Introduction: The Birth of Vascular Surgery in Greenville, SC
Early origins: The need for specialized training to optimally manage the vascular patient has been recognized for decades. In Greenville, SC the care of the vascular patient moved out of the hands of the general surgeon and into the hands of specially trained physicians with the arrival of Bruce Snyder in the late 1980's. Our current department chairman, Dr. Spence Taylor was the second fellowship trained vascular surgeon who relocated to Greenville in the early 1990's. The establishment of a formal vascular surgery service did not occur until 1994 with the arrival of Dr. Eugene Langan. A desire to create a contemporary surgical center of excellence prompted the rapid recruitment of additional physicians, many of whom could perform both open surgical procedures and endovascular interventions. One such physician, Timothy Sullivan, trained at the Cleveland Clinic Foundation and had intimate knowledge of the Clinic's multi-disciplinary approach to all vascular diseases. He was instrumental in the arrival of Dr. Bruce Gray, another Cleveland Clinic fellowship-trained vascular internist who joined the Greenville team in 2000.
Recognizing the need for extensive, formalized interventional training, Greenville Health System created a highly desirable and innovative vascular surgery fellowship under the guidance of Eugene Langan. Established in 2000, this program graduated their first surgeon in 2002 that had spent two years in training, 6 months of this in the interventional suite. The progressive and innovative program now has two fellows a year and the curriculum includes training in the outpatient department, wound care center, vein center, and interventional suite in addition to a busy open surgical experience.
The Background of Vascular Medicine in Greenville, SC
It has also properly noted that the effective management of the vascular patient usually does not include surgery or endovascular intervention. Add to this another sobering observation: an estimated 9 million people in the United States suffer from symptomatic peripheral arterial disease, venous disease, acute DVT, carotid disease, etc. The need for medical specialists devoted to the care of vascular patients was apparent. Although Dr. Bruce Gray is a fellowship trained vascular internist, his sub-specialty training was in endovascular intervention and he essentially functioned as a vascular surgeon. In December 2001, Dr. Marcus Stanbro, another Cleveland Clinic trained vascular internist joined the Greenville group. Dr. Stanbro brought with him sub-specialty expertise in phlebology and lymphology. In 2004, a local nephrologist-turned vascular internist, Dr. Thomas Oliver joined the group and the Upstate's first vascular medicine group began to take form. Dr. Oliver used his nephrology background to specialize in cardiovascular risk reduction and hypertension management. After several years of planning and preparation, South Carolina's first vascular medicine fellowship was established and the first two trainees were enrolled in 2007. In November 2007, the vascular surgeons and vascular internists consolidated their practices into a single location, establishing the Institute for Vascular Health at the brand new Patewood medical campus. After graduation, both of these inaugural vascular medicine trainees stayed and joined the Institute. Dr. Jessica Morse has academic and clinical interests in venous thromboembolic disease, non-invasive vascular laboratory testing and wound care. Dr. Lisa Darby joined the Vein Center and devotes her considerable energy to phlebology. These five physicians now form the faculty for the vascular medicine fellowship, with Dr. Stanbro acting as director.
The Program Today
The vascular medicine fellowship at Greenville Memorial Hospital's Institute for Vascular Health provides subspecialty knowledge in patient care with regards to the diagnostic, therapeutic, and preventative approaches to all peripheral vascular diseases. This field routinely uses non-invasive vascular testing to quantify disease and then determines if medical management is appropriate; and if not, assists in the application of invasive therapies. Fellows will become experienced in the clinical characteristics of all vascular diseases, including arterial, venous and lymphatic, as they occur at peripheral, aortic, renal, mesenteric, coronary, cerebral, pulmonary, and other sites. Trainees will receive extensive exposure to the pathogenesis of vascular diseases including arteriosclerosis obliterans, aneurysms, vasculitis, arteriovenous fistulas, lipid disorders, essential hypertension, renovascular hypertension, arterial and venous thrombosis, pulmonary embolism, lymphedema, chronic venous diseases and vasospastic disorders. Completion of the GHS Vascular Medicine Fellowship will prepare the fellow for practice in the field of vascular medicine and enable the fellow to sit for and pass the ABVM general vascular medicine board examination.
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