Robert D. McBane, II, M.D.

Location

SUMMARY

Robert D. McBane, II, M.D., has a dual research focus in the areas of cardiology and hematology owing to his interest in hemostasis and thrombosis.

Dr. McBane sees patients in Mayo Clinic's Gonda Vascular Center, a multidisciplinary practice devoted to the evaluation and care of patients with vascular diseases. Within the center is a high-volume clinic for patients with thrombotic diseases. In this context, Dr. McBane's specific research interest is the evaluation and management of cancer-related thrombosis, including multicenter randomized controlled trials enrolling patients with cancer and venous thromboembolism.

Focus areas

• Periprocedural anticoagulation management. Dr. McBane and team assess variables that contribute to adverse events in the context of periprocedural anticoagulation management. Their studies use artificial intelligence strategies and natural language processing methodologies to identify variables contributing to periprocedural management decision-making.

• Cancer-associated venous thrombosis. Dr. McBane has participated in a number of randomized controlled trials focused on the prevention and treatment of cancer associated-venous thromboembolism. These trials include the Apixaban and Dalteparin in Active Malignancy-Associated Venous Thromboembolism (ADAM VTE), CAPRINI and EVE trials. Each of these trials has assessed the efficacy and safety of direct oral anticoagulants compared with low-molecular weight heparin for patients with cancer.

  In addition, Dr. McBane participates in ongoing studies on mortality outcomes related to major bleeding or thrombus recurrence for patients who are taking anticoagulants. He has recently completed a study on efficacy and safety related to anticoagulant adherence in the cancer care setting. He also is interested in cancer-associated marantic endocarditis epidemiology and outcomes, including assembly of a retrospective cohort experiencing this complication.

• Artificial intelligence and peripheral arterial occlusive disease. Dr. McBane and team are assessing the diagnosis of peripheral arterial occlusive disease. To do this, they are tapping into Mayo Clinic's rich vascular laboratory resources, collaborating with experts in artificial intelligence, and using a Doppler signal and deep neural network analysis. This strategy has been shown to identify patients with peripheral arterial occlusive disease with excellent sensitivity, specificity and overall accuracy.

  The team is conducting further studies to determine whether artificial intelligence and deep neural network analysis of Doppler signals can predict important outcomes such as major adverse cardiac events, major adverse limb events and overall mortality.

• Venous plethysmography, poor calf muscle pump function and survival. Also using Mayo's vascular laboratory resources, Dr. McBane and colleagues have assembled a cohort of patients who have undergone venous plethysmography testing to assess the implications of poor calf muscle pump function and long-term survival. Like heart failure, "calf-pump failure" is associated with poor survival rates. The team is pursuing further studies to determine variables that influence poor calf muscle pump function and adversely affect survival rates.

Significance to patient care

Each of Dr. McBane's research focus areas drives improvements in patient care and outcomes.

• Periprocedural anticoagulation management. Many people who take anticoagulants require invasive procedures that include temporary anticoagulant interruption. During these interruptions, patients are at risk of major bleeding or thrombosis, with substantial related risk of morbidity and mortality. By improving the understanding of health care teams' decision-making and management processes, Dr. McBane seeks to identify and facilitate improved periprocedural anticoagulant management to limit adverse outcomes.
• Cancer-associated venous thrombosis. Patients with cancer are at increased risk of both bleeding and clotting. Managing cancer-associated venous thromboembolism is complicated and requires dedicated research to develop best-practice models. Dr. McBane's research aims to determine the most effective and safest anticoagulant strategy in this context.
• Artificial intelligence and peripheral arterial occlusive disease. Peripheral arterial occlusive disease is common and increasing. It also is associated with increased cardiac mortality risk and is an independent predictor of adverse outcomes. Identifying patients with peripheral artery disease is an important priority but remains challenging. Developing tools to recognize patients with this disease would help doctors put prevention in place. Dr. McBane's research aims to develop tools to help doctors diagnose peripheral arterial occlusive disease earlier.
• Venous plethysmography, poor calf muscle pump function and survival. The calf muscles are important circulatory organs because they pump blood from the lower part of the legs back to the right atrium of the heart. Dr. McBane's research aims to improve prognoses for patients with heart failure by identifying variables contributing to poor calf muscle pump function and associated risk of mortality.