4,600 specialty-trained vascular surgeons and other medical professionals who are dedicated to the prevention and cure of vascular disease. Visit its website at www.VascularWeb.org®