Midwest Vascular Collaborative Newsletter
VOLU ME 4 ISSU E 1
August 2016
MVC Officers
From the Midwest Vascular Collaborative Medical Director:
MVC Medical Director
Gary Lemmon, MD
O| 317.962.0286
E| [email protected]
MVC Program Manager
Cynthia Richardson, RN
O| 317.962.9465
E| [email protected]
MVC Quality Chair
Mir Ishti Ali, MD
O| 267.258.4854
E| [email protected]

Please take the time to review new features on the VQI website: www.vascularqualityinitiative.org
Included are updates from the VAM highlights detailing the Inaugural VQI Annual meeting here:
Review of Inaugural VQI Annual Meeting

Regional Group meeting summary and a New Annual Report are also located on this site and
linked here: 2016 VQI Annual Report

Our spring biannual meeting was held in Columbus, Indiana with a focus on carotid disease. Jim
Wadzinski representing the SVS/PSO and Betty Kerrigan with M2S attended and provided valuable updates affecting the registry and upcoming events. Details of the Spring meeting can be found
on the website on the lower right corner of the page: VQI Midwest Collaborative

Please note that Larry Kraiss MD, Chair of the SVS/PSO, has informed all members that future
biannual meeting attendance will be required for members to receive credit for participation. Remote viewing whether via conferencing or web viewing will no longer count for the expected one out
of two meetings for each member per year. Please read below for how we hope to help with this
change. As the SVS VQI evolves, conversations are underway for public reporting of those hospitals receiving the Star rating system in US News and World Report. As it is currently proposed,
participating hospitals achieving 1 – 3 Stars would be included in the report. Those participating
hospitals achieving zero stars would be omitted. Star grading includes physician participation,
Long Term Follow up participation thresholds and the number of registries the facility participates
in.

The Indiana, Western Ohio and Kentucky hospitals that comprise the MVC are both diverse academic and community institutions spread over a large geographic area. This makes travel to a
biannual meeting difficult to achieve for busy schedules in one day. Following an EC survey and to
improve attendance at our regional meetings, we have decided to change our venue and meeting
format. Our next biannual meeting will occur on Oct 28th and 29th at the French Lick Springs Resort (www.frenchlick.com). The resort is a family friendly location full of amenities for both adults
and family and (with exception to our northern Indiana colleagues) is the most geographic central
location for most centers to reach in a 2+ hour travel time. This fall meeting will focus on Aortic
and EVAR procedures. The meeting format change includes:
MVC RAC Chair
Raghu Motaganahalli, MD
O| 317.962.0281
E| [email protected]
SVS PSO National Governing Council
Representative
Michael Dalsing, MD
O| 317.962.0283
E| [email protected]
SVS PSO National Venous Quality Council
Representative
Sabah Butty, MD
O| 317.962.0804
E| [email protected]
SVS PSO National Arterial Quality Council
Representative
Charles Kiell, MD
O| 828.238.2669
E| [email protected]
MVC FALL 2016
Biannual Meeting
October 28-29th, 2016
French Lick Springs Resort
French Lick, Indiana
Inside This Issue
Message from the
1-2
National VQI Update
2
Research Update
2
Oct 28th: Reception cocktails/meet and greet from 5-6P at the resort. We will then have dinner
for members and invited guests from 6-8P. Dr. David Minion from UK will provide a 3045 min talk on the “Power of Choice” for EVAR procedures. Following this presentation, members are invited to bring interesting cases via flash drive/PowerPoint for group
discussion and help with treatment options. I would hope to have 3-4 members bring
their interesting case to this format for a 60-90 minute round table discussion. We will be
sending out requests and give further instructions later. Portions of this meeting will be
underwritten by Endologix by submitting a grant to the SVS/PSO for our use.
Oct 29th: Our Biannual meeting will commence with EC and Abstractor breakouts from 7-8
am. The BAM will begin at 8A and last until about 1P. Three invited speakers will be
included on this agenda focusing on Aortic EVAR care. Topics included are “Open
AAA surgery in the era of EVAR”; “FEVAR-lessons learned in VQI data”;
“Choosing the right EVAR device for the right patient”. COPI reports focusing on
EVAR data will be emphasized during this meeting.
Hopefully, this new venue provides added value to members, their guests and possibly family all while
making the most out of a 24 hour travel limit. Of course, making a weekend of it at the resort is also
possible. Further details on the event and overnight costs will be in a separate announcement. We have
secured 20 rooms at the French Lick resort for the meeting; please place your reservation soon.
Newsletter Sponsored by IUH Methodist Hospital
VOLU ME 4 ISSU E 1
M I D W ES T V A S CU L A R C O L L A B OR A T I V E N E W S L ET T ER
MVC Medical Director cont.:
I would like to take this moment to bring exciting information to all about
the results of recent news from one of our researchers in limb salvage, Dr.
Mike Murphy. As this is beneficial to all members treating patients with
ischemic arterial disease, I believe this is a reasonable forum to share these
exciting findings:
The multi-center Phase III MOBILE Trial lead by investigators at the Indiana University School of Medicine has completed all of the one year follow
up examinations on the 152 enrolled patients at 30 centers. This study was
designed to assess the efficacy of autologous bone marrow mononuclear cells
(ABMNC) in promoting limb salvage in patients with critical limb ischemia. There was a significant decrease in major amputation rates in all
Rutherford 4 and non-diabetic Rutherford 5 patients at one year. The MOBILE Trial will be continuing as an open access registry for patients with
CLI to be treated with ABMNC. The good news is that all patients will be
treated, there is no randomization.
Gary Lemmon MD, Medical Director, MVC
Cynthia Richardson, MVC Project Manager
National VQI Update
PAGE 2
New Research Update
Full Letter from by Michael P. Murphy, MD:
Dear Colleagues,
I am excited to announce that the investigator designed multi-center
Phase III MOBILE Trial has completed all of the one year follow up
examinations on the 152 enrolled patients at 30 centers. As you will
recall this study seeks to assess the efficacy of autologous bone marrow mononuclear cells (ABMNC) in promoting limb salvage in patients
with critical limb ischemia. We have unblinded the data and are excited
to report that there was a significant decrease in major amputation
rates in all Rutherford 4 and non-diabetic Rutherford 5 patients at one
year! This is the first positive study in the field of cell therapy in peripheral arterial disease and a major landmark accomplishment!
The costs for treatment, complication rates ,infections, major adverse
limb events , hospital readmission rates, and deaths were significantly
less than disease severity matched cohorts undergoing surgical bypass.
We have funding to proceed with a continued access registry for
patients with CLI to be treated with ABMNC. The good news is that all
patients will be treated, there is no randomization. In addition we have
funding for ancillary studies to identify who responds to ABMNC and
define the mechanisms by which ABMNCs may improve limb perfusion
and prevent amputation in that patient cohort of "responders".
STAR Award System: VQI issued via email in May that we will no longer receive
STAR points for attending the Biannual meetings remotely. The highlights of
that letter is as follows:
1) Not all regions agree with or can provide regional access (too costly or too distracting for those attending the meeting in person)
2) Remote attendance was not felt to provide meaningful participation and is
often hampered by technical issues.
3) Video conferencing could provide a more meaningful experience, but the current technology is either too expensive or fraught with issues.
Other STAR Award News: Each site’s STAR rating is noted on the VQI website now.
In addition, VQI is in discussion with U.S. News regarding an article that will publish the 1, 2, and 3 STAR facilities. Sites with “0” stars will not be listed in the
article and they are not listed on the VQI website. To view the VQI site with the
STAR listings: VQI Resource Library
Furthermore if you have any patients who are "poor option" surgical
candidates, defined as sub-optimal vein diameter (<3.0mm), require
composite vein or PTFE, please consider them for MOBILE CA as this is
part of our inclusion criteria. If cell therapy does not work, the patient
can return for their bypass. If cells do relieve rest pain or promote
ulcer healing it will save the patient from significant discomfort and
disability from multiple surgical incisions, infectious complications, ,
major adverse limb events, readmission for surgical complications, and
overall costs.
Kristen Wanczyk, RN ( [email protected] )and I will be immediately
available to screen any patients whom you feel are candidates for this
study.
Thank you for your support,
Michael P. Murphy, MD
Division of Vascular Surgery
Indiana University School of Medicine
Cell: (317)809-9034
Scroll down to SVS PSO Documentation. It is the first item on the list: VQI Participation Awards 2015 – *NEW*
VAM Spring 2016 in Washington, D.C., June 8-11th:
The first VQI meeting for Data Abstractors was held in Washington,
DC on June 8th. There was robust dialog between VQI/PATHWAYS
and the attendees regarding registry issues and future changes.
Several hospital teams throughout the U.S. presented their process
improvement results based on VQI report data.
CONTACTS:
Gary Lemmon, MD– Recruitment/ Case Presentations
Cynthia Richardson, RN– General Information
Lillian Camino– Registry Questions, (O) 317-962-9695
email: [email protected]
We Look Forward to Seeing You at the MVC Biannual Fall Meeting October 28-29, 2016