At the recent Diabetic Foot Global Conference (DFCon), organizers announced that Anahita Dua, MD, MS, MBA was awarded the first ALPS Traveling Fellowship.
The fellowship enables recipients to visit two centers of excellence in limb preservation and provides up to $7,500 for expenses related to travel, research, and clerical assistance. Dr. Dua, an Assistant Professor of Surgery at the Massachusetts General Hospital and Harvard Medical School, was elated at the news and the opportunity to continue learning from leading experts in the treatment of high-risk patients with diabetic foot ulcers and chronic limb-threatening ischemia (CLTI). She notes an array of goals for her ALPS Traveling Fellowship.
“I wish to truly learn from the experts. I want to see what techniques they employ down to the wires and access tricks for particular lesions, and I want to watch how they work with the multidisciplinary team to achieve great outcomes,” asserts Dr. Dua, the Director of the Vascular Lab, Co-Director of the Peripheral Arterial Disease (PAD) Program and Associate Director of the Wound Care Center at Massachusetts General Hospital.
From a research perspective, Dr. Dua sees the ALPS Traveling Fellowship as an opportunity to build collaborations that will enable her to conduct multidisciplinary studies at the Massachusetts General Hospital as well as participate in multicenter studies with the limb preservation centers of excellence she plans to visit. Dr. Dua says the fellowship may also allow her to “immerse myself” in another specialty, such as podiatry or wound care, “to understand how they approach patients and how I can do things as a vascular surgeon to cultivate the same relationships at my home institution.”
Dr. Dua is appreciative of the fellowship experience and cites previous mini-fellowships with the interventional cardiologists George Adams, MD, MHS, FACC, and Roberto Ferraresi, MD. She says Dr. Adams taught her a variety of interventions and credits Dr. Ferraresi for showing her “spectacular tools of the trade, including deep venous arterialization,” that she now employs for patients at Massachusetts General Hospital.
However, she says it was her experience working with Venita Chandra, MD during her vascular surgery fellowship at Stanford Health Care that fueled her interest in specializing in limb salvage. Dr. Dua praises Dr. Chandra as a teacher for foundational skills in the management and advanced treatment of patients with CLTI, and a key mentor in fostering multidisciplinary alliances to treat patients who were on the brink of amputations.
“Watching (Dr. Chandra) work in a collaborative way with so many different specialties (podiatry, medicine, infectious disease, wound care, etc.) to achieve what many thought was unachievable, and then watching the patients reach out to her with such respect and gratitude was all the convincing I needed that this was the specialty for me,” recalls Dr. Dua. “Dr. Chandra didn’t change the lives of these patients. She gave them their lives back, took their pain away and saved their leg. I wanted to do that for other people.”
To that end, Dr. Dua recalls a particularly rewarding case involving a 56-year-old patient with diabetes and a large wound on the dorsum of his foot that was festering, necrotic and painful. She notes the patient had repeatedly been told by other physicians that he needed a below-knee amputation (BKA). When the patient came to see her. Dr. Dua proceeded to do a vascular workup that revealed an occlusion of the external iliac artery and superficial femoral artery (SFA) with severe plaque in the common femoral artery (CFA).
“We did a femoral endarterectomy with retrograde recanalization and stenting of the external iliac artery, and subsequent antegrade recanalization of the SFA,” explains Dr. Dua. “We then debrided his wound and utilized vacuum-assisted closure (VAC) therapy until the wound was ready for skin grafting. He achieved full healing of the wound, kept his leg, and brings me chocolate at every appointment!”
For medical students considering a limb salvage specialty, Dr. Dua strongly encourages them to join the fight to prevent unnecessary amputations.
“We need you and your expertise so badly and, more importantly, our patients need you,” maintains Dr. Dua. “Diabetes is a wildfire sweeping across the globe and the number of patients that will need your help in the future is going to be astronomical. We need your hands, minds, and innovations to change the face of CLTI and prevent amputations in this population.”