Jason Chuen

University of Melbourne | MSD · Department of Surgery (Austin)

Vascular research questions can be answered using various study designs. Observational studies are frequently used to address a wide range of clinical questions when randomized clinical trials are not feasible or practical. One of the powerful vascular research tools is the cohort study. The cohort study is a reliable observational study design in...

Objective To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services du...

Objectives Better tools are needed for risk assessment of Type B aortic dissection (TBAD) to determine optimal treatment for patients with uncomplicated disease. Magnetic resonance imaging (MRI) has the potential to inform computational fluid dynamics (CFD) simulations for TBAD by providing individualised quantification of haemodynamic parameters,...

Purpose: To outline the process of the STABILISE technique and its use; reporting patient outcomes and midterm follow up for complicated aortic dissection. Materials and methods: Single centre retrospective analysis from January 2011 to January 2021 using the STABILISE technique which utilises balloon assistance to facilitate intimal disruption...

Background: Peripheral pulmonary lesion (PPL) incidence is rising because of increased chest imaging sensitivity and frequency. For PPLs suspicious for lung cancer, current clinical guidelines recommend tissue diagnosis. Radial endobronchial ultrasound (R-EBUS) is a bronchoscopic technique used for this purpose. It has been observed that diagnosti...

Introduction: Surgical planning for complex total hip arthroplasty (THA) often presents a challenge. Definitive plans can be difficult to decide upon, requiring unnecessary equipment to be ordered and a long theatre list booked. We present a pilot study utilising patient-specific 3D printed models as a method of streamlining the pre-operative plann...

Like many areas of medicine, vascular surgery has been transformed by the COVID-19 pandemic. Public health precautions to minimize disease transmission have led to reduced attendance at hospitals and clinics in elective and emergency settings, fewer face-to-face and hands-on clinical interactions, and increased reliance on telemedicine, virtual att...

Purpose Over the past two decades, the proliferation of endovascular surgery has changed the approach to abdominal aortic aneurysm (AAA) repair. In Australia, close to two-thirds of surgical procedures are performed in the private healthcare system. We aimed to describe the trends in AAA repair in the Australian private sector throughout the early...

Purpose: This study aims to assess the trends of elective open (OAR) and endovascular AAA repair (EVAR) in Australia using the Australasian Vascular Audit (AVA). Methodology: Prospectively collected data on elective AAA repairs in Australia between 2010-2019 using the AVA database were analysed. Patients ≥50 years were included, age-standardised in...

The spread of coronavirus disease 2019 has drastically altered the medical landscape and profoundly affected the way we conduct our vascular surgery practices. The pandemic was a time of change, not only in the way health care was provided, but also in how people in the health care systems interacted. Social media has rapidly become a crucial commu...

Background 3D printed (3DP) abdominal aortic aneurysm (AAA) phantoms are emerging in the literature as an adjunct for the visualization of complex anatomy, particularly for presurgical device selection and simulation. This is the first systematic review to provide a comprehensive overview of 3DP for endovascular aneurysm repair (EVAR) planning and...

Objective FEVAR has yet to gain widespread adoption due to the technical complexity and increased risk of complications. 3D printed templates to guide fenestrated Physician Modified Stent grafts (PMSGs) are a novel technique that may have the potential to increase the accuracy of fenestration alignment, and to disrupt both the cost and timing of th...

Introduction: 3D printed patient-specific vascular phantoms provide superior anatomical insights for simulating complex endovascular procedures. Currently, lack of exposure to the technology poses a barrier for adoption. We offer an accessible, low-cost guide to producing vascular anatomical models using routine CT angiography, open source software...

Spurred in part by literature published in the immediate aftermath of the severe acute respiratory syndrome epidemic in 2003, powered air‐purifying respirators have seen increased use worldwide during the COVID‐19 pandemic. Whereas these devices provide excellent protection of the user, there is an added element of risk during doffing and cleaning...

3D printing is a novel manufacturing technique that allows surgeons to turn their ideas into reality within the healthcare environment. While surgeons are accustomed to assuming a position of leadership where frontier technologies intersect with patient care, barriers to the uptake of 3D printing include lack of expertise among surgeons, and the pe...

A four-dimensional phase-contrast magnetic resonance imaging sequence with respiratory-controlled adaptive k-space reordering (ReCAR-4DPC) offers potential benefits of improved scan efficiency and motion robustness. Imaging was performed on 15 volunteers and 2 patients with aortic dissection. Inter-scan repeatability and inter-reader agreement of f...

Introduction: Diabetic patients with peripheral arterial disease (PAD) are challenging to assess. Non-contrast magnetic resonance angiography (MRA) offers a safe alternative in patients with renal impairment. The study objective is to evaluate accuracy of lower limb quiescent-interval single-shot (QISS) MRA and pedal QISS-arterial spin-labelled (A...

Objective Three-dimensional printing is a revolutionary technology that is disrupting the status quo in surgery. It has been rapidly adopted by otolaryngology as a tool in surgical simulation for high-risk, low-frequency procedures. This systematic review comprehensively evaluates the contemporary usage of three-dimensional printed otolaryngology s...

The meta-analysis published in December 2018 by Katsanos et al. identified increased mortality in peripheral arterial disease (PAD) patients exposed to drug-eluting peripheral devices. We aimed to investigate proceduralists' attitudes towards the use of drug-eluting technologies within an Australian and New Zealand setting.

Background: Three-dimensional (3D) printing has seen increasing interest in surgery, where it improves the visualization of difficult anatomy in complex cases. This literature review investigates the benefits and limitations of 3D printed models in preoperative planning in the field of orthopaedic surgery. Methods: A literature search was perfor...

Retroperitoneal lymph node dissection (RPLND) is technically challenging with an overall morbidity of 17–33%. We present an illustrative case of malignant RPLND following curative resection of colorectal cancer using the fusion of robotic surgery and 3D‐modelling in preoperative planning and in intraoperative integration of these models to aid prec...

Objectives High-quality research is fundamental to the advancement of surgical practice. Currently, there is no quantitative assessment of the research output of vascular surgeons in Australia and New Zealand. By conducting this bibliometric analysis, we aim to provide an objective representation of the trends in vascular surgery and guide future r...

High-quality research is fundamental to the continuing advancement of surgical practice. Bibliometric studies investigate the academic productivity of different specialties and can be used to identify strengths and gaps in the literature. Currently, there is no quantitative assessment of research output of vascular surgeons in Australia and New Zea...

Aim: The 3D printing is a developing technology which has begun to flourish in fields where the ability to visualize complex anatomy in novel ways can aid interventions. This paper reviews the literature on 3D printing in cardiac surgery. Methods: We performed a literature search in three databases using appropriate search terms to capture publicat...

Vascular surgeons may be requested to participate in non-core vascular procedures pre-emptively or emergently. The consults can vary significantly due to the hospital setting and the type of work conducted by other specialist units. This study aims to examine the type and nature of cross-disciplinary vascular surgery consultations in a twelve-month...

3D printing and additive manufacturing processes have become increasingly accessible since their invention in the 1980s. Nevertheless the uptake of 3D printing technologies in medical care has been slow and patchy. Recent years have seen accelerating interest in this technology and significant growth in the applications of 3D printing to medicine a...

Background: Rotator cuff repair surgery aims to create a secure, pressurized tendon-bone footprint to permit re-establishment of the fibrovascular interface and tendon healing. Flat-braided suture-tape is an alternative suture material to traditional suture-wire that has potential to reproduce a larger repair construct contact area. The objective...

Introduction: Endovascular intervention for chronic total occlusions (CTO) in aorto-iliac occlusive disease (AIOD) poses technical challenges. In this manuscript, our experience of fine needle recanalisation (FNR) for treatment of iliac artery CTO is described. Method: A prospective database recorded treatment of 11 limbs in 11 patients since 20...

Objective: Ultrasound-guided foam sclerotherapy (UGFS) is a low-cost and minimally invasive treatment option for varicose veins. There is a relative paucity of outcome reports. Methods: UGFS procedures at a tertiary public hospital between 2010 and 2017 were studied. Either the great saphenous vein (GSV) or small saphenous vein (SSV) was treated...

Carotid endarterectomy is a commonly performed vascular surgical procedure with well-known complications, such as stroke and nerve injury. Neovascular glaucoma (NVG) is an exceedingly rare complication after carotid endarterectomy that can result in loss of vision. All previous reports of NVG after carotid endarterectomy have occurred on the same s...

Purpose Although high costs are often cited as the main limitation of 3D printing (3DP) in the medical field, current lack of clinical evidence is asserting itself as an impost as the field begins to mature. The aim is to review clinical trials in the field of 3DP, an area of research which has grown dramatically in recent years. Methods We survey...

Management of Type 1A endoleaks can be challenging. In the endovascular era, this condition is expected to become more frequent. Conventionally, surgical explant of the endograft remains the "last resort" surgical treatment when all endovascular or other open options are exhausted. Endograft removal is a difficult and morbid procedure. An alternati...

Introduction Brachial plexus block (BPB) for the creation of arteriovenous fistula (AVF) has been shown to improve arteriovenous fistula patency rates compared with local anaesthetic infiltration1. Less is known about the impact of BPB on patency rates when compared to general anaesthesia (GA). This is important to investigate as there are many si...

Despite being a 30-year old technology and widely adopted in the manufacturing industry, 3D-printing has been slow to enter the medical sphere. Nevertheless, there are signs of increasing interest and good progress in the uptake, research and practical implementation of 3D-printing technologies in medical and surgical applications. This presentatio...

Purpose: There has been an explosion of interest in 3D-printing in Surgery. We seek to demonstrate the contributions to patient-centred care, quality and safety 3D-printing brings to current best practice, and break down the perceived barriers to health services adopting this technology. Methodology: We performed a literature search using Ovid MED...

(a) Introduction Airway management is a critical element in anaesthesia, and one of the emergencies feared by all airway specialists is the "cannot intubate, cannot oxygenate" (CICO) scenario. Albeit uncommon, this is life-threatening and can lead to brain damage or death if not managed appropriately. Thus, there is a great demand for simulation tr...

Purpose: 3D-printing has started to establish itself as an adjunct to endovascular procedures, where the ability to visualise complex anatomy with physical 3D models provides better anatomical clarity than can be achieved via traditional imaging. Methodology: We performed a literature search using Ovid MEDLINE, Ovid EMBASE and PubMed. The search t...

Background: Minor amputation in vascularpaths may be a sentinel event predicting poor outcomes, with a paucity of data of outcomes. Aim: To determine clinical outcome following non-traumatic lower limb minor amputations. Method: Retrospective analysis of 200 vascular patients who required minor amputation between 2010-2015. Patients were followed...

Background Abdominal aortic aneurysm (AAA) remains one of the hallmark pathologies in vascular surgery and an area of intense research interest. Treatment options have expanded in recent years to increase the range of morphology suitable for endovascular aneurysm repair (EVAR), and with potential implications on treatment thresholds. Objective This...

Background Screening and diagnostic surveillance of latent conditions have a profound impact on public healthcare expenditure and clinical outcomes. Abdominal aortic aneurysm (AAA) remains one of the hallmark pathologies in vascular surgery and an area of intense research interest. Objective This article is the second of two that will outline curr...

PurposeThree-dimensional (3D) printing was invented in 1983 but has only just begun to influence medicine and surgery. Conversion of digital images into physical models demonstrates promise to revolutionize multiple domains of surgery. In the field of uro-oncology, researchers and clinicians have recognized the potential of this technology and are...

Social media, Twitter in particular, has emerged as an essential tool for surgeons. In the realm of academic surgery, it enables surgeons to advance the core values of academic surgery, as outlined by the Association for Academic Surgery: inclusion, leadership, innovation, scholarship, and mentorship. This article details the ways in which surgeons...

This presentation accompanies a hands-on workshop in ultrasound guidance for vascular access.

Introduction: We present a simple technique for the pre-operative planning and technical practice of complicated aortic surgery using 3D printed models. Methods: A 1040 slice CT of a complicated aortic case was imported into imaging processing software and a stereolithographic replica printed using Formlabs Clear Resin and polished with Dulux Dur...

Introduction: Ultrasound-guided foam sclerotherapy (UGFS) is a low-cost and minimally invasive treatment option for varicose veins. There is a relative paucity of outcome reports. Methods: UGFS at a tertiary hospital between 2010 and 2017 were studied. Treatments were either the greater saphenous vein (GSV) or short saphenous vein (SSV). Pre-trea...

Introduction: 3D printing is a rapidly developing technology which has started to flourish in fields where the ability to visualise complex anatomy in novel ways may aid interventions. As such, the most prolific medical disciplines utilising 3D printing to date have been the surgical specialties. This paper reviews the published literature on 3D pr...

Objective: Non-contrast magnetic resonance angiography (NC-MRA) is an attractive technique for imaging peripheral arterial disease (PAD) in diabetic patients where arterial calci cation and renal impairment are common. Our purpose was to evaluate patient perception of lower limb NC-MRA and compare this perception to that of digital subtraction angi...

Carotid surveillance and screening comes with risks, some of which are not readily apparent. Principles of screening and surveillance should be followed when implementing such programs.

Cerebrovascular events following carotid endarterectomy (CEA) remains at 2-7%. Despite evidence that antiplatelet therapies reduce the risk of occlusive vascular events, no clear consensus exists regarding the peri-operative use of these drugs. This study reviews the use of single and dual antiplatelet therapy in patients undergoing CEA at a tertia...

Individualised 3D models have the potential to improve preoperative planning when the underlying anatomy or pathology is complex. These models provide an enhanced visualisation of the patient’s anatomy. The use of patient specific 3D printed models in complex aortic surgery has been explored previously and has been shown to be a useful visualisatio...

Screening programs have the potential to detect disease early so that treatment can be offered and long term health burden reduced. Nevertheless there are risks to screening and these should be weighed up carefully before implementation.

Ultrasound-guided vascular access has become increasingly popular. This paper reviews the current evidence for ultrasound guidance for central venous and femoral arterial access.

“Development of 3D Liver Tumour Models for Preoperative Planning and Patient Education.”

Introduction 3D printing has begun to establish itself as a useful adjunct in Vascular Surgery, where the ability to visualise complex anatomy with physical 3D models provides better anatomical clarity than 3D reconstructions or 2D imaging modalities. Of note is its increasing utility as an interventional planning tool for endovascular procedures....

Aims: Acute thrombosis of hemodialysis (HD) arteriovenous access is an urgent problem for HD patients and is commonly managed by endovascular thrombolysis. Pulmonary embolism (PE) is a recognized complication of HD access thrombosis and thrombolysis but the risk and outcomes are unclear. This study aims to determine the incidence, predictors, and...

Background: • Liver and kidney surgery is complicated due to the segmented vasculature network that makes up these organs. • Curative surgery requires sufficient amount of tumour excision, while leaving behind sufficient functioning organ. • Existing medical imaging technology is limited as it represents these three- dimensional (3D) relationships...

Purpose To assess feasibility, image quality and measured venous caliber of non-contrast MRV (NC-MRV) of central and upper extremity veins, compared to contrast-enhanced MRV (CE-MRV) and ultrasound (US) in healthy volunteers. Materials and methods 10 subjects underwent NC-MRV and CE-MRV at 1.5 T, with comparison to US. Two radiologists evaluated M...

Background: Rapid growth of three-dimensional (3D) printing in recent years has led to new applications of this technology across all medical fields. This review article presents a broad range of examples on how 3D printing is facilitating liver surgery, including models for preoperative planning, education, and simulation. Materials and methods:...

Purpose: Rapid growth of three-dimensional (3D) printing in recent years has led to new applications of this technology across all medical fields. Our review presents a broad range of examples on how 3D printing is facilitating liver surgery, including models for preoperative planning, education and simulation. Methodology: We performed an extensiv...

We have analyzed and extracted data from 15 papers on the use of three-dimensional (3D) printing in liver surgery. Reviewed studies have covered predominately models used in preoperative planning and as an intraoperative guidance. It has also been noted that most of developed 3D-printed structures have been accurate enough to provide valuable insig...

Three-dimensional printing has rapidly become an easily accessible, innovative and versatile technology, with a vast range of applications across a wide range of industries. There has been a recent emergence in the scientific literature relating to its potential application across a multitude of fields within medicine and surgery; however, its use...

We describe a simple technique in which current and freely available technology can be utilised by surgeons while operating the Da Vinci Si/Xi Surgical Robotic systems. This technique allows for a parallel intraoperative display within the surgical console of any desired subject material from a standard computer, utilising commercially available ca...

Overview of Subclavian Steal Syndrome. View full chapter at http://emedicine.medscape.com/article/462036-overview

Extracranial carotid ultrasound is the initial diagnostic modality of choice when evaluating symptomatic and symptomatic internal carotid artery (ICA) stenosis. Whilst there are no universally established guidelines, carotid intervention thresholds at 50%, 60%, 70% and 80% ICA stenosis have been proposed, based on previous trials (ACST, ECST). Ame...

Abdominal aortic aneurysms are often asymptomatic, with common risk factors including older age, male gender, smoking and hypertension. It is essential to identify, monitor and repair these aneurysms before they rupture. This first part of a two-part article discusses assessment, surveillance protocols, screening and indications for prophylactic re...

Objective: The aim of this study was to evaluate image quality and accuracy of 64+ detector multidetector computed tomography angiography (MDCTA) for hemodynamically significant (≥50%) stenosis in patients with symptomatic peripheral arterial disease (PAD) using digital subtraction angiography as the reference standard. Methods: This is a retros...