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Improving care for those living with vascular disease

Stephen Black talks about how he and his colleagues have improved the healing rates of ulcers from under 30% to more than 80%. 

This Valentine’s Day, we went speed-dating with colleagues at King’s Health Partners Cardiovascular to find out how the work they’re doing is improving patient care.

Stephen Black [pictured right], tell us about yourself stephen black

I am a consultant vascular surgeon at King’s Health Partners and a reader in venous surgery at King’s College London. I am currently clinical lead for vascular surgery and co-lead for cardiovascular research and development.

Vascular disease – both arterial and venous - has a significant impact on both length and quality of life. My area of focus, venous disease, has long been the Cinderella story of vascular disease, being largely, unstudied, but at King’s Health Partners we are slowly redefining that. I love that we have the potential to fundamentally change people’s lives by delivering cutting-edge care in a world class centre.

What are you looking for to improve outcomes and patient experience for those with cardiovascular disease in south east London? 

The two principle areas I am currently focused on are improving the care for patients with leg ulcers and for those who have suffered from deep vein thrombosis (DVT).

In the leg ulcer field, we recently completed a novel project called “Leg Ulcer Pathway Audit” (LUPA) which tried to accelerate the care of leg ulcer patients from our community. In doing so we have improved the healing rates of ulcers at one year from under 30% to over 80%.

We also engaged in an active project to improve outcomes for patients suffering from DVT and its consequences, such as the Venous Thrombus Extraction study (VETEX) in which we performed a first in man study of a novel clot removal device and the CLEAR DVT Study where we are leading a multi-national team in six sites evaluating clot removal techniques.

Both projects would not have been achievable without the significant breadth of resource, in both people and facilities, available at King’s Health Partners. The LUPA project engaged vascular surgeons and interventional radiologists, nurses in both the hospital and primary care settings, administration teams and the world class facilities available to us, for example Magnetic Resonance Imaging (MRI). My colleagues have truly advanced techniques; we have a superb breadth of interventional radiological talent.

In the DVT projects we have drawn on the fantastic translational research capacity afforded by the laboratory run by Professor Alberto Smith and supported by Praksash Saha, Professor Bijan Modarai and Ashish Patel. This has enabled us to develop genuinely cutting-edge research projects where we can look for biological markers to directly patient benefits.

Additional projects have drawn on the amazing cardiological practices of Professors Ajay Shah, Phil Chowiencyk and Mike Marber, the Imaging Sciences created by Professor Reza Razavi and Pulmonolgy and Anaesthology, Dr Phil Marino and Dr Aimie Brame, to develop a novel physiological study to evaluate patients with chronic blood vessel blockage of the inferior vena cava (a large vein that carries de-oxygenated blood from the lower body to the heart) - also known as the EXERT study.

The two research fellows running these projects, Adam Gwozdz and Rachael Morris, and the research nurses, Audrey Hau, Lilly Bento and Federica Francia, mean that we have a truly incomparable team. When this is allied with our exceptional nursing teams on the clinical front (ward and theatre) King’s Health Partners Cardiovascular is immensely well positioned to be at the cutting-edge of future research endeavours, such as the VETEX study. 

Are you looking for something long-term? Where would you like to see this project going?

With the VETEX study we hope to get the new device through the 30-patient safety evaluation and then move to a larger study. The potential for VETEX is to allow us to treat clots more safely, by eliminating the need for lytic drugs which cause bleeding, and more quickly, to allow for cost efficiencies.

Along with LUPA and EXERT our hope is that we can use these results to make our treatments better from a clinical perspective and more cost effective for the NHS. We hope to realise the potential benefit to a broad patient population in the south east and, by leveraging the leadership position that King’s Health Partners is privileged to hold, influence treatment for these patients throughout the country and beyond.

Valentine’s Day is all about partnerships.  What do you value most about being part of King’s Health Partners?

King’s Health Partners enables synergies to be developed between multiple world class individuals that becomes bigger than the sum of its parts. We can step out of our silos and utilise the incredible ground-breaking work going on around us to harness these novel techniques to directly enhance the care we offer to patients.

King’s Health Partners has a long history of being at the forefront of medicine. In my field, venous, we have a distinguished line of pioneers – Professor Kevin Burnand, Professor Norman Browse, Kinmonth, Frank Cockett – and so on who allow us to have instant recognition on a world stage. This means that as we build on this legacy, King’s Health Partners will continue to drive positive change and developments for patients the world over. Resource, scale, innovation, position – all factors that create a wonderful place to be an innovator and clinician.

Our speed-date with Dr Stephen Black is part of a Valentine’s Day series. Don’t miss our Valentine’s Day interviews with Ronak Rajani, who explores how his and collegues’ world first procedures deliver personalised patient care, and the Education Working Group on delivering education for world-leading clinicians

Interested in learning more about King’s Health Partners Cardiovascular? Visit the Institute’s webpages.