Southern Association for Vascular surgery

SAVS History

The Southern Association for Vascular Surgery: A Short History

Spence M. Taylor, Secretary-Treasurer and Daniel S. Rush, Archivist

January, 2009

The Southern Association for Vascular Surgery is a vascular surgical organization established to promote the art and science of peripheral vascular surgery, to further education, and to perpetuate friendships of its selected members. It is comprised of over 500 active, senior, candidate, honorary and corresponding members primarily from the 13 southern states of Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, South Carolina, Tennessee, Texas, Virginia, West Virginia, and Washington DC. Association members are invited and selected on the basis of their surgical competence and professional merit. The Southern Association for Vascular Surgery, is widely considered among the most established and vibrant regional vascular organizations in the United States. Founded in January, 1976, the Association convened its 33rd Annual Meeting on January 14, 2009 in Tucson Arizona.

Historical Background and Traditions

On the occasion of the 25th anniversary of the Southern Association for Vascular Surgery’s first annual meeting, Calvin B. Ernst, M.D., the Associations first Secretary-Treasurer, recounted the early history of the association in an address before the membership. [1] In that address, he relayed that an informal meeting occurred in December of 1975 during the annual meeting of the Southern Surgical Association at the Homestead in Hot Springs, Virginia. At that meeting Dr. John Foster of Nashville invited a few surgeons interested in vascular surgery to his hotel room to discuss the feasibility of organizing a regional vascular society. That informal meeting lead to the planning of the Southern Regional Vascular Group Organizational Meeting which met on January 24, 1976 in Nashville, Tennessee. Invited to that meeting were the recognized leaders in vascular surgery from most of the southern states and included Carlos Chavez of Jackson, Mississippi, Andrew Dale of Nashville, Tennessee, Calvin Ernst of Lexington, Kentucky, John Foster of Nashville, Tennessee, Ed Garrett of Memphis, Tennessee, Garland Perdue of Atlanta, Georgia, Manley Stallworth of Charleston, South Carolina, Bernard Thompson of Little Rock, Arkansas, Robert Cordell of Winston-Salem, North Carolina, Stanley Crawford of Houston, Texas, William Edwards of Nashville, Tennessee, George Johnson of Chapel Hill, North Carolina, Norman Rich of Bethesda, Maryland, Francis Robicsek of Charlotte, North Carolina, Jesse Thompson of Dallas, Texas, Glenn Young of Durham, North Carolina, and Melville Williams of Baltimore, Maryland. These distinguished surgeons became recognized as the Founding Members of the Southern Association for Vascular Surgery. Dr. John Foster presided over the meeting which was attended by Drs. Chavez, Dale, Ernst, Garrett, Perdue, Stallworth, and Thompson. Present, as well, was a junior faculty vascular surgery member from Vanderbilt University, Dr. Richard Dean. At that daylong meeting, most of the organizational and operational proceedings of the current Association were established. In addition to the Association’s mission, a decision was made to have an Annual Meeting in midwinter at a warm climate featuring half day scientific sessions. This format was selected in order to maximize collegial interaction among its members. The group agreed to avoid University Centers as meeting sites. As well, the group selected its first officers –John Foster, President; Garland Perdue, Vice President; and Cal Ernst, Secretary-Treasurer.

After additional planning sessions at the national vascular society meeting in Albuquerque, New Mexico in June and another in October, the first Annual Meeting was held February 4 and 5, 1977 at the Indes Inn in Duck Key, Florida. In attendance were 34 members and 32 guests as well as 30-35 spouses. The scientific session included 16 member presentations and an invited Honorary Guest Lecture from Dr. Alton Ochsner of New Orleans, Louisiana. From these humble beginnings, The Southern Association for Vascular Surgery grew and, today hosts an Annual Meeting which is typically attended by well over 300 members and guests from all over the world.  While the size of the Association has increased, the traditions and proceedings have deviated very little from those established by the Founding Members more than 30 years ago.

Rudolph Matas

 The Founding Members chose the portrait of Dr. Rudolph Matas (1860-1957) from New Orleans, Louisiana to adorn the seal of the Southern Association for Vascular Surgery. Dr. Matas was chosen because of his prominent role in American surgery and because of his southern academic heritage, being professor and professor emeritus at Tulane University for more than 33 years. He is widely acknowledged as the father of American vascular surgery,
  In 1888, Dr. Matas described a better method of treating peripheral aneurysms than arterial ligation, the prevailing treatment of choice at the time. His technique of endoaneurysmorrhaphy, involved clamping above and below the aneurysm, opening it, ligating branches from within and buttressing the wall with imbricated sutures. By 1906, he had performed 22 obliterative operations and 7 restorative operations (preserving the arterial lumen) with no recurrences. The Matas endoaneurysmorrhaphy prestaged the current prevailing of “Internal” or intrasaccular reconstruction conceived by Oscar Creech and Michael DeBakey. In 1913, Matas reported 225 cases of endoaneurysmorrhaphy repair. [2, 3, 4] In summing up his career in 1940, he reported to the American Surgical Association some 600 major vascular operations and 108 papers, predominantly on vascular surgery topics.

Rudolph Matas died at the age of 97 years. His life span included watching the death of a patient from renal failure after laparotomy performed with Listerian carbolic acid spray to the use of cardiopulmonary bypass in resection of thoracic aortic aneurysms. [5]  In choosing Rudolph Matas to adorn the official logo of the Southern Association for Vascular Surgery, the Founding Members believed that he embodied all the qualities that a southern vascular surgeon should possess. [1]

Academic Proceedings

At the 1976 organizational meeting in Nashville, the Founding Members established a mechanism by which the Association, through its president, would invite an Honorary Guest Lecturer (the precursor to today’s Distinguished Guest Lecturer) to address the membership at the Annual Meeting. The first Honorary Guest Lecture was entitled “Reflections on Rudolph Matas—A Pioneer Southern Surgeon”. Upon delivering that lecture, Dr. Alton Ochsner was inducted as the Association’s first Honorary Member. Since that address, over 30 Distinguished Guest Lectures have been delivered on a variety of topics related to vascular surgery and over 30 Honorary Members have been inducted into the Association.

By1980, free papers and case reports were solicited and presented at the Annual Meeting. Initially, free paper manuscripts were submitted to Surgery to be considered for publication and, when once established, to The Journal of Vascular Surgery. In a review by Huber and Seeger published in the Journal of Vascular Surgery on the occasion of the Association’s 25th anniversary in 2001, they reported that a total of 413 (73%)  of 569 free papers presented at the Annual Meeting from 1980-2000 were published in peer reviewed journals as identified by MEDLINE. [6] In calculating the number of citations in the contemporary literature attributed to these 413 articles, they concluded that the Southern Association for Vascular Surgery had made a significant impact on the quantity and quality of the scientific literature devoted to peripheral vascular disease. Since 2001, the Association has maintained a publication rate greater than 75% for free papers submitted to the Journal of Vascular Surgery. This includes a publication acceptance rate of 88% in 2007, the best publication rate of any regional or national vascular society.

In 1981, the Association was approached by the William J. von Liebig Foundation and asked if the Annual Meeting could be the forum for the presentation and awarding of the von Liebig’s Annual Excellence in Vascular Surgical Research for Residents Award. The von Liebig Foundation offered a $5000 award to the resident and/or fellow presenting the best essay on a problem in general vascular surgery. In addition, a $10,000 award was presented to the research mentor supporting a researcher receiving the first place award. From 1982-2004, the von Liebig Foundation presented a total of 23 national awards for original research before the membership of the Southern Association for Vascular Surgery.

In 1999, Dr. Ralph B. Pfeiffer of Mobile, Alabama proposed that the Association establish a traveling fellowship to commemorate the life and contributions of S. Timothy String, M.D., the 19th President of the Southern Association for Vascular Surgery, after Dr. String’s untimely death in 1997. With an annual grant a $5000, provided by W.L Gore and Associates, the S. Timothy String Traveling Fellowship was approved by the Executive Council in June 1999. Qualified applicants were screened and the first award was given at the January 2000 Annual Meeting. Applicants for the Traveling Fellowship were required to be chief residents in general surgery, fellows in an approved peripheral vascular fellowship, or first year surgeons who desired further training in some aspect of vascular surgery. Winners were required to complete the fellowship within 12 months of the award and to present a synopsis of their experience to the membership of the Association at the following Annual Meeting. Unlike other traveling fellowships awarded in vascular surgery, applicants were not restricted to pursue only bench research, but instead, were encouraged to pursue more clinically oriented experiences in accordance with the career taken by Dr. String. The first S. Timothy String Traveling Fellowship was awarded in 2000 to Paul H.S. Bloch of Norfolk, Virginia. At the 2001 Annual Meeting of the Association, Dr. Bloch relayed the activities of his fellowship, in which he traveled to Sydney, Australia to work with Dr. James May on innovative management strategies for complicated endoleaks after stent graft abdominal aortic aneurysm repair. The 2001 and 2002 S. Timothy String Traveling Fellowships were awarded to Nancy L. Harthun, M.D. of Charlottesville, Virginia and Thomas T. Terramani, M.D. of Atlanta, Georgia respectively.

At the Executive Council meeting in January 2003 the S. Timothy String Traveling Fellowship award was reconfigured and combined with the President’s Award. The President’s Award was an annual award established by the Association in 1992 to recognize the best free paper presented at the Annual Meeting by a new member. The combined award was reestablished to recognize the best overall free paper presented at the Annual Meeting. The first S. Timothy String Presidential Award was presented at the 2004 Annual Meeting and continues to be awarded annually. In addition to this award, the Association has awarded the Founders Award since 1998. This award is given to the best clinical or basic science paper presented by a medical trainee (student, resident, or fellow) at the Annual Meeting.

Other successful academic initiatives undertaken by The Southern Association for Vascular Surgery include the initiation in 2004 of the annual Postgraduate Course and the Mock Oral Certifying Examination. The Postgraduate Course was initiated in response to a need by the membership to learn new (mostly endovascular) techniques. These courses, taught on the day prior to the initiation of the Annual Meeting, typically stress hands-on procedural learning. The Mock Oral Certifying Examination offers a realistic simulation of the Vascular Certifying Examination given by The American Board of Surgery. It is given to vascular trainees and Candidate Members who are preparing for board certification in vascular surgery. The exam is given on the day prior to the Annual Meeting as well.

Summary

The Southern Association for Vascular Surgery is a vibrant organization that has maintained its relevance through the years. Its current mission statement can be summarized by the following:

To promote the art and science of vascular surgery and to further education in the comprehensive care of vascular disease, including disorders of the arteries, veins, lymphatics and microcirculation exclusive of the heart and brain.

As envisioned by the Founding Members, the Association, through its Annual Meeting, provides the perfect mix of scientific didactics, interactive discussion and recreational activity. This mix has proven to promote the collegial interchange of professional ideas which has, in turn, served to improve the overall care delivered to the vascular patients in our region.

References

1. Ernst CB. The Southern Association for Vascular surgery: The beginning. J Vasc Surg 2001; 34:381-3
2. Rob CG. A history of arterial surgery. Arch Surg 1973; 105:821-3
3. Dale WA. The beginnings of vascular surgery. Surgery 1974; 76:849-66
4. Matas R. Traumatic aneurysm of the left brachial artery. Med News 1888; 53:462
5. Scannell JG. Ruldolph Matas ( 1860-1957). J Thorac Cardiovasc Surg 1996; 111:1294
6. Huber TS, Seeger JM. Contribution of the Southern Association for Vascular Surgery to the scientific literature. J Vasc Surg 2001; 34:393-6