Impact of the Endovascular Revolution on Vascular Training Through Analysis of National Data Case Reports

Document Type

Article

Publication Title

Journal of Vascular Surgery

Abstract

Background: In the last couple decades, there has been a shift in use of endovascular procedures in vascular surgery. We aim to examine the impact of this endovascular shift on vascular trainees, determine whether surgical experiences of trainees in the integrated residency and fellowship program changed over time, and identify differences between the two training paradigms.

Methods: Data was extracted from the Accreditation Council for Graduate Medical Education National Data Case Logs for the vascular surgery fellowship (1999-2021) and integrated residency (2012-2021) programs. Every procedure was categorized as open or endovascular, then designated into the following subcategories: thoracic aneurysm repairs, cerebrovascular, abdominal aneurysm repairs, venous, vascular access, peripheral arterial disease, visceral, and miscellaneous. We compared the prevalence of open and endovascular cases in the fellowship and integrated residency using data from overlapping years (2012-2021). Also, we compared the mean number of cases per trainee per year within designated time intervals. The vascular surgery fellowship was grouped into three intervals: 1999-2006, 2006-2013, and 2013-2021; the integrated vascular surgery residency was grouped into two intervals: 2012-2017 and 2017-2021. Data were standardized to represent the average number of cases per trainee per year.

Results: Within the fellowship, we found a 362.37% increase in endovascular procedures (Mean±standard deviation, 56.80±32.57 vs. 262.63±9.91, p0.001) procedures than residents. Overall, 52-53% of cases performed by trainees per year were open procedures in both the fellowship and integrated residency (288.56±12.10 vs. 261.27±10.13, 365.52±17.23 vs. 319.58±6.62, both p

Conclusion: Vascular surgery training has incorporated new endovascular techniques and technologies while maintaining operative training in open procedures. Despite changes in vascular surgery training, trainees are still performing more open procedures than endovascular procedures per year. However, there are evolving deficits in specific types of procedures.

DOI

10.1016/j.jvs.2024.01.207

Publication Date

2-15-2024

Keywords

Surgery, endovascular procedures, fellowship, residency, vascular surgery, vascular surgery training

ISSN

1097-6809

Link to Full Text

Share

COinS