Dr. Matthew Eagleton, President of the Society for Vascular Surgery and chief of vascular and endovascular surgery at Massachusetts General Hospital, joined Fierce Healthcare to discuss the evolving landscape of vascular care and why public awareness is more critical than ever.
In the wide-ranging interview, Eagleton outlined the changing nature of vascular surgery training, noting how residency pathways have evolved to streamline education while still producing skilled specialists. He also described how technological advancements, particularly in endovascular techniques, have significantly reduced patient recovery times and surgical risks.
“Patients with vascular disease often have other serious health conditions,” Eagleton said. “Less invasive procedures mean we’re minimizing stress on already vulnerable patients.”
Despite these improvements, Eagleton emphasized that vascular disease remains under-recognized, both by the public and within medical school curriculums. With an estimated 100 million Americans expected to be at risk by 2030, he called for greater education and proactive screening.
Looking ahead, Eagleton pointed to the promise of artificial intelligence in tailoring care pathways and improving decision-making in treatment planning. “AI will help us personalize vascular care in ways that just aren’t possible manually,” he said.
To learn more about the future of vascular health and hear Dr. Eagleton’s full insights, watch the complete interview.
Chris Hayden:
Welcome everyone, and thank you for tuning in today. My name is Chris Hayden. I am a producer with Fierce Healthcare, and today I'm joined by Dr. Matthew Eagleton. He's the President of the Society for Vascular Surgery and the Chief of the Division of Vascular and Endovascular Surgery at Massachusetts General Hospital. Dr. Eagleton, welcome today. And I'd like to give you a moment if you could introduce yourself to our audience.
Dr. Matthew Eagleton:
Thanks, Chris. I very much appreciate that opportunity. My name is Matt Eagleton. I'm a vascular surgeon by training, and I am the Head of Vascular Surgery for the Mass General Brigham System, which is a new system that's developed with the integration of both the Mass General Hospital program and the Brigham and Women's Hospital program. I'm also currently the President of the Society for Vascular Surgery. One of the reasons I'm here today is to educate the public about what vascular disease is and why it should be important to them.
Chris Hayden:
Excellent, excellent. I know there's a lot of consolidation in the Boston area for hospitals right now.
Dr. Matthew Eagleton:
There is. It's certainly a dense area for academic medical centers as well as other medical centers, so it's a great environment to live in.
Chris Hayden:
Exactly. I'll be honest, for the audience, I'm a New Englander as well, so there's a dear place in my heart for Mass General and Brigham. So, thank you for joining us today. Really appreciate it.
So, we'll just jump right into the questions here. And I'd be curious, Matt, I'd love to hear, how has your training informed your approach to treating patients?
Dr. Matthew Eagleton:
Training to become a vascular surgeon takes years. And it has changed over the past couple of decades about how we can get trained in vascular surgery and what that training entails. Historically, in a program that I was part of, once you'd finished medical school, you would go on and do a general surgery training and become a general surgeon or a board-certified general surgeon. That takes anywhere from five to seven years, depending on the program you're enrolled in.
After that, to get additional vascular training, you would do what's called a vascular fellowship, which is additional two years of training to focus almost exclusively on vascular disease with vascular surgery. We recognize that's a long period of time for people to be in training. And many people are in the middle of their lives once they've reached the end of that training. In an effort to train more vascular surgeons and to shorten that process by at least a couple of years, we developed a vascular residency program where people can go into vascular training right out of medical school. And those years of training are between five to seven years. The five to seven years in both instances are usually because people at some point in the middle of their training decide they want to do additional training or additional research or those sorts of things to enhance their academic potential longer term. And that's why I have a range there.
So since about 2006 or 2007, we've had this direct pathway from medical school into vascular surgical training. For people like me who are on the beginning of the endovascular revolution where that became a more prominent thing for vascular surgeons to perform, I also did additional training at the Cleveland Clinic at the end of my standard vascular surgery fellowship to gain those skills so that I could become more proficient at those types of procedures. We don't see separate endovascular training occur much anymore as it's really been ingrained in our culture, ingrained in our specialty. And most vascular surgeons get plenty of that during their conventional vascular surgery training now.
Chris Hayden:
Sure. Now, where was your schooling done, Matthew? Did you do your schooling in Boston?
Dr. Matthew Eagleton:
I did not go to school in Boston. I actually moved here about seven years ago to become the Director of Vascular Surgery for the Mass General Hospital at that time. I did my medical school and general surgery at the University of Rochester in upstate New York. I did my vascular surgery fellowship at the University of Michigan in Ann Arbor. And then I did an endovascular fellowship at the Cleveland Clinic. I then stayed at the Cleveland Clinic as faculty until about seven or eight years ago before I moved to Boston.
Chris Hayden:
That's great. That's quite the road. Now, I'm really curious about this question. I'm looking forward to your answer here. But how would you describe the transformation of vascular care in the last 20 years?
Dr. Matthew Eagleton:
It's been a significant transformation in the past 20 years. I alluded to that already with the endovascular revolution. When I was in training, vascular surgery was predominantly done by what's called conventional or open surgery, where we'd make incisions on patients, sew on blood vessels. And that's still appropriate in many situations, but we are always striving to provide something better for our patients in newer technology. And one of the things that has become an exciting way to treat patients is endovascular care, endovascular surgery, or endovascular interventions in which we can treat people without making large incisions. We can treat them percutaneously or through small incisions using balloons such as angioplasty balloons like we talk about with heart disease, using stents also like we talk about with heart disease. But we can use those in the peripheral body as well. And that has changed our approach to treating patients with significant vascular disease.
Patients who have vascular disease aren't a healthy group of patients at baseline. They often have a number of other comorbidities. And so if we can limit the stress we're inducing on these patients by doing a less invasive procedure, they're likely to benefit from that in the long run.
Chris Hayden:
I love that. I love it. That is fascinating. Now, this is a good question as well. How has the importance of vascular health changed over the years, with diet, obesity, and those kinds of things?
Dr. Matthew Eagleton:
I think vascular disease as an entity has not been a mainstream topic for anybody. I don't have a good explanation for that. If we look even at medical school curriculums currently, it's not usually a big ticket item on their agenda. And we don't know why. Vascular disease is prevalent throughout the United States, it's prevalent throughout the world.
In the United States, they're estimating by 2030 that there will be a hundred million adults who are at risk for developing significant vascular disease. We don't have enough physicians that know about this disease, how to identify it (or how to identify it early). And then what steps can we take to help prevent vascular disease from getting worse. And in what instances should they be referred to an expert in order to provide them the treatment that would help them improve the quality of their life or prevent something catastrophic from happening, such as an aneurysm rupture or a leg amputation or any of those sorts of untoward events.
Chris Hayden:
And kind of follow up on that, where do you see the future of vascular surgery heading?
Dr. Matthew Eagleton:
Vascular surgery plays an important role as part of a medical care team, I think. I think that's something that we have already seen start happening, and we're going to continue to see that happening where it's not just a single person who's taking care of patients with vascular disease. It does take a whole team. It takes a village, if you will. We will rely on primary care providers to help do the day-to-day management of some patients. We will work in collaboration with interventional cardiologists who also provide some procedures, cardiologists, vascular medicine specialists, and interventional radiologists who also provide some procedural support. So, that's a group of people that need to work together in order to meet the needs of this growing population of people who are going to be at risk for having vascular disease.
I think we also have to do a better job of engaging with our medical schools and having them understand this is an important disease process that's been gaining prevalence in the United States and in the world, and have that be a stronger part of the curriculum so that more people know about it. And we need to continue to educate the public to help achieve that goal.
The Society for Vascular Surgery to help do that this year, launched its Highway to Health program, which is really out there to alert the public to this health problem, let them know what it is, who they should talk to about it. But also to alert our colleagues and our other physician partners that we work with what this disease process is. And what they should be looking for in their patients and when they should consider a referral to a vascular surgeon or to another vascular specialist.
Chris Hayden:
Now, Dr. Eagleton, it's hard to have any kind of conversation in healthcare right now without talking about AI, so I apologize, but we have to address it. And again, I think this is a fascinating facet to this, but what role do you think artificial intelligence or other technological advances will play in vascular care in the future?
Dr. Matthew Eagleton:
Are we waiting for artificial intelligence to tell us how we're going to be utilizing it?
Chris Hayden:
Yes, we are.
Dr. Matthew Eagleton:
So, the answer I give is just a mere human. I don't have artificial intelligence in me yet. So, I think artificial intelligence will play a huge role in a number of aspects of medical care. But if I focus more specifically on vascular problems, vascular disease, I think there are two areas where we'll see it be extraordinarily helpful.
I think one of them will be helping to identify patient care pathways for specific patients. Vascular disease isn't caused by a single gene that gets flipped on or flipped off. There's a number of different factors that play into whether patients develop a disease somewhere in their body or don't. It can be genetics, it can be social, it can be environmental, it can be familial. And we don't have a clear way to identify this person's going to get this problem and we should be aware of that early on just based on a number of risk factors.
And I think AI will help us with that complex system analysis to be able to provide more personal level care to patients. Instead of this being sort of a herd mentality, we'll treat the group. We can say, "We'll treat this patient with specific information about them, specifically, and identify the best patient care pathway for them."
I also think it'll provide us with help in understanding which procedures are appropriate for which patients. We have a lot of discussion about the quality of healthcare we provide. And is conventional surgery in one situation better than endovascular therapy in the same situation? And which one should we choose in a specific patient at which time? And it's going to help us identify those algorithms as well.
Chris Hayden:
Yeah, that's fascinating. I love that. Well, Dr. Eagleton, thank you so much for joining us today. I really appreciate your time and your expertise and the conversation. So just want to remind everybody, my name is Chris Hayden. We have Dr. Matthew Eagleton here. And thank you everybody, for joining us today. Really appreciate it.
Dr. Matthew Eagleton:
Thank you very much for the opportunity, Chris. This has been a lot of fun.