Neal R. Barshes, M.D., M.P.H.

Associate Professor of Surgery

(713) 794-7892

Positions

Associate Professor of Surgery: Division of Vascular Surgery & Endovascular Therapy
Baylor College of Medicine

Chief, Vascular Surgery Section: Michael E. DeBakey VA Medical Center

Addresses

Michael E. DeBakey VA Medical Center (Hospital): 2002 Holcombe Boulevard
OCL-112
Houston, TX, 77030
United States

Education

BS from University of Illinois at Urbana-Champaign: 05/1997 - Urbana-Champaign, Illinois, United States; psychology

MD from University of Illinois at Chicago College of Medicine: 05/2001 - Chicago, Illinois, United States

MPH from University of Texas at Houston Health Science Center: 05/2006 - Houston, Texas, United States; healthcare delivery systems

Residency at Michael E. DeBakey Department of Surgery / Baylor College of Medicine: 06/2009 - Houston, Texas, United States; general surgery

Clinical Fellowship at Harvard Medical School / Brigham and Women's Hospital: 06/2011 - Boston, Massachusetts, United States; vascular surgery and endovascular therapy

Certifications

General Surgery: American Board of Surgery

Vascular Surgery: American Board of Surgery

Registered Physician in Vascular Interpretation: American Registry for Diagnostic Medical Sonography

Honors & Awards

Clark Faculty Service Award: Baylor College of Medicine

Star Award for Excellence in Patient Care: Baylor College of Medicine

Gene Guinn M.D. Outstanding Teaching Faculty Award for excellence in teaching general surgery residents: Michael E. DeBakey Department of Surgery (07/2014 - 07/2015)

Outstanding Teaching Faculty Award for excellence in teaching medical students: Michael E. DeBakey Department of Surgery (07/2013 - 06/2014)

Outstanding Teaching Faculty Award for excellence in teaching medical students: Michael E. DeBakey Department of Surgery (07/2014 - 06/2015)

Top Doctor: Vascular Surgery: Houstonia Magazine

Faculty Excellence Award for Educational Materials: Norton Rose Fulbright Awards (07/2026)

Professional Interests

Leg bypass operations, including tibial, pedal, and pedal branch targets
Ewing technique for transtibial (below-knee) amputations
Microvascular anastomoses
Aortic aneurysms
Carotid artery operations for stroke prevention
Peripheral arterial disease (PAD)

Professional Statement

Dr. Neal R. Barshes is a double board-certified vascular surgeon. He diagnoses and treats the full spectrum of peripheral vascular disorders, especially peripheral artery disease (PAD) and critical limb-threatening ischemia (CLTI).

Dr. Barshes currently sees patients and operates exclusively at the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) in Houston, Texas.

As an academic vascular surgeon, Dr. Barshes works to develop cost-effective, resilient and equitable strategies to prevent leg amputations. He has authored more than 150 original, peer-reviewed articles to professional medical journals. He has served on guideline writing committees for the American Heart Association, the Society for Vascular Surgery, and the International Working Group for the Diabetic Foot.

For his clinical efforts, Dr. Barshes was awarded the Baylor College of Medicine Star Clinician Award “for clinical excel-lence and expertise” and the Clark Service Award for representing “Baylor’s mission, vision and values at the highest level”.

Websites

Dr. Barshes's academic portfolio on GitHub

Dr. Barshes's publications on Google Scholar

Selected Publications

Barshes NR, Chambers JD, Cohen J, Belkin M. " Cost-effectiveness in the contemporary management of critical limb ischemia with tissue loss. " J. Vasc. Surg.. 2012 Oct ; 56 (4) : 1015-1024.e1.
Pubmed PMID: 22854267.
Barshes NR, Flores E, Belkin M, Kougias P, Armstrong DG, Mills JL Sr. " The accuracy and cost-effectiveness of strategies used to identify peripheral artery disease among patients with diabetic foot ulcers. " J Vasc Surg. 2016 ; 64 : 1682-1690.
Pubmed PMID: 27575813.
Barshes NR, Sigireddi M, Wrobel JS, Mahankali A, Robbins JM, Kougias P, Armstrong DG. " The system of care for the diabetic foot: objectives, outcomes, and opportunities " Diab Foot Ankle. 2013 Oct ;
Pubmed PMID: 24130936.
Barshes NR, Menard MT, Nguyen LL, Bafford R, Ozaki CK, Belkin M. " Infrainguinal bypass is associated with lower perioperative mortality than major amputation in high-risk surgical candidates. " J. Vasc. Surg.. 2011 May ; 53 (5) : 1251-1259.e1.
Pubmed PMID: 21292432.
Barshes NR, Ozaki CK, Kougias P, Belkin M. " A cost-effectiveness analysis of infrainguinal bypass in the absence of great saphenous vein conduit. " J. Vasc. Surg.. 2013 Jun ; 57 (6) : 1466-70.
Pubmed PMID: 23395205.
Barshes NR, Belkin M. " A framework for the evaluation of value" and cost-effectiveness in the management of critical limb ischemia." " J. Am. Coll. Surg.. 2011 Oct ; 213 (4) : 552-66.e5.
Pubmed PMID: 21943802.
Barshes, NR, Gold B, Garcia A, Bechara CF, Pisimisis G, Kougias P.. " Minor Amputation and Palliative Wound Care as a Strategy to Avoid Major Amputation in Patients with Foot Infections and Severe Peripheral Arterial Disease " Int J Low Extrem Wounds. 2014 ;
Pubmed PMID: 25049375.
Barshes NR, Rodriguez-Barradas MC, Bechara CF, Pisimisis G, Young EJ, Kougias P.. " Microbial Isolates and Their Antimicrobial Susceptibilities in Inframalleolar Foot Infections " Surg Infect. 2014 ;
Pubmed PMID: 24827989.
Barshes NR, Saedi S, Wrobel J, Kougias P, Kundakcioglu OE, Armstrong DG. " A model to estimate cost-savings in diabetic foot ulcer prevention efforts. " J Diabetes Complications. 2017 ; 31 (4) : 700-707.
Pubmed PMID: 28153676.
Barshes NR, Mindru C, Ashong C, Rodriguez-Barradas M, Trautner BW. " Treatment Failure and Leg Amputation Among Patients With Foot Osteomyelitis. " Int J Low Extrem Wounds. 2016 ; 15 (5) : 303-312.
Pubmed PMID: 27581112.
Barshes NR, Vavra AK, Miller A, Brunicardi FC, Goss JA, Sweeney JF. " General surgery as a career: a contemporary review of factors central to medical student specialty choice. " J. Am. Coll. Surg.. 2004 Nov ; 199 (5) : 792-9.
Pubmed PMID: 15501122.
Barshes NR, Chambers JD, Cantor SB, Cohen J, Belkin M. " A primer on cost-effectiveness analyses for vascular surgeons. " J. Vasc. Surg.. 2012 Jun ; 55 (6) : 1794-800.
Pubmed PMID: 22608043.
Choi JC, Miranda J, Greenleaf E, Hansraj N, Conte MS, Gerhard-Herman MD, Mills JL, Barshes NR.. " Lower-extremity pressure, staging, and grading thresholds to identify chronic limb-threatening ischemia. " Vasc Med. 2023 ; 28 : 45-53..
Pubmed PMID: 36759932.
Bidare D, Sharath SE, Cerise F, Barshes NR.. " Specialist Access and Leg Amputations among Texas Medicaid Patients. " Semin Vasc Surg. 2023 ; 36 : 49-57..
Pubmed PMID: 36958897.
Barshes NR, Minc SD. " Healthcare Disparities In Vascular Surgery - A Critical Review. " J Vasc Surg. 2021 ; 74 ((S2)) : 6S-14S.e1..
Pubmed PMID: 34303462.
Barshes NR, Bidare D, Kougias P, Mills JL, LeMaire SA.. " Racial and Ethnic Disparities in Abdominal Aortic Aneurysm Evaluation and Treatment Rates in Texas. " J Vasc Surg. 2022 ; 76 : 141-148..
Pubmed PMID: 35063611.
Barshes NR, Clark NJ, Bidare D, Dudenhoeffer JH, Mindru C, Rodriguez-Barradas M.. " Polymicrobial Foot Infection Patterns are Common and Associated with Treatment Failure. " Open Forum Infect Dis. 2022 ; 9 : ofac475.
Pubmed PMID: 36267251.
Minami HR, Greenleaf EK, Nejim BJ, Manikonda SPR, Barshes NR. " Cost-effectiveness analysis of surgical repair versus observation of complex abdominal aortic aneurysms in elderly patients " J Vasc Surg. 2025 ; 83 : 699-709.
Pubmed PMID: 41067588.
Barshes NR, Kougias P, Ozaki CK, Pisimisis G, Bechara CF, Henson HK, Belkin M.. " Cost-effectiveness of revascularization for limb preservation in patients with marginal functional status " Ann Vasc Surg. 2014 Jan ; 28 (1) : 10-17.
Pubmed PMID: 24332257.
Conte MS, Aulivola B, Barshes NR, Bertges DJ, Corriere MA, Murad MH, Powell RJ, Reed AB, Robinson WP 3rd, Simons JP. " Society for Vascular Surgery Clinical Practice Guideline on the Management of Intermittent Claudication: Focused Update " J Vasc Surg. 2025 ; 82 : 303-326.
Pubmed PMID: 40316185.
Menard MT, Farber A, Powell RJ, Rosenfield K, Conte MS, Hamza TH, Kaufman JA, Cziraky MJ, Creager MA, Dake MD, Jaff MR, Reid D, Sopko G, White CJ, Strong MB, van Over M, Chisci E, Goodney PP, Gray B; BEST-CLI Investigators.. " Quality of Life in Patients With Chronic Limb-Threatening Ischemia Treated With Revascularization " Circulation. 2024 ; 149 : 1241-1253.
Pubmed PMID: 38597097.

Memberships

American College of Surgeons

Society for Vascular Surgery

American Diabetes Association

Society of Brigham Surgical Alumni

Texas Surgical Society

Funding

Randomized, Multicenter, Controlled Trial to Compare Best Endovascular versus Best Surgical Therapy in Patients with Critical Limb Ischemia (BEST-CLI) #ClinicalTrials.gov ID NCT01229358: (12/01/2014 - 12/01/2022); Grant funding from The National Institutes of Health (NIH); the National Heart, Lung and Blood Institute (NHLBI); Prospective, randomized, multicenter trial comparing endovascular therapy (angioplasty with or without stent placement) to leg bypass surgery to improve leg circulation for limb-threatening conditions and avoidance of leg amputations.

Investigation of Rifampin to Reduce Pedal Amputations for Osteomyelitis in Diabetics (VA-INTREPID) #ClinicalTrials.gov ID NCT03012529: $834,207.00 (08/01/2017 - 06/30/2025); Grant funding from Veterans Health Administration Cooperative Studies Program; Prospective, randomized, double-blind, placebo-controlled multicenter trial comparing a six week course of adjunctive rifampin vs. adjunctive matched placebo added to standard antibacterial therapy for the treatment of diabetic foot osteomyelitis.

Transfusion Trigger after Operation in High Cardiac Risk Patients #ClinicalTrials.gov ID NCT03229941: $1,370,683.00 (08/01/2017 - 06/30/2025); Grant funding from Veterans Health Administration Cooperative Studies Program; Prospective, randomized, multicenter clinical trial that compared postoperative outcomes in a restrictive transfusion strategy (Hb < 7 gm/dl) vs. a non-restrictive transfusion strategy (Hb < 10 gm/dl) in Veterans at high cardiac risk who undergo major open vascular and general surgery operations

Randomized Clinical Trial for Ewing Amputation in the VA #; ClinicalTrials.gov ID NCT05437562: (06/01/2026); Grant funding from Veterans Health Administration Office of Research and Development, Clinical Science Research & Development; Prospective, randomized, multicenter clinical trial comparing ambulatory function and mobility in patients undergoing transtibial (below-knee amputation using traditional vs. Ewing surgical technique.

Impact of Colchicine on Peri-Operative Major Adverse Cardiovascular Events in Patients with Prior Coronary Revascularization: The Peri-OPerative COlchicine to Reduce Nega-tive Events (POPCORN) Trial #ClinicalTrials.gov ID NCT05618353: (06/01/2025); Grant funding from Veterans Affairs Office of Research and Development; Prospective, randomized, multicenter trial comparing the clinical outcomes (including perioperative major adverse cardiac events) and systemic inflammation associated with colchicine compared to placebo in patients with prior coronary revascularization or high coronary atherosclerotic burden who undergo intermediate- or high-risk non-cardiac surgery.