Archive February 2017 XVIII, No. 2

Inside Our Outpatient Vascular Surgical Center

How we tapped into an expanding opportunity of treating vein-related maladies and diseases.

Mohmmed Margni

Mohmmed Margni, MD, FACS, RPVI


vein-related procedure STRIPPING AND LIGATION Today, vascular surgeons and interventionists can perform most vein-related procedures on an outpatient basis, like this varicose vein stripping.

Are outpatient settings suitable for most vein-related procedures? From venograms and venoplasty to angiograms and angioplasty, the answer is an emphatic yes. With the right training, the right equipment, the right staff and the right space, vascular surgeons and interventionists — especially those trained in the last 10 or 15 years — should be able to handle the vast majority of vein-related procedures without ever needing to hospitalize patients. And thanks to many specially focused fellowships and residencies, the number of practitioners with the needed skill set is growing.

At the Vascular Institute of Michigan, which my partner and I opened in 2016, we're doing twice as many procedures as we were able to do in the hospital, and doing most of them on an outpatient basis. We practice all facets of vascular surgery, including lower extremity angiograms and venograms, laser ablation, micro phlebectomy, dialysis access and maintenance, catheter placement and mediport insertion. The only procedures we always do in the hospital are carotid stenting and aortic aneurysm endovascular repair (EVAR).

Along with being a fantastic arrangement for us, patient satisfaction has greatly increased as a result. Of course, we didn't just lease a building, haul in some equipment, throw open the doors and start treating patients. Planning was essential.

We actually started from scratch with a building that had to be gutted and rebuilt from the ground up. But before we opened, my partner and I made several site visits all over the country to other facilities that specialize in vascular procedures. We had a vision, but we wanted to make sure we knew what pitfalls to watch out for. We learned a lot.

1 The right space. If all you're doing is pain intervention, you don't need much space. You'll be using either radiofrequency ablation or laser ablation, and both machines are very small. Nor will you need a lot of room for personnel, because those procedures require only an anesthesia provider and a nurse, in addition to the surgeon.

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