Vascular Surgeon Works to Both Provide State-of-the-Art Care and Define It
Author: Lucy Schultze
How can you decrease the chance a diabetic patient will need a limb amputated? What’s the best way to break up a dangerous blood clot in a patient who can’t tolerate invasive surgery? Which new device will best remedy a complex aortic aneurysm?
It’s questions like these that fuel the motivation of Mohamed Zayed, MD, PhD, as he dedicates his efforts in both the operating room and the science laboratory. His goal is not just to provide state-of-the-art care, but also to help define it.
“I feel very fortunate to be able to provide novel therapies to patients who would otherwise have limited options,” said Zayed, a vascular surgeon at Barnes-Jewish Hospital and assistant professor at Washington University School of Medicine.
Since joining Barnes-Jewish Hospital in 2014, Zayed has developed a diverse clinical practice that ranges from treating young patients with straightforward issues to older ones with severe life-threatening co-morbidities.
“My practice allows me to treat patients with a variety of vascular disorders,” he said. “I enjoy being able to operate across the full spectrum of the venous and arterial systems, and to be able to help patients from all walks of life.”
At the same time, Zayed’s clinical investigatory appointment at Wash U allows him to devote considerable time to research. His basic science laboratory is based in the Division of Endocrinology, Metabolism and Lipid Research, and he has received support from the Society of Vascular Surgery Foundation and the Vascular Cures Foundation. His award from the latter, the Wylie Scholar Award, is granted to only one vascular surgeon in North America each year.
“The focus of my laboratory is to look at mechanisms that make diabetic patients more prone to peripheral arterial disease,” Zayed said. “Unfortunately, in that subset of patients, the peripheral arterial disease is much more prevalent than the general population and leads to significant life-altering complications.”
Working as a physician scientist at a leading institution is the realization of a long-held ambition for Zayed.
Born in Egypt, he and his family moved to England and ultimately to the United States, as his father completed a PhD at the University of London followed by a postdoctoral fellowship at the University of California, Berkeley. His father, Adel, has since led a research career in plant physiology and biochemistry.
“I used to visit my father’s laboratory as a child,” Zayed said. “I ultimately decided I wanted to be a scientist just like my father.”
That focus was refined during Zayed’s freshman year at the University of North Carolina at Chapel Hill when his father suffered a heart attack. Zayed became interested in medicine, and particularly in vascular biology. He was accepted into a medical scientist training program (MD/PhD) at UNC, sponsored by the National Institutes of Health (NIH). During his PhD research in pharmacology, he studied the molecular processes that help blood-vessels development. Meanwhile, he connected with several vascular surgeon mentors at UNC, sealing the choice for his clinical focus.
“I also wanted to be like my mentors,” he said. “They were caring clinicians, but they were also thoughtful scientists. They were interested not only in treating the disease process, but also further understanding it in a way that can promote health in a larger set of patients.”
Zayed opted to do a full five-year residency in vascular surgery, selecting Stanford University for its program’s particular blend of medicine, science, and engineering.
“My training not only involved learning how to take care of patients and perform complex operations, but was also molded with opportunities for research and collaboration,” he said. “While I was in Palo Alto I also had the chance to serve as chief medical officer in a medical-technology company, which was truly a unique time of growth and development for me.”
Since arriving in St. Louis, Zayed has gotten his lab rolling with the mentorship of Dr. Clay Semenkovich, Washington University School of Medicine Chief of Endocrinology, and with recent grant funding. This has helped create the Translational Cardiovascular Biobank & Repository program between Wash U and Barnes-Jewish Hospital.
“With support from the Department of Surgery, we have been able to restructure a protocol to allow patients coming for a vascular operation, to donate their plaque so that we can molecularly and biochemically study it in the laboratory,” he said. “This provides a huge opportunity for us as surgeons to be able to study the underlying processes that lead to these diseases in the first place.”
In one current study, Zayed’s lab is identifying the molecular and biochemical causes of severe vascular disease in the lower extremities of diabetics.
“In my practice, unfortunately, I do at least one amputation a week,” he said. “This is a disheartening process, as the limb has not been able to be saved. Obviously, we would like to preserve the limbs and make sure our patients maintain their functional capabilities.”
Zayed’s lab has generated preliminary findings that show differences between the lipid structure of plaques in diabetics versus non-diabetics. The lab is currently studying enzymatic pathways that regulate these lipids, to learn how they can be targeted therapeutically.
In his clinical practice, Zayed has been involved in implementing Angiovac™ as a new minimally invasive treatment option for removing large-volume blood clots in the chest, abdomen, and lower extremities. Entering the body through small punctures or incision at the base of the neck or at the groin, the system works by suctioning the blood clots under x-ray supervision.
“I had used similar devices during my training,” Zayed said. “Through a joint collaboration between Barnes-Jewish Hospital interventional radiology and vascular surgery, we have been able to combine our expertise to introduce this unique option for patients who come to the Heart and Vascular Center for treatment.
“The key thing is providing patients with multiple options, both surgically and medically — especially those with unique comorbidities who cannot otherwise tolerate traditional treatment modalities.
“We encourage physicians in the broader community to feel free to consult with us if they have patients that are not candidates for conventional treatment options. Our clinical practice at Washington University and Barnes-Jewish Hospital has access to a unique array of novel treatments, as well as clinical and investigational trials that can benefit patients with a wide complexity of vascular disease.”
For both clinical and laboratory-based projects, Zayed and his teams aim to publish their findings in peer-reviewed journals in the coming year.
Outside of work, Zayed plays golf and tennis and spends time with his family. He and his wife, Nuha, have a son, Yusuf, and daughter, Nour.
Washington University Physicians: Mohamed Zayed, MD, PhD
Washington University School of Medicine: Vascular Surgery
Vascular Cures: Wylie Scholar Program