Matthew Mell, M.D., M.S., a national leader in defining health policy for managing and treating aortic disease, joined UC Davis Health from Stanford University in 2018 as director of the UC Davis Vascular Center and chief of the Division of Vascular and Endovascular Surgery in UC Davis Health’s Department of Surgery.
At Stanford, Mell was medical director of the Vascular Clinic and Stanford Healthcare Ambulatory Specialty Care, and vice chair of clinical affairs for the surgery department. He is an expert in promoting early recognition of vascular disease to reduce the risks of heart attack, stroke and amputation, and is well-known nationally for improving knowledge and standards for screening, surveillance and treatment of abdominal aortic aneurysm.
At UC Davis, Mell leads a multidisciplinary team of experts who offer advanced diagnostics and both endovascular and surgical interventions for vascular diseases — from venous conditions to peripheral artery disease and critical limb ischemia. In his own clinical practice, he specializes in complex vascular and endovascular surgery, including open and endovascular reconstruction of the abdominal and thoracic aorta, renal and mesenteric arteries, carotid and subclavian arteries, and arteries of the lower extremities.
Mell has been recognized as the Pearl Stamps Stewart Endowed Professor in Surgery, complementing Diana Farmer’s Pearl Stamps Stewart Endowed Chair.
Q. Can you describe your role in the spectrum of complex vascular care here?
I oversee all operational aspects of the Vascular Center, which links experts in radiology, surgery and internal medicine. My administrative role is to be the catalyst for bringing in new technology to support my faculty. Clinically, my practice is broad and has focused on new technologies for aortic, carotid, and peripheral vascular disease. I also provide complex open surgical repair for such conditions.
Q. What are your thoughts on current trends in the overall complex vascular field? What’s new and on the horizon, and how is this coming into play at UC Davis Health?
New technologies continue to be on the horizon. In the past year and a half since I’ve been at UC Davis Health, we have expanded our abilities to provide complex endovascular aortic repair; transcarotid endovascular stents (TCAR); and alternative access for endovascular treatment of peripheral artery disease (radial access, pedal access). We’re constantly monitoring the field and working to introduce new and improved diagnostic and treatment modalities in our region.
Q. Are there specialized services in particular that you’d like to highlight for referring physicians in our 33-county area?
Aortic aneurysm repair for one, including endovascular repair (EVAR) with all FDA-approved endografts. We also offer aortic fenestration and other newer aortic dissection repair techniques. Some other key areas are carotid artery stenting and endarterectomy, and endovascular and surgical treatment for PAD.
Our overall goal is to offer the latest proven technologies, and an approach that includes personalized decision-making based on the patient’s specific situation and both medical and surgical treatment options. For example we can provide complete aorta care in different modalities, from open replacement to endovascular surgery, and tailor plans for venous disorders to address aesthetic and medical concerns.
Our noninvasive vascular lab is central California’s busiest and the best in our region — accredited and with outstanding technologists focused solely on vascular imaging.
Q. The UC Davis Vascular Center was one of the region’s first providers to make transcarotid artery revascularization (TCAR) available to patients. Why did we pursue early adoption, and what are the advantages for our patients?
This is the first endovascular or hybrid carotid procedure with outcomes that appear to be equivalent or better than traditional surgical carotid endarterectomy. Roughly two-thirds of patients with surgical carotid disease may be candidates for TCAR. I wanted to bring the exciting new technology to UC Davis.
TCAR generally offers three major benefits over traditional carotid procedures: stents travel less distance; loosened material travels away from the brain to larger, lower extremity vessels; and the treatment takes up to half the time of traditional procedures.
Q. You’re well-known for improving screening, surveillance and treatment of abdominal aortic aneurysm (AAA), and you’ve been a driving force behind national standards for identification, monitoring and treatment following rupture. Why this particular area of interest?
These areas, along with treatment advances, are an effective way to improve the outcomes for patients with AAA at both an individual and population level. Optimizing screening, surveillance, and timely treatment of ruptured AAA assumes special importance for central California because the region is challenged with large rural areas.
Q. You’ve published extensively on AAA, including on practice guidelines, long-term outcomes, and opportunities for population-based management. Care to share any key takeaways?
Increased screening for men with any smoking history. And for those with documented aneurysms, routine surveillance is mandatory!
Q. You and colleagues here recently published a study that indicated less-invasive procedures for opening severely-clogged leg arteries are as good as more-invasive open surgeries at helping people avoid and survive amputation. Can you tell more about the findings and their potential impact?
This retrospective study suggested that the invasiveness of the procedure is not as critical as reestablishing blood flow for these patients with chronic limb-threatening ischemia. At a patient level, the intervention needs to be chosen at an individual level. This is an example of precision medicine that we can provide.