Making history and recording history are rarely thought of in the same context; however occasionally the two are one and the same. Such is the case as the Michigan Vascular Center, a private vascular practice located in Flint, Michigan, enters its 50th year of service to its community and state. Barring documentation to the contrary, we believe the Michigan Vascular Center is the
oldest and longest running private practice vascular surgery group in the country. What follows in this edition is a brief summary of its remarkable history.
The accompanying diagram on the back page represents a schematic of how our center has grown in response to the needs of our vascular practice and the vascular patient. We initiated the first non-invasive vascular lab in Mid-Michigan to aid in the diagnosis of vascular disease. The Michigan Vascular Research Center was later formed to bring the advantage of cutting-edge clinical trials to Genesee County. Over the years we have added and expanded two free-standing VeinSolutions offices and two free-standing outpatient diagnostic/angio-access centers. Our latest addition is a Mobility Center to enable the amputee to regain mobility. It has proven to be a great psychological boost to the amputee. On November 2, 2012, we were accepted by the Accreditation Council for Graduate Medical Education (ACGME) to begin training future vascular surgeons in a community-wide Vascular Fellowship Program.
We are very proud of our independent, private practice vascular center, planning for another 50 years, and believe that by adhering to our cultural values, we will make The Michigan Vascular Center a member of the 100 year club. The current health reform agenda presents challenges; yet given the size of our group, we feel confident in the value and cost-effective systems we provide and believe we will find opportunity. We look forward to the future.
Carlo A. Dall’Olmo, M.D. President
PAGE 2 VOLUME 8, ISSUE 1
Albert J. Macksood, M.D., son of a Lebanese immigrant-physician, Joseph
Macksood, M.D., returned home to Flint on July 1, 1963, after completing his surgical
training with Dr. D. Emerick Szilagyi at Henry Ford Hospital in Detroit. Dr. Szilagyi was
one of the original pioneers in peripheral vascular surgery having performed one of the
world’s first abdominal aortic aneurysm repairs in 1952. Dr. Macksood brought skills to
Flint few in the country possessed. These were the formative years for our specialty.
Joining his father, Joseph Macksood, M.D. a
family physician and his older brother
William (Bill) Macksood, M.D. a general
surgeon, he moved into the Macksood Medical Building on
Pierson Road built in 1961. There were so many Macksoods we
simply called them, Dr. Joe, Dr. Bill, and Dr. Al.
Confident in his ability, imbued with boundless energy
and an uncanny ability to engage any and all in meaningful
dialogue, Dr. Al was advised by his father to only practice vascular
surgery. Highly unusual for those years; but so as not to compete
with the general surgeons who lacked his vascular skills, he committed to the specialty. He performed the first
open abdominal aortic aneurysmectomy, the first carotid endarterectomy, and the first femoral-popliteal bypass
in Mid-Michigan in 1963. Most remarkable about Dr. Macksood, however, was his simple, yet revolutionary
philosophy: “cover the waterfront.” That meant all three Flint area hospitals (McLaren, St. Joseph/now
Genesys, and Hurley) which have had continuous emergency vascular coverage ever since. He also believed
only fellowship trained vascular surgeons should be added as the need dictated envisioning a true group
practice. This philosophy maintained that patients were part of the group practice and each partner shared
equally in the responsibility for their care. The patient received the benefit of having multiple physician input
into their vascular care. In addition this created an equal work load and shared compensation allowing all
physicians of the group to have a home life, making time for family and interests more predictable.
Additionally, it created power in numbers with the opportunity and support to broaden our horizons.
As the practice grew, Dr. Macksood tapped Dr. Szilagyi’s program for recruits. Dr. Al Morgan joined
in 1965. Dr. Frederick Sherrin was recruited in 1972 and a professional corporation was formed under the
name of Vascular Surgery Associates, P.C. Dr. Carlo Dall’Olmo, the
current president, joined in 1975. Dr. Dall’Olmo performed the first
tibial artery bypass for limb salvage in Mid-Michigan in 1975. The fact
that the first four members came from Dr. Szilagyi’s program was
important to our early success. All shared a common culture and work
ethic. We were “in synch” says Dr. Dall’Olmo. We shared the same
philosophical approach to the patient and the practice of our specialty.
This made incorporating a new partner a seamless experience.
The Legacy Begins . . .
The Founder
1960s & 70s—New Partners
Macksood Medical Building,
Plaque dated 1961
3169 W. Pierson Rd., Flint, MI
Albert J. Macksood, M.D.
Carlo A. Dall’Olmo, M.D. Frederick W. Sherrin, M.D.
PAGE 3 VOLUME 8, ISSUE 1
Non-invasive vascular testing was emerging as a way of assisting vascular
surgeons in their clinical decision making. Dr. Dall’Olmo spear-headed a project to
open the first non-invasive vascular lab in Mid-Michigan as a part of
our practice. Patients could now enjoy less risky initial testing in the
same office. Our technical lab director, Joanne Drago, LPN, RVT,
opened the lab in 1980 and has been with us since its inception. It
was, indeed, a cutting edge decision, as formal recognition of vascular
technologists came a few years later in 1984. A certification exam for
the RVT credential was developed.
In 1982 with the anticipation of additional partners, the group
relocated from Pierson Road to G-5119 W. Bristol Road in a newly
emerging development near the Genesee Valley Mall. Allan L.
Ippolito, M.D. and John M. McIlduff, M.D., vascular fellows from the
Cleveland Clinic, joined the group. The following summer Wayne K. Kinning, M.D.
arrived from St. Anthony’s in Columbus, Ohio.
Having, again, outgrown our facility, a
parcel of land on the corner of Linden and Bristol
Roads was purchased. The current 6000 square foot
facility was constructed at G-5020 W. Bristol Road and
the group relocated in 1985.
In 1990, Gregory J. Fortin, M.D., another Cleveland Clinic vascular fellow was
added followed by Scott A. Garner, M.D., a vascular fellow from the Medical College of
Virginia in 1993. The corporation was now one of the largest
groups of vascular surgeons in private practice in the United States.
Also in 1990, the Intersocietal Commission for the
Accreditation of Vascular Laboratories (ICAVL) implemented
national standards and accredited their first vascular labs. We were
eager to participate and became one of the first vascular labs to
receive accreditation. Vascular Diagnostic Center was incorporated
on February 11, 1992.
Current facility at 5020 W. Bristol Rd. 1990s—Largest Group in Midwest
1980s—The Practice Grows
Allan L. Ippolito, M.D.
John M. McIlduff, M.D.
Wayne K. Kinning, M. D.
Gregory J. Fortin, M.D.
Scott A. Garner, M.D.
ICAVL has now celebrated over 20 years and Michigan Vascular Center has continued to
participate in the accreditation process throughout that time. We are proud to announce our
23rd consecutive year of maintaining the high standards of accreditation.
PAGE 4 VOLUME 8, ISSUE 1
Toward the end of the decade, Robert G. Molnar,
M.D. arrived from Vanderbuilt in Nashville, Tennessee,
having acquired skills in newly emerging endovascular
techniques. These minimally invasive, catheter based
techniques were poised to transform the treatment of
vascular disease.
Thanks to our networking with representatives
from various medical device companies and other vascular
surgeons, our members were able to travel nationally and
internationally gaining the necessary skills for aortic endografting and carotid
stenting.
In keeping with our future goals, another name change was in order. In
2001 we became Michigan Vascular Center. In 2002 our group of physicians
established Michigan Vascular Research Center (MVRC), a non-profit
organization. MVRC was designed for involvement in numerous clinical trials
underway in the field of vascular surgery and to offer hands-on experience in
teaching other vascular surgeons from around the country the art of carotid
artery stenting.
Dr. Garner took a special interest in venous disease and in 2003
became the medical director for our free-standing VeinSolutions Center.
Dr. Garner is now one of the region’s most experienced physicians in
minimally invasive procedures for varicose veins and venous insufficiency
including endovenous closure/ablation.
In 2004, Russell W. Becker, D.O., another
Michigan native, joined our practice after completing his Vascular Fellowship at Wayne
State University in Detroit, MI. Dr. Becker brought additional endovascular experience to
the practice and a research interest in endovascular therapies for dialysis access.
Subsequently, in 2005 Michigan Vascular Center opened Mid-Michigan’s first free-standing,
full service, Hemodialysis Access Center
Special thanks to:
● Kathy Patterson, then with
Bard Medical
● Cheryl Lubin, Boston
Scientific
● Amy Ketola, John
Toddhunter & Matt
Borenzweig, then with
Medtronic
● Dr. Vic Burnhardt & Dr. Ted
Diethrich, Arizona Heart
Institute
● Dr. Antonio, Modena, Italy
● Dr. Cremonesi and Dr.
Castriota, Ravenna, Italy
2000s—Stepping Into The Future
Robert G. Molnar, M.D.
Russell W. Becker, D.O.
Michigan Vascular Access Center (MVAC) is located in the lower level of The
Surgery Center, 5202 Miller Rd., Flint, MI. It was the first of its kind in the
area to offer a comprehensive vascular service to patients with end stage renal
disease (ESRD). This specialized center evaluates patients for new vascular
access; and evaluates, repairs and maintains existing access.
PAGE 5 VOLUME 8, ISSUE 1
On April 27, 2009, Michigan Vascular Center opened its Clarkston
Campus. This campus was designed to provide a full range of vascular
services to the citizens of North Oakland County. It consists of a
VeinSolutions office, an Access Center for renal dialysis patients, and a non
-invasive vascular lab to aid in the diagnosis and treatment of vascular
disease.
In 2010 Nitin G. Malhotra, M.D., joined the
group after completing his Vascular Fellowship in
Albany, NY. Dr. Malhotra is a highly trained
peripheral vascular surgeon in both open surgical repair and endovascular techniques. He
brings additional expertise in the area of thoracic endografting
In keeping our commitment to provide unparalleled vascular
services to the community, Michigan Vascular Center voluntarily sought
accreditation by the Accreditation Association for Ambulatory Health Care
(AAAHC). In 2010 all locations received full accreditation. Since this
demands a high level of commitment and effort, it challenges us to find better ways to serve
our patients.
Our newest endeavor is the addition of a Mobility Center at the main campus.
Specially dedicated to restoring mobility to the amputee patient, Jeff Eschenburg, a
certified prosthetist, joined us in April, 2012. An amputee himself, he has proven to bring
a great psychological boost to the amputee. Patients have access to ‘advanced surgical
amputation’ a process requiring input from both the vascular surgeon and the prosthetist
to determine the optimum level of amputation with future mobility in mind. Jeff’s skills
include custom creation of prosthetics in our own in-house workshop.
Our fiftieth year welcomes a new partner. Cherie R. Phillips, M.D.
will be joining the practice in July. A native of Cleveland Ohio, Dr.
Phillips received a Master’s degree in Bioethics prior to entering medical
school. She received her medical degree from Wayne State University
School of Medicine in Detroit. After completing her general surgery residency at
Howard University Hospital in Washington, DC, she entered her Vascular Surgery
Fellowship at University Hospital, Cincinnati, Ohio. Dr. Phillips is the recipient of
several awards and honors including the Howard University Department of Surgery
Chief Resident of the Year 2010.
The University of Cincinnati’s Vascular Surgery Department was one of the first
academic practices in the country to develop a formal practice in endovascular surgery.
Dr. Phillips comes highly trained in both open and cutting-edge, minimally invasive endovascular procedures.
5701 Bow Pointe Dr., Ste 212
Clarkston, MI
Nitin G. Malhotra, M.D.
2013—OUR FIFTIETH YEAR!
Cherie R. Phillips, M.D.
PAGE 6 VOLUME 8, ISSUE 1
Rounding out our fifty-year celebration is the introduction of a Vascular
Surgery Fellowship to Genesee County. With the accumulated wealth of knowledge
and experience by our faculty, it seemed a natural progression to train future vascular specialists. Michigan
State University in conjunction with Michigan Vascular Center, McLaren Regional Medical Center, Hurley
Medical Center, and Genesys Regional Medical Center are now offering a two-year vascular Fellowship
training program covering all aspect of vascular medicine and vascular and endovascular surgery. Several years
in the making, it was approved by the Accreditation Council of Graduate Medical Education (ACGME) in
November 2012. We will be eligible to receive residents who have completed an approved General Surgery
program. Most Fellowship programs are institutionally based. This community-based program will not only
give Fellows exposure to several institutions, it will add experience in a private practice setting. Dr. Dall’Olmo,
Program Director, says, “Few programs in this country offer the Vascular Fellow as extensive an exposure to the entire
spectrum of a vascular practice.” We are now poised for the future and planning for another 50 years!
50 Years . . . And Counting!
COMING SOON!
MICHIGAN VASCULAR ACCESS CENTER
SAGINAW CAMPUS
With
Teamwork
The Sky
Is The Limit!
PAGE 7 VOLUME 8, ISSUE 1
MICHIGAN VASCULAR CENTER FIRSTS
1963 First open Abdominal Aortic Aneurysmectomy in
Mid-Michigan
2004 First in the state of Michigan to implant FDA- approved Carotid stent (manufactured by Guidant, Inc.)
1963 First Carotid Endarterectomy in Mid-Michigan 2005 Opened Mid-Michigan’s first free-standing, full service, Hemodialysis Access Center
1963 First Femoral-Popliteal Bypass in Mid-Michigan 2005 First and only site in the state of Michigan to implant a superficial femoral artery drug coated stent (manufactured by Cook, Inc.) (Zilver Trial)
1975 First in Mid-Michigan to offer Tibial Artery Bypass
for limb salvage
2006 First in the state of Michigan to implant FDA
approved abdominal aortic aneurysm pressure
monitoring device (manufactured by CardioMEMS)
1977 Development of a Vascular Registry 2008 First in the state of Michigan to perform
endovascular removal of blood clots from veins
(Stride I Clinical Research Trial using the Trellis® 8
device)
1988 First in Flint to implant a Palmaz Stent (R. Iliac
Artery)
2008 Mid-Michigan’s first percutaneous repair of AAA
under local anesthesia
1992 Mid-Michigan’s first ICAVL-Accredited Vascular
Laboratory
2008 Michigan Vascular Center chosen as one of five
training sites in the US for the Endologix Powerlink
endograft for AAA
1998 Mid-Michigan’s first Endovascular Repair of Abdominal Aortic Aneurysm
2008 First Endologix Powerlink XL AAA endograft implanted in Michigan
2004 Formed Mid-Michigan’s only dedicated non-profit Vascular Clinical Research Center
2012 First Mobility Center in Michigan and one of the
nation’s first, dedicated to the rehabilitation of the
amputee
MVC Core Values
We are a professional organization –a team– working equally in a common cause: To
provide the best possible vascular care for the physicians, patients, and institutions of our
community.
We share a commitment to excellence in the vascular care of patients through the pursuit of
knowledge, communication, innovation, and research.
We value our employees and incorporate them into our team.
We commit to each other to honor & pursue these values.
MIC
HIG
AN
VA
SC
UL
AR
CE
NT
ER
—M
AIN
CA
MP
US
ST
AF
F
PAGE 10 VOLUME 8, ISSUE 1
NON-INVASIVE VASCULAR LAB—1980
A Word From the Technical Directors
To check on a vascular lab accreditation, visit:
www.intersocietal.org
Click on “Helpful Resources”, then “IAC Accredited Facilities”
Michigan Vascular Center opened its non-invasive vascular lab in 1980 as the first of its kind in
Genesee County. As technology progressed and the value of non-invasive vascular testing was established, a
need arose for standards in the industry. In 1990 the Intersocietal Commission for the Accreditation of
Vascular Laboratories (ICAVL) implemented national standards and accredited their
first vascular labs. Michigan Vascular Center was eager to participate and became one
of the first vascular labs to receive accreditation.
ICAVL is now celebrating its 23rd year. Michigan Vascular Center has continued to
participate in the accreditation process throughout those 23 years. We are proud to
announce our 23rd consecutive year of maintaining the high standards of
Throughout the accreditation process laboratories must assess every aspect of daily operations and the
quality of patient care. Laboratories conduct a detailed self-evaluation using the ICAVL standards and the
application. This includes actual case studies for review. Once the self-evaluation is complete the documents
and case studies are reviewed by the ICAVL Board of Directors. As part of the Accreditation Agreement,
vascular labs agree to undergo random site visits.
MVC
ONE OF THE
FIRST
ACCREDITED
VASCULAR LABS
IN THE COUNTRY
Since the inception of our vascular lab, it has been our goal to
complement Michigan Vascular Center’s Mission Statement by
providing “quality patient care” with quality vascular testing. By
continuing to succeed in fulfilling the standards for the voluntary
lab accreditation process we have achieved the goal of excellence in
the specialty field of vascular testing and diagnostics.
Joanne Drago, LPN, RVT, FSVU
Co-Technical Director
Ann Inskeep, RVT
Co-Technical Director
PAGE 11 VOLUME 8, ISSUE 1
RESEARCH DEPARTMENT—2002
Michigan Vascular Research Department is one of the country’s most experienced sites for carotid stenting and AAA endovascular repair. Our specialists have participated in many different phases of research from Phase I to Phase IV. Michigan Vascular has participated in multiple FDA trials including:
Carotid Stenting
AAA Endovascular Repair
AAA Endovascular Pressure Measurement
Iliac Stenting
Renal stenting
SFA Stenting
Fistula Placement
Stem Cell Treatment for Critical Limb Ischemia
DVT (Deep Venous Thrombosis)
Our research team consists of 9 vascular surgeons, two clinical research coordinators and a research
assistant. Because of Michigan Vascular Research Center’s dedication and commitment toward conducting
research, we were the first in the state to enroll patients in several trials.
First in the state of Michigan to implant a FDA approved carotid stent manufactured by Guidant,
Inc. in September 2004.
First and only site in the state of Michigan to implant a superficial femoral artery drug-coated stent
manufactured by Cook, Inc. in October 2005.
First in the state of Michigan to implant a FDA approved abdominal aortic aneurysm pressure
monitoring device, manufactured by CardioMEMS in June 2006. This device is used in patients
who undergo endovascular repair of an AAA and measures the pressure over time within the
excluded AAA for leaks.
First in the state of Michigan to enroll a patient into the Stride Study in May 2008. The Stride
Study uses the Trellis-8 system for treatment of DVT.
Linda Reynolds, RA Barb Lewis, CRC Maureen Angles, CCRC
PAGE 12 VOLUME 8, ISSUE 1
VEINSOLUTIONS—2003 CLARKSTON CAMPUS—2009
Michigan Vascular Center has been treating varicose veins and other venous problems for 50 years. In October of 2003 the VeinSolutions office opened, dedicated to providing comprehensive and exclusive care for patients with venous problems. Our aim is to provide patients with the most experienced, board certified vascular surgeons who use the latest technologies in the diagnosis and treatment of varicose and spider veins, venous insufficiency, and vascular birthmarks.
Michigan Vascular Center opened VeinSolutions to cater specifically to patients with vein problems. Our nurses and support staff are highly trained health care professionals with a special interest in vein care. Therefore, patients receive the highest quality of care—not only from a clinical aspect—but also from a personal point of view. Every patient receives friendly, helpful, and prompt service. Our patient satisfaction surveys bear this out with continued high patient satisfaction ratings.
The first visit to VeinSolutions is a free consultation with our board certified vascular surgeon who will evaluate
the patient for possible venous problems. If a problem is suspected, a recommendation will be made for further
evaluation, most often with a venous duplex and physician consultation. However if there is no clinical evidence of a
venous problem, then no further evaluation is required. If indicated, cosmetic treatment options will then be discussed
with the patient.
Many, but not all treatments are covered by insurance. Based on the initial consultation, and possible venous duplex, medical necessity is determined. When treatment options are presented to a patient, we are able to inform them prospectively if the procedure is covered by insurance or considered cosmetic. If a treatment is cosmetic we explain that it is not covered by insurance and we provide a cost estimate of what a treatment will cost.
Endovenous ablation is the treatment of choice for underlying venous insufficiency. It is minimally invasive, usually requires only local anesthesia, and is performed in the comfort and convenience of our office. In most instances, patients return immediately to normal light activity with little or no time off from work.
Endovenous ablation entails percutaneous placement of a catheter into the incompetent vein. Energy is delivered using either radiofrequency or laser which injures the target vein wall and results in fibrotic obliteration of the insufficient vein. We at VeinSolutions introduced endovenous ablation to this area and have the most extensive experience with this procedure.
Free Consultation
VeinSolutions—Flint
Endovenous Ablation
TREATMENTS
Insurance Coverage
Disposable catheter
inserted into vein
Vein heats
And collapses
Catheter withdrawn,
Closing vein
PAGE 13 VOLUME 8, ISSUE 1
TWO CENTERS DEDICATED TO VEIN PROBLEMS
In most instances, ambulatory phlebectomy is the preferred therapeutic option for the treatment of larger varicose veins. In general, this minor procedure is done under local anesthesia, in an office setting, and requires only minute stab incisions which require no sutures or stitches. For larger veins, ambulatory phlebectomies afford improved aesthetics and quicker resolution of varicose veins compared with sclerotherapy.
Though varicose veins and leg discomfort are the most common manifestations of venous insufficiency, venous dermatitis and ulceration are not uncommon, and will respond well to treatment. Lower extremity venous dermatitis and ulceration can be longstanding, difficult to heal, and have a significant rate of recurrence. In some patients correction of the underlying venous hypertension will result in accelerated wound healing and a significant reduction in recurrence of venous ulcers.
Sclerotherapy is an effective treatment for spider telangiectasias, reticular veins, and smaller varicose veins.
The Pharmaco-Mechanical Trellis® procedure is a revolutionary new treatment for removal of deep venous thrombosis. It is aimed at emulsifying and eradicating the clot, thus preserving the function of the vein and its valve, and reducing chronic obstructive pathology which can lead to more severe longstanding post-phlebitic problems. It is recommended in selected patients with extensive acute (within two weeks of onset of the DVT) ilio-femoral deep venous thrombosis when appropriate expertise and resources are available.
VeinSolutions—Clarkston
Venous Dermatitis & Ulceration
Immediate Post-op Post Trellis®
VeinSolutions has allowed Michigan Vascular Center to provide
quality of treatment to your patients with vein problems by
offering the full range of diagnostic and treatment
options. In addition to providing state of the art
venous care, the doctors and staff at VeinSolutions
strive to give your patients an enjoyable and
convenient office experience.
Scott A. Garner, M.D.
Ambulatory Phlebectomy
Excellent outcome post ambulatory phlebectomy
Sclerotherapy
Pharmaco-Mechanical Treatment
PAGE 14 VOLUME 8, ISSUE 1
The Michigan Vascular Center opened its first office dedicated to the vascular needs of renal patients in 2005. The Michigan Vascular Access Center was the first of its kind in the area to offer a comprehensive vascular service to patients with end stage renal disease (ESRD). The center is committed to offering the highest standard of care at one site. This specialized center evaluates patients for new vascular access as well as evaluating, repairing and maintaining existing access.
In the past, patients with access problems would require numerous visits to various locations. This lead to duplicate testing and delays in
appropriate treatment. MVAC has developed a single-center concept. The patient can have all their access needs addressed and corrected immediately. The center performs a variety of procedures such as diagnostic imaging of fistulas and grafts via duplex imaging and Doppler ultrasound. Repairs and/or minimally invasive procedures using catheter-based techniques such as venograms, fistulograms, percutaneous transluminal balloon angioplasty (PTA) are among the many daily procedures offered. Other common treatments are coil embolization of fistula side branches, graft declots, and hemodialysis catheter insertions and removals.
In 2009, a second free-standing angio-access center was opened in Clarkston, Michigan. It is located in the Clarkston Medical Building. As in Flint, there is a board certified vascular surgeon present at the center Monday through Friday. The citizens of North Oakland County are now able to receive the same convenient, one-stop services that are invaluable in patients with this disease process.
Both the Flint and Clarkston Access Centers are located alongside a full service surgery center. Patients who need a new access undergo a thorough evaluation adhering to the concept of “fistula first” to maximize the use of native fistulas. In most cases, the fistula or graft can be placed conveniently at the adjoining surgery centers.
MVAC is proud to join in a team effort with nephrologists and dialysis units in order to deliver comprehensive care that provides excellent and compassionate service to our patients.
HEMODIALYSIS ACCESS CENTER—2005
TWO LOCATIONS
Flint
Lower Level of The
Surgery Center
5202 Miller Road
810-600-0530
Clarkston
Clarkston Medical Bldg.
5701 Bow Point Dr.
248-620-3900
The Michigan Vascular Access Center now provides a clinical
rotation for Baker College. Dialysis access technician students
gain additional experience which prepares them to excel as
technicians. Students enrolled in Baker’s Bonent approved,
Hemodialysis Technician Program (one of 12 existing
programs in the United States) have the opportunity to observe
