Seminars In Vascular Surgery[JOURNAL]
Sun
200 papers
Open revascularization for infrainguinal peripheral arterial disease in elderly patients: A scoping review.
Yu G, Etkin Y, Silpe J
Semin Vasc Surg · 2025 Sep · PMID 40921557 · Publisher ↗
Peripheral arterial disease (PAD) is a prevalent and debilitating condition in elderly patients, often leading to critical limb threatening ischemia (CLTI) and major amputations. While endovascular interventions are usua...
Peripheral arterial disease (PAD) is a prevalent and debilitating condition in elderly patients, often leading to critical limb threatening ischemia (CLTI) and major amputations. While endovascular interventions are usually preferred for their lower perioperative risk, open surgical revascularization should also be considered due to its durability and superior patency in complex disease patterns. Age alone does not determine suitability for surgery; rather, candidacy hinges on frailty, functional status, comorbidities, and anatomical considerations. Contemporary global guidelines endorse a patient-centered approach that integrates these multidimensional factors. This scoping review will evaluate the outcomes of open infrainguinal revascularization in patients over 70, compared to endovascular approaches, and discuss how these findings align with contemporary guidelines and clinical decision-making paradigms. A scoping review was performed using one independent reviewer who screened PubMed to identify peer-reviewed observational studies and randomized controlled trials (2004-2024) involving patients aged >70 undergoing open infrainguinal revascularization. Keywords included "infrainguinal PAD," "open revascularization," and "elderly." Key data extracted included perioperative morbidity, mortality, graft patency, limb salvage, and comparative effectiveness against endovascular strategies. A total of 1,574 articles were identified through reference search. We then screened these articles and assessed 265 full-text articles for eligibility. After exclusion, 19 full-text articles were selected for final inclusion. Nineteen eligible studies were included. Open revascularization in the elderly demonstrated 30-day mortality rates of 2% to 5% and 80% to 90% limb salvage rates in patients. Compared to endovascular techniques, open bypass yielded lower reintervention rates and superior long-term patency, especially when an autologous vein was used. Endovascular procedures were favored in high-risk or frail patients for their favorable perioperative profile. Frailty, functional independence, and conduit availability emerged as key determinants of surgical success. Open infrainguinal revascularization remains a viable and often preferable option for select elderly PAD patients. Decision-making should prioritize biological age, anatomical suitability, and patient preferences over chronological age. A multidisciplinary, guideline-driven approach can optimize outcomes, minimize risk, and preserve limb function and quality of life in this growing population.
Navigating treatment decisions for CLTI in older adults: Primary amputation vs revascularization.
Radomski SN, Holscher CM
Semin Vasc Surg · 2025 Sep · PMID 40921556 · Publisher ↗
As the world's elderly population continues to grow, the proportion of people living with chronic medical conditions is also increasing. Cardiovascular diseases including hypertension, diabetes, and atherosclerosis are a...
As the world's elderly population continues to grow, the proportion of people living with chronic medical conditions is also increasing. Cardiovascular diseases including hypertension, diabetes, and atherosclerosis are among the most common, and as a result peripheral artery disease (PAD) is increasingly prevalent in this population. It is estimated that 15% to 20% of the elderly population has been diagnosed with PAD, and consequentially there is also a large proportion who have progressed to chronic limb threatening ischemia (CLTI). The management of this end stage of PAD is complex regardless of age, as there is high variability in current practice patterns and a lack of consensus on endovascular or surgical bypass as the initial treatment modality. The treatment paradigm becomes even more complicated in the elderly population, and special considerations must be given to treatment including the decision to offer revascularization (surgical or endovascular) vs primary amputation. This article explores the risks and benefits of the 2 approaches in the context of mortality, quality of life, and cost in the elderly population. Although there is good evidence that revascularization confers benefits in mortality, quality of life, and cost, there are also data that indicate that this approach should only be offered to fully independent individuals as outcomes in those with a nonambulatory status preoperatively are poor. Overall, the authors advocate for a patient-centered, multidisciplinary approach to treating CLTI in this population that focuses first and foremost on patient goals.
Assessment and management of chronic venous, arterial, and diabetic wounds in older adults.
Dowling C, Chu L, Etkin Y … +1 more , Oropallo A
Semin Vasc Surg · 2025 Sep · PMID 40921555 · Publisher ↗
Nonhealing wounds are increasingly prevalent, present in 1% to 2% of the global population, with higher incidence in geriatric patients. These chronic wounds pose challenges to older adult patients owing to physiologic c...
Nonhealing wounds are increasingly prevalent, present in 1% to 2% of the global population, with higher incidence in geriatric patients. These chronic wounds pose challenges to older adult patients owing to physiologic changes that hinder healing, common medical comorbidities that promote inflammation and damage microcirculation, poor nutritional status and mobility, and psychosocial barriers to receiving care. In this literature review, the epidemiology, pathophysiology, systems costs, and management of chronic venous leg ulcers, arterial ulcers, and diabetic foot wounds in older adult patients are investigated. Evolving skin structure, pro-inflammatory cellular changes, and propensity for infection place the geriatric population at risk for all wound types. Strategies to differentiate between nonhealing wounds through physical examination, standardized tools, and patient-specific characteristics are outlined. Optimal wound care management principles for each wound type, including wound bed debridement, moisture optimization, biofilm control, and management of edema are addressed. Venous leg ulcers secondary to venous insufficiency are particularly common in older adults and often recur, requiring innovative techniques in compression and tissue substitutes. Emerging therapies, including skin grafts, hyperbaric and topical oxygen, and bedside imaging devices, are discussed. Finally, older adult patients are susceptible to social circumstances that place them at risk for suboptimal wound care and poor healing. The combination of access gaps to regular caretakers, immobility, nociceptive and neuropathic pain, and frailty must be acknowledged and addressed in older adult patients with wounds. The aims of this literature review were to clarify these factors to consolidate awareness and to advocate for a multidisciplinary approach to wound care management.
Management of claudication in older adults and the role of exercise therapy.
Aalami OO, Corriere MA
Semin Vasc Surg · 2025 Sep · PMID 40921554 · Publisher ↗
Claudication from peripheral artery disease is a common mobility-limiting condition in older adults. Exercise therapy, whether delivered through supervised programs or structured home-based programs, plays a central role...
Claudication from peripheral artery disease is a common mobility-limiting condition in older adults. Exercise therapy, whether delivered through supervised programs or structured home-based programs, plays a central role in claudication care for older adults, offering substantial functional gains with minimal risk, and should be the cornerstone of management alongside optimized medical therapy. This review examines contemporary management of claudication in the aging population, with emphasis on exercise therapy. Treatment modalities, including best medical therapy, supervised exercise therapy, home-based exercise programs, and invasive interventions (endovascular and open surgery) are critically evaluated. Pharmacotherapy (eg, cilostazol) can modestly improve walking distance, and aggressive risk factor control (eg, smoking cessation and statins) is imperative for all patients. Invasive revascularization is reserved for select individuals with lifestyle-limiting claudication unresponsive to conservative measures, given procedural risks and the potential for repeated interventions. Recent society guidelines (American College of Cardiology and the American Heart Association 2016 and European Society for Vascular Surgery 2024) and the Society for Vascular Surgery's 2025 focused update uniformly endorse exercise and medical therapy as initial management, restricting revascularization to severe claudication after conservative therapy trials and emphasizing individualized shared decision-making approaches. Claudication outcomes (ankle-brachial index changes, 6-minute walk improvements, and patient-reported outcomes) across treatments are reviewed alongside indications, contraindications, and benefits of each strategy.
Management and Outcomes of Renal Artery Aneurysms in Older Adults.
Sanin G, Wood E, Ots H … +2 more , Werenski H, Velazquez G
Semin Vasc Surg · 2025 Sep · PMID 40921553 · Publisher ↗
Renal artery aneurysms (RAAs) are rare but clinically significant vascular abnormalities. The management of RAA in older adults poses unique challenges related to their baseline comorbidities and age-related vascular cha...
Renal artery aneurysms (RAAs) are rare but clinically significant vascular abnormalities. The management of RAA in older adults poses unique challenges related to their baseline comorbidities and age-related vascular changes. Traditionally, open surgery has been the gold standard for large or complex RAA. However, recent data and guidelines support a more conservative threshold for intervention and broader adoption of endovascular therapies, which offer lower perioperative morbidity, shorter hospital stays, and overall faster recovery. General indications for repair include symptomatic aneurysms, medically refractory hypertension, and lesions ≥3 cm. Medical management and surveillance are appropriate for asymptomatic patients with stable aneurysms < 3 cm, especially for those with limited life expectancy. Open surgical techniques include both in situ and ex vivo reconstructions with demonstrated long-term durability but are associated with higher perioperative risk. Endovascular techniques, including coil embolization and stent grafting, are increasingly being used in anatomically suitable patients with high success. Postoperative outcomes suggest comparable long-term results between open and endovascular approaches. However, endovascular repair is associated with fewer complications and is increasingly preferred in elderly or high-risk populations. An individualized approach is essential to optimize outcomes, balancing the risks of intervention with the natural history of the disease. This is a review of the epidemiology, diagnosis, management, and outcomes of RAAs in older adults.
Management and outcomes of chronic mesenteric ischemia in older adults: A comprehensive review.
Sudina Y, Anan H, Daher J … +1 more , Chaer RA
Semin Vasc Surg · 2025 Sep · PMID 40921552 · Publisher ↗
Chronic mesenteric ischemia (CMI) is a rare, yet increasingly prevalent, condition, especially among older adults. Diagnosing CMI in older adults presents significant challenges. Along with the burden of comorbidities an...
Chronic mesenteric ischemia (CMI) is a rare, yet increasingly prevalent, condition, especially among older adults. Diagnosing CMI in older adults presents significant challenges. Along with the burden of comorbidities and the physiological changes associated with aging, timely intervention is often delayed, leading to poorer outcomes. Current diagnostic protocols and treatment guidelines do not address the unique challenges faced by this population. In this comprehensive review, the authors examined the existing literature on diagnostic strategies and management options for CMI in older adults. The importance of a thorough preoperative workup and early optimization to minimize perioperative stress, while considering nutritional and functional capabilities, is emphasized. Risk stratification models incorporating frailty and other geriatric-specific indices can inform therapeutic decisions and improve outcomes. Despite the increasing disease burden in this group, there are limited data on long-term outcomes, the impact of nutrition, and quality of life metrics after intervention. This emphasizes the necessity for more prospective studies to address these gaps and implement age-specific approaches for the evaluation and treatment of older adult patients with CMI.
Outcomes of ruptured abdominal aortic aneurysms in older adults and who should be offered surgery.
Meinke C, Giles KA
Semin Vasc Surg · 2025 Sep · PMID 40921551 · Publisher ↗
As life expectancy increases, the prevalence of ruptured abdominal aortic aneurysms (rAAA) poses a significant challenge for our healthcare system. Aging induces biochemical changes, including degradation of the extracel...
As life expectancy increases, the prevalence of ruptured abdominal aortic aneurysms (rAAA) poses a significant challenge for our healthcare system. Aging induces biochemical changes, including degradation of the extracellular matrix and loss of vascular smooth muscle cells, which increase the propensity for the development of aneurysms and subsequent rupture due to compromised integrity of the aortic wall. The mortality rate for elderly patients presenting with rAAA is high, ranging from 80 to 90%. Both open and endovascular repair come with substantial risk for elderly patients. While EVAR has been shown to have lower perioperative mortality in this population, elderly patients face significant post-operative recovery challenges related to age and frailty. In determining who should be offered surgery for rAAA, patient selection is crucial. Frailty and existing comorbidities should be factored into whether or not patients are offered surgery. A tailored approach that is individualized to patient specific goals and accounts for pre-existing comorbidities and functional status is essential to improving outcomes for elderly patients presenting with rAAA.
Management and outcomes of thoracic dissection in older adults.
Murphy BE, Zettervall SL
Semin Vasc Surg · 2025 Sep · PMID 40921550 · Full text
Aortic dissection carries significant morbidity and mortality, particularly with involvement of the ascending aorta. The estimated prevalence of aortic dissection in the general population is between 2.0 and 3.5 per 100,...
Aortic dissection carries significant morbidity and mortality, particularly with involvement of the ascending aorta. The estimated prevalence of aortic dissection in the general population is between 2.0 and 3.5 per 100,000 people; the risk of which increases with age and underlying risk factors, such as hypertension, long-term tobacco use, and genetic aortopathy. The older adult population continues to increase exponentially, with people older than 65 years accounting for nearly 20% of the total population. The unique challenges associated with treating older patients include consideration of reduced physiologic reserve, increased comorbidity profiles, and clinical frailty. Although surgical repair and endovascular repair have notable survival benefits in the setting of acute aortic dissection, older patients are more frequently offered medical management alone. More recently, the proliferation and evolution of endovascular therapies has offered novel and minimally invasive treatment options for older patients with acute and chronic post-dissection thoracoabdominal aortic aneurysms. In this article, the underlying risk factors, pathophysiology, and clinical decision making for patients with acute dissection are described. In addition, the considerations for treatment of both acute and chronic aortic dissection in this unique patient population are outlined.
Complex aortic repair in older adults.
Haqqani M, Boggs H, Stern JR
Semin Vasc Surg · 2025 Sep · PMID 40921549 · Publisher ↗
As the population ages, the rate of identification and repair of complex aortic pathology in patients of advanced age is rising. The older adult patient, defined here as 80 years or older, presents unique challenges for...
As the population ages, the rate of identification and repair of complex aortic pathology in patients of advanced age is rising. The older adult patient, defined here as 80 years or older, presents unique challenges for aortic repair due to medical comorbidities, declining functional status and independence, and anatomic changes. In this review, the evidence-based risk assessment and perioperative management are discussed, including the use of geriatric assessment tools, frailty indices, and emerging prehabilitation strategies. Outcomes for both open and endovascular procedures are examined, with a focus on more complex repairs, such as fenestrated and branched repair for paravisceral and thoracoabdominal pathology. Finally, ethical and social considerations, such as shared decision making, expectation management, and cost are addressed. Careful patient selection and individualized optimization is critical for successful aortic repair in this vulnerable patient population, with the goal of minimizing morbidity and loss of independence without compromising outcomes.
Management and outcomes of asymptomatic carotid stenosis in octogenarians and nonagenarians.
Velez K, Caldropoli J, Talathi S
Semin Vasc Surg · 2025 Sep · PMID 40921548 · Publisher ↗
As medicine evolves and life expectancy increases, octogenarians and nonagenarians represent growing populations that are at increased risk of ischemic stroke from asymptomatic carotid stenosis (ACS). Despite the signifi...
As medicine evolves and life expectancy increases, octogenarians and nonagenarians represent growing populations that are at increased risk of ischemic stroke from asymptomatic carotid stenosis (ACS). Despite the significant disability and mortality that results from stroke in older adults, there are few data on the management of ACS in this population to inform clinical practice guidelines. The authors sought to assess the current body of literature on the management and outcomes of ACS in older adults. Prior landmark randomized controlled trials comparing carotid endarterectomy with best medical therapy alone have been questioned, as modern best medical therapy strategies have significantly evolved since their conception. These studies either do not include octogenarians and nonagenarians or involve a limited sample size, making it challenging to apply these findings to older adult population. Two particular areas of interest in our review are the potential benefits of carotid revascularization and risk stratification. Retrospective studies suggest that carotid endarterectomy may improve cognitive functioning in older adults. Frailty is shown to be associated with worse postoperative outcomes of carotid revascularization in the general population, although few data exist on the impact of frailty on outcomes in octogenarians and nonagenarians. Overall, there is a limited body of literature informing the clinical management of ACS in octogenarians and nonagenarians, and future randomized controlled trials are needed to compare outcomes of carotid revascularization with best medical therapy alone in this population.
Perioperative Evaluation and Risk Stratification of the Elderly Patient Undergoing Vascular Intervention.
Cui CL, Fereydooni A, Arya S … +1 more , Drudi LM
Semin Vasc Surg · 2025 Sep · PMID 40921547 · Publisher ↗
The surgical management of elderly patients has become increasingly important as the population ages in the U.S. and globally, and the incidence of cardiovascular risk factors continues to rise. Geriatric surgical patien...
The surgical management of elderly patients has become increasingly important as the population ages in the U.S. and globally, and the incidence of cardiovascular risk factors continues to rise. Geriatric surgical patients face heightened surgical risks due to age-related physiological changes, which may extend beyond comorbidities, best described as geriatric syndromes. A thorough geriatric evaluation involves examining risk factors for these syndromes, which includes an extensive review of the patient's medical history, frailty assessment, nutritional evaluation, medication review, and evaluation of social support. The goal of this assessment is not to deem patients "safe" or "unsafe" for surgery, but to evaluate their risk levels and identify opportunities for prehabilitation prior to surgery. This approach necessitates collaboration between surgical teams and a comprehensive perioperative team that includes geriatricians. This narrative review aims to analyze the components of a geriatric evaluation and identify subsequent actions for patients at increased risk of postoperative complications and identify areas for innovation as it relates to vascular care in aging populations.
Vascular surgery in older adults: Looking beyond the number.
Talathi S, Etkin Y
Semin Vasc Surg · 2025 Sep · PMID 40921546 · Publisher ↗
Abstract loading — click title to view on PubMed.
Interview format: Current state and future directions.
Jim J, Rigberg DA
Semin Vasc Surg · 2025 Jun · PMID 40523710 · Publisher ↗
Applicant interviews remain an integral part of the match process used in graduate medical education. In vascular surgery, in-person interviews of the applicant by program faculty at the institution have been the standar...
Applicant interviews remain an integral part of the match process used in graduate medical education. In vascular surgery, in-person interviews of the applicant by program faculty at the institution have been the standard for decades. The COVID-19 pandemic forced a dramatic pivot to virtual interviews. With this unexpected change, there is now insight that interview format can affect equal and fair access, negatively impact the environment, as well as alter financial and administrative burden for both the applicants and programs. Future modifications to the match process will have to be explored to ensure both applicants and programs are able to mutually find their best match.
Perspectives in community training in vascular surgery.
Bakhshi K, Kanuika P, Ahmed A … +3 more , Asghar J, Kunhammed S, Weis TL
Semin Vasc Surg · 2025 Jun · PMID 40523709 · Publisher ↗
It has been established that there is a shortage of vascular surgeons nationwide. This is attributed partially to an imbalance between the number of vascular trainees, and consequently the number of newly graduated vascu...
It has been established that there is a shortage of vascular surgeons nationwide. This is attributed partially to an imbalance between the number of vascular trainees, and consequently the number of newly graduated vascular surgeons entering the workforce, and the number of clinically active vascular surgeons approaching retirement age. Concurrently, a "silver tsunami" of an aging population in the United States, and increasing prevalence of morbid obesity, diabetes, and peripheral vascular disease portends a marked increase in the patient population in need of vascular care. This anticipated lack of appropriate vascular care may disproportionately affect specific populations. It is our aim to explore the role community training can serve in addressing this issue.
A contextual review of trainee unions in the United States.
Gomez-Sanchez CM, Woodford C
Semin Vasc Surg · 2025 Jun · PMID 40523708 · Publisher ↗
Trainee unions have been a source of great contention between resident physicians, staff physicians, hospital administrators, and the public since their inception in the 1930s. Resident physicians strike a unique balance...
Trainee unions have been a source of great contention between resident physicians, staff physicians, hospital administrators, and the public since their inception in the 1930s. Resident physicians strike a unique balance between being students learning medicine under the watchful eye of attendings and being employees without whom the healthcare system in the United States would struggle to function. Unions seek to improve the working conditions for residents and to protect them from exploitation by hospital systems but have often been perceived as conflicting with professional ideals, patient care, and the educational environment. The goal of this review was to examine the history of resident physician unions, contextualize the arguments for and against them, and describe the best available evidence on the impact of unions on the lives of resident physicians.
Diversity, equity, and inclusivity in vascular surgical education.
Dorsey C, Gordon A, Hashmi M … +4 more , Ogunnowo S, Pascarella L, Sutton G, Afifi R
Semin Vasc Surg · 2025 Jun · PMID 40523707 · Publisher ↗
The decline in diversity in medical education, following the Supreme Court's 2023 ruling against race-based affirmative action, exacerbates existing health disparities. With decreasing enrollment of underrepresented grou...
The decline in diversity in medical education, following the Supreme Court's 2023 ruling against race-based affirmative action, exacerbates existing health disparities. With decreasing enrollment of underrepresented groups in medical schools, residency attrition, and gaps in diversity, equity and inclusion (DEI) standards, urgent efforts are needed to address systemic inequities in medical training and patient care. Vascular surgery has made important progress in increasing diversity within its training programs, but there is still much work to be done to create a truly inclusive environment. While there has been growth in the representation of women within vascular surgery, the proportion of underrepresented in medicine (UriM) physicians has not kept pace. Addressing the lack of diversity in vascular surgery requires a multi-pronged approach focused on recruitment, retention, and the creation of an inclusive learning and work environment. Establishing an inclusive environment goes beyond recruitment; it requires fostering a culture where all trainees and faculty feel valued and heard. Through targeted initiatives, commitment to transparency, and systemic changes to academic and clinical environments, the field can make substantial strides in workforce diversity and in turn addressing disparities.
A narrative review of psychological safety in the surgical learning environment.
Cui CL, Tuttle B, Coleman DM
Semin Vasc Surg · 2025 Jun · PMID 40523706 · Publisher ↗
Psychological safety is a critical component of the medical learning environment. While multiple synthesis studies exist for psychological safety within broader medical education, few have focused specifically on surgica...
Psychological safety is a critical component of the medical learning environment. While multiple synthesis studies exist for psychological safety within broader medical education, few have focused specifically on surgical training paradigms. This narrative review evaluates psychological safety for surgical trainees. A literature search of PubMed was conducted to identify studies discussing psychological safety within the surgical learning environment. Studies were included if psychological safety was a primary outcome, predictor, or theme. Studies were excluded if surgical trainees were not included or specifically discussed. A total of 53 articles were screened. Of these, 36 were excluded for relevance, and the remaining 17 full texts were reviewed. Reasons for exclusion include: study was conducted internationally; psychological safety was not a critical outcome, predictor, or theme; study focused on nonsurgical medical specialties (ie, anesthesia or psychiatry); and psychological safety of surgical trainees was not discussed despite surgical trainees being within the study cohort. A total of 11 studies were included for comparison. Four studies evaluated the positive impact of psychological safety within care teams that included surgical trainees. Two discussed the importance of building psychological safety as a surgical educator. Five studies evaluated learning environment factors or interventions that predicted psychological safety. Existing literature on psychological safety within the surgical learning environment focuses on educators, surgical teams, and specific aspects of the learning environment. While these studies offer valuable insight, additional studies are needed to identify effective interventions and operationalization of previous recommendations.
Teaching health disparities in vascular surgery training programs.
Carter T, Weaver ML
Semin Vasc Surg · 2025 Jun · PMID 40523705 · Publisher ↗
Health disparities occur due to complex interactions of individual and environmental factors in the presence of structural inequities and social determinants of health, and disproportionately impact disadvantaged and vul...
Health disparities occur due to complex interactions of individual and environmental factors in the presence of structural inequities and social determinants of health, and disproportionately impact disadvantaged and vulnerable patient populations. Vascular surgery cares for a diverse patient population who often experience socioeconomic disadvantage. Understanding the complex reasons for differences in presentation, management, and outcomes in vulnerable patient populations is critical to providing optimal vascular surgical care and mitigating health disparities. We outline the need for implementation of health disparities curriculum in graduate medical education and proposes a framework for health disparities curriculum development specific to vascular surgery.
The Use of Simulation in Vascular Surgery Education: Current State and Future Directions.
Fereydooni A, Sgroi MD
Semin Vasc Surg · 2025 Jun · PMID 40523704 · Publisher ↗
Simulation-based training (SBT) has become essential in vascular surgery education, providing a risk-free environment for skill development. This scoping review evaluates the current state of vascular surgery simulation,...
Simulation-based training (SBT) has become essential in vascular surgery education, providing a risk-free environment for skill development. This scoping review evaluates the current state of vascular surgery simulation, highlighting validated models, educational impact, and areas for improvement. A systematic literature search was conducted in PubMed, Embase, and Scopus, following PRISMA-ScR guidelines. Studies assessing validated simulation models for open and endovascular procedures, vascular anastomosis, carotid interventions, peripheral vascular interventions, and nontechnical skills training were included. Data extraction focused on fidelity, skill acquisition, procedural efficiency, and accessibility. Validated high-fidelity models, including 3D-printed, virtual reality (VR), and pulsatile cadaveric systems, significantly enhance technical proficiency and confidence. Bench and porcine models improve vascular anastomosis training, while VR-based simulators enhance catheter manipulation and decision-making. However, simulation remains limited by high costs, accessibility challenges, and lack of standardized nontechnical skills training. Simulation improves competency in vascular surgery but requires further integration into training curricula. AI-driven assessments, hybrid simulation models, and expanded cost-effective solutions are needed to bridge existing gaps. Standardization and broader adoption of simulation will enhance competency-based training and improve patient outcomes.
Fundamentals of vascular surgery: A plan for the uniform instruction and assessment of basic skills in vascular surgery.
Tanamal P, Sheahan C, Sheahan M
Semin Vasc Surg · 2025 Jun · PMID 40523703 · Publisher ↗
Training surgeons poses many unique challenges. In addition to the clinical acumen that must be learned, a minimum threshold of technical competency is a requisite for independent practice. The trends of endovascular int...
Training surgeons poses many unique challenges. In addition to the clinical acumen that must be learned, a minimum threshold of technical competency is a requisite for independent practice. The trends of endovascular interventions and open surgical procedures add another layer of complexity to vascular surgery training. Simulation can provide a solution for both technical skills training and evaluating proficiency. The Education Committee of the Association of Program Directors of Vascular Surgery (APDVS) developed the Fundamentals of Vascular and Endovascular Surgery platform to provide an opportunity for more uniform basic technical skill teaching and assessment across all vascular training programs. Evaluation by experts with standardized scoring of Objective Structured Assessment of Technical Skills (OSATS) Global Rating Score and Global Summary grading systems have demonstrated correlation with participant ability when completing the end-to-side anastomosis, patch angioplasty, and clockface suturing models. Future research should be directed toward developing autonomous and objective methods for technical assessments on these models.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe