Expand your Knowledge - Dive into the Base

An open aortic aneurysm repair is a surgical procedure to treat an aortic aneurysm, a dangerous bulge in the body's main artery. During the surgery, the aneurysmal segment of the aorta is replaced with a synthetic graft through a large incision in the abdomen or chest. This procedure is performed to prevent the aneurysm from rupturing, which can be life-threatening.

Carotid artery disease refers to the narrowing or blockage of the carotid arteries, which are the primary blood vessels supplying blood to the brain. This condition is often caused by atherosclerosis, a process in which fatty deposits, calcium and thrombus (plaque) build up on the arterial walls, leading to reduced blood flow and increasing the risk of serious complications such as stroke. Training in carotid endarterectomy (CEA) is the classical procedure and important for the prevention of strokes. Training on a simulator allows to pass the learning curve in a safe environment ‘outside the patient’. The patient will be grateful to you.

An endovascular aortic aneurysm repair(EVAR) is a surgical procedure to treat an aortic aneurysm, a dangerous bulge in the body's main artery. When the thoracic rather than the abdominal aorta is concerned, the procedure is called TEVAR (thoracic endovascular aneurysm repair). During the procedure, the aneurysmal segment of the aorta is excluded from the circulation by placing and deploying a stentgraft, typically introduced via small incisions in the groin. This procedure is performed to prevent the aneurysm from rupturing, which is an acutely life-threatening event with high mortality.

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Endovascular techniques are increasingly becoming integral to vascular surgery. Basic training equips trainees with a diverse skill set that includes both open surgical procedures and modern minimally invasive approaches. This versatility is crucial for providing comprehensive patient care. Knowledge about radiation protection, access challenges and becoming familiar with the endovascular tools are prerequisites and will prepare trainees for the demands of modern practice.

Complex endovascular aortic repair can be necessary in several specific clinical scenarios, usually involving complicated aortic pathology that cannot be adequately managed with standard endovascular techniques. Some common indications include aortic aneuryms extending into the juxtarenal, pararenal or visceral aorta or into the aortic arch, and aortic dissections. Image analysis and preprocessing is absolutely key.

Training in imaging and preprocessing for endovascular surgery is essential in this rapidly evolving field. Precise analysis and measurements are key and optimizes procedural planning and therefore proper device selection and strategic procedure planning. Training includes recognizing potential complications that can be identified through imaging, such as dissections, perforations, or thrombosis following endovascular interventions. As technology advances, ongoing education in imaging modalities and preprocessing methods will remain integral to the practice of endovascular surgery.

Training on leg arteries, anastomosis, and bypass procedures is crucial for developing the skills necessary to perform vascular surgeries safely and effectively. Comprehensive training that combines anatomy, proper surgical techniques, and patient care will prepare surgical trainees to deliver high-quality vascular care. Even in the endovascular era, vascular surgery training remains critically important for managing the growing elderly population for several reasons.

Ultrasound training is essential for vascular surgeons as it not only enhances their diagnostic and procedural capabilities but also improves patient care and outcomes. By integrating ultrasound into their practice, vascular surgeons can offer comprehensive, accurate, and timely evaluations and interventions, ultimately leading to improved management of vascular diseases.