Certification in endovascular hemostasis for trauma surgeons: Possible and practical?

Area of Science:

• Surgical Innovation
• Trauma Surgery
• Endovascular Techniques

Background:

• Endovascular hemostasis is a common procedure.
• Acute care surgeons (ACSs) may expand their practice with sufficient endovascular experience.
• Training opportunities for ACSs in endovascular procedures were assessed at a dedicated center.

Purpose of the Study:

• To quantify the case load and training opportunities for ACS fellows in endovascular procedures.
• To assess if ACS fellows can achieve sufficient experience for certification within a 6-month fellowship.
• To compare acquired experience with certification requirements of other surgical specialties.

Main Methods:

• Retrospective case series of 6 years (2013-2018) of endovascular activity at an academic Level I trauma center.
• Quantified procedures including arterial access, angiography, embolization, stent/stent graft placement, and IVC filter procedures.
• Compared case volumes with certification requirements for interventional radiology, vascular surgery, cardiothoracic surgery, and interventional cardiology.

Main Results:

• A total of 4960 procedures were performed on 1179 patients over 6 years.
• Annual procedure rates included arterial access (193.5), angiography (352), embolization (90.5), stent placement (24), and IVC filter procedures (16.5).
• A 6-month case volume met or approached 85% of requirements for vascular surgery and interventional radiology, except for stent-graft deployment and specific therapeutic procedures.

Conclusions:

• A high-volume academic trauma center provides sufficient endovascular case volume for fellowship certification.
• ACS trainees are informally acquiring valuable endovascular experience.
• Development of a formal endovascular trauma curriculum is recommended to support ACS fellowship certification.