Impact of an Office Based Interventional Lab on Resident and Fellow Training at a University Vascular Surgery Program

Office-based interventional labs (OBLs) are a well-established site for vascular procedures in vascular surgical practices. Safe and effective performance of interventions in this setting requires careful patient selection and methodology specific to this particular practice environment. Most university-based vascular surgery training programs do not offer an OBL training experience as part of their educational curriculum. Our study goal was to describe the impact of an OBL experience on the case volume and training environment of vascular surgery trainees at an academic vascular surgery program.

Resident training logs were reviewed from 2004 to 2023. Two 10-year time periods were compared: before the OBL was established (Period 1, from 2004 to 2013) and after the OBL (Period 2, from 2014 to 2023). A registry of cases performed in our OBL with trainee involvement were reviewed for number and types of cases and then compared to self-reported training logs.

Over the 20-year study period, a total of 44,816 open and endovascular resident training vascular cases were logged, with 17,431 in Period 1 and 27,385 in Period 2. This represented a 57% increase in cases (P = 0.02). Trainees logged a total of 17,930 endovascular cases, with 7,039 cases in Period 1 and 10,891 cases in Period 2. This represented an increase of 55% (P = 0.03). Trainees logged an average of 476 cases per trainee over the entire study, with an average of 444 cases in Period 1 and an average of 496 in Period 2 (P > 0.05). Overall, endovascular cases represented 40% of total cases, of which 16% were performed in the OBL. Out of 1,892 total OBL cases, only 4 (0.21%) emergency transfers to the main hospital were required.

The establishment of an OBL within an academic vascular surgery program was associated with a 57% increase in overall trainee case volume from Period 1 to Period 2. This increased case volume allowed for expansion of our training program without compromising case volume. Trainees learned the elements of an OBL in clinical practice. Clinical experience in an OBL as part of vascular surgery training offers experience absent from most traditional educational paradigms and is directly applicable to modern vascular surgery practice.