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Vascular Acute Care Surgery (VACS) Services: A New Model for the Future and a Solution to the Emerging Vascular Surgery Coverage Crisis

  • Vascular Surgery (R. S. Crawford, Section Editor)
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Abstract

Purpose of Review

The following is a comprehensive review of the current practice of Vascular Surgery, highlighting the existing gaps in vascular surgical care and delivery and providing evidence-based suggestions for improvements moving forward.

Recent Findings

Recent data demonstrate that a shift of many vascular surgical procedures from extensive, high-risk, inpatient operations toward minimally invasive, endovascular, same-day surgeries has created a gap in the ability of the community-based vascular surgeon to adequately care for acute vascular events.

Summary

The trends towards outpatient vascular surgery, coupled with the increasing demands of acute vascular surgical expertise for less-common open and high-risk procedures have created a crisis in the field. When the field of General Surgery was at a similar crossroads in the early 2000s, the community responded with the development of Acute Care Surgery (ACS) services to manage resource-intensive emergencies. Vascular surgery should learn from the ACS experience and consider the development of Vascular Acute Care Surgery (VACS) services responsible for the care of acute vascular patients.

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Acknowledgement

The editors would like to thank Dr. Anne Fischer for taking the time to review this manuscript.

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Authors and Affiliations

  1. Emory University School of Medicine, Atlanta, USA

    M. Aizpuru & A. P. Sweeney

  2. Heart, Lung, and Vascular Center, David Grant Medical Center, Travis AFB, Fairfield, CA, USA

    J. D. Watson

  3. Department of Surgery, University of Wisconsin, Madison, USA

    D. G. Harris

  4. Department of Surgery, University of Maryland Medical Center, Baltimore, USA

    C. B. Drucker

  5. Division of Acute Care Surgery, University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, USA

    J. J. Diaz

  6. Division of Vascular & Endovascular Surgery, Emory University School of Medicine, Emory St. Joseph’s Hospital, Attending Surgeon, 5673 Peachtree-Dunwoody, Suite 675, Georgia, 30342, USA

    R. S. Crawford

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Correspondence to R. S. Crawford.

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Matthew Aizpuru, Aidan P. Sweeney, J. Devin Watson, Donald G. Harris, Charles B. Drucker, Jose J. Diaz, and Robert S. Crawford each declare no potential conflicts of interest.

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Aizpuru, M., Sweeney, A.P., Watson, J.D. et al. Vascular Acute Care Surgery (VACS) Services: A New Model for the Future and a Solution to the Emerging Vascular Surgery Coverage Crisis. Curr Surg Rep 7, 16 (2019). https://doi.org/10.1007/s40137-019-0236-y

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