The surgeon-scientists of the Emory Division of Vascular Surgery and Endovascular Therapy are cultivating discovery and innovation, refining and designing new therapies, and improving and initiating standards of protocol that will benefit the patient, drive sustainable and excellent outcomes, and foster cutting-edge and compassionate care.
Funding sources for prior and current basic science research projects of the Emory Division of Vascular Surgery includes the American Heart Association, National Institutes of Health, National Science Foundation, Juvenile Diabetes Research Foundation, industry sponsors, and private donors.
Since joining the faculty at Emory in 2011, Dr. Luke Brewster has used his clinical and scientific knowledge to form teams of clinicians and scientists to identify novel fields of investigation for the common purpose of improving lives of patients with vascular disease. His translational laboratory focuses on the fundamental causes of adverse vascular remodeling and the regenerative potential of stem cells in the ischemic limb. Through his joint affiliations with the Atlanta Clinical and Translational Science Institute and the Georgia Institute of Technology's Bioengineering Program and Parker H. Petit Institute for Bioengineering and Bioscience, Dr. Brewster is consolidating diverse thought leaders, exceptional students, and projects for developing novel solutions for arterial disease and limb ischemia.
By working with advanced modeling systems, clinically relevant animal models, and human tissue from IRB approved studies, Dr. Brewster's research is providing innovative therapies for arterial hardening and blockages and identifying new strategies for delivering cellular therapies to at-risk patients. His goal is to promote arterial health and prevent major amputations in aging patients.
Current projects rely on the recruitment of resident stem cells in ischemic legs as part of the solution to the amputation problem and to rejuvenate old and diseased cells and reimplant them into ischemic muscle. These studies—funded by a National Center Research Program Innovative Research Grant from the American Heart Association and internal seed grant funding from the Regenerative Medicine and Engineering Program at Emory/Georgia Tech—involve the culturing of cells harvested from ischemic limbs that required amputation in order to identify ways to prevent amputations in future patients.
Dr. Brewster's April 2013 receipt of an NIH Mentored Clinical Scientist Research Career Development K08 Award is funding his lab's examinations of the molecular mechanisms involved in arterial stiffening through blood flow and arterial wall changes. Several months later, he received an additional K08 from the SVS Foundation/American College of Surgeons that is providing matching funds for the study. Other projects include investigations of the role of weight stabilization and weight loss on the arterial health of obese adolescent patients.
Former and current Emory vascular surgery faculty have focused on the genetics of abdominal aortic aneurysm and peripheral artery disease; novel stents for treatment of thoracic and abdominal aortic aneurysms; evaluation of new catheter based strategies, drugs, and gene therapy for treatment of peripheral arterial disease; artificial blood vessels; new devices for prevention of stroke and treatment of carotid disease; and artificial venous valves.
Dr. Yazan Duwayri is conducting clinical trials at Emory University Hospital (EUH). As the EUH-based-site of the national PRESERVE-Zenith® Iliac Branch Clinical Study, the team is studying the safety and effectiveness of the Zenith® Branch Endovascular Graft-Iliac Bifurcation in combination with the Zenith® Connection Endovascular Stent/ConnectSX™/Atrium iCAST™ covered stent in the treatment of aorto-iliac and iliac aneurysms. The EUH group is also heading up the Emory-based site of the TX2® Low Profile TAA Endovascular Graft trial, which is evaluating the safety and effectiveness of the Zenith® TX2® Low Profile TAA Endovascular Graft in treating aneurysms/ulcers of the descending thoracic aorta.
Dr. Ravi Rajani, the director of vascular and endovascular surgery at Grady Memorial Hospital, is the local PI of the FDA-approved Zenith® Transection Clinical Study, which is assessing the safety and effectiveness of the Zenith® TX2® Low Profile Endovascular Graft in the treatment of patients with blunt injury of the descending thoracic aorta. Dr. Rajani and his team enrolled and treated the first patient in the national trial.
The HSR focus of the division as a whole, and particularly such faculty as Dr. Shipra Arya, is the ongoing evaluation of quality and effectiveness of vascular procedures and secondary prevention of vascular disease. Dr. Arya is currently investigating the impact of frailty and aging on surgical patients. She is also looking at resource effectiveness and cost effectiveness of various vascular surgical procedures and system processes.
Dr. Yazan Duwayri is the chief quality officer for the Division of Vascular Surgery and has led Emory's promotion of quality improvement in the treatment of vascular disease on a regional level. He managed Emory's inclusion in the Florida Georgia Vascular Study Group—a quality alliance of Florida and Georgia hospitals—and directs its participation in the Vascular Quality Initiative (VQI)—a consortium of regional quality groups that collects and analyzes perioperative and one-year follow-up data and generates real-time benchmarked reports in an effort to determine best practices in vascular surgery. By sharing and reviewing this data, the VQI's member groups initiate quality improvement projects to improve care. Dr. Duwayri instituted and pioneered an automatic data import mechanism which allows for accurate and cost-saving interaction between Emory's electronic medical record and the VQI database.