Radcliffe Vascular meets with Prof Konstantinos Donas ahead of LINC 2020, to discuss life in his new role as Chief of Vascular Surgery at Asklepios Clinic Langen, DE and his plans for innovating his department; as well as commentary on what's upcoming for him personally at #LINC2020 and what visitors to the congress can expect.
Videographer and Interviewer: David Ramsey

Transcript Below :

So good morning, thank you very much Radcliffe Vascular on the way to Leipzig and LINC, to make a short stop in Frankfurt area in Langen, having the opportunity to introduce myself from a different city, in a different role. I'm not anymore in Münster with Professor Torsello, I am in Frankfurt area in Langen as head of the department of vascular surgery, and I'm more than glad to have the opportunity, the experience after 12 years working with Professor Torsello in Münster to bring in the Rhein-Main area in order to offer a different approach and also a good quality for the patients here. 

Question 1 : How are you hoping to innovate treatment options for patients in your new role ?

I have to be honest, I didn't expect to have so many patients with PADs and trophic lesions. So patients came to the hospital with excessive trophic lesions with severe atherosclerotic occlusions of mainly below- the-knee arteries or distal SFA, and we were able to treat this group of patients efficiently, less invasive, with different options and techniques of atherectomy for instance, or with Shockwave balloons, so bringing them the new innovative techniques in this area. In this context, I'm really impressed and more than happy extending the field to offer also the entire spectrum and the entire arsenal of options, starting from the carotid of course artery, the AAAs, the infrarenal aorta, the pararenal aorta, all thoracic disease, and of course coming to the foot arteries. 

Question 2 : Please explain the need for and benefits of a dedicated homepage on AAA : hostile neck techniques in association with Radcliffe Vascular ?

Yes, there is no doubt that e-learning platforms for example like Vascupedia, are very, very important nowadays, giving the opportunity to many, many colleagues from the entire world to have access and have the possibility to provide information, to speak with experts of all the world, presenting cases, analysing drawbacks or new techniques. In this context I think is very, very crucial also to have the possibility to have a homepage focusing on the treatment of AAAs with hostile and challenging necks. There is no doubt that we have many, many options, and we have had meetings, almost debates, between the one or the other techniques but the clinical reality is completely different. For different reasons, one or the other technique is not possible to be used and therefore is important to have alternatives, to learn from experts about the limitations, about the strengths of the one and the other technique and each physician is responsible to use the one or the other technique based on his skills, based on the infrastructure, and based on the local conditions of his hospital. In this context I believe that a homepage focusing on the treatment of hostile neck including all available options could be beneficial for the physicians and increase the evidence and the possibility to optimise the results. 

Question 3 : What are you presenting at LINC 2020 ?

Of course LINC is one of the biggest meetings regarding the vascular diseases. Also this year I'm more than glad to be part and present new evidence in the topics of the the juxtarenal aortic aneurysms. In Münster we have a huge experience with endovascular and open repair of pararenal aortic aneurysms. In this context we conducted a study focusing on the re-interventions and also on the cost and cost-effectiveness of fenestrated and chimney endografting, and for first time we will present the late outcomes but also the impact of the intervention on the costs, analysing finally the cost-effectiveness of chimney and fenestrated endograft. I'm more than glad also to present in the section of PADs. My experience with the treatment of atherosclerotic lesions in the popliteal artery using the orbital atherectomy system. I think the involvement of the popliteal artery is always challenging because up to now we don't have robust evidence about the superiority of the one or the other stent in this area, and if we have an option to avoid to deploy a stent in the popliteal artery, would be beneficial. So my preliminary experience with the orbital atherectomy is very positive avoiding the additional use of stenting. I'm more than glad also to participate different meetings about the treatment of hostile necks. 

Question 4 : What are you excited to see at LINC 2020 ?

There is no doubt that the debate about the use or the avoidance of drug-coated balloons for claudicants will still be an interesting and hot topic at LINC and in this context I would like to highlight our study, the first real-world data analysis which we published last year in September, evaluating the long-term followup of claudicants who underwent drug-coated paclitaxel balloons versus POBA and we didn't observe any statistical significant difference regarding the mortality. So, it was in contradiction with the Katsanos meta-analysis, after a sophisticated statistical evaluation and propels this core analysis to match homogenous groups. So there is no doubt that this is an interesting topic, we will see what is now the latest evidence, the latest recommendation, but there is no doubt that this topic will be also this year one of the main interest topics of the future meetings.