JVS-vascular insights最新文献

{"title":"Raising the tides in vascular surgery","authors":"Jeniann A. Yi MD, MSCS","doi":"10.1016/j.jvsvi.2024.100123","DOIUrl":"10.1016/j.jvsvi.2024.100123","url":null,"abstract":"","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100123"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949912724000710/pdfft?md5=7170113b5a3ab9d221df5b2be77dec48&pid=1-s2.0-S2949912724000710-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular surgeons widely underrepresented in online news regarding vascular pathologies","authors":"Joshua R. Chen BS ,&nbsp;Adam Ostrovsky BS ,&nbsp;Robert Tatum MD ,&nbsp;Sanath Patil BS ,&nbsp;Kapila Kommareddy MD ,&nbsp;Dawn Salvatore MD ,&nbsp;Paul Dimuzio MD ,&nbsp;Michael Nooromid MD ,&nbsp;Babak Abai MD","doi":"10.1016/j.jvsvi.2024.100128","DOIUrl":"10.1016/j.jvsvi.2024.100128","url":null,"abstract":"<div><h3>Background</h3><p>Vascular surgeons have traditionally been under-represented in various media platforms. Our study aims to characterize vascular surgeon involvement in online news coverage as it relates to vascular pathologies.</p></div><div><h3>Methods</h3><p>Google news was queried for news articles published between July 31, 2022, and August 1, 2023, using 11 keywords (“carotid stenosis,” “carotid artery disease,” “dialysis fistula,” “abdominal aortic aneurysm,” “aortic dissection,” “varicose vein,” “deep vein thrombosis,” “peripheral vascular disease,” “peripheral arterial disease,” “limb ischemia,” and “claudication). Unrelated articles and medical press under a paywall were excluded. Article and represented physician demographic information were collected. Representation was defined as being the author, interviewed, or involved in the review process of the news article.</p></div><div><h3>Results</h3><p>One thousand six hundred forty-eight news articles were screened yielding 1257 articles (76%) for analysis. Seven hundred eighty-four (62%) were classified as medical press and 473 (38%) as lay press. Four hundred fifty-seven (36%) news articles had medical professional representation. Vascular surgeons were represented in 186 news articles (14.8%) and medicine doctors in 346 news articles (27.5%). Articles regarding abdominal aortic aneurysm had the highest vascular surgeon representation (28.9%). The most common vascular surgeon involvement type was as an interviewee (67.2%). Most articles represented vascular surgeons from academic centers (80.6%), with varicose vein having the highest private practice representation (37%). Female vascular surgeons were represented in 18.3% of articles, which was proportionate to their workforce representation.</p></div><div><h3>Conclusions</h3><p>Vascular surgeons are widely under-represented in online news articles regarding common vascular pathologies. Vascular surgeons should focus more efforts on promoting their expertise in news regarding peripheral disease and dialysis.</p></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100128"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294991272400076X/pdfft?md5=9203aa13c65914e721e665bbbe7d8cc7&pid=1-s2.0-S294991272400076X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mentorship matters: Fostering the growth of the next generation of vascular surgeon-scientists","authors":"Shernaz S. Dossabhoy MD, MBA,&nbsp;Ronald L. Dalman MD","doi":"10.1016/j.jvsvi.2024.100129","DOIUrl":"10.1016/j.jvsvi.2024.100129","url":null,"abstract":"<div><div>Mentorship is a well-recognized cornerstone of surgical training. Effective mentoring is critical at each step of the surgeon's development from medical student to senior faculty. Mentorship is even more important to small surgical specialties, such as vascular surgery, to promote the next generation of vascular surgeon-researchers. We review the literature for key lessons on effective mentorship at each stage of the vascular surgeon's journey, in addition to highlighting areas of concern and future strategic focus to keep the vascular surgery-scientist pipeline robust for generations to come.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100129"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142428781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of telehealth and remote monitoring in vascular surgery","authors":"Halbert Bai MPH,&nbsp;Adriana Pero BS,&nbsp;Pavel Kibrik DO,&nbsp;Annie Chang MS,&nbsp;Eric Lee,&nbsp;Windsor Ting MD","doi":"10.1016/j.jvsvi.2024.100133","DOIUrl":"10.1016/j.jvsvi.2024.100133","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review aims to describe the benefits and obstacles of the current and future uses of telehealth and remote monitoring in the field of vascular surgery. Telehealth refers to connecting patients and providers in different locations, whereas remote monitoring refers to telehealth in addition to the use of patient sensors to collect health data.</div></div><div><h3>Methods</h3><div>Articles indexed in PubMed, Google Scholar, and Scopus were eligible for review. The specific search keywords were “remote monitoring” and “vascular surgery” with articles published from January 1, 2000, to December 31, 2022, considered eligible for inclusion. We identified 906 unique studies initially and, after applying inclusion and exclusion criteria, 22 studies were eligible for inclusion. The PRISMA criteria were followed to structure this review.</div></div><div><h3>Results</h3><div>During the coronavirus disease 2019 pandemic, the adoption of telehealth and remote monitoring, particularly in vascular surgery, has increased significantly, driven by the need for quarantine and social distancing. The review includes 23 papers and 9717 patients. The greatest number of papers discussed general vascular surgery (n = 12 [52.2%]), followed by wound care (n = 9 [39.1%]) and carotid endarterectomy (n = 3 [13.0%]). The number of articles increased significantly by year (<em>P</em> = .0017). Many patients rated telehealth favorably, with 80.6% reporting their interaction as very good and 66.8% of patients rating telehealth as more convenient. The use of telehealth provided cost savings of $1,065,684 over 5 years and allowed the identification of an additional 31.1% of patients with hypoxemia in the postoperative period. Evidence for use of telehealth in the treatment of diabetic foot ulcers is equivocal, with one study finding increased mortality for diabetic foot ulcer patients in the telehealth group (hazard ratio, 8.68; 95% confidence interval, 6.93-10.88; <em>P</em> = .0001), but another showing decreased mortality in the telehealth group by 21%. Remote monitoring for carotid endarterectomy was shown to be feasible with patients reporting reduced anxiety.</div></div><div><h3>Conclusions</h3><div>Remote monitoring in vascular surgery has gained support and encouragement in the available literature. In addition to improving patient outcomes and satisfaction, remote monitoring is more affordable to patients and hospitals while improving access between doctors and patients. However, limitations of remote monitoring persist, including difficulties for elderly patients, the need for specific training, and differences in race and socioeconomic status causing disparities in access.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100133"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravascular ultrasound use in peripheral arterial and deep venous interventions: Multidisciplinary expert opinion from SCAI/AVF/AVLS/SIR/SVM/SVS","authors":"Eric A. Secemsky MD, MSc ,&nbsp;Herbert D. Aronow MD, MPH ,&nbsp;Christopher J. Kwolek MD, MBA ,&nbsp;Mark Meissner MD ,&nbsp;Patrick E. Muck MD ,&nbsp;Sahil A. Parikh MD ,&nbsp;Ronald S. Winokur MD ,&nbsp;Jon C. George MD ,&nbsp;Gloria Salazar MD ,&nbsp;Erin H. Murphy MD ,&nbsp;Mary M. Costantino MD ,&nbsp;Wei Zhou MD ,&nbsp;Jun Li MD ,&nbsp;Robert Lookstein MD ,&nbsp;Kush R. Desai MD","doi":"10.1016/j.jvsvi.2023.100033","DOIUrl":"10.1016/j.jvsvi.2023.100033","url":null,"abstract":"<div><div>Percutaneous revascularization is the primary strategy for treating lower extremity venous and arterial disease. Angiography is limited by its ability to accurately size vessels, precisely determine the degree of stenosis and length of lesions, characterize lesion morphology, or correctly diagnose postintervention complications. These limitations are overcome with use of intravascular ultrasound (IVUS). IVUS has demonstrated the ability to improve outcomes following percutaneous coronary intervention, and there is increasing evidence to support its benefits in the setting of peripheral vascular intervention. At this stage in its evolution, there remains a need to standardize the use and approach to peripheral vascular IVUS imaging. This manuscript represents considerations and consensus perspectives that emerged from a roundtable discussion including 15 physicians with expertise in interventional cardiology, interventional radiology, and vascular surgery, representing 6 cardiovascular specialty societies, held on February 3, 2023. The roundtable’s aims were to assess the current state of lower extremity revascularization, identify knowledge gaps and need for evidence, and determine how IVUS can improve care and outcomes for patients with peripheral arterial and deep venous pathology.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100033"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the utilization of drug-eluting stents to treat femoropopliteal peripheral artery disease","authors":"Daniella Kadian-Dodov MD ,&nbsp;Abimbola O. Williams MPH, MS ,&nbsp;Ryoko Sato PhD ,&nbsp;Luckyboy Vang BA ,&nbsp;Michael R. Jaff DO","doi":"10.1016/j.jvsvi.2024.100136","DOIUrl":"10.1016/j.jvsvi.2024.100136","url":null,"abstract":"<div><h3>Objective</h3><div>There is a paucity of data exploring the real-world use of the two drug-eluting stents approved for use in the United States for the treatment of femoropopliteal peripheral artery disease. This study examined the use trends of Eluvia drug-eluting vascular stent and Zilver PTX drug-eluting peripheral stent between 2016 and 2022 using medical claims.</div></div><div><h3>Methods</h3><div>Using the Truveta data platform, patients aged ≥18 years with peripheral artery disease who underwent lower extremity femoropopliteal peripheral artery endovascular revascularization with either Eluvia paclitaxel-eluting stents (introduced in 2018) or Zilver PTX paclitaxel-coated stents were identified between January 1, 2016, and December 31, 2022. The annual use overall by setting (inpatient vs outpatient) and within clinical subgroups were explored.</div></div><div><h3>Results</h3><div>Overall, 710 patients who received paclitaxel-eluting stents and 620 who received paclitaxel-coated stents were identified. The paclitaxel-eluting stent was released during the study period; by the end of the study period, paclitaxel-eluting stents accounted for 82% of the index femoropopliteal peripheral artery procedures. The use of paclitaxel-coated stents decreased from 100% to 18% over the same period. This change occurred among patients with diabetes, chronic limb-threatening ischemia, and chronic kidney disease. There were significant differences in stent use by race and geographic region.</div></div><div><h3>Conclusions</h3><div>The use of paclitaxel-eluting stent for the treatment of femoropopliteal peripheral artery disease in the United States has increased steadily since its introduction in 2018; by 2022, it was used in 82% of femoropopliteal peripheral artery procedures in medical centers using the Truveta platform.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100136"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with general surgery residents’ perceptions of vascular surgery","authors":"Kevin West BA ,&nbsp;Tyler Arismendi BS ,&nbsp;Nicholas Schaper BS, MS ,&nbsp;Yuanzun Peng BA ,&nbsp;Saideep Bose MD ,&nbsp;Matthew R. Smeds MD","doi":"10.1016/j.jvsvi.2024.100063","DOIUrl":"10.1016/j.jvsvi.2024.100063","url":null,"abstract":"<div><h3>Objectives</h3><p>Shortages of vascular surgeons are projected through 2050, and vascular surgery fellowships (VSFs) remain a critical pathway for training vascular surgeons. We sought to identify general surgery (GS) residents' perceptions of/attitudes toward VS.</p></div><div><h3>Methods</h3><p>Anonymous, electronic questionnaires were sent to GS residents. Questions assessed demographics, fellowship preferences, and exposure to and perceptions of VS. Univariate and multivariate analyses were performed.</p></div><div><h3>Results</h3><p>Of 152 respondents (15% response rate), 20 (13.2%) will apply for VSF, 64 (42.1%) are interested in VS (IVS), 62 (40.8%) are not interested in VS (NIVS), and 6 (3.9%) remain undecided. Overall, among respondents encompassing all postgraduate years, 106 (69.7%) felt comfortable with medical management of vascular disease, 52 (34.2%) felt comfortable with open surgical management, and 14 (9.2%) felt comfortable with endovascular management. Compared with residents NIVS, trainees planning on applying for VSF or IVS reported greater familiarity with diseases treated (97.6%; <em>P</em> = .003) and procedures performed (88.1%; <em>P</em> = .013) by vascular surgeons. Those applying for VSFs were more likely to perceive they were essential members of the vascular team (<em>P</em> = .003), and their time in the operating room was productive (<em>P</em> = .001). Fifty-five (36.2%) respondents believed their exposure to VS in residency was inadequate for a surgeon not pursuing a VSF. More trainees NIVS reported disrespectful treatment by VS attendings, residents, and fellows (<em>P</em> = .043). Stratified by gender, 25 female residents (29.4%) cited male dominant (<em>P</em> &lt; .001) as a reason for not choosing VS. When asked how vascular training programs impacted exposure while on VS rotations, 45 residents (70.3%) at institutions with both a VSF and integrated VS residency indicated diminished experiences owing to the presence of vascular trainees (<em>P</em> = .014), and 25 (39.1%) expressed lower satisfaction with their rotation (<em>P</em> = .012).</p></div><div><h3>Conclusions</h3><p>Exposure to VS during GS residency may be inadequate for a general surgeon entering practice. Reasons for not pursuing a VSF included disrespectful interactions from VS residents, fellows, and attendings, as well as a male-dominant field. Residents at institutions with vascular training programs expressed lower satisfaction and experiences gained. Improving these factors may increase interest in VSFs.</p></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100063"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949912724000114/pdfft?md5=645d772bf812f3c2fe291d970cf9955c&pid=1-s2.0-S2949912724000114-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140280307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the progression of artificial intelligence and large language models in medicine through comparative analysis of ChatGPT-3.5 and ChatGPT-4 in generating vascular surgery recommendations","authors":"Arshia P. Javidan MD, MSc ,&nbsp;Tiam Feridooni MD, PhD ,&nbsp;Lauren Gordon MD, PhD ,&nbsp;Sean A. Crawford MD, PhD","doi":"10.1016/j.jvsvi.2023.100049","DOIUrl":"10.1016/j.jvsvi.2023.100049","url":null,"abstract":"<div><h3>Objective</h3><p>Artificial intelligence (AI) continues to become increasingly integrated with clinical medicine. Generative AI, and particularly large language models (LLMs) like ChatGPT-3.5 and ChatGPT-4, have shown promise in generating human-like text, providing a potential tool for augmenting clinical care. These online AI chatbots have already demonstrated remarkable clinical potential, having passed the US Medical Licensing Exam, for example. The evaluation of these LLMs in the surgical literature, especially as it applies to judgement and decision-making, is sparse. This study aimed to (1) evaluate the efficacy of ChatGPT-4 in providing clinician-level vascular surgery recommendations and (2) compare its performance with its predecessor, ChatGPT-3.5, to gauge the progression of clinical competencies of LLMs.</p></div><div><h3>Methods</h3><p>A set of 40 clinician-level questions spanning 4 domains of vascular surgery (carotid artery disease, visceral artery aneurysms, abdominal aortic aneurysms, chronic limb-threatening ischemia) were generated by clinical experts. These domains were chosen based on the availability of updated guidelines published before September 2021, which served as the cutoff date for the training dataset of the LLMs. The questions, devoid of additional context or prompts, were input into ChatGPT-3.5 and ChatGPT-4 between March 20 and March 25, 2023. Responses were independently evaluated by two blinded reviewers using a 5-point Likert scale assessing comprehensiveness, accuracy, and consistency with guidelines. The Flesch-Kincaid grade level of each response was also determined. Independent samples <em>t</em> test and Fisher's exact test were used for comparative analysis.</p></div><div><h3>Results</h3><p>ChatGPT-4 significantly outperformed ChatGPT-3.5 by providing appropriate recommendations in 38 of 40 questions (95%) as compared with 13 of 40 (32.5%) by ChatGPT-3.5 (Fisher's exact test <em>P</em> &lt; .001). Despite longer response lengths (chatGPT-4 mean 317 ± 58 words vs chatGPT-3.5 mean 265 ± 74 words; <em>P</em> &lt; .001), the reading ease of both models remained similar, corresponding with college-level graduate texts.</p></div><div><h3>Conclusions</h3><p>ChatGPT-4 can consistently respond accurately to complex clinician-level vascular surgery questions. This also represents a substantial advancement in performance compared with its predecessor, which was released only a few months prior, highlighting the progress of performance of LLMs in clinical medicine. Several limitations persist with the use of LLMs, including hallucinations, data privacy issues, and the black box problem, However, these findings suggest that, with further refinements, LLMs like ChatGPT-4 have the potential to become indispensable tools in clinical decision-making, thereby marking an exciting frontier in the fusion of AI with clinical medicine and vascular surgery.</p></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100049"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949912723000466/pdfft?md5=c3655f45a31080cfd13797a6738f0b01&pid=1-s2.0-S2949912723000466-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139189835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of the use of parenteral direct thrombin inhibitors in carotid endarterectomy in patients with a history of heparin-induced thrombocytopenia","authors":"Melissa A. King MSc ,&nbsp;Matthew Walker MD, FRCPC ,&nbsp;Trana Hussaini BSc (Pharm), ACPR, PharmD ,&nbsp;Jonathan Misskey MD, MPHE, FRCSC ,&nbsp;Jason Faulds MD, MHSc, FRCSC","doi":"10.1016/j.jvsvi.2024.100102","DOIUrl":"10.1016/j.jvsvi.2024.100102","url":null,"abstract":"<div><h3>Background</h3><p>Carotid endarterectomy reduces the risk of recurrent stroke in symptomatic carotid stenosis. In patients with a history of heparin-induced thrombocytopenia, heparin is contraindicated, and these patients require an alternative parenteral anticoagulant during carotid endarterectomy. The aim of this review was to review the literature for evidence of the use of parenteral direct thrombin inhibitors (DTIs) (hirudin, hirudin derivatives [lepirudin, desirudin, and bivalirudin], and argatroban) in carotid endarterectomy.</p></div><div><h3>Methods</h3><p>A literature search was conducted using MEDLINE through PubMed on October 14, 2023. All reports that described treatment with parenteral direct thrombin inhibitors in carotid endarterectomy were included. Two authors independently screened abstract and titles according to the predefined criteria, and nonagreement was discussed with a third author for the final decision.</p></div><div><h3>Results</h3><p>46 publications were identified, and 39 were excluded based on predefined criteria. Seven case reports were included, identifying seven patients who underwent carotid endarterectomy with intraoperative parenteral DTI use. There were four reports of the use of argatroban, two of bivalirudin, and one report of hirudin in a case of concurrent carotid endarterectomy and coronary artery bypass grafting. Argatroban was the preferred agent in patients with renal insufficiency. DTIs were administered parenterally through bolus and infusion and were monitored through activated clotting times or plasma-modified activated clotting times. There were no significant bleeding events, and all procedures were successfully performed. The pharmacology of DTIs and the use of DTIs in other peripheral vascular and cardiac procedures will also be reviewed.</p></div><div><h3>Conclusions</h3><p>Overall, the use of DTIs for anticoagulation in vascular surgery appears to be safe and effective. The DTIs with the most evidence supporting their use in carotid endarterectomy are bivalirudin and argatroban.</p></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100102"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949912724000503/pdfft?md5=cc36a34d64420a40575a05ed4d0d0b5e&pid=1-s2.0-S2949912724000503-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141392513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scaled performance on the Vascular Qualifying Examination does not correlate with Vascular Certifying Examination first attempt pass in a national cohort of residents and fellows","authors":"M. Libby Weaver MD ,&nbsp;Yoon Soo Park PhD ,&nbsp;Andrew T. Jones PhD ,&nbsp;Malachi G. Sheahan MD ,&nbsp;Kellie R. Brown MD ,&nbsp;Rabih A. Chaer MD ,&nbsp;Thomas S. Huber MD, PhD ,&nbsp;Brigitte K. Smith MD, MHPE","doi":"10.1016/j.jvsvi.2024.100088","DOIUrl":"10.1016/j.jvsvi.2024.100088","url":null,"abstract":"<div><h3>Background</h3><p>Specialty board certification is an important indicator of surgeon competence and necessary for residency and fellowship programs to maintain accreditation by the Accreditation Council for Graduate Medical Education. Thus, identification of trainees at risk of board certification failure is important for both vascular surgery graduates and their parent program. We sought to examine the correlation of Vascular Qualifying Examination (VQE) performance on first-time pass achievement of the Vascular Certifying Examination (VCE).</p></div><div><h3>Methods</h3><p>We used American Board of Surgery data to examine predictive associations of a national longitudinal cohort of all vascular surgery integrated residents (VIRs) and vascular surgery fellows (VSFs) who completed the VQE and VCE from 2016 through 2021. Descriptive statistics were used to examine trends. We used χ² tests to examine proportional group differences. Predictive associations between VQE scaled score performance and first-time pass achievement on subsequent VCE attempts were examined using logistic regression.</p></div><div><h3>Results</h3><p>VQE scaled score performance and VCE pass rates were obtained for all VIRs and VSFs (n = 579; 175 residents and 404 fellows) from 151 programs (48 residency and 103 fellowship) during the study period. First-attempt pass rate for the VQE was 96% in the study cohort, and first-attempt pass rate for the VCE was 94%. There were no significant differences in pass-fail rates in VQE and VCE for VIR and VSF candidates (<em>P</em> = .210 and <em>P</em> = .116, respectively). Trainee scaled score performance on the VQE was not predictive of subsequent first-attempt pass achievement on VCE (odds ratio, 1.00; 95% confidence interval, 1.00-1.01; <em>P</em> = .077). Stratified subgroup analyses by VIR and VSF cohorts also showed no significant predictive first-attempt VCE pass achievement (<em>P</em> = .190 and <em>P</em> = .094, respectively).</p></div><div><h3>Conclusions</h3><p>In this national cohort of vascular trainees taking the VQE and VCE, VQE performance was not predictive of subsequent VCE first-time pass achievement. This finding highlights the necessity to identify other measures of trainee competence to indicate the preparedness of trainees for board certification examinations. Furthermore, this may be reflective of the ability to assess distinctive competencies between the two examinations, with the VQE focused on medical knowledge and the VCE on clinical judgment and interpersonal communication skills, thus broadening assessment of the Accreditation Council for Graduate Medical Education core competencies to ensure certification of vascular surgeons possessing both the knowledge and judgment necessary to maintain high-quality standards within our specialty.</p></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"2 ","pages":"Article 100088"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949912724000369/pdfft?md5=6318b6e07fc3acd8279a3e85838eb806&pid=1-s2.0-S2949912724000369-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141048155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}