The Status of Vascular Surgery Practice in the United States

Abstract

There have been major changes in the practice of vascular surgery in the United States over the last few decades. Vascular Surgery has evolved from a predominantly open surgical specialty to a modern hybrid practice, with majority of vascular surgeons performing both open surgical and endovascular interventions. As catheter based technologies continue to evolve there has been a significant increase in endovascular procedures including aortic aneurysm repair and peripheral intervention. Vascular surgeons and interventional cardiologists have replaced interventional radiologists as the predominant specialty providers performing peripheral arterial intervention across the county. The training of vascular surgery has also evolved to accommodate the changes and demands of modern day practice. There are now a few different training pathways, including the traditional (5+2) and integrated (5+0) programs that can lead to vascular surgery certification. Clinical outcome research and evidence-based medicine have also impacted the practice of vascular surgery; there has been a major emphasis placed on vascular surgeons to participate in national and regional quality improvement programs, such as Vascular Quality Initiative, in order to improve the safety and cost-effectiveness of their patient care.