NephMadness 2015: Vascular Surgery • First Round Results

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Surveillance of AVG vs Clinical Monitoring of AVG
Winner: Clinical Monitoring of AVG

4-3 split

This was a victory for all of the coaches teaching the fundamentals. Who needs high tech fancy gadgets to detect stenosis? The tried and true physical exam with auscultation, cannulation problems and lab findings (KtV) are actually not that bad when used together. The overriding problem with Team Surveillance was the dreaded false positive. The access that gets intervention that in reality didn’t really need it. So, in the end it was the offensively minded Clinical Monitoring that moves on to face Team Laparoscopic.   

Laparoscopic PD Placement vs Open PD Placement
Winner: Laparoscopic PD Placement

7-0 split

This one wasn’t even close. It’s clear that the open approach is a relic from the past. The blue-ribbon panel sided with the laparoscopy. This is in line with the data that suggests a clear advantage to the laparoscopic approach to PD catheter placement in terms of better 1-year survival, less catheter migration and borderline improved 2-year survival of the PD catheter. This brings Team Laparoscopic to a round of 32 matchup with Team Clinical Monitoring. This will again, pit a classic approach with a high tech approach. How will Team Laparoscopic fare?

Upstream Hemodynamics vs Downstream Vascular Biology
Winner: Downstream Vascular Biology

5-2 split

The diaper dandies pulled off the win. With McDonald’s all Americans like HO-1, MCP-1, oxidative stress and endothelial dysfunction, how could they lose. Upstream hemodynamics were always at a distinct disadvantage. Even though Team Upstream Hemodynamics have a seasoned center with the menacing name of “disturbed flow” that has be wreaking havoc all year long. The next battle with be epic for sure. The Achilles heels of dialysis will face off next. The patency of catheters versus the longevity of arteriovenous access. Which one will more to the sweet 16.   

Prophylactic Antibiotics Catheter Lock vs Heparin Catheter Lock
Winner: Prophylactic Antibiotics Catheter Lock

6-1 split

The blue-ribbon panel picked prophylactic antibiotic over heparin catheter locks. Here are a few of the comments from the panel.

Catheters are going to show they came out of weak conferences and got lucky with their first round match-up. Antibiotic catheter locks are the starting 4 on the All-Airport Team – strong, full of promise and look great in the airport but they never see the court once the game starts.

The panel might have picked a winner here but it is clear they weren’t really impressed with either one. Team Prophy will have a difficult time again Team Downstream in the round of 32.

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