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Updated: Jun 12, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Prioritizing quality improvement in vascular surgery.

Peter L Schilling¹, Justin B Dimick, John D Birkmeyer

¹University of Michigan, Ann Arbor, MI 48109-0604, USA. petschil@med.umich.edu

Surgical Innovation

|May 28, 2010

Summary

This summary is machine-generated.

A few vascular surgery procedures cause most adverse events and hospital days. Lower extremity bypass, abdominal aortic reconstruction, amputation, and carotid endarterectomy are key targets for quality improvement initiatives.

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Published on: November 19, 2019

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Last Updated: Jun 12, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg

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Published on: November 19, 2019

Area of Science:

Vascular Surgery Outcomes
Healthcare Quality Improvement
Surgical Procedure Analysis

Background:

Quality improvement (QI) in vascular surgery is growing, but specific high-impact procedures for QI remain unclear.
Identifying procedures with the greatest potential for improvement is crucial for targeted QI efforts.

Purpose of the Study:

To assess the relative contribution of different vascular surgery procedures to overall morbidity, mortality, and excess length of stay.
To inform targeted quality improvement initiatives by identifying high-risk procedures.

Main Methods:

Utilized data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) for 16,096 vascular surgery patients from 2005-2006.
Categorized patients into 29 distinct procedure types using CPT codes.
Analyzed procedures based on their contribution to overall morbidity, mortality, and excess hospital length of stay.

Main Results:

Four procedure types accounted for 72% of adverse events and 68% of excess hospital days.
Lower extremity bypass graft (29%), abdominal aortic reconstruction (20%), lower extremity amputation (16%), and carotid endarterectomy (8%) were the leading contributors to adverse events.
These top procedures also represented the most common operations, driving a disproportionate burden of poor outcomes.

Conclusions:

A small subset of vascular surgery procedures significantly contributes to overall morbidity, mortality, and excess hospital stay.
These high-volume, high-risk procedures are prime targets for quality improvement efforts, including those utilizing the ACS-NSQIP database.
Focusing QI initiatives on these specific procedures can lead to substantial improvements in vascular surgery outcomes.