“A yearly hub for innovation in vascular access”: i-VAS 2019 and beyond

Alexandros Mallios

Following the 2019 International Vascular Access Symposium (i-VAS 2019; 13 September, Paris, France), current president Alexandros Mallios talks to Vascular News about his highlights of this year’s meeting, what we can look forward to next year, and what makes i-VAS stand out in the field of vascular access.

Can you provide a brief history of the i-VAS meeting?

I did my Vascular Surgery fellowship in Tulsa, USA, between 2012 and 2014. When I went there, I was already fully trained as a Vascular Surgeon in Europe and already fairly experienced in Vascular Access surgery. I realised that between the USA and Europe there are significant differences in the way things are being done and none was superior than the other they were just different and complementary. I discovered the Proximal Radial Artery Fistula and other interesting techniques with the pioneer of “Fistula First” William C Jennings (goes by Tip), who then became my mentor and friend and I realised that although in the beginning I thought I knew everything, there was still plenty of stuff to learn. As Tip says very wisely and with a perfect southern accent: “People don’t know what they don’t know”. I was a very good example of that (laughing would go here if it was to be reproduced as a live interview).

When I came back I decided to do a meeting that will bring the two worlds (America and Europe) together for an intense meeting, focused in Vascular Access and innovation, with live cases and debates where industry has the opportunity to expose all the new material that is being developed, presented by the people with the widest experience world-wide. I asked Pierre Bourquelot and William Jennings to be my co-directors and then the rest is history.

Now in its second year, how has i-VAS developed since the inaugural meeting?

Being kind of a “new kid on the bloc”, as far as organising meetings is concerned, there is a big challenge in organising a meeting that is yearly in a sense, that you want to have all the big names and the interesting stuff presented but in the same time trying to avoid repeating yourself.

This year we had more people presenting that were not available last year, including Tobias Steinke and Charmaine Lok, colleagues that are definitely top notch in the field of vascular access, people who know their stuff and when they present the audience is captivated. We also had Bob Lee from the FDA and Pr. Amabile representing the equivalent authority in France, who explained what the processes are for new devices to get approved and used in both continents.

We also had more partners from the industry presenting lots of interesting new technologies and data, like the Hero graft, the inside out surfacer and the VasQ external support, while I shouldn’t forget to mention that we supported the humanitarian actions with a presentation from BOL regarding the work that is being done in countries of the third world where experts go as volunteers to do vascular access surgery under very difficult conditions, I was blessed to participate to quite a few in Jamaica and Guatemala where we did adults and children respectively.

What makes i-VAS stand out in the field of vascular access?

I-VAS was created with a vision to be a yearly hub for innovation in vascular access. There are really not so many international meetings focused in vascular access and even less in new innovative technologies. If you go to all the big meetings like CX, Veith, CACVS, CIRSE, there is always a vascular access session, but it is always in the periphery. People go there to listen other more sexy stuff. If I had to choose between a presentation by Stephan Haulon on branched stent grafts for the aortic arch or percutaneous fistulae by Mallios et al, I would probably go to listen to Stephan!

So, we really need a dedicated forum where people will join from all continents, Paris is very central (and beautiful) and this helps a lot.

Also, we are not hesitant to acknowledge the central role of industry in pushing technology forward. I believe there is a level of hypocrisy when people are pointing fingers around when someone is a consultant or shareholder for a company, as if it means that he is not independent anymore when he expresses his scientific opinion. Conferences cannot happen without the money from the industry, while research and new products are the same. Universities and governments cannot follow any more and support this expensive modern medicine in a world where resources are more and more scarce and budgets more and more tight.

Everyone has biases for whatever reasons, it can be because of his financial interests or his own personal bad experience with a product, or just because he thinks that what he does is always the best—a very common place for surgeons. For me things are simple; when you go up on the podium, you put up your disclosures, which are public data anyway most of the time, you put up your slides and your arguments and the audience will judge if you are a colleague worthy of respect or an industry puppet.

That is what i-VAS is all about—everything on the table.

What are your highlights of the i-VAS 2019 meeting?

I believe the two lives of the pAVF technologies would be the one that I would choose, although many other presentations were amazing. For the first time we had a live case for both Ellipsys and Wavelinq. Our case was uneventful as usual but we did it locally and we have done already so many in many conferences, including CiDA last year where BD had a great video case presented by Erik Peden. Panos Kitrou from Patras, Greece did a very good job this year and we all know how challenging it can be to do a live case especially for a new device and for the first time in the world ever. We had Tobias Steinke who has big experience with Wavelinq and while Panos was doing his case Tobias explained lots of tips and tricks and potential pitfalls for the device: that was really very cool and helpful. We had some connection problems but this is just an opportunity for improvement next year.

What can we expect from the next meeting?

Lots of new things are coming… We will change the venue in order to have more space for attendees and booths, more space for workshops also, better acoustics and better overall conditions in the room that were in good for the first two years but need to get better as we move forward. We will also add half day more, in order to have a dedicated time for hands-on workshops only for all industry partners, and also allow more time for presentations and discussions as I think that this year the programme was too dense and as a result we finished too late. People may have better things to do on a Friday night in Paris.

We will also add on site translation with personal headsets—given that lots of our attendees are French speaking this might improve the understanding and exchange of opinions. I am also working in partnership with other meetings and colleagues—we will try to keep everyone excited… stay tuned.

In the digital age, why is it important to continue to attend meetings such as this?

I am pretty much a “high tech junkie” myself, but I can tell you that conferences will always remain relevant because humans will always need the personal contact that cannot be replaced by the internet and digital technology. Sure, you can watch and study a technique over the internet and see an expert doing a case on YouTube, there is nothing wrong with that; we should all do it, as it is great and very efficient training, but meeting the actual person live, asking him questions, networking with your colleagues and industry, shaking hands and even having a glass of wine together at the end of an intense day of scientific brainstorming are all part of a healthy social life that we need to maintain and cannot be replaced by technology.


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