My clinical research group has an active interest in vascular surgery outcomes research on a local and national level. As emerging technologies evolve the way we practice medicine, comparative effectiveness research has been instrumental in the identification of best practices from among an increasingly complex set of therapeutic options. Our main interest is to compare outcomes after open surgery and endovascular surgery for a variety of vascular diseases, including aortic aneurysms, carotid disease, and lower extremity arterial disease, in order to help guide patient selection for each type of procedure. We utilize a wide range of observational, registry, and administrative data from real-world settings to better understand the impact of vascular treatments on disease processes.

Our experience at BIDMC, boasting the world’s largest series of distal bypass and tibial angioplasty procedures, provided rich data from which we have published on the effectiveness of primary endovascular therapy for critical limb-threatening ischemia and the benefits of statin dose intensities. We have used our institutional experience with novel imaging systems to show reduced radiation exposure and contrast dose for patients and providers. Joining other institutions in the region, nationally, and internationally, we are an active participant in the Vascular Study Group of New England (VSGNE), the Vascular Quality Initiative (VQI), and the International Registry of Acute Aortic Dissection (IRAD). These large databases provide detailed procedural and patient-related information from which we have investigated differences in patient selection, treatment, and outcomes of abdominal aortic aneurysms (AAA), carotid artery stenosis, and peripheral arterial disease (PAD), among other vascular diseases. We have developed and published work on risk-prediction models that can be used in real-world settings to guide physicians in counseling a patient on his/her individual risk of surgery. Through the VQI as well as other databases such as the National Surgical Quality Improvement Project (NSQIP), we shed light on disparities in presentation, treatment selection, and outcomes across sex and racial/ethnic groups.