VASGBI - 2006 Annual Scientific Meeting
Report of the VASGBI Annual Scientific Meeting 2006
Royal Armouries Museum Leeds, Monday 11 th–Tuesday 12 th September 2006
The 10th Annual Scientific Meeting of the VASGBI was hosted by Andy Lumb in the capital of Yorkshire and indeed all of northern England. The meeting was attended by over 230 delegates and followed the format of the previous year, extending to mid afternoon on the second day. The programme encompassed both the science and art of vascular anaesthesia from speakers whose backgrounds included vascular surgery, radiology, and cardiology. Delegates responded once again by partaking fully in all the scientific and social aspects of the meeting.
The meeting opened with Dr Pierre-Guy Chassot of Lausanne, whose talk was entitled ‘Blood Preservation in Vascular Surgery’. This included a comprehensive overview of the evidence base for current recommended transfusion thresholds and of the different methods available for the conservation of blood in the perioperative period. The next lecture was given by Dr Richard Storey, Senior Lecturer in Cardiology at the University of Sheffield who elucidated modern concepts of platelet biology and function. This included a clear description of the methods of action of aspirin and clopidogrel and he also dispelled some myths surrounding aspirin and clopidogrel resistance.
The next session featured Professor Julian Scott, a vascular surgeon from the Leeds Institute of Genetics, Health and Therapeutics. He explained to the audience the links between abdominal aortic aneurysm and inflammatory pathways and offered intriguing possibilities for the future, including that the susceptibility to AAA might be amenable to laboratory screening tests for genetic or inflammatory markers. Dr James Pittman of Exeter then gave us an inclusive synopsis of the devices currently available for monitoring cardiac output. This generated particular debate amongst some of the audience who were more or less enthusiastic about the merits of different devices. The announcement that the next session would comprise the subcommittee reports and Annual General Meeting prompted the usual stampede for the exits, (the bar was open) but those who stayed were treated to a quick and efficient conduct of the necessary business. The conference banquet dinner was held amidst the suits of armour in the Royal Armouries museum. Yet again the wine flowed and the meal was followed by the customary late bar. Some headed for the bright lights of metropolitan Leeds but few mishaps were reported.
Of particular note was the fact that despite the rigours of socialising the evening before, the first session on Tuesday morning (free papers followed by the debate) was attended by almost all the delegates. Clearly this demonstrates the inner fortitude strengths and skills of the society members, an enduring characteristic of vascular anaesthetists which separates us from the rest. This was exemplified by the Chairman of the next session whose witty asides and masterful handling of both nervous SpRs and the more hoary and vocal contributors to the debate made this for me one of the highlights of the meeting. The quality and number of papers submitted to the meeting continues to improve each year and this year’s prize of £200 was awarded to Dr D McIntosh of Sunderland for his paper entitled ‘Audit of perioperative cardiac protection in elective aortic aneurysm repair’.
Dr D McIntosh of Sunderland receives his cheque for the best trainee presentation from Richard Telford
The Armouries museum was the perfect setting for the verbal jousting which occurs during the formal debate. The motion ‘This house believes that a specialist vascular anaesthetist should be present during all ruptured AAA cases’ was proposed by Mr Martin Thomas of Chertsey. Unusually for a vascular surgeon, his arguments were logical and well constructed; these were delivered in a brilliant and hilarious fashion and his insults aimed broadly but accurately at everyone from orthopaedic surgeons to physicians, politicians to priests. The motion was opposed by Dr Neal Edwards ( Sheffield): his skilful response comprised large amounts of vigour, logic, facts, humour, abuse and emotional blackmail. Pre-debate votes were: 31 for the motion and 144 against. After the debate a significant swing had occurred with 58 for the motion and 123 votes against. A chi-squared test by mental arithmetic from the audience suggested this to be statistically significant and even though the pre- and post votes were not equal in number there was a clear message.
The penultimate session was delivered by Dr Alasdair Short of Chelmsford, who detailed the available strategies for the preservation of renal function in the perioperative period. An interesting and well-explained summary of aspects of renal physiology was followed by the message that apart from judicious maintenance of extracellular fluid volume, there are no proven effective therapies available. Dr John Rose of Newcastle then spoke on the current role of EVAR. He gave a useful insight into the practical and technical aspects of EVAR and a dispassionate account of the limitations of the current literature. The final session comprised a ‘current controversies’ session. This allowed individuals a 15 minute presentation on selected topics. Andy Lumb of Leeds discussed the anaesthestic Management of EVAR, Andrew Bodenham covered the topic of where to send vascular patients after surgery, George Clark (Sheffield) discussed the evidence regarding clopidogrel and epidural analgesia, and Chris Snowden (Newcastle) précised the current evidence regarding ACE inhibitors and ATII receptor antagonists in the perioperative period. This session was popular and generated much debate from the audience.
In his closing remarks, Richard Telford gave a presentation to George Clark, who has been a stalwart of the VASGBI and has been Treasurer since its inception. He also thanked Jane Heppenstall and Andy Lumb for organising an excellent meeting and closed with a reminder that next year’s meeting is to be held in the Stockton on Tees Campus of the University of Durham on September 11 th-12 th 2007. The draft programme already looks impressive and as usual members are advised to book early to avoid disappointment.
George Clark, desperately hoping that one of the gifts was a tie straightener...
