Patrick Peeters, chief, Department of Cardiovascular Surgery, Imelda Hospital, Bonheiden, Belgium, followed his father’s and grandfather’s footsteps into surgery. Specialising in cardiac, thoracic and vascular surgery, some of his greatest moments took place when he implanted endovascular devices for the first time. With rapid evolution in the endovascular world, “our cathlab has become a ‘museum’ of endovascular devices,” he says.
When did you decide you wanted a career in medicine?
Even when I was a little boy, I did not want to be part of the herd. I became a scout in my childhood, and that helped me to develop leadership skills and creativity. I was fascinated by the way you can construct things with toys such as model buildings and Meccano. It is interesting to see how bolts and iron rods can be turned into useful objects. You just need to add the right pieces together and aim for perfection.
In 1971, I started my studies as a Doctor of Medicine at the Catholic University of Louvain, as the third generation of surgeons in my family (my father and grandfather both were general surgeons). I graduated in 1978 with major distinction. My interest in medicine is probably in the genes. Yet, medicine was not enough for me. At the same time I was studying criminology. Criminology gave me the chance to develop a critical view on society.
Why vascular and thoracic surgery?
In medicine, I specifically enjoyed the course on vascular and heart surgery. This was very new and spectacular and caught my attention immediately. As I was consumed by this novel interest, one of the lines in my future career was drawn.
After graduating, I received further training at the Louvain University Hospital between 1978 and 1983. During this period I was trained as a general surgeon under the supervision of Jaques Gruwez, and as a cardiovascular and thoracic specialist under the supervision of G Stalpaert, R Suy, and G Deneffe.
Originally, I was to follow in the footsteps of my father, who had his own hospital, but because of my interest for vascular and heart surgery, this never happened.
I joined the Royal Belgian Society for Surgery in 1980 and the Flemish Surgeons’ Syndicate in 1982. In 1984, I was officially recognised as a general surgeon with cardiac, thoracic and vascular specialties. In August of the same year, I was appointed vascular and thoracic surgeon at the Imelda Hospital in Bonheiden, Belgium, where I am still active today.
How have endovascular therapies changed your career?
The introduction of endovascular therapy came as a tremendous gift to me. Even though I was trained as a classical vascular surgeon, these minimally invasive techniques were right up my alley. This new field of experience granted me a way to bundle my interests and creativity. I was lucky to be able to turn my hobbies (Meccano) into my work.
In 1987, I initiated my first peripheral endovascular programme, focusing on laser ablation of the superficial femoral artery. One year later, I became a member of the International College of Surgeons (Belgian Section) and the International Union of Angiology.
I became a member of the European Society for Vascular Surgery in July 1988, and have been a loyal adherent to the society ever since. In 1989, I became a member of the Union of Belgian Specialists (and its subdivision Professional Union of Belgian Surgeons).
In the beginning of the 90s, I developed an endovascular unit within the Imelda Hospital. Here, I performed and trained specialists in the newest endovascular techniques, comprising EVAR cases as well as peripheral percutaneous transluminal angioplasty and stenting. Within this setting, I organised workshops and trainings on a regular basis, next to my proctoring activities. Also, each year two international fellows receive endovascular training at the Imelda Hospital.
In 1991, I founded the Flemish Endovascular Surgeons, which offered a more structured and elaborate platform for the organisation of symposia and for the motivation and training of peripheral vascular surgeons in endovascular techniques. This is the reason why today vascular surgeons in Belgium perform endovascular procedures themselves.
In 1992, I was one of the founding members of the Belgian Society for Vascular Surgery.
You have founded a clinical research organisation with Marc Bosiers. How does it work?
We founded the Flanders Medical Research Program (FMRP) in 1995. This project grew out of the knowledge that one plus one is more than two. Instead of working separately on your own island, working together expands possibilities and results. This organisation gave us the possibility to do medical research, data management, copywriting and workshop organisation. If someone had told me during my student years I would be committing myself to rigorously collecting and writing down patient data in order to make further analysis of them, I would have laughed. Yet the FMRP platform granted us the possibility of doing this.
Participation in important clinical trials, which are likely to change patient care, is for me a source of gratification. Also having the opportunity to contribute to the education of young surgeons via workshops and training is very satisfactory.
Who has inspired you in your career?
Prof Suy inspired me in my career. He taught me a very good lesson of humility: “Pride comes before a fall.” Also Dr Ted Diethrich and Dr Julio Palmaz, who achieved some milestones in the endovascular field, are inspiring to me.
The recurring theme throughout all of this was the constant support of my father, who always taught me that kindness to the patient and competence are the cornerstones of medical practice.
Which technique/technology has had a profound effect on your career?
I remember the occasion when I learnt in a conference that Ted Diethrich and Giancarlo Biamino had used laser to treat a femoral stenosis. Of course, this made me curious. In our hospital there was a Yag Sharplan Laser available to gastroenterologists to do recanalisation of tumours in the rectum and colon. As these procedures were done under general anaesthesia, this laser was in the operating theatre. I then wondered: “Could we use this to treat artery stenosis?” This was the first tentative step towards an endovascular approach. The next step was the use of a guidewire and a balloon.
Congresses such as iCON, CX and VEITHsymposium still fascinate me. At such congresses, I can introduce new devices and techniques and discuss vascular disease with colleagues and their approach to treat them.
How has vascular surgery evolved since you began your career?
Amazing and fascinating things have happened over the past 20 years. Endovascular techniques have become less invasive and efficient; for example, the treatment of abdominal aortic aneurysms with an endoprosthesis. This was a great evolution, and is so much better for the patient. More new and promising devices are on the market. I participated in a lot of trials with new endovascular devices. Our cathlab has become a “museum” of endovascular devices.
What have your proudest moments been?
My proudest professional moments are: The first implant of a nitinol self-expandable stent (1991), the first implant of an endoprosthesis (1995, together with Claude Mialhe), the first endovascular intervention in a carotid lesion with a 0.035” device and the first implant of a bioabsorbable stent. Seeing a patient who could not walk being able to walk again makes me happy and proud every time. Patient care is always rewarding.
How do you see the vascular surgical field developing in the future?
There will be more and more need for prevention of atherosclerosis. More efficient devices and techniques will become available. Gene therapy will probably expand.
What are your interests outside medicine?
My interests outside medicine are playing golf, sailing and travelling. I also like Burgundy wine.
Training and activities
1978 Doctor of Medicine, major distinction, Catholic University of Louvain
1982 Licentiate in Criminology, Catholic University of Louvain
1984 Recognised as general surgeon with cardiac, thoracic and vascular speciality
1984 Employed as vascular and thoracic surgeon in the Imelda Hospital in Bonheiden, Belgium
1985 Chief of the department of Cardiovascular Surgery
- Training of General Surgery, Catholic University of Louvain (Supervision Prof J Gruwez)
- Training of Cardio-Vascular and Thoracic Surgery, Catholic University of Louvain (Supervision Prof G Stalpaert, Prof R Suy, Prof G Deneffe)
- Royal Belgian Society for Surgery (RBSS)
- Belgian Society for Vascular Surgery (BSVS) – treasurer 1996–2000, secretary 2000–2002 and 2006–2010, president 2002–2006 and since 2010
- Working group of Endovascular Surgery and Diagnosis Department of the Belgian Society for Vascular Surgery – president 1996–2008
- International Society of Endovascular Specialists (ISES) – member of the Board for International Relations since 1996, treasurer 1998–2004, secretary since 2005
- International College of Surgeons (Belgian section)
- International Society for Cardio-Vascular Surgery (ISCVS)
- European Society for Cardio-Vascular Surgery (ESCVS)
- European Society for Vascular Surgery (ESVS)
- International Union of Angiology
- Member of the editorial board of Journal of Endovascular Therapy, Endovascular Today, Tijdschrift voor Geneeskunde, and Acta Chirurgica Belgica
- Reviewer of Journal of Endovascular Therapy, Endovascular Today, and Acta Chirurgica Belgica
- 123 publications
- 464 lectures
- Involvement in 89 congresses