The endovascular performance spectrum of vascular surgery departments in Germany

Abstract

AimTo survey the scope of vascular surgery services in Germany.MethodA total of 308 senior German vascular surgeons received a 19-point questionnaire pertaining to department structure and scope of services. Of these surgeons 223 replied between 16 August 2015 and 23 October 2015 (response rate 72 %), with 62.2 % reporting an additional qualification as an endovascular surgeon according to the guidelines of the German Society for Vascular Surgery and Vascular Medicine (Deutsche Gesellschaft für Gefäßchirurgie und Gefäßmedizin, DGG) and 43.5 % as a DGG® endovascular specialist.ResultsThe number of respondents fully authorized to train in vascular surgery was 71.3 %, while 28.3 % were authorized for limited training. Authorization as a DGG® endovascular surgeon was reported by 24.2 % and authorization as a DGG® endovascular specialist by 17 % of respondents. All respondents performed endovascular interventions on pelvic vessels and 99.1 % also reported carrying out femoral and popliteal endovascular interventions. Endovascular procedures in crural vessels were carried out by 90.1 % and 93.7 % of vascular surgeons performed endovascular procedures in the region of the abdominal aorta (segment V), arteriovenous (AV) fistulas and shunts (85.2 %), upper extremity vessels (80.3 %), the thoracic aorta (segment III, 68.2 %), renal arteries (62.8 %) and visceral aorta (segment IV, 60.5 %). In all 43.5 % of respondents reported experience with endovascular procedures on the carotid bifurcation. Percutaneous arterial procedures formed the focus of endovascular activity, totalling on average 259 interventions per year and department, followed by diagnostic angiography (without intervention) at 166 procedures per year and hybrid arterial interventions at 141 interventions per year.ConclusionThis survey revealed a high level of endovascular expertise among vascular surgeons in Germany. This applies not only to the scope of endovascular activities in diagnosis and treatment but also to the number of estimated annual procedures.

Rupture of an Infrarenal Aortic Aneurysm Due to a Secondary Type 1a Endoleak Following Endovascular Aneurysm Sealing with the Nellix<sup>®</sup> Device

“…EVAR has become a mainstay of AAA treatment [7]. EVAS technology was introduced to overcome certain problems with conventional endografts such as device migration and secondary sac progression caused by type 1 and 2 endoleaks.…”

Was ändert sich durch die Novellierung des endovaskulären Curriculums der DGG?

“…Nachdem die endovaskuläre Therapie breit und in großer Zahl in den deutschen gefäßchirurgischen Kliniken und Abteilungen durchgeführt wird [4,5] und die Entwicklung der endovaskulären Techniken im aortalen Bereich, im peripher arteriellen Bereich, dem venösen Bereich und auch bei weiteren Entitäten (Shunt, Blutungen, Endoleakbehandlungen, AV-Malformationen usw.) weiter rapide voranschreitet, war es angezeigt, das nun fast 10 Jahre alte Curriculum zu aktualisieren.…”