VASGBI - 2004 Annual Scientific Meeting
The 2004 ASM VASGBI committee at Churchill College, Cambridge.
Report of the VASGBI Annual Scientific Meeting
Churchill College Cambridge, 13/14 September 2004
The meeting opened with an informative and entertaining talk on ‘Emergency Aortic Aneurysms- selection and outcome’ by Mr Jon Boyle of Cambridge. He described the literature on risk factors for poor outcome after emergency AAA repair and the available scoring systems. The limitations of the prospective application of these systems were discussed. The emergence of endovascular repair of ruptured AAA was considered with individual series reporting mortality rates of 10-20%; in future scoring systems may require revision to incorporate endovascular AAA repair. Professor Monty Mythen of UCH then gave an excellent account of current knowledge regarding perioperative fluid management entitled ‘Ideal Fluid report- wet at the time, drier spells to follow’. The recent papers comparing colloid and crystalloid-based regimens were considered and the role of goal-directed therapy in the management of high-risk surgical patients. The relative benefits of different crystalloid and colloid solutions and their effects on metabolic homeostasis were reviewed in an enlightening manner. The second session commenced with an account of ‘Pain in the ischaemic limb-mechanisms and management’ by Dr Raj Munglani of Bury St Edmunds. He detailed the neurophysiology and neuropharmacology of chronic pain syndromes accompanied by a presentation containing some interesting graphical effects. He was followed by another vascular surgeon, Mr Kevin Varty of Cambridge, who updated the meeting with an excellent description of current developments entitled ‘What’s new in peripheral limb surgery?’. This covered advances in angioplasty and stenting techniques for lower limb arterial disease, and the emergence of endovenous laser therapy and foam sclerotherapy for venous disease. He predicted that these would replace conventional varicose vein surgery in the not-too-distant future for many patients, with a significant change in practice.
The subcommittee reports and Annual General Meeting were well received by those who managed to stay away from the bars. The conference dinner maintained the society’s traditional sociable and informal manner including an entertaining after-dinner speech by the local conference organiser Dr Mike Lindop, and followed by the customary late bar.
The second day began with the free paper session which was well attended. The prize for the best free paper was awarded to Dr. K. Cantlay and the best poster presentation was awarded to Dr. Hashem.
Dr Michaela Stadler from Charleroi, Belgium then gave an excellent talk on perioperative epidural analgesia, including the data from recent studies and advice on practical aspects of quality control and how to manage a first class epidural service. This was followed by a keynote lecture from Professor Lee Fleisher of the University of Pennsylvania who is now chairman of the ACC guidelines committee for preoperative evaluation. His outstanding report comprehensively covered preoperative evaluation, the role of coronary revascularisation, and pharmacological approaches including alpha and beta blockade, statins and non-pharmacological strategies and was particularly well received. The final session comprised the formal debate, which was entitled ‘This house believes that all patients undergoing vascular surgery should receive beta blockers unless strongly contraindicated, between Dr Alastair Nimmo, Edinburgh (for) and Dr Simon Howell, Leeds (against). Both speakers were erudite and entertaining in equal measure. The pre-debate votes were: 84 for the motion and 53 against. After the debate a significant swing had occurred with 54 for the motion and 90 votes against. Clearly the audience had paid attention, and although the phrase catastrophic turn-around may be too strong, it may be pertinent to point out in Dr Nimmo’s defence that this result may partly reflect the content of Professor Fleisher’s preceding lecture and his contribution to the discussion!
The meeting then closed with a reminder that next year’s meeting is to be held in St Catherine’s College Oxford on September 19 th-20 th and members are advised to book their study leave early as the ASM seems to be going from strength to strength.
Professor Lee Fleisher (second, rear) with members of the VASGBI committee
