Current training and practice of endovascular surgery: A survey

Endovascular surgery (EVS) has become of great interest to the vascular com munity. However, little data exist about the current status of training and utilization of EVS, thus prompting this survey. During a national vascular meeting, all participants (n = 132) filled out a 2-page questionnaire. Res pondents (mean age 39 years, 87% male) were 68 vascular surgeons in practic e (52%), and 64 fellows (48%), representing a significant fraction of train ees in North America. Practice location included university hospital (39%), private hospital/clinic (52%), and government hospital (8%). According to respondents, in their respective communities, most of the EVS was performed by radiologists (66%), followed by vascular surgeons (19%), cardiologists (13%), and vascular medicine physicians (2%). A majority of respondents (75 %) currently perform EVS; surgeons in practice <3 years had the highest rat e (90%). Utilization rates among the nine interventions surveyed ranged fro m angiography (72%) and angioplasty (65%) to intravascular ultrasound (IVUS ) (21%) and atherectomy (12%). Procedure totals showed that approximately 2 0% of fellows performed >100 angiograms and 10% performed >25 endovascular grafts/year, whereas nonfellows performed few of the latter. Most of the EV S (72%) was performed in the operating room with portable imaging equipment and EVS accounted for 14% of all vascular procedures. Most respondents (86 %) believed that EVS would become a major component of vascular surgery and comprise 30% of their future practice. Seventy-six percent thought their t raining was insufficient and 85% said they would devote 3 months or less fo r further endovascular training. In conclusion, a vast majority of vascular trainees and surgeons are performing EVS, however, individual caseloads va ry greatly. The belief that endovascular surgery will play an increasing ro le in vascular surgery practice is strong and interest in further training of short duration is widespread. Broader-based data collection and longitud inal studies on this issue are warranted.