Residency and Education

Vascular Surgical Fellowship

4 minute video about the program

The Vascular Surgical Fellowship at Loyola University Medical Center was created in 1978, with the primary objective of providing comprehensive training for the management of arterial and venous disease. In addition to the clinical strength we offer at Loyola, combined with the Hines VA, we have an established tradition in graduate and undergraduate education and research. Clinical research is encouraged during the fellowship, and basic science research is available to those interested. Our program is a two-year fellowship that provides exposure to the entire spectrum of arterial and venous disease, and includes non-operative care, as well as open surgical and endovascular management. The fellowship also includes exposure to clinical research and non-invasive vascular laboratory training, the latter being particularly essential for the armamentarium of future vascular surgeons.

Clinical Fellows divide their time and rotate between the Foster G. McGaw Hospital at the university campus and the Hines Veterans Affairs Hospital.  These institutions are located within one block of each other in Maywood, Illinois, west of downtown Chicago. Foster G. McGaw Hospital (Loyola University Medical Center) is a 500-bed University Hospital that generates at least 250 major vascular cases per year.  The Hines Veterans Affairs Hospital has approximately 520 beds and performs 200 major vascular cases per year. The Loyola University service is headed by Dr. Peter Kalman, and the VA service by Dr. Fred Littooy. 

The Loyola Medical Complex is an academic center that strongly emphasizes patient care, in addition to research and education. This tertiary care center offers the spectrum of open vascular and endovascular procedures, with cerebrovascular, aortoiliac and infrainguinal occlusive disease, abdominal aneurysms, visceral arterial disease and venous surgery. The vascular service at Loyola supports the facility’s busy Level I trauma Center. The vascular case volume of both open and endovascular cases easily fulfills the requirements of the Vascular Surgery Fellowship requirements of the American Board of Surgery, and all fellows to date have far exceeded this goal. In addition to the operating room experience, the fellow will be expected to supervise the vascular house staff for inpatient care and actively participate in the ambulatory clinic as well.

 The vascular surgical fellowship at the Loyola University Medical Center is geared to but not exclusive to, the surgeon who is interested in an academic career.  The first year of the fellowship emphasizes acquiring endovascular techniques, vascular laboratory background and skills as well as initiation of clinical research projects. It is expected that the projects developed will be completed over the 2-year fellowship. In the second year, the vascular fellow will be exposed to a broad spectrum of clinical experiences that should enable the candidate to become an excellent vascular surgeon with both open and endovascular skills.

 FACULTY

Dr. Howard P. Greisler

 Dr. Howard Greisler began his surgical education at Columbia University in New York.  After completing his vascular fellowship, he began his academic appointment as a member of the faculty at Columbia. Two years later, in 1983, he joined the faculty at Loyola.  Dr. Greisler commits fifty percent of his time pursuing his basic science interests, in addition to his clinical activity. He has demonstrated sustained excellence as a clinician-scientist, and has continuous NIH Funding for the past 23 years. He currently has an RO1 award and two F32 awards, plus a VA Merit Review award as well as industry grants. Dr. Greisler is a past President of the Midwestern Vascular Surgical Society and the International Society for Applied Cardiovascular Biology. Noted among his extramural appointments, he is Chairman, NIH/NHLBI, Special Emphasis Panel (Innovative Concepts and Approaches to Developing Functional Tissues and Organs for Heart, Vascular, Lung and Blood Applications: Exploratory/Development), and is Chairman, Lifeline Foundation Research & Education Committee. Dr. Greisler has mentored numerous surgical and medical fellows, graduate students and postdoctoral fellows. He serves on the editorial board of seven journals.

Dr. Bernadette Aulivola

Dr. Aulivola is the most recent addition to the vascular faculty at Loyola.  She is a native of New York and a graduate of Washington University School of Medicine in St. Louis, MO.  She obtained her general surgery training at the Rush University Medical Center/ Cook County Hospital program in Chicago, and completed a vascular fellowship at the Beth Israel Deaconess/ Harvard Hospitals program in Boston. Dr. Aulivola was awarded the Marco Polo Traveling Scholarship which is an international award sponsored by the Society for Vascular Surgery and the European Society for Vascular Surgery to support the exchange of vascular surgical trainees between North America and Europe. With this award, Dr. Aulivola trained in advanced endovascular techniques at the University of Bologna and several other medical centers in Italy. Her areas of specific interest include carotid artery stenting, endovascular AAA repair and complex distal lower extremity revascularization. 

Dr. Marc Borge

Dr. Borge is Associate Professor, Departments of Radiology and Surgery, and is the Director of the Vascular and Interventional Radiology Section of the Department of Radiology.  Dr. Borge and the Division of Vascular Surgery have developed a collaboration that has enriched the experience of the vascular fellows by exposing them to endovascular techniques by another discipline with a different background. This relationship is expected to continue and grow in the future.

 2-YEAR FELLOWSHIP CURRICULUM

 Vascular surgery is a mature program at Loyola, and has been complemented by the development of our endovascular program.  We offer the complete spectrum of endovascular training that includes diagnostic arteriography, balloon angioplasty of peripheral and visceral arteries (renal, mesenteric), carotid angioplasty and stenting, endograft repair of abdominal and iliac aneurysms.  The endovascular program that has been developed complements our open vascular surgery experience, which includes both routine and complex procedures (aortic aneurysm and occlusive disease, lower extremity bypass, carotid endarterectomy, mesenteric and renal artery bypass, venous surgery, vascular access for hemodialysis).

 Two-Year Vascular Surgery Fellowship Program

 A) Objectives
       a)      Inpatient and outpatient care of the patient with arterial and venous disease
       b)      Identification and management of co-morbidities prior to planning intervention
       c)      Performance, interpretation and application of non-invasive vascular
                laboratory diagnosis
       d)      The ability to provide the best treatment options (conservative and open vs.
                endovascular)
       e)      Open vascular surgery - routine and complex procedures (aortic aneurysm
                and occlusive disease, lower extremity bypass, carotid endarterectomy,
                mesenteric and renal artery bypass, venous surgery, vascular access for
                hemodialysis).
        f)      Endovascular intervention - diagnostic arteriography, balloon angioplasty of
                peripheral and visceral arteries (renal, mesenteric), carotid angioplasty and
                stenting, endograft repair of abdominal and iliac aneurysms)
        g)     Designing and conducting clinical vascular outcomes studies
 

B)  Curriculum 

Principles of Two-Year Curriculum    

       1)      Two sites for vascular and endovascular surgery (LUMC & Hines VA)
       2)      Responsible for 2 vascular fellows & 1 general surgery chief resident
       3)      Senior fellow & chief residents to switch between LUMC & Hines VA
                every 2 months
       4)      Junior fellow will perform endovascular interventions at both institutions where
                the Chief resident is stationed (i.e. senior fellow will perform the endovascular
               cases where he/she is stationed)

 1) First Year Curriculum (Junior Fellow)

Clinical Research (dedicated)                                           12 months
Non-invasive vascular laboratory
Endovascular

NOTE:

       1)      Flexibility to add electives as requested by individual (e.g. atherosclerotic
                risk factor modification, high risk cardiac assessment)
       2)      Open vascular surgery (when 2 rooms are open, when senior fellow or chief
                resident are on holiday)
       3)      Clinical research projects that are initiated will continue throughout the
                 fellowship
       4)      Share responsibility for conferences
       5)      Share in call schedule

2) Second Year Curriculum (Senior Fellow)

Open and Endovascular interventions                 12 months
(Senior Fellow has priority for case selection)

 Administrative Responsibilities        Call schedule (house-staff)
                                                       Clinic schedule (house-staff)
                                                       Operating Room (house-staff)
                                                       Conferences
                                                       Documentation of M&M

C) Curriculum Description

1) First Year Curriculum (Junior Fellow)

i) Clinical Research                                                       

The skills for performing clinical research and the initiation of the projects will be a focus of the junior fellow.  The projects initiated are expected to continue over the two-year fellowship.

Specific skills:

 ii) Non-invasive vascular laboratory                              

             a)      Theory - vascular ultrasound physics (as defined by ARDMS)
             b)      Hands-on experience performing the entire spectrum of non-invasive
                       vascular testing
             c)      Interpretation of studies
             d)      RVT certification (ARDMS) - the fellow will be expected to apply for
                      and obtain RVT certification

 iii) Endovascular

             a)      Radiation Safety - understanding of the principles and practical guidelines
             b)      Training – within Division of Vascular Surgery, with selected training with
                       Interventional Radiology (e.g. Carotid arteriography)
             c)      Diagnostic Arteriography - demonstrate skill in the use of various
                      endovascular tools & techniques
                      1)    Needles, guide wires and various catheters
                      2)    Various arterial access picture sites (femoral, axillary, brachial)
                      3)    Arterial sheaths – indications, placement
                      4)    Closure devices
                      5)    Contrast agents and their differences (ionic contrast, non-ionic
                             contrast, hyper/hypo osmolar)
                      6)    Injector machines
                      7)    Selective catheterization of primary, secondary and tertiary arterial
                             beds (innominate, carotid, subclavian, aorta, internal iliac, renal,
                             visceral, femoral, popliteal, tibial)
                      8)    Angioplasty and stenting (indications and techniques)
                      9)    Arterial and venous thrombolysis (principles, indications,
                             contraindications, techniques)
                    10)    Venous interventions (cannulation, venography, angioplasty, stenting,
                              IVC filter placement
                    11)    Aortic endografts (principles, indications, techniques, various devices
                             available)
 

2) Second Year Curriculum (Senior Fellow)

i) Open and Endovascular interventions              12 months

ii) Administrative Responsibilities