In this issue:
AUGUST 2023 Volume 19 Number 08
2G uest Editorial Adam Tanious ruminates on how to navigate industry rep exchanges
11 O BL Drilling into the detail behind the value of an office-based lab
8 u TBAD A new randomized trial aimed at improving the lives of aortic dissection patients
13 CMS Proposed reduced conversion factor and reimbursement cuts
THE OFFICIAL NEWSPAPER OF THE
www.vascularspecialistonline.com
APPROPRIATE CARE
CMYK
16,A,001,Bs-4C,E
SVS responds to NYT exposé on overuse of vascular interventions In an official Society response, SVS President Joseph Mills, MD, tackles recent coverage of inappropriateness in vascular care in the mainstream media. See page 4
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VOL . CLX XII
. . . No. 59,8 51
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DAY, JULY 16, 2023
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Beijing Targets Canada Critics VAST FIELDS FULL From Overseas OF MINES HINDER
UKRAINE’S FORCES
Meddling With Otta wa Part of Global Aim s GRIM By NORIMITS
PICTURE IN SOUTH
U ONISHI
RICHMOND, Britis Array of Trip Wire — The polls predic h Columbia s and tion victory, mayb ted a re-elecBooby Traps Slow e even a landslide. s Counteroffensive But a couple of weeks before the vote, Kenny Chiu, a memb er of Canada’s Parlia ment and a critic of China’s huma By ANDREW E. n rights record KRAMER was panicking. , ORIK flipped among Something had grisly HIV, Ukraine — It was a the scene of blood y limbs and voters in his Britis ethnic Chinese crump led vehicles as h Columbia district. a series of Russian mines exploded acros “Initially, they sa field in southern Ukrai ne. ive,” he said. “And were supportOne Ukrainian all of a sudde soldie they just vanis hed, vaporized, n, on a mine and tumbl r stepped dis- grass ed onto the appeared.” in the buffer zone between Longtime suppo the two armies. Nearb rters originally y lay other from mainland Ukrainian troop China were not s, their legs re- tourn turning his calls. in iquets, waiting for ported icy greeti Volunteers re- evacu ation, according medical friendly home ngs at formerly posted to videos online and the s. Kelly Hanna, whos accounts of guage news outlet Chinese-lan- several soldie e leg was amputated s stopp rs involv ed coved. ering him. And in 2020, received Soon, an armor he was facing at least 18 artery ed an onslau vehic le arght of attacks CYDNI ELLEDGE -opening procedures FOR THE NEW — from un- rived to rescue them. A YORK TIMES traceable sourc on her legs from medic jumped out to es a Michigan docto treat the woun community’s most — on the local and ded r. knelt on groun d he networking app, popular social safe — only to trigge deemed the Chineseowned WeChat. r another mine with his knee. The sudden he performed Five This article is collapse of Mr. weeks into a count at least by Katie Thom Chiu’s campaign as, artery-opening proce that many Jessica — in the last fed- sive that even Ukrainian eroffenSilver-Greenberg dures on Ms. eral election, officials say is off to a and Hanna’s legs, Robert Gebeloff. in which plaque, halting start, intertelling her they drawing renew 2021 — is now views a sticky slurry would improve ed scrutiny amid with commander of fat, calcium and Kelly Hanna’s leg blood flow and s and solother materials, mounting evidence diers fighting along prewas amputat- vent amputation accumulates in ed on a summer s. the terference in Canad of China’s in- cate the arteries of day in 2020, after the slow progr front indiThey didn’t — the ian politics. legs. For a tiny a Michigan docto for Ms. Hanna ess comes Mr. portion of patien r or ts, electe Chiu and several other down to one major proble the plaque can self “the leg saver who called him- many of his other patien m: choke d land officials critica ts. ” had damaged geons at off blood flow, leading l of Beijing mines. her arteries nearby hospitals Surwere to amputation by snaking metal seen The fields Ukrai had s or that targets of a Chinese state death. so many of his nian forces has increasingly patients with amputations and exerted its must cross are littered with But more than OPERATING PROF other problems Times has found. With the doza decade of medi- influence over Chinese ens of types of that they comp finan- cal research ITS cial backing diaspora mines — made comm lained has unitie of plastic and metal of ‘The Leg Saver shown that the medical devic to Michis worldwide as gan’s medical board vast majority ’ , part of an aggressive of about his con- manufacturers, he has becom e of chewing tobac shaped like tins campaign duct. An insura e a ripheral artery people with pe- pand its leader of a boom nce global reach, accor to ex- and with colorf co or soda cans, disease have mild state authorities company told try that peddl ing cottage indus- or no symp wires through ul ding to current and toms and them to clear away that 45 people es risky procedures witch” and “the names like “the had lost limbs plaque. leaf.” treatment, aside don’t require cials, Canad former elected offito millions of Amer after treatment ian Ukraine’s army icans — enrich at ing docto his clinics in the It started with - more exercise and from getting cials and exper intelligence offiis also hindered rs and device comp past by four a taking a ts fester lack on years Chine medic of air ing . wound on her left anies tion. Experts se Dr. Mustapha and sometimes said even those a- disinformation campaigns state deep network support and the costing patien trist referred Ms. foot. Her podia- operator worki is no back-alley their limbs who of defensive struc. ts do have sever Canada recently . e symptoms, expelled a Chi- tures the Russians have had Mustapha. Hanna to Dr. Ji- of the medic ng in the shadows like Ms. Hanna, shoul The industry built. But Over 18 month al establishment, it is the vast array dn’t undergo re- nese diplomat accused of consp targets the peate s, investigatio an roughly 12 of mines iring d procedures in n by The New a short peri- the to intimidate a lawmaker from wires, booby traps and , trip York peripheral million Americans with od of time. Toronto area, Micha improvised explosive artery diseas el Chong devices that has e, in after , he successfully Continued on Page led efforts in Ukrainian forces bogge 14 Parliament to d down only label a few miles from ment of its Uygh China’s treat- starte where they d. ur Muslim community a genoc “I couldn’t imagi ide. Canada’s intelne ligence agenc something like this,” said a y Ukrainian privat least a half-dozen has warned at name e d Serhiy, part current and former elected officia of a unit ls that they rescued the soldiers woun that have been target ed by Beijing, in- the explosions. “I thoug ded by cluding Jenny Kwan, a lawmaker would be lain in lines. ht mines from Vancouver But whole fields are filled with and a critic of By SHEERA FREN Beijing’s polici them, everyKEL where.” es in Hong Kong. and STUART A. The Chinese gover THOMPSON Mines have long nment, emFor more than ploying a globa been a staple of Russi l playb 20 years, Kit Loffstadt has portionately focuse ook, dispro- sively an warfare, used extenwritten fan fiction in Afghanistan d on Chinese exploring altern Canadian electe and Chechnya and earlie ate universes d officia ls reprer phases of the for “Star Wars” heroe senting distric fightin ts Vampire Slaye s and “Buffy the Vancouver and in and around back g in Ukraine, stretching r” villains, sharin Toronto, exper to her stories free g say. It has levera ts south 2014. But the minefields in online. ged large diasp ern Ukraine are ra populations oBut in May, with family and complex, beyond what vast and Ms. Loffst adt business ties to stopped postin had been previously know g her creations China n, soldiers who ing that the levers and ensurafter she learne d that a data comof power in Continued on Page those communitie pany had copied 8 s are on its side, according to electe fed them into the her stories and artificial intelli nadian intelligenced officials, Cagence technology underlying experts on Chine officials and ChatGPT, the viral chatbot. se disinformation. Dismayed, she hid her writing behin “Under Xi Jinpin a locked accou d nt. China has doubl g’s leadership, Ms. Loffstadt also ed assertive nation down on this nize an act of rebell helped orgaalist policy toward the diasp against A.I. systemion last month ora,” said Feng s. Along with Chongyi, a histor dozens of other ian and an assofan fiction writer ciate professor she published a s, at the University flood of irreverent of Technology stories online Sydney. China to overwhelm role in Canada ’s ALBERTO PEZZALI and confuse the data-c mirro /ASSOCIATED PRESS ollection serv- The unseeded happened in Austr red what has ices that feed Marketa Vondrouso alia, he added. writers’ work va beat Ons Jabeu Chinese state into A.I. technology. interf r in straight sets its threat to Canad erence and MAURICIO LIMA in the women’s final. “We each have FOR THE NEW a’s democracy YORK TIMES to do whatever Page 25. There are many we can to show Contin ued them the outpu on Page 10 types of mines. t of our creativity This one sprays is not shrapnel. to harvest as they for machines Loffstadt, a 42-ye like,” said Ms. tor from South ar-old voice acsuburbs, or west Yorkshire in BritBy J. DAVID GOOD to ain. MAN sprouting in count find fields Lone Star cultur PRAIRIE VIEW y parks. e Fan fiction writer The game of cricke Drive northwest , Texas — in all things, especof competition Tim Cork, a deput group now stagin s are just one out of Houston, ially sports. t — a batball-and-wicket and as cow pastu g Cricket’s swift eral at the Britis y consul genBend County. contest of paA.I. systems as revolts against res wrestle rise h tience and athlet back the flat expan a has attracted intern in Houston Houston. “Ther consulate in “When I came icism that was technology has fever over the se from the e are Indians, ational attento this country, born gripped Silico tion in Pakistanis, there’ Britain and is barely and helped make the only sport city’s tentacled Valley and the n s obvio I knew was Texas the understood by world. In recen launching pad ACRO huge cricket,” said KP SS number of Brits usly a spraw most months, social t for l, there arise George, the here, Aus— has surprisingl Americans media companies American profes the sport’s first tralian accen THE county judge in along the road, such as Reddit y taken ts siona where l hold Fort Bend, who leagu ver you go.” immig COUNTRY in the land of Frida e, and Major League The number of suddenly, impro rated from India y night football. organizations includTwitter, news Cricket, whose people of IndibaA in 1993. surgin inaug ing When he was electe an heritage in g population of ural season began The New bly, many, many York Times and Texas South on Asian immigrants NBC News, au- cricket fields. Thursday outsid none of the count d in 2018, over the last decad has doubled around House Dalla Continued on Page Head south to ton and Dallas “One of the unkno s. cricket field, he y parks had a million, according e to half a find a small imported their 18 said. Now there wn things cricket stadium favorite sport to about Houston are seven, and from the Censu to estimates nestled in the their adopted is the diversity each is reserved s Bureau’s annua home, where it of the population survey, with 73,000 l for play months in has grown amid advance. in Harris a cricket-play from many INTER NATIO County, which “There’s a huge ing countries,” NAL 4-11 includ said said. “We’re worki demand,” he and 64,000 in subur es Houston, ng on a couple ban Fort Poisoned by Boot Continued on Page leg Liquor ARTS & LEISU 21 Iran’s ban on alcoho RE l has led to a wave of deaths linked Meet Postmoder to a unregulated marke flourishing and n Barbie SUND AY BUSIN t. Margot Robbie ESS PAGE 4 and Ryan Goslin g on the complexity found Making the Next 2 Polluters Meet in turning dolls with histor ‘Squ on a y Clim into id Gam movie characters. ate e’ Netflix is thinki The U.S. envoy PAGE 10 ng globally but John Kerry travel acting locally, building s to China as Wash worldwide audie A Return to ‘Just ington nces by focusing on start talks on globa and Beijing reified’ regional tastes l warming. PAGE Timothy Olyph . PAGE 1 ant seems relaxe 10 d about reprising the role SPOR TS 25-27 More Doom Than of NATIO NAL 12-21 which transformed Raylan Givens, Ballo ons Listening in on his career. PAGE Messi Officially the pre-release 14 preparaHollywood’s Mom tions at a chatb in M.L.S. ot start-up revea SPEC IAL SECT The superstar ent of Angst SUND AY STYL led workers’ fear, panic ION is expected to The movie and ES join Inter and dread. PAGE television busin Miami this week ess is on a contract that 1 being buffeted Turn Off the Stov Where the Trees on a dizzying numb through the 2025 runs e season. er of fronts. The strike Tell SUND AY OPIN Tales It’s PAGE summ by actors is only ION 27 er, and for many The Folly Tree latest disruption. the Arboretum in East of us it is simply too hot Hamp Gay Broadcaster’s Nicholas Kristof to actually cook. ton, N.Y., has gathe PAGE 18 So we offer 24 recipe red 250 speciPath mens with intere PAGE s that skip the 2 An openly gay broad sting histories, heat. caster in minor like the useless Osage league baseball orange. has major leagu PAGE 10 e aspirations. It hasn’t been easy. PAGE
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Joseph Mills
LONG-AWAITED FDA UPDATE FINDS DATA DO NOT SUPPORT EXCESS MORTALITY RISK FOR PACLITAXELCOATED DEVICES IN A LETTER TO HEALTHCARE providers dated July 11, 2023, the Food and Drug Administration (FDA) declared that the risk of mortality associated with paclitaxelcoated devices to treat peripheral arterial disease (PAD) is no longer supported based on data and analyses. The update signaled a lowering of the red flag raised in a 2019 letter from the FDA— published in response to a meta-analysis that indicated a late mortality signal—warning that treatment of PAD with paclitaxel-coated balloons and paclitaxel-eluting stents was “potentially associated with increased mortality.” Alongside the letter, the FDA has updated its
See page 7
Vascular surgery added as named specialty to influential national hospital rankings U.S. NEWS & WORLD Report has renamed the specialty formerly known as “Cardiology & Heart Surgery” to include vascular surgery in its national rankings of the best hospitals in the country. The category will now be called “Cardiology, Heart & Vascular Surgery,” the media company announced ahead of the Aug. 1 publication of its 2023–2024 Best Hospitals rankings and ratings.
See page 3
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