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The Vascular Research Initiatives Conference and over 25 years of conversations on the science of vascular disease

2013; Elsevier BV; Volume: 57; Issue: 2 Linguagem: Inglês

10.1016/j.jvs.2012.10.013

1097-6809

John A. Curci, Larry W. Kraiss, Ronald L. Dalman, Alan Daugherty, Robert W. Thompson, Alan Dardik,

Cardiac, Anesthesia and Surgical Outcomes

The Vascular Research Initiatives Conference (VRIC) is an annual conference established in 1986. This conference has successfully provided a forum for the presentation and discussion of high-quality innovative and relevant research related to the scientific underpinnings of vascular surgery. We have accomplished this by bringing young and more accomplished vascular surgeon researchers together with a broad representation of other high-caliber vascular biologists. The VRIC provides a unique venue for the vascular surgery community to showcase research produced by vascular surgeon scientists—a group of physicians with an exceptional understanding of vascular disease whose direct access to patients facilitates acquisition of tissue specimens. The VRIC creates important interdisciplinary collaborations among a wide variety of vascular biology investigators. Goal-directed research progress in vascular biology is critical, as vascular disease continues to affect much of the world's population and, in particular, continues to be the leading cause of morbidity and mortality for the citizens of the United States. The first aim of the VRIC is to provide a scientific forum for the presentation, dissemination, and critique of new data regarding preclinical translational research in vascular surgical diseases. There is emphasis on mechanistic studies and discoveries of novel treatment targets that may lead to practical applications and therapies for affected patients. This aim is accomplished by (1) selection of the highest-quality research for a program designed to stimulate constructive interaction between all attendees, (2) invitation of a keynote speaker with distinction in the field of vascular research, (3) planned free time for informal discussions and creation of collaborations, and (4) coordinated and collaborative meeting arrangements with the annual meeting of the Arteriosclerosis, Thrombosis and Vascular Biology (ATVB) Council of the American Heart Association (AHA), another well-established premier vascular biology meeting. The second aim of the VRIC is to provide scientific and career development support for aspiring vascular surgeon scientists. This is provided through (1) presentations by junior investigators, coupled with vibrant, thought-provoking, question-and-answer sessions; (2) opportunities for informal interactions with senior faculty and presenters; (3) opportunities to develop networks with vascular scientists at other institutes; (4) encouragement of attendance of a broad community of researchers and appropriate role models, including women, minorities, and persons with disabilities; and (5) interaction with representatives from the National Heart, Lung, and Blood Institute. Over 100 participants from academia, government, and industry attend each year. The main strength of the VRIC is the opportunity for vascular surgeons and biologists to discuss cutting-edge research in a well-structured, yet informal and intellectually stimulating atmosphere. This is expected to stimulate collaborations and new directions of vascular research, inspired by highly focused, cross-disciplinary interactions among the conference participants. The VRIC has an original and innovative format that plays an essential role in exposing the participants, and especially junior investigators, to new areas in the important translational field of vascular disease. The VRIC, known formerly as the Research Initiatives in Vascular Disease Conference, is an annual conference established in 1986.1Strandness D.E. The research initiatives meeting and the National Institutes of Health.J Vasc Surg. 1996; 23: 1058-1068Abstract Full Text Full Text PDF Scopus (4) Google Scholar, 2Pearce W.H. Mannick J.A. Clowes A.W. Yao J.S.T. Twentieth anniversary of American Vascular Association/Lifeline Foundation: a celebration.J Vasc Surg. 2008; 47: 1351-1355Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar This conference was originally designed to highlight the best quality and newest vascular surgery research by bringing the most important vascular surgeon researchers together with leading vascular biologists. In the over 20 years of this conference, vascular surgery research has grown in scope as well as in its ability to perform innovative translational research.3Conte M.S. Bandyk D.F. Clowes A.W. Moneta G.L. Seely L. Lorenz T.J. et al.Results of PREVENT III: a multicenter, randomized trial of edifoligide for the prevention of vein graft failure in lower extremity bypass surgery.J Vasc Surg. 2006; 43: 742-751Abstract Full Text Full Text PDF PubMed Scopus (491) Google Scholar However, vascular disease continues to affect much of the world's population, and, in particular, it continues to be the leading cause of morbidity and mortality for the citizens of the United States.4Lloyd-Jones D. Adams R.J. Brown T.M. Carnethon M. Dai S. De Simone G. et al.American Heart Association Statistics Committee and Stroke Statistics SubcommitteeExecutive summary: heart disease and stroke statistics—2010 update.Circulation. 2010; 121: 948-954Crossref PubMed Scopus (3799) Google Scholar The need for basic and translational research in vascular disease and vascular surgery remains pivotal to the advancement of our understanding of vascular pathobiology. The format of the VRIC has changed only a little since its inception, other than the changing of the timing and location of the conference, starting in 2009, to coincide with the day before the annual spring ATVB Scientific Sessions. The structure of the current conference, as noted earlier, has two main objectives: (1) to provide a scientific forum for the presentation, dissemination, and critique of new data regarding preclinical translational research in vascular surgical diseases with emphasis on the study of mechanisms and discovery of novel treatment targets that may lead to practical applications and treatment of affected patients; and (2) to provide scientific and career development support for aspiring vascular surgeon scientists. The VRIC has traditionally been planned by the Society for Vascular Surgery (SVS) Research and Education (R&E) committee. The R&E committee was formed in 1986 with the mission to support the career development of young research-oriented vascular surgeons.2Pearce W.H. Mannick J.A. Clowes A.W. Yao J.S.T. Twentieth anniversary of American Vascular Association/Lifeline Foundation: a celebration.J Vasc Surg. 2008; 47: 1351-1355Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar The chair of the committee (Table) is usually a 3-year position and that leads an eight- to 10-person committee. The SVS R&E committee is responsible for planning of the VRIC. This planning involves many tasks, including program structure, abstract review, program selection, and selection of the invited speakers.TableThe Vascular Research Initiatives Conference (VRIC), 1986-2012YearConference titleOrganizer1986Workshop on Vascular DiseaseEugene Strandness, MD1988Research Initiatives ConferenceEugene Strandness, MD1989Intimal HyperplasiaFrank W. LoGerfo, MD1990Thrombosis And ThrombolysisFrank W. LoGerfo, MD1991Prosthetic Arterial GraftsFrank W. LoGerfo, MD1992Molecular Biology And Vascular SurgeryG. Patrick Clagett, MD1993Ischemia, Reperfusion And Organ DysfunctionG. Patrick Clagett, MD1994Research Models in Vascular Disease and Symposium on Transluminally Placed Endovascular ProsthesesG. Patrick Clagett, MD1995Atherosclerosis and Restenosis: The Failure of Conventional WisdomAlexander W. Clowes, MD1996Vascular Gene Transfer: Models of Disease and TherapyAlexander W. Clowes, MD1997How to Build a Blood VesselAlexander W. Clowes, MD1998Inflammatory and Immune Mechanisms in Vascular DiseaseHoward P. Greisler, MD1999Movers and Shakers in the Vascular Tree—Hemodynamic and Biomechanical Factors in Blood Vessel PathologyHoward P. Greisler, MD2000The Biology of Vascular Interventions—Minimally Invasive Approaches to Vascular DiseaseHoward P. Greisler, MD2001Cellular Signaling—Pathways for the Development of Vascular DiseaseK. Craig Kent, MD2002From Bench to Clinical Practice—Translational Research in Vascular DiseaseK. Craig Kent, MD2003Emerging Technology and the Future of Vascular ResearchK. Craig Kent, MD2004From Bench to Bedside to BoardroomRobert W. Thompson, MD2005Translational Research on Vascular Diseases: The Road AheadRobert W. Thompson, MD2006Tools for the Next DecadeRobert W. Thompson, MD2007Inflammation and Thrombosis—Mechanisms and PreventionLarry W. Kraiss, MD2008Clinical Trials in Vascular Disease: Getting Answers That MatterLarry W. Kraiss, MD2009Research Initiatives in Vascular Disease ConferenceLarry W. Kraiss, MD2010Toward Better Models of Vascular DiseaseAlan Dardik, MD, PhD2011Basic Foundations of Translational Research in Vascular DiseaseAlan Dardik, MD, PhD2012Experimental and Applied Vascular BiologyAlan Dardik, MD, PhD Open table in a new tab The SVS R&E committee receives advice and oversight from the SVS Research Council. The chair of the SVS Research Council and the chair of the R&E committee regularly discuss plans for the VRIC throughout the year, both formally during monthly conference calls and informally as needed. From its inception in 1986 until 2008, the VRIC was held in the Washington, DC area. The original intention of choosing this location was to encourage attendance by the staff of the National Institutes of Health (NIH). However, in 2009, the location and time of the meeting were changed to occur on the day preceding the ATVB Scientific Sessions. This change has been highly successful in facilitating exchange between the vascular surgery and vascular biology communities. The particular goals are (1) to promote scientific exchange and collaboration between vascular surgeons and vascular biologists, (2) to provide increased exposure to the VRIC program, and (3) to promote ever increasing cooperation and scientific interaction between the two conferences while maintaining a focus on issues critical to vascular surgery. The 2009 meeting took place on April 28, 2009, in Washington, DC. Although this was the first VRIC meeting that was tied to the ATVB meeting, the meeting was successful by all accounts, including the attendance and the quality of the scientific presentations. The 2010 VRIC, held on April 7, 2010, in San Francisco, California, capitalized on the momentum of the 2009 meeting. Vascular surgeons and vascular biologists both commented, in postmeeting evaluations, that the coordination of the meeting with ATVB was “outstanding” and “promoted interactions” as well as “promoted future collaborations.” The quality of the science was noted to be “outstanding” and “under recognized by the broader community,” suggesting the need to continue the combined new format (Fig 1). The 2011 VRIC was held on April 27, 2011, in Chicago, Illinois, and was viewed as similarly outstanding as the 2010 meeting, building on the efforts of the previous year and advancing both science as well as collaboration between the vascular surgery and vascular biology communities (Fig 2). Dr Dardik and Dr Lentz, chair of the ATVB Scientific Sessions Program Committee, made a video describing the success of the VRIC and ATVB meetings' integration and collaboration (available on YouTube at: http://www.youtube.com/watch?v=6TfuJ8-zlBU; as well as the SVS and AHA conference websites). Similarly, Dr Dardik and Dr Mary McDermott, Chair of the AHA Peripheral Vascular Disease Council, made a video during the 2012 conference (available on YouTube at: http://www.youtube.com/watch?v=PH_2WA-Wr4s; and at the respective conference websites).Fig 2Results of the evaluations of the scientific program by attendees of the Vascular Research Initiatives Conference (VRIC) from 2007 through 2011. The scale for evaluation ranges from 1 (poor) to 5 (excellent). The attendees were asked to evaluate the program relevance and overall quality each year. This period encompasses the period of change in format and location, and demonstrates that the mean evaluation scores have been consistently very good to excellent.View Large Image Figure ViewerDownload Hi-res image Download (PPT) The VRIC is organized around several core themes that are decided upon by the program committee. Each core topic consists of several abstract presentations. An invited speaker or panel begins the morning and afternoon sessions. Invited speakers are senior distinguished investigators of international reputation, chosen by the program committee and approved by the chair of the committee. The program committee chooses the panels. Abstracts are chosen by the program committee from the highest-scoring abstracts that were submitted in response to the “Call for Abstracts” for the meeting. Abstracts are scored in blinded fashion by the program committee. Between each core session, time is allotted for interaction. Breakfast, lunch, and postsession reception time are scheduled to promote interaction and discussion. Based upon feedback from the 2009 meeting, the lunch speaker was eliminated in favor of small group discussion. The feedback from the 2010 and 2011 meetings suggested that this change was quite favorable. Based on feedback from the 2011 meeting, an after-lunch panel session on translational research was added to the 2012 meeting. Before the start of the first session are the introductory remarks of the program chair as well as the reports of the previous year's K08 and K23 awardees. The SVS promotes the NIH K08 and K23 grant programs for its trainees and junior faculty members, with the highest-scoring awardees receiving matching funding. This program has been extremely successful, with all awardees finishing this program achieving the status of an independent investigator.5Thompson R.W. Schucker B. Kent K.C. Clowes A.W. Kraiss L.W. Mannick J.A. et al.Reviving the vascular surgeon–scientist: an interim assessment of the jointly sponsored Lifeline Foundation/National Heart, Lung, and Blood Institute William J. Von Liebig Mentored Clinical Scientist Development (K08) Program.J Vasc Surg. 2007; 45: A2-A7Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar Over 20 K08 and K23 awards have been given.2Pearce W.H. Mannick J.A. Clowes A.W. Yao J.S.T. Twentieth anniversary of American Vascular Association/Lifeline Foundation: a celebration.J Vasc Surg. 2008; 47: 1351-1355Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar The reports from the K08 and K23 winners finishing their first funded year of research are presented at the VRIC. The VRIC sessions are planned to occur on the day immediately after the ATVB Scientific Sessions. This allows VRIC attendees to attend the ATVB conference as well as ATVB conference attendees to attend the VRIC conference. Several of the ATVB conference sessions are planned in coordinate fashion between the SVS and ATVB program committees, including the first day combined morning session as well as the evening poster session of the ATVB conference. This integration of VRIC with ATVB is a distinct advantage of VRIC compared with other surgical meetings that address basic science, such as the Academic Surgical Conference, which are stand-alone meetings and not planned coordinately with a basic science partner. The program reflects the state-of-the-art basic science research performed in vascular surgery. As such, the breadth of vascular surgery is represented. Typical topics include peripheral arterial disease, both acute and chronic; ischemia/reperfusion; vascular endothelium; thrombosis; aneurysms; angiogenesis; stem cells; diabetes and metabolism; bioengineering; tissue engineering; animal models. Other topics may be included as needed. As noted, the attendance for the meeting is growing and currently has an audience of approximately 100 participants. Participants include vascular surgeons, vascular biologists, members of industry, NIH administrators and scientists, and others, including scientists or clinicians in related disciplines. The meeting is advertised in several places, including paper and online versions of vascular surgery journals and websites, the VRIC website, and the ATVB Scientific Sessions website. Blast e-mails are sent to the members of the SVS. Next year the abstract selection will be expanded to the members of the AHA ATVB Council. The VRIC is the only annual vascular surgery meeting devoted to discussion, presentation, and dissemination of basic science research. The ATVB Scientific Sessions has some overlapping content and is often attended by similar participants; this was precisely the rationale that led the leaders of both the SVS and ATVB to suggest coordination of the annual VRIC and ATVB meetings. However, the separate identity of the VRIC, even if it is coordinated with the ATVB meeting, is critical to its recognition as the premier vascular surgery scientific meeting. The committee consisted of Alan Dardik, Yale University (chair); April Boyd, University of Manitoba; Ankur Chandra, University of Rochester (candidate member); John Curci, Washington University; Matthew Eagleton, Cleveland Clinic; Raul Guzman, Vanderbilt University; Peter Henke, University of Michigan; Christopher Owens, University of California San Francisco; Ravi Veeraswamy, Emory University; and Omaida Velazquez, University of Miami. The 2012 VRIC program is an excellent example of the high-quality programs brought together annually. It showcased the top-notch vascular research being performed by surgeons and other investigators worldwide. Authors and attendees were a diverse group that included investigators from the United Kingdom, Netherlands, Canada, Australia, Israel, France, Switzerland, and the United States. All sessions were co-moderated by a scientific member of the SVS and ATVB. The program consisted of two invited speakers spanning a spectrum of experience and a four-speaker panel selected to present the opportunities and challenges of translational vascular research. However, the heart of the meeting was the scientific sessions, which included new and exciting research on the common topics of intimal hyperplasia (IH; number of presentations = 5), angiogenesis/arteriogenesis (5), ischemic myopathy (2), abdominal aortic aneurysms (AAAs; 8), deep venous thrombosis/endothelial dysfunction (3), diabetic wound healing (2), carotid plaque instability (1), and tissue-engineered grafts (2) as well as novel fully synthetic vascular endografts (1). A staple of the annual program is a talk from a recent career development awardee in vascular surgery; this talk is eagerly awaited each year. This year's presentation was from the most recent Vascular Surgeon NIH K23 program awardee, Dr Brian Nolan, of the Dartmouth-Hitchcock Medical Center. Dr Nolan described his planned work to evaluate the effects of a diagnosis of a small AAA on the quality of life of patients who undergo a surveillance regimen. He described a rigorous scientific plan to evaluate a large cohort of patients with small AAA at multiple institutions across the country. He also described his plan for career development, which included specific training in psychometrics that will allow him to continue to contribute to the critically important evaluation of quality-of-life results for patients with vascular disease. The keynote speaker for the VRIC Senior Investigator Invited Lecturer was Dr Michael T. Watkins, of Harvard Medical School and the Massachusetts General Hospital. His talk was titled “Translational Research in Spinal Cord Ischemia-Reperfusion Injury.” His talk emphasized the limitations of animal models and the importance of developing animal models that are closely congruent with human disease. These sessions were lively and included thought-provoking questions from the moderators and the attendees. Moderators for each session consisted of a team of two scientists, one from the SVS R&E committee and one from the ATVB Scientific Sessions program committee. The moderators this year were Raul Guzman, MD, from Vanderbilt University Medical Center; Katey Rayner, PhD, from NYU Langone Medical Center; Peter Henke, MD, from University of Michigan; William Muller, MD, PhD, from Northwestern University; Matthew Eagleton, MD, from Cleveland Clinic; Robert Hegele, MD, from University of Western Ontario; Ankur Chandra, MD, from University of Rochester; and David A. Dicheck, MD, from University of Washington. An interesting clinical study was presented from the University of Florida, where fluid shear from lower extremity bypass grafts were computed by duplex ultrasound and computed tomographic scanning in 33 patients early and late after implantation, along with evaluation of serum markers of inflammation. Areas of low shear at 1 week were reported to be associated with development of graft stenosis, which was more pronounced in patients with elevated serum markers of inflammation. Potential mechanisms of IH development were reported from the University of Wisconsin-Madison and the University of Maryland. The Wisconsin investigators presented a series of experimental results that implicated the activity of protein kinase Cδ and macrophage chemoattractant protein-1 in the migration of smooth muscle cells (SMCs) into the diseased intima. The Maryland investigators found that MARCKS signaling is increased in vein grafts and that inhibition of this signaling specifically blocks proliferation of vascular SMCs and may work through cell cycle modulating protein p27kip1. Presentations from Northwestern University and the University of Tennessee addressed issues surrounding potential local therapies to reduce IH. The effect of nitric oxide on inhibition of IH in the setting of diabetes was found to be related to proteins responsible for ubiquination and degradation of intracellular peptides by the Northwestern group. The Tennessee group evaluated the effectiveness of gene transfer in blocking expression of membrane-type 1 matrix metalloproteinase (MMP) with a polymeric transfection method and found that it appeared to be as effective as prior methods of transfection. The mechanisms that result in the development of perfusion conduits to an ischemic extremity and the means to enhance angiogenesis/arteriogenesis were the focus of five presentations. The first of these from Pittsburgh evaluated the purogenic receptor P2Y2 on the arteriogenic response to hindlimb ischemia in mice and found that absence of the P2Y2 receptor impaired the development of arteries after ischemic challenge. The remainder of the presentations evaluated the potential for stem cell therapy to enhance the response to ischemia. Blood markers of endothelial damage and active stem cell mobilization were found to be increased in patients with critical limb ischemia in a large clinical trial from the Netherlands. These investigators also demonstrated evidence of impaired production and function of circulating angiogenic stem cells in this population. The presentation from a group in Indiana suggested that progenitor cell treatment using cells derived from the chorionic villi of human placenta are better than adipose-derived stem cells for promoting angiogenesis after ischemia. From Massachusetts, we had two reports regarding endothelial progenitor cell function in diabetics. One group of investigators reported that oxidative stress in diabetic stem cells, mediated through Nox4, can reduce the angiogenic potential of these cells. They also presented evidence that inhibition of Nox4 can restore the angiogenic properties of the cells. The other group evaluated the effect of p53 silencing on stem cells obtained from diabetic mice, which were infused into ischemic limbs, and found better angiogenic response with these cells compared with cells without p53 silencing. Understanding the changes in muscle subjected to ischemia was another focus of the research. An investigative team from London and Switzerland as well as researchers from Pittsburgh presented study results regarding the mechanisms of ischemic changes in muscle. Both groups looked at the Toll-like receptor (TLR) pathway, and both groups independently presented evidence that muscle necrosis in response to ischemia is related to the MyD88 downstream signaling from TLR activation. The effect of cytokines on AAA development was featured by several groups. Investigators from Virginia and Indiana presented results of studies involving the role of interleukin (IL)-17 in the development of aneurysm disease. They demonstrated that IL-17 is increased in human tissue and that the absence of the protein in a mouse model results in smaller aneurysms with reduced production of interferon-γ and tumor necrosis factor-α. Another group of investigators from Virginia demonstrated the presence of increased IL-1β in human AAA and that deficiency of both IL-1β and the IL-1 receptor inhibits the development of AAA in a mouse model. Cellular immunity was also evaluated in AAA. A group from France presented work regarding the effect of regulatory (CD4+CD25+) cells on the development and rupture of model aneurysms. Although neither Th1 nor Th2 lymphocyte inhibition affected aneurysm development in this model, the investigators showed evidence that Treg cell depletion increased aneurysm severity and the incidence of aortic rupture. Investigators from Stanford suggested that splenocyte trafficking may play a role in some models of AAA development, particularly as a reservoir for infiltrating monocytes. Molecular pathways that may affect the phenotype or growth of SMCs were evaluated by researchers from Townsville, Australia, and Rochester, New York. The Australian group presented data implicating increased urocortin-2 as a mechanism for the poor growth of aneurysm-derived SMCs. The Rochester group presented data implicating reduced sonic hedgehog and Notch signaling in the growth inhibition and phenotypic changes characteristic of cells from AAA. Investigators from Massachusetts, Israel, and Maryland applied leptin-containing gels to the aorta of apolipoprotein E–deficient animals. These experiments resulted in enhanced AAA formation suggesting that leptin may play a role in AAA development. Finally, computational models were used by a group from Winnipeg, Canada to evaluate the stress and shear characteristics of the aorta to develop predictive modeling of aortic rupture. Two groups investigated the unique features of the pulmonary endothelium on both local and remote disease. An investigator group from Rochester evaluated differences in pulmonary and peripheral endothelium reactivity and fibrinolytic activity to help understand the occurrence of pulmonary embolism in a patient without deep venous thrombosis. Another group from Houston explored the mechanisms behind pulmonary failure and acute kidney injury and presented evidence that apoptosis of pulmonary endothelium may be related to tumor necrosis factor-α release due to ischemic renal injury. Researchers from Michigan evaluated the regulation of MMP and its relationship to thrombus resolution in an acute model of deep venous thrombosis. By evaluating the changes in this model in response to plasminogen activator inhibitor-1 deficiency, the evidence suggested that MMP-9 and MMP-2 were suppressed despite an increase in fibrinolytic activity. Understanding the mechanisms related to poor wound healing in diabetics was evaluated by two research groups. A group from Miami presented data on improved response of diabetic wound healing to stromal cell derived factor-1 α when it is used to stimulate bone marrow cells before injection into the wound. Investigators from Michigan looked at bone marrow cells from diabetics and found evidence for epigenetic changes to the cells that promote an M1 macrophage phenotype. A clinical study was undertaken by a research group from New Orleans to evaluate changes that may result in vulnerable carotid atherosclerotic plaque. They reported that the microribonucleic acid miR-221 was significantly decreased in the plaque of patients presenting for urgent carotid endarterectomy. The research into the development of vascular conduits from biologics continues to progress as highlighted in two presentations. Investigators from Pennsylvania and New Jersey evaluated the differentiation potential of stem cells from diabetic patients and presented results suggesting that these cells can form a lining on a vascular graft. Researchers from Connecticut evaluated the mechanical and histologic properties of bioengineered grafts used for venous reconstruction and found important differences in these properties compared with normal vein. A group of investigators from London and Oxford in the United Kingdom described the development and characteristics of a nanocomposite polymer stent graft for use in proximal aortic disease. They presented new evidence that this novel polymer has compliance characteristics that more closely mimic normal vascular compliance compared with other standard graft materials (expanded polytetrafluoroethylene and Dacron). As a new item for the conference, the program also included a panel of senior investigators who presented talks and fielded questions regarding practical issues in converting research findings in the laboratory into practical treatments for patients. The first talk by Dr Michael Conte of the University of San Francisco discussed a number of important issues regarding the translation of a concept for a novel pharmacotherapeutic into humans. The talk included drug development costs and the available public funding mechanisms available to investigators with an idea. He gave a helpful description of differences between Small Business Innovation Research (SBIR) and Small Technology Transfer Innovation Research (STTR) programs at the NIH, as well as the Science Moving towArds Research Translation and Therapy (SMARTT) program, which provides services to investigators to support regulatory submissions and preclinical studies, manufacturing, preclinical study planning, and pharmacology/toxicology services. Finally, he discussed the recent Vascular Interventions/Innovations and Therapeutic Advances (VITA) program from the National Heart, Lung, and Blood Institute, which specifically focuses on translational support for treatments of noncardiac vascular disorders, thrombotic diseases, and pulmonary hypertension. The second talk by Dr Christopher Breuer of Yale University School of Medicine focused on unique aspects of bringing a bioengineered tissue product to clinical trial. He emphasized some of the unique regulatory hurdles to performing studies in the United States. Based on his experiences, Dr Breuer noted the importance of reassessing the results of interventions in the clinic and bringing those observations back to the laboratory in order to develop an improved product. From the Mayo Clinic, Dr Peter Gloviczki, the current President of the SVS, described his career in research and presented some of the components of the framework for a successful program of research in an individual career and as part of an academic program. With regard to research program development, he discussed the need for a stimulatory environment and for selecting staff surgeons with research interest and providing them with sufficient opportunity to develop their research program (50% minimum time). He noted that leaders should be involved and thereby lead by example. He similarly emphasized for the individual investigator the need to be part of cooperative groups of investigators, including basic scientists and other clinicians, to create a multidisciplinary team. He also emphasized the importance of sharing responsibility and recognition among the team. The current chair of the Research Council of the SVS, Dr Larry Kraiss of the University of Utah, discussed the specific support mechanisms and research goals of the Society. Current available funding mechanisms through the SVS were presented and discussed. Key awards include the supplemental support for early-stage vascular surgeon researchers who receive Mentored Clinical Scientist Development Awards from the National Heart, Lung, and Blood Institute. He noted the success of the program where 12 of 16 recipients in the K08 pathway have gone on to receive funding through R01 or equivalent VA award mechanisms. Dr Kraiss described how clinical/translational studies are also supported through three mechanisms. One is the Clinical Research Seed Grant, which provides funding of up to $15,000 for a 1-year project by an SVS member or a board-eligible vascular surgeon under the mentorship of an SVS member. He also presented a recently introduced funding mechanism patterned broadly after the NIH R34, the “Multicenter Clinical Studies Planning Grant,” which will provide $100,000 for 1 year to support the production of the manual of operations, site coordination, and other mechanics necessary to establish a study to answer an important clinical question in a multicenter trial format. The final mechanism pertains to large clinical trials. The SVS will evaluate the protocols and may award a letter of approval from the President of the SVS to be used to signify support of the trial to funding and other agencies. Lastly, Dr Kraiss reported that the SVS has committed funds to nurture the next generation of clinical investigators through support of students doing research in laboratories mentored by members of the SVS. Its original organizer, Dr Eugene Strandness, reflecting upon the VRIC after its first 10 years, elegantly summarized the contributions of the VRIC to the science of vascular surgery: “…one must fairly ask to what extent this collaborative effort has been a success. It is my view that it has succeeded in many different ways. First, and perhaps most importantly, it has provided a forum for an interchange of ideas and in-depth discussion of important problems. In addition, because it is held annually, most topics that are discussed are timely and up-to-date. Both the NIH and the scientific community have benefited from this type of exposure…. As one will note from the programs over the years, the topics reviewed at the meetings have been of increasing complexity. This is in a sense a mirror of what is happening in real life. In addition, these conferences do provide a forum for ‘science,’ which is often put aside these days because of our concerns over health care delivery and cost containment. Although there is no argument over concerns related to health care delivery, the solutions to many of our problems in the future will come from the basic science community. It is my view that the leadership…should be commended for urging this kind of collaborative effort.”1Strandness D.E. The research initiatives meeting and the National Institutes of Health.J Vasc Surg. 1996; 23: 1058-1068Abstract Full Text Full Text PDF Scopus (4) Google Scholar Some of the practical successes of the VRIC meeting were subsequently reviewed a decade later.2Pearce W.H. Mannick J.A. Clowes A.W. Yao J.S.T. Twentieth anniversary of American Vascular Association/Lifeline Foundation: a celebration.J Vasc Surg. 2008; 47: 1351-1355Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar, 5Thompson R.W. Schucker B. Kent K.C. Clowes A.W. Kraiss L.W. Mannick J.A. et al.Reviving the vascular surgeon–scientist: an interim assessment of the jointly sponsored Lifeline Foundation/National Heart, Lung, and Blood Institute William J. Von Liebig Mentored Clinical Scientist Development (K08) Program.J Vasc Surg. 2007; 45: A2-A7Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar In particular, this meeting has stimulated a generation of vascular surgeon–scientists. At this point, over 20 NIH K awards have been awarded to vascular surgeons, all of which have been presented at VRIC. The meeting has stimulated numerous young vascular surgeons to enter research careers. It has helped develop collaborations focused on solving specific issues in vascular surgery research. As evidenced by the presentations at the 2012 meeting, the ability of the VRIC to provide an essential forum for communication and collaboration for the solutions of the future remains strong. The VRIC is the only meeting devoted to discussing and presenting the basic and translational science related to the broad discipline of vascular surgery. As such, this meeting is a unique opportunity for vascular surgeons who perform basic and translational research, as it is (1) the only annual venue devoted to state-of-the-art basic science research in the field of vascular surgery, (2) the only annual venue devoted to vascular surgeons presenting basic science research to their peers, (3) the only annual venue for vascular surgery trainees to present their work to their peers, (4) the only annual venue for vascular surgeons and vascular biologists to review vascular surgery basic science research, and (5) the most visible venue for NIH/SVS K08/K23 awardees to present their research. These awards represent the first partnership of NIH with a surgical society for K08 grant sponsorship.2Pearce W.H. Mannick J.A. Clowes A.W. Yao J.S.T. Twentieth anniversary of American Vascular Association/Lifeline Foundation: a celebration.J Vasc Surg. 2008; 47: 1351-1355Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar The progress of the past several years is anticipated to continue to impact the prominence of the VRIC. Maintaining and growing the conference through outreach to international scientific contributors as well as the flourishing of the collaboration with the ATVB will continue to yield significant value for the meeting attendees. Ultimately, the VRIC will continue to play an important role in the scientific process and will provide an environment conducive to the development of important discoveries to improve the health of all patients with vascular disease. The next conference is scheduled to take place at the Dolphin Hotel, Orlando, Fla, on April 30, 2013. This work was supported by the resources and by the use of facilities at the VA Connecticut Healthcare System , West Haven, Conn, and the St. Louis VA Healthcare System , St. Louis, Mo. The authors thank the members of the Society for Vascular Surgery (SVS) Research and Education committee as well as the SVS Research Council for their continued support of the conference and of the SVS research mission. The authors particularly thank the governance of the SVS and the SVS Foundation for their continued support of the VRIC and commitment to fostering research into the foundations of vascular disease.