Margaret Rigamer, MD Vascular Fellow (PGY-7) Margaret.Rigamer1
VCU Vascular takes top honors in skills competition at 2015 National Vascular Surgery Conference Learn More.
The Vascular Surgery Fellowship at Virginia Commonwealth University is a fully accredited two-year Fellowship Program, satisfying all requirements of the American Board of Surgery for Certification in Vascular Surgery.
Recent graduates from our Vascular Fellowship program completed between 675 and 885 vascular surgery cases over two years.
2015-17 Vascular Fellow: Alexander Nguyen, MD
The Fellowship is structured in four sequential rotations, each 6 months in length. The Fellowship training is a coordinated effort among all of the Vascular Surgery faculty at VCU Medical Center, as well as the Interventional Radiology faculty.
1st Rotation: The first 6 months, the Fellow rotates on the core Vascular Surgical Service at MCV Hospitals, the teaching hospital component of the VCU Medical Center. During that period of time, the Fellow is exposed to both core conventional open Vascular Surgery as well as many advanced endovascular procedures including carotid stenting, renal stenting, and percutaneous lower extremity revascularization. During this rotation the Fellow begins to develop their expertise in both Endovascular Aneurysm Repair (using both percutaneous and open femoral exposure), as well as Thoracic Endovascular Aneurysm Repair (TEVAR).
Most advanced vascular procedures are currently performed in VCU’s advanced Endovascular Operating Room Suites. Clinical pre- and post-operative experience is provided weekly during a continuity clinic, where the Fellow develops longitudinal patient relationships that span the two years of the Fellowship. While working on this core rotation, the Vascular Fellow is usually working together with two General Surgery Residents and the Vascular Service Nurse Practitioner.
2nd Rotation: During the 2nd 6-month rotation during the Fellow’s 1st year they pursue a dedicated Interventional Radiology Rotation, with focus on performance of the wide breadth of that field. During this rotation, the Fellows fine tune their percutaneous access skills, and continue to perform routine carotid, aortic, renal, and lower extremity revascularization. In addition they develop advanced micro-catheter skills often utilized in the context of chemoembolization cases that they perform together with the Interventional Radiology staff. They develop expertise in management of dysfunctional and thrombosed dialysis access during this rotation. Cases are all performed in several state-of-the-art Interventional Suites on the MCV campus.
In addition, during this 6-month Interventional Rotation, the Fellows develop increasing expertise in venous ablation for varicose veins. Utilizing both laser as well as radiofrequency ablation, the Fellows perform these procedures both at the MCV campus of VCU as well as at the newly opened Baird Vascular Institute, a joint outpatient team effort spearheaded by both VCU Vascular Surgery and Interventional Radiology.
3rd Rotation: The third 6-month rotation for the VCU Vascular Fellow spans from July through December of their 2nd Year and has a dedicated focus to ambulatory and community based Vascular Surgery.
During this rotation, the Vascular Fellows work together with the VCU Vascular Surgery faculty at John Randolph Medical Center in Hopewell, performing primarily lower extremity revascularization, carotid endarterectomy and creation and maintenance of dialysis access. The Fellow is exposed to routine Vascular Surgery practice in a community setting.
Simultaneously during this rotation, the Fellows work in the outpatient environment of Baird Vascular Institute, continuing to develop their expertise in outpatient lower extremity revascularization, and venous ablation. While at Baird Vascular Institute and at John Randolph Medical Center patients who are evaluated with more complex aortic pathology are often offered surgical procedures at VCU Medical Center. In those circumstances, the Fellow returns to the MCV campus to perform those procedures.
During the Interventional (2nd) and Ambulatory/Community Based (3rd) Fellowship Rotations, the Fellows begin their dedicated training in the preliminary interpretation of Vascular Laboratory studies. The VCU Peripheral Vascular Lab performs over 10,000 peripheral vascular studies per year providing ample experience for the Fellow to eventually qualify for their RPVI credential.
4th Rotation: During the 4th and final 6-month rotation, the Vascular Fellow returns to the core VCU Vascular Surgery rotation. Here, with graduated responsibility, they work together with all of the Vascular Surgery faculty performing advanced vascular and endovascular procedures commensurate with their level of training.
The Division of Vascular Surgery at VCU has several ongoing clinical research programs underway, including outcomes research related to lower extremity revascularization using various endovascular techniques.
Recent Vascular Fellows have presented their work at regional and national meetings on a variety of topics including lower extremity bypass, dialysis access, aneurysm management, and upper extremity deep venous thrombosis management. Although there is no dedicated research rotation at present, our current Fellows find adequate time to work on clinical research projects particularly when they are on their Interventional and Ambulatory/Community Based rotations.
DIVISION OF VASCULAR SURGERY—Overview
Vascular Surgery at VCU provides clinical services at multiple venues, including the VCU Medical Center, the McGuire VA Medical Center, Baird Vascular Institute, and John Randolph Medical Center. Each of these locations is geographically distinct and each of these rotations is distinct in terms of their house staff presence. Senior Residents in General Surgery do their primary rotations in Vascular Surgery at the McGuire Veteran’s hospital, while the Vascular Fellows do their core Vascular Surgery rotations at MCV Hospitals.
Throughout the two-year Fellowship, the Fellows attend core teaching conferences in the Departments of Surgery and Interventional Radiology, including a bimonthly Dialysis Access Conference (founded by a VCU Vascular Fellow), General Surgery Grand Rounds, General Surgery D&C Conference, and Vascular Surgery D&C Conference.
However, in addition, we provide a core Interdisciplinary Vascular Basic Science Conference each Tuesday morning — which is widely attended by both VCU and Community Vascular Surgeons, as well as VCU Interventional Radiologists, VCU Cardiologists, Peripheral Vascular Lab technologists, General Surgery Residents, and Medical Students. Working together with other residents, the Vascular Fellow is introduced to core concepts during this Teaching Conference. Monthly Journal Clubs round out the regular didactic schedule by introducing current Vascular and Endovascular Literature.